20 CFR 30.318 - Can the FAB consider objections to HHS's reconstruction of a radiation dose or to the guidelines...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Can the FAB consider objections to HHS's... OF 2000, AS AMENDED Adjudicatory Process Hearings and Final Decisions on Claims § 30.318 Can the FAB... to HHS's reconstruction of the radiation dose to which the employee was exposed, the FAB will...

'Nothing is agreed until everything is agreed'

DEFF Research Database (Denmark)

McQuaid, Sara Dybris

In terms of conflict resolution, we may think of Northern Ireland as a case of (deferring conflict by) institutionalising radical disagreement, in particular through the Agreement from 1998. The violence has largely if not completely stopped, but the key constitutional question of whether Northern...... Ireland should be British or Irish, is only settled for now. In the language of dialogue, the parties have “agreed to disagree” with an understanding that these matters can be reopened at some future date if there is a majority wish to do so. In the meantime, a system of designated power-sharing has been...

24 CFR 241.1070 - Agreed interest rate.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 241.1070...-Eligibility Requirements § 241.1070 Agreed interest rate. The equity or acquisition loan shall bear interest at the rate agreed upon by the borrower and the lender. ...

32 CFR 1900.33 - Allocation of resources; agreed extensions of time.

Science.gov (United States)

2010-07-01

... time. 1900.33 Section 1900.33 National Defense Other Regulations Relating to National Defense CENTRAL... Administrative Matters § 1900.33 Allocation of resources; agreed extensions of time. (a) In general. Agency... the component, (2) The business demands imposed on the component by the Director of Central...

78 FR 42080 - Privacy Act of 1974; CMS Computer Match No. 2013-07; HHS Computer Match No. 1303; DoD-DMDC Match...

Science.gov (United States)

2013-07-15

... 1974; CMS Computer Match No. 2013-07; HHS Computer Match No. 1303; DoD-DMDC Match No. 18 AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION... Act of 1974, as amended, this notice announces the establishment of a CMP that CMS plans to conduct...

24 CFR 242.26 - Agreed interest rate.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 242.26... MORTGAGE INSURANCE FOR HOSPITALS Mortgage Requirements § 242.26 Agreed interest rate. (a) The mortgage shall bear interest at the rate or rates agreed upon by the mortgagee and the mortgagor. (b) The amount...

24 CFR 203.20 - Agreed interest rate.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 203.20... § 203.20 Agreed interest rate. (a) The mortgage shall bear interest at the rate agreed upon by the mortgagee and the mortgagor. (b) Interest shall be payable in monthly installments on the principal amount...

24 CFR 241.560 - Agreed interest rate.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Agreed interest rate. 241.560... § 241.560 Agreed interest rate. (a) The mortgage shall bear interest at the rate agreed upon by the lender and the borrower. (b) Interest shall be payable in monthly installments on the principal amount of...

78 FR 48169 - Privacy Act of 1974; CMS Computer Match No. 2013-02; HHS Computer Match No. 1306; DoD-DMDC Match...

Science.gov (United States)

2013-08-07

... 1974; CMS Computer Match No. 2013-02; HHS Computer Match No. 1306; DoD-DMDC Match No. 12 AGENCY: Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). ACTION: Notice... of 1974, as amended, this notice establishes a CMP that CMS plans to conduct with the Department of...

Army agrees to new study of biowarfare laboratory.

Science.gov (United States)

Smith, R Jeffrey

1985-02-08

As a result of a lawsuit initiated by Washington activist Jeremy Rifkin and joined by the attorney general for the state of Utah, the U.S. Army has agreed to defer construction, pending a study of potential environmental hazards, of a new laboratory that was authorized by a small number of Congressmen under an unusual procedure in December 1984. The laboratory, intended for tests of highly infectious and lethal biological aerosols, has aroused controversy because of fears that the data gathered there might be used to develop offensive biological weapons.

Evidence-based practice guidelines in OHS: are they agree-able?

Science.gov (United States)

Hulshof, Carel; Hoenen, John

2007-01-01

The purpose of this study was to evaluate the acceptance, validity, reliability and feasibility of the AGREE (Appraisal of Guidelines and REsearch and Evaluation) instrument to assess the quality of evidence-based practice guidelines for occupational physicians. In total, 6 practice guidelines of the Netherlands Society of Occupational Medicine (NVAB) were appraised by 20 occupational health professionals and experts in guideline development or implementation. Although appraisers often disagreed on individual item scores, the internal consistency and interrater reliability for most domains was sufficient. The AGREE criteria were in general considered relevant and no major suggestions for additional items for use in the context of occupational health were brought up. The domain scores for the individual guidelines show a wide variety: 'applicability' had on average the lowest mean score (53%) while 'scope and purpose' had the highest one (87%). Low scores indicate where improvements are possible and necessary, e.g. by providing more information about the development. Key experts in occupational health report that AGREE is a relevant and easy to use instrument to evaluate quality aspects and the included criteria provide a good framework to develop or update evidence-based practice guidelines in the field of occupational health.

75 FR 45628 - Delayed Update of the HHS Poverty Guidelines for the Remainder of 2010

Science.gov (United States)

2010-08-03

..., Division of Facilities Compliance and Recovery, Health Resources and Services Administration, HHS, Room 10... reduction in eligibility for certain means-tested programs, including Medicaid, Supplemental Nutrition Assistance Program (SNAP), and child nutrition * * *.'' (Congressional Record (House), December 16, 2009, p...

AGREED-UPON PROCEDURES, PROCEDURES FOR AUDITING EUROPEAN GRANTS

Directory of Open Access Journals (Sweden)

Daniel Petru VARTEIU

2016-12-01

The audit of EU-funded projects is an audit based on agreed-upon procedures, which are established by the Managing Authority or the Intermediate Body. Agreed-upon procedures can be defined as engagements made in accordance with ISRS 4400, applicable to agreed-upon procedures, where the auditor undertakes to carry out the agreed-upon procedures and issue a report on factual findings. The report provided by the auditor does not express any assurance. It allows users to form their own opinions about the conformity of the expenses with the project budget as well as the eligibility of the expenses.

A Novel Protein Elicitor BAR11 From Saccharothrix yanglingensis Hhs.015 Improves Plant Resistance to Pathogens and Interacts With Catalases as Targets

OpenAIRE

Yanan Zhang; Yanan Zhang; Xia Yan; Xia Yan; Hongmei Guo; Hongmei Guo; Feiyang Zhao; Feiyang Zhao; Lili Huang; Lili Huang

2018-01-01

Previously, we reported the biocontrol effects of Saccharothrix yanglingensis strain Hhs.015 on Valsa mali. Here, we report a novel protein elicitor BAR11 from the biocontrol strain Hhs.015 and its functions in plant defense responses. Functional analysis showed that the elicitor BAR11 significantly stimulated plant systemic resistance in Arabidopsis thaliana to Pseudomonas syringae pv. tomato DC3000. In addition, systemic tissues accumulated reactive oxygen species and deposited callose in a...

The AGREE Enterprise: a decade of advancing clinical practice guidelines.

Science.gov (United States)

Makarski, Julie; Brouwers, Melissa C

2014-08-15

The original AGREE (Appraisal of Guidelines for REsearch and Evaluation) Instrument was published in 2003, and its revision, the AGREE II, in 2009. Together, they filled an important gap in the guideline and quality of care fields. Ten years later, the AGREE Enterprise reflects on a trajectory of projects and international collaboration that have contributed to advancing the science and quality of practice guidelines and the uptake of AGREE/AGREE II. The AGREE Enterprise has undertaken activities to improve the tool and to develop resources to support its use. Since 2003, the uptake and adoption of AGREE by the international community has been swift and broad. A total of 33 language translations of the original AGREE Instrument and the current AGREE II are available and were initiated by the international community. A recent scan of the published literature identified over 600 articles that referenced the AGREE tools. The AGREE tools have been widely received and applied, with several organizations having incorporated the AGREE as part of their formal practice guideline programs. Since its redevelopment in 2010, the AGREE Enterprise website (www.agreetrust.org) continues to experience steady increases in visitors per month and currently has over 10,000 registered users. The AGREE Enterprise has contributed to the advancements of guidelines through research activities and international participation by scientific and user communities. As we enter a new decade, we look forward to ongoing collaborations and contributing to further advancements to improve quality of care and health care systems.

Updated Findings from the HHS Teen Pregnancy Prevention Evidence Review: January 2011 Through April 2013

OpenAIRE

Brian Goesling; Joanne Lee; Julieta Lugo-Gil; Timothy Novak

2014-01-01

Since 2009, the U.S. Department of Health and Human Services (HHS) has sponsored an ongoing systematic review of the teen pregnancy prevention research literature to help identify programs with evidence of effectiveness in reducing teen pregnancy, sexually transmitted infections (STIs), and associated sexual risk behaviors.

Federal Research Opportunities: DOE, DOD, and HHS Need Better Guidance for Participant Activities

Science.gov (United States)

2016-01-01

contract with DOE and the Economy Act of 1932, as amended. In addition, we examined documents developed by ORAU and used by DOE, DOD, and HHS to set forth...energy and climate change policy and analyses in the international economy , and building efficiencies. Environmental Protection Agency Climate...biomarkers for environmental contaminants. Federal Bureau of Investigation Juvenile prostitution and child abduction, causes of postmortem hair root

Improving Community Stroke Preparedness in the HHS (Hip-Hop Stroke) Randomized Clinical Trial.

Science.gov (United States)

Williams, Olajide; Leighton-Herrmann Quinn, Ellyn; Teresi, Jeanne; Eimicke, Joseph P; Kong, Jian; Ogedegbe, Gbenga; Noble, James

2018-04-01

Deficiencies in stroke preparedness cause major delays to stroke thrombolysis, particularly among economically disadvantaged minorities. We evaluated the effectiveness of a stroke preparedness intervention delivered to preadolescent urban public school children on the stroke knowledge/preparedness of their parents. We recruited 3070 fourth through sixth graders and 1144 parents from 22 schools into a cluster randomized trial with schools randomized to the HHS (Hip-Hop Stroke) intervention or attentional control (nutrition classes). HHS is a 3-hour culturally tailored, theory-based, multimedia stroke literacy intervention targeting school children, which systematically empowers children to share stroke information with parents. Our main outcome measures were stroke knowledge/preparedness of children and parents using validated surrogates. Among children, it was estimated that 1% (95% confidence interval [CI], 0%-1%) of controls and 2% (95% CI, 1%-4%; P =0.09) of the intervention group demonstrated optimal stroke preparedness (perfect scores on the knowledge/preparedness test) at baseline, increasing to 57% (95% CI, 44%-69%) immediately after the program in the intervention group compared with 1% (95% CI, 0%-1%; P <0.001) among controls. At 3-month follow-up, 24% (95% CI, 15%-33%) of the intervention group retained optimal preparedness, compared with 2% (95% CI, 0%-3%; P <0.001) of controls. Only 3% (95% CI, 2%-4%) of parents in the intervention group could identify all 4 letters of the stroke FAST (Facial droop, Arm weakness, Speech disturbance, Time to call 911) acronym at baseline, increasing to 20% at immediate post-test (95% CI, 16%-24%) and 17% at 3-month delayed post-test (95% CI, 13%-21%; P =0.0062), with no significant changes (3% identification) among controls. Four children, all in the intervention group, called 911 for real-life stroke symptoms, in 1 case overruling a parent's wait-and-see approach. HHS is an effective, intergenerational model for

Agreeing on expectations

DEFF Research Database (Denmark)

Nielsen, Christian; Bentsen, Martin Juul

Commitment and trust are often mentioned as important aspects of creating a perception of reliability between counterparts. In the context of university-industry collaborations (UICs), agreeing on ambitions and expectations are adamant to achieving outcomes that are equally valuable to all parties...... involved. Despite this, our initial probing indicated that such covenants rarely exist. As such, this paper draws on project management theory and proposes the possibility of structuring assessments of potential partners before university-industry collaborations are brought to life. Our analysis suggests...

48 CFR 311.7001 - Section 508 accessibility standards for HHS Web site content and communications materials.

Science.gov (United States)

2010-10-01

..., documents, charts, posters, presentations (such as Microsoft PowerPoint), or video material that is specifically intended for publication on, or delivery via, an HHS-owned or -funded Web site, the Project... standards, and resolve any related issues. (c) Based on those discussions, the Project Officer shall provide...

Resilience or hope? Incremental and convergent validity of the resilience scale for adults (RSA and the Herth hope scale (HHS in the prediction of anxiety and depression

Directory of Open Access Journals (Sweden)

Roxanna Morote

2017-10-01

Full Text Available Abstract Background Hope and resilience protect against inner vulnerabilities or harsh life circumstances; they explain individual differences in physical or mental health outcomes under high stress. They have been studied in complementary or competing theoretical frameworks; therefore, the study of measures of hope and resilience should be undertaken prior to explore if they are truly value-added for research. This study investigates the convergent and incremental validity of the Resilience Scale for Adults (RSA and the Herth Hope Scale (HHS, in the prediction of anxiety and depression (HSCL-25. Methods Participants in this community-based sample are 762 adults from 18 to 74 years old. They answered the RSA, HHS, Spanish Language Stressful Life-Events Checklist (SL-SLE, and the Hopkins Symptom Checklist-25 (HSCL-25. Incremental validity analyses combined hierarchical regression and structural equation models (SEM. First, hierarchical regression models were compared based on three criteria (R 2 Diff., ΔF, and semi-partial r, then the direct effect of resilience on affective symptoms was compared with the mediated effect of resilience on affective symptoms through hope. Results The hierarchical models showed that (1 hope and resilience account significantly for the variance of affective symptoms above age, sex, and life-stress; (2 Resilience Total score has greater incremental validity than positive scales of HHS Hope; and (3 RSA Total score, HHS Optimism/Spiritual support, Stressful life-events and sex are unique predictors of affective symptoms. The SEM analyses verified a stronger direct effect of resilience in the prediction of affective symptoms above the significant partial mediated effect of resilience through hope. Additionally, results show that age and better educational opportunities were associated with protection (i.e. resilience and hope and emotional well-being (i.e. affective symptoms and hopelessness. Women showed higher scores

Resilience or hope? Incremental and convergent validity of the resilience scale for adults (RSA) and the Herth hope scale (HHS) in the prediction of anxiety and depression.

Science.gov (United States)

Morote, Roxanna; Hjemdal, Odin; Krysinska, Karolina; Martinez Uribe, Patricia; Corveleyn, Jozef

2017-10-27

Hope and resilience protect against inner vulnerabilities or harsh life circumstances; they explain individual differences in physical or mental health outcomes under high stress. They have been studied in complementary or competing theoretical frameworks; therefore, the study of measures of hope and resilience should be undertaken prior to explore if they are truly value-added for research. This study investigates the convergent and incremental validity of the Resilience Scale for Adults (RSA) and the Herth Hope Scale (HHS), in the prediction of anxiety and depression (HSCL-25). Participants in this community-based sample are 762 adults from 18 to 74 years old. They answered the RSA, HHS, Spanish Language Stressful Life-Events Checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL-25). Incremental validity analyses combined hierarchical regression and structural equation models (SEM). First, hierarchical regression models were compared based on three criteria (R 2 Diff., ΔF, and semi-partial r), then the direct effect of resilience on affective symptoms was compared with the mediated effect of resilience on affective symptoms through hope. The hierarchical models showed that (1) hope and resilience account significantly for the variance of affective symptoms above age, sex, and life-stress; (2) Resilience Total score has greater incremental validity than positive scales of HHS Hope; and (3) RSA Total score, HHS Optimism/Spiritual support, Stressful life-events and sex are unique predictors of affective symptoms. The SEM analyses verified a stronger direct effect of resilience in the prediction of affective symptoms above the significant partial mediated effect of resilience through hope. Additionally, results show that age and better educational opportunities were associated with protection (i.e. resilience and hope) and emotional well-being (i.e. affective symptoms and hopelessness). Women showed higher scores in social competences and resources (RSA

Guideline appraisal with AGREE II: online survey of the potential influence of AGREE II items on overall assessment of guideline quality and recommendation for use.

Science.gov (United States)

Hoffmann-Eßer, Wiebke; Siering, Ulrich; Neugebauer, Edmund A M; Brockhaus, Anne Catharina; McGauran, Natalie; Eikermann, Michaela

2018-02-27

The AGREE II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within six domains. AGREE II also includes two overall assessments (overall guideline quality, recommendation for use). Our aim was to investigate how strongly the 23 AGREE II items influence the two overall assessments. An online survey of authors of publications on guideline appraisals with AGREE II and guideline users from a German scientific network was conducted between 10th February 2015 and 30th March 2015. Participants were asked to rate the influence of the AGREE II items on a Likert scale (0 = no influence to 5 = very strong influence). The frequencies of responses and their dispersion were presented descriptively. Fifty-eight of the 376 persons contacted (15.4%) participated in the survey and the data of the 51 respondents with prior knowledge of AGREE II were analysed. Items 7-12 of Domain 3 (rigour of development) and both items of Domain 6 (editorial independence) had the strongest influence on the two overall assessments. In addition, Items 15-17 (clarity of presentation) had a strong influence on the recommendation for use. Great variations were shown for the other items. The main limitation of the survey is the low response rate. In guideline appraisals using AGREE II, items representing rigour of guideline development and editorial independence seem to have the strongest influence on the two overall assessments. In order to ensure a transparent approach to reaching the overall assessments, we suggest the inclusion of a recommendation in the AGREE II user manual on how to consider item and domain scores. For instance, the manual could include an a-priori weighting of those items and domains that should have the strongest influence on the two overall assessments. The relevance of these assessments within AGREE II could thereby be further specified.

Seven words you can never say at HHS

Directory of Open Access Journals (Sweden)

Robbins RA

2017-12-01

Full Text Available No abstract available. Article truncated at 150 words. The recent announcement of the seven words you can never say at Health & Human Services (HHS reminded me of the late George Carlin’s routine, “Seven Words You Can Never Say on Television” (1. Policy analysts at the Centers for Disease Control (CDC in Atlanta were told of the list of forbidden words at a meeting last Thursday, December 14, with senior CDC officials who oversee the budget, according to an analyst who took part in the 90-minute briefing (2. The forbidden words are "vulnerable," "entitlement," "diversity," "transgender," "fetus," "evidence-based" and "science-based." In some instances, the analysts were given alternative phrases. Instead of “science-based” or “evidence-based,” the suggested phrase is “CDC bases its recommendations on science in consideration with community standards and wishes,” the person said. In other cases, no replacement words were immediately offered. This is the latest attempt by government departments to distort fact. As an example, the …

45 CFR 1351.18 - What criteria has HHS established for deciding which Runaway and Homeless Youth Program grant...

Science.gov (United States)

2010-10-01

... which Runaway and Homeless Youth Program grant applications to fund? 1351.18 Section 1351.18 Public... SERVICES BUREAU RUNAWAY AND HOMELESS YOUTH PROGRAM Runaway and Homeless Youth Program Grant § 1351.18 What criteria has HHS established for deciding which Runaway and Homeless Youth Program grant applications to...

75 FR 57958 - Solicitation of Written Comments on Draft Tier 2 Strategies/Modules for Inclusion in the “HHS...

Science.gov (United States)

2010-09-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Solicitation of Written Comments on Draft Tier 2 Strategies/ Modules for Inclusion in the ``HHS Action Plan to Prevent Healthcare- Associated Infections'' AGENCY: Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of...

78 FR 48170 - Privacy Act of 1974; CMS Computer Match No. 2013-12; HHS Computer Match No. 1307; SSA Computer...

Science.gov (United States)

2013-08-07

....hhs.gov . SUPPLEMENTARY INFORMATION: The Computer Matching and Privacy Protection Act of 1988 (Public... computer matching involving Federal agencies could be performed and adding certain protections for... Affordability Programs under the Patient Protection and Affordable Care Act''. SECURITY CLASSIFICATION...

Verification and Validation of Heat Transfer Model of AGREE Code

Energy Technology Data Exchange (ETDEWEB)

Tak, N. I. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Seker, V.; Drzewiecki, T. J.; Downar, T. J. [Department of Nuclear Engineering and Radiological Sciences, Univ. of Michigan, Michigan (United States); Kelly, J. M. [US Nuclear Regulatory Commission, Washington (United States)

2013-05-15

The AGREE code was originally developed as a multi physics simulation code to perform design and safety analysis of Pebble Bed Reactors (PBR). Currently, additional capability for the analysis of Prismatic Modular Reactor (PMR) core is in progress. Newly implemented fluid model for a PMR core is based on a subchannel approach which has been widely used in the analyses of light water reactor (LWR) cores. A hexagonal fuel (or graphite block) is discretized into triangular prism nodes having effective conductivities. Then, a meso-scale heat transfer model is applied to the unit cell geometry of a prismatic fuel block. Both unit cell geometries of multi-hole and pin-in-hole types of prismatic fuel blocks are considered in AGREE. The main objective of this work is to verify and validate the heat transfer model newly implemented for a PMR core in the AGREE code. The measured data in the HENDEL experiment were used for the validation of the heat transfer model for a pin-in-hole fuel block. However, the HENDEL tests were limited to only steady-state conditions of pin-in-hole fuel blocks. There exist no available experimental data regarding a heat transfer in multi-hole fuel blocks. Therefore, numerical benchmarks using conceptual problems are considered to verify the heat transfer model of AGREE for multi-hole fuel blocks as well as transient conditions. The CORONA and GAMMA+ codes were used to compare the numerical results. In this work, the verification and validation study were performed for the heat transfer model of the AGREE code using the HENDEL experiment and the numerical benchmarks of selected conceptual problems. The results of the present work show that the heat transfer model of AGREE is accurate and reliable for prismatic fuel blocks. Further validation of AGREE is in progress for a whole reactor problem using the HTTR safety test data such as control rod withdrawal tests and loss-of-forced convection tests.

Evaluation of the quality of guidelines for myasthenia gravis with the AGREE II instrument.

Directory of Open Access Journals (Sweden)

Zhenchang Zhang

Full Text Available Clinical practice guidelines (CPGs are systematically developed statements to assist practitioners in making decisions about appropriate healthcare in specific clinical circumstances. The methodological quality of CPGs for myasthenia gravis (MG are unclear.To critically evaluate the methodological quality of CPGs for MG using AGREE II instrument.A systematical search strategy on PubMed, EMBASE, DynaMed, the National Guideline Clearinghouse (NGC and the Chinese Biomedical Literature database (CBM was performed on September 20th 2013. All guidelines related to MG were evaluated with AGREE II. The software used for analysis was SPSS 17.0.A total of 15 CPGs for MG met the inclusion criteria (12 CPGs in English, 3 CPGs in Chinese. The overall agreement among reviews was moderate or high (ICC >0.70. The mean scores (mean ± SD for al six domains were presented as follows: scope and purpose (60.93% ± 16.62%, stakeholder involvement (40.93% ± 20.04%, rigor of development (37.22% ± 30.46%, clarity of presentation (64.26% ± 16.36%, applicability (28.19% ± 20.56% and editorial independence (27.78% ± 28.28%. Compared with non-evidence-based CPGs, evidence-based CPGs had statistically significant higher quality scores for all AGREE II domains (P0.05. The quality scores of CPGs developed by NGC/AAN were higher than the quality scores of CPGs developed by other organizations for all domains. The difference was statistically significant for all domains with the exception of clarity of presentation (P = 0.07.The qualities of CPGs on MG were generally acceptable with several flaws. The AGREE II instrument should be adopted by guideline developers, particularly in China.

Defense Civil Support: DOD, HHS, and DHS Should Use Existing Coordination Mechanisms to Improve Their Pandemic Preparedness

Science.gov (United States)

2017-02-01

documentation is not shared with a broad audience , HHS officials said that it is available to DOD stakeholders upon request, and as soon as it is approved...instructions to support incident relief efforts. • Alerts the NDMS FCCs to activate NDMS patient reception plans with a phased, regional approach and, when...patient reception areas, using available DOD transportation resources in coordination with the NDMS Medical Interagency Coordination Group

75 FR 30839 - Privacy Act of 1974; CMS Computer Match No. 2010-03, HHS Computer Match No. 1003, SSA Computer...

Science.gov (United States)

2010-06-02

... 1974; CMS Computer Match No. 2010-03, HHS Computer Match No. 1003, SSA Computer Match No. 1048, IRS... Services (CMS). ACTION: Notice of renewal of an existing computer matching program (CMP) that has an...'' section below for comment period. DATES: Effective Dates: CMS filed a report of the Computer Matching...

76 FR 24901 - Request for Input To Inform a Possible Surgeon General Action on Prescription Drug Abuse in Youth

Science.gov (United States)

2011-05-03

... self- harm (suicide attempts). Approach: ONDCP highlighted prescription drug abuse in its 2010 National... a Possible Surgeon General Action on Prescription Drug Abuse in Youth AGENCY: National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services (HHS). ACTION...

China, Argentina agree to further strategic ties

Institute of Scientific and Technical Information of China (English)

2011-01-01

According to Xinhua,China and Argentina have agreed to further enhance mutual trust and their strategic partnership as the two emerging economies are playing an increasingly important role in the world arena.“China will work with Argentina to strengthen strategic mutual trust,expand cooperation and coordination within multilateral frameworks in order to promote bilateral ties and benefit the two peoples,” Vice President Xi Jinping told Argentine Foreign Minister Hector Timerman on September 9.

Bimetric general relativity

International Nuclear Information System (INIS)

Rosen, N.

1979-01-01

A modification of general relativity is proposed involving a second metric tensor describing a space-time of constant curvature and associated with the fundamental rest-frame of the universe. The theory generally agrees with the Einstein theory, but gives cosmological models without singularities which can account for present observation, including helium abundance

On being examined: do students and faculty agree?

Science.gov (United States)

Perrella, Andrew; Koenig, Joshua; Kwon, Henry; Nastos, Stash; Rangachari, P K

2015-12-01

Students measure out their lives, not with coffee spoons, but with grades on examinations. But what exams mean and whether or not they are a bane or a boon is moot. Senior undergraduates (A. Perrella, J. Koenig, and H. Kwon) designed and administered a 15-item survey that explored the contrasting perceptions of both students (n = 526) and faculty members (n = 33) in a 4-yr undergraduate health sciences program. A series of statements gauged the level of agreement on a 10-point scale. Students and faculty members agreed on the value of assessing student learning with a variety of methods, finding new information to solve problems, assessing conceptual understanding and logical reasoning, having assessments with no single correct answer, and having comments on exams. Clear differences emerged between students and faculty members on specific matters: rubrics, student choice of exam format, assessing creativity, and transfer of learning to novel situations. A followup questionnaire allowed participants to clarify their interpretation of select statements, with responses from 71 students and 17 faculty members. All parties strongly agreed that exams should provide a good learning experience that would help them prepare for the future (students: 8.64 ± 1.71 and faculty members: 8.03 ± 2.34). Copyright © 2015 The American Physiological Society.

76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan

Science.gov (United States)

2011-09-19

...] Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration, HHS. ACTION... information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to achieve... Information Technology Plan.'' This plan will meet one of the performance goals agreed to under the 2007...

ARCO and Sun agree to settle Iranian claims

International Nuclear Information System (INIS)

Anon.

1992-01-01

This paper reports that ARCO and Sun Co. Inc. have agreed to separate settlements totaling almost $261 million that resolve their claims over oil field assets expropriated by Iran in 1978--80. The agreements are subject to approval by the Iran-U.S. claims tribunal at The Hague. The tribunal was set up in 1981 to resolve foreign claims to assets nationalized by the government of Ayatollah Khomeini following the fall of the Shah of Iran as a result of the 1978-79 Iranian revolution. The settlements are seen as the latest steps Iran has taken to normalize relations with the U.S., notably through petroleum related deals

A novel cadaver-based educational program in general surgery training.

Science.gov (United States)

Lewis, Catherine E; Peacock, Warwick J; Tillou, Areti; Hines, O Joe; Hiatt, Jonathan R

2012-01-01

To describe the development of a cadaver-based educational program and report our residents' assessment of the new program. An anatomy-based educational program was developed using fresh frozen cadavers to teach surgical anatomy and operative skills to general surgery (GS) trainees. Residents were asked to complete a voluntary, anonymous survey evaluating perceptions of the program (6 questions formulated on a 5-point Likert scale) and comparing cadaver sessions to other types of learning (4 rank order questions). Large university teaching hospital. Medical students, residents, and faculty members were participants in the cadaver programs. Only GS residents were asked to complete the survey. Since its implementation, 150 residents of all levels participated in 13 sessions. A total of 40 surveys were returned for a response rate of 89%. Overall, respondents held a positive view of the cadaver sessions and believed them to be useful for learning anatomy (94% agree or strongly agree), learning the steps of an operation (76% agree or strongly agree), and increasing confidence in doing an operation (53% agree or strongly agree). Trainees wanted to have more sessions (87% agree or strongly agree), and believed they would spend free time in the cadaver laboratory (58% agree or strongly agree). Compared with other learning modalities, cadaver sessions were ranked first for learning surgical anatomy, followed by textbooks, simulators, web sites, animate laboratories, and lectures. Respondents also ranked cadaver sessions first for increasing confidence in performing a procedure and for learning the steps of an operation. Cost of cadavers represented the major expense of the program. Fresh cadaver dissections represent a solution to the challenges of efficient, safe, and effective general surgery education. Residents have a positive attitude toward these teaching sessions and found them to be more effective than other learning modalities. Copyright © 2012 Association of

States agree on stronger physical protection regime

International Nuclear Information System (INIS)

2005-01-01

Full text: Delegates from 89 countries agreed on 8 July to fundamental changes that will substantially strengthen the Convention on the Physical Protection of Nuclear Material (CPPNM). IAEA Director General Mohamed ElBaradei welcomed the agreement in saying 'This new and stronger treaty is an important step towards greater nuclear security by combating, preventing, and ultimately punishing those who would engage in nuclear theft, sabotage or even terrorism. It demonstrates that there is indeed a global commitment to remedy weaknesses in our nuclear security regime.' The amended CPPNM makes it legally binding for States Parties to protect nuclear facilities and material in peaceful domestic use, storage as well as transport. It will also provide for expanded cooperation between and among States regarding rapid measures to locate and recover stolen or smuggled nuclear material, mitigate any radiological consequences of sabotage, and prevent and combat related offences. The original CPPNM applied only to nuclear material in international transport. Conference President Dr. Alec Baer said 'All 89 delegations demonstrated real unity of purpose. They put aside some very genuine national concerns in favour of the global interest and the result is a much improved convention that is better suited to addressing the nuclear security challenges we currently face.' The new rules will come into effect once they have been ratified by two-thirds of the 112 States Parties of the Convention, expected to take several years. 'But concrete actions are already taking place around the world. For more than 3 years, the IAEA has been implementing a systematic Nuclear Security plan, including physical protection activities designed to prevent, detect and respond to malicious acts,' said Anita Nillson, Director of the IAEA's Office of Nuclear Security. The Agency's Nuclear Security Fund, set up after the events of 9/11, has delivered $19.5 million in practical assistance to 121 countries

Pediatric dentists' perspective of general dentists' role in treating children aged 0-3 years.

Science.gov (United States)

Coe, Julie M; Razdan, Shinjni; Best, Al M; Brickhouse, Tegwyn H

2017-01-01

This study examined pediatric dentists' perspectives on the types of dental services general dentists provide to children who are 0-3 years old. A web-based survey was sent to 5185 pediatric dentists and 769 (14.8%) responded. Among the respondents, 58% agreed with general dentists' providing an age 1 dental visit. Only 24% agreed with general dentists' performing complex behavior management techniques, such as sedation, to patients aged 0-3 years. Those respondents who taught pediatric dentistry full time were more likely to agree with general dentists' providing an age 1 dental visit (P = 0.0088). Those who reported that their own dental school had adequately prepared them for this type of age 1 visit were also more in agreement (P pediatric dentists' perceptions of the level of collaboration between general dentists and pediatric dentists; the types of oral health services general dentists can provide for children aged 0-3 years; and the anticipated level of competency of entry-level general dentists.

Generalized Einstein relation for the mutual diffusion coefficient of a binary fluid mixture.

Science.gov (United States)

Felderhof, B U

2017-08-21

The method employed by Einstein to derive his famous relation between the diffusion coefficient and the friction coefficient of a Brownian particle is used to derive a generalized Einstein relation for the mutual diffusion coefficient of a binary fluid mixture. The expression is compared with the one derived by de Groot and Mazur from irreversible thermodynamics and later by Batchelor for a Brownian suspension. A different result was derived by several other workers in irreversible thermodynamics. For a nearly incompressible solution, the generalized Einstein relation agrees with the expression derived by de Groot and Mazur. The two expressions also agree to first order in solute density. For a Brownian suspension, the result derived from the generalized Smoluchowski equation agrees with both expressions.

Spray-on-skin cells in burns: a common practice with no agreed protocol.

Science.gov (United States)

Allouni, Ammar; Papini, Remo; Lewis, Darren

2013-11-01

Cultured epithelial autograft (CEA) has been used for skin coverage after burn wound excision since 1981. It is used in burn units and centres throughout the U.K.; however, there appears to be no agreed standards of practice. We aimed to investigate the experience and current practice with its usage in the management of acute burn injury. An online survey was sent to twenty-five burns consultants in the U.K., who are members of the British Burn Association. We received 14 responses. Rarely have the responders agreed to the same practice in most of the questions. Different choices were given by responders with regards the indications for cell culture, techniques used, primary and secondary dressings used, first wound review timing, and measures used to evaluate outcomes. In the current economic environment, the NHS needs to rationalize services on the basis of cost effectiveness. CEA is an expensive procedure that requires an adequately sterile laboratory, special equipments and highly experienced dedicated staff. When dealing with expensive management options, it is important to have an agreed protocol that can form the standard that can be referred to when auditing practices and results to improve burn management and patients' care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

E-learning interventions are comparable to user's manual in a randomized trial of training strategies for the AGREE II

Directory of Open Access Journals (Sweden)

Durocher Lisa D

2011-07-01

Full Text Available Abstract Background Practice guidelines (PGs are systematically developed statements intended to assist in patient and practitioner decisions. The AGREE II is the revised tool for PG development, reporting, and evaluation, comprised of 23 items, two global rating scores, and a new User's Manual. In this study, we sought to develop, execute, and evaluate the impact of two internet interventions designed to accelerate the capacity of stakeholders to use the AGREE II. Methods Participants were randomized to one of three training conditions. 'Tutorial'--participants proceeded through the online tutorial with a virtual coach and reviewed a PDF copy of the AGREE II. 'Tutorial + Practice Exercise'--in addition to the Tutorial, participants also appraised a 'practice' PG. For the practice PG appraisal, participants received feedback on how their scores compared to expert norms and formative feedback if scores fell outside the predefined range. 'AGREE II User's Manual PDF (control condition'--participants reviewed a PDF copy of the AGREE II only. All participants evaluated a test PG using the AGREE II. Outcomes of interest were learners' performance, satisfaction, self-efficacy, mental effort, time-on-task, and perceptions of AGREE II. Results No differences emerged between training conditions on any of the outcome measures. Conclusions We believe these results can be explained by better than anticipated performance of the AGREE II PDF materials (control condition or the participants' level of health methodology and PG experience rather than the failure of the online training interventions. Some data suggest the online tools may be useful for trainees new to this field; however, this requires further study.

IAEA and EU Review Progress on Cooperation, Agree on Next Steps at Annual Meeting

International Nuclear Information System (INIS)

2018-01-01

The International Atomic Energy Agency (IAEA) and the European Union (EU) reviewed progress achieved in working together on a range of nuclear activities and agreed to further enhance cooperation during their sixth annual Senior Officials Meeting in Vienna. The talks on 8 February at the IAEA’s headquarters provided a forum for exchanging views on strengthening collaboration on nuclear safety, security, safeguards, sustainable development, nuclear energy research and increasing innovation. The two organizations welcomed the fruitful cooperation and progress achieved over the past years. They agreed to deepen cooperation in several areas, particularly in the promotion of nuclear applications for sustainable development.

[How to assess clinical practice guidelines with AGREE II: The example of neonatal jaundice].

Science.gov (United States)

Renesme, L; Bedu, A; Tourneux, P; Truffert, P

2016-03-01

Neonatal jaundice is a very frequent condition that occurs in approximately 50-70% of term or near-term (>35 GA) babies in the 1st week of life. In some cases, a high bilirubin blood level can lead to kernicterus. There is no consensus for the management of neonatal jaundice and few countries have published national clinical practice guidelines for the management of neonatal jaundice. The aim of this study was to assess the quality of these guidelines. We conducted a systematic review of the literature for national clinical practice guidelines for the management of neonatal jaundice in term or near-term babies. Four independent reviewers assessed the quality of each guideline using the AGREE II evaluation. For each of the clinical practice guidelines, the management modalities were analyzed (screening, treatment, follow-up, etc.). Seven national clinical practice guidelines were found (South Africa, USA AAP, UK NICE, Canada, Norway, Switzerland, and Israel). The AGREE II score showed widespread variation regarding the quality of these national guidelines. There was no major difference between the guidelines concerning the clinical management of these babies. The NICE guideline is the most valuable guideline regarding the AGREE II score. NICE showed that, despite a strong and rigorous methodology, there is no evidenced-based recommended code of practice (RCP). Comparing RCPs, we found no major differences. The NICE guideline showed the best quality. The AGREE II instrument should be used as a framework when developing clinical practice guidelines to improve the quality of the future guideline. In France, a national guideline is needed for a more standardized management of neonatal jaundice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

New German abortion law agreed.

Science.gov (United States)

Karcher, H L

1995-07-15

The German Bundestag has passed a compromise abortion law that makes an abortion performed within the first three months of pregnancy an unlawful but unpunishable act if the woman has sought independent counseling first. Article 218 of the German penal code, which was established in 1871 under Otto von Bismarck, had allowed abortions for certain medical or ethical reasons. After the end of the first world war, the Social Democrats tried to legalize all abortions performed in the first three months of pregnancy, but failed. In 1974, abortion on demand during the first 12 weeks was declared legal and unpunishable under the social liberal coalition government of chancellor Willy Brandt; however, the same year, the German Federal Constitution Court in Karlsruhe ruled the bill was incompatible with article 2 of the constitution, which guarantees the right to life and freedom from bodily harm to everyone, including the unborn. The highest German court also ruled that a pregnant woman had to seek a second opinion from an independent doctor before undergoing an abortion. A new, extended article 218, which included a clause giving social indications, was passed by the Bundestag. When Germany was unified, East Germans agreed to be governed by all West German laws, except article 218. The Bundestag was given 2 years to revise the article; however, in 1993, the Federal Constitution Court rejected a version legalizing abortion in the first 3 months of the pregnancy if the woman sought counsel from an independent physician, and suggested the recent compromise passed by the Bundestag, the lower house of the German parliament. The upper house, the Bundesrat, where the Social Democrats are in the majority, still has to pass it. Under the bill passed by the Bundestag, national health insurance will pay for an abortion if the monthly income of the woman seeking the abortion falls under a certain limit.

Department of Defense, Office of Inspector General Semiannual Report to the Congress, 1 April - 30 September 1984.

Science.gov (United States)

1984-11-29

Healthi Fraud, Potential Fraud or Potential Fraud and Human Services (lDoHHS) because of the contrac--0 Referred to Civilian Prosecutive Agencies tor’s...Administra- 7/31/84 Resourec and (;round Fuel Ac(otiunng tion, Government Property in the Cuintrol at Marine Ctirps Air Station, Possession of Contractors...DLA Defense Logistics Agency DoD Department of Defense DoHHS Department of Health and Human Services DoJ Department of Justice EPA Environmental

Using AGREE II to Evaluate the Quality of Traditional Medicine Clinical Practice Guidelines in China.

Science.gov (United States)

Deng, Wei; Li, Le; Wang, Zixia; Chang, Xiaonan; Li, Rui; Fang, Ziye; Wei, Dang; Yao, Liang; Wang, Xiaoqin; Wang, Qi; An, Guanghui

2016-03-15

To evaluate/assess the quality of the Clinical Practice Guidelines (CPGs) of traditional medicine in China. We systematically searched the literature databases WanFang Data, VIP, CNKI and CBM for studies published between 1978 and 2012 to identify and select CPGs of traditional medicine. We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to evaluate these guidelines. A total of 75 guidelines were included, of which 46 guidelines (62%) were on Traditional Chinese Medicine, 19 (25%) on Chinese Integrated Medicine, and 10 (13%) on Uyghur Medicine. Most traditional medicine CPGs published in domestic journals scored medicine. In each domain of AGREE II, traditional Medicine CPGs performed clearly better than international CPGs. The same trend was seen in guidelines of Modern Medicine. An increasing amount of CPGs are being published, but their quality is low. Referring to the key points of international guidelines development, supervision through AGREE II, cooperating with international groups and exploring the strategy of guideline development could improve the quality of CPGs on traditional medicine. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

46 CFR 502.403 - General authority.

Science.gov (United States)

2010-10-01

... Alternative Dispute Resolution § 502.403 General authority. (a) The Commission intends to consider using a dispute resolution proceeding for the resolution of an issue in controversy, if the parties agree to a... fulfilling that requirement. (c) Alternative means of dispute resolution authorized under this subpart are...

New general relativity

International Nuclear Information System (INIS)

Hayashi, K.; Shirafuji, T.

1979-01-01

A gravitational theory is formulated on the Weitzenboeck space-time, characterized by the vanishing curvature tensor (absolute parallelism) and by the torsion tensor formed of four parallel vector fields. This theory is called new general relativity, since Einstein in 1928 first gave its original form. New general relativity has three parameters c 1 , c 2 , and lambda, besides the Einstein constant kappa. In this paper we choose c 1 = 0 = c 2 , leaving open lambda. We prove, among other things, that (i) a static, spherically symmetric gravitational field is given by the Schwarzschild metric, that (ii) in the weak-field approximation an antisymmetric field of zero mass and zero spin exists, besides gravitons, and that (iii) new general relativity agrees with all the experiments so far carried out

Report: Agreed-Upon Procedures on EPA’s Fiscal Year 2009 First Quarter Financial Statements

Science.gov (United States)

Report #09-2-0161, June 8, 2009. We compared the statements with EPA’s crosswalk, recomputed them for mathematical accuracy, and compared them with balances separately generated by us. Except for immaterial rounding differences, the amounts agreed.

System for Delivering Student Aid Is Flawed, Many Agree, But What's the Solution?

Science.gov (United States)

Burd, Stephen

1997-01-01

Public officials and student aid experts agree that the federal program delivery system is outdated, inefficient, and vulnerable to fraud, but they disagree on how bad the situation is and whether the Education Department has the structure necessary to fix it. A 1995 project to integrate all federal grant and loan programs into one system has not…

Generalizing: The descriptive struggle

Directory of Open Access Journals (Sweden)

Barney G. Glaser, Ph.D.; Hon Ph.D.

2006-11-01

Full Text Available The literature is not kind to the use of descriptive generalizations. Authors struggle and struggle to find and rationalize a way to use them and then fail in spite of trying a myriad of work-arounds. And then we have Lincoln and Guba’s famous statement: “The only generalization is: there is no generalization” in referring to qualitative research. (op cit, p. 110 They are referring to routine QDA yielding extensive descriptions, but which tacitly include conceptual generalizations without any real thought of knowledge about them. In this chapter I wish to explore this struggle for the purpose of explaining that the various contra arguments to using descriptive generalizations DO NOT apply to the ease of using conceptual generalizations yielded in SGT and especially FGT. I will not argue for the use of descriptive generalization. I agree with Lincoln and Guba with respect to QDA, “the only generalization is: there is no generalization.” It is up to the QDA methodologists, of whom there are many; to continue the struggle and I wish them well.

General dental practitioner's views on dental general anaesthesia services.

Science.gov (United States)

Threlfall, A G; King, D; Milsom, K M; Blinkhom, A S; Tickle, M

2007-06-01

Policy has recently changed on provision of dental general anaesthetic services in England. The aim of this study was to investigate general dental practitioners' views about dental general anaesthetics, the reduction in its availability and the impact on care of children with toothache. Qualitative study using semi-structured interviews and clinical case scenarios. General dental practitioners providing NHS services in the North West of England. 93 general dental practitioners were interviewed and 91 answered a clinical case scenario about the care they would provide for a 7-year-old child with multiple decayed teeth presenting with toothache. Scenario responses showed variation; 8% would immediately refer for general anaesthesia, 25% would initially prescribe antibiotics, but the majority would attempt to either restore or extract the tooth causing pain. Interview responses also demonstrated variation in care, however most dentists agree general anaesthesia has a role for nervous children but only refer as a last resort. The responses indicated an increase in inequalities, and that access to services did not match population needs, leaving some children waiting in pain. Most general dental practitioners support moving dental general anaesthesia into hospitals but some believe that it has widened health inequalities and there is also a problem associated with variation in treatment provision. Additional general anaesthetic services in some areas with high levels of tooth decay are needed and evidence based guidelines about caring for children with toothache are required.

Context, Complexity and Contestation: Birmingham's Agreed Syllabuses for Religious Education since the 1970s

Science.gov (United States)

Parker, Stephen G.; Freathy, Rob J. K.

2011-01-01

The present article offers an historical perspective on the 1975, 1995 and 2007 Birmingham Agreed Syllabuses for Religious Education. It draws upon historical evidence uncovered as part of "The hidden history of curriculum change in religious education in English schools, 1969-1979" project, and curriculum history theories, especially…

Particle field in bimetric general relativity

International Nuclear Information System (INIS)

Falik, D.; Rosen, N.

1980-01-01

The field equations of the bimetric general relativity theory proposed recently by one of the authors (N. Rosen) are put into a static form. The equations are solved near the Schwarzschild sphere, and it is found that the field differs from that of the Einstein general relativity theory: instead of a black hole, one has an impenetrable sphere. For larger distances the field is found to agree with that of ordinary general relativity, so that solar system observations cannot distinguish between the two theories. For very large distances one gets a cosmic contribution to the field which may affect the dynamics of clusters of galaxies

Resourcing the National Goals for Schooling: An Agreed Framework of Principles for Funding Schools

Science.gov (United States)

Ministerial Council on Education, Employment, Training and Youth Affairs (NJ1), 2012

2012-01-01

Funding for school education in Australia should be on the basis of clear and agreed policy principles for achieving effectiveness, efficiency, equity and a socially and culturally cohesive society. On the basis of these principles a national framework for funding schools will be supported by complementary State and Commonwealth models for funding…

A critical appraisal of chronic kidney disease mineral and bone disorders clinical practice guidelines using the AGREE II instrument.

Science.gov (United States)

Sekercioglu, Nigar; Al-Khalifah, Reem; Ewusie, Joycelyne Efua; Elias, Rosilene M; Thabane, Lehana; Busse, Jason W; Akhtar-Danesh, Noori; Iorio, Alfonso; Isayama, Tetsuya; Martínez, Juan Pablo Díaz; Florez, Ivan D; Guyatt, Gordon H

2017-02-01

Patients with chronic kidney disease mineral and bone disorders (CKD-MBD) suffer high rates of morbidity and mortality, in particular related to bone and cardiovascular outcomes. The management of CKD-MBD remains challenging. The objective of this systematic survey is to critically appraise clinical practice guidelines (CPGs) addressing CKD-MBD. Data sources included MEDLINE, EMBASE, the National Guideline Clearinghouse, Guideline International Network and Turning Research into Practice up to May 2016. Teams of two reviewers, independently and in duplicate, screened titles and abstracts and potentially eligible full text reports to determine eligibility and subsequently appraised the guidelines using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE). Sixteen CPGs published from 2003 to 2015 addressing the diagnosis and management of CKD-MBD in adult patients (11 English, two Spanish, one Italian, one Portuguese and one Slovak) proved eligible. The National Institute for Health and Care Excellence guideline performed best with respect to AGREE II criteria; only three other CPGs warranted high scores on all domains. All other guidelines received scores of under 60% on one or more domains. Major discrepancies in recommendations were not, however, present, and we found no association between quality of CPGs which was not associated with resulting recommendations. Most guidelines assessing CKD-MBD suffer from serious shortcomings using AGREE criteria although limitations with respect to AGREE criteria do not necessarily lead to inappropriate recommendations.

Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand

Directory of Open Access Journals (Sweden)

Critchley Julia

2005-06-01

Full Text Available Abstract Background Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand. Methods Questionnaire survey of general practitioners in community hospitals, to estimate: i use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii views on the optimal duration of benzodiazepine use. Results Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%, panic disorder (n = 43, 78%, depression (n = 26, 43%, essential hypertension (n = 15, 27 % and uncomplicated low back pain (n = 10, 18%. Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%; or from 1 week to 1 month (47%; or 1 to 4 months (16%; or 4 to 6 months (5% or more than 6 months (2%. Twenty-five general practitioners (45% accepted that they used benzodiazepines excessively in the past year. Conclusion A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.

Four African Nations Agree to Water Management Programme

International Nuclear Information System (INIS)

2013-01-01

Full text: Seeking to improve their management of water resources, four northeast African nations today agreed at the International Atomic Energy Agency (IAEA) to establish a long-term framework for utlizing a key underground water system. Chad, Egypt, Libya and Sudan signed a Strategic Action Programme (SAP) that aims to optimize the equitable use of the Nubian Sandstone Aquifer System, a huge water resource that lies beneath the four nations. The SAP also commits the countries to strengthen and build upon a previously existing regional coordination mechanism, in part by establishing a new Joint Authority for the Nubian Aquifer System. The Programme lays the groundwork for improving cooperation among the four arid nations and for strengthening their capacity to monitor and manage the aquifer effectively. With growing populations and decreasing water availability from other sources in the region, the aquifer is under mounting pressure. Removing water without a clear understanding of transboundary and other implications threatens water quality and has the potential to harm biodiversity and accelerate land degradation. The agreement resulted from a joint Technical Cooperation project of the United Nations Development Programme (UNDP) and the Global Environment Facility (GEF), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the IAEA. ''I congratulate all involved on this significant achievement,'' said IAEA Director General Yukiya Amano. ''Water is a key resource, and effective management and use of such water resources is essential for the future. The agreement of the Strategic Action Programme is the result of real cooperation between the four States, the Agency and UNDP-GEF. I am confident that this Programme will be a success and will benefit the people of the region. This positive project experience benefits strengthened and expanded cooperation between the IAEA and the UNDP-GEF.'' ''UNDP would like to congratulate the

40 CFR 80.131 - Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously...

Science.gov (United States)

2010-07-01

..., certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline... gasoline used to produce gasoline, and butane blenders. (a) Attest procedures for GTAB. The following are... conventional gasoline and of RFG produced. Agree the volumes from the tank activity records to the batch volume...

Verifying the agreed framework between the United States and North Korea

International Nuclear Information System (INIS)

May, M.M.

2001-01-01

Under the 1994 Agreed Framework (AF) between the United States and the Democratic People Republic of Korea (DPRK), the US and its allies will provide two nuclear-power reactors and other benefits to the DPRK in exchange for an agreement by the DPRK to declare how much nuclear-weapon material it has produced; to identify, freeze, and eventually dismantle specified facilities for producing this material; and to remain a party to the nuclear Non- Proliferation Treaty (NPT) and allow the implementation of its safeguards agreement. This study assesses the verifiability of these provisions. The study concludes verification can be accomplished, given cooperation and openness from the DPRK. Special effort will be needed from the IAEA, as well as support from the US and the Republic of Korea. (author)

The definition of commonly agreed stylized human intrusion scenarios for use in the long term safety assessments of radioactive waste disposal systems

International Nuclear Information System (INIS)

Carboneras, P.

2002-01-01

Recent international advice on the treatment of human intrusion in relation to the safety of radioactive waste repositories is reviewed. The outstanding issues which need to be resolved in order to establish an agreed international approach to assessing the consequences and judging the impact of human intrusion are summarized. Finally, a way forward towards an internationally agreed assessment approach is proposed. (author)

The scientific motivation of the internationally agreed ‘well below 2 °C’ climate protection target

NARCIS (Netherlands)

Leemans, Rik; Vellinga, Pier

2017-01-01

The UNFCCC parties in their last 2015-meeting in Paris agreed to hold the increase in the global average temperature well below 2 °C above pre-industrial levels. However, how this target came about is rarely substantiated in the scientific literature. We review and document the history of this

Do patients and physicians agree on diabetes management? A study conducted in Public Healthcare Centres in Brazil

NARCIS (Netherlands)

de Figueiredo, R.C.; Snoek, F.J.; Barreto, S.M.

2013-01-01

Objective: To explore to what extent patients with diabetes agree with their physicians on diabetes management and whether the agreement varies according to patients' socio-demographic characteristics. Methods: A cross-sectional study was conducted among patients with diabetes and their Family

Decisions to Perform Emergency Caesarean Sections at a University Hospital; Do obstetricians agree?

Directory of Open Access Journals (Sweden)

Gowri Vaidyanathan

2016-02-01

Full Text Available Objectives: This study was undertaken to assess the degree of agreement amongst obstetricians regarding decisions to perform emergency Caesarean section (CS procedures at a university hospital. Methods: This retrospective clinical audit was carried out on 50 consecutive emergency CS procedures performed between November 2012 and March 2013 on women with singleton pregnancies at the Sultan Qaboos University Hospital in Muscat, Oman. Data on each procedure were collected from electronic patient records and independently reviewed by six senior obstetricians to determine agreement with the decision. Results: Of the 50 women who underwent CS procedures, the mean age was 28.9 ± 5.1 years and 48% were primigravidae. A total of 65% of the CS procedures were category I. The most common indications for a CS was a non-reassuring fetal heart trace (40% and dystocia (32%. There was complete agreement on the decision to perform 62% of the CS procedures. Five and four obstetricians agreed on 80% and 95% of the procedures, respectively. The range of disagreement was 4–20%. Disagreement occurred primarily with category II and III procedures compared to category I. Additionally, disagreement occurred in cases where the fetal heart trace pattern was interpreted as an indication for a category II CS. Conclusion: The majority of obstetricians agreed on the decisions to perform 94% of the emergency CS procedures. Obstetric decision-making could be improved with the implementation of fetal scalp pH testing facilities, fetal heart trace interpretation training and cardiotocography review meetings.

How do Perceptions of Autonomy Differ in General Surgery Training Between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study.

Science.gov (United States)

Kempenich, Jason W; Willis, Ross E; Rakosi, Robert; Wiersch, John; Schenarts, Paul Joseph

2015-01-01

Identify barriers to resident autonomy in today's educational environment as perceived through 4 selected groups: senior surgical residents, teaching faculty, hospital administration, and the general public. Anonymous surveys were created and distributed to senior residents, faculty, and hospital administrators working within 3 residency programs. The opinions of a convenience sample of the general public were also assessed using a similar survey. Keesler Medical Center, Keesler AFB, MS; the University of Texas Health Science of San Antonio, TX; and the University of Nebraska Medical Center, Omaha, NE. A total of 169 responses were collected: 32 residents, 50 faculty, 20 administrators, and 67 general public. Faculty and residents agree that when attending staff grant more autonomy, residents' self-confidence and sense of ownership improve. Faculty felt that residents should have less autonomy than residents did (p autonomy at their institution, 47% of residents felt that they had too little autonomy and 38% of faculty agreed. No resident or faculty felt that residents had too much autonomy at their institution. The general public were more welcoming of resident participation than faculty (p = 0.002) and administrators (p = 0.02) predicted they would be. When the general public were asked regarding their opinions about resident participation with complex procedures, they were less welcoming than faculty, administrators, and residents thought (p autonomy as important for resident development. The general public are more receptive to resident participation than anticipated. However, with increasing procedural complexity and resident independence, they were less inclined to have residents involved. The general public also had more concerns regarding quality of care provided by residents than the other groups had. Published by Elsevier Inc.

[Diagnostic rationalism. Views of general practitioners on fibromyalgia].

Science.gov (United States)

Daehli, B

1993-09-20

Clinical practice is characterized by having to make numerous important decisions, including the diagnosis. In this study, general practitioners were asked to agree or to disagree with statements of fibromyalgia. The main purpose was to test the usefulness of two well-known models for decision-making when studying diagnosis in cases of uncertainty and scepticism. The results show that the models are inadequate to explain the decisions.

Attitudes toward Euthanasia in Hong Kong--A Comparison between Physicians and the General Public

Science.gov (United States)

Chong, Alice Ming-lin; Fok, Shiu-yeu

2005-01-01

This article reports the findings of a cross-sectional study that compared the attitudes of 618 respondents of a general household survey and a random sample of 1,197 physicians toward different types of euthanasia in Hong Kong. The general public was found to agree with active euthanasia and non-voluntary euthanasia and was neutral about passive…

Predictors of excellent early outcome after total hip arthroplasty

Directory of Open Access Journals (Sweden)

Smith George H

2012-03-01

Full Text Available Abstract Background Not all patients gain the same degree of improvement from total hip replacement and the reasons for this are not clear. Many investigators have assessed predictors of general outcome after hip surgery. This study is unique in its quest for the predictors of the best possible early outcome. Methods We prospectively collected data on 1318 total hip replacements. Prior to surgery patient characteristics, demographics and co-morbidities were documented. Hip function and general health was assessed using the Harris Hip score (HHS and the Short-Form 36 respectively. The HHS was repeated at three years. We took a maximal HHS of 100 to represent an excellent outcome (102 patients. Multiple logistic regression analysis was used to identify independent predictors of excellent outcome. Results The two strongest predictive factors in achieving an excellent result were young age and a high pre-operative HHS (p = 0.001. Conclusions It was the young and those less disabled from their arthritis that excelled at three years. When making a decision about the timing of hip arthroplasty surgery it is important to take into account the age and pre-operative function of the patient. Whether these patients continue to excel however will be the basis of future research.

The Confrontation between General Relativity and Experiment

Directory of Open Access Journals (Sweden)

Will Clifford

2001-01-01

Full Text Available The status of experimental tests of general relativity and of theoretical frameworks for analysing them are reviewed. Einstein's equivalence principle (EEP is well supported by experiments such as the Eötvös experiment, tests of special relativity, and the gravitational redshift experiment. Future tests of EEP and of the inverse square law will search for new interactions arising from unification or quantum gravity. Tests of general relativity at the post-Newtonian level have reached high precision, including the light deflection, the Shapiro time delay, the perihelion advance of Mercury, and the Nordtvedt effect in lunar motion. Gravitational wave damping has been detected in an amount that agrees with general relativity to half a percent using the Hulse-Taylor binary pulsar, and new binary pulsar systems may yield further improvements.When direct observation of gravitational radiation from astrophysical sources begins, new tests of general relativity will be possible.

Do you agree with the doctor's decision to continue treatment?: A scenario-based study of hospital nurses in Italy

Directory of Open Access Journals (Sweden)

Francesca Ingravallo

2015-12-01

Full Text Available INTRODUCTION: A lack of social consensus on the duty to comply with a patient's request to forgo treatment was reported in Italy, but little is known about the nurses' attitudes regarding this issue. MATERIALS AND METHODS: Questionnaire including two clinical scenarios regarding doctor's decision to not comply with a competent patient's request to forgo treatment was administered to all nurses (n = 487 of an Italian medium-sized hospital. RESULTS: Eighty-five percent of nurses completed the study. Although 83% of participants supported a general right to self-determination, around 40% of them agreed with the doctor's decision in both scenarios. The multivariate analyses adjusted for gender, age, length of professional experience, and care setting showed that the agreement with the doctor's decision was significantly associated with nurses' personal background beliefs about self-determination and quality of life. DISCUSSION AND CONCLUSIONS: Many nurses have difficulty in accepting a patient's request to forgo treatment. Increasing ethical reflection and discussion at both educational and professional level, and introducing ethical consultation services would be essential to develop a consistent approach to end-of-life decisions in Italian hospitals.

Generalized Expression for Polarization Density

International Nuclear Information System (INIS)

Wang, Lu; Hahm, T.S.

2009-01-01

A general polarization density which consists of classical and neoclassical parts is systematically derived via modern gyrokinetics and bounce-kinetics by employing a phase-space Lagrangian Lie-transform perturbation method. The origins of polarization density are further elucidated. Extending the work on neoclassical polarization for long wavelength compared to ion banana width [M. N. Rosenbluth and F. L. Hinton, Phys. Rev. Lett. 80, 724 (1998)], an analytical formula for the generalized neoclassical polarization including both finite-banana-width (FBW) and finite-Larmor-radius (FLR) effects for arbitrary radial wavelength in comparison to banana width and gyroradius is derived. In additional to the contribution from trapped particles, the contribution of passing particles to the neoclassical polarization is also explicitly calculated. Our analytic expression agrees very well with the previous numerical results for a wide range of radial wavelength.

The Confrontation between General Relativity and Experiment

Directory of Open Access Journals (Sweden)

Will Clifford M.

2006-03-01

Full Text Available The status of experimental tests of general relativity and of theoretical frameworks for analyzing them is reviewed. Einstein’s equivalence principle (EEP is well supported by experiments such as the Eötvös experiment, tests of special relativity, and the gravitational redshift experiment. Ongoing tests of EEP and of the inverse square law are searching for new interactions arising from unification or quantum gravity. Tests of general relativity at the post-Newtonian level have reached high precision, including the light deflection, the Shapiro time delay, the perihelion advance of Mercury, and the Nordtvedt effect in lunar motion. Gravitational wave damping has been detected in an amount that agrees with general relativity to better than half a percent using the Hulse-Taylor binary pulsar, and other binary pulsar systems have yielded other tests, especially of strong-field effects. When direct observation of gravitational radiation from astrophysical sources begins, new tests of general relativity will be possible.

Towards the five-loop beta function for a general gauge group

International Nuclear Information System (INIS)

Luthe, Thomas; Schroeder, York

2016-06-01

We present analytical results for the N"4_f and N"3_f terms of the five-loop beta function, for a general gauge group. While the former term agrees with results available from large-N_f studies, the latter is new and extends the value known for SU(3) from an independent calculation.

Field reliability of competence to stand trial opinions: How often do evaluators agree, and what do judges decide when evaluators disagree?

Science.gov (United States)

Gowensmith, W Neil; Murrie, Daniel C; Boccaccini, Marcus T

2012-04-01

Despite many studies that examine the reliability of competence to stand trial (CST) evaluations, few shed light on "field reliability," or agreement among forensic evaluators in routine practice. We reviewed 216 cases from Hawaii, which requires three separate evaluations from independent clinicians for each felony defendant referred for CST evaluation. Results revealed moderate agreement. In 71% of initial CST evaluations, all evaluators agreed about a defendant's competence or incompetence (kappa = .65). Agreement was somewhat lower (61%, kappa = .57) in re-evaluations of defendants who were originally found incompetent and sent for restoration services. We also examined the decisions judges made about a defendant's CST. When evaluators disagreed, judges tended to make decisions consistent with the majority opinion. But when judges disagreed with the majority opinion, they more often did so to find a defendant incompetent than competent, suggesting a generally conservative approach. Overall, results reveal moderate agreement among independent evaluators in routine practice. But we discuss the potential for standardized training and methodology to further improve the field reliability of CST evaluations.

Do primary care professionals agree about progress with implementation of primary care teams: results from a cross sectional study.

Science.gov (United States)

Tierney, E; O'Sullivan, M; Hickey, L; Hannigan, A; May, C; Cullen, W; Kennedy, N; Kineen, L; MacFarlane, A

2016-11-22

Primary care is the cornerstone of healthcare reform with policies across jurisdictions promoting interdisciplinary team working. The effective implementation of such health policies requires understanding the perspectives of all actors. However, there is a lack of research about health professionals' views of this process. This study compares Primary Healthcare Professionals' perceptions of the effectiveness of the Primary Care Strategy and Primary Care Team (PCT) implementation in Ireland. Design and Setting: e-survey of (1) General Practitioners (GPs) associated with a Graduate Medical School (N = 100) and (2) Primary Care Professionals in 3 of 4 Health Service Executive (HSE) regions (N = 2309). After piloting, snowball sampling was used to administer the survey. Descriptive analysis was carried out using SPSS. Ratings across groups were compared using non-parametric tests. There were 569 responses. Response rates varied across disciplines (71 % for GPs, 22 % for other Primary Healthcare Professionals (PCPs). Respondents across all disciplines viewed interdisciplinary working as important. Respondents agreed on lack of progress of implementation of formal PCTs (median rating of 2, where 1 is no progress at all and 5 is complete implementation). GPs were more negative about the effectiveness of the Strategy to promote different disciplines to work together (median rating of 2 compared to 3 for clinical therapists and 3.5 for nurses, P = 0.001). Respondents identified resources and GP participation as most important for effective team working. Protected time for meetings and capacity to manage workload for meetings were rated as very important factors for effective team working by GPs, clinical therapists and nurses. A building for co-location of teams was rated as an important factor by nurses and clinical therapists though GPs rated it as less important. Payment to attend meetings and contractual arrangements were considered important factors by

Hospital emergency preparedness and response during Superstorm Sandy.

Science.gov (United States)

2015-01-01

This article presents the findings of a report by the HHS Office of Inspector General (OIG) on the performance of 172 Medicare-certified hospitals in the New York Metropolitan Area before, during, and after Sandy. It makes recommendations on how to close gaps that were found in emergency planning and execution for a disaster of this magnitude. To download the complete 40-page report and a Podcast based on it, go to http://oig.hhs.gov/oei/ reports/oei-06-13-00260. asp.

Using science centers to expose the general public to the microworld

Energy Technology Data Exchange (ETDEWEB)

Malamud, E. [Fermi National Accelerator Lab., Batavia, IL (United States)]|[Science and Technology Interactive Center, Aurora, IL (United States)

1994-08-01

Despite the remarkable progress in the past decades in understanding our Universe, we particle physicists have failed to communicate the wonder, excitement, and beauty of these discoveries to the general public. I am sure all agree there is a need, if our support from public funds is to continue at anywhere approximating the present level, for us collectively to educate and inform the general public of what we are doing and why. Informal science education and especially science and technology centers can play an important role in efforts to raise public awareness of particle physics in particular and of basic research in general. Science Centers are a natural avenue for particle physicists to use to communicate with and gain support from the general public.

Using science centers to expose the general public to the microworld

International Nuclear Information System (INIS)

Malamud, E.

1994-08-01

Despite the remarkable progress in the past decades in understanding our Universe, we particle physicists have failed to communicate the wonder, excitement, and beauty of these discoveries to the general public. I am sure all agree there is a need, if our support from public funds is to continue at anywhere approximating the present level, for us collectively to educate and inform the general public of what we are doing and why. Informal science education and especially science and technology centers can play an important role in efforts to raise public awareness of particle physics in particular and of basic research in general. Science Centers are a natural avenue for particle physicists to use to communicate with and gain support from the general public

Effect of Health Literacy on Help-seeking Behavior in Morbidly Obese Patients Agreeing to Bariatric Surgery.

Science.gov (United States)

Cayci, Haci Murat; Erdogdu, Umut Eren; Demirci, Hakan; Ardic, Aykut; Topak, Nevruz Yildirim; Taymur, İbrahim

2018-03-01

We aimed to evaluate the effect of health literacy on agreement for bariatric surgery among morbidly obese patients. The data of 242 morbidly obese patients (body mass index-BMI ≥ 40 kg/m 2 ) were evaluated in a cross-sectional case-control pattern. The patients were classified into two groups as those who were attending the clinic for the purpose of receiving bariatric surgery (n = 138) and those who did not (n = 104). The Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47), consisting of 47 questions, was used for the health literacy evaluation. It was seen that patients who accepted bariatric surgery were younger and had higher weight and BMI values (p bariatric surgery and 26.04 (8.33:46.88) in the group who did not agree to bariatric surgery, and a statistically significant difference was determined between the two groups (p bariatric surgery and 45.2% of the group who did not (p  25-33) (respectively, 36.2%, 37.5%, p = 0.840). A sufficient level (> 33-42) and a perfect level were higher in the group who agreed to bariatric surgery (respectively, 42.8%, 18.1%, p bariatric surgery in morbidly obese patients. The higher the health literacy level, the more the agreement to bariatric surgery increased.

Electromagnetic axial anomaly in a generalized linear sigma model

Science.gov (United States)

Fariborz, Amir H.; Jora, Renata

2017-06-01

We construct the electromagnetic anomaly effective term for a generalized linear sigma model with two chiral nonets, one with a quark-antiquark structure, the other one with a four-quark content. We compute in the leading order of this framework the decays into two photons of six pseudoscalars: π0(137 ), π0(1300 ), η (547 ), η (958 ), η (1295 ) and η (1760 ). Our results agree well with the available experimental data.

The Confrontation between General Relativity and Experiment

Directory of Open Access Journals (Sweden)

Clifford M. Will

2014-06-01

Full Text Available The status of experimental tests of general relativity and of theoretical frameworks for analyzing them is reviewed and updated. Einstein’s equivalence principle (EEP is well supported by experiments such as the Eötvös experiment, tests of local Lorentz invariance and clock experiments. Ongoing tests of EEP and of the inverse square law are searching for new interactions arising from unification or quantum gravity. Tests of general relativity at the post-Newtonian level have reached high precision, including the light deflection, the Shapiro time delay, the perihelion advance of Mercury, the Nordtvedt effect in lunar motion, and frame-dragging. Gravitational wave damping has been detected in an amount that agrees with general relativity to better than half a percent using the Hulse–Taylor binary pulsar, and a growing family of other binary pulsar systems is yielding new tests, especially of strong-field effects. Current and future tests of relativity will center on strong gravity and gravitational waves.

The Confrontation between General Relativity and Experiment.

Science.gov (United States)

Will, Clifford M

2014-01-01

The status of experimental tests of general relativity and of theoretical frameworks for analyzing them is reviewed and updated. Einstein's equivalence principle (EEP) is well supported by experiments such as the Eötvös experiment, tests of local Lorentz invariance and clock experiments. Ongoing tests of EEP and of the inverse square law are searching for new interactions arising from unification or quantum gravity. Tests of general relativity at the post-Newtonian level have reached high precision, including the light deflection, the Shapiro time delay, the perihelion advance of Mercury, the Nordtvedt effect in lunar motion, and frame-dragging. Gravitational wave damping has been detected in an amount that agrees with general relativity to better than half a percent using the Hulse-Taylor binary pulsar, and a growing family of other binary pulsar systems is yielding new tests, especially of strong-field effects. Current and future tests of relativity will center on strong gravity and gravitational waves.

Views of the Scottish general public on community pharmacy weight management services: international implications.

Science.gov (United States)

Weidmann, Anita Elaine; Cunningham, Scott; Gray, Gwen; Hansford, Denise; Bermano, Giovanna; Stewart, Derek

2012-04-01

Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of community pharmacy services in other parts of the UK and internationally. To describe the views of the Scottish general public on the provision of weight management services via community pharmacies. General public in Scotland. A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Views on community pharmacy led weight management services. Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through community pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists' specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Overall, respondents appear to be receptive to the idea of accessing weight management services through community pharmacy but a perceived lack of privacy, poor knowledge of pharmacists' skill level and of public health services available to

Irish general practitioner attitudes toward decriminalisation and medical use of cannabis: results from a national survey.

Science.gov (United States)

Crowley, Des; Collins, Claire; Delargy, Ide; Laird, Eamon; Van Hout, Marie Claire

2017-01-13

Governmental debate in Ireland on the de facto decriminalisation of cannabis and legalisation for medical use is ongoing. A cannabis-based medicinal product (Sativex®) has recently been granted market authorisation in Ireland. This unique study aimed to investigate Irish general practitioner (GP) attitudes toward decriminalisation of cannabis and assess levels of support for use of cannabis for therapeutic purposes (CTP). General practitioners in the Irish College of General Practitioner (ICGP) database were invited to complete an online survey. Anonymous data yielded descriptive statistics (frequencies, percentages) to summarise participant demographic information and agreement with attitudinal statements. Chi-square tests and multi-nominal logistic regression were included. The response rate was 15% (n = 565) which is similar to other Irish national GP attitudinal surveys. Over half of Irish GPs did not support the decriminalisation of cannabis (56.8%). In terms of gender, a significantly higher proportion of males compared with females (40.6 vs. 15%; p cannabis should be decriminalised (54.1 vs. 31.5%; p = 0.021). Over 80% of both genders supported the view that cannabis use has a significant effect on patients' mental health and increases the risk of schizophrenia (77.3%). Over half of Irish GPs supported the legalisation of cannabis for medical use (58.6%). A higher percentage of those who were level 1-trained (trained in addiction treatment but not to an advanced level) agreed/strongly agreed cannabis should be legalised for medical use (p = 0.003). Over 60% agreed that cannabis can have a role in palliative care, pain management and treatment of multiple sclerosis (MS). In the regression response predicator analysis, females were 66.2% less likely to agree that cannabis should be decriminalised, 42.5% less likely to agree that cannabis should be legalised for medical use and 59.8 and 37.6% less likely to agree that cannabis has a role in

Agreed framework of 21 October 1994 between the United States of America and the Democratic People's Republic of Korea

International Nuclear Information System (INIS)

1994-01-01

The attached text of the Agreed Framework between the United States of America and the Democratic People's Republic of Korea, signed in Geneva on 21 October 1994, is being circulated to all Member States of the Agency at the request of the Resident Representative of the United States of America

Generalized perturbation theory using two-dimensional, discrete ordinates transport theory

International Nuclear Information System (INIS)

Childs, R.L.

1979-01-01

Perturbation theory for changes in linear and bilinear functionals of the forward and adjoint fluxes in a critical reactor has been implemented using two-dimensional discrete ordinates transport theory. The computer program DOT IV was modified to calculate the generalized functions Λ and Λ*. Demonstration calculations were performed for changes in a reaction-rate ratio and a reactivity worth caused by system perturbations. The perturbation theory predictions agreed with direct calculations to within about 2%. A method has been developed for calculating higher lambda eigenvalues and eigenfunctions using techniques similar to those developed for generalized functions. Demonstration calculations have been performed to obtain these eigenfunctions

What About Their Performance Do Free Jazz Improvisers Agree Upon? A Case Study

Directory of Open Access Journals (Sweden)

Amandine Pras

2017-06-01

. But these kinds of statements were polarizing; the performers were more likely to agree with each other in their ratings of statements about the music itself and negative statements. As in Schober and Spiro (2014, the evidence supports a view that fully shared understanding is not needed for joint improvisation by professional musicians in this genre and that performing partners can agree with an outside listener more than with each other.

What About Their Performance Do Free Jazz Improvisers Agree Upon? A Case Study.

Science.gov (United States)

Pras, Amandine; Schober, Michael F; Spiro, Neta

2017-01-01

were polarizing; the performers were more likely to agree with each other in their ratings of statements about the music itself and negative statements. As in Schober and Spiro (2014), the evidence supports a view that fully shared understanding is not needed for joint improvisation by professional musicians in this genre and that performing partners can agree with an outside listener more than with each other.

[Clinical Practice Guidelines for Management of Schizophrenia: Evaluation Using AGREE II].

Science.gov (United States)

de la Hoz Bradford, Ana María; Ávila, Mauricio J; Bohórquez Peñaranda, Adriana Patricia; García Valencia, Jenny; Arenas Borrero, Álvaro Enrique; Vélez Traslaviña, Ángela; Jaramillo González, Luis Eduardo; Gómez-Restrepo, Carlos

2014-01-01

Colombia is developing multiple national practice guidelines from a range of diseases. Clinical practice guidelines represent a very useful tool to be able to take decision over a patient care that is widely available for the clinician. In psychiatry there are a good number of international clinical guidelines for the treatment of schizophrenia nevertheless there is no article that evaluate them scientifically In the settings of developing a Colombian schizophrenia practice guideline, a systematic search was performed in multiple databases and the results were then evaluated by two trained persons. We present the results globally and by domains. We found 164 matches for possible guidelines. After screening 7 guidelines were evaluated with the AGREE II instrument. Globally and by the different domains, the National Institute for Health and Care Excellence (NICE) was the guideline that got the best score. From the guidelines that were reviewed, 4 were from Europe and only 2 were from Latin America. None of the guidelines used GRADE methodology for the recommendations. The diversity of the schizophrenia treatment guidelines does not allow an easy adoption of the recommendation by a psychiatrist in Colombia. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Comparison of Einstein-Boltzmann solvers for testing general relativity

Science.gov (United States)

Bellini, E.; Barreira, A.; Frusciante, N.; Hu, B.; Peirone, S.; Raveri, M.; Zumalacárregui, M.; Avilez-Lopez, A.; Ballardini, M.; Battye, R. A.; Bolliet, B.; Calabrese, E.; Dirian, Y.; Ferreira, P. G.; Finelli, F.; Huang, Z.; Ivanov, M. M.; Lesgourgues, J.; Li, B.; Lima, N. A.; Pace, F.; Paoletti, D.; Sawicki, I.; Silvestri, A.; Skordis, C.; Umiltà, C.; Vernizzi, F.

2018-01-01

We compare Einstein-Boltzmann solvers that include modifications to general relativity and find that, for a wide range of models and parameters, they agree to a high level of precision. We look at three general purpose codes that primarily model general scalar-tensor theories, three codes that model Jordan-Brans-Dicke (JBD) gravity, a code that models f (R ) gravity, a code that models covariant Galileons, a code that models Hořava-Lifschitz gravity, and two codes that model nonlocal models of gravity. Comparing predictions of the angular power spectrum of the cosmic microwave background and the power spectrum of dark matter for a suite of different models, we find agreement at the subpercent level. This means that this suite of Einstein-Boltzmann solvers is now sufficiently accurate for precision constraints on cosmological and gravitational parameters.

Quality assessment of recent evidence-based clinical practice guidelines for management of type 2 diabetes mellitus in adults using the AGREE II instrument.

Science.gov (United States)

Anwer, Muhammad A; Al-Fahed, Ousama B; Arif, Samir I; Amer, Yasser S; Titi, Maher A; Al-Rukban, Mohammed O

2018-02-01

Type 2 diabetes mellitus (T2DM) is a worldwide and national public health problem that has a great impact on the population in Saudi Arabia. High-quality clinical practice guidelines (CPGs) are cornerstones in improving the health care provided for patients with diabetes. This study evaluated the methodological rigour, transparency, and applicability of recently published CPGs. Our group conducted a systematic search for recently published CPGs for T2DM. The searching and screening for Source CPGs were guided by tools from the ADAPTE methods with specific inclusion/exclusion criteria. Five reviewers using the second version of the Appraisal of Guidelines for Research and Evaluation (AGREE II) Instrument independently assessed the quality of the retrieved Source CPGs. Domains of Scope and purpose and Clarity of presentation received the highest scores in all CPGs. Most of the assessed CPGs (86%) were considered with high overall quality and were recommended for use. Rigour of development and applicability domains were together highest in 3 CPGs (43%). The overall high quality of DM CPGs published in the last 3 years demonstrated the continuous development and improvement in CPG methodologies and standards. Health care professionals should consider the quality of any CPG for T2DM before deciding to use it in their daily clinical practice. Three CPGs have been identified, using the AGREE criteria, as high-quality and trustworthy. Ideally, the resources provided by the AGREE trust including the AGREE II Instrument should be used by a clinician to scan through the large number of published T2DM CPGs to identify the CPGs with high methodological quality and applicability. © 2017 John Wiley & Sons, Ltd.

Bimetric general relativity and cosmology

International Nuclear Information System (INIS)

Rosen, N.

1980-01-01

A modification of the general relativity theory is proposed (bimetric general relativity) in which, in addition to the usual metric tensor gsub(μupsilon) describing the space-time geometry and gravitation, there exists also a background metric tensor γsub(μupsilon). The latter describes the space-time of the universe if no matter were present and is taken to correspond to a space-time of constant curvature with positive spatial curvature (k = 1). Field equations are obtained, and these agree with the Einstein equations for systems that are small compared to the size of the universe, such as the solar system. Energy considerations lead to a generalized form of the De Donder condition. Simple isotropic closed models of the universe can be set up which first contract and then expand without going through a singular state. It is suggested that the maximum density of the universe was of the order of c 5 -h -1 G -2 approximately 10 93 g/cm 3 . The expansion from such a high-density state is similar to that from the singular state ('big bang') of the general relativity models. In the case of the dust-filled model the parameters can be fitted to present cosmological data. Using the radiation-filled model to describe the early history of the universe, the cosmic abundance of helium and other light elements can be accounted for in the same way as in ordinary general relativity. (author)

Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey.

Science.gov (United States)

Sudarshan, Monisha; Hanna, Wael C; Jamal, Mohammed H; Nguyen, Lily H P; Fraser, Shannon A

2012-02-01

The purpose of this study was to describe Canadian general surgery residents' perceptions regarding potential implementation of work-hour restrictions. An ethics review board-approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents' responses. Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75-100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p seniors and juniors thought limiting their work hours would improve their lifestyle (86% v. 96%, p = 0.12). Overall, 60% of residents did not believe limiting work hours would extend the length of their training. Regarding 24-hour call, 60% of juniors thought it was hazardous to their health; 30% of seniors agreed (p = 0.001). Both senior and junior residents thought abolishing 24-hour call would decrease their operative exposure (84% v. 70%, p = 0.21). Overall, 31% of residents supported abolishing 24-hour call. About 47% of residents (41% seniors, 51%juniors, p = 0.26) agreed with the adoption of the 80-hour work week. There is a training-level based dichotomy of opinion among general surgery residents in Canada regarding the perceived effects of work hour restrictions. Both groups have voted against abolishing 24-hour call, and neither group strongly supports the implementation of the 80-hour work week.

Autoionizing states of atoms calculated using generalized sturmians

DEFF Research Database (Denmark)

Avery, James Emil; Avery, John Scales

2005-01-01

The generalized Sturmian method is applied to autoionizing states of atoms and ions. If the Goscinskian basis sets allow for a sufficient amount of angular correletion, the calculated energies of doubly-excited (autoionizing) states are found to agree well with the few available experimental...... energies. A large-Z approximation is discussed, and simple formulas are derived which are valid not only for autoionizing states, but for all states of an isoelectronic atomic series. Diagonalization of a small block of the interelectron repulsion matrix yields roots that can be used for a wide range of Z...

Medicare and You

Science.gov (United States)

... If you have general comments about this handbook, email us at medicareandyou@ cms. hhs. gov . We can’t respond to every comment, but we’ll consider your feedback when writing future handbooks.

45 CFR 73.735-101 - Purpose.

Science.gov (United States)

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION STANDARDS OF CONDUCT General Provisions § 73.735-101 Purpose. To assure that the business of the Department of Health and Human Services... responsibilities. In accord with these principles, the regulations in this part are issued to inform HHS employees...

Generalization of free-operant avoidance behavior in pigeons1

Science.gov (United States)

Klein, Marty; Rilling, Mark

1974-01-01

Three groups of four pigeons, trained to press a treadle on a free-operant avoidance schedule, were given auditory discrimination training. Alternating 2-min components of avoidance and no shock were paired with either a tone or white noise. The pigeons were subsequently given two types of generalization tests, with and without avoidable shocks scheduled. Two of the groups, trained interdimensionally, produced excitatory and inhibitory generalization gradients along the tone frequency dimension. A predicted post-discrimination gradient was computed from the algebraic summation of these gradients of excitation and inhibition. The predicted gradient was compared with the actual post-discrimination gradient obtained from the third group of pigeons that had been given intradimensional discrimination training on the tone frequency dimension. The predicted postdiscrimination gradient agreed in shape with the empirical postdiscrimination gradient. The results in general support Spence's (1937) gradient interaction theory. PMID:16811735

31 CFR 19.645 - Do other Federal agencies know if the Department of the Treasury agrees to a voluntary exclusion?

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Do other Federal agencies know if the Department of the Treasury agrees to a voluntary exclusion? 19.645 Section 19.645 Money and Finance: Treasury... Principles Relating to Suspension and Debarment Actions § 19.645 Do other Federal agencies know if the...

Gravitational redshift of galaxies in clusters as predicted by general relativity.

Science.gov (United States)

Wojtak, Radosław; Hansen, Steen H; Hjorth, Jens

2011-09-28

The theoretical framework of cosmology is mainly defined by gravity, of which general relativity is the current model. Recent tests of general relativity within the Lambda Cold Dark Matter (ΛCDM) model have found a concordance between predictions and the observations of the growth rate and clustering of the cosmic web. General relativity has not hitherto been tested on cosmological scales independently of the assumptions of the ΛCDM model. Here we report an observation of the gravitational redshift of light coming from galaxies in clusters at the 99 per cent confidence level, based on archival data. Our measurement agrees with the predictions of general relativity and its modification created to explain cosmic acceleration without the need for dark energy (the f(R) theory), but is inconsistent with alternative models designed to avoid the presence of dark matter. © 2011 Macmillan Publishers Limited. All rights reserved

Critical Appraisal of International Clinical Practice Guidelines in Kidney Transplantation Using the Appraisal of Guidelines for Research and Education (AGREE) II Tool: A Systematic Review.

Science.gov (United States)

OʼDonoghue, Katriona Jane Marie; Reed, Rhiannon D; Knight, Simon R; O'Callaghan, John M; Ayaz-Shah, Anam A; Hassan, Sevda; Weissenbacher, Annemarie; Morris, Peter J; Pengel, Liset H M

2018-05-22

Whilst Clinical Practice Guidelines (CPGs) are used for the development of local protocols in kidney transplantation (Ktx), the quality of their methodology is variable. This systematic review aimed to critically appraise international CPGs in all aspects of Ktx using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. CPGs in Ktx and donation published between 2010 and 2017 were identified from MEDLINE, Embase, National Guideline Clearinghouse, NHS and NICE Evidence Searches, and the websites of transplant societies. Using AGREE II, 3 appraisers assessed the quality of CPGs. Interrater reliability was measured using the intraclass correlation coefficient (ICC). Searches identified 3,168 records and 115 CPGs were included. The highest scoring AGREE II domain was 'Scope and Purpose' (80%; Range 30-100%), followed by 'Clarity of Presentation' (77%; Range 43-98%), 'Editorial independence' (52%; Range 0-94%), 'Rigour of Development' (47%; Range 6-97%) and 'Stakeholder Involvement' (41%; Range 11-85%). The poorest scoring domain was 'Applicability' (31%; Range 3-74%). Most CPGs were recommended for future use either with (63%) or without modifications (18%). A small number were not recommended for future use (14%) or reviewers did not agree on recommending the CPG (5%). The overall mean CPG quality score was 4 out of 7 (Range 2-7). The mean ICC of 0.74 indicated substantial agreement between reviewers. The quality of international CPGs in Ktx was variable, and most CPGs lacked key aspects of methodological robustness and transparency. Improvements in methodology, patient involvement and strategies for implementation are required.

Almost half of the Danish general practitioners have negative a priori attitudes towards a mandatory accreditation programme

DEFF Research Database (Denmark)

Waldorff, Frans Boch; Nicolaisdottir, Dagny Ros; Kousgaard, Marius Brostrøm

2016-01-01

: A total of 1,906 (56%) GPs completed the questionnaire. In all, 861 (45%) had a negative attitude towards accreditation, whereas 429 (21%) were very positive or posi-tive. The negative attitudes towards accreditation were associated with being older, male and with working in a singlehanded practice.......018 (95% CI: 0.013-0.025)), more likely to agree that it would affect job satisfaction negatively (OR = 21.88 (95% CI: 16.10-29.72)), and they were generally less satisfied with their present job situation (OR = 2.51 (95% CI: 1.85-3.41)). CONCLUSION: Almost half of the GPs had negative attitudes towards....... A regional difference was observed as well. GPs with negative expectations were more likely to agree that accreditation was a tool meant for external control (odds ratio (OR) = 1.87 (95% confidence interval (CI): 1.18-2.95)), less likely to agree that accreditation was a tool for quality improvement (OR = 0...

Agreement on Access and Benefit-sharing for Academic Research: A toolbox for drafting Mutually Agreed Terms for access to Genetic Resources and to Associated Traditional Knowledge and Benefit-sharing

OpenAIRE

Biber-Klemm, Susette; Martinez, Sylvia I.; Jacob, Anne; Jevtic, Ana

2016-01-01

This manual contains a set of model clauses that enables users and providers of genetic resources and associated traditional knowledge to set up a legal contract that is adapted to the individual academic research situation. If mutually negotiated and agreed upon by the involved partners this agreement can yield a “Mutually Agreed Terms” ABS contract.

How to get residents/owners in housing cooperatives to agree on sustainable renovation

Energy Technology Data Exchange (ETDEWEB)

Lappegard Hauge, A. [SINTEF Building and Infrastructure, P.O. Box 124, Blindern, 0314 Oslo (Norway); Thomsen, J. [SINTEF Building and Infrastructure, 7465 Trondheim (Norway); Loefstroem, E. [SINTEF Building and Infrastructure, 7491 Trondheim (Norway)

2013-05-15

What factors increase the chance that residents/owners in housing cooperatives agree on sustainable energy efficient renovation? Based on 30 qualitative interviews with professional advisors in cooperative housing associations and chairman/board and residents in three chosen case studies, an analysis of opportunities and barriers for making a common decision on renovation is performed. Success criteria and barriers are found on the societal level as well as on the organizational/individual level. The barriers and success criteria identified on the societal level are: knowledge level on energy-efficient renovation among relevant actors, owner structure of the housing cooperative, and existing regulations and incentives. On the organizational and individual level, the following categories influencing renovation processes were identified: the time frame and organization of the process, understanding the residents' needs, economy, the information given, and the existence of available exemplary projects and role models. Based on the results of the study, ten guidelines that contribute to more successful decision making processes and increase the chances of sustainable energy efficient renovation in housing cooperatives are presented.

General Practitioner's Attitudes and Confidence in Managing Patients with Dementia in Singapore.

Science.gov (United States)

Subramaniam, Mythily; Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Shafie, Saleha; Siva Kumar, Fiona Devi; Foo, Sophia; Ng, Li Ling; Lum, Alvin; Vaingankar, Janhavi A; Chong, Siow Ann

2018-03-01

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.

Fronts between hexagons and squares in a generalized Swift-Hohenberg equation

DEFF Research Database (Denmark)

Kubstrup, Christian; Herrero, H.; Pérez-García, C.

1996-01-01

Pinning effects in domain walls separating different orientations in patterns in nonequilibrium systems, are studied. Usually; theoretical studies consider perfect structures, but in experiments, point defects, grain boundaries, etc., always appear. The aim of this paper is to perform an analysis...... of the stability of fronts between hexagons and squares in a generalized Swift-Hohenberg model equation. We focus the analysis on pinned fronts between domains with different symmetries by using amplitude equations and by considering the small-scale structure in the pattern. The conditions for pinning effects...... and stable fronts are determined. This study is completed with direct simulations of the generalized Swift-Hohenberg equation. The results agree qualitatively with recent observations in convection and in ferrofluid instabilities....

75 FR 5335 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-02-02

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... previously issued communications, emphasizing communications challenges. Examples, selected for illustrative...

Proposals for future activities agreed upon at the seminar on wastewater treatment in urban areas

International Nuclear Information System (INIS)

1987-01-01

The programme of the seminar was divided into three different sections: - Sewerage systems, - Discharge of industrial wastewater to municipal sewerage systems, - Reduction of nitrogen. For each subject the participants of the seminar agreed upon the following proposal for future activities: Sewerage systems: a) Combined sewer overflows (CSO). Brief state-of-the-art reports should be compiled by the Contracting Parties. The reports should provide information on: - extent of combined sewers (in % of sewered area), - design practices including flow equalization, - rates of inflow/infiltration, - pollution due to CSO, - current research, - trends. A compilation of these reports may hopefully lead to the derivation of suitable effluent standards, which may be expressed as frequencies, total volumes or total amount of pollution load. The effluent standards may be expressed as monthly to yearly values

Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia.

Science.gov (United States)

Hassali, Mohamed Azmi Ahmad; Al-Haddad, Mahmoud; Shafie, Asrul Akmal; Tangiisuran, Balamurugan; Saleem, Fahad; Atif, Muhammad; Al-Qazaz, Harith

2012-06-01

This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia. A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry. A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers. General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.

Enhancement of high-order harmonics in a plasma waveguide formed in clustered Ar gas.

Science.gov (United States)

Geng, Xiaotao; Zhong, Shiyang; Chen, Guanglong; Ling, Weijun; He, Xinkui; Wei, Zhiyi; Kim, Dong Eon

2018-02-05

Generation of high-order harmonics (HHs) is intensified by using a plasma waveguide created by a laser in a clustered gas jet. The formation of a plasma waveguide and the guiding of a laser beam are also demonstrated. Compared to the case without a waveguide, harmonics were strengthened up to nine times, and blue-shifted. Numerical simulation by solving the time-dependent Schrödinger equation in strong field approximation agreed well with experimental results. This result reveals that the strengthening is the result of improved phase matching and that the blue shift is a result of change in fundamental laser frequency due to self-phase modulation (SPM).

Patients and physicians agree only partially in symptoms and clinical findings before and after treatment for varicose veins

DEFF Research Database (Denmark)

Klitfod, Lotte; Sillesen, Henrik; Jensen, Leif Panduro

2018-01-01

findings. Methods In the period January-March 2011, 379 legs in 287 patients treated for varicose veins were registered in the Danish Clinical Vein Database and compared to the Aberdeen Varicose Vein Questionnaire. Results Patients and physicians agreed in reduction of symptoms after intervention with one...... or more complaints still present in 128 (93%) patients according to Aberdeen Varicose Vein Questionnaire compared to the Danish Clinical Vein Database with only 64 (47%) patients. Patients reported cosmetic complaints and teleangiectasies both before and after treatment (p 

International Atomic Energy Agency thirty-third general conference

International Nuclear Information System (INIS)

Anon.

1989-01-01

A brief account is given of the 33rd session of IAEA General Conference held in Vienna from 25 to 29 September 1989. The Minister for Primary Industry and Energy, Mr John Kerin, led the Australian delegation. His statement to the General Conference highlighted Australia's role as a major uranium exporter, its committment to the Non-Proliferation of Nuclear Weapon Treaty and support for the role which the Agency plays in it. The major Australian policy initiatives in environmental areas were also outlined. Australia continues to make a substantial extra-budgetary contribution to the Regional Cooperation Agreement for Asia and Pacific (RCA), and it has recently expanded its committment by agreeing to support a series of new RCA projects. In this context, the role played by the Australian Nuclear Science and Technology Organization for the provision of technical assistance and cooperation in many areas of the Agency's activities is discussed. ills

76 FR 58519 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-09-21

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... discuss implications, for strategic communication, of recent theoretical developments on information use...

75 FR 32472 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

Science.gov (United States)

2010-06-08

... Coordinator for Health Information Technology AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of committee recommendations and invitation for public input... Coordinator for Health Information Technology (ONC). Name of Committee: HIT Standards Committee. General...

Electrocardiogram interpretation in general practice: relevance to prehospital thrombolysis.

Science.gov (United States)

McCrea, W A; Saltissi, S

1993-01-01

OBJECTIVE--To assess, in the context of their possible role in prehospital thrombolysis, the ability of general practitioners to recognise acute transmural myocardial ischaemia/infarction on an electrocardiogram. DESIGN--150 doctors (every fifth name) were selected from the alphabetical list of 750 on Merseyside general practitioner register and without prior warning were asked to interpret a series of six 12 lead electrocardiograms. Three of these showed acute transmural ischaemia/infarction, one was normal, and two showed non-acute abnormalities. Details of doctors' ages, postgraduate training, and clinical practice were sought. SETTING--General practitioners' surgeries and postgraduate centres within the Merseyside area. PARTICIPANTS--106 general practitioners (mean age 45 years) agreed to participate. MAIN OUTCOME MEASURE--Accuracy of general practitioners' interpretations of the six electrocardiograms. RESULTS--82% of general practitioners correctly recognised a normal electrocardiogram. Recognition of acute abnormalities was less reliable. Between 33% and 61% correctly identified acute transmural ischaemia/infarction depending on the specific trace presented. Accurate localisation of the site of the infarct was achieved only by between 8% and 30% of participants, while between 22% and 25% correctly interpreted non-acute abnormalities. Neither routine use of electrocardiography nor postgraduate hospital experience in general medicine was associated with significantly greater expertise. CONCLUSION--The current level of proficiency of a sample of general practitioners in the Merseyside area in recognising acute transmural ischaemia/infarction on an electrocardiogram suggests that refresher training is needed if general practitioners are to give prehospital thrombolysis. Images PMID:8398491

Child overweight in general practice - parents' beliefs and expectations - a questionnaire survey study.

Science.gov (United States)

Andersen, Merethe K; Christensen, Bo; Søndergaard, Jens

2013-10-11

Care for overweight children in general practice involves collaboration with parents. Acknowledging the parents' frames of references is a prerequisite for successful management. We therefore aimed to analyse parental beliefs about the presumed causes and consequences of overweight in children and expectations towards the GP. Moreover, we aimed at comparing the beliefs and expectations of parents of non-overweight children (NOWC) and parents of overweight children (OWC). A cross-sectional survey. Data were obtained from a questionnaire exploring parents' beliefs and expectations regarding overweight in children. The questionnaires were completed by parents following their child's participation in the five-year preventive child health examination (PCHE).Parental agreement upon statements concerning beliefs and expectations regarding overweight in children was measured on a Likert scale. Differences in levels of agreement between parents of non-overweight children and parents of overweight children were analysed using Chi-squared test and Fisher's exact test. Parents of 879 children completed and returned questionnaires. Around three fourths of the parents agreed that overweight was a health problem. A majority of parents (93%) agreed that the GP should call attention to overweight in children and offer counselling on diet and exercise. Almost half of the parents expected a follow-up programme. Parents of overweight children seemed to agree less upon some of the proposed causes of overweight, e.g. inappropriate diet and lack of exercise. These parents also had stronger beliefs about overweight disappearing by itself as the child grows up. According to parental beliefs and expectations, general practice should have an important role to play in the management of child overweight. Moreover, our findings suggest that GPs should be aware of the particular beliefs that parents of overweight children may have regarding causes of overweight in their child.

77 FR 70450 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-11-26

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... 1. Contact Person: Lee L. Zwanziger, Risk Communication Staff, Food and Drug Administration, 10903...

75 FR 57279 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-09-20

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... Committee will hear and discuss developments in FDA's ongoing communications programs, such as FDA's...

77 FR 62242 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-10-12

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... Person: Lee L. Zwanziger, Risk Communication Staff, Office of Planning, Food and Drug Administration...

76 FR 44017 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-07-22

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... and former members of the Risk Communication Advisory Committee. FDA intends to make background...

75 FR 70933 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-11-19

...] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... of Committee: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committees... appropriate clinical study design for thromboxane receptor antagonists for prevention of cardiovascular events...

45 CFR 46.111 - Criteria for IRB approval of research.

Science.gov (United States)

2010-10-01

... Section 46.111 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.111 Criteria for IRB... protect the rights and welfare of these subjects. ...

75 FR 33818 - Nationwide Limited Public Interest Waiver of Section 1605 (Buy American Requirement) of American...

Science.gov (United States)

2010-06-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Nationwide Limited Public Interest... Funds Provided Under ARRA AGENCY: Indian Health Service, HHS. ACTION: Notice. SUMMARY: The Indian Health... generally familiar with the conditions of availability, the potential alternatives for each detailed...

General PFG signal attenuation expressions for anisotropic anomalous diffusion by modified-Bloch equations

Science.gov (United States)

Lin, Guoxing

2018-05-01

Anomalous diffusion exists widely in polymer and biological systems. Pulsed-field gradient (PFG) anomalous diffusion is complicated, especially in the anisotropic case where limited research has been reported. A general PFG signal attenuation expression, including the finite gradient pulse (FGPW) effect for free general anisotropic fractional diffusion { 0 integral modified-Bloch equation, were extended to obtain general PFG signal attenuation expressions for anisotropic anomalous diffusion. Various cases of PFG anisotropic anomalous diffusion were investigated, including coupled and uncoupled anisotropic anomalous diffusion. The continuous-time random walk (CTRW) simulation was also carried out to support the theoretical results. The theory and the CTRW simulation agree with each other. The obtained signal attenuation expressions and the three-dimensional fractional modified-Bloch equations are important for analyzing PFG anisotropic anomalous diffusion in NMR and MRI.

Guide for preparing annual reports on radiation-safety testing of electronic products (general)

International Nuclear Information System (INIS)

1987-10-01

For manufacturers of electronic products other than those for which a specific guide has been issued, the guide replaces the Guide for the Filing of Annual Reports (21 CFR Subchapter J, Section 1002.11), HHS Publication FDA 82-8127. The electronic product (general) annual reporting guide is applicable to the following products: products intended to produce x radiation (accelerators, analytical devices, therapy x-ray machines); microwave diathermy machines; cold-cathode discharge tubes; and vacuum switches and tubes operating at or above 15,000 volts. To carry out its responsibilities under Public Law 90-602, the Food and Drug Administration's Center for Devices and Radiological Health (CDRH) has issued a series of regulations contained in Title 21 of the Code of Federal Regulations (CFR). Part 1002 of 21 CFR deals with records and reports. Section 1002.61 categorizes electronic products into Groups A through C. Section 1002.30 requires manufacturers of products in Groups B and C to establish and maintain certain records, while Section 1002.11 requires such manufacturers to submit an Annual Report summarizing the contents of the required records. Section 1002.7 requires that reports conform to reporting guides issued by CDRH unless an acceptable justification for an alternate format is provided

48 CFR 339.101 - Policy.

Science.gov (United States)

2010-10-01

... the latter term, see http://www.hhs.gov/ocio/policy.) An HHS information security policy waiver, the template for which is available at: http://intranet.hhs.gov/infosec/policies_memos.html, must be approved.... An HHS information security policy waiver, the template for which is available at: http://intranet...

76 FR 16427 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-03-23

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... discuss developments in FDA's ongoing communications programs. The discussion will focus on the use of...

75 FR 20608 - Risk Communication Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-04-20

...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... Communication Advisory Committee. General Function of the Committee: To provide advice and recommendations to... relevant to improving risk communication at FDA, and discuss applications or gaps for strategic planning of...

78 FR 76307 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-12-17

...] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and... combined endpoint of cardiovascular death, MI, stroke, and urgent coronary revascularization. FDA intends...

45 CFR 46.114 - Cooperative research.

Science.gov (United States)

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.114 Cooperative research. Cooperative... conduct of cooperative research projects, each institution is responsible for safeguarding the rights and...

77 FR 57567 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-09-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 50690 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-08-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 15760 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

76 FR 39108 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-07-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS ACTION: Notice of... the public. Name of Committee: HIT Policy Committee. General Function of the Committee: to provide...

77 FR 37407 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-06-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

76 FR 22397 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-04-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 22787 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-04-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 27459 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-05-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: to provide recommendations to...

76 FR 28783 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-05-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

76 FR 79684 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-12-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 73660 - HIT Policy Committee Advisory Meetings; Notice of Meetings

Science.gov (United States)

2012-12-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 28881 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-05-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: to provide recommendations to...

76 FR 46298 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-08-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

77 FR 65691 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-10-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

76 FR 70455 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-11-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: to provide recommendations to...

77 FR 2727 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-01-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

76 FR 14975 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-03-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: to provide recommendations to...

76 FR 50734 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-08-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

76 FR 55912 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2011-09-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... the public. Name of Committee: HIT Policy Committee. General Function of the Committee: To provide...

77 FR 41788 - HIT Policy Committee Advisory Meeting; Notice of Meeting

Science.gov (United States)

2012-07-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of... of Committee: HIT Policy Committee. General Function of the Committee: To provide recommendations to...

45 CFR 89.2 - Definitions.

Science.gov (United States)

2010-10-01

... person. Leadership Act means the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION ORGANIZATIONAL INTEGRITY OF ENTITIES... Leadership Act funds for HIV/AIDS programs directly or indirectly from HHS. Sex trafficking means the...

Bell's inequalities from the field concept in general relativity

International Nuclear Information System (INIS)

Sachs, M.

1980-01-01

A nonlinear field theory of matter, based axiomatically on general relativity, has an asymptotic, low-energy limit that predicts the outcome of experimental tests of Bell's inequalities. The inequalities should follow if spin-correlated, spin-1/2 particles, observed in coincidence, were a spacelike distance apart; they should be violated if they were separated by timelike distances. The experiment at timelike separations, for scattered protons observed in coincidence, was carried out by Lahemi-Rachti and Mittig and, thus far, agrees with this theory. Extension of the low-energy pp scattering experiment to observations at spacelike distances is suggested, with the prediction that agreement should be obtained with Bell's inequalities there. (author)

A longitudinal study of risk factors for community-based home help services in Alzheimer’s disease: the influence of cholinesterase inhibitor therapy

Directory of Open Access Journals (Sweden)

Wattmo C

2013-03-01

Full Text Available Carina Wattmo, Elisabeth Paulsson, Lennart Minthon, Elisabet LondosClinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö, SwedenBackground: To investigate the long-term effects of cholinesterase inhibitor (ChEI therapy and the influence of sociodemographic and clinical factors on the use of community-based home help services (HHS by patients with Alzheimer’s disease (AD.Methods: This 3-year, prospective, multicenter study included 880 AD patients treated with donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every 6 months, the patients were assessed with several rating scales, including the Mini-Mental State Examination, Instrumental Activities of Daily Living (IADL, and Physical Self-Maintenance Scale. Doses of ChEI and amounts of HHS per week were recorded. Cox regression models were used to predict the time to HHS, and multiple linear regression was used to predict the volume of HHS used.Results: During the study, 332 patients (38% used HHS. Factors that both postponed HHS use and predicted lower amounts of HHS were higher doses of ChEIs, better IADL ability, and living with family. Men, younger individuals, and those with a slower IADL decline showed a longer time to HHS, whereas female sex, a lower cognitive status, or more medications at baseline predicted fewer hours of HHS.Conclusions: Higher doses of ChEI might reduce the use of HHS, possibly reducing the costs of community-based care. Female spouses provide more informal care than do male spouses, so the likelihood of using HHS is greater among women with AD. The "silent group" of more cognitively impaired and frail elderly AD patients receives less HHS, which might precipitate institutionalization.Keywords: cognition, activities of daily living, treatment effect, gender, predictors

Ratepayers should not fund IP-2 outage, NY Attorney General says

International Nuclear Information System (INIS)

Anon.

1981-01-01

The New York Attorney General is trying to block Consolidated Edison's effort to pay for an Indian Point nuclear plant outage through the fuel-adjustment clause on the grounds that the utility had repeated system warnings and should have taken action to prevent the leakage of water into the containment building. The utility rejects the assessment of personnel negligence and, blaming equipment failure, plans to replace its heat exchangers. The New York Public Service Commission approved Con Ed's use of the fuel-adjustment clause to pay for replacement power, but agrees that ratepayers should not pay the costs of negligence if the charges are proved. The Attorney General feels that Con Ed could legally challenge a later request for refunds. Other funding possibilities include nuclear-insurance policies or legal action against the equipment manufacturer

75 FR 68613 - Part C Early Intervention Services Grant

Science.gov (United States)

2010-11-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Part C Early Intervention Services Grant AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of non-competitive transfer of Part C funds from North General Hospital to the Institute for Family...

77 FR 12062 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-02-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... of Committee: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee...

78 FR 76308 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-12-17

...] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and..., Inc., for the proposed indication to reduce the risk of thrombotic cardiovascular events in patients...

75 FR 57474 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-09-21

...] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and... analyses of the TREAT (Trial to Reduce Cardiovascular Events with Aranesp Therapy) study of ARANESP...

77 FR 21982 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-04-12

...] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...., to reduce the risk of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS...

42 CFR 493.638 - Certificate fees.

Science.gov (United States)

2010-10-01

... for quality control, quality assurance, and proficiency testing purposes) and specialties tested, with... collected by HHS under the laboratory program must be sufficient to cover the general costs of administering... certificates and certificates of compliance, the costs include issuing the certificates, collecting the fees...

78 FR 734 - Medical Imaging Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-01-04

...] Medical Imaging Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... and Drug Administration (FDA). The meeting will be open to the public. Name of Committee: Medical Imaging Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

75 FR 9420 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-03-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

76 FR 29766 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

77 FR 4566 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-01-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

77 FR 69635 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-11-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

75 FR 5334 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-02-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

75 FR 82031 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-12-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

77 FR 74486 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-12-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

77 FR 69636 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-11-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

75 FR 5333 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-02-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

78 FR 46976 - Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-08-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Pulmonary-Allergy Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...-Allergy Drugs Advisory Committee. General Function of the Committee: To provide advice and recommendations...

Validation of general job satisfaction in the Korean Labor and Income Panel Study.

Science.gov (United States)

Park, Shin Goo; Hwang, Sang Hee

2017-01-01

The purpose of this study is to assess the validity and reliability of general job satisfaction (JS) in the Korean Labor and Income Panel Study (KLIPS). We used the data from the 17th wave (2014) of the nationwide KLIPS, which selected a representative panel sample of Korean households and individuals aged 15 or older residing in urban areas. We included in this study 7679 employed subjects (4529 males and 3150 females). The general JS instrument consisted of five items rated on a scale from 1 (strongly disagree) to 5 (strongly agree). The general JS reliability was assessed using the corrected item-total correlation and Cronbach's alpha coefficient. The validity of general JS was assessed using confirmatory factor analysis (CFA) and Pearson's correlation. The corrected item-total correlations ranged from 0.736 to 0.837. Therefore, no items were removed. Cronbach's alpha for general JS was 0.925, indicating excellent internal consistency. The CFA of the general JS model showed a good fit. Pearson's correlation coefficients for convergent validity showed moderate or strong correlations. The results obtained in our study confirm the validity and reliability of general JS.

Child overweight in general practice – parents’ beliefs and expectations – a questionnaire survey study

Science.gov (United States)

2013-01-01

Background Care for overweight children in general practice involves collaboration with parents. Acknowledging the parents’ frames of references is a prerequisite for successful management. We therefore aimed to analyse parental beliefs about the presumed causes and consequences of overweight in children and expectations towards the GP. Moreover, we aimed at comparing the beliefs and expectations of parents of non-overweight children (NOWC) and parents of overweight children (OWC). Methods A cross-sectional survey. Data were obtained from a questionnaire exploring parents’ beliefs and expectations regarding overweight in children. The questionnaires were completed by parents following their child’s participation in the five-year preventive child health examination (PCHE). Parental agreement upon statements concerning beliefs and expectations regarding overweight in children was measured on a Likert scale. Differences in levels of agreement between parents of non-overweight children and parents of overweight children were analysed using Chi-squared test and Fisher’s exact test. Results Parents of 879 children completed and returned questionnaires. Around three fourths of the parents agreed that overweight was a health problem. A majority of parents (93%) agreed that the GP should call attention to overweight in children and offer counselling on diet and exercise. Almost half of the parents expected a follow-up programme. Parents of overweight children seemed to agree less upon some of the proposed causes of overweight, e.g. inappropriate diet and lack of exercise. These parents also had stronger beliefs about overweight disappearing by itself as the child grows up. Conclusions According to parental beliefs and expectations, general practice should have an important role to play in the management of child overweight. Moreover, our findings suggest that GPs should be aware of the particular beliefs that parents of overweight children may have regarding causes

Normal versus anomalous self-diffusion in two-dimensional fluids: Memory function approach and generalized asymptotic Einstein relation

Science.gov (United States)

Shin, Hyun Kyung; Choi, Bongsik; Talkner, Peter; Lee, Eok Kyun

2014-12-01

Based on the generalized Langevin equation for the momentum of a Brownian particle a generalized asymptotic Einstein relation is derived. It agrees with the well-known Einstein relation in the case of normal diffusion but continues to hold for sub- and super-diffusive spreading of the Brownian particle's mean square displacement. The generalized asymptotic Einstein relation is used to analyze data obtained from molecular dynamics simulations of a two-dimensional soft disk fluid. We mainly concentrated on medium densities for which we found super-diffusive behavior of a tagged fluid particle. At higher densities a range of normal diffusion can be identified. The motion presumably changes to sub-diffusion for even higher densities.

78 FR 32255 - HHS-Operated Risk Adjustment Data Validation Stakeholder Meeting

Science.gov (United States)

2013-05-29

... States'') is assigned a host (in accordance with the Department Foreign Visitor Management Policy... general public. Visitors to the complex are required to show a valid U.S. Government issued photo... lobby, and the cafeteria. If a visitor is found outside of those areas without proper escort, they may...

A Comparative Study between Intramuscular Midazolam and Oral Clonidine As A Premedication For General Anesthesia

OpenAIRE

Jignasa J Patel; Kalpana A Desai

2015-01-01

Background: Most anesthesiologists agree on the need for efficient pre-medication. The pattern of desired effects of a pre-medication is however, complex and includes relief of anxiety, sedation and relaxation of the patient. The present study was undertaken to compare the effects of Midazolam and clonidine as premedication. Methodology: A comparative study between midazolam and clonidine as a premedication for general anesthesia was conducted. Patients were divided in two groups: Group I: In...

76 FR 14637 - State Medicaid Fraud Control Units; Data Mining

Science.gov (United States)

2011-03-17

...] State Medicaid Fraud Control Units; Data Mining AGENCY: Office of Inspector General (OIG), HHS. ACTION... and analyzing State Medicaid claims data, known as data mining. To support and modernize MFCU efforts... (FFP) in the costs of defined data mining activities under specified conditions. In addition, we...

77 FR 43093 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-07-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

78 FR 38717 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-06-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

75 FR 35496 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-06-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

77 FR 43600 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2012-07-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

75 FR 1395 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-01-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-N-0664] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

78 FR 36787 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2013-06-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

75 FR 52762 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-08-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

75 FR 30839 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2010-06-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

76 FR 82310 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-12-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

76 FR 39404 - Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-07-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS...: Cardiovascular and Renal Drugs Advisory Committee. General Function of the Committee: To provide advice and...

45 CFR 46.123 - Early termination of research support: Evaluation of applications and proposals.

Science.gov (United States)

2010-10-01

... of applications and proposals. 46.123 Section 46.123 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human... rights and welfare of human subjects (whether or not the research was subject to federal regulation). ...

76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

Science.gov (United States)

2011-08-03

... to the interim final regulations implementing the rules for group health plans and health insurance... dates. These interim final regulations generally apply to group health plans and group health insurance... from HHS on private health insurance for consumers can be found on the Centers for Medicare & Medicaid...

75 FR 9012 - Privacy Act of 1974, as Amended; Computer Matching Program (SSA/U.S. Department of Health and...

Science.gov (United States)

2010-02-26

... INFORMATION: A. General The Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503), amended... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2009-0052] Privacy Act of 1974, as Amended; Computer Matching Program (SSA/ U.S. Department of Health and Human Services (HHS), Administration for...

Trace anomaly of the stress-energy tensor for massless vector particles propagating in a general background metric

International Nuclear Information System (INIS)

Adler, S.L.; Lieberman, J.

1978-01-01

We reanalyze the problem of regularization of the stress-energy tensor for massless vector particles propating in a general background metric, using covariant point separation techniques applied to the Hadamard elementary solution. We correct an error, point out by Wald, in the earlier formulation of Adler, Lieberman, and Ng, and find a stress-energy tensor trace anomaly agreeing with that found by other regularization methods

General practitioners’ views of clinically led commissioning: cross-sectional survey in England

Science.gov (United States)

Moran, Valerie; Checkland, Kath; Coleman, Anna; Spooner, Sharon; Gibson, Jonathan; Sutton, Matt

2017-01-01

Objectives Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commissioning and future intentions for engagement. Design and setting Survey of a random sample of GPs across England in 2015. Method The Eighth National GP Worklife Survey was distributed to GPs in spring 2015. Responses were received from 2611 respondents (response rate = 46%). We compared responses across different GP characteristics and conducted two sample tests of proportions to identify statistically significant differences in responses across groups. We also used multivariate logistic regression to identify the characteristics associated with wanting a formal CCG role in the future. Results While GPs generally agree that they can add value to aspects of commissioning, only a minority feel that this is an important part of their role. Many current leaders intend to quit in the next 5 years, and there is limited appetite among those not currently in a formal role to take up such a role in the future. CCGs were set up as ‘membership organisations’ but only a minority of respondents reported feeling that they had ‘ownership’ of their local CCG and these were often GPs with formal CCG roles. However, respondents generally agree that the CCG has a legitimate role in influencing the work that they do. Conclusion CCGs need to engage in active succession planning to find the next generation of GP leaders. GPs believe that CCGs have a legitimate role in influencing their work, suggesting that there may be scope for CCGs to involve GPs more fully in roles short of formal leadership. PMID:28596217

Economic effects of a carbon tax: with a general equilibrium illustration for Belgium

International Nuclear Information System (INIS)

Proost, S.; Regemorter, D. Van

1992-01-01

The feasibility and efficiency arguments of an international and a national carbon tax are analysed. It is argued that an internationally organized carbon tax can be a good instrument for implementing an international CO 2 abatement strategy. Less efficient instruments like national CO 2 reduction emission objectives are more likely to be implemented. A national carbon tax is analysed as a policy instrument to reach such an internationally agreed national CO 2 emission reduction objective. This is done for Belgium using a dynamic general equilibrium model. (author)

A smartphone-enabled communication system to improve hospital communication: usage and perceptions of medical trainees and nurses on general internal medicine wards.

Science.gov (United States)

Wu, Robert; Lo, Vivian; Morra, Dante; Appel, Eva; Arany, Teri; Curiale, Beth; Ryan, Joanne; Quan, Sherman

2015-02-01

There is increasing interest in the use of information and communication technologies to improve how clinicians communicate in hospital settings. We implemented a communication system with support for physician handover and secure messaging on 2 general internal medicine wards. We measured usage and surveyed physicians and nurses on perceptions of the system's effects on communication. Between May 2011 and August 2012, a clinical teaching team received, on average, 14.8 messages per day through the system. Messages were typically sent as urgent (69.1%) and requested a text reply (76.5%). For messages requesting a text reply, 8.6% did not receive a reply. For those messages that did receive a reply, the median response time was 2.3 minutes, and 84.5% of messages received a reply within 15 minutes. Of those who completed the survey, 95.3% were medical residents (82 of 86) and 81.7% were nurses (83 of 116). Medical trainees (82.8%) and nursing staff (78.3%) agreed or strongly agreed that the system helped to speed up their daily work tasks. Overall, 67.1% of the trainees and 73.2% of nurses agreed or strongly agreed that the system made them more accountable in their clinical roles. Only 35.8% of physicians and 26.3% of nurses agreed or strongly agreed that the system was useful for communicating complex issues. In summary, with a system designed to improve communication, we found that there was high uptake and that users perceived that the system improved efficiency and accountability but was not appropriate for communicating complex issues. © 2014 Society of Hospital Medicine.

Gravitational waves from axisymmetric rotating stellar core collapse to a neutron star in full general relativity

International Nuclear Information System (INIS)

Shibata, Masaru; Sekiguchi, Yu-ichirou

2004-01-01

Axisymmetric numerical simulations of rotating stellar core collapse to a neutron star are performed in the framework of full general relativity. The so-called Cartoon method, in which the Einstein field equations are solved in Cartesian coordinates and the axisymmetric condition is imposed around the y=0 plane, is adopted. The hydrodynamic equations are solved in cylindrical coordinates (on the y=0 plane in Cartesian coordinates) using a high-resolution shock-capturing scheme with maximum grid size (2500,2500). A parametric equation of state is adopted to model collapsing stellar cores and neutron stars following Dimmelmeier, Font, and Mueller. It is found that the evolution of the central density during the collapse, bounce, and formation of protoneutron stars agrees well with that in the work of Dimmelmeier, Font, and Mueller in which an approximate general relativistic formulation is adopted. This indicates that such an approximation is appropriate for following axisymmetric stellar core collapses and the subsequent formation of protoneutron stars. Gravitational waves are computed using a quadrupole formula. It is found that the waveforms are qualitatively in good agreement with those by Dimmelmeier, Font, and Mueller. However, quantitatively, two waveforms do not agree well. The possible reasons for the disagreement are discussed

Do generalists and specialists agree on descriptive acne morphology?

DEFF Research Database (Denmark)

Yazdanyar, S; Bryld, L E; Heidenheim, M

2013-01-01

BACKGROUND: Acne is a common skin disease, which is treated by many different specialities. Clinical guidelines for treatment are based on the recognition of acne morphology. The assessment of acne morphology is therefore an important element of the proper diagnosis and treatment of acne. OBJECTIVE......: To evaluate the level of congruence in the assessment of acne morphology in General Practitioners (GPs) and Dermatologists compared to the assessment of an expert. METHODS: The study was conducted during 2008-2009. Randomly selected GP and Dermatologists Practitioners, (DPs) from Denmark were invited...... in the distribution of answers. CONCLUSION: GPs described acne morphology recognized clinical hallmarks of severity in acne less well than dermatologists and were far less consistent....

48 CFR 301.607-77 - Governance.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Governance. 301.607-77 Section 301.607-77 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES GENERAL HHS... Governance. The Departmental ACM, in ASFR/OGAPA/DA, serves as the Departmental FAC-P/PM Program Manager and...

45 CFR 46.109 - IRB review of research.

Science.gov (United States)

2010-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.109 IRB review of research. (a) An... judgment the information would meaningfully add to the protection of the rights and welfare of subjects. (c...

45 CFR 46.107 - IRB membership.

Science.gov (United States)

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.107 IRB membership. (a) Each IRB shall have... respect for its advice and counsel in safeguarding the rights and welfare of human subjects. In addition...

78 FR 1214 - Agency Information Collection Activities: Proposed Collection: Comment Request

Science.gov (United States)

2013-01-08

... OMB approval of the information collections contained in regulations found at 45 CFR Part 60 governing... the HIPDB was delegated by the HHS Office of the Inspector General to HRSA. This rule [[Page 1215..., to identify and discipline those who engage in unprofessional behavior; and to restrict the ability...

Agreeing in Ignorance

DEFF Research Database (Denmark)

Ploug, Thomas; Holm, Søren

2014-01-01

Many ICT services require that users explicitly consent to conditions of use and policies for the protection of personal information. This consent may become 'routinised'. We define the concept of routinisation and investigate to what extent routinisation occurs as well as the factors influencing...... routinisation in a survey study of internet use. We show that routinisation is common and that it is influenced by factors including gender, age, educational level and average daily internet use. We further explore the reasons users provide for not reading conditions and policies and show that they can...

Does the specialist nurse enhance or deskill the general nurse?

Science.gov (United States)

Marshall, Z; Luffingham, N

Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.

The origin of continental crust: Outlines of a general theory

Science.gov (United States)

Lowman, P. D., Jr.

1985-01-01

The lower continental crust, formerly very poorly understood, has recently been investigated by various geological and geophysical techniques that are beginning to yield a generally agreed on though still vague model (Lowman, 1984). As typified by at least some exposed high grade terranes, such as the Scottish Scourian complex, the lower crust in areas not affected by Phanerozoic orogeny or crustal extension appears to consist of gently dipping granulite gneisses of intermediate bulk composition, formed from partly or largely supracrustal precursors. This model, to the degree that it is correct, has important implications for early crustal genesis and the origin of continental crust in general. Most important, it implies that except for areas of major overthrusting (which may of course be considerable) normal superposition relations prevail, and that since even the oldest exposed rocks are underlain by tens of kilometers of sial, true primordial crust may still survive in the lower crustal levels (of. Phinney, 1981).

75 FR 81556 - Solicitation of New Safe Harbors and Special Fraud Alerts

Science.gov (United States)

2010-12-28

... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... the public on recommendations for developing new or revised safe harbors and Special Fraud Alerts...

Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.

Directory of Open Access Journals (Sweden)

Jen-Yu Wang

Full Text Available BACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS attack. The objective of this study was to investigate the risk of ischemic stroke in type 2 DM patients after an HHS attack. METHODS: From 2004 to 2008, this retrospective observational study was conducted on a large cohort of Taiwanese using Taiwan's National Health Insurance Research Database (NHIRD. We identified 19,031 type 2 DM patients who were discharged with a diagnosis of HHS and 521,229 type 2 DM patients without an HHS diagnosis. Using the propensity score generated from logistic regression models, conditional on baseline covariates, we matched 19,031 type 2 DM patients with an HHS diagnosis with the same number from the comparison cohort. The one-year cumulative rate for ischemic stroke was estimated using the Kaplan-Meier method. After adjusting covariates, Cox proportional hazard regression was used to compute the adjusted one-year rate of ischemic stroke. RESULTS: Of the patients sampled, 1,810 (9.5% of the type 2 DM patients with HHS and 996 (5.2% of the comparison cohort developed ischemic stroke during the one-year follow-up period. After adjusting for covariates, the adjusted HR for developing ischemic stroke during the one-year follow-up period was 1.8 (95% C.I., 1.67 to 1.95, P<0.001 for type 2 DM patients with HHS compared with those without HHS. CONCLUSION: Although DM is a well-recognized risk factor for atherosclerosis, type 2 DM patients that have suffered a HHS attacks are at an increased risk of developing ischemic stroke compared with those without HHS.

Keeping morality out and the GP in. Consultations in Danish general practice as a context for smoking cessation advice

DEFF Research Database (Denmark)

Guassora, Ann Dorrit; Tulinius, Anne Charlotte

2008-01-01

in observation of their own consultations. RESULTS: Patients and GPs agreed that the GP should adopt an attitude of moral acceptance towards patients. Ideals of moral acceptance of patients in general practice consultations were challenged by the prevailing negative moral values associated with smoking......OBJECTIVE: To describe consultations in Danish general practice as a context for a mass strategy of smoking cessation advice. METHODS: The focus of the study was on consultations for health problems that were not related to smoking. Interviews with eleven patients and their six GPs were grounded....... A general aim of mutuality in the conversation in consultations could not always be achieved in smoking cessation advice. Achieving mutuality was especially a problem when smoking cessation advice was repeated at short intervals. CONCLUSION: Two elements of Danish general practice consultations were...

Tests of general relativity from timing the double pulsar.

Science.gov (United States)

Kramer, M; Stairs, I H; Manchester, R N; McLaughlin, M A; Lyne, A G; Ferdman, R D; Burgay, M; Lorimer, D R; Possenti, A; D'Amico, N; Sarkissian, J M; Hobbs, G B; Reynolds, J E; Freire, P C C; Camilo, F

2006-10-06

The double pulsar system PSR J0737-3039A/B is unique in that both neutron stars are detectable as radio pulsars. They are also known to have much higher mean orbital velocities and accelerations than those of other binary pulsars. The system is therefore a good candidate for testing Einstein's theory of general relativity and alternative theories of gravity in the strong-field regime. We report on precision timing observations taken over the 2.5 years since its discovery and present four independent strong-field tests of general relativity. These tests use the theory-independent mass ratio of the two stars. By measuring relativistic corrections to the Keplerian description of the orbital motion, we find that the "post-Keplerian" parameter s agrees with the value predicted by general relativity within an uncertainty of 0.05%, the most precise test yet obtained. We also show that the transverse velocity of the system's center of mass is extremely small. Combined with the system's location near the Sun, this result suggests that future tests of gravitational theories with the double pulsar will supersede the best current solar system tests. It also implies that the second-born pulsar may not have formed through the core collapse of a helium star, as is usually assumed.

45 CFR 46.115 - IRB records.

Science.gov (United States)

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy... injuries to subjects. (2) Minutes of IRB meetings which shall be in sufficient detail to show attendance at... findings provided to subjects, as required by § 46.116(b)(5). (b) The records required by this policy shall...

77 FR 76434 - Solicitation of New Safe Harbors and Special Fraud Alerts

Science.gov (United States)

2012-12-28

... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-121-N...

78 FR 78807 - Solicitation of New Safe Harbors and Special Fraud Alerts

Science.gov (United States)

2013-12-27

... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-122-N...

41 CFR 102-75.1160 - What definitions apply to this subpart?

Science.gov (United States)

2010-07-01

... to 40 U.S.C. 524. GSA means the United States General Services Administration. HHS means the United States Department of Health and Human Services. Homeless means— (1) An individual or family that lacks a... otherwise detained under an Act of Congress or a State law. HUD means the United States Department of...

Comparison between the Harris- and Oxford Hip Score to evaluate outcomes one-year after total hip arthroplasty

NARCIS (Netherlands)

Weel, Hanneke; Lindeboom, Robert; Kuipers, Sander E.; Vervest, Ton M. J. S.

2017-01-01

Harris Hip Score (HHS) is a surgeon administered measurement for assessing hip function before and after total hip arthroplasties (THA). Patient reported outcome measurements (PROMs) such as the Oxford Hip Score (OHS) are increasingly used. HHS was compaired to the OHS assessing whether the HHS can

78 FR 16857 - Office of the Assistant Secretary for Financial Resources, Office of Grants and Acquisition...

Science.gov (United States)

2013-03-19

... Inventory.'' The following should be changed: The notice provided an incorrect URL address: http://www.hhs.gov/grants/servicecontractsfy11.html . The correct URL address is as follows: http://www.hhs.gov... following URL address: http://www.hhs.gov/grants/servicecontractsfy11.html . Change the fiscal year to FY...

General practitioners' views of clinically led commissioning: cross-sectional survey in England.

Science.gov (United States)

Moran, Valerie; Checkland, Kath; Coleman, Anna; Spooner, Sharon; Gibson, Jonathan; Sutton, Matt

2017-06-08

Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commissioning and future intentions for engagement. Survey of a random sample of GPs across England in 2015. The Eighth National GP Worklife Survey was distributed to GPs in spring 2015. Responses were received from 2611 respondents (response rate = 46%). We compared responses across different GP characteristics and conducted two sample tests of proportions to identify statistically significant differences in responses across groups. We also used multivariate logistic regression to identify the characteristics associated with wanting a formal CCG role in the future. While GPs generally agree that they can add value to aspects of commissioning, only a minority feel that this is an important part of their role. Many current leaders intend to quit in the next 5 years, and there is limited appetite among those not currently in a formal role to take up such a role in the future. CCGs were set up as 'membership organisations' but only a minority of respondents reported feeling that they had 'ownership' of their local CCG and these were often GPs with formal CCG roles. However, respondents generally agree that the CCG has a legitimate role in influencing the work that they do. CCGs need to engage in active succession planning to find the next generation of GP leaders. GPs believe that CCGs have a legitimate role in influencing their work, suggesting that there may be scope for CCGs to involve GPs more fully in roles short of formal leadership. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted

76 FR 14017 - Call for Comments on the Draft Report of the Adult Immunization Working Group to the National...

Science.gov (United States)

2011-03-15

... and recommendations could be found on the Web at http://www.hhs.gov/nvpo/nvac/subgroups/adultimmunization . The Web address where the draft report and recommendations can be found is http://www.hhs.gov...) The draft report and recommendations are available on the Web at http://www.hhs.gov/nvpo/nvac...

GPs' job satisfaction: doctors who chose general practice early or late.

Science.gov (United States)

Lambert, Trevor; Smith, Fay; Goldacre, Michael

2013-11-01

In the UK many practising GPs did not choose general practice as their first choice of career when they originally graduated as doctors. To compare job satisfaction of GPs who chose general practice early or later in their career. Questionnaires were sent to all UK-trained doctors who graduated in selected years between 1993 and 2000. Questionnaires were sent to the doctors 1, 3, 7 and 10 years after graduation. Of all 3082 responders working in general practice in years 7 and 10, 38% had first specified general practice as their preferred career when responding 1 year after graduation, 19% by year 3, 21% by year 5, and 22% after year 5. Job satisfaction was high and, generally, there was little difference between the first three groups (although, when different, the most positive responses were from the earliest choosers); but there were slightly lower levels of job satisfaction in the 'more than 5 years' group. For example, in response to the statement 'I find enjoyment in my current post', the percentages agreeing in the four groups, respectively, were 91.5%, 91.1%, 91.0% and 88.2%. In response to 'I am doing interesting and challenging work' the respective percentages were 90.2%, 88.0%, 86.6% and 82.6%. Job satisfaction levels were generally high among the late choosers as well as the early choosers. On this evidence, most doctors who turn to general practice, after preferring another specialty in their early career, are likely to have a satisfying career.

Long-term follow-up of hypothenar hammer syndrome: a series of 47 patients.

Science.gov (United States)

Marie, Isabelle; Hervé, Fabien; Primard, Etienne; Cailleux, Nicole; Levesque, Hervé

2007-11-01

Hypothenar hammer syndrome (HHS) is an uncommon form of secondary Raynaud phenomenon, occurring mainly in subjects who use the hypothenar part of the hand as a hammer; the hook of the hamate strikes the superficial palmar branch of the ulnar artery in the Guyon space, leading to occlusion and/or aneurysm of the ulnar artery. In patients with HHS, such injuries of the palmar ulnar artery may lead to severe vascular insufficiency in the hand with occlusion of digital artery. To date, only a few series have analyzed the long-term outcome of patients with HHS. This prompted us to conduct the current retrospective study to 1) evaluate the prevalence of HHS in patients with Raynaud phenomenon and 2) assess the short-term and long-term outcome in patients with HHS. From 1990 to 2006, 4148 consecutive patients were referred to the Department of Internal Medicine at the University of Rouen medical center for evaluation of Raynaud phenomenon using nailfold capillaroscopy. HHS was diagnosed in 47 of these 4148 patients (1.13% of cases).Forty-three patients (91.5%) had occupational exposure to repetitive palmar trauma. The more common occupations were factory worker (21.3%), mason (12.8%), carpenter (10.6%), and metal worker (10.6%); the mean duration of occupational exposure to repetitive palmar trauma at HHS diagnosis was 21 years. One patient (2.1%) had recreational exposure (aikido training) to repetitive trauma of the palmar ulnar artery, and 3 other patients (6.4%) developed HHS related to a single direct injury to the hypothenar area. Clinical manifestations were more often unilateral (87.2%) involving the dominant hand (93%). HHS complications included digital ischemic symptoms (ischemia: n = 21, necrosis: n = 20) and irritation of the sensory branch of the ulnar nerve (n = 11). In HHS patients, angiography demonstrated occlusion of the ulnar artery in the area of the Guyon space (59.6%), aneurysm of the ulnar artery in the area of the Guyon space (40.4%), and embolic

Scaled MP3 non-covalent interaction energies agree closely with accurate CCSD(T) benchmark data.

Science.gov (United States)

Pitonák, Michal; Neogrády, Pavel; Cerný, Jirí; Grimme, Stefan; Hobza, Pavel

2009-01-12

Scaled MP3 interaction energies calculated as a sum of MP2/CBS (complete basis set limit) interaction energies and scaled third-order energy contributions obtained in small or medium size basis sets agree very closely with the estimated CCSD(T)/CBS interaction energies for the 22 H-bonded, dispersion-controlled and mixed non-covalent complexes from the S22 data set. Performance of this so-called MP2.5 (third-order scaling factor of 0.5) method has also been tested for 33 nucleic acid base pairs and two stacked conformers of porphine dimer. In all the test cases, performance of the MP2.5 method was shown to be superior to the scaled spin-component MP2 based methods, e.g. SCS-MP2, SCSN-MP2 and SCS(MI)-MP2. In particular, a very balanced treatment of hydrogen-bonded compared to stacked complexes is achieved with MP2.5. The main advantage of the approach is that it employs only a single empirical parameter and is thus biased by two rigorously defined, asymptotically correct ab-initio methods, MP2 and MP3. The method is proposed as an accurate but computationally feasible alternative to CCSD(T) for the computation of the properties of various kinds of non-covalently bound systems.

Preliminary support for a generalized arousal model of political conservatism.

Science.gov (United States)

Tritt, Shona M; Inzlicht, Michael; Peterson, Jordan B

2013-01-01

It is widely held that negative emotions such as threat, anxiety, and disgust represent the core psychological factors that enhance conservative political beliefs. We put forward an alternative hypothesis: that conservatism is fundamentally motivated by arousal, and that, in this context, the effect of negative emotion is due to engaging intensely arousing states. Here we show that study participants agreed more with right but not left-wing political speeches after being exposed to positive as well as negative emotion-inducing film-clips. No such effect emerged for neutral-content videos. A follow-up study replicated and extended this effect. These results are consistent with the idea that emotional arousal, in general, and not negative valence, specifically, may underlie political conservatism.

Preliminary Support for a Generalized Arousal Model of Political Conservatism

Science.gov (United States)

Tritt, Shona M.; Inzlicht, Michael; Peterson, Jordan B.

2013-01-01

It is widely held that negative emotions such as threat, anxiety, and disgust represent the core psychological factors that enhance conservative political beliefs. We put forward an alternative hypothesis: that conservatism is fundamentally motivated by arousal, and that, in this context, the effect of negative emotion is due to engaging intensely arousing states. Here we show that study participants agreed more with right but not left-wing political speeches after being exposed to positive as well as negative emotion-inducing film-clips. No such effect emerged for neutral-content videos. A follow-up study replicated and extended this effect. These results are consistent with the idea that emotional arousal, in general, and not negative valence, specifically, may underlie political conservatism. PMID:24376687

HHS Enterprise Data Inventory

Data.gov (United States)

U.S. Department of Health & Human Services — The Enterprise Data Inventory (EDI) is the comprehensive inventory listing of agency data resources including public, restricted public, and non-public datasets.

Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

DEFF Research Database (Denmark)

Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper

2004-01-01

OBJECTIVE: To assess Danish obstetricians' and gynecologists' personal preference and general attitude towards elective cesarean section on maternal request in uncomplicated single cephalic pregnancies at term. DESIGN: Nation-wide anonymous postal questionnaire. POPULATION: Four hundred and fifty......-five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...... and gynecologists would personally prefer vaginal delivery in uncomplicated pregnancies, but nearly 40% agree with the woman's right to request a cesarean section....

Enforcement Alert: U.S. EPA Encourages Iron and Steel Minimills to Self Audits to Address Noncompliance with Environmental Requirements; Nucor Corp. agrees to Control Practices; Provides Model for Industry

Science.gov (United States)

This is the enforcement alert for U.S. EPA Encourages Iron and Steel Minimills to Self Audits to Address Noncompliance with Environmental Requirements; Nucor Corp. agrees to Control Practices; Provides Model for Industry

Transfer of scientific knowledge to the general public from the scientists' point of view

International Nuclear Information System (INIS)

Peters, H.P.; Krueger, J.

1985-07-01

Our analysis demonstrates that nearly all scientists agree to having responsibilities to disseminate information about their work not only to collegues but also to the general public. More than two-thirds of the respondents perceive personal benefits for their career and/or the acquisition of research funding when reports about their work appear in the mass media. Most scientists rated the interest of the population in reports on science at least as ''medium'', but most of them are also sceptical of the population's ability to understand those reports. Only a minority of the scientists surveyed perceives hostility against science among the public. About 40% of the respondents reported having contacts with journalists. Their experiences during these contacts were often not encouraging. More than half of the scientists whose work had been reported in media answered that at least something had been incorrectly reported. Three-quarters of the scientists who have had contacts with journalists have had partially bad experiences. There are indications that scientists do not see science reporting solely as a task of journalists; they want to be involved in that process, not only as information sources. However, during the contacts with journalists, scientists will experience that their ideas of good science reporting contradict the journalistic approach. Journalists have other quality standards and emphasize other aspects than scientists do. Therefore the collision of scientific norms and values with those of the journalism leads to experiences which are probably frustrating for both sides, although scientists and journalists agree on the general goal of public information. (orig./HP) [de

77 FR 31864 - Prospective Grant of Exclusive License: Development of PANVACTM

Science.gov (United States)

2012-05-30

... divisional applications claiming priority to this application; 7. Australia Patent No. 745863 [HHS Ref. No. E... and divisional applications; [HHS Ref. No. E-260-1994/2-JP-21, JP-25 and JP-26]; Australia Patent No... Patent Application No. 2,412,050 filed June 15, 2001 [HHS Ref. No. E-187-2000/0-CA-05]; Australia Patent...

General solution of superconvergent sum rules for scattering of I=1 reggeons on baryons

International Nuclear Information System (INIS)

Grigoryan, A.A.; Khachatryan, G.N.

1986-01-01

Superconvergent sum rules for reggeon-particle scattering are applied to scattering of reggeons α i (i=π, ρ, A 2 ) with isospin I=1 on baryons with strangeness S=-1. The saturation scheme of these sum rules is determined on the basis of experimental data. Two series of baryon resonances with arbitrary isospins I and spins J=I+1/2 and J=I-1/2 are predicted. A general solution for vertices of interaction of these resonances with α i is found. Predictions for coupling vertices B α i B'(B, B'=Λ, Σ, Σ * ) agree well with the experiment. It is shown that the condition of sum rules saturation by minimal number of resonances brings to saturation schemes resulting from experimental data. A general solution of sum rules for scattering of α i reggeons on Ξ and Ω hyperons is analyzed

Modelling the Common Agricultural Policy with the Modular Agricultural GeNeral Equilibrium Tool (MAGNET). Effects of the 2014-2020 CAP financial agreement on welfare, trade, factor and product markets

OpenAIRE

BOULANGER PIERRE; PHILIPPIDIS GEORGE

2013-01-01

This JRC report presents methodological development of the Modular Applied GeNeral Equilibrium Tool (MAGNET), a global computable general equilibrium (CGE) model, for representing the Common Agricultural Policy (CAP). Using original data on European Union (EU) domestic support, it examines some likely macroeconomic effects of the expected CAP budget over the period 2014-2020. Results suggest that agreed budget cuts, in constant price, have limited impacts on EU and world markets, given the br...

Towards Thermodynamics with Generalized Uncertainty Principle

International Nuclear Information System (INIS)

Moussa, Mohamed; Farag Ali, Ahmed

2014-01-01

Various frameworks of quantum gravity predict a modification in the Heisenberg uncertainty principle to a so-called generalized uncertainty principle (GUP). Introducing quantum gravity effect makes a considerable change in the density of states inside the volume of the phase space which changes the statistical and thermodynamical properties of any physical system. In this paper we investigate the modification in thermodynamic properties of ideal gases and photon gas. The partition function is calculated and using it we calculated a considerable growth in the thermodynamical functions for these considered systems. The growth may happen due to an additional repulsive force between constitutes of gases which may be due to the existence of GUP, hence predicting a considerable increase in the entropy of the system. Besides, by applying GUP on an ideal gas in a trapped potential, it is found that GUP assumes a minimum measurable value of thermal wavelength of particles which agrees with discrete nature of the space that has been derived in previous studies from the GUP

Supporting near-peer teaching in general practice: a national survey.

Science.gov (United States)

van de Mortel, Thea F; Silberberg, Peter L; Ahern, Christine M; Pit, Sabrina W

2016-05-12

Training bodies see teaching by junior doctors and vocational trainees in general practice (family medicine) as integral to a doctor's role. While there is a body of literature on teacher training programs, and on peer and near-peer teaching in hospitals and universities, there has been little examination of near-peer teaching in general practice. Near-peer teaching is teaching to those close to oneself but not at the same level in the training continuum. This study investigated the perceptions of key stakeholders on near-peer teaching in general practice, their current near-peer teaching activities, and methods of recruitment and support. A national anonymous online survey was used to obtain data on Australian stakeholders' perceptions of, and processes related to, near-peer teaching in general practice. Recruitment occurred via electronic invitations sent by training providers and stakeholder associations. Separate questionnaires, which were validated via several cycles of review and piloting, were developed for supervisors and learners. The survey included both fixed response and open response questions. Responses (n = 1,122) were obtained from 269 general practitioner supervisors, 221 general practice registrars, 319 prevocational trainees, and 313 medical students. All stakeholder groups agreed that registrars should teach learners in general practice, and 72% of registrars, 68% of prevocational trainees, and 33% of medical students reported having done some teaching in this setting. Three-quarters of supervisors allowed learners to teach. Having another learner observe their consultations was the most common form of teaching for registrars and prevocational trainees. Eight percent of registrars received some remuneration for teaching. The approach used to determine teaching readiness and quality varied greatly between supervisors. Near-peer teaching was supported by the majority of stakeholders, but is underutilised and has poor structural support

Next-Generation Entrepreneurs Ready to Advance Breast Cancer Research Innovations | Poster

Science.gov (United States)

By Michele Newton and Thomas Stackhouse, Contributing Writers, and Rosemarie Truman, Guest Writer Editor’s note: In May 2014, the Breast Cancer Start-Up Challenge was named one of six finalists in the HHS Innovates Award Competition. This award celebrates innovations developed by employees of the U.S. Department of Health and Human Services (HHS) to support the mission of HHS.

Hydroxide as general base in the saponification of ethyl acetate.

Science.gov (United States)

Mata-Segreda, Julio F

2002-03-13

The second-order rate constant for the saponification of ethyl acetate at 30.0 degrees C in H(2)O/D(2)O mixtures of deuterium atom fraction n (a proton inventory experiment) obeys the relation k(2)(n) = 0.122 s(-1) M(-1) (1 - n + 1.2n) (1 - n + 0.48n)/(1 - n + 1.4n) (1 - n + 0.68n)(3). This result is interpreted as a process where formation of the tetrahedral intermediate is the rate-determining step and the transition-state complex is formed via nucleophilic interaction of a water molecule with general-base assistance from hydroxide ion, opposite to the direct nucleophilic collision commonly accepted. This mechanistic picture agrees with previous heavy-atom kinetic isotope effect data of Marlier on the alkaline hydrolysis of methyl formate.

Proton magnetic spectroscopy agreed better with magnetic resonance image to lateralization of epileptogenic zone than with surface electroencephalography

Directory of Open Access Journals (Sweden)

Ricardo Andre Amorim Leite

2013-09-01

Full Text Available Objective To analyze the agreement rate of proton magnetic spectroscopy with magnetic resonance image (MRI and surface electroence-phalography (EEG in extratemporal neocortical epilepsies. Methods A cross-sectional study, type series of cases included 33 patients, age range 13–59 years old, of both gender, presenting structural alteration identified by MRI (75.8% or by neurophysiologic techniques (72.7%. The variables were alterations of N-acetyl-aspartate/choline, N-acetyl-aspartate/creatine, choline/creatine, and N-acetyl-aspartate/cho-line+creatine coefficient of asymmetry. Results Agreement rates of lateralization by coefficient of asymmetry of NAA/Cho, NAA/Cr, Co/Cr, and NAA/Cho+Cr with MRI, independent of alteration of surface EEG, were equal to 93.3, 57.9, 15.4, and 93.3%, respectively, modifying to 100, 33.3, 0, and 100%, in 16 patients, with lateralization agreement of MRI and surface EEG. Conclusion Proton magnetic spectroscopy agreed better with MRI to lateralization of epileptogenic zone than with surface EEG.

Translation, cross-cultural adaptation, and validation of the Turkish version of the Harris Hip Score.

Science.gov (United States)

Çelik, Derya; Can, Canan; Aslan, Yasemin; Ceylan, Hasan Huseyin; Bilsel, Kerem; Ozdincler, Arzu Razak

2014-01-01

The Harris Hip Score (HHS) developed to assess function and pain from the perspective of patients hip pathologies. The purpose of this study was to translate and culturally adapt the HHS into Turkish, and thereby determine the reliability and validity of the translated version. The HHS was translated into Turkish in accordance with the stages recommended by Beaton. The measurement properties of the HHS were tested in 80 patients; 52 males, mean age 51 years (range 21-75 years) suffering from different hip pathologies. The test-retest reliability was tested in 58 patients; 28 males mean age, 52 years (range 30-73 years) after an interval of seven days. The Cronbach's Alpha was used to assess internal consistency and the intra-class correlation coefficient (ICC) was used to estimate the test-retest reliability. Patients were asked to answer the Oxford Hip Score (OHS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the VAS and the Short Form-36 (SF-36) for the validity of the estimation. The Turkish version of the HHS showed sufficient internal consistency (Cronbach's alpha,0.70) and test-retest reliability (ICC = 0.91). The correlation coefficients between the HHS, the WOMAC and the OHS were 0.64 and 0.89 respectively. The highest correlations between the HHS and SF-36 were with the physical function scale (r = 0.72), and the lowest correlations were with the mental function scale (r = 0.10). We observed no floor or ceiling effects. The Turkish version of the HHS has sufficient reliability and validity to measure patient-reported outcome for Turkish-speaking individuals with a variety of hip disorders.

Essential health benefits and the Affordable Care Act: law and process.

Science.gov (United States)

Bagley, Nicholas; Levy, Helen

2014-04-01

Starting in 2014, the Affordable Care Act (ACA) will require private insurance plans sold in the individual and small-group markets to cover a roster of "essential health benefits." Precisely which benefits should count as essential, however, was left to the discretion of the Department of Health and Human Services (HHS). The matter was both important and controversial. Nonetheless, HHS announced its policy by posting on the Internet a thirteen-page bulletin stating that it would allow each state to define essential benefits for itself. On both substance and procedure, the move was surprising. The state-by-state approach departed from the uniform, federal standard that the ACA appears to anticipate and that informed observers expected HHS to adopt. And announcing the policy through an Internet bulletin appeared to allow HHS to sidestep traditional administrative procedures, including notice and comment, immediate review in the courts, and White House oversight. This article explores two questions. First, is the state-by-state approach a lawful exercise of HHS's authority? Second, did HHS in fact evade the procedural obligations that are meant to shape the exercise of its discretion?

Notes on a National Strategy for Global Education

Science.gov (United States)

2011-12-01

Hewson (“Bono”) and Oprah Winfrey, or entrepreneurs-turned- philanthropists such as Bill Gates and Warren Buffet , will no doubt come readily to mind as...Service Institute GAO Government Accountability Office (formerly the General Accounting Office) HHS Department of Health and Human Services IACP...6 U.S. Government Accountability Office, Foreign Languages: Human Capital Approach Needed to Correct Staffing and Proficiency Shortfalls, No

Effectiveness of oncogenetics training on general practitioners' consultation skills: a randomized controlled trial.

Science.gov (United States)

Houwink, Elisa J F; Muijtjens, Arno M M; van Teeffelen, Sarah R; Henneman, Lidewij; Rethans, Jan Joost; van der Jagt, Liesbeth E J; van Luijk, Scheltus J; Dinant, Geert Jan; van der Vleuten, Cees; Cornel, Martina C

2014-01-01

General practitioners are increasingly called upon to deliver genetic services and could play a key role in translating potentially life-saving advancements in oncogenetic technologies to patient care. If general practitioners are to make an effective contribution in this area, their genetics competencies need to be upgraded. The aim of this study was to investigate whether oncogenetics training for general practitioners improves their genetic consultation skills. In this pragmatic, blinded, randomized controlled trial, the intervention consisted of a 4-h training (December 2011 and April 2012), covering oncogenetic consultation skills (family history, familial risk assessment, and efficient referral), attitude (medical ethical issues), and clinical knowledge required in primary-care consultations. Outcomes were measured using observation checklists by unannounced standardized patients and self-reported questionnaires. Of 88 randomized general practitioners who initially agreed to participate, 56 completed all measurements. Key consultation skills significantly and substantially improved; regression coefficients after intervention were equivalent to 0.34 and 0.28 at 3-month follow-up, indicating a moderate effect size. Satisfaction and perceived applicability of newly learned skills were highly scored. The general practitioner-specific training proved to be a feasible, satisfactory, and clinically applicable method to improve oncogenetics consultation skills and could be used as an educational framework to inform future training activities with the ultimate aim of improving medical care.

A critical appraisal of 2007 American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines for Interventional Pain Management: an independent review utilizing AGREE, AMA, IOM, and other criteria.

Science.gov (United States)

Manchikanti, Laxmaiah; Singh, Vijay; Helm, Standiford; Trescot, Andrea M; Hirsch, Joshua A

2008-01-01

Today, with the growing interest of the medical community and others in practice guidelines, there is greater emphasis on formal procedures and methods for arriving at a widely scrutinized and endorsed consensus than ever before. Conflicts in terminology and technique are notable for the confusion that guidelines create and for what they reflect about differences in values, experiences, and interests among different parties. While public and private development activities continue to multiply, the means for coordinating these efforts to resolve inconsistencies, fill in gaps, track applications and results, and assess the soundness of particular guidelines continue to be limited. In this era of widespread guideline development by private organizations, the American College of Occupational and Environment Medicine (ACOEM) has developed guidelines that evaluate areas of clinical practice well beyond the scope of occupational medicine and yet fail to properly involve physicians expert in these, especially those in the field of interventional pain management. As the field of guidelines suffers from imperfect and incomplete scientific knowledge as well as imperfect and uneven means of applying that knowledge without a single or correct way to develop guidelines, ACOEM guidelines have been alleged to hinder patient care, reduce access to interventional pain management procedures, and transfer patients into a system of disability, Medicare, and Medicaid. To critically appraise occupational medicine practice guidelines for interventional pain management by an independent review utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE), American Medical Association (AMA), Institute of Medicine (IOM), and other commonly utilized criteria. Revised chapters of ACOEM guidelines, low back pain and chronic pain, developed in 2007 and 2008 are evaluated, utilizing AGREE, AMA, IOM instruments, and Shaneyfelt et al's criteria, were independently reviewed by 4

A generalized scaling law for the ignition energy of inertial confinement fusion capsules

International Nuclear Information System (INIS)

Herrmann, M.C.

2001-01-01

The minimum energy needed to ignite an inertial confinement fusion capsule is of considerable interest in the optimization of an inertial fusion driver. Recent computational work investigating this minimum energy has found that it depends on the capsule implosion history, in particular, on the capsule drive pressure. This dependence is examined using a series of LASNEX simulations to find ignited capsules which have different values of the implosion velocity, fuel adiabat and drive pressure. It is found that the main effect of varying the drive pressure is to alter the stagnation of the capsule, changing its stagnation adiabat, which, in turn, affects the energy required for ignition. To account for this effect a generalized scaling law has been devised for the ignition energy, E ign ∝α if 1.88±0.05 υ -5.89±0.12 P -0.77±0.03 . This generalized scaling law agrees with the results of previous work in the appropriate limits. (author)

Characterizing the adequacy, effectiveness, and barriers related to research mentorship among junior pediatric hospitalists and general pediatricians at a large academic institution.

Science.gov (United States)

Ragsdale, Judith R; Vaughn, Lisa M; Klein, Melissa

2014-03-01

The purpose of this qualitative study was to characterize the adequacy, effectiveness, and barriers related to research mentorship among junior pediatric hospitalists and general pediatricians at a large academic institution. Junior faculty and staff physicians in hospital medicine and general pediatrics at a large academic institution were invited to participate in this qualitative study. In-depth interviews were conducted. Experienced mentors were invited to be interviewed for theoretical sampling. Interviews were conducted and analyzed by using grounded theory methodology. Twenty-six (75%) of the eligible physicians, pediatric hospitalists representing 65% of this sample, agreed to be interviewed about their mentoring experiences. Satisfied and dissatisfied participants expressed similar mentoring themes: acquisition of research skills, academic productivity, and career development. Four experienced mentors were interviewed and provided rationale for mentoring clinicians in research. Both groups of participants agreed that institutional support is vital for promoting mentorship. Junior pediatric hospitalists and general pediatricians indicated considerable interest in being mentored to learn to do clinical research. Developing faculty and staff physicians to their utmost potential is critical for advancement in academic medicine. Mentoring clinical physicians seeking to add research skills and academic productivity to their practice merits study as an innovative path to develop clinical investigators. Hospital medicine, as a rapidly developing pediatric specialty, is well-positioned to implement the necessary infrastructure to mentor junior faculty in their academic pursuits, thereby optimizing the potential impact for individuals, families, learners, and institutions.

Human regulator of telomere elongation helicase 1 (RTEL1) is required for the nuclear and cytoplasmic trafficking of pre-U2 RNA.

Science.gov (United States)

Schertzer, Michael; Jouravleva, Karina; Perderiset, Mylene; Dingli, Florent; Loew, Damarys; Le Guen, Tangui; Bardoni, Barbara; de Villartay, Jean-Pierre; Revy, Patrick; Londoño-Vallejo, Arturo

2015-02-18

Hoyeraal-Hreidarsson syndrome (HHS) is a severe form of Dyskeratosis congenita characterized by developmental defects, bone marrow failure and immunodeficiency and has been associated with telomere dysfunction. Recently, mutations in Regulator of Telomere ELongation helicase 1 (RTEL1), a helicase first identified in Mus musculus as being responsible for the maintenance of long telomeres, have been identified in several HHS patients. Here we show that RTEL1 is required for the export and the correct cytoplasmic trafficking of the small nuclear (sn) RNA pre-U2, a component of the major spliceosome complex. RTEL1-HHS cells show abnormal subcellular partitioning of pre-U2, defects in the recycling of ribonucleotide proteins (RNP) in the cytoplasm and splicing defects. While most of these phenotypes can be suppressed by re-expressing the wild-type protein in RTEL1-HHS cells, expression of RTEL1 mutated variants in immortalized cells provokes cytoplasmic mislocalizations of pre-U2 and other RNP components, as well as splicing defects, thus phenocopying RTEL1-HHS cellular defects. Strikingly, expression of a cytoplasmic form of RTEL1 is sufficient to correct RNP mislocalizations both in RTEL1-HHS cells and in cells expressing nuclear mutated forms of RTEL1. This work unravels completely unanticipated roles for RTEL1 in RNP trafficking and strongly suggests that defects in RNP biogenesis pathways contribute to the pathology of HHS. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

The minimum agreed upon

NARCIS (Netherlands)

Stella Hoff; Corinne van Gaalen; Arjan Soede; Albert Luten; Cok Vrooman; Sanne Lamers

2010-01-01

What does the concept of poverty mean? What kind of shelter, diet, clothing, participation and recreation does one need in order not to be poor? And what monthly budget is currently required to afford these necessities in the Netherlands? Four focus groups met several times to discuss such

Reshocks, rarefactions, and the generalized Layzer model for hydrodynamic instabilities

International Nuclear Information System (INIS)

Mikaelian, K.O.

2008-01-01

We report numerical simulations and analytic modeling of shock tube experiments on Rayleigh-Taylor and Richtmyer-Meshkov instabilities. We examine single interfaces of the type A/B where the incident shock is initiated in A and the transmitted shock proceeds into B. Examples are He/air and air/He. In addition, we study finite-thickness or double-interface A/B/A configurations like air/SF 6 /air gas-curtain experiments. We first consider conventional shock tubes that have a 'fixed' boundary: A solid endwall which reflects the transmitted shock and reshocks the interface(s). Then we focus on new experiments with a 'free' boundary--a membrane disrupted mechanically or by the transmitted shock, sending back a rarefaction towards the interface(s). Complex acceleration histories are achieved, relevant for Inertial Confinement Fusion implosions. We compare our simulation results with a generalized Layzer model for two fluids with time-dependent densities, and derive a new freeze-out condition whereby accelerating and compressive forces cancel each other out. Except for the recently reported failures of the Layzer model, the generalized Layzer model and hydrocode simulations for reshocks and rarefactions agree well with each other, and remain to be verified experimentally

Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs

DEFF Research Database (Denmark)

Christiansen, Janus D.; Laursen, Mogens B; Ejaz, Ashir

2018-01-01

INTRODUCTION: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). METHODS......: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline......% (95% confidence interval [CI], 4-16; p = 0.003) and 8% (95% CI, 1-15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23-69) to 93 (55...

General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil.

Science.gov (United States)

Ventura, Carla Aparecida Arena; Carrara, Bruna Sordi; Bobbili, Sireesha; Vedana, Kelly Graziani Giacchero; Khenti, Akwatu; Hayashida, Miyeko; Ferreira, Paulo Sergio

2017-09-01

People who use drugs are continuously subjected to harsh stigmatization through a process of relational and social degradation, which limits their possibility for recovery. This quantitative study explores the perspectives of family members or significant others of illicit drug users, regarding general beliefs about illicit drug use and their stigma. Respondents agree that most people do not trust people who use drugs, disregard individuals who have been hospitalized due to drug problems and do not think people who use drugs are as intelligent as the general population. These findings reveal a high level of public stigma regarding illicit drug use.

What Should General Practice Trainees Learn about Atopic Eczema?

Directory of Open Access Journals (Sweden)

Deepani Munidasa

2015-02-01

Full Text Available Effective atopic eczema (AE control not only improves quality of life but may also prevent the atopic march. The Royal College of General Practitioners’ (RCGP curriculum does not currently provide specific learning outcomes on AE management. We aimed to gain consensus on learning outcomes to inform curriculum development. A modified Delphi method was used with questionnaires distributed to gather the views of a range of health care professionals (HCPs including general practitioners (GPs, dermatologists, dermatology nurses and parents of children with AE attending a dedicated paediatric dermatology clinic. Ninety-one questionnaires were distributed to 61 HCPs and 30 parents; 81 were returned. All agreed that learning should focus on the common clinical features, complications and management of AE and the need to appreciate its psychosocial impact. Areas of divergence included knowledge of alternative therapies. Parents felt GPs should better understand how to identify, manage and refer severe AD and recognized the value of the specialist eczema nurse. Dermatologists and parents highlighted inconsistencies in advice regarding topical steroids. This study identifies important areas for inclusion as learning outcomes on AE management in the RCGP curriculum and highlights the importance of patients and parents as a valuable resource in the development of medical education.

Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

DEFF Research Database (Denmark)

Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper

2004-01-01

OBJECTIVE: To assess Danish obstetricians' and gynecologists' personal preference and general attitude towards elective cesarean section on maternal request in uncomplicated single cephalic pregnancies at term. DESIGN: Nation-wide anonymous postal questionnaire. POPULATION: Four hundred and fifty......-five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...... indication. Obstetricians and gynecologists who had experienced a noninstrumental vaginal delivery themselves or practiced as a private gynecologist only, were less likely to agree with the woman's right to elective cesarean section on maternal request. CONCLUSION: The vast majority of Danish obstetricians...

Three counting methods agree on cell and neuron number in chimpanzee primary visual cortex

Directory of Open Access Journals (Sweden)

Daniel James Miller

2014-05-01

Full Text Available Determining the cellular composition of specific brain regions is crucial to our understanding of the function of neurobiological systems. It is therefore useful to identify the extent to which different methods agree when estimating the same properties of brain circuitry. In this study, we estimated the number of neuronal and non-neuronal cells in the primary visual cortex (area 17 or V1 of both hemispheres from a single chimpanzee. Specifically, we processed samples distributed across V1 of the right hemisphere after cortex was flattened into a sheet using two variations of the isotropic fractionator cell and neuron counting method. We processed the left hemisphere as serial brain slices for stereological investigation. The goal of this study was to evaluate the agreement between these methods in the most direct manner possible by comparing estimates of cell density across one brain region of interest in a single individual. In our hands, these methods produced similar estimates of the total cellular population (approximately 1 billion as well as the number of neurons (approximately 675 million in chimpanzee V1, providing evidence that both techniques estimate the same parameters of interest. In addition, our results indicate the strengths of each distinct tissue preparation procedure, highlighting the importance of attention to anatomical detail. In summary, we found that the isotropic fractionator and the stereological optical fractionator produced concordant estimates of the cellular composition of V1, and that this result supports the conclusion that chimpanzees conform to the primate pattern of exceptionally high packing density in V1. Ultimately, our data suggest that investigators can optimize their experimental approach by using any of these counting methods to obtain reliable cell and neuron counts.

Transition probabilities for general birth-death processes with applications in ecology, genetics, and evolution

Science.gov (United States)

Crawford, Forrest W.; Suchard, Marc A.

2011-01-01

A birth-death process is a continuous-time Markov chain that counts the number of particles in a system over time. In the general process with n current particles, a new particle is born with instantaneous rate λn and a particle dies with instantaneous rate μn. Currently no robust and efficient method exists to evaluate the finite-time transition probabilities in a general birth-death process with arbitrary birth and death rates. In this paper, we first revisit the theory of continued fractions to obtain expressions for the Laplace transforms of these transition probabilities and make explicit an important derivation connecting transition probabilities and continued fractions. We then develop an efficient algorithm for computing these probabilities that analyzes the error associated with approximations in the method. We demonstrate that this error-controlled method agrees with known solutions and outperforms previous approaches to computing these probabilities. Finally, we apply our novel method to several important problems in ecology, evolution, and genetics. PMID:21984359

Communication: General variational approach to nuclear-quadrupole coupling in rovibrational spectra of polyatomic molecules

Science.gov (United States)

Yachmenev, Andrey; Küpper, Jochen

2017-10-01

A general algorithm for computing the quadrupole-hyperfine effects in the rovibrational spectra of polyatomic molecules is presented for the case of ammonia (NH3). The method extends the general variational approach TROVE [J. Mol. Spectrosc. 245, 126-140 (2007)] by adding the extra term in the Hamiltonian that describes the nuclear quadrupole coupling, with no inherent limitation on the number of quadrupolar nuclei in a molecule. We applied the new approach to compute the nitrogen-nuclear-quadrupole hyperfine structure in the rovibrational spectrum of NH143. These results agree very well with recent experimental spectroscopic data for the pure rotational transitions in the ground vibrational and ν2 states and the rovibrational transitions in the ν1, ν3, 2ν4, and ν1 + ν3 bands. The computed hyperfine-resolved rovibrational spectrum of ammonia will be beneficial for the assignment of experimental rovibrational spectra, further detection of ammonia in interstellar space, and studies of the proton-to-electron mass variation.

Responses to lost letters about a 2000 General Election amendment to abolish prohibition of interracial marriages in Alabama.

Science.gov (United States)

Bridges, F Stephen; Keeton, Kato B; Clark, L Nicholle

2002-12-01

A field study using 621 "lost" letters was conducted in the city of Mobile and in small towns in mostly rural Baldwin County, Alabama. Milgram's lost letter technique was validated against the actual votes cast during the November 7, 2000 General Election. The technique was successful as an unobtrusive measure useful for predicting patterns of voting behavior. Rates of return of lost letters "in favor of and opposed to legalizing interracial marriage" agreed with the actual election returns (chi-square "goodness of fit"). Community size seemed associated with return of lost letters.

78 FR 42951 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

Science.gov (United States)

2013-07-18

... the document identifier HHS-OS-19133-30D for reference. Information Collection Request Title: MOVE... and Human Services (HHS) Coordinating Committee on Lesbian, Gay, Bi-sexual and Transgender (LGBT...

Centralization of politrauma. Study of Ferrara’s reality and simulation of an agreed-upon protocol

Directory of Open Access Journals (Sweden)

Luigi Melcarne

2011-09-01

Full Text Available In a time in which everybody’s asked a big effort to use hospitals, resources and emergency departments in a rational way, the Centralization – that is sending the right patient to the right hospital at the right time – allows an optimization of the resources and a better management of medical patients. In this study we examined the actual state of Centralization in the city of Ferrara where an experimental protocol of “centralization” has been introduced. This study has the purpose of simulating reality if the protocol had been introduced in the years 2008/2009. The results confirm not only that an important number of patients that were meant to be sent to the CTZ of Ferrara where instead sent to the PST but also that, on the contrary, patients from the suburbs that didn’t require advanced treatments were sent to the Sant’Anna hospital of Ferrara. So if medical literature already points out the advantages of a correct Centralization for patients with polytraumas; the study, based on the reality in Ferrara , shows how the creation of an agreed protocol with the goal to guide health workers at sending polytrauma patients to the right destination , instead of creating an excessive flow th the main hub, can improve the overall organization of health services, with an equal distribution between hub and spoke. When considering First Aid not always speed and rapidity guarantee survival; this is so much more real in the case of patients with polytrauma, where quality of cures assumes more importance than time.

78 FR 56897 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Science.gov (United States)

2013-09-16

... Health and Human Services (HHS), HHS collects some basic information about the company's product through... necessity and utility of the proposed information collection for the proper performance of the agency's...

77 FR 31856 - Meeting of the Chronic Fatigue Syndrome Advisory Committee

Science.gov (United States)

2012-05-30

... streamed at www.HHS.gov/Live and archived through the CFSAC Web site: www.hhs.gov/advocomcfs . Listening... not include sensitive personal information, such as social security number, birthdates, driver's...

77 FR 57089 - Meeting of the Chronic Fatigue Syndrome Advisory Committee

Science.gov (United States)

2012-09-17

... streamed at www.HHS.gov/Live and archived through the CFSAC Web site: www.hhs.gov/advocomcfs . Listening..., such as social security number, birthdates, driver's license number, state identification or foreign...

Motivations and Training Needs of General Practitioner Preceptors

Science.gov (United States)

Ren, Wen; Hasenbieke, Nulanbieke; Liu, Ying; Qiu, Yan; Zhou, Zhao-Nong; Mao, Xiao-Yan; Ren, Jing-Jing

2017-01-01

Background: General practitioner (GP) preceptors play an important role in the cultivation of GPs. Many problems exist in the training of GP preceptors. This study aimed to explore the willingness and training needs of GP preceptors and compare the differences between preceptors from general practice and other specialties. Methods: A total of 375 questionnaire forms were sent to 375 GP preceptors from 11 different provinces, and 344 completed forms were returned. The main outcome included general information, teaching motivations, and training needs of GP preceptors. Results: The study showed that about 89.2% of GP preceptors were willing to be teachers. The majority of respondents strongly agreed that the motivation for becoming a GP supervisor was to learn from teaching. The most important capability they should master was clinical teaching (92.2%), followed by lecture (83.1%) and doctor–patient communication (83.1%). The top three preferred methods of GP preceptors training were case discussion (78.8%), workshop (57.6%), and classroom teaching (56.4%). The domains in which most GP preceptors wanted to acquire knowledge and skill were mental health (59.3%), rehabilitation (47.1%), pediatrics (41.0%), and obstetrics (37.5%). No significant differences were found in the willingness to train GPs (χ2 = 3.34, P > 0.05) and whether they would become or continue to become a GP supervisor after the training (χ2 = 1.106, P > 0.05). Conclusions: Although most preceptors were under on-the-job training, they were glad to train GPs. To be qualified, preceptors should be trained according to the actual needs of GP preceptors. PMID:28685719

General relativistic continuum mechanics and the post-Newtonian equations of motion

International Nuclear Information System (INIS)

Morrill, T.H.

1991-01-01

Aspects are examined of general relativistic continuum mechanics. Perfectly elastic materials are dealt with but not exclusively. The derivation of their equations of motion is emphasized, in the post-Newtonian approximation. A reformulation is presented based on the tetrad formalism, of Carter and Quintana's theory of general relativistic elastic continua. A field Lagrangian is derived describing perfect material media; show that the usual covariant conservations law for perfectly elastic media is fully equivalent to the Euler-Lagrange equations describing these same media; and further show that the equations of motion for such materials follow directly from Einstein's field equations. In addition, a version of this principle shows that the local mass density in curved space-time partially depends on the amount and distribution of mass energy in the entire universe and is related to the mass density that would occur if space-time were flat. The total Lagrangian was also expanded in an EIH (Einstein, Infeld, Hoffmann) series to obtain a total post-Newtonian Lagrangian. The results agree with those found by solving Einstein's equations for the metric coefficients and by deriving the post-Newtonian equations of motion from the covariant conservation law

Connections between the Sznajd model with general confidence rules and graph theory

Science.gov (United States)

Timpanaro, André M.; Prado, Carmen P. C.

2012-10-01

The Sznajd model is a sociophysics model that is used to model opinion propagation and consensus formation in societies. Its main feature is that its rules favor bigger groups of agreeing people. In a previous work, we generalized the bounded confidence rule in order to model biases and prejudices in discrete opinion models. In that work, we applied this modification to the Sznajd model and presented some preliminary results. The present work extends what we did in that paper. We present results linking many of the properties of the mean-field fixed points, with only a few qualitative aspects of the confidence rule (the biases and prejudices modeled), finding an interesting connection with graph theory problems. More precisely, we link the existence of fixed points with the notion of strongly connected graphs and the stability of fixed points with the problem of finding the maximal independent sets of a graph. We state these results and present comparisons between the mean field and simulations in Barabási-Albert networks, followed by the main mathematical ideas and appendices with the rigorous proofs of our claims and some graph theory concepts, together with examples. We also show that there is no qualitative difference in the mean-field results if we require that a group of size q>2, instead of a pair, of agreeing agents be formed before they attempt to convince other sites (for the mean field, this would coincide with the q-voter model).

Household Obesity Prevention: Take Action—a Group-Randomized Trial

Science.gov (United States)

French, Simone A.; Gerlach, Anne F.; Mitchell, Nathan R.; Hannan, Peter J.; Welsh, Ericka M.

2018-01-01

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated. PMID:21212771

Constitutional mutations in RTEL1 cause severe dyskeratosis congenita.

Science.gov (United States)

Walne, Amanda J; Vulliamy, Tom; Kirwan, Michael; Plagnol, Vincent; Dokal, Inderjeet

2013-03-07

Dyskeratosis congenita (DC) and its phenotypically severe variant, Hoyeraal-Hreidarsson syndrome (HHS), are multisystem bone-marrow-failure syndromes in which the principal pathology is defective telomere maintenance. The genetic basis of many cases of DC and HHS remains unknown. Using whole-exome sequencing, we identified biallelic mutations in RTEL1, encoding a helicase essential for telomere maintenance and regulation of homologous recombination, in an individual with familial HHS. Additional screening of RTEL1 identified biallelic mutations in 6/23 index cases with HHS but none in 102 DC or DC-like cases. All 11 mutations in ten HHS individuals from seven families segregated in an autosomal-recessive manner, and telomere lengths were significantly shorter in cases than in controls (p = 0.0003). This group had significantly higher levels of telomeric circles, produced as a consequence of incorrect processing of telomere ends, than did controls (p = 0.0148). These biallelic RTEL1 mutations are responsible for a major subgroup (∼29%) of HHS. Our studies show that cells harboring these mutations have significant defects in telomere maintenance, but not in homologous recombination, and that incorrect resolution of T-loops is a mechanism for telomere shortening and disease causation in humans. They also demonstrate the severe multisystem consequences of its dysfunction. Copyright © 2013 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Are surgery training programs ready for virtual reality? A survey of program directors in general surgery.

Science.gov (United States)

Haluck, R S; Marshall, R L; Krummel, T M; Melkonian, M G

2001-12-01

The use of advanced technology, such as virtual environments and computer-based simulators (VR/CBS), in training has been well established by both industry and the military. In contrast the medical profession, including surgery, has been slow to incorporate such technology in its training. In an attempt to identify factors limiting the regular incorporation of this technology into surgical training programs, a survey was developed and distributed to all general surgery program directors in the United States. A 22-question survey was sent to 254 general surgery program directors. The survey was designed to reflect attitudes of the program directors regarding the use of computer-based simulation in surgical training. Questions were scaled from 1 to 5 with 1 = strongly disagree and 5 = strongly agree. A total of 139 responses (55%) were returned. The majority of respondents (58%) had seen VR/CBS, but only 19% had "hands-on" experience with these systems. Respondents strongly agreed that there is a need for learning opportunities outside of the operating room and a role for VR/CBS in surgical training. Respondents believed both staff and residents would support this type of training. Concerns included VR/CBS' lack of validation and potential requirements for frequent system upgrades. Virtual environments and computer-based simulators, although well established training tools in other fields, have not been widely incorporated into surgical education. Our results suggest that program directors believe this type of technology would be beneficial in surgical education, but they lack adequate information regarding VR/CBS. Developers of this technology may need to focus on educating potential users and addressing their concerns.

Repository of Evaluation Reports

Data.gov (United States)

U.S. Department of Health & Human Services — To inform the HHS, Congress, and the public about the efficiency, effectiveness, and integrity of HHS programs and to recommend actions to promote those goals.

42 CFR 93.318 - Notifying ORI of special circumstances.

Science.gov (United States)

2010-10-01

... need to protect human or animal subjects. (b) HHS resources or interests are threatened. (c) Research... public prematurely so that HHS may take appropriate steps to safeguard evidence and protect the rights of...

Hypnotizability, hypnosis and prepulse inhibition of the startle reflex in healthy women: an ERP analysis.

Science.gov (United States)

De Pascalis, Vilfredo; Russo, Emanuela

2013-01-01

A working model of the neurophysiology of hypnosis suggests that highly hypnotizable individuals (HHs) have more effective frontal attentional systems implementing control, monitoring performance, and inhibiting unwanted stimuli from conscious awareness, than low hypnotizable individuals (LHs). Recent studies, using prepulse inhibition (PPI) of the auditory startle reflex (ASR), suggest that HHs, in the waking condition, may show reduced sensory gating although they may selectively attend and disattend different stimuli. Using a within subject design and a strict subject selection procedure, in waking and hypnosis conditions we tested whether HHs compared to LHs showed a significantly lower inhibition of the ASR and startle-related brain activity in both time and intracerebral source localization domains. HHs, as compared to LH participants, exhibited (a) longer latency of the eyeblink startle reflex, (b) reduced N100 responses to startle stimuli, and (c) higher PPI of eyeblink startle and of the P200 and P300 waves. Hypnosis yielded smaller N100 waves to startle stimuli and greater PPI of this component than in the waking condition. sLORETA analysis revealed that, for the N100 (107 msec) elicited during startle trials, HHs had a smaller activation in the left parietal lobe (BA2/40) than LHs. Auditory pulses of pulse-with prepulse trials in HHs yielded less activity of the P300 (280 msec) wave than LHs, in the cingulate and posterior cingulate gyrus (BA23/31). The present results, on the whole, are in the opposite direction to PPI findings on hypnotizability previously reported in the literature. These results provide support to the neuropsychophysiological model that HHs have more effective sensory integration and gating (or filtering) of irrelevant stimuli than LHs.

Developing Agreed and Accepted Understandings of Spirituality and Spiritual Care Concepts among Members of an Innovative Spirituality Interest Group in the Republic of Ireland

Directory of Open Access Journals (Sweden)

Fiona Timmins

2016-03-01

Full Text Available A Spirituality Interest Group (SIG was set up in in the School of Nursing and Midwifery, Trinity College Dublin, Republic of Ireland (ROI, in March 2013. This paper reports on some of the journey and requirements involved in developing the group. It highlights the essential work of establishing agreed understandings in an objective way in order for the group to move forward with action. These agreed understandings have contributed to the group’s success. Outlining the group’s journey in arriving at agreements may be of use to others considering creating similar groups. One key action taken to determine the suitability of the group’s aims and terms of reference was the distribution of a Survey Monkey to group members (n = 28 in 2014. One early meeting of the group discussed future goals and direction using the responses of this anonymous survey. This paper reports on the results of the survey regarding the establishment of the SIG and the development of a shared understanding of spiritual care among the members. There is consensus in the group that the spiritual care required by clients receiving healthcare ought to be an integrated effort across the healthcare team. However, there is an acceptance that spirituality and spiritual care are not always clearly understood concepts in practice. By developing shared or at least accepted understandings of spirituality and spiritual care, SIG hopes to be able to underpin both research and practice with solid foundational conceptual understanding, and in the process also to meet essential prerequisites for achieving the group’s aims.

The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation.

Science.gov (United States)

Henderson, Emily J; Rubin, Greg P

2013-05-01

To evaluate the utility of Isabel, an online diagnostic decision support system developed by Isabel Healthcare primarily for secondary medical care, in the general practice setting. Focus groups were conducted with clinicians to understand why and how they used the system. A modified online post-use survey asked practitioners about its impact on their decision-making. Normalization process theory (NPT) was used as a theoretical framework to determine whether the system could be incorporated into routine clinical practice. The system was introduced by NHS County Durham and Darlington in the UK in selected general practices as a three-month pilot. General practitioners and nurse practitioners who had access to Isabel as part of the Primary Care Trust's pilot. General practitioners' views, experiences and usage of the system. Seven general practices agreed to pilot Isabel. Two practices did not subsequently use it. The remaining five practices conducted searches on 16 patients. Post-use surveys (n = 10) indicated that Isabel had little impact on diagnostic decision-making. Focus group participants stated that, although the diagnoses produced by Isabel in general did not have an impact on their decision-making, they would find the tool useful if it were better tailored to the primary care setting. Our analysis concluded that normalization was not likely to occur in its current form. Isabel was of limited utility in this short pilot study and may need further modification for use in general practice.

Illness Mapping: a time and cost effective method to estimate healthcare data needed to establish community-based health insurance

Directory of Open Access Journals (Sweden)

Binnendijk Erika

2012-10-01

Full Text Available Abstract Background Most healthcare spending in developing countries is private out-of-pocket. One explanation for low penetration of health insurance is that poorer individuals doubt their ability to enforce insurance contracts. Community-based health insurance schemes (CBHI are a solution, but launching CBHI requires obtaining accurate local data on morbidity, healthcare utilization and other details to inform package design and pricing. We developed the “Illness Mapping” method (IM for data collection (faster and cheaper than household surveys. Methods IM is a modification of two non-interactive consensus group methods (Delphi and Nominal Group Technique to operate as interactive methods. We elicited estimates from “Experts” in the target community on morbidity and healthcare utilization. Interaction between facilitator and experts became essential to bridge literacy constraints and to reach consensus. The study was conducted in Gaya District, Bihar (India during April-June 2010. The intervention included the IM and a household survey (HHS. IM included 18 women’s and 17 men’s groups. The HHS was conducted in 50 villages with1,000 randomly selected households (6,656 individuals. Results We found good agreement between the two methods on overall prevalence of illness (IM: 25.9% ±3.6; HHS: 31.4% and on prevalence of acute (IM: 76.9%; HHS: 69.2% and chronic illnesses (IM: 20.1%; HHS: 16.6%. We also found good agreement on incidence of deliveries (IM: 3.9% ±0.4; HHS: 3.9%, and on hospital deliveries (IM: 61.0%. ± 5.4; HHS: 51.4%. For hospitalizations, we obtained a lower estimate from the IM (1.1% than from the HHS (2.6%. The IM required less time and less person-power than a household survey, which translate into reduced costs. Conclusions We have shown that our Illness Mapping method can be carried out at lower financial and human cost for sourcing essential local data, at acceptably accurate levels. In view of the good fit of

Illness Mapping: a time and cost effective method to estimate healthcare data needed to establish community-based health insurance.

Science.gov (United States)

Binnendijk, Erika; Gautham, Meenakshi; Koren, Ruth; Dror, David M

2012-10-09

Most healthcare spending in developing countries is private out-of-pocket. One explanation for low penetration of health insurance is that poorer individuals doubt their ability to enforce insurance contracts. Community-based health insurance schemes (CBHI) are a solution, but launching CBHI requires obtaining accurate local data on morbidity, healthcare utilization and other details to inform package design and pricing. We developed the "Illness Mapping" method (IM) for data collection (faster and cheaper than household surveys). IM is a modification of two non-interactive consensus group methods (Delphi and Nominal Group Technique) to operate as interactive methods. We elicited estimates from "Experts" in the target community on morbidity and healthcare utilization. Interaction between facilitator and experts became essential to bridge literacy constraints and to reach consensus.The study was conducted in Gaya District, Bihar (India) during April-June 2010. The intervention included the IM and a household survey (HHS). IM included 18 women's and 17 men's groups. The HHS was conducted in 50 villages with1,000 randomly selected households (6,656 individuals). We found good agreement between the two methods on overall prevalence of illness (IM: 25.9% ±3.6; HHS: 31.4%) and on prevalence of acute (IM: 76.9%; HHS: 69.2%) and chronic illnesses (IM: 20.1%; HHS: 16.6%). We also found good agreement on incidence of deliveries (IM: 3.9% ±0.4; HHS: 3.9%), and on hospital deliveries (IM: 61.0%. ± 5.4; HHS: 51.4%). For hospitalizations, we obtained a lower estimate from the IM (1.1%) than from the HHS (2.6%). The IM required less time and less person-power than a household survey, which translate into reduced costs. We have shown that our Illness Mapping method can be carried out at lower financial and human cost for sourcing essential local data, at acceptably accurate levels. In view of the good fit of results obtained, we assume that the method could work elsewhere

Reshocks, rarefactions, and the generalized Layzer model for hydrodynamic instabilities

Energy Technology Data Exchange (ETDEWEB)

Mikaelian, K O

2008-06-10

We report numerical simulations and analytic modeling of shock tube experiments on Rayleigh-Taylor and Richtmyer-Meshkov instabilities. We examine single interfaces of the type A/B where the incident shock is initiated in A and the transmitted shock proceeds into B. Examples are He/air and air/He. In addition, we study finite-thickness or double-interface A/B/A configurations like air/SF{sub 6}/air gas-curtain experiments. We first consider conventional shock tubes that have a 'fixed' boundary: A solid endwall which reflects the transmitted shock and reshocks the interface(s). Then we focus on new experiments with a 'free' boundary--a membrane disrupted mechanically or by the transmitted shock, sending back a rarefaction towards the interface(s). Complex acceleration histories are achieved, relevant for Inertial Confinement Fusion implosions. We compare our simulation results with a generalized Layzer model for two fluids with time-dependent densities, and derive a new freeze-out condition whereby accelerating and compressive forces cancel each other out. Except for the recently reported failures of the Layzer model, the generalized Layzer model and hydrocode simulations for reshocks and rarefactions agree well with each other, and remain to be verified experimentally.

Effect of personal and work stress on burnout, job satisfaction and general health of hospital nurses in South Africa

Directory of Open Access Journals (Sweden)

Natasha Khamisa

2017-10-01

Full Text Available The majority of studies to date have focused on the effects of work stress in the nursing environment, with the effect of personal stress in nursing being less explored. This study sought to determine whether personal stress is a more significant predictor of burnout, job satisfaction and general health than work stress. Of the 1200 nurses randomly selected to participate in the study, 895 agreed to complete six questionnaires over 3 weeks. Data was analysed using hierarchical multiple linear regression. Findings revealed that personal stress is a better predictor of burnout and general health than job satisfaction, which is better predicted by work stress. The findings of this study could inform potential solutions to reduce the impact of personal and work stress on burnout, job satisfaction and general health. Coping strategies and staffing strategies need to be evaluated within developing contexts such as South Africa to as certain their effectiveness.

Pain Information Brochure

Science.gov (United States)

... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ...

NIH Pain Consortium

Science.gov (United States)

... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ...

Repository of Audit Reports

Data.gov (United States)

U.S. Department of Health & Human Services — To inform the HHS, Congress, and the public about the efficiency, effectiveness, and integrity of HHS programs and to recommend actions to promote those goals. To...

Management of dental trauma in primary care: a postal survey of general dental practitioners.

Science.gov (United States)

Jackson, N G; Waterhouse, P J; Maguire, A

2005-03-12

To determine the self-perceived knowledge and attitudes of general dental practitioners (GDPs) concerning management of dental trauma in primary care. To identify potential barriers to the management of dental trauma in primary care. A self-completion postal questionnaire survey of 417 GDPs in six local health authority districts in northeast England. Likert scale responses to 20 statements designed to test self-perceived knowledge and attitudes. Following descriptive statistical analysis. Factor analysis with principle components analysis was undertaken to identify areas of correlation in questionnaire responses, followed by Chi squared test, Spearman's Rank Correlation and analysis of variance (ANOVA) to measure association between variables. The response rate was 74%. Enamel and dentine fractures were the most common injury, with 45% of GDPs responding seeing more than 10 cases of dental trauma in the preceding year and 53% of respondents seeing one to three cases of complicated crown fracture. Seventy-eight per cent believed that NHS remuneration was inadequate, but only 8% would refer patients with dental trauma to secondary care for this reason. Half of the GDPs believed that trauma could be treated more effectively in practice if NHS payments were greater. GDPs were significantly more likely to agree with this statement if they had previously undertaken a postgraduate course in the treatment of dental trauma (p=0.002). Single handed GDPs were statistically significantly more likely to agree with the statements 'I would not treat dental trauma cases at my practice because the NHS payment is inadequate' (p=0.008) and 'Treating dental trauma at my practice requires too much of my clinical time to be worthwhile' (p=0.002). Ninety-six per cent of GDPs disagreed that treatment of dental trauma rested solely within secondary care. Ninety-six per cent of GDPs agreed that they had a responsibility to provide initial emergency treatment for trauma patients prior to

Bivariate spatial analysis of temperature and precipitation from general circulation models and observation proxies

KAUST Repository

Philbin, R.

2015-05-22

This study validates the near-surface temperature and precipitation output from decadal runs of eight atmospheric ocean general circulation models (AOGCMs) against observational proxy data from the National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis temperatures and Global Precipitation Climatology Project (GPCP) precipitation data. We model the joint distribution of these two fields with a parsimonious bivariate Matérn spatial covariance model, accounting for the two fields\\' spatial cross-correlation as well as their own smoothnesses. We fit output from each AOGCM (30-year seasonal averages from 1981 to 2010) to a statistical model on each of 21 land regions. Both variance and smoothness values agree for both fields over all latitude bands except southern mid-latitudes. Our results imply that temperature fields have smaller smoothness coefficients than precipitation fields, while both have decreasing smoothness coefficients with increasing latitude. Models predict fields with smaller smoothness coefficients than observational proxy data for the tropics. The estimated spatial cross-correlations of these two fields, however, are quite different for most GCMs in mid-latitudes. Model correlation estimates agree well with those for observational proxy data for Australia, at high northern latitudes across North America, Europe and Asia, as well as across the Sahara, India, and Southeast Asia, but elsewhere, little consistent agreement exists.

Bivariate spatial analysis of temperature and precipitation from general circulation models and observation proxies

KAUST Repository

Philbin, R.; Jun, M.

2015-01-01

This study validates the near-surface temperature and precipitation output from decadal runs of eight atmospheric ocean general circulation models (AOGCMs) against observational proxy data from the National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis temperatures and Global Precipitation Climatology Project (GPCP) precipitation data. We model the joint distribution of these two fields with a parsimonious bivariate Matérn spatial covariance model, accounting for the two fields' spatial cross-correlation as well as their own smoothnesses. We fit output from each AOGCM (30-year seasonal averages from 1981 to 2010) to a statistical model on each of 21 land regions. Both variance and smoothness values agree for both fields over all latitude bands except southern mid-latitudes. Our results imply that temperature fields have smaller smoothness coefficients than precipitation fields, while both have decreasing smoothness coefficients with increasing latitude. Models predict fields with smaller smoothness coefficients than observational proxy data for the tropics. The estimated spatial cross-correlations of these two fields, however, are quite different for most GCMs in mid-latitudes. Model correlation estimates agree well with those for observational proxy data for Australia, at high northern latitudes across North America, Europe and Asia, as well as across the Sahara, India, and Southeast Asia, but elsewhere, little consistent agreement exists.

A General Symbolic PDE Solver Generator: Explicit Schemes

Directory of Open Access Journals (Sweden)

K. Sheshadri

2003-01-01

Full Text Available A symbolic solver generator to deal with a system of partial differential equations (PDEs in functions of an arbitrary number of variables is presented; it can also handle arbitrary domains (geometries of the independent variables. Given a system of PDEs, the solver generates a set of explicit finite-difference methods to any specified order, and a Fourier stability criterion for each method. For a method that is stable, an iteration function is generated symbolically using the PDE and its initial and boundary conditions. This iteration function is dynamically generated for every PDE problem, and its evaluation provides a solution to the PDE problem. A C++/Fortran 90 code for the iteration function is generated using the MathCode system, which results in a performance gain of the order of a thousand over Mathematica, the language that has been used to code the solver generator. Examples of stability criteria are presented that agree with known criteria; examples that demonstrate the generality of the solver and the speed enhancement of the generated C++ and Fortran 90 codes are also presented.

SUMMARY OF GENERAL WORKING GROUP A+B+D: CODES BENCHMARKING.

Energy Technology Data Exchange (ETDEWEB)

WEI, J.; SHAPOSHNIKOVA, E.; ZIMMERMANN, F.; HOFMANN, I.

2006-05-29

Computer simulation is an indispensable tool in assisting the design, construction, and operation of accelerators. In particular, computer simulation complements analytical theories and experimental observations in understanding beam dynamics in accelerators. The ultimate function of computer simulation is to study mechanisms that limit the performance of frontier accelerators. There are four goals for the benchmarking of computer simulation codes, namely debugging, validation, comparison and verification: (1) Debugging--codes should calculate what they are supposed to calculate; (2) Validation--results generated by the codes should agree with established analytical results for specific cases; (3) Comparison--results from two sets of codes should agree with each other if the models used are the same; and (4) Verification--results from the codes should agree with experimental measurements. This is the summary of the joint session among working groups A, B, and D of the HI32006 Workshop on computer codes benchmarking.

Measuring dental fear using the CFSS-DS. Do children and parents agree?

Science.gov (United States)

Krikken, Janneke B; van Wijk, Arjen J; ten Cate, Jacob M; Veerkamp, Jaap S J

2013-03-01

In most studies, the parental version of the CFSS-DS is used; however, no information is available concerning the extent to which parents are able to report dental fear on behalf of their children. This study aims to assess whether parents are accurate reporters of their child's dental fear. The CFSS-DS was filled out by 326 children in a classroom setting and by 167 parents (mostly mothers) at home on behalf of their child. Intraclass correlation coefficients were used as a measure of agreement between both CFSS-DS versions, and reasons for nonagreement were assessed. Mean CFSS-DS for children was 21.15 (SD = 6.4) and for parents 23.26 (SD = 6.7). The intraclass correlation coefficient was 0.57. After selection of the 73.1% most accurate reporting parents, the ICC was 0.90. In general, parents estimate the dental fear of their children higher than their children do (P ≤ 0.001), whereas parents of high anxious children (HAC) estimate this fear lower, and parents of low anxious children (LAC) estimate this fear higher. Anxious parents (AP) estimate the dental fear of their children significantly higher than nonanxious parents (NAP) (P ≤ 0.001), but the children of AP do not estimate their own dental fear higher than children of NAP. In general, parents tend to estimate the dental fear of their children slightly higher than their children. © 2012 The Authors. International Journal of Paediatric Dentistry © 2012 BSPD, IAPD and Blackwell Publishing Ltd.

77 FR 11116 - Draft National Plan To Address Alzheimer's Disease

Science.gov (United States)

2012-02-24

... Alzheimer's Disease, which is available at http://aspe.hhs.gov/daltcp/napa/NatlPlan.shtml . DATES: Submit... Web site as soon as possible after they have been received: http://aspe.hhs.gov/daltcp/napa/#comments...

Developing Common Competencies for Southeast Asian General Dental Practitioners.

Science.gov (United States)

Chuenjitwongsa, Supachai; Poolthong, Suchit; Bullock, Alison; Oliver, Richard G

2017-09-01

Current policy in Southeast Asian dental education focuses on high-quality dental services from new dental graduates and the free movement of dental practitioners across the region. The Southeast Asian Nations (ASEAN) Dental Councils have proposed the "Common Major Competencies for ASEAN General Dental Practitioners" to harmonize undergraduate dental education. This article discusses how the ASEAN competencies were developed and established to assist the development of general dental practitioners with comparable knowledge, skills, and attitudes across ASEAN. The competencies were developed through four processes: a questionnaire about current national oral health problems, a two-round Delphi process that sought agreement on competencies, a panel discussion by representatives from ASEAN Dental Councils, and data verification by the representatives after the meeting. Key themes of the ASEAN competencies were compared with the competencies from the U.S., Canada, Europe, Australia, and Japan. A total of 33 competency statements, consistent with other regions, were agreed upon and approved. Factors influencing the ASEAN competencies and their implementation include oral health problems in ASEAN, new knowledge and technology in dentistry, limited institutional resources, underregulated dental schools, and uneven distribution of dental practitioners. The ASEAN competencies will serve as the foundation for further developments in ASEAN dental education including policy development, curriculum revision, quality assurance, and staff development. Collaboration amongst stakeholders is essential for successful harmonization of ASEAN dental education.

Coulomb excitation of rotational states in the 162Dy nucleus in the framework of the generalized semiclassical approximation

International Nuclear Information System (INIS)

Bolotin, Yu.L.; Gonchar, V.Yu.; Chekanov, N.A.

1985-01-01

Coulomb excitation of rotational states induced in heavyion collisions is treated in the framework of the generalized semiclassical approximation. The Hamiltonian of the system under consideration involves not only Coulomb forces (monopole, quadrupole, and hexadecapole) but as well a real nuclear potential in the form of the deformed Woods-Saxon potential. Strong dependence of the excitation probability on the interference between the Coulomb and nuclear interactions is shown. Calculations are carried out for the reaction 40 Ar+ 162 Dy at E=148.6 MeV. The calculated Coulomb excitation probabilities agree satisfactory with the corresponding experimental values

HHS Administration for Children and Families Table of Contents for Listings of Agency Data Sets

Data.gov (United States)

U.S. Department of Health & Human Services — This is a compilation of URLs, dataset names and general information about the Federal Assistance Award (CFDA) program name, the associated sub-agency and the types...

32 CFR 176.10 - Applicability.

Science.gov (United States)

2010-07-01

... received by HHS prior to October 25, 1994, and were spending with the Secretary of HHS on that date. These... application, but property has not been assigned or otherwise disposed of by the Military Department, the LRA...

The characteristics of general practice and the attractiveness of working as a GP: medical students' views.

Science.gov (United States)

Landstrom, Bjorn; Mattsson, Bengt; Nordin, Per; Rudebeck, Carl E

2014-03-15

The aim of the study was to investigate medical students' views on general practice based on their experiences in training, and to find out whether there were certain views associated with the intention to become a GP. A questionnaire, based on our earlier studies about GP working behaviour, was handed out to medical students in terms 1, 3, 5, 7, 10 and 11 of undergraduate studies in Gothenburg, Sweden. The analysis comprised statistical descriptions and comparisons. The students regarded general practice positively. They found the work environment good, the GP's awareness of patients' living conditions necessary, and that GP work requires medical breadth. The status of the GP in the medical profession was not considered high. One-fourth of the students strongly agreed with the possibility of a future as a GP. This attitude was statistically associated with support to the statements that general practice offers a good work environment and should be a major component in undergraduate training. Students with a negative attitude to working as GPs were also negative to having a major component of general practice in undergraduate training. Medical students with a positive stated attitude towards becoming GPs support changes in undergraduate training to include more general practice. The risk of increasing a negative attitude should be considered when changes are discussed.

Developing and implementing health and sustainability guidelines for institutional food service.

Science.gov (United States)

Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

2012-05-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

Science.gov (United States)

Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

2012-01-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

Hip Arthroscopy Outcomes With Respect to Patient Acceptable Symptomatic State and Minimal Clinically Important Difference.

Science.gov (United States)

Levy, David M; Kuhns, Benjamin D; Chahal, Jaskarndip; Philippon, Marc J; Kelly, Bryan T; Nho, Shane J

2016-09-01

To determine whether the hip arthroscopy literature to date has shown outcomes consistent with published patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) estimates. All clinical investigations of hip arthroscopy using modified Harris Hip Score (mHHS) and/or Hip Outcome Score (HOS) outcomes with at least 1 year of follow-up were reviewed. Ninety-one studies (9,746 hips) were included for review. Eighty-one studies (9,317 hips) contained only primary hip arthroscopies and were the primary focus of this review. The remaining studies (429 hips) did not exclude patients with prior surgical history and were thus considered separately. Mean mHHS, HOS-ADL (Activities of Daily Living) and HOS-SS (Sports-Specific) scores were compared with previously published PASS and MCID values. After 31 ± 20 months, 5.8% of study populations required revision arthroscopy and 5.5% total hip arthroplasty. A total of 88%, 25%, and 30% of study populations met PASS for mHHS, HOS-ADL, and HOS-SS, respectively, and 97%, 90%, and 93% met MCID. On bivariate analysis, increasing age was associated with significantly worse postoperative mHHS (P arthroscopy, we have found that more than 90% of study populations meet MCID standards for the most commonly used patient-reported outcomes measures in hip arthroscopy literature, mHHS and HOS. Eighty-eight percent meet PASS standards for the mHHS, but PASS standards are far more difficult to achieve for HOS-ADL (25%) and HOS-SS (30%) subscales. Differences in psychometric properties of the mHHS and HOS likely account for the discrepancies in PASS. Level IV, systematic review of Level I to IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Hypnotizability, hypnosis and prepulse inhibition of the startle reflex in healthy women: an ERP analysis.

Directory of Open Access Journals (Sweden)

Vilfredo De Pascalis

Full Text Available A working model of the neurophysiology of hypnosis suggests that highly hypnotizable individuals (HHs have more effective frontal attentional systems implementing control, monitoring performance, and inhibiting unwanted stimuli from conscious awareness, than low hypnotizable individuals (LHs. Recent studies, using prepulse inhibition (PPI of the auditory startle reflex (ASR, suggest that HHs, in the waking condition, may show reduced sensory gating although they may selectively attend and disattend different stimuli. Using a within subject design and a strict subject selection procedure, in waking and hypnosis conditions we tested whether HHs compared to LHs showed a significantly lower inhibition of the ASR and startle-related brain activity in both time and intracerebral source localization domains. HHs, as compared to LH participants, exhibited (a longer latency of the eyeblink startle reflex, (b reduced N100 responses to startle stimuli, and (c higher PPI of eyeblink startle and of the P200 and P300 waves. Hypnosis yielded smaller N100 waves to startle stimuli and greater PPI of this component than in the waking condition. sLORETA analysis revealed that, for the N100 (107 msec elicited during startle trials, HHs had a smaller activation in the left parietal lobe (BA2/40 than LHs. Auditory pulses of pulse-with prepulse trials in HHs yielded less activity of the P300 (280 msec wave than LHs, in the cingulate and posterior cingulate gyrus (BA23/31. The present results, on the whole, are in the opposite direction to PPI findings on hypnotizability previously reported in the literature. These results provide support to the neuropsychophysiological model that HHs have more effective sensory integration and gating (or filtering of irrelevant stimuli than LHs.

Knowledge, attitude, behaviour and practices (KABP) of the community and resultant IEC leading to behaviour change about dengue in Jodhpur City, Rajasthan.

Science.gov (United States)

2016-01-01

In recent years dengue has been witnessed as an emerging public health problem. Therefore, the present study was undertaken in order to assess the knowledge, attitude, behaviour and practices (KABP) adopted by the society for its control and prevention. The changes in behaviour of community after imparting health education were also recorded to determine the effectiveness of information, education and communication (IEC) for dengue prevention and control in Jodhpur City of Rajasthan, India. A threefold study was conducted in Jodhpur City regarding KABP about dengue fever amongst the community. Out of 106 cases of dengue reported from Jodhpur City in the year 2008, only 20 households (HHs) could be located. Therefore, nine HHs around one dengue positive household were selected so as to cover the sample size of 200 HHs for eliciting information through structured recorded interview-schedule. Health education as provided through audiovisuals and group discussion etc. and resultant change in KABP was recorded again through interview of respondents from 100 households. Prevention from dengue mosquito bites through mats and liquid vaporizer was known to 32 and 22% HHs respectively. Inhabitants of 87% HHs preferred to visit private health facility, 85% of HHs were not aware about the symptoms of dengue, while74% HHs stated that dengue mosquito breeds in dirty water. Awareness about source of mosquito breeding and source reduction was found to be very poor, i.e. 3 and 13% which improved to 78 and 88% respectively after undertaking IEC activities. Being urban area, the economic condition and education level were somewhat similar and satisfactory in Jodhpur City. IEC resulted in significant improvement in knowledge about transmission, breeding habitats of mosquito transmitting dengue, source reduction and health treatment seeking behaviour at government facility. Through such mass awareness programmes in the communities, desired results in prevention and control of dengue

Measuring Sexual Orientation: A Review and Critique of U.S. Data Collection Efforts and Implications for Health Policy.

Science.gov (United States)

Wolff, Margaret; Wells, Brooke; Ventura-DiPersia, Christina; Renson, Audrey; Grov, Christian

The U.S. Department of Health and Human Services' (HHS) Healthy People 2020 goals sought to improve health outcomes among sexual minorities; HHS acknowledged that a dearth of sexual orientation items in federal and state health surveys obscured a broad understanding of sexual minority-related health disparities. The HHS 2011 data progression plan aimed to advance sexual orientation data collection efforts at the national level. Sexual orientation is a complex, multidimensional construct often composed of sexual identity, sexual attraction, and sexual behavior, thus posing challenges to its quantitative and practical measurement and analysis. In this review, we (a) present existing sexual orientation constructs; (b) evaluate current HHS sexual orientation data collection efforts; (c) review post-2011 data progression plan research on sexual minority health disparities, drawing on HHS survey data; (d) highlight the importance of and (e) identify obstacles to multidimensional sexual orientation measurement and analysis; and (f) discuss methods for multidimensional sexual orientation analysis and propose a matrix for addressing discordance/branchedness within these analyses. Multidimensional sexual orientation data collection and analysis would elucidate sexual minority-related health disparities, guide related health policies, and enhance population-based estimates of sexual minority individuals to steer health care practices.

Control of communicable disease; foreign--requirements for importers of nonhuman primates (NHP). Final rule.

Science.gov (United States)

2013-02-15

The Centers for Disease Control and Prevention (CDC), located within the Department of Health and Human Services (HHS), is amending regulations for the importation of live nonhuman primates (NHPs) by extending existing requirements for the importation of Macaca fascicularis (cynomolgus), Chlorocebus aethiops (African green), and Macaca mulatta (rhesus) monkeys to all NHPs with the exception of the filovirus testing requirement. Filovirus testing will only be required for Old World NHPs in quarantine that have illness consistent with filovirus infection or that die for any reason other than trauma during quarantine. HHS/CDC is also finalizing a provision to reduce the frequency at which importers of cynomolgus, African green, and rhesus monkeys are required to renew their special permits (from every 180 days to every 2 years). HHS/CDC is incorporating existing guidelines into the regulations and adding new provisions to address the following: NHPs imported as part of an animal act; NHPs imported or transferred by zoological societies; the transfer of NHPs from approved laboratories; and non-live imported NHP products. Finally, HHS/CDC is also requiring that all NHPs be imported only through ports of entry where a HHS/CDC quarantine station is located.

Humans and Deep Networks Largely Agree on Which Kinds of Variation Make Object Recognition Harder.

Science.gov (United States)

Kheradpisheh, Saeed R; Ghodrati, Masoud; Ganjtabesh, Mohammad; Masquelier, Timothée

2016-01-01

View-invariant object recognition is a challenging problem that has attracted much attention among the psychology, neuroscience, and computer vision communities. Humans are notoriously good at it, even if some variations are presumably more difficult to handle than others (e.g., 3D rotations). Humans are thought to solve the problem through hierarchical processing along the ventral stream, which progressively extracts more and more invariant visual features. This feed-forward architecture has inspired a new generation of bio-inspired computer vision systems called deep convolutional neural networks (DCNN), which are currently the best models for object recognition in natural images. Here, for the first time, we systematically compared human feed-forward vision and DCNNs at view-invariant object recognition task using the same set of images and controlling the kinds of transformation (position, scale, rotation in plane, and rotation in depth) as well as their magnitude, which we call "variation level." We used four object categories: car, ship, motorcycle, and animal. In total, 89 human subjects participated in 10 experiments in which they had to discriminate between two or four categories after rapid presentation with backward masking. We also tested two recent DCNNs (proposed respectively by Hinton's group and Zisserman's group) on the same tasks. We found that humans and DCNNs largely agreed on the relative difficulties of each kind of variation: rotation in depth is by far the hardest transformation to handle, followed by scale, then rotation in plane, and finally position (much easier). This suggests that DCNNs would be reasonable models of human feed-forward vision. In addition, our results show that the variation levels in rotation in depth and scale strongly modulate both humans' and DCNNs' recognition performances. We thus argue that these variations should be controlled in the image datasets used in vision research.

Humans and deep networks largely agree on which kinds of variation make object recognition harder

Directory of Open Access Journals (Sweden)

Saeed Reza Kheradpisheh

2016-08-01

Full Text Available View-invariant object recognition is a challenging problem that has attracted much attention among the psychology, neuroscience, and computer vision communities. Humans are notoriously good at it, even if some variations are presumably more difficult to handle than others (e.g. 3D rotations. Humans are thought to solve the problem through hierarchical processing along the ventral stream, which progressively extracts more and more invariant visual features. This feed-forward architecture has inspired a new generation of bio-inspired computer vision systems called deep convolutional neural networks (DCNN, which are currently the best models for object recognition in natural images. Here, for the first time, we systematically compared human feed-forward vision and DCNNs at view-invariant object recognition task using the same set of images and controlling the kinds of transformation (position, scale, rotation in plane, and rotation in depth as well as their magnitude, which we call variation level. We used four object categories: car, ship, motorcycle, and animal. In total, 89 human subjects participated in 10 experiments in which they had to discriminate between two or four categories after rapid presentation with backward masking. We also tested two recent DCNNs (proposed respectively by Hinton's group and Zisserman's group on the same tasks. We found that humans and DCNNs largely agreed on the relative difficulties of each kind of variation: rotation in depth is by far the hardest transformation to handle, followed by scale, then rotation in plane, and finally position (much easier. This suggests that DCNNs would be reasonable models of human feed-forward vision. In addition, our results show that the variation levels in rotation in depth and scale strongly modulate both humans' and DCNNs' recognition performances. We thus argue that these variations should be controlled in the image datasets used in vision research.

Relativistic configuration interaction treatment of generalized oscillator strength for krypton

International Nuclear Information System (INIS)

Wang Huangchun; Qu Yizhi; Liu Chunhua

2007-01-01

A fully relativistic configuration interaction method is developed to investigate the transition energies and general oscillator strengths of the lower lying states of krypton, for both optically allowed and optically forbidden transitions. The calculated results are in agreement with the recent experimental measurements. The calculated transition energies for the 5s and 5s' transitions are 9.970 and 10.717 eV, which agree with the experimental data of 10.033 and 10.643 eV. The calculated oscillator strengths are 0.211 and 0.170, comparable with the experimental results 0.214(±0.012) and 0.194 (±0.012), respectively. The momentum transfer positions (K 2 in a.u.) of the minimum and maximum GOSs in the 4s 2 4p 6 →4s 2 4p 5 (5s + 5s') transitions are 1.105 and 2.225, comparable with the measurements results 1.24 and 2.97. (authors)

Relativistic Configuration Interaction Treatment of Generalized Oscillator Strength for Krypton

Institute of Scientific and Technical Information of China (English)

WANG Huang-Chun; QU Yi-Zhi; LIU Chun-Hua

2007-01-01

A fully relativistic configuration interaction method is developed to investigate the transition energies and general oscillator strengths of the lower lying states of krypton, for both optically allowed and optically forbidden transitions. The calculated results are in agreement with the recent experimental measurements. The calculated transition energies for the 5s and 5s' transitions are 9.970 and 10.717eV, which agree with the experimental data of 10.033 and 10.643 eV. The calculated oscillator strengths are 0.211 and 0.170, comparable with the experimental results 0.214(±0.012) and 0.194 (±0.012), respectively. The momentum transfer positions ( K2 in a.u.) of the minimum and maximum GOSs in the 4s24p6 → 4s24p5 (5s + 5s') transitions are 1.105 and 2.225, comparable with the measurements results 1.24 and 2.97 [Phys. Rev. A 67 (2003) 062708].

A study on image of radiotechnologist of the general public

International Nuclear Information System (INIS)

Lee, Won Jin; Kim, Gyeong Geun

1986-01-01

This study was designed to find out the image of Radiotechnologist of the general public and ro see Radiotechnologist as a profession. The data were collected by 437 arbitrarily selected groups of college students, teachers, office workers and housewives residing in Daegu, with questionnaires from July 15 to September 30, 1985. The findings are as follows: 1. Most responds are regarded first impressions and appearance of Radiotechnologist as common of 66.6%, 54.0%, respectively. 2. 28.4% of respondents are regarded Radiotechnologist as responsibility 36.5% as skill fullness, 31.4% as overwork. 34.3% of respondants saw a Radiotechnologist as a doctor's assistant, 12.4% as a counselor about patient diseases and 52.7% as ones who have independent professional vocation. 3. For Radiotechnological education, 42.3% of respondents agreed to four year college program and 36.7% as three year Junior College program. 4. Only 13.7% of respondents wanted their children to become Radiotechnologist while 19.5% of them did not want

Hurricane-type vortices in a general circulation model. Pt. 1

International Nuclear Information System (INIS)

Bengtsson, L.; Botzet, M.; Esch, M.

1994-01-01

A very high resolution atmospheric general circulation model, T106-L19, has been used for the simulation of hurricanes in a multi-year numerical experiment. Individual storms as well as their geographical and seasonal distribution agree remarkably well with observations. In spite of the fact that only the thermal and dynamical structure of the storms have been used as criteria of their identification, practically all of them occur in areas where the sea surface temperature is higher or equal to 26 C. There are some variations from year to year in the number of storms in spite of the fact that there are no interannual variations in the SST pattern. It is found that the number of storms in particular areas depend on the intensity of the Hadley-Walker cell. The result is clearly resolution dependant. At lower horizonal resolution, T42, for example, the intensity of the storms is significantly reduced and their overall structure is less realistic, including their vertical form and extention. (orig.)

Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument.

Science.gov (United States)

Sanclemente, Gloria; Acosta, Jorge-Luis; Tamayo, Maria-Eulalia; Bonfill, Xavier; Alonso-Coello, Pablo

2014-04-01

A significant number of clinical practice guidelines (CPGs) about the treatment of acne vulgaris in adolescents and adults have been published worldwide. However, little is known about the quality of CPGs in this field. The aim of this study was to appraise the methodological quality of published acne vulgaris CPGs. We performed a systematic review of published CPGs on acne vulgaris therapy from July 2002 to July 2012. Three reviewers independently assessed each CPG using the AGREE II instrument. A standardized score was calculated for each of the six domains. Our search strategy identified 103 citations but just six met our inclusion criteria. Agreement among reviewers was very good: 0.981. The domains that scored better were: "scope and purpose" and "clarity and presentation". Those that scored worse were "stakeholder involvement", "rigor of development", and "applicability". The European and the Malaysian CPGs were the only recommended with no further modifications. In addition, the Mexican, Colombian and the United States guidelines were recommended with provisos, with lower scores regarding stakeholder involvement, rigor of development and applicability. Only two guidelines clearly reported outcome measures for evaluating efficacy or included quality of life outcomes. CPGs varied regarding the consideration of light/laser therapy or consideration of complementary/alternative medicines. None of them included cost considerations of drugs such as systemic isotretinoin. In conclusion, published acne vulgaris CPGs for acne therapy vary in quality with a clear need to improve their methodological rigor. This could be achieved with the adherence to current CPGs development standards.

The general expression for the transition amplitude of two-photon ionization of atomic hydrogen

Energy Technology Data Exchange (ETDEWEB)

Karule, E [Institute of Atomic Physics and Spectroscopy, University of Latvia, Raina Boulevard 19, Riga, LV-1586 (Latvia); Moine, B [Universite Paris Sud, 91405 Orsay Cedex (France)

2003-05-28

Two-photon ionization of atomic hydrogen with an excess photon is revisited. The non-relativistic dipole approximation and Coulomb Green function (CGF) formalism are applied. Using the CGF Sturmian expansion straightforwardly, one gets the radial transition amplitude in the form of an infinite sum over Gauss hypergeometric functions which are polynomials. It is convergent if all intermediate states are in the discrete spectrum. In the case of two-photon ionization with an excess photon, when photoionization is also possible, intermediate states are in the continuum. We performed the explicit summation over intermediate states and got a simple general expression for the radial transition amplitude in the form of a finite sum over Appell hypergeometric functions, which are not polynomials. An Appell function may be expressed as an infinite sum over Gauss functions. In the case of ionization by an excess photon, Gauss functions are transformed to give a convergent radial transition amplitude for the whole region. The generalized cross sections for two-photon above-threshold ionization of atomic hydrogen in the ground state and excited states calculated by us agree very well with results of previous calculations. Generalized cross sections for two-photon ionization of positronium in the ground state are obtained by scaling those for atomic hydrogen.

DNA Processing and Reassembly on General Purpose FPGA-based Development Boards

Directory of Open Access Journals (Sweden)

SZÁSZ Csaba

2017-05-01

Full Text Available The great majority of researchers involved in microelectronics generally agree that many scientific challenges in life sciences have associated with them a powerful computational requirement that must be solved before scientific progress can be made. The current trend in Deoxyribonucleic Acid (DNA computing technologies is to develop special hardware platforms capable to provide the needed processing performance at lower cost. In this endeavor the FPGA-based (Field Programmable Gate Arrays configurations aimed to accelerate genome sequencing and reassembly plays a leading role. This paper emphasizes benefits and advantages using general purpose FPGA-based development boards in DNA reassembly applications beside the special hardware architecture solutions. An original approach is unfolded which outlines the versatility of high performance ready-to-use manufacturer development platforms endowed with powerful hardware resources fully optimized for high speed processing applications. The theoretical arguments are supported via an intuitive implementation example where the designer it is discharged from any hardware development effort and completely assisted in exclusive concentration only on software design issues providing greatly reduced application development cycles. The experiments prove that such boards available on the market are suitable to fulfill in all a wide range of DNA sequencing and reassembly applications.

Inhibition of the Hedgehog Signaling Pathway Depresses the Cigarette Smoke-Induced Malignant Transformation of 16HBE Cells on a Microfluidic Chip.

Science.gov (United States)

Qin, Yong-Xin; Yang, Zhi-Hui; Du, Xiao-Hui; Zhao, Hui; Liu, Yuan-Bin; Guo, Zhe; Wang, Qi

2018-05-20

The hedgehog signaling system (HHS) plays an important role in the regulation of cell proliferation and differentiation during the embryonic phases. However, little is known about the involvement of HHS in the malignant transformation of cells. This study aimed to detect the role of HHS in the malignant transformation of human bronchial epithelial (16HBE) cells. In this study, two microfluidic chips were designed to investigate cigarette smoke extract (CSE)-induced malignant transformation of cells. Chip A contained a concentration gradient generator, while chip B had four cell chambers with a central channel. The 16HBE cells cultured in chip A were used to determine the optimal concentration of CSE for inducing malignant transformation. The 16HBE cells in chip B were cultured with 12.25% CSE (Group A), 12.25% CSE + 5 μmol/L cyclopamine (Group B), or normal complete medium as control for 8 months (Group C), to establish the in vitro lung inflammatory-cancer transformation model. The transformed cells were inoculated into 20 nude mice as cells alone (Group 1) or cells with cyclopamine (Group 2) for tumorigenesis testing. Expression of HHS proteins was detected by Western blot. Data were expressed as mean ± standard deviation. The t-test was used for paired samples, and the difference among groups was analyzed using a one-way analysis of variance. The optimal concentration of CSE was 12.25%. Expression of HHS proteins increased during the process of malignant transformation (Group B vs. Group A, F = 7.65, P < 0.05). After CSE exposure for 8 months, there were significant changes in cellular morphology, which allowed the transformed cells to grow into tumors in 40 days after being inoculated into nude mice. Cyclopamine could effectively depress the expression of HHS proteins (Group C vs. Group B, F = 6.47, P < 0.05) and prevent tumor growth in nude mice (Group 2 vs. Group 1, t = 31.59, P < 0.01). The activity of HHS is upregulated during the CSE-induced malignant

76 FR 4463 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of... Program Records, HHS/CDC/NIOSH.'' HHS is proposing to add the following Breach Response Routine Use... and responding to the Breach of Personally Identifiable Information: [[Page 4464

76 FR 4443 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of... Health Benefit Recipients, HHS/CDC/NCHSTP.'' HHS is proposing to add the following Breach Response..., Safeguarding Against and Responding to the Breach of Personally Identifiable Information. To appropriate...

Recurrent Hypothenar Hammer Syndrome: A Case Report.

Science.gov (United States)

Adams, Nicholas S; Ford, Ronald D

2016-10-01

Hypothenar hammer syndrome (HHS) is a rare cause of digital ischemia and pain caused from repetitive trauma to the palm. Often related to occupational practices, thrombosis and embolization can occur. Treatment is often surgical and involves excision with or without reconstruction. We describe a 55 year-old, male pipe fitter previously diagnosed and treated for HHS with excision and repair using a reversed interpositional vein graft in the mid-1980's. He continued to work in the profession, which he regularly used his palm as a hammer and returned approximately 30 years later with recurrent symptoms of cold intolerance and pain. Angiography confirmed occlusion of the ulnar artery with emboli present distally. The patient was again treated with excision and reconstruction. HHS is an uncommon cause of digital ischemia. Its recurrence is even more rare. To our knowledge, this is the first described case of diagnosed and treated recurrent HHS.

Human RTEL1 deficiency causes Hoyeraal-Hreidarsson syndrome with short telomeres and genome instability.

Science.gov (United States)

Le Guen, Tangui; Jullien, Laurent; Touzot, Fabien; Schertzer, Michael; Gaillard, Laetitia; Perderiset, Mylène; Carpentier, Wassila; Nitschke, Patrick; Picard, Capucine; Couillault, Gérard; Soulier, Jean; Fischer, Alain; Callebaut, Isabelle; Jabado, Nada; Londono-Vallejo, Arturo; de Villartay, Jean-Pierre; Revy, Patrick

2013-08-15

Hoyeraal-Hreidarsson syndrome (HHS), a severe variant of dyskeratosis congenita (DC), is characterized by early onset bone marrow failure, immunodeficiency and developmental defects. Several factors involved in telomere length maintenance and/or protection are defective in HHS/DC, underlining the relationship between telomere dysfunction and these diseases. By combining whole-genome linkage analysis and exome sequencing, we identified compound heterozygous RTEL1 (regulator of telomere elongation helicase 1) mutations in three patients with HHS from two unrelated families. RTEL1 is a DNA helicase that participates in DNA replication, DNA repair and telomere integrity. We show that, in addition to short telomeres, RTEL1-deficient cells from patients exhibit hallmarks of genome instability, including spontaneous DNA damage, anaphase bridges and telomeric aberrations. Collectively, these results identify RTEL1 as a novel HHS-causing gene and highlight its role as a genomic caretaker in humans.

The knowledge and attitude of general dentists toward denture adhesives in Tehran

Directory of Open Access Journals (Sweden)

Fakhri Hamidreza

2009-01-01

Full Text Available Background: The purpose of this study was to generate discussion and communication among a group of general dentists in Tehran on their viewpoints regarding denture adhesives. Have they accepted denture adhesive as a material to enhance denture retention, stability and function? Materials and Methods: In the summer of 2007, a questionnaire was mailed to 300 general dentists who were assigned with a random systematic sampling method from general dentists in Tehran. The questions were arranged in two parts of evaluating knowledge and attitude. In evaluation of knowledge, dentists were classified into groups of good, moderate, weak and lack of knowledge. In evaluation of attitude, dentists were classified into positive, moderate and negative groups. (Evaluating attitude was carried out in good and moderate groups of knowledge. Results: The study showed that 14%, 32% and 37% of the general dentists had respectively good, moderate and weak knowledge toward denture adhesive while 16.3% had no knowledge about this material. In evaluation of attitude through dentists with positive and moderate knowledge toward denture adhesive, 9.3%, 71.3% and 19.4% had respectively positive, moderate and negative attitude toward denture adhesive. The χ2 test showed a significant statistical relation between situation of knowledge and experiences of dentists. Discussion: This study demonstrated that the rate of knowledge of these 300 general dentists in Tehran towards denture adhesives has not been in a good situation. It is believed that denture adhesive be able to enhance the fitness of a denture and provide psychological relief to the patient. Dentists agreed that education, not only for practitioners but also for patients, would raise the advantageous features and reduce the misuse of denture adhesive. Education of the topic "Denture adhesive" should be more concerned in dental universities.

Parental views on acute otitis media (AOM) and its therapy in children--results of an exploratory survey in German childcare facilities.

Science.gov (United States)

Kautz-Freimuth, Sibylle; Redaèlli, Marcus; Samel, Christina; Civello, Daniele; Altin, Sibel V; Stock, Stephanie

2015-12-01

Acute otitis media (AOM) is one of the main reasons for medical consultation and antibiotic use during childhood. Although 80% of AOM cases are self-limiting, antibiotic prescription is still high, either for physician- or for parent-related factors. This study aims to identify parental knowledge about, beliefs and attitudes towards, and experiences with AOM and its therapy and thus to gain insights into parents' perspectives within the German health care system. An exploratory survey was conducted among German-speaking parents of children aged 2 to 7 years who sent their children to a childcare facility. Childcare facilities were recruited by convenience sampling in different urban and rural sites in Germany, and all parents with children at those facilities were invited to participate. Data were evaluated using descriptive statistical analyses. One-hundred-thirty-eight parents participated. Of those, 75.4% (n = 104) were AOM-experienced and 75.4% (n = 104) had two or more children. Sixty-six percent generally agree that bacteria cause AOM. 20.2% generally agree that viruses cause AOM. 30.5% do not generally agree that viruses cause AOM. Eight percent generally agree that AOM resolves spontaneously, whereas 53.6% do not generally agree. 92.5% generally (45.7%) and partly (42.8%) agree that AOM needs antibiotic treatment. With respect to antibiotic effects, 56.6% generally agree that antibiotics rapidly relieve earache. 60.1% generally agree that antibiotics affect the gastrointestinal tract and 77.5% generally agree that antibiotics possibly become ineffective after frequent use. About 40% generally support and about 40% generally reject a "wait-and-see" strategy for AOM treatment. Parental-reported experiences reveal that antibiotics are by far more often prescribed (70.2%) than actively requested by parents (26.9%). Parental views on AOM, its therapy, and antibiotic effects reveal uncertainties especially with respect to causes, the natural course of the disease

76 FR 4469 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of..., HHS/CDC/NIOSH.'' HHS is proposing to add the following Breach Response Routine Use Language to comply... to the Breach of Personally Identifiable Information: To appropriate Federal agencies and Department...

76 FR 4445 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of..., ``Alien Mental Waiver Program, HHS/CDC/ NCID. HHS is proposing to add the following Breach Response..., Safeguarding Against and Responding to the Breach of Personally Identifiable Information: To appropriate...

76 FR 4451 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of..., ``Fellowship Program and Guest Researcher Records, HHS/CDC/AHRC.'' HHS is proposing to add the following Breach..., Safeguarding Against and responding to the Breach of Personally Identifiable Information: To appropriate...

76 FR 4435 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of... Interpreting Physician File, HHS/CDC/NIOSH.'' HHS is proposing to add the following Breach Response Routine Use... and responding to the Breach of Personally Identifiable Information: To appropriate Federal agencies...

76 FR 4466 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of..., HHS/CDC/NIOSH.'' HHS is proposing to add the following Breach Response Routine Use Language to comply... to the Breach of Personally Identifiable Information: To appropriate federal agencies and Department...

76 FR 4478 - Privacy Act of 1974; Report of Modified or Altered System of Records

Science.gov (United States)

2011-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Privacy Act of..., HHS/CDC/NCHSTP.'' HHS is proposing to add the following Breach Response Routine Use Language to comply... to the Breach of Personally Identifiable Information: To appropriate Federal agencies and Department...

77 FR 5012 - Environmental Protection Agency, Department of Health and Human Services and Department of...

Science.gov (United States)

2012-02-01

..., Department of Health and Human Services and Department of Agriculture; Memorandum of Understanding Regarding... Memorandum of Understanding (MOU). The MOU will support and encourage cooperation and communication between... Department of Human Services (HHS) and the U.S. Department of Agriculture (USDA). HHS's Centers for Disease...

78 FR 57858 - Tribal Consultation Meeting

Science.gov (United States)

2013-09-20

... and posted on the Early Childhood Learning and Knowledge Center Web site at http://eclkc.ohs.acf.hhs... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation Meeting AGENCY: Administration for Children and Families' Office of Head Start (OHS), HHS. ACTION...

Strongly Agree or Strongly Disagree?

DEFF Research Database (Denmark)

Carrizosa, Emilio; Nogales-Gómez, Amaya; Morales, Dolores Romero

2016-01-01

In linear classifiers, such as the Support Vector Machine (SVM), a score is associated with each feature and objects are assigned to classes based on the linear combination of the scores and the values of the features. Inspired by discrete psychometric scales, which measure the extent to which a ...

Unusual Cases of Hypothenar Hammer Syndrome.

Science.gov (United States)

Orrapin, Saranat; Arworn, Supapong; Wisetborisut, Anawat

2015-01-01

Hypothenar hammer syndrome (HHS) is a rare occupational disease. The risk group of HHS is patient whose dominate hand used as a hammer. Our study report unusually cases in Chiang Mai University Hospital. 19 year-old basketball player had right ulnar artery aneurysm for two months. After operation, his symptom was relieved and returned to play basketball again. 65 year-old housekeeper had non-dominated hand ulnar artery aneurysm for two years. After operation she still had hand claudication due to poor run-off vessel. HHS is previously state in risk group. But from our report there was a risk in different occupation.

Analytical Solution of Displacements Around Circular Openings in Generalized Hoek-Brown Rocks

Directory of Open Access Journals (Sweden)

Huang Houxu

2017-09-01

Full Text Available The rock in plastic region is divided into numbers of elements by the slip lines, resulted from shear localization. During the deformation process, the elements will slip along the slip lines and the displacement field is discontinuous. Slip lines around circular opening in isotropic rock, subjected to hydrostatic stress are described by the logarithmic spirals. Deformation of the plastic region is mainly attributed to the slippage. Relationship between the shear stresses and slippage on slip lines is presented, based on the study of Revuzhenko and Shemyakin. Relations between slippage and rock failure are described, based on the elastic-brittle-plastic model. An analytical solution is presented for the plane strain analysis of displacements around circular openings in the Generalized Hoek-Brown rock. With properly choosing of slippage parameters, results obtained by using the proposed solution agree well with those presented in published sources.

76 FR 53913 - Award of an Urgent Single-Source Grant to Survivors of Torture International (SOTI) in San Diego...

Science.gov (United States)

2011-08-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Refugee Resettlement Award of an Urgent Single... Refugee Resettlement, ACF, HHS. ACTION: Notice; correction. CFDA Number: 93.604. SUMMARY: The Office of Refugee Resettlement, ACF, HHS published a document in the Federal Register of August 16, 2011 (76 FR...

77 FR 15759 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2012-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

78 FR 21955 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2013-04-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

78 FR 70949 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2013-11-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

77 FR 60438 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2012-10-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

75 FR 37812 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2010-06-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... and Human Services (HHS) gives notice concerning the final effect of the HHS decision to designate a...

77 FR 60437 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2012-10-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

77 FR 69845 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2012-11-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

78 FR 21954 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2013-04-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

78 FR 57293 - Distribution of Reference Biological Standards and Biological Preparations

Science.gov (United States)

2013-09-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 7 [Docket No. CDC-2013-0013] RIN 0920-AA52 Distribution of Reference Biological Standards and Biological Preparations AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human Services (HHS). ACTION: Confirmation of...

75 FR 37811 - Agency Information Collection Request; 60-Day Public Comment Request

Science.gov (United States)

2010-06-30

... Health and Human Services' (HHS) high priority programs and is supportive of HHS Strategic Goal 1: Health...- prescribing and quality reporting functionalities, and the number of providers who have become meaningful.... Additionally, it allows for the synergy of grantee business processes and technology to increase transparency...

Clinical heterogeneity in a family with DKC1 mutation, dyskeratosis congenita and Hoyeraal-Hreidarsson syndrome in first cousins

Directory of Open Access Journals (Sweden)

Cristina Olivieri

2017-10-01

Full Text Available Dyskeratosis congenita (DC is an inherited bone marrow failure disorder characterized by mucocutaneous features (skin pigmentation, nail dystrophy and oral leukoplakia, pulmonary fibrosis, hematologic and solid malignancies. Its severe form, recognized as Hoyeraal-Hreidarsson syndrome (HHS, also includes cerebellar hypoplasia, microcephaly, developmental delay and prenatal growth retardation. In literature phenotypic variability among DC patients sharing the same mutation is wellknown. To our knowledge this report describes for the first time a family of DC patients, characterized by a member with features of classic DC and another one with some features of HHS, both with the same mutation in DKC1. Our family confirms again that one mutation can be associated with different phenotypes and different hematological manifestations. It’s possible to speculate that there are likely to be patients who do not clinically fit neatly into either classical DC or HHS, but whose clinical features are due to mutations in DKC1 or in genes responsible for autosomal DC/HHS.

75 FR 51816 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

Science.gov (United States)

2010-08-23

... Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a... Special Exposure Cohort (SEC) under the Energy Employees Occupational Illness Compensation Program Act of...

Novel GALNT3 mutations causing hyperostosis-hyperphosphatemia syndrome result in low intact fibroblast growth factor 23 concentrations.

Science.gov (United States)

Ichikawa, Shoji; Guigonis, Vincent; Imel, Erik A; Courouble, Mélanie; Heissat, Sophie; Henley, John D; Sorenson, Andrea H; Petit, Barbara; Lienhardt, Anne; Econs, Michael J

2007-05-01

Hyperostosis-hyperphosphatemia syndrome (HHS) is a rare metabolic disorder characterized by hyperphosphatemia and localized hyperostosis. HHS is caused by mutations in GALNT3, which encodes UDP-N-acetyl-alpha-D-galactosamine:polypeptide N- acetylgalactosaminyltransferase 3. Familial tumoral calcinosis (TC), characterized by ectopic calcifications and hyperphosphatemia, is caused by mutations in the GALNT3 or fibroblast growth factor 23 (FGF23) genes. Our objective was to identify mutations in FGF23 or GALNT3 and determine serum FGF23 levels in an HHS patient. Mutation detection in FGF23 and GALNT3 was performed by DNA sequencing, and serum FGF23 concentrations were measured by ELISA. A 5-year-old French boy with HHS and his family members participated. The patient presented with painful cortical lesions in his leg. Radiographs of the affected bone showed diaphyseal hyperostosis. The lesional tissue comprised trabeculae of immature, woven bone surrounded by fibrous tissue. Biochemistry revealed elevated phosphate, tubular maximum rate for phosphate reabsorption per deciliter of glomerular filtrate, and 1,25-dihydroxyvitamin D levels. The patient was a compound heterozygote for two novel GALNT3 mutations. His parents and brother were heterozygous for one of the mutations and had no biochemical abnormalities. Intact FGF23 level in the patient was low normal, whereas C-terminal FGF23 was elevated, a pattern similar to TC. The presence of GALNT3 mutations and elevated C-terminal, but low intact serum FGF23, levels in HHS resemble those seen in TC, suggesting that HHS and TC are different manifestations of the same disorder. The absence of biochemical abnormalities in the heterozygous individuals suggests that one normal allele is sufficient for secretion of intact FGF23.

General Principles of the WTO and European Community Laws in Building International Competition Norms

Directory of Open Access Journals (Sweden)

Chan Mo Chung

2002-12-01

Full Text Available The World Trade Organization (WTO established a Working Group on the interaction between trade and competition policy in 1996. By the Doha Ministerial Declaration, it recognized the case for international competition policy framework and agreed that the relevant negotiations take place after the Fifth Session of the Ministerial Conference. The Working Group is meant to focus on the clarification of: core principles, including transparency, non-discrimination and procedural fairness among others in the period until the Fifth Session. This article attempts to clarify the implications of the core (WTO principles to the would-be international competition laws and practices. It further tries to get lessons from competition law and practices of the European Community. Protection of fundamental rights, proportionality, non-discrimination, transparency, supremacy, subsidiarity and direct effect are the general principles of the European Community law to be discussed in relation to the competition law and policy. It concludes that the general principles of the WTO and EC laws provide guiding principles for the future international competition norms, and makes some preliminary assessment of the present Korean competition law and policy in the light of those principles.

Hypothenar hammer syndrome: caused by a muscle anomaly? A case report with review of the literature.

Science.gov (United States)

Estermann, Lea; Ducommun, Pascal; Steurer-Dober, Isabelle; Hug, Urs

2018-05-01

The hypothenar hammer syndrome (HHS) is a rare entity of secondary Raynaud's phenomenon. The blunt hypothenar trauma causes a lesion of the vessel wall with a consecutive thrombosis or aneurysm of the ulnar artery at the Guyon's canal. Different risk factors are discussed such as nicotine abuse, or a muscle anomaly in the Guyon's canal. To date, there are five case reports published about muscle anomalies and HHS. We present a case of a 51-year-old shipbuilder with a unilateral HHS on his right dominant hand with a bilateral muscle anomaly. We successfully treated the patient by resection of the aneurysm without a resection of the atypical muscle.

A randomized trial of three marketing strategies to disseminate a screening and brief alcohol intervention programme to general practitioners.

Science.gov (United States)

Lock, C A; Kaner, E F; Heather, N; McAvoy, B R; Gilvarry, E

1999-09-01

Research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. A dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. To evaluate the effectiveness and cost-effectiveness of different marketing strategies for the dissemination of a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). Seven hundred and twenty-nine GPs, one per practice, from the former Northern and Yorkshire Regional Health Authority were randomly assigned to one of three marketing strategies: postal marketing (mailing a promotional brochure to GPs), telemarketing (following a script to market the programme over the telephone), and personal marketing (following the same script during face-to-face marketing at GPs' practices). GPs who took up the programme were asked if they would agree to use it. Outcome measures included the proportions of GPs who took up the programme and agreement to use it. Of the 614 GPs eligible for the study, 321 (52%) took the programme. There was a significant difference in the proportions of GPs from the three marketing strategies who took the programme (82% telemarketing, 68% personal marketing, and 22% postal marketing). Of the 315 GPs who took the programme and were eligible to use it, 128 (41%) agreed to use the programme for three months. GPs in the postal marketing group were more likely to agree to use the programme (55% postal marketing, 44% personal marketing, and 34% telemarketing). Personal marketing was the most effective overall dissemination strategy; however, economic analysis revealed that telemarketing was the most cost-effective strategy. Costs for dissemination per GP were: 13 Pounds telemarketing, 15 Pounds postal marketing, and 88 Pounds personal marketing. Telemarketing appeared to be the most cost-effective strategy for dissemination of SBI to GPs.

75 FR 42362 - Responsibility of Applicants for Promoting Objectivity in Research for Which Public Health...

Science.gov (United States)

2010-07-21

... Department of Health and Human Services (HHS or the Department), including the HHS Public Health Service (PHS... DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 50 45 CFR Part 94 [Docket Number NIH-2010-0001] RIN 0925-AA53 Responsibility of Applicants for Promoting Objectivity in Research for Which Public...

77 FR 18246 - Agency Information Collection Request; 30-Day Public Comment Request

Science.gov (United States)

2012-03-27

... data collection will enable OMH to track progress on this measure over time as necessitated by current... of Minority Health (OMH). Abstract: The proposed survey seeks to collect data for one of OMH's annual..., within and outside of HHS, who are interested in capturing progress made over time as HHS disseminates...

48 CFR 352.242-71 - Tobacco-free facilities.

Science.gov (United States)

2010-10-01

... personal or company vehicles operated by Contractor employees while on an HHS property. This policy also... HHS policy will apply to the maximum area permitted by both law and current lease agreements. The Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understand...

78 FR 52939 - Prospective Grant of Exclusive Patent License: Use of Scopolamine to Treat Depression

Science.gov (United States)

2013-08-27

... Exclusive Patent License: Use of Scopolamine to Treat Depression AGENCY: National Institutes of Health, HHS... Application 11/137,114, filed May 25, 2005, titled ``Scopolamine for the Treatment of Depression and Anxiety... ``Scopolamine for the Treatment of Depression and Anxiety'' [HHS Ref. No. E-175-2004/0-EP-03]; 3. German Patent...

75 FR 16485 - Meeting of the Chronic Fatigue Syndrome Advisory Committee

Science.gov (United States)

2010-04-01

....hhs.gov/about/hhhmap.html . FOR FURTHER INFORMATION CONTACT: Wanda K. Jones, Dr.P.H.; Executive... can be found at http://www.hhs.gov/advcomcfs/charter/index.html . Members of the public will have the....gov . Dated: March 29, 2010. Wanda K. Jones, Executive Secretary, CFSAC. [FR Doc. 2010-7337 Filed 3-31...

Spinning solutions in general relativity with infinite central density

Science.gov (United States)

Flammer, P. D.

2018-05-01

This paper presents general relativistic numerical simulations of uniformly rotating polytropes. Equations are developed using MSQI coordinates, but taking a logarithm of the radial coordinate. The result is relatively simple elliptical differential equations. Due to the logarithmic scale, we can resolve solutions with near-singular mass distributions near their center, while the solution domain extends many orders of magnitude larger than the radius of the distribution (to connect with flat space-time). Rotating solutions are found with very high central energy densities for a range of adiabatic exponents. Analytically, assuming the pressure is proportional to the energy density (which is true for polytropes in the limit of large energy density), we determine the small radius behavior of the metric potentials and energy density. This small radius behavior agrees well with the small radius behavior of large central density numerical results, lending confidence to our numerical approach. We compare results with rotating solutions available in the literature, which show good agreement. We study the stability of spherical solutions: instability sets in at the first maximum in mass versus central energy density; this is also consistent with results in the literature, and further lends confidence to the numerical approach.

The waiting room: vector for health education? The general practitioner's point of view.

Science.gov (United States)

Gignon, Maxine; Idris, Hadjila; Manaouil, Cecile; Ganry, Oliver

2012-09-18

General practitioners (GPs) play a central role in disseminating information and most health policies are tending to develop this pivotal role of GPs in dissemination of health-related information to the public. The objective of this study was to evaluate use of the waiting room by GPs as a vector for health promotion. A cross-sectional study was conducted on a representative sample of GPs using semi-structured, face-to-face interviews. A structured grid was used to describe the documents. Quantitative and qualitative analysis was performed. Sixty GPs participated in the study. They stated that a waiting room had to be pleasant, but agreed that it was a useful vector for providing health information. The GPs stated that they distributed documents designed to improve patient care by encouraging screening, providing health education information and addressing delicate subjects more easily. However, some physicians believed that this information can sometimes make patients more anxious. A large number of documents were often available, covering a variety of topics. General practitioners intentionally use their waiting rooms to disseminate a broad range of health-related information, but without developing a clearly defined strategy. It would be interesting to correlate the topics addressed by waiting room documents with prevention practices introduced during the visit.

Selecting, training and assessing new general practice community teachers in UK medical schools.

Science.gov (United States)

Hydes, Ciaran; Ajjawi, Rola

2015-09-01

Standards for undergraduate medical education in the UK, published in Tomorrow's Doctors, include the criterion 'everyone involved in educating medical students will be appropriately selected, trained, supported and appraised'. To establish how new general practice (GP) community teachers of medical students are selected, initially trained and assessed by UK medical schools and establish the extent to which Tomorrow's Doctors standards are being met. A mixed-methods study with questionnaire data collected from 24 lead GPs at UK medical schools, 23 new GP teachers from two medical schools plus a semi-structured telephone interview with two GP leads. Quantitative data were analysed descriptively and qualitative data were analysed informed by framework analysis. GP teachers' selection is non-standardised. One hundred per cent of GP leads provide initial training courses for new GP teachers; 50% are mandatory. The content and length of courses varies. All GP leads use student feedback to assess teaching, but other required methods (peer review and patient feedback) are not universally used. To meet General Medical Council standards, medical schools need to include equality and diversity in initial training and use more than one method to assess new GP teachers. Wider debate about the selection, training and assessment of new GP teachers is needed to agree minimum standards.

Potential Rebates Saved by HHS Determinations

Data.gov (United States)

U.S. Department of Health & Human Services — These estimates are provided from 2010 data. Final amount of rebates will vary with market conditions and may be lower as insurance companies lower premiums for...

Generalized Superconductivity. Generalized Levitation

International Nuclear Information System (INIS)

Ciobanu, B.; Agop, M.

2004-01-01

In the recent papers, the gravitational superconductivity is described. We introduce the concept of generalized superconductivity observing that any nongeodesic motion and, in particular, the motion in an electromagnetic field, can be transformed in a geodesic motion by a suitable choice of the connection. In the present paper, the gravitoelectromagnetic London equations have been obtained from the generalized Helmholtz vortex theorem using the generalized local equivalence principle. In this context, the gravitoelectromagnetic Meissner effect and, implicitly, the gravitoelectromagnetic levitation are given. (authors)

Climatic irregular staircases: generalized acceleration of global warming.

Science.gov (United States)

De Saedeleer, Bernard

2016-01-27

Global warming rates mentioned in the literature are often restricted to a couple of arbitrary periods of time, or of isolated values of the starting year, lacking a global view. In this study, we perform on the contrary an exhaustive parametric analysis of the NASA GISS LOTI data, and also of the HadCRUT4 data. The starting year systematically varies between 1880 and 2002, and the averaging period from 5 to 30 yr - not only decades; the ending year also varies . In this way, we uncover a whole unexplored space of values for the global warming rate, and access the full picture. Additionally, stairstep averaging and linear least squares fitting to determine climatic trends have been sofar exclusive. We propose here an original hybrid method which combines both approaches in order to derive a new type of climatic trend. We find that there is an overall acceleration of the global warming whatever the value of the averaging period, and that 99.9% of the 3029 Earth's climatic irregular staircases are rising. Graphical evidence is also given that choosing an El Niño year as starting year gives lower global warming rates - except if there is a volcanic cooling in parallel. Our rates agree and generalize several results mentioned in the literature.

[Non-cemented self-locking total arthroplasty of the hip. Clinical and radiological results after three years].

Science.gov (United States)

Desjardins, A L; Roy, A; Duchesne, R; Béliveau, P; Fallaha, M; Bornais, S

1993-01-01

We reviewed 47 patients who had fifty-one (51) primary, cementless biofit total hip arthroplasties (THA) implanted at Maisonneuve-Rosemont Hospital between 1986 and 1990. An independent observer rated the patients on the Harris Hip Score (HHS) by questionnaire, physical examination and radiological assessment. The average follow-up was 40 months. Twenty-two percent (22%) of the femoral components had been revised because of incapacitating pain, limping or a HHS inferior to 60. A little more than 20% of the unrevised prostheses had a mediocre result (HHS inferior to 70). There was no correlation between results and radiological signs of instability. The femoral component of the hip arthroplasty has a poor clinical performance which compares unfavourably with cemented prostheses.

Absolute generalized oscillator strength for the Lyman--Birge--Hopfield band of N2 as determined by high energy electron impact spectroscopy

International Nuclear Information System (INIS)

Wong, T.C.; Lee, J.S.; Wellenstein, H.F.; Bonham, R.A.

1975-01-01

The absolute generalized oscillator strength for the dipole forbidden quadrupole allowed Lyman--Birge--Hopfield band a 1 Pi/subg/ reverse arrow X 1 Σ + /subg/ in molecular nitrogen at an energy loss of 9.35 eV is observed by electron impact spectroscopy using 25 keV electrons over the momentum transfer range 0.04less than or equal toK 2 less than or equal to10 a.u. The results agree in the zero angle (zero momentum transfer) limit with the previous observations of Skerbele and Lassettre, but are in disagreement with previous theoretical and experimental results for K 2 >0.5. (auth)

Bringing Breast Cancer Technologies to Market | Poster

Science.gov (United States)

CCR research is recognized in novel competition to encourage the commercialization of breast cancer inventions. Editor’s note: This article was originally published in CCR Connections (Volume 8, No. 1). The Breast Cancer Startup Challenge was named one of six finalists in the HHS Innovates Award Competition, and was one of three finalists recognized by HHS Secretary Sylvia

A study of knowledge, attitude and practices regarding hair dye use among general population

Directory of Open Access Journals (Sweden)

Mrinal Gupta

2018-02-01

Full Text Available Background: Hair dye usage is extremely common all over the world. Hair dyes have been reported to cause a wide range of adverse effects, therefore, the consumer’s knowledge about hair dyeing and related side effects are important. Aim: To assess the knowledge, attitude and practices of general population towards the use of hair dyes. Materials and Methods: Two hundred and fifty consecutive persons using hair dyes were enrolled for this questionnaire-based cross-sectional, descriptive study. Results: These 250 patients comprised 141 men (56.4% and 109 women (43.6% (M: F 1.29:1, aged between 16 and 74 (mean 47.13 years. The majority, 212 patients (84.8% were aged between 20–60 years and 66.4% (n=166 belonged to an urban background. When asked about the reason for using hair color, the principle reason was “to look younger” (59.6%, n=149. Most of the respondents were using synthetic hair dye preparations (55.2%, n=138 and when asked about the brand of hair dye being used, 25.2% (n=63 did not know about the brand they were using. When asked about their perception regarding safety of HD, 61% (n=152 respondents agreed that hair dyes are not safe and on being asked about the carcinogenic potential of HD, only 24% (n=60 respondents agreed. When enquired about the safest variety of HD, majority of respondents (52.4%, n=131 believed that plant based hair colors are the safest. When asked about the safety of HD during pregnancy and lactation, 68% (n=168 of the respondents were unaware regarding this aspect. 14.4% of the respondents reported suffering from some adverse effects due to hair dye use but only 11.11% (n=4 of those stopped using hair dyes. Conclusions: There is lack of awareness about the hair dyes and their adverse effects in the general population. There is an urgent need to increase awareness among consumers regarding the adverse effects of hair dyes and the available safer alternatives. Limitations: Small number of respondents and

Identifying and Eliminating Deficiencies in the General Surgery Resident Core Competency Curriculum.

Science.gov (United States)

Tapia, Nicole M; Milewicz, Allen; Whitney, Stephen E; Liang, Michael K; Braxton, Carla C

2014-06-01

Although the Accreditation Council for Graduate Medical Education has defined 6 core competencies required of resident education, no consensus exists on best practices for reaching resident proficiency. Surgery programs must develop resourceful methods to incorporate learning. While patient care and medical knowledge are approached with formal didactics and traditional Halstedian educational formats, other core competencies are presumed to be learned on the job or emphasized in conferences. To test the hypothesis that our residents lack a foundation in several of the nonclinical core competencies and to seek to develop a formal curriculum that can be integrated into our current didactic time, with minimal effect on resident work hours and rest hours. Anonymous Likert-type scale needs assessment survey requesting residents within a large single general surgery residency program to rate their understanding, working knowledge, or level of comfort on the following 10 topics: negotiation and conflict resolution; leadership styles; health care legislation; principles of quality delivery of care, patient safety, and performance improvement; business of medicine; clinical practice models; role of advocacy in health care policy and government; personal finance management; team building; and roles of innovation and technology in health care delivery. Proportions of resident responses scored as positive (agree or strongly agree) or negative (disagree or strongly disagree). In total, 48 surgery residents (70%) responded to the survey. Only 3 topics (leadership styles, team building, and roles of innovation and technology in health care delivery) had greater than 70% positive responses, while 2 topics (negotiation and conflict resolution and principles of quality delivery of care, patient safety, and performance improvement) had greater than 60% positive responses. The remaining topics had less than 40% positive responses, with the least positive responses on the topics

Hierarchical heterostructures of p-type bismuth oxychloride nanosheets on n-type zinc ferrite electrospun nanofibers with enhanced visible-light photocatalytic activities and magnetic separation properties.

Science.gov (United States)

Sun, Yucong; Shao, Changlu; Li, Xinghua; Guo, Xiaohui; Zhou, Xuejiao; Li, Xiaowei; Liu, Yichun

2018-04-15

P-type bismuth oxychloride (p-BiOCl) nanosheets were uniformly grown on n-type zinc ferrite (n-ZnFe 2 O 4 ) electrospun nanofibers via a solvothermal technique to form hierarchical heterostructures of p-BiOCl/n-ZnFe 2 O 4 (p-BiOCl/n-ZnFe 2 O 4 H-Hs). The density and loading amounts of the BiOCl nanosheets with exposed {0 0 1} facets were easily controlled by adjusting the reactant concentration in the solvothermal process. The p-BiOCl/n-ZnFe 2 O 4 H-Hs exhibited enhanced visible-light photocatalytic activities for the degradation of Rhodamine B (RhB). The apparent first-order rate of the p-BiOCl/n-ZnFe 2 O 4 H-Hs and its normalized constant were about 12.6- and 8-fold higher than pure ZnFe 2 O 4 nanofibers. This suggests that both the improved charge separation efficiency from the uniform p-n heterojunctions and the enlarged active surface sites from the hierarchical structures increase the photocatalytic performances. Furthermore, the p-BiOCl/n-ZnFe 2 O 4 H-Hs could be efficiently separated from the solution with an external magnetic field via the ferromagnetic behavior of ZnFe 2 O 4 nanofibers. The magnetic p-BiOCl/n-ZnFe 2 O 4 H-Hs with enhanced visible-light photocatalytic performances might have potential applications in water treatment. Copyright © 2018. Published by Elsevier Inc.

Comprehensive comparison of the chemical and structural characterization of landfill leachate and leonardite humic fractions.

Science.gov (United States)

Tahiri, Abdelghani; Richel, Aurore; Destain, Jacqueline; Druart, Philippe; Thonart, Philippe; Ongena, Marc

2016-03-01

Humic substances (HS) are complex and heterogeneous mixtures of organic compounds that occur everywhere in the environment. They represent most of the dissolved organic matter in soils, sediments (fossil), water, and landfills. The exact structure of HS macromolecules has not yet been determined because of their complexity and heterogeneity. Various descriptions of HS are used depending on specific environments of origin and research interests. In order to improve the understanding of the structure of HS extracted from landfill leachate (LHS) and commercial HS from leonardite (HHS), this study sought to compare the composition and characterization of the structure of LHS and HHS using elemental composition, chromatographic (high-performance liquid chromatography (HPLC)), and spectroscopic techniques (UV-vis, FTIR, NMR, and MALDI-TOF). The results showed that LHS molecules have a lower molecular weight and less aromatic structure than HHS molecules. The characteristics of functional groups of both LHS and HHS, however, were basically similar, but there was some differences in absorbance intensity. There were also less aliphatic and acidic functional groups and more aromatic and polyphenolic compounds in the humic acid (HA) fraction than in the fulvic acid (FA) and other molecules (OM) fractions of both origins. The differences between LHS and HHS might be due to the time course of humification. Combining the results obtained from these analytical techniques cold improve our understanding of the structure of HS of different origins and thus enhance their potential use.

Student performance of the general physical examination in internal medicine: an observational study

Science.gov (United States)

2014-01-01

Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

Expanding access to rheumatology care: the rheumatology general practice toolbox.

LENUS (Irish Health Repository)

Conway, R

2015-02-01

Management guidelines for many rheumatic diseases are published in specialty rheumatology literature but rarely in general medical journals. Musculoskeletal disorders comprise 14% of all consultations in primary care. Formal post-graduate training in rheumatology is limited or absent for many primary care practitioners. Primary care practitioners can be trained to effectively treat complex diseases and have expressed a preference for interactive educational courses. The Rheumatology General Practice (GP) Toolbox is an intensive one day course designed to offer up to date information to primary care practitioners on the latest diagnostic and treatment guidelines for seven common rheumatic diseases. The course structure involves a short lecture on each topic and workshops on arthrocentesis, joint injection and DXA interpretation. Participants evaluated their knowledge and educational experience before, during and after the course. Thirty-two primary care practitioners attended, who had a median of 13 (IQR 6.5, 20) years experience in their specialty. The median number of educational symposia attended in the previous 5 years was 10 (IQR-5, 22.5), with a median of 0 (IQR 0, 1) in rheumatology. All respondents agreed that the course format was appropriate. Numerical improvements were demonstrated in participant\\'s confidence in diagnosing and managing all seven common rheumatologic conditions, with statistically significant improvements (p < 0.05) in 11 of the 14 aspects assessed. The Rheumatology Toolbox is an effective educational method for disseminating current knowledge in rheumatology to primary care physicians and improved participant\\'s self-assessed competence in diagnosis and management of common rheumatic diseases.

A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment

DEFF Research Database (Denmark)

Beck, Anne Marie; Ovesen, Lars; Schroll, M.

2001-01-01

Objective: To assess the prevalence of old people at risk of undernutrition according to the Mini Nutritional Assessment (MNA), characterise the at risk group with regard to nutritional state, energy intake, and physical and mental functioning, and to assess the consequences of the MNA score over...... a 6 month period. Design: A cross-sectional prospective study. Setting: The clinic of a general practitioner. Subjects: Ninety-four patients 65 + -y-old with no acute illness contacted at the clinic. Sixty-one subjects (65%) agreed to participate at baseline and 34 (56%) showed up at the follow-up 6...

Hilbert-Huang Spectrum as a new field for the identification of EEG event related de-/synchronization for BCI applications.

Science.gov (United States)

Panoulas, Konstantinos I; Hadjileontiadis, Leontios J; Panas, Stavros M

2008-01-01

Brain Computer Interfaces (BCI) usually utilize the suppression of mu-rhythm during actual or imagined motor activity. In order to create a BCI system, a signal processing method is required to extract features upon which the discrimination is based. In this article, the Empirical Mode Decomposition along with the Hilbert-Huang Spectrum (HHS) is found to contain the necessary information to be considered as an input to a discriminator. Also, since the HHS defines amplitude and instantaneous frequency for each sample, it can be used for an online BCI system. Experimental results when the HHS applied to EEG signals from an on-line database (BCI Competition III) show the potentiality of the proposed analysis to capture the imagined motor activity, contributing to a more enhanced BCI performance.

A statistical intercomparison of temperature and precipitation predicted by four general circulation models with historical data

International Nuclear Information System (INIS)

Grotch, S.L.

1991-01-01

This study is a detailed intercomparison of the results produced by four general circulation models (GCMs) that have been used to estimate the climatic consequences of a doubling of the CO 2 concentration. Two variables, surface air temperature and precipitation, annually and seasonally averaged, are compared for both the current climate and for the predicted equilibrium changes after a doubling of the atmospheric CO 2 concentration. The major question considered here is: how well do the predictions from different GCMs agree with each other and with historical climatology over different areal extents, from the global scale down to the range of only several gridpoints? Although the models often agree well when estimating averages over large areas, substantial disagreements become apparent as the spatial scale is reduced. At scales below continental, the correlations observed between different model predictions are often very poor. The implications of this work for investigation of climatic impacts on a regional scale are profound. For these two important variables, at least, the poor agreement between model simulations of the current climate on the regional scale calls into question the ability of these models to quantitatively estimate future climatic change on anything approaching the scale of a few (< 10) gridpoints, which is essential if these results are to be used in meaningful resource-assessment studies. A stronger cooperative effort among the different modeling groups will be necessary to assure that we are getting better agreement for the right reasons, a prerequisite for improving confidence in model projections. 11 refs.; 10 figs

A statistical intercomparison of temperature and precipitation predicted by four general circulation models with historical data

International Nuclear Information System (INIS)

Grotch, S.L.

1990-01-01

This study is a detailed intercomparison of the results produced by four general circulation models (GCMs) that have been used to estimate the climatic consequences of a doubling of the CO 2 concentration. Two variables, surface air temperature and precipitation, annually and seasonally averaged, are compared for both the current climate and for the predicted equilibrium changes after a doubling of the atmospheric CO 2 concentration. The major question considered here is: how well do the predictions from different GCMs agree with each other and with historical climatology over different areal extents, from the global scale down to the range of only several gridpoints? Although the models often agree well when estimating averages over large areas, substantial disagreements become apparent as the spatial scale is reduced. At scales below continental, the correlations observed between different model predictions are often very poor. The implications of this work for investigation of climatic impacts on a regional scale are profound. For these two important variables, at least, the poor agreement between model simulations of the current climate on the regional scale calls into question the ability of these models to quantitatively estimate future climatic change on anything approaching the scale of a few (< 10) gridpoints, which is essential if these results are to be used in meaningful resource-assessment studies. A stronger cooperative effort among the different modeling groups will be necessary to assure that we are getting better agreement for the right reasons, a prerequisite for improving confidence in model projections

[Burnout syndrome in medical residents at the General Hospital of Durango, México].

Science.gov (United States)

Terrones-Rodríguez, Jovany Francisco; Cisneros-Pérez, Vicente; Arreola-Rocha, José Jesús

2016-01-01

The burnout syndrome is commonly spread among health workers and students, due to the excessive demands they feel on their workspaces. Depersonalization, emotional exhaustion and personal accomplishment are the areas assessed. To determine the prevalence of burnout syndrome in medical residents at the General Hospital of Durango; a descriptive, prolective, cross-sectional study was designed and applied to residents of different specialties of the General Hospital of Durango who agreed to participate, the "Maslach Burnout Inventory" was applied. We surveyed 116 residents, 43.1 % (50) women and 56.89 % (66) men. The overall prevalence was 89.66 % (95 % CI: 82.63- 94.54). Affected in a single area the 48.28 % (95 % CI: 38.90-57.74), in two areas the 35.34 % (95 % CI: 26.69-44.76) and in the three areas 6.03 % (95 % CI: 2.46-12.04). Stratified by areas, high emotional exhaustion was 41.38 % (95 % CI: 32.31-50.90), high depersonalization in 54.31 % (95 % CI: 44.81-63.59), and low personal accomplishment 41.38 % (95 % CI: 32.31-50.90). The prevalence is higher than the reported. The most frequently affected is depersonalization, followed by emotional exhaustion and finally the personal accomplishment. In the areas of Gynecology and obstetrics, Internal medicine, Pediatrics and Orthopedics, the 100 % of the residents are affected.

RETRACTED ARTICLE: Clinical effectiveness of continuous passive motion (CPM) following femoroacetabular impingement surgery in adolescents.

Science.gov (United States)

Hosalkar, Harish; Bomar, James D

2012-08-01

This study hypothesizes that the use of continuous passive motion (CPM) following open femoroacetabular impingement (FAI) surgery in the adolescent population improves clinical outcomes in terms of the modified Harris hip score (mHHS). Twenty-nine symptomatic adolescent FAI patients were postoperatively divided into one of three groups; no CPM, two days of inpatient CPM, and two weeks of CPM. mHHS was used preoperatively and postoperatively at six weeks, three months, six months, and nine months in all cases. Kruskal-Wallis (KW) analysis was performed to determine statistical differences in mHHS. mHHS was then re-evaluated using the Mann-Whitney test. There were no statistically significant differences in hip scores between the three groups preoperatively (p = 0.158). There were statistically significant differences (p CPM had the best outcome scores. The results of this study suggest that postoperative CPM use following open hip preservation surgery for symptomatic FAI in adolescents improves clinical outcomes. These benefits seem to be related to the duration of CPM. Retrospective comparative study, Level III. Patients treated one way compared with patients treated another way at the same institution.

Reconstructing Generalized Logical Networks of Transcriptional Regulation in Mouse Brain from Temporal Gene Expression Data

Energy Technology Data Exchange (ETDEWEB)

Song, Mingzhou (Joe) [New Mexico State University, Las Cruces; Lewis, Chris K. [New Mexico State University, Las Cruces; Lance, Eric [New Mexico State University, Las Cruces; Chesler, Elissa J [ORNL; Kirova, Roumyana [Bristol-Myers Squibb Pharmaceutical Research & Development, NJ; Langston, Michael A [University of Tennessee, Knoxville (UTK); Bergeson, Susan [Texas Tech University, Lubbock

2009-01-01

The problem of reconstructing generalized logical networks to account for temporal dependencies among genes and environmental stimuli from high-throughput transcriptomic data is addressed. A network reconstruction algorithm was developed that uses the statistical significance as a criterion for network selection to avoid false-positive interactions arising from pure chance. Using temporal gene expression data collected from the brains of alcohol-treated mice in an analysis of the molecular response to alcohol, this algorithm identified genes from a major neuronal pathway as putative components of the alcohol response mechanism. Three of these genes have known associations with alcohol in the literature. Several other potentially relevant genes, highlighted and agreeing with independent results from literature mining, may play a role in the response to alcohol. Additional, previously-unknown gene interactions were discovered that, subject to biological verification, may offer new clues in the search for the elusive molecular mechanisms of alcoholism.

A critical analysis of a locally agreed protocol for clinical practice

International Nuclear Information System (INIS)

Owen, A.; Hogg, P.; Nightingale, J.

2004-01-01

Within the traditional scope of radiographic practice (including advanced practice) there is a need to demonstrate effective patient care and management. Such practice should be set within a context of appropriate evidence and should also reflect peer practice. In order to achieve such practice the use of protocols is encouraged. Effective protocols can maximise care and management by minimising inter- and intra-professional variation; they can also allow for detailed procedural records to be kept in case of legal claims. However, whilst literature exists to encourage the use of protocols there is little published material available to indicate how to create, manage and archive them. This article uses an analytical approach to propose a suitable method for protocol creation and archival, it also offers suggestions on the scope and content of a protocol. To achieve this an existing clinical protocol for radiographer reporting barium enemas is analysed to draw out the general issues. Proposals for protocol creation, management, and archival were identified. The clinical practice described or inferred in the protocol should be drawn from evidence, such evidence could include peer-reviewed material, national standards and peer practice. The protocol should include an explanation of how to proceed when the radiographers reach the limit of their ability. It should refer to the initial training required to undertake the clinical duties as well as the on-going continual professional updating required to maintain competence. Audit of practice should be indicated, including the preferred audit methodology, and associated with this should be a clear statement about standards and what to do if standards are not adequately met. Protocols should be archived, in a paper-based form, for lengthy periods in case of legal claims. On the archived protocol the date it was in clinical use should be included

An Examination of Binder Systems and Their Influences on Burn Rates of High-Nitrogen Containing Formulations

Science.gov (United States)

2011-01-01

sought-after to advance existing HHS technology. Currently existing HHS candle formulations contain significant amounts of potassium perchlorate...Defense spends tens of billions of dollars annually on per- chlorate remediation efforts. Therefore, efforts to elimi- nate perchlorate from military...develop per- chlorate -free formulations of the M126A1 red star para- chute. To maximize the performance of these formula- tions, KClO4 was replaced

76 FR 60510 - Prospective Grant of Exclusive License: Compositions and Method for Preventing Reactogenicity...

Science.gov (United States)

2011-09-29

... intussusception observed 3 to 7 days following administration of the initial dose of rotavirus vaccine at about 2... Application No. 60/178,689, filed January 28, 2000 [HHS Ref. No. E-088-2000/0-US-01], now expired; PCT Patent... WO/2001/54718 on August 2, 2001, now expired; U.S. Patent No. 7,431,931 [HHS Ref. No. E-088-2000/0-US...

Young Adult Perceptions of the British American Tobacco New Zealand Agree/Disagree Plain Packaging Counter-Campaign.

Science.gov (United States)

McCool, Judith; Wong-Cornall, Cecilia; Freeman, Becky

2017-10-01

In 2012, British American Tobacco New Zealand (BATNZ) launched a mass media campaign branded "Agree/ Disagree" as a response to the New Zealand government's plans to introduce plain packaging. We examined young adult's views about the campaign to assist tobacco control policymakers in planning future interventions. Interviews with young adults living in the Auckland area were conducted. Interviews covered existing knowledge about plain packaging of tobacco, knowledge about the tobacco industry, and perceptions of specific advertisements included in the campaign. Interview data were analyzed to determine the dominant views about the campaign. Perspectives from 12 interviews reflect the dominant discourse in New Zealand on the benefits of serving economic progress and international trade. Pervasive views about the campaigns reflected perceptions of the risk to the New Zealand image, trade, and economy. Similarly, participants expressed concern about the potential for plain packaging to creep toward other products, such as alcohol. Perceptions of the tobacco industry were mixed but reflect a tolerant view of the ethics of business if viewed to be beneficial to the economy. Participants were broadly accepting of the campaign messages. We identified a tendency toward quasi-libertarian leanings when discussing economics and trade, commercial versus personal responsibility, and the value of freedom (commercial and social). These perspectives were often held simultaneously with conflicting socially responsive values and references to the hegemonic position of "big business." This study affirms the importance of closely monitoring public opinion about tobacco control and of broadening denormalization strategies to reflect the critical role the tobacco industry plays in prolonging the tobacco epidemic. To date there is little evidence on the perceptions young adults hold toward to the tobacco industry and their arguments regarding the introduction of plain packaged

Hemi-convulsion-hemiplegia syndrome revisited: longitudinal MRI findings in 10 children

International Nuclear Information System (INIS)

Barcia; Giulia; Chemaly, Nicole; Dulac, Olivier; Nabbout, Rima; Desguerre, Isabelle; Carmona, Orietta; Barnerias, Christine; Gitiaux, Cyril; Brunelle, Francis; Boddaert, Nathalie

2013-01-01

Hemi-convulsion-hemiplegia syndrome (HHS) is a rare severe epilepsy of infancy consisting of unilateral convulsive status epilepticus immediately followed by transient or lasting ipsilateral hemiplegia. HHS may occur either in patients with previous brain pathology or without any identified cause, so-called 'idiopathic HHS'. We retrospectively analysed clinical and MRI longitudinal findings of a series of 10 patients (six females, four males) presenting with HHS. Age at the study inclusion ranged from 2 years 6 months to 15 years (mean of 5 y 10 mo, median 4 y 2 mo). After defining magnetic resonance imaging (MRI) features as 'typical', i.e. strictly unilateral involvement, and 'atypical', i.e. bilateral, we compared clinical data from both groups. Cognitive level was assessed using Brunet-Lezine or Wechsler scales. HHS occurred at a mean age of 20.5 months (range 8-48 mo). In all cases, status epilepticus lasted for more than 1 hour and was characterised by unilateral clonic seizures followed by ipsilateral hemiplegia (persistent in five patients). Two patients in this series died: the first from multi-organ failure 2 weeks after the status epilepticus and the other from a second episode of ipsilateral intractable febrile status epilepticus 3 years after the first episode. Early MRI (days 1-7 from status epilepticus) showed hemispheric cytotoxic oedema in all, extending to the contralateral side for one. T2 hyperintensity in the basal ganglia was disclosed in 70% of patients and in the hippocampus in 60%. After 1 month (in intermediate and chronic phases), all surviving patients but one showed hemispheric cortical atrophy corresponding to the regions involved during the early stage. Comparing clinical features of patients presenting with 'typical' features, to those with 'atypical' findings, the second group presented psychomotor delay before status epilepticus. This series underlines the major value of early MRI

Hemi-convulsion-hemiplegia syndrome revisited: longitudinal MRI findings in 10 children

Energy Technology Data Exchange (ETDEWEB)

Barcia,; Giulia,; Chemaly, Nicole; Dulac, Olivier; Nabbout, Rima [Reference Centre for Rare Epilepsies, Department of Paediatric Neurology, Hopital Necker-Enfants malades, APHP, Paris (France); Inserm U663, Paris [France; University Paris Descartes, CEA, Gif sur Yvette (France); Desguerre, Isabelle; Carmona, Orietta; Barnerias, Christine; Gitiaux, Cyril [Reference Centre for Rare Epilepsies, Department of Paediatric Neurology, Hopital Necker-Enfants malades, APHP, Paris (France); Brunelle, Francis; Boddaert, Nathalie [Paediatric Radiology Department, Hopital Necker-Enfants malades, APHP, Paris, (France)

2013-07-01

Hemi-convulsion-hemiplegia syndrome (HHS) is a rare severe epilepsy of infancy consisting of unilateral convulsive status epilepticus immediately followed by transient or lasting ipsilateral hemiplegia. HHS may occur either in patients with previous brain pathology or without any identified cause, so-called 'idiopathic HHS'. We retrospectively analysed clinical and MRI longitudinal findings of a series of 10 patients (six females, four males) presenting with HHS. Age at the study inclusion ranged from 2 years 6 months to 15 years (mean of 5 y 10 mo, median 4 y 2 mo). After defining magnetic resonance imaging (MRI) features as 'typical', i.e. strictly unilateral involvement, and 'atypical', i.e. bilateral, we compared clinical data from both groups. Cognitive level was assessed using Brunet-Lezine or Wechsler scales. HHS occurred at a mean age of 20.5 months (range 8-48 mo). In all cases, status epilepticus lasted for more than 1 hour and was characterised by unilateral clonic seizures followed by ipsilateral hemiplegia (persistent in five patients). Two patients in this series died: the first from multi-organ failure 2 weeks after the status epilepticus and the other from a second episode of ipsilateral intractable febrile status epilepticus 3 years after the first episode. Early MRI (days 1-7 from status epilepticus) showed hemispheric cytotoxic oedema in all, extending to the contralateral side for one. T2 hyperintensity in the basal ganglia was disclosed in 70% of patients and in the hippocampus in 60%. After 1 month (in intermediate and chronic phases), all surviving patients but one showed hemispheric cortical atrophy corresponding to the regions involved during the early stage. Comparing clinical features of patients presenting with 'typical' features, to those with 'atypical' findings, the second group presented psychomotor delay before status epilepticus. This series underlines the major value of early MRI for the prompt diagnosis of HHS, and shows that

Left, right, and meeting in the middle: Addressing addiction is something we can agree about.

Science.gov (United States)

Narayanan, Arthi K; Harding, John D; Saba, Shaddy K; Conley, James; Gordon, Adam J

2016-01-01

The United States faces an addiction health crisis. Presidential election cycles in the United States are cause for creation of political party platforms. These platforms provide general stances and specific policies on a variety of issues. We undertook a review of the addiction policies of the 2016 Republican and Democratic platforms. Despite differences in focus, we found more similarities than differences between the two. We call upon those in political power to use every evidence-based policy at their disposal to promote addiction treatment and prevention.

The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II.

Science.gov (United States)

Ng, Jeremy Y; Liang, Laurel; Gagliardi, Anna R

2016-10-29

Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines. A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. From 3,126 unique search results, 17 guidelines (two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies) published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3 %), scope and purpose (83.3 %), rigour of development (61.2 %), editorial independence (60.1 %), stakeholder involvement (52.0 %) and applicability (20.7 %). Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications. Guidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available

A General Model of Organizational Values in Educational Administration

Science.gov (United States)

Mueller, Robin Alison

2014-01-01

Values theorists in educational administration agree that understanding organizational values is integral to organizational effectiveness. However, research in this area tends to be superficial, and a review of pertinent literature reveals no clear definition of organizational values or consequent implications for practical application. One of the…

Getting started with robotics in general surgery with cholecystectomy: the Canadian experience

Science.gov (United States)

Jayaraman, Shiva; Davies, Ward; Schlachta, Christopher M.

2009-01-01

Background The value of robotics in general surgery may be for advanced minimally invasive procedures. Unlike other specialties, formal fellowship training opportunities for robotic general surgery are few. As a result, most surgeons currently develop robotic skills in practice. Our goal was to determine whether robotic cholecystectomy is a safe and effective bridge to advanced robotics in general surgery. Methods Before performing advanced robotic procedures, 2 surgeons completed the Intuitive Surgical da Vinci training course and agreed to work together on all procedures. Clinical surgery began with da Vinci cholecystectomy with a plan to begin advanced procedures after at least 10 cholecystectomies. We performed a retrospective review of our pilot series of robotic cholecystectomies and compared them with contemporaneous laparoscopic controls. The primary outcome was safety, and the secondary outcome was learning curve. Results There were 16 procedures in the robotics arm and 20 in the laparoscopic arm. Two complications (da Vinci port-site hernia, transient elevation of liver enzymes) occurred in the robotic arm, whereas only 1 laparoscopic patient (slow to awaken from anesthetic) experienced a complication. None was significant. The mean time required to perform robotic cholecystectomy was significantly longer than laparoscopic surgery (91 v. 41 min, p robotic procedures (14 v. 11 min, p = 0.015). We observed a trend showing longer mean anesthesia time for robotic procedures (23 v. 15 min). Regarding learning curve, the mean operative time needed for the first 3 robotic procedures was longer than for the last 3 (101 v. 80 min); however, this difference was not significant. Since this experience, the team has confidently gone on to perform robotic biliary, pancreatic, gastresophageal, intestinal and colorectal operations. Conclusion Robotic cholecystectomy can be performed reliably; however, owing to the significant increase in operating room resources, it

Getting started with robotics in general surgery with cholecystectomy: the Canadian experience.

Science.gov (United States)

Jayaraman, Shiva; Davies, Ward; Schlachta, Christopher M

2009-10-01

The value of robotics in general surgery may be for advanced minimally invasive procedures. Unlike other specialties, formal fellowship training opportunities for robotic general surgery are few. As a result, most surgeons currently develop robotic skills in practice. Our goal was to determine whether robotic cholecystectomy is a safe and effective bridge to advanced robotics in general surgery. Before performing advanced robotic procedures, 2 surgeons completed the Intuitive Surgical da Vinci training course and agreed to work together on all procedures. Clinical surgery began with da Vinci cholecystectomy with a plan to begin advanced procedures after at least 10 cholecystectomies. We performed a retrospective review of our pilot series of robotic cholecystectomies and compared them with contemporaneous laparoscopic controls. The primary outcome was safety, and the secondary outcome was learning curve. There were 16 procedures in the robotics arm and 20 in the laparoscopic arm. Two complications (da Vinci port-site hernia, transient elevation of liver enzymes) occurred in the robotic arm, whereas only 1 laparoscopic patient (slow to awaken from anesthetic) experienced a complication. None was significant. The mean time required to perform robotic cholecystectomy was significantly longer than laparoscopic surgery (91 v. 41 min, p robotic procedures (14 v. 11 min, p = 0.015). We observed a trend showing longer mean anesthesia time for robotic procedures (23 v. 15 min). Regarding learning curve, the mean operative time needed for the first 3 robotic procedures was longer than for the last 3 (101 v. 80 min); however, this difference was not significant. Since this experience, the team has confidently gone on to perform robotic biliary, pancreatic, gastresophageal, intestinal and colorectal operations. Robotic cholecystectomy can be performed reliably; however, owing to the significant increase in operating room resources, it cannot be justified for routine use. Our

General general game AI

OpenAIRE

Togelius, Julian; Yannakakis, Georgios N.; 2016 IEEE Conference on Computational Intelligence and Games (CIG)

2016-01-01

Arguably the grand goal of artificial intelligence research is to produce machines with general intelligence: the capacity to solve multiple problems, not just one. Artificial intelligence (AI) has investigated the general intelligence capacity of machines within the domain of games more than any other domain given the ideal properties of games for that purpose: controlled yet interesting and computationally hard problems. This line of research, however, has so far focuse...

Assessment of general public perceptions toward traditional medicines used for aphrodisiac purpose in state of Penang, Malaysia.

Science.gov (United States)

Hassali, Mohamed Azmi; Saleem, Fahad; Shafie, Asrul Akmal; Al-Qazaz, Harith Khalid; Farooqui, Maryam; Aljadhey, Hisham; Atif, Muhammad; Masood, Imran

2012-11-01

The study aims to evaluate general public perceptions regarding the use of Traditional and Complementary Medicines (TCM) for aphrodisiac purposes. A questionnaire based, cross-sectional study was undertaken. Respondents were selected in the state of Penang, Malaysia. A total of 392 respondents were included in the study. Descriptive statistics were used for data analysis. Chi Square/Fischer Exact tests were used where appropriate. Out of 392 respondents, 150 (38.26%) reported using specific Traditional medicines for aphrodisiac purposes. Most respondents (46.94%) agreed that aphrodisiac medicines were easily available t. Moreover, 40.31% of the respondents reported that traditional aphrodisiac medicines were cheaper than modern (prescription) medicines. This study highlights limited public knowledge regarding the use of traditional aphrodisiac medicine. Healthcare professionals should be aware of informal TCM usage when prescribing allopathic medicines. Copyright © 2012 Elsevier Ltd. All rights reserved.

Generalized functions

CERN Document Server

Gelfand, I M; Graev, M I; Vilenkin, N Y; Pyatetskii-Shapiro, I I

Volume 1 is devoted to basics of the theory of generalized functions. The first chapter contains main definitions and most important properties of generalized functions as functional on the space of smooth functions with compact support. The second chapter talks about the Fourier transform of generalized functions. In Chapter 3, definitions and properties of some important classes of generalized functions are discussed; in particular, generalized functions supported on submanifolds of lower dimension, generalized functions associated with quadratic forms, and homogeneous generalized functions are studied in detail. Many simple basic examples make this book an excellent place for a novice to get acquainted with the theory of generalized functions. A long appendix presents basics of generalized functions of complex variables.

Evaluation of aerodynamic characteristics of a coupled fluid-structure system using generalized Bernoulli's principle: An application to vocal folds vibration.

Science.gov (United States)

Zhang, Lucy T; Yang, Jubiao

2016-12-01

In this work we explore the aerodynamics flow characteristics of a coupled fluid-structure interaction system using a generalized Bernoulli equation derived directly from the Cauchy momentum equations. Unlike the conventional Bernoulli equation where incompressible, inviscid, and steady flow conditions are assumed, this generalized Bernoulli equation includes the contributions from compressibility, viscous, and unsteadiness, which could be essential in defining aerodynamic characteristics. The application of the derived Bernoulli's principle is on a fully-coupled fluid-structure interaction simulation of the vocal folds vibration. The coupled system is simulated using the immersed finite element method where compressible Navier-Stokes equations are used to describe the air and an elastic pliable structure to describe the vocal fold. The vibration of the vocal fold works to open and close the glottal flow. The aerodynamics flow characteristics are evaluated using the derived Bernoulli's principles for a vibration cycle in a carefully partitioned control volume based on the moving structure. The results agree very well to experimental observations, which validate the strategy and its use in other types of flow characteristics that involve coupled fluid-structure interactions.

10 CFR 780.36 - Conditions and issuance of license.

Science.gov (United States)

2010-01-01

... continued existence of these circumstances. The parties will propose and agree on a reasonable royalty fee within a reasonable time as determined by the General Counsel. A reasonable royalty shall provide... General Counsel or if a royalty fee cannot be agreed upon within the reasonable time period established by...

10 CFR 780.47 - Conditions and issuance of license.

Science.gov (United States)

2010-01-01

... continued existence of these circumstances. The parties will propose and agree on a reasonable royalty fee within a reasonable time as determined by the General Counsel. A reasonable royalty shall provide... General Counsel or if a royalty fee cannot be agreed upon within the reasonable time period established by...

29 CFR 4.141 - General criteria for measuring amount.

Science.gov (United States)

2010-07-01

... Government for such work under his contract or may even agree to pay the Government in return for the right... formal advertising, in arriving at the aggregate amount involved, there must be included all property and... single advertisement for bids if the procurement were being effected by formal advertising. Therefore, if...

The analytic structure of conformal blocks and the generalized Wilson-Fisher fixed points

Energy Technology Data Exchange (ETDEWEB)

Gliozzi, Ferdinando [Dipartimento di Fisica, Università di Torino andIstituto Nazionale di Fisica Nucleare - sezione di Torino,Via P. Giuria 1, I-10125 Torino (Italy); Guerrieri, Andrea L. [Department of Physics, Faculty of Science, Chulalongkorn University,Thanon Phayathai, Pathumwan, Bangkok 10330 (Thailand); I.N.F.N. Sezione di Roma Tor Vergata,Via della Ricerca Scientifica, I-00133 Roma (Italy); Petkou, Anastasios C. [Institute of Theoretical Physics, Aristotle University of Thessaloniki,54124 Thessaloniki (Greece); Wen, Congkao [Walter Burke Institute for Theoretical Physics, California Institute of Technology,Pasadena, CA 91125 (United States); Mani L. Bhaumik Institute for Theoretical Physics,Department of Physics and Astronomy, UCLA,Los Angeles, CA 90095 (United States)

2017-04-11

We describe in detail the method used in our previous work https://arxiv.org/abs/1611.10344 to study the Wilson-Fisher critical points nearby generalized free CFTs, exploiting the analytic structure of conformal blocks as functions of the conformal dimension of the exchanged operator. Our method is equivalent to the mechanism of conformal multiplet recombination set up by null states. We compute, to the first non-trivial order in the ϵ-expansion, the anomalous dimensions and the OPE coefficients of infinite classes of scalar local operators using just CFT data. We study single-scalar and O(N)-invariant theories, as well as theories with multiple deformations. When available we agree with older results, but we also produce a wealth of new ones. Unitarity and crossing symmetry are not used in our approach and we are able to apply our method to non-unitary theories as well. Some implications of our results for the study of the non-unitary theories containing partially conserved higher-spin currents are briefly mentioned.

Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

Directory of Open Access Journals (Sweden)

Wright F

2012-10-01

Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain.

Science.gov (United States)

Kruschinski, Carsten; Wiese, Birgitt; Dierks, Marie-Luise; Hummers-Pradier, Eva; Schneider, Nils; Junius-Walker, Ulrike

2016-01-28

To investigate what a geriatric assessment in general practice adds towards previous findings of prevalence, location, impact and the dyadic doctor-patient perception of pain in this age group. Cross-sectional study. Consecutive patients aged 70 and over underwent a comprehensive geriatric assessment in general practice that included a basic pain assessment (severity, sites and impact). Patients with pain and their doctors then independently rated its importance. Pain was correlated with further findings from the assessment, such as overall health, physical impairments, everyday function, falls, mood, health related lifestyle, social circumstances, using bivariate and multivariate statistics. Patient-doctor agreement on the importance of pain was calculated using kappa statistics. 219 out of 297 patients (73.7 %) reported pain at any location. Pain was generally located at multiple sites. It was most often present at the knee (33.9%), the lumbar spine (33.5%) as well as the hip (13.8%) and correlated with specific impairments such as restrictions of daily living (knee) or sleep problems (spine). Patients with pain and their physicians poorly agreed on the importance of the pain problem. A basic pain assessment can identify older patients with pain in general practice. It has resulted in a high prevalence exceeding that determined by encounters in consultations. It has been shown that a geriatric assessment provides an opportunity to address pain in a way that is adapted to older patients' needs - addressing all sites, its specific impact on life, and the patients' perceived importance of pain. Since there is little doctor-patient agreement, this seems a valuable strategy to optimize concrete treatment decisions and patient centered care. This study is registered in the German Clinical Trial Register ( DRKS00000792 ).

Generalization of the van der Pauw relationship derived from electrostatics

Science.gov (United States)

Weiss, Jonathan D.

2011-08-01

In an earlier paper, this author, along with two others Weiss et al. (2008) [1], demonstrated that the original van der Pauw relationship could be derived from three-dimensional electrostatics, as opposed to van der Pauw's use of conformal mapping. The earlier derivation was done for a conducting material of rectangular cross section with contacts placed at the corners. Presented here is a generalization of the previous work involving a square sample and a square array of electrodes that are not confined to the corners, since this measurement configuration could be a more convenient one. As in the previous work, the effects of non-zero sample thickness and contact size have been investigated. Buehler and Thurber derived a similar relationship using an infinite series of current images on a large and thin conducting sheet to satisfy the conditions at the boundary of the sample. The results presented here agree with theirs numerically, but analytic agreement could not be shown using any of the perused mathematical literature. By simply equating the two solutions, it appears that, as a byproduct of this work, a new mathematical relationship has been uncovered. Finally, the application of this methodology to the Hall Effect is discussed.

Hydropericardium Hepatitis Syndrome Emerged in Cherry Valley Ducks in China.

Science.gov (United States)

Chen, H; Dou, Y; Zheng, X; Tang, Y; Zhang, M; Zhang, Y; Wang, Z; Diao, Y

2017-08-01

Since June 2015, a highly pathogenic disease occurred in duck flocks in China, causing pericardial effusion, enlarged discoloured liver, renal enlargement and haemorrhagic lung with a mortality ranging from 5% to 20%. Previous study confirmed that Fowl adenovirus group C (FAdV-C) and some field FAdVs isolates had been identified as causative agents of hydropericardium hepatitis syndrome (HHS) in chickens and geese world widely. In this study, we firstly report the isolation of FAdV-C from ducks with HHS. The two isolates, designated as SDSX and SDJX, were separated from liver samples using 9-day-old SPF chicken embryos and could cause severe cytopathic effects in duck and chicken embryonic kidney cells. The entire ORF sequences of hexon gene of the two isolates were amplified, sequenced and analysed by restriction fragment length polymorphism. Phylogenetic analysis of loop 1 sequences of hexon gene of FAdVs revealed that the two isolates were closely related to FAdV-C isolates, which could cause HHS in chickens. Experimental infection indicated that the isolate was high pathogenicity to 20-day-old ducks. Our study shows that the recently emerged HHS in ducks was caused by FAdV-C and may possess a potential risk to other poultry flocks. © 2016 Blackwell Verlag GmbH.

Clinical and genetic features of dyskeratosis congenita, cryptic dyskeratosis congenita, and Hoyeraal-Hreidarsson syndrome in Japan.

Science.gov (United States)

Yamaguchi, Hiroki; Sakaguchi, Hirotoshi; Yoshida, Kenichi; Yabe, Miharu; Yabe, Hiromasa; Okuno, Yusuke; Muramatsu, Hideki; Takahashi, Yoshiyuki; Yui, Shunsuke; Shiraishi, Yuichi; Chiba, Kenichi; Tanaka, Hiroko; Miyano, Satoru; Inokuchi, Koiti; Ito, Etsuro; Ogawa, Seishi; Kojima, Seiji

2015-11-01

Dyskeratosis congenita (DKC) is an inherited bone marrow failure (BMF) syndrome typified by reticulated skin pigmentation, nail dystrophy, and mucosal leukoplakia. Hoyeraal-Hreidarsson syndrome (HHS) is considered to be a severe form of DKC. Unconventional forms of DKC, which develop slowly in adulthood but without the physical anomalies characteristic of DKC (cryptic DKC), have been reported. Clinical and genetic features of DKC have been investigated in Caucasian, Black, and Hispanic populations, but not in Asian populations. The present study aimed to determine the clinical and genetic features of DKC, HHS, and cryptic DKC among Japanese patients. We analyzed 16 patients diagnosed with DKC, three patients with HHS, and 15 patients with cryptic DKC. We found that platelet count was significantly more depressed than neutrophil count or hemoglobin value in DKC patients, and identified DKC patients with large deletions in the telomerase reverse transcriptase and cryptic DKC patients with RTEL1 mutations on both alleles. This led to some patients previously considered to have unclassifiable BMF being diagnosed with cDKC through identification of new gene mutations. It thus seems important from a clinical viewpoint to re-examine the clinical characteristics, frequency of genetic mutations, and treatment efficacy in DKC, HHS, and cDKC.

Awareness of the general public relations strategy for nuclear power generation in Korea

Energy Technology Data Exchange (ETDEWEB)

Kim, Chano-Ok

1989-02-01

Ten years has passed since the first nuclear power plant was established in Korea. During the period, the total nuclear power generation capacity has increased to 5,716,000 kW, and additional two 950,000 kW plants currently under construction will start operating in 1988 and 1989, respectively. As of the end of 1987, nuclear power generation accounted for 53.1 % of the total power generated in the nation. The average utilization rate of the plants increased continuously from 46.3 % ten years ago up to 79.7 % in 1987. Public opinion polls were conducted in August and October of 1986, the year when the Chernobyl accident took place. The first survey covered 2,000 residents in urban and rural areas while the second one covered a total 1,000 nuclear-related engineers, scientists, administrative officials, businessmen, journalists and writers. The surveys have shown that 74.4 % of the general public agree on the construction of more nuclear power plants. The corresponding figure was 75 % for engineers and 50 % for journalists and writers. However, 73 % of the respondents who are for their construction did not want such a plant to be constructed near their residences. Concerning the safety of these plants, 79.5 % of the experts gave a positive reply while the corresponding figure was only 48.3 % for the general public. It is concluded that more active public relations activities are required in the future. (Nogami, K.).

Awareness of the general public relations strategy for nuclear power generation in Korea

International Nuclear Information System (INIS)

Kim, Chano-Ok

1989-01-01

Ten years has passed since the first nuclear power plant was established in Korea. During the period, the total nuclear power generation capacity has increased to 5,716,000 kW, and additional two 950,000 kW plants currently under construction will start operating in 1988 and 1989, respectively. As of the end of 1987, nuclear power generation accounted for 53.1 % of the total power generated in the nation. The average utilization rate of the plants increased continuously from 46.3 % ten years ago up to 79.7 % in 1987. Public opinion polls were conducted in August and October of 1986, the year when the Chernobyl accident took place. The first survey covered 2,000 residents in urban and rural areas while the second one covered a total 1,000 nuclear-related engineers, scientists, administrative officials, businessmen, journalists and writers. The surveys have shown that 74.4 % of the general public agree on the construction of more nuclear power plants. The corresponding figure was 75 % for engineers and 50 % for journalists and writers. However, 73 % of the respondents who are for their construction did not want such a plant to be constructed near their residences. Concerning the safety of these plants, 79.5 % of the experts gave a positive reply while the corresponding figure was only 48.3 % for the general public. It is concluded that more active public relations activities are required in the future. (Nogami, K.)

The General Factor of Personality: A General Critique.

Science.gov (United States)

Revelle, William; Wilt, Joshua

2013-10-01

Recently, it has been proposed that all non-cognitive measures of personality share a general factor of personality. A problem with many of these studies is a lack of clarity in defining a general factor. In this paper we address the multiple ways in which a general factor has been identified and argue that many of these approaches find factors that are not in fact general. Through the use of artificial examples, we show that a general factor is not: The first factor or component of a correlation or covariance matrix.The first factor resulting from a bifactor rotation or biquartimin transformationNecessarily the result of a confirmatory factor analysis forcing a bifactor solution We consider how the definition of what constitutes a general factor can lead to confusion, and we will demonstrate alternative ways of estimating the general factor saturation that are more appropriate.

Highlights of the 2nd session of the General Conference

Energy Technology Data Exchange (ETDEWEB)

NONE

1959-01-15

The debates of the Conference were based on the 'First Annual Report to the General Conference' (GC(n)/39) covering the period 23 October 1957 to 30 June 1958, the 'Programme and Budget for 1959' (GC(H)/36) both submitted by the Board of Governors and on the statement made by the Director General on 22 September 1958 (GC(II)OR. 14) which brought the survey of the Agency's activities up-to-date. Delegates appraised the first year's achievements and many speakers emphasized the importance of close international co-operation in the field of atomic energy and dealt with the role the IAEA was called upon to play. Referring to the offers of various and in particular fissionable materials several delegates supported the statement made by the Director General in his opening address that some preferential treatment must be given the Agency by the offering countries thereby providing some inducement for governments to utilize the channels of true international co-operation. Issues concerning safeguards and reactors were discussed. The Conference finally recommended that the Board of Governors should give earnest and early consideration to initiating action for a survey to be made of the needs of the less developed countries in the matter of nuclear power generation plants, and to the adoption of measures for continuing study regarding the development of technology and economics of small and medium scale nuclear power reactors best suited for less developed countries, and assisting them in planning and implementing their training programmes in that connection. The Conference, finally, voted in favour of the appropriations necessary for the setting up of laboratory facilities. Practically all delegates agreed, although with varying emphasis, on the importance of technical assistance and other activities of the IAEA which would soonest benefit the less advanced countries. The General Conference finally approved by 59 votes, none against and one abstention the Board of Governors

Becoming willing to role model. Reciprocity between new graduate nurses and experienced practice nurses in general practice in New Zealand: a constructivist grounded theory.

Science.gov (United States)

Hoarea, Karen J; Millsc, Jane; Francis, Karen

2013-01-01

Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing, realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing, the first core category of this grounded theory features three sub-categories: building respectful relationships, proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of 'transition shock' of newly graduated nurses in the work place.

The General Factor of Personality: A General Critique

OpenAIRE

Revelle, William; Wilt, Joshua

2013-01-01

Recently, it has been proposed that all non-cognitive measures of personality share a general factor of personality. A problem with many of these studies is a lack of clarity in defining a general factor. In this paper we address the multiple ways in which a general factor has been identified and argue that many of these approaches find factors that are not in fact general. Through the use of artificial examples, we show that a general factor is not: The first factor or component of a correla...

On a Generalized Hankel Type Convolution of Generalized Functions

Indian Academy of Sciences (India)

Generalized Hankel type transformation; Parserval relation; generalized ... The classical generalized Hankel type convolution are defined and extended to a class of generalized functions. ... Proceedings – Mathematical Sciences | News.

Informant Agreement in Treatment Gains for Child Anxiety

Science.gov (United States)

Benjamin, Courtney L.; Puleo, Connor M.; Kendall, Philip C.

2011-01-01

The present study examined multiple informant agreement in reports of treatment gains in a sample of children (M age = 10.27) treated for social phobia, generalized anxiety disorder, and separation anxiety disorder. Mothers and fathers agreed on their child's improvement, and parents and children also generally agreed on the child's improvement.…

Patients' views about the use of their personal information from general practice medical records in health research: a qualitative study in Ireland.

Science.gov (United States)

Clerkin, P; Buckley, B S; Murphy, A W; MacFarlane, A E

2013-02-01

National policies are being developed, which may limit access to patients' records for health research. This could reduce the ability of health research to benefit society as a whole. It is important to develop an in-depth understanding of people's views across demographic groups to inform such policy development. Aims. To explore patients' views about the use of their general practice records in health research with attention to gender and age. Design of study. Qualitative study using focus groups. Six General Practices in the west of Ireland. Focus Group interviews with 35 people who were patients at the practices. Overall, participants were positively inclined towards the idea of information from their records (anonymous and identifiable) being used in research for the 'greater good' although there were some concerns about personal information being 'leaked'. Males emphasized risks in relation to employment and finances, whereas females emphasized risks in relation to social discomfort and embarrassment. Participants were supportive of consent models that enable patients to give prior ongoing consent for specific agreed 'levels' of data use, affording patients self-determination without the need for consent request on study-by-study basis. Overall male and female patients of different ages are supportive of the use of their general practice records in health research and of general practitioners as data protectors.

Method or Madness: Federal Oversight Structures for Critical Infrastructure Protection

Science.gov (United States)

2007-12-01

daughters, Amber and Lauren, who always say just the right things to keep this all in perspective. Bike rides and soccer games helped to provide just...security perspective, is shared by the U.S. Department of Agriculture and the Department of Health and Human Services. The USDA monitors the meat ... poultry , and egg sectors, while HHS oversees production of all other food products.90 HHS implements a two-prong strategy to achieve a safe and

Human regulator of telomere elongation helicase 1 (RTEL1) is required for the nuclear and cytoplasmic trafficking of pre-U2 RNA

OpenAIRE

Schertzer , Michael; Jouravleva , Karina; Perderiset , Mylène; Dingli , Florent; Loew , Damarys; Le Guen , Tangui; Bardoni , Barbara; De Villartay , Jean-Pierre; Revy , Patrick; Londono-Vallejo , Arturo

2015-01-01

International audience; Hoyeraal-Hreidarsson syndrome (HHS) is a severe form of Dyskeratosis congenita characterized by developmental defects, bone marrow failure and im-munodeficiency and has been associated with telom-ere dysfunction. Recently, mutations in Regulator of Telomere ELongation helicase 1 (RTEL1), a helicase first identified in Mus musculus as being responsible for the maintenance of long telomeres, have been identified in several HHS patients. Here we show that RTEL1 is require...

General relativistic razor-thin disks with magnetically polarized matter

Science.gov (United States)

Navarro-Noguera, Anamaría; Lora-Clavijo, F. D.; González, Guillermo A.

2018-06-01

The origin of magnetic fields in the universe still remains unknown and constitutes one of the most intriguing questions in astronomy and astrophysics. Their significance is enormous since they have a strong influence on many astrophysical phenomena. In regards of this motivation, theoretical models of galactic disks with sources of magnetic field may contribute to understand the physics behind them. Inspired by this, we present a new family of analytical models for thin disks composed by magnetized material. The solutions are axially symmetric, conformastatic and are obtained by solving the Einstein-Maxwell Field Equations for continuum media without the test field approximation, and assuming that the sources are razor-thin disk of magnetically polarized matter. We find analytical expressions for the surface energy density, the pressure, the polarization vector, the electromagnetic fields, the mass and the rotational velocity for circular orbits, for two particular solutions. In each case, the energy-momentum tensor agrees with the energy conditions and also the convergence of the mass for all the solutions is proved. Since the solutions are well-behaved, they may be used to model astrophysical thin disks, and also may contribute as initial data in numerical simulations. In addition, the process to obtain the solutions is described in detail, which may be used as a guide to find solutions with magnetized material in General Relativity.

Can general practitioner commissioning deliver equity and excellence? Evidence from two studies of service improvement in the English NHS.

Science.gov (United States)

Gridley, Kate; Spiers, Gemma; Aspinal, Fiona; Bernard, Sylvia; Atkin, Karl; Parker, Gillian

2012-04-01

To explore some of the key assumptions underpinning the continued development of general practitioner-led commissioning in health services. Qualitative data from two studies of service improvement in the English NHS were considered against England's plans for GP-led commissioning. These data were collected through in-depth interviews with a total of 187 professionals and 99 people affected by services in 10 different primary care trust areas across England between 2008 and 2009. Internationally, GPs are seen to have a central position in health systems. In keeping with this, the English policy places emphasis on the 'pivotal role' of general practitioners, considered to be ideally placed to commission in the best interests of their patients. However, our evidence suggests that general practitioners do not always have a pivotal role for all patients. Moreover, it is planned that the new commissioning groups in England will not be subject to top-down performance management and this raises the question of how agreed quality standards will be met under the proposed new system. This paper questions the assumption that GPs are best placed to commission health services in a way that meets quality standards and leads to equitable outcomes. There is little evidence to suggest that GPs will succeed where others have failed and a risk that, without top-down performance management, service improvement will be patchy, leading to greater, not reduced, inequity.

A Dataset and a Technique for Generalized Nuclear Segmentation for Computational Pathology.

Science.gov (United States)

Kumar, Neeraj; Verma, Ruchika; Sharma, Sanuj; Bhargava, Surabhi; Vahadane, Abhishek; Sethi, Amit

2017-07-01

Nuclear segmentation in digital microscopic tissue images can enable extraction of high-quality features for nuclear morphometrics and other analysis in computational pathology. Conventional image processing techniques, such as Otsu thresholding and watershed segmentation, do not work effectively on challenging cases, such as chromatin-sparse and crowded nuclei. In contrast, machine learning-based segmentation can generalize across various nuclear appearances. However, training machine learning algorithms requires data sets of images, in which a vast number of nuclei have been annotated. Publicly accessible and annotated data sets, along with widely agreed upon metrics to compare techniques, have catalyzed tremendous innovation and progress on other image classification problems, particularly in object recognition. Inspired by their success, we introduce a large publicly accessible data set of hematoxylin and eosin (H&E)-stained tissue images with more than 21000 painstakingly annotated nuclear boundaries, whose quality was validated by a medical doctor. Because our data set is taken from multiple hospitals and includes a diversity of nuclear appearances from several patients, disease states, and organs, techniques trained on it are likely to generalize well and work right out-of-the-box on other H&E-stained images. We also propose a new metric to evaluate nuclear segmentation results that penalizes object- and pixel-level errors in a unified manner, unlike previous metrics that penalize only one type of error. We also propose a segmentation technique based on deep learning that lays a special emphasis on identifying the nuclear boundaries, including those between the touching or overlapping nuclei, and works well on a diverse set of test images.

A General Framework for Setting Quantitative Population Objectives for Wildlife Conservation

Directory of Open Access Journals (Sweden)

Kristen E. Dybala

2017-03-01

Full Text Available https://doi.org/10.15447/sfews.2017v15iss1art8Quantitative population objectives are necessary to successfully achieve conservation goals of secure or robust wildlife populations. However, existing methods for setting quantitative population objectives commonly require extensive species-specific population viability data, which are often unavailable or are based on estimates of historical population sizes, which may no longer represent feasible objectives. Conservation practitioners require an alternative, science-based method for setting long-term quantitative population objectives. We reviewed conservation biology literature to develop a general conceptual framework that represents conservation biology principles and identifies key milestones a population would be expected to pass in the process of becoming a recovered or robust population. We then synthesized recent research to propose general hypotheses for the orders of magnitude at which most populations would be expected to reach each milestone. The framework is structured as a hierarchy of four population sizes, ranging from very small populations at increased risk of inbreeding depression and extirpation (< 1,000 adults to large populations with minimized risk of extirpation (> 50,000 adults, along with additional modifiers describing steeply declining and resilient populations. We also discuss the temporal and geographic scales at which this framework should be applied. To illustrate the application of this framework to conservation planning, we outline our use of the framework to set long-term population objectives for a multi-species regional conservation plan, and discuss additional considerations in applying this framework to other systems. This general framework provides a transparent, science-based method by which conservation practitioners and stakeholders can agree on long-term population objectives of an appropriate magnitude, particularly when the alternative approaches are

Europe Agrees on Common Strategy to Initiate Study of LSA/MMA

Science.gov (United States)

1998-09-01

strong involvement in millimetre astronomy: the 5 x 15-m IRAM array on Plateau de Bure (France), the 30-m IRAM antenna (Spain), the 20-m at Onsala (Sweden), the 15-m Swedish-ESO Submillimetre Telescope (SEST, La Silla), the 15-m JCMT (Mauna Kea, Hawaii), the 10-m HHT (Arizona), and others. Over 60 research institutes around Europe use these facilities. Many of them have developed technical expertise and leadership in this area together with European industry, so it is natural that a European collaboration should be looking to the future. The idea of a large European southern millimetre array has been discussed since 1991. In 1995, an LSA Project collaboration was established between ESO, the Institut de Radio Astronomie Millimetrique (IRAM), the Onsala Space Observatory, and the Netherlands Foundation for Research in Astronomy (NFRA). This consortium of observatories agreed to pool resources to study critical technical areas and conduct site surveys in Chile. Details are available in a Messenger article (March 98). Possibilities of intercontinental collaboration An important step was taken in June 1997. A similar project is under study in the United States of America (the "Millimeter Array", MMA ). An agreement was entered into between ESO and the U.S. National Radio Astronomy Observatory (NRAO) to explore the possibility of merging the two projects into one. Until then the emphasis in Europe had been on the large collecting area provided by 16-m antennas operating at purely millimetre wavelengths, while in the U.S. the concept was a smaller array of 8-m antennas with good submillimetre performance. However, as there is also considerable interest in Europe in submillimetre observations, and in the U.S. in a larger collecting area, a compromise seemed feasible. Several joint working groups formed under the ESO-NRAO agreement were set up to explore the possibility of a collaborative project. It was concluded that a homogeneous array of 64 x 12-m antennas, providing

Factors influencing nurse absenteeism in a general hospital in Durban, South Africa.

Science.gov (United States)

Mudaly, P; Nkosi, Z Z

2015-07-01

To establish reasons for absenteeism amongst professional nurses, enrolled nurses and enrolled nurse auxiliaries in a general hospital in Durban, in order to recommend strategies that could decrease absenteeism. Nurses endure increased workload, resulting in burnout and absenteeism in workplace environments that already suffer staff shortages. This study was a quantitative, non-experimental survey. The study population consisted of 60 nurses, including professional and enrolled nurses and enrolled nurse auxiliaries. The survey consisted of closed-ended questions to options of 'agree' and 'disagree' and an open-ended section. Family matters, lack of motivation to attend work, illness, finance, favouritism, unfriendly nurse managers, long work hours, increased workload, unsatisfactory work conditions, lack of equipment, unfair promotions and selection of nurses for training, staff shortages, lack of a reward system and incoherent decision-making caused nurse absenteeism. Personal, professional and organisational factors may cause nurse absenteeism, crippling the health sector further against the backdrop of human and mechanical resource shortage. Nurse managers have an important role in reducing absenteeism by addressing the employees' concerns, which can lead to productivity, increased staff morale, decreased medical hazards and satisfied patients. © 2013 John Wiley & Sons Ltd.

General mixture item response models with different item response structures: Exposition with an application to Likert scales.

Science.gov (United States)

Tijmstra, Jesper; Bolsinova, Maria; Jeon, Minjeong

2018-01-10

This article proposes a general mixture item response theory (IRT) framework that allows for classes of persons to differ with respect to the type of processes underlying the item responses. Through the use of mixture models, nonnested IRT models with different structures can be estimated for different classes, and class membership can be estimated for each person in the sample. If researchers are able to provide competing measurement models, this mixture IRT framework may help them deal with some violations of measurement invariance. To illustrate this approach, we consider a two-class mixture model, where a person's responses to Likert-scale items containing a neutral middle category are either modeled using a generalized partial credit model, or through an IRTree model. In the first model, the middle category ("neither agree nor disagree") is taken to be qualitatively similar to the other categories, and is taken to provide information about the person's endorsement. In the second model, the middle category is taken to be qualitatively different and to reflect a nonresponse choice, which is modeled using an additional latent variable that captures a person's willingness to respond. The mixture model is studied using simulation studies and is applied to an empirical example.

Assessment of knowledge of general practitioners about nuclear medicine

International Nuclear Information System (INIS)

Zakavi, R.; Derakhshan, A.; Pourzadeh, Z.

2002-01-01

. Two questions of urogenital system was correctly answered in 23 cases, and 43 cases had incorrect answers to both. Thirty three cases answered correctly two questions of thyroid therapy and 41 cases answered only one of questions correctly. In nuclear oncology correct answers was noted 24%. One correct answer was noted in 37% and 39% cases had no correct answer the pathology, only 3% correctly answered all questions, 41 cases had one correct answer and 56 cases than 7 patients and 30% get 7-8 points. Also 9-10 points was noted in 26%. Ten patients had scores of 11-12 and two patients had 13-14 points. 80% of cases agree with classic study of nuclear medicine as a subject or credit during study of general medicine. Also 90% of cases like to have more information in the field, 65% of them prefer educational pamphlets

Pain modulation in waking and hypnosis in women: event-related potentials and sources of cortical activity.

Directory of Open Access Journals (Sweden)

Vilfredo De Pascalis

Full Text Available Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA method revealed significant activations of the bilateral primary somatosensory (BA3, middle frontal gyrus (BA6 and anterior cingulate cortices (BA24. Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32, while for the P200 wave, activity was increased in the superior (BA22, middle (BA37, inferior temporal (BA19 gyri and superior parietal lobule (BA7. Hypnotic hypoalgesia in

Pain Modulation in Waking and Hypnosis in Women: Event-Related Potentials and Sources of Cortical Activity

Science.gov (United States)

De Pascalis, Vilfredo; Varriale, Vincenzo; Cacace, Immacolata

2015-01-01

Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs) whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs) during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA) method revealed significant activations of the bilateral primary somatosensory (BA3), middle frontal gyrus (BA6) and anterior cingulate cortices (BA24). Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32), while for the P200 wave, activity was increased in the superior (BA22), middle (BA37), inferior temporal (BA19) gyri and superior parietal lobule (BA7). Hypnotic hypoalgesia in HHs, for N

[Changing to a career in general practice - a qualitative study reveals motives of specialists].

Science.gov (United States)

Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth

2016-12-01

In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of

Rotational effect on Rayleigh, Love and Stoneley waves in fibre-reinforced anisotropic general viscoelastic media of higher and fraction orders with voids

Energy Technology Data Exchange (ETDEWEB)

Abd-Alla, A. M.; Abo-Dahab, S. M. [Taif University, Taif (Egypt); Khan, Aftab [COMSATS, Chakshahzad (Pakistan)

2015-10-15

In this paper, we investigated the propagation of surface waves in a rotating fibre-reinforced viscoelastic anisotropic media of a higher order and fraction orders of nth order including time rate of strain with voids. The general surface wave speed is derived to study the effect of rotation and voids on surface waves. Particular cases for Stoneley, Love and Rayleigh waves are also discussed. The results obtained in this investigation are more general in the sense that some earlier published results are obtained from our result as special cases. In order zero our results are well agreeing with classical results. Also by neglecting the reinforced elastic parameters and voids the results reduce to well known isotropic medium. Comparison was made with the results obtained in the presence and absence of rotation and parameters for fibre-reinforced of the material medium. It is observed that Love wave remains unaffected with respect to rotation and voids. It is also observed that, surface waves cannot propagate in a fast rotating medium. Numerical results are given and illustrated graphically.

Rotational effect on Rayleigh, Love and Stoneley waves in fibre-reinforced anisotropic general viscoelastic media of higher and fraction orders with voids

International Nuclear Information System (INIS)

Abd-Alla, A. M.; Abo-Dahab, S. M.; Khan, Aftab

2015-01-01

In this paper, we investigated the propagation of surface waves in a rotating fibre-reinforced viscoelastic anisotropic media of a higher order and fraction orders of nth order including time rate of strain with voids. The general surface wave speed is derived to study the effect of rotation and voids on surface waves. Particular cases for Stoneley, Love and Rayleigh waves are also discussed. The results obtained in this investigation are more general in the sense that some earlier published results are obtained from our result as special cases. In order zero our results are well agreeing with classical results. Also by neglecting the reinforced elastic parameters and voids the results reduce to well known isotropic medium. Comparison was made with the results obtained in the presence and absence of rotation and parameters for fibre-reinforced of the material medium. It is observed that Love wave remains unaffected with respect to rotation and voids. It is also observed that, surface waves cannot propagate in a fast rotating medium. Numerical results are given and illustrated graphically.

[The relative's need of participation in the care plan in a general medicine ward].

Science.gov (United States)

Artioli, Giovanna; Finotto, Stefano; Paverelli, Luisa; Carpanoni, Marika; Casadei, Elena Turroni

2006-01-01

All the scientific literature agrees on the fact that the shelter in hospital is a delicate moment for the patient. Also for relatives the shelter in hospital of their dear one is not of easy management, often they are excluded, insecure, alone and with a frankly uncertain role. The purpose of this study is to explore the role and the needs perceived from the relatives of an in-patient in a general medicine unit and to explore which role and which needs of the relatives are perceived from the nurses of a same ward. The sample of the study consisted of 49 relatives of in-patients in the ward of Medicina III dell'Azienda Ospedaliera di Reggio Emilia and of 18 nurses of the same ward. It was found that information is the most important need expressed by the relatives and that for the nurses is hard to satisfy it. Moreover, the nurses haven't a clear idea of the relative's role and they are inclined to exclude them from the care project.

"NOTHING IS AGREED UNTIL EVERYTHING IS AGREED": INSTITUTIONALIZING RADICAL DISAGREEMENT AND DEALING WITH THE PAST IN NORTHERN IRELAND

DEFF Research Database (Denmark)

McQuaid, Sara Dybris

2018-01-01

constitutional futures. It demonstrates that in the absence of an overarching framework for dealing with the past in Northern Ireland, the model is coming into view as accumulated, piecemeal, pluralistic, complex and often contradictory efforts, emerging in the tensions between radical disagreement and attempts...... at reconciliation, between community initiatives and policy discourses, in what may be called a protracted peace process. The chapter argues that navigating this paradox of fixity and fluidity has crucially involved somewhat futile attempts at separating distinct lines of truth and justice in coming to terms...

United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

International Nuclear Information System (INIS)

Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

2016-01-01

The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

Hyponatremic hypertensive syndrome secondary to renal ischemia – Case report

Directory of Open Access Journals (Sweden)

Joana Cunha Oliveira

2018-01-01

Full Text Available Hyponatremic hypertensive syndrome (HHS is characterized by hypertensive crisis, and hyponatremia secondary to unilateral renal damage with glomerular and tubular dysfunction. Elevated plasma levels of renin in most cases suggest that the stimulation of renin release from the ischemic kidney plays an important pathophysiologic role. Activation of the renin-angiotensin system results in hypertension and causes secondary hyperfiltration, pressure diuresis and sodium loss from contralateral non-damaged kidney. An elevated renin level is a pathognomonic finding in HHS. Potassium deficiency from hyperaldosteronism may further stimulate renin secretion and intensify this vicious circle.We report a female term newborn, who presented with hypertensive crisis on the seventh day after traumatic birth. The first three days of life were uneventful. Initial treatment with captopril resulted in severe hypotension and hemodynamic instability. Lab work revealed hyponatremia, hypokalemia, and elevated peripheral renin activity and aldosterone levels. Complementary sonography and magnetic resonance confirmed right adrenal gland hematoma and several ischemic areas in the upper pole of the right kidney. The diagnosis of HHS secondary to renal ischemia was evoked.HHS is a rare condition in the neonatal period, though still under-recognized. In the neonatal and early infancy period, renovascular disease is the most common cause of secondary hypertension. In this case, there was no sign of vascular disease, the renin-angiotensin system was activated secondary to direct renal ischemia and infarction. The intense renin stimulation and pressure through the contralateral normal kidney results in high pressure natriuresis facilitating a severe volume-depleted state. Although the use of renin-angiotensin system inhibitors is the treatment of choice, it is imperative to re-establish hydration and renal perfusion before starting this antihypertensive medication. We aimed to

Reactive Case Detection for Plasmodium vivax Malaria Elimination in Rural Amazonia.

Directory of Open Access Journals (Sweden)

Pablo S Fontoura

2016-12-01

Full Text Available Malaria burden in Brazil has reached its lowest levels in 35 years and Plasmodium vivax now accounts for 84% of cases countrywide. Targeting residual malaria transmission entrenched in the Amazon is the next major challenge for ongoing elimination efforts. Better strategies are urgently needed to address the vast reservoir of asymptomatic P. vivax carriers in this and other areas approaching malaria elimination.We evaluated a reactive case detection (RCD strategy tailored for P. vivax transmission in farming settlements in the Amazon Basin of Brazil. Over six months, 41 cases detected by passive surveillance triggered four rounds of RCD (0, 30, 60, and 180 days after index case enrollment, using microscopy- and quantitative real-time polymerase chain reaction (qPCR-based diagnosis, comprising subjects sharing the household (HH with the index case (n = 163, those living in the 5 nearest HHs within 3 km (n = 878, and individuals from 5 randomly chosen control HHs located > 5 km away from index cases (n = 841. Correlates of infection were identified with mixed-effects logistic regression models. Molecular genotyping was used to infer local parasite transmission networks.Subjects in index and neighbor HHs were significantly more likely to be parasitemic than control HH members, after adjusting for potential confounders, and together harbored > 90% of the P. vivax biomass in study subjects. Clustering patterns were temporally stable. Four rounds of microscopy-based RCD would identify only 49.5% of the infections diagnosed by qPCR, but 76.8% of the total parasite biomass circulating in the proximity of index HHs. However, control HHs accounted for 27.6% of qPCR-positive samples, 92.6% of them from asymptomatic carriers beyond the reach of RCD. Molecular genotyping revealed high P. vivax diversity, consistent with complex transmission networks and multiple sources of infection within clusters, potentially complicating malaria elimination efforts.

Generalized 2-vector spaces and general linear 2-groups

OpenAIRE

Elgueta, Josep

2008-01-01

In this paper a notion of {\\it generalized 2-vector space} is introduced which includes Kapranov and Voevodsky 2-vector spaces. Various kinds of generalized 2-vector spaces are considered and examples are given. The existence of non free generalized 2-vector spaces and of generalized 2-vector spaces which are non Karoubian (hence, non abelian) categories is discussed, and it is shown how any generalized 2-vector space can be identified with a full subcategory of an (abelian) functor category ...

Employment and satisfaction trends among general surgery residents from a community hospital.

Science.gov (United States)

Cyr-Taro, Amy E; Kotwall, Cyrus A; Menon, Rema P; Hamann, M Sue; Nakayama, Don K

2008-01-01

Physician satisfaction is an important and timely issue in health care. A paucity of literature addresses this question among general surgeons. To review employment patterns and job satisfaction among general surgery residents from a single university-affiliated institution. All general surgery residents graduating from 1986 to 2006, inclusive, were mailed an Institutional Review Board-approved survey, which was then returned anonymously. Information on demographics, fellowship training, practice characteristics, job satisfaction and change, and perceived shortcomings in residency training was collected. A total of 31 of 34 surveys were returned (91%). Most of those surveyed were male (94%) and Caucasian (87%). Sixty-one percent of residents applied for a fellowship, and all but 1 were successful in obtaining their chosen fellowship. The most frequent fellowship chosen was plastic surgery, followed by minimally invasive surgery. Seventy-one percent of residents who applied for fellowship felt that the program improved their competitiveness for a fellowship. Most of the sample is in private practice, and of those, 44% are in groups with more than 4 partners. Ninety percent work less than 80 hours per week. Only 27% practice in small towns (population job. Twenty-three percent agreed that they had difficulty finding their first job, and 30% had fewer job offers than expected. Thirty-five percent of the graduates have changed jobs: 29% of the residents have changed jobs once, and 6% have changed jobs at least twice since completing training. Reasons for leaving a job included colleague issues (82%), financial issues (82%), inadequate referrals (64%), excessive trauma (64%), and marriage or family reasons (55% and 55%, respectively). One half to three fourths of the graduates wished they had more teaching on postresidency business and financial issues, review of contracts, and suggestions for a timeline for finding a job. Although general surgical residencies prepare

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans.

Science.gov (United States)

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2017-03-07

The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients' CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans

Science.gov (United States)

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2017-03-01

The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

Differing manifestations of hepatitis C and tacrolimus on hospitalized diabetes mellitus occurring after kidney transplantation.

Science.gov (United States)

Abbott, Kevin C; Bernet, Victor J; Agodoa, Lawrence Y; Yuan, Christina M

2005-09-01

Previous studies suggest the association of recipient hepatitis C seropositivity (HCV+) and use of tacrolimus (TAC) with post-transplant diabetes mellitus (PTDM) may differ by manifestations of type I or type II diabetes, but this has not been assessed in the era of current immunosuppression. We performed a retrospective cohort study of 10,342 Medicare primary renal transplantation recipients without evidence of diabetes at the time of listing in the United States Renal Data System between January 1, 1998 and July 31, 2000, followed until December 31, 2000. Outcomes were hospitalizations for a primary diagnosis of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS). Cox regression analysis was used to calculate adjusted hazard ratios (AHR) for time to DKA or HHS, stratified by diabetes status at the time of transplant. In Cox regression analysis, use of TAC at discharge was independently associated with shorter time to DKA (AHR, 1.88; 95% CI, 1.05-3.37, p=0.034) but not HHS. In contrast, recipient HCV+ was independently associated with shorter time to HHS (AHR, 3.90; 1.59-9.60, p=.003), but not DKA. There was no interaction between TAC and HCV+ for either outcome. These results confirm earlier findings that TAC and HCV+ may mediate the risk of PTDM through different mechanisms, even in the modern era.

[The general practitioners in front of reforms: the reactions of the sample group of liberal physicians of the region PACA].

Science.gov (United States)

Videau, Yann; Ventelou, Bruno; Combes, Jean-Baptiste; Verger, Pierre; Paraponaris, Alain

2007-05-01

The general practitioners in front of reforms: the reactions of the sample group of liberal physicians of the region PACA This article intends to analyse the opinion of general practioners (GPs) about the two laws of July 2004, relating to the health insurance reform and to public health planning. We used a panel data sample of 528 GPs practising in Provence Alpes Côte d'Azur in order to analyse the determinants of physicians' adherence to the reform, using multinomial logistic regression models. The results show that GPs do not seem to be fully convinced by this reform (45% agree with it, whereas 48% don't): this mistrustful opinion is more marked for young physicians and appears little correlated with their practices. 75% of the GPs are favourable to the Personal Medical File (Dossier Médical Personnel in french) and 76% estimate that they should draw a better attention to the public health dimension of their practice. Two barriers concerning GPs' adherence to the doctor > reform (réforme du ) seem relevant: the burden of administrative tasks and the disadvantage of young physicians who have not already fixed their own clientele.

The presence of radiological features on chest radiographs: How well do clinicians agree?

Energy Technology Data Exchange (ETDEWEB)

Edwards, M. [Department of Child Health, School of Medicine, Cardiff University (United Kingdom); Lawson, Z. [Department of Child Health, School of Medicine, Cardiff University (United Kingdom); Department of Primary Care and Public Health, School of Medicine, Cardiff University (United Kingdom); Morris, S.; Evans, A.; Harrison, S.; Isaac, R. [Department of Paediatric Radiology, University Hospital of Wales, Cardiff (United Kingdom); Crocker, J. [Department of Primary Care and Public Health, School of Medicine, Cardiff University (United Kingdom); Powell, C., E-mail: powellc7@cardiff.ac.uk [Department of Child Health, School of Medicine, Cardiff University (United Kingdom)

2012-07-15

Aim: To compare levels of agreement amongst paediatric clinicians with those amongst consultant paediatric radiologists when interpreting chest radiographs (CXRs). Materials and methods: Four paediatric radiologists used picture archiving and communication system (PACS) workstations to evaluate the presence of five radiological features of infection, independently in each of 30 CXRs. The radiographs were obtained over 1 year (2008) from children with fever and signs of respiratory distress, aged 6 months to <16 years. The same CXRs were interpreted a second time by the paediatric radiologists and by 21 clinicians with varying experience levels, using the Web 1000 viewing system and a projector. Intra- and interobserver agreement within groups, split by grade and specialty, were analysed using free-marginal multi-rater kappa. Results: Normal CXRs were identified consistently amongst all 25 participants. The four paediatric radiologists showed high levels of intraobserver agreement between methods (kappa scores between 0.53 and 1.00) and interobserver agreement for each method (kappa scores between 0.67 and 0.96 for PACS assessment). The 21 clinicians showed varying levels of agreement from 0.21 to 0.89. Conclusion: Paediatric radiologists showed high levels of agreement for all features. In general, the clinicians had lower levels of agreement than the radiologists. This study highlights the need for improved training in interpreting CXRs for clinicians and the timely reporting of CXRs by radiologists to allow appropriate patient management.

Generalized oscillator strength for the argon 3p6-3p5 4s transition: Correlation and exchange effects on the characteristic minimum

International Nuclear Information System (INIS)

Chen, Zhifan; Msezane, Alfred Z.; Amusia, M. Ya.

1999-01-01

We have investigated the generalized oscillator strength (GOS) for a transition of the type np→(n+1)s, where n is the principal quantum number of the outermost filled shell of the atomic ground state, using the random-phase approximation with exchange. We find that the influence of correlation and exchange effects on the position of the characteristic minimum in the GOS of Ar(n=3) is insignificant. Also, our first Born approximation predicts the position of the minimum accurately provided that accurate target wave functions are employed. Our results agree excellently with measurements and are expected to be applicable equally to the corresponding subshells of Ne(n=2), Kr(n=4), and Xe(n=5). (c) 1999 The American Physical Society

Reasons of general practitioners for not prescribing lipid-lowering medication to patients with diabetes: a qualitative study

Directory of Open Access Journals (Sweden)

AB Elisabeth

2009-04-01

Full Text Available Abstract Background Lipid-lowering medication remains underused, even in high-risk populations. The objective of this study was to determine factors underlying general practitioners' decisions not to prescribe such drugs to patients with type 2 diabetes. Methods A qualitative study with semi-structured interviews using real cases was conducted to explore reasons for not prescribing lipid-lowering medication after a guideline was distributed that recommended the use of statins in most patients with type 2 diabetes. Seven interviews were conducted with general practitioners (GPs in The Netherlands, and analysed using an analytic inductive approach. Results Reasons for not-prescribing could be divided into patient and physician-attributed factors. According to the GPs, some patients do not follow-up on agreed medication and others object to taking lipid-lowering medication, partly for legitimate reasons such as expected or perceived side effects. Furthermore, the GPs themselves perceived reservations for prescribing lipid-lowering medication in patients with short life expectancy, expected compliance problems or near goal lipid levels. GPs sometimes postponed the start of treatment because of other priorities. Finally, barriers were seen in the GPs' practice organisation, and at the primary-secondary care interface. Conclusion Some of the barriers mentioned by GPs seem to be valid reasons, showing that guideline non-adherence can be quite rational. On the other hand, treatment quality could improve by addressing issues, such as lack of knowledge or motivation of both the patient and the GP. More structured management in general practice may also lead to better treatment.

The Application of the Socratic Method in Teaching General Education Law Courses

Directory of Open Access Journals (Sweden)

Ling-Shuang Shih

2013-06-01

Full Text Available The Socratic Method emphasizes that students obtain knowledge and test their beliefs in the process of engaging in dialogues. As general education emphasizes critical thinking, this method has much applied value, specifically in teaching law courses in general education programs. In light of different perspectives, the Socratic Method could be classified into three models: the test model, the Meno model, and the Theaetetus model. Besides, it could be classified into two approaches: the non-autocratic approach and the authoritarian approach. The Socratic Method is often adopted in the teaching at law schools in the United States. In their different experiences of studying and teaching, scholars’ views over the use of the Socratic Method in teaching the law is controversial. The approvers consider that the method is effective in teaching basic legal principles. The dissenters consider that the classroom experience is humiliating to all students. However, most scholars would agree that it depends on how well teachers implement the Socratic Method so that students may benefit from the process. Comparatively, there is also possibility that these models or approaches of the Socratic Method might be properly applied in the teaching of different law courses. In United States, the Meno model is mainly applied. Besides, for students’ understanding the application of law, teachers may adopt the authoritarian approach. For students to understand the amending of law, teachers may use the non-autocratic approach. In this article, the author introduced and analyzed his teaching of law using the Socratic Method and demonstrated how useful it has been for educating students to have deliberation ability.

Holiday heart syndrome revisited after 34 years.

Science.gov (United States)

Tonelo, David; Providência, Rui; Gonçalves, Lino

2013-08-01

The cardiovascular effects of alcohol are well known. However, most research has focused on the beneficial effects (the "French paradox") of moderate consumption or the harmful consequences, such as dilated cardiomyopathy, associated with heavy consumption over an extended period. An association between the ingestion of acute alcohol and onset of cardiac arrhythmias was first reported in the early 70's. In 1978, Philip Ettinger described "Holiday heart syndrome" (HHS) for the first time, as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking. The name is derived from the fact that episodes were initially observed more frequently after weekends or public holidays. Since the original description of HHS, 34 years have passed and new research in this field has increased the volume of knowledge related to this syndrome. Throughout this paper the authors will comprehensively review most of the available data concerning HHS and highlight the questions that remain unresolved.

Drug Pricing Program Ceiling Price and Manufacturer Civil Monetary Penalties Regulation. Final rule; further delay of effective date.

Science.gov (United States)

2017-09-29

The Health Resources and Services Administration (HRSA) administers section 340B of the Public Health Service Act (PHSA), known as the "340B Drug Pricing Program" or the "340B Program." HRSA published a final rule on January 5, 2017, that set forth the calculation of the ceiling price and application of civil monetary penalties. The final rule applied to all drug manufacturers that are required to make their drugs available to covered entities under the 340B Program. On August 21, 2017, HHS solicited comments on further delaying the effective date of the January 5, 2017, final rule to July 1, 2018 (82 FR 39553). HHS proposed this action to allow a more deliberate process of considering alternative and supplemental regulatory provisions and to allow for sufficient time for additional rulemaking. After consideration of the comments received on the proposed rule, HHS is delaying the effective date of the January 5, 2017, final rule, to July 1, 2018.

The opinion of the general practitioner toward clinical management of patients with psychogenic nonepileptic seizures.

LENUS (Irish Health Repository)

O'Sullivan, S S

2012-02-03

OBJECTIVE: The purpose of this work was to assess the opinion of general practitioners (GPs) regarding the diagnosis of psychogenic nonepileptic seizures (PNES) and the role they feel they should play in the management of the disorder. METHODS: Patients with PNES were identified from hospital records. Seizure and patient characteristics were recorded. Their GPs were surveyed regarding their understanding of the diagnosis and ongoing management of PNES. RESULTS: Twenty-three patients were identified over a 3-year period as having been diagnosed with PNES. Sixty-five percent of GPs agreed with the diagnosis, and when asked to grade their understanding of the diagnosis (poor = 1, excellent = 10), the mean score was 5.7 (+\\/-SD 2.3). Thirty-five percent of GPs felt psychological input was of benefit to their patients. Fifty-two percent of GPs felt comfortable following up these patients, either with or without neurology outpatient services. CONCLUSIONS: PNES remains a difficult disease to manage. There is a high level of uncertainty regarding the optimum management of PNES among primary care physicians, for which further education is needed.

Generalized Probability Functions

Directory of Open Access Journals (Sweden)

Alexandre Souto Martinez

2009-01-01

Full Text Available From the integration of nonsymmetrical hyperboles, a one-parameter generalization of the logarithmic function is obtained. Inverting this function, one obtains the generalized exponential function. Motivated by the mathematical curiosity, we show that these generalized functions are suitable to generalize some probability density functions (pdfs. A very reliable rank distribution can be conveniently described by the generalized exponential function. Finally, we turn the attention to the generalization of one- and two-tail stretched exponential functions. We obtain, as particular cases, the generalized error function, the Zipf-Mandelbrot pdf, the generalized Gaussian and Laplace pdf. Their cumulative functions and moments were also obtained analytically.

77 FR 12444 - Airworthiness Directives; General Electric Company (GE) Turbofan Engines

Science.gov (United States)

2012-03-01

... not agree with unconditional deferral to the next shop visit as unacceptable cooling flow could affect... acceptable flows determined during an optional borescope inspection. Request To Revise Criteria for Shop... bore cooling flow for a specified number of cycles. We are issuing this AD to prevent an uncontained...

Generalized Cartan Calculus in general dimension

Science.gov (United States)

Wang, Yi-Nan

2015-07-01

We develop the generalized Cartan Calculus for the groups and SO(5 , 5). They are the underlying algebraic structures of d = 9 , 7 , 6 exceptional field theory, respectively. These algebraic identities are needed for the "tensor hierarchy" structure in exceptional field theory. The validity of Poincaré lemmas in this new differential geometry is also discussed. Finally we explore some possible extension of the generalized Cartan calculus beyond the exceptional series.

Evaluation of aerodynamic characteristics of a coupled fluid-structure system using generalized Bernoulli’s principle: An application to vocal folds vibration

Science.gov (United States)

Zhang, Lucy T.; Yang, Jubiao

2017-01-01

In this work we explore the aerodynamics flow characteristics of a coupled fluid-structure interaction system using a generalized Bernoulli equation derived directly from the Cauchy momentum equations. Unlike the conventional Bernoulli equation where incompressible, inviscid, and steady flow conditions are assumed, this generalized Bernoulli equation includes the contributions from compressibility, viscous, and unsteadiness, which could be essential in defining aerodynamic characteristics. The application of the derived Bernoulli’s principle is on a fully-coupled fluid-structure interaction simulation of the vocal folds vibration. The coupled system is simulated using the immersed finite element method where compressible Navier-Stokes equations are used to describe the air and an elastic pliable structure to describe the vocal fold. The vibration of the vocal fold works to open and close the glottal flow. The aerodynamics flow characteristics are evaluated using the derived Bernoulli’s principles for a vibration cycle in a carefully partitioned control volume based on the moving structure. The results agree very well to experimental observations, which validate the strategy and its use in other types of flow characteristics that involve coupled fluid-structure interactions. PMID:29527541

Occupation of the cytochrome P450 substrate pocket by diverse compounds at general anesthesia concentrations.

Science.gov (United States)

LaBella, F S; Stein, D; Queen, G

1998-10-02

Each of a diverse array of compounds, at concentrations reported to effect general anesthesia, when added to liver microsomes, forms a complex with cytochromes P450 to generate, with reference to a cuvette containing microsomes only, a characteristic absorbance-difference spectrum. This spectrum results from a change in the electron-spin state of the heme iron atom induced upon entry by the anesthetic molecule into the enzyme catalytic pocket. The difference spectrum, representing the anesthetic-P450 complex, is characteristic of substances that are substrates for the enzyme. For the group of compounds as a whole, the magnitudes of the absorbance-difference spectra vary only about twofold, although the anesthetic potencies vary by several orders of magnitude. The dissociation constants (Ks), calculated from absorbance data and representing affinities of the anesthetics for P450, agree closely with the respective EC50 (concentration that effects anesthesia in 50% of individuals) values, and with the respective Ki (concentration that inhibits P450 catalytic activities half-maximally) values reported by us previously. The absorbance complex resulting from the occupation of the catalytic pocket by endogenous substrates, androstenedione and arachidonic acid, is inhibited, competitively, by anesthetics. Occupation of and perturbation of the heme catalytic pocket by anesthetic, as monitored by the absorbance-difference spectrum, is rapidly reversible. The presumed in vivo consequences of perturbation by general anesthetics of heme proteins is suppression of the generation of chemical signals that determine cell sensitivity and response.

Accuracy assessment of the linear Poisson-Boltzmann equation and reparametrization of the OBC generalized Born model for nucleic acids and nucleic acid-protein complexes.

Science.gov (United States)

Fogolari, Federico; Corazza, Alessandra; Esposito, Gennaro

2015-04-05

The generalized Born model in the Onufriev, Bashford, and Case (Onufriev et al., Proteins: Struct Funct Genet 2004, 55, 383) implementation has emerged as one of the best compromises between accuracy and speed of computation. For simulations of nucleic acids, however, a number of issues should be addressed: (1) the generalized Born model is based on a linear model and the linearization of the reference Poisson-Boltmann equation may be questioned for highly charged systems as nucleic acids; (2) although much attention has been given to potentials, solvation forces could be much less sensitive to linearization than the potentials; and (3) the accuracy of the Onufriev-Bashford-Case (OBC) model for nucleic acids depends on fine tuning of parameters. Here, we show that the linearization of the Poisson Boltzmann equation has mild effects on computed forces, and that with optimal choice of the OBC model parameters, solvation forces, essential for molecular dynamics simulations, agree well with those computed using the reference Poisson-Boltzmann model. © 2015 Wiley Periodicals, Inc.

General Editorial

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education. General Editorial. Articles in Resonance – Journal of Science Education. Volume 19 Issue 1 January 2014 pp 1-2 General Editorial. General Editorial on Publication Ethics · R Ramaswamy · More Details Fulltext PDF. Volume 19 Issue 1 January 2014 pp 3-3 ...

Does Media Use Result in More Active Communicators? Differences Between Native Dutch and Turkish-Dutch Patients in Information-Seeking Behavior and Participation During Consultations With General Practitioners.

Science.gov (United States)

Schinkel, Sanne; Van Weert, Julia C M; Kester, Jorrit A M; Smit, Edith G; Schouten, Barbara C

2015-08-01

This study investigates differences between native Dutch and Turkish-Dutch patients with respect to media usage before and patient participation during medical consultations with general practitioners. In addition, the authors assessed the relation between patient participation and communication outcomes. The patients were recruited in the waiting rooms of general practitioners, and 191 patients (117 native Dutch, 74 Turkish-Dutch) completed pre- and postconsultation questionnaires. Of this sample, 120 patients (62.8%; 82 native Dutch, 38 Turkish-Dutch) agreed to have their consultations recorded to measure patient participation. Compared with Turkish-Dutch patients of similar educational levels, results showed that native Dutch patients used different media to search for information, participated to a greater extent during their consultations and were more responsive to their general practitioner. With respect to the Turkish-Dutch patients, media usage was related to increased patient participation, which was correlated with having fewer unfulfilled information needs; however, these relations were not found in the native Dutch patient sample. In conclusion, interventions that enhance participation among ethnic minority patients will better fulfill informational needs when such interventions stimulate information-seeking behavior in that group before a medical consultation.

Practices, patients and (imperfect data - feasibility of a randomised controlled clinical drug trial in German general practices

Directory of Open Access Journals (Sweden)

Hummers-Pradier Eva

2011-04-01

Full Text Available Abstract Background Randomised controlled clinical (drug trials supply high quality evidence for therapeutic strategies in primary care. Until now, experience with drug trials in German general practice has been sparse. In 2007/2008, the authors conducted an investigator-initiated, non-commercial, double-blind, randomised controlled pilot trial (HWI-01 to assess the clinical equivalence of ibuprofen and ciprofloxacin in the treatment of uncomplicated urinary tract infection (UTI. Here, we report the feasibility of this trial in German general practices and the implementation of Good Clinical Practice (GCP standards as defined by the International Conference on Harmonisation (ICH in mainly inexperienced general practices. Methods This report is based on the experience of the HWI-01 study conducted in 29 German general practices. Feasibility was defined by 1 successful practice recruitment, 2 sufficient patient recruitment, 3 complete and accurate data collection and 4 appropriate protection of patient safety. Results The final practice recruitment rate was 18%. In these practices, 79 of 195 screened UTI patients were enrolled. Recruitment differed strongly between practices (range 0-12, mean 2.8 patients per practice and was below the recruitment goal of approximately 100 patients. As anticipated, practice nurses became the key figures in the screening und recruitment of patients. Clinical trial demands, in particular for completing symptom questionnaires, documentation of source data and reporting of adverse events, did not agree well with GPs' documentation habits and required support from study nurses. In many cases, GPs and practice staff seemed to be overwhelmed by the amount of information and regulations. No sudden unexpected serious adverse reactions (SUSARs were observed during the trial. Conclusions To enable drug trials in general practice, it is necessary to adapt the setup of clinical research infrastructure to the needs of GPs and

The fusion rules for the Temperley–Lieb algebra and its dilute generalization

International Nuclear Information System (INIS)

Belletête, Jonathan

2015-01-01

The Temperley–Lieb (TL) family of algebras is well known for its role in building integrable lattice models. Even though a proof is still missing, it is agreed that these models should go to conformal field theories in the thermodynamic limit and that the limiting vector space should carry a representation of the Virasoro algebra. The fusion rules are a notable feature of the Virasoro algebra. One would hope that there is an analogous construction for the TL family. Such a construction was proposed by Read and Saleur (2007 Nucl. Phys. B 777 316) and partially computed by Gainutdinov and Vasseur (2013 Nucl. Phys. B 868 223–70) using the bimodule structure over the TL algebras and the quantum group Uq (sl2).We use their definition for the dilute Temperley–Lieb (dTL) family, a generalization of the original TL family. We develop a new way of computing fusion by using induction and show its power by obtaining fusion rules for both dTL and TL. We recover those computed by Gainutdivov and Vasseur and new ones that were beyond their scope. In particular, we identify a set of irreducible TL- or dTL-representations whose behavior under fusion is that of some irreducibles of the minimal models of conformal field theory. (paper)

The impact of general practitioner morale on patient satisfaction with care: a cross-sectional study

Directory of Open Access Journals (Sweden)

McKinstry Brian

2007-09-01

Full Text Available Abstract Background The association between stress and morale among general practitioners (GP is well documented. However, the impact of GP stress or low morale on patient care is less clear. GPs in the UK now routinely survey patients about the quality of their care including organizational issues and consultation skills and the General Practice Assessment Questionnaire (GPAQ is widely used for this purpose. We aimed to see if there was a relationship between doctor morale as measured by a validated instrument, the Morale Assessment in General Practice Index (MAGPI and scores in the GPAQ. Methods All GPs in Lothian, Scotland who were collecting GPAQ data were approached and asked to complete the MAGPI. Using an anonymised linkage system, individual scores on the MAGPI were linked to the doctors' GPAQ scores. Levels of association between the scores were determined by calculating rank correlations at the level of the individual doctor. Hypothesised associations between individual MAGPI and GPAQ items were also assessed. Results 276 of 475 GPs who were approached agreed to complete a MAGPI questionnaire and successfully collected anonymous GPAQ data from an average of 49.6 patients. There was no significant correlation between the total MAGPI score and the GPAQ communication or enablement scale. There were weak correlations between "control of work" in the MAGPI scale and GPAQ items on waiting times to see doctors (r = 0.24 p Conclusion This study showed no relationship between overall GP morale and patient perception of performance. There was a weak relationship between patients' perceptions ofquality and doctors' beliefs about their workload and whether patients value them. Further research is required to elucidate the complex relationship between workload, morale and patients' perception of care.

Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II.

Science.gov (United States)

Chiappini, Elena; Bortone, Barbara; Galli, Luisa; de Martino, Maurizio

2017-07-31

Several societies have produced and disseminated clinical practice guidelines (CPGs) for the symptomatic management of fever in children. However, to date, the quality of such guidelines has not been appraised. To identify and evaluate guidelines for the symptomatic management of fever in children. The research was conducted using PubMed, guideline websites, and Google (January 2010 to July 2016). The quality of the CPGs was independently assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, and specific recommendations in guidelines were summarised and evaluated. Domain scores were considered of sufficient quality when >60% and of good quality when >80%. Seven guidelines were retrieved. The median score for the scope and purpose domain was 85.3% (range 66.6-100%). The median score for the stakeholder involvement domain was 57.5% (range 33.3-83.3%) and four guidelines scored >60%. The median score for the rigour of development domain was 52.0% (range 14.6-98.9%), and only three guidelines scored >60%. The median score for the clarity of presentation domain was 80.9% (range 50.0-94.4%). The median score for the applicability domain was 39.3% (8.3-100%). Only one guideline scored >60%. The median score for the editorial independence domain was 48.84% (0-91.6%); only three guidelines scored >60%. Most guidelines were recommended for use even if with modification, especially in the methodology, the applicability and the editorial independence domains. Our results could help improve reporting of future guidelines, and affect the selection and use of guidelines in clinical practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Generalized convexity, generalized monotonicity recent results

CERN Document Server

Martinez-Legaz, Juan-Enrique; Volle, Michel

1998-01-01

A function is convex if its epigraph is convex. This geometrical structure has very strong implications in terms of continuity and differentiability. Separation theorems lead to optimality conditions and duality for convex problems. A function is quasiconvex if its lower level sets are convex. Here again, the geo­ metrical structure of the level sets implies some continuity and differentiability properties for quasiconvex functions. Optimality conditions and duality can be derived for optimization problems involving such functions as well. Over a period of about fifty years, quasiconvex and other generalized convex functions have been considered in a variety of fields including economies, man­ agement science, engineering, probability and applied sciences in accordance with the need of particular applications. During the last twenty-five years, an increase of research activities in this field has been witnessed. More recently generalized monotonicity of maps has been studied. It relates to generalized conve...

10 CFR Appendix A to Part 824 - General Statement of Enforcement Policy

Science.gov (United States)

2010-01-01

... positive incentives for a DOE contractor's: (1) Timely self-identification of security deficiencies, (2..., when verification is received that corrective actions have been implemented, DOE will close the... Administrator who agrees that further enforcement action should not be pursued if verification is received that...

Multicenter Analysis of Midterm Clinical Outcomes of Arthroscopic Labral Repair in the Hip: Minimum 5-Year Follow-up.

Science.gov (United States)

Hevesi, Mario; Krych, Aaron J; Johnson, Nick R; Redmond, John M; Hartigan, David E; Levy, Bruce A; Domb, Benjamin G

2018-02-01

The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown. To perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes. Cohort study; Level of evidence, 3. Prospectively collected data of primary hip arthroscopic labral repair performed at 4 high-volume centers between 2008 and 2011 were reviewed retrospectively. Patients were assessed preoperatively and postoperatively with the visual analog scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score-Sports-Specific Subscale (HOS-SSS) at a minimum of 5 years' follow-up. Factors including age, body mass index (BMI), Tönnis grade, and cartilage grade were analyzed in relation to outcome scores, and revision rates were determined. Failure was defined as subsequent ipsilateral hip surgery, including revision arthroscopic surgery and open hip surgery. A total of 303 patients (101 male, 202 female) with a mean age of 32.0 years (range, 10.7-58.9 years) were followed for a mean of 5.7 years (range, 5.0-7.9 years). Patients achieved mean improvements in VAS of 3.5 points, mHHS of 20.1 points, and HOS-SSS of 29.3 points. Thirty-seven patients (12.2%) underwent revision arthroscopic surgery, and 12 (4.0%) underwent periacetabular osteotomy, resurfacing, or total hip arthroplasty during the study period. Patients with a BMI >30 kg/m 2 had a mean mHHS score 9.5 points lower and a mean HOS-SSS score 15.9 points lower than those with a BMI ≤30 kg/m 2 ( P 35 years at surgery had a mean mHHS score 4.5 points lower and a HOS-SSS score 6.7 points lower than those aged ≤35 years ( P = .03). Patients with Tönnis grade 2 radiographs demonstrated a 12.5-point worse mHHS score ( P = .02) and a 23.0-point worse HOS-SSS score ( P SSS scores after arthroscopic

Hip Arthroscopy for Femoral-Acetabular Impingement: Do Active Claims Affect Outcomes?

Science.gov (United States)

Gigi, Roy; Rath, Ehud; Sharfman, Zachary T; Shimonovich, Shachar; Ronen, Itai; Amar, Eyal

2016-04-01

To compare outcomes of 3 patient groups undergoing hip arthroscopy. This study included 138 consecutive hip arthroscopies (106 analyzed) for femoral-acetabular impingement (FAI) with or without labral tear in patients with a minimum 1-year follow-up. Inclusion criteria included patients older than 18 with clinical or radiologic manifestation of FAI with or without labral tear. Exclusion criteria included previous hip surgery and various hip pathologies. Patients were classified into 3 study groups. Group 1 included work-related injuries with active claims ACs (n = 33); mean age, 32 (range, 19 to 63); group 2 included sports injuries with no ACs (n = 35); mean age, 32 (range, 18 to 69); and group 3 included non-sports-related injuries without pending ACs (NAS; n = 38); mean age, 45 (range, 20 to 68). Outcomes were assessed using modified Harris hip scores (mHHS) and hip outcome scores (HOS) preoperatively and during the final evaluation. Baseline score for all groups did not significantly differ (P = .210 for mHHS, P = .176 for HOS). All groups significantly improved from preoperative to final evaluation (group 1: mHHS P = .42, HOS P = .001; group 2: mHHS P arthroscopy. Hip arthroscopy as an intervention in patients with ACs provided positive outcomes, corroborating that an AC is not a contraindication for this procedure. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Inherited mutations in the helicase RTEL1 cause telomere dysfunction and Hoyeraal-Hreidarsson syndrome.

Science.gov (United States)

Deng, Zhong; Glousker, Galina; Molczan, Aliah; Fox, Alan J; Lamm, Noa; Dheekollu, Jayaraju; Weizman, Orr-El; Schertzer, Michael; Wang, Zhuo; Vladimirova, Olga; Schug, Jonathan; Aker, Memet; Londoño-Vallejo, Arturo; Kaestner, Klaus H; Lieberman, Paul M; Tzfati, Yehuda

2013-09-03

Telomeres repress the DNA damage response at the natural chromosome ends to prevent cell-cycle arrest and maintain genome stability. Telomeres are elongated by telomerase in a tightly regulated manner to ensure a sufficient number of cell divisions throughout life, yet prevent unlimited cell division and cancer development. Hoyeraal-Hreidarsson syndrome (HHS) is characterized by accelerated telomere shortening and a broad range of pathologies, including bone marrow failure, immunodeficiency, and developmental defects. HHS-causing mutations have previously been found in telomerase and the shelterin component telomeric repeat binding factor 1 (TRF1)-interacting nuclear factor 2 (TIN2). We identified by whole-genome exome sequencing compound heterozygous mutations in four siblings affected with HHS, in the gene encoding the regulator of telomere elongation helicase 1 (RTEL1). Rtel1 was identified in mouse by its genetic association with telomere length. However, its mechanism of action and whether it regulates telomere length in human remained unknown. Lymphoblastoid cell lines obtained from a patient and from the healthy parents carrying heterozygous RTEL1 mutations displayed telomere shortening, fragility and fusion, and growth defects in culture. Ectopic expression of WT RTEL1 suppressed the telomere shortening and growth defect, confirming the causal role of the RTEL1 mutations in HHS and demonstrating the essential function of human RTEL1 in telomere protection and elongation. Finally, we show that human RTEL1 interacts with the shelterin protein TRF1, providing a potential recruitment mechanism of RTEL1 to telomeres.

Inherited mutations in the helicase RTEL1 cause telomere dysfunction and Hoyeraal–Hreidarsson syndrome

Science.gov (United States)

Deng, Zhong; Glousker, Galina; Molczan, Aliah; Fox, Alan J.; Lamm, Noa; Dheekollu, Jayaraju; Weizman, Orr-El; Schertzer, Michael; Wang, Zhuo; Vladimirova, Olga; Schug, Jonathan; Aker, Memet; Londoño-Vallejo, Arturo; Kaestner, Klaus H.; Lieberman, Paul M.; Tzfati, Yehuda

2013-01-01

Telomeres repress the DNA damage response at the natural chromosome ends to prevent cell-cycle arrest and maintain genome stability. Telomeres are elongated by telomerase in a tightly regulated manner to ensure a sufficient number of cell divisions throughout life, yet prevent unlimited cell division and cancer development. Hoyeraal–Hreidarsson syndrome (HHS) is characterized by accelerated telomere shortening and a broad range of pathologies, including bone marrow failure, immunodeficiency, and developmental defects. HHS-causing mutations have previously been found in telomerase and the shelterin component telomeric repeat binding factor 1 (TRF1)-interacting nuclear factor 2 (TIN2). We identified by whole-genome exome sequencing compound heterozygous mutations in four siblings affected with HHS, in the gene encoding the regulator of telomere elongation helicase 1 (RTEL1). Rtel1 was identified in mouse by its genetic association with telomere length. However, its mechanism of action and whether it regulates telomere length in human remained unknown. Lymphoblastoid cell lines obtained from a patient and from the healthy parents carrying heterozygous RTEL1 mutations displayed telomere shortening, fragility and fusion, and growth defects in culture. Ectopic expression of WT RTEL1 suppressed the telomere shortening and growth defect, confirming the causal role of the RTEL1 mutations in HHS and demonstrating the essential function of human RTEL1 in telomere protection and elongation. Finally, we show that human RTEL1 interacts with the shelterin protein TRF1, providing a potential recruitment mechanism of RTEL1 to telomeres. PMID:23959892

Generalized oscillator strength for the argon 3p{sup 6}-3p{sup 5} 4s transition: Correlation and exchange effects on the characteristic minimum

Energy Technology Data Exchange (ETDEWEB)

Chen, Zhifan [Center for Theoretical Studies of Physical Systems, and Department of Physics, Clark Atlanta University, Atlanta, Georgia 30314 (United States); Msezane, Alfred Z. [Center for Theoretical Studies of Physical Systems, and Department of Physics, Clark Atlanta University, Atlanta, Georgia 30314 (United States); Amusia, M. Ya. [Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem 91904, (Israel)

1999-12-01

We have investigated the generalized oscillator strength (GOS) for a transition of the type np{yields}(n+1)s, where n is the principal quantum number of the outermost filled shell of the atomic ground state, using the random-phase approximation with exchange. We find that the influence of correlation and exchange effects on the position of the characteristic minimum in the GOS of Ar(n=3) is insignificant. Also, our first Born approximation predicts the position of the minimum accurately provided that accurate target wave functions are employed. Our results agree excellently with measurements and are expected to be applicable equally to the corresponding subshells of Ne(n=2), Kr(n=4), and Xe(n=5). (c) 1999 The American Physical Society.

What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India.

Science.gov (United States)

Vadepally, Ashwant Kumar; Sinha, Ramen

2018-06-01

To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 ( p  oral and maxillofacial surgery was found to be 50.2%. The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.

Action principle for the generalized harmonic formulation of general relativity

International Nuclear Information System (INIS)

Brown, J. David

2011-01-01

An action principle for the generalized harmonic formulation of general relativity is presented. The action is a functional of the spacetime metric and the gauge source vector. An action principle for the Z4 formulation of general relativity has been proposed recently by Bona, Bona-Casas, and Palenzuela. The relationship between the generalized harmonic action and the Bona, Bona-Casas, and Palenzuela action is discussed in detail.

Management of stage I and II A/B avascular necrosis of femoral head with core decompression autologous cancellous bone grafting and platelet rich plasma factors

Directory of Open Access Journals (Sweden)

Tushar Agarwal

2015-01-01

Full Text Available Background: Avascular necrosis (AVN of the femoral head is a progressive disease that generally affects patients in the third through fifth decades of life; if left untreated, it leads to complete deterioration of the hip joint. Treatments range from simple decompression of the femoral head, to bone grafting of the involved area, or by using a vascularized fibular graft with varying degree of success. In most instances, the disease progresses further causing secondary arthritis. We present a study of management of early stage AVN (stage I and II A/B of Ficat Arlet classification with core decompression autologous cancellous bone grafting along with platelet rich plasma. Aims: To evaluate the results of the above modality in the management of AVN of the hip. Settings and Design: This prospective study of 30 cases was done during the period of 2011-2013. Materials and Methods: Patients with stage I and II A/B were treated with the above modality and were followed up for 1-year. The results were evaluated on the basis of progression or remission of the disease by radiographic studies, preoperative and postoperative Harris hip score (HHS, age and sex distribution. Statistical Analysis Used: Primer software for calculating the statistical data was used and paired t-test was applied to all the data. Results: Show males were more affected than females and average age group of presentation in stage I and II was 29 years (22-55. The most common cause was idiopathic followed by steroid use. Average preoperative HHS was 56.80 and postoperative HHS was 79.73. 60% (18 showed remission of the disease (radiographically compared to preoperative stage at 1-year follow-up, in 30% (9 disease did not progress further and 10% (3 progressed and required arthroplasty. Conclusion: Management of stage I and II A/B AVN of femur showed good satisfactory results in terms of disease remission and prevention of the further progress of the disease by the above method at 1

Generalized polygons

CERN Document Server

Van Maldeghem, Hendrik

1998-01-01

Generalized Polygons is the first book to cover, in a coherent manner, the theory of polygons from scratch. In particular, it fills elementary gaps in the literature and gives an up-to-date account of current research in this area, including most proofs, which are often unified and streamlined in comparison to the versions generally known. Generalized Polygons will be welcomed both by the student seeking an introduction to the subject as well as the researcher who will value the work as a reference. In particular, it will be of great value for specialists working in the field of generalized polygons (which are, incidentally, the rank 2 Tits-buildings) or in fields directly related to Tits-buildings, incidence geometry and finite geometry. The approach taken in the book is of geometric nature, but algebraic results are included and proven (in a geometric way!). A noteworthy feature is that the book unifies and generalizes notions, definitions and results that exist for quadrangles, hexagons, octagons - in the ...

Discontinuation of approval of modifications in notes, guaranteed under Title VI or VII of the Public Health Service Act, proposed to permit use of the notes as collateral for tax-exempt financings--PHS. Final rule.

Science.gov (United States)

1983-09-21

The Department of Health and Human Services (HHS) adds a new section to regulations for making and guaranteeing loans for construction and modernization of hospitals and medical facilities and to regulations for guaranteeing loans for the construction of teaching facilities for health professions personnel. Under these regulations HHS will not approve the modification of the terms of an existing loan guaranteed under Title VI or Title VII of the Public Health Service (PHS) Act if the modification would permit use of the guarantee (or guaranteed loan) as collateral for tax-exempt financing.

Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs.

Science.gov (United States)

Rodgers, S; Avery, A J; Meechan, D; Briant, S; Geraghty, M; Doran, K; Whynes, D K

1999-09-01

It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice. To determine whether intervention practices made savings relative to controls. An evaluation of an initiative set up by Doncaster Health Authority. Eight practices agreed to take part and received intensive input from five pharmacists for one year (September 1996 to August 1997) at a cost of 163,000 Pounds. Changes in prescribing patterns were investigated by comparing these practices with eight individually matched controls for both the year of the intervention and the previous year. Prescribing data (PACTLINE) were used to assess these changes. The measures used to take account of differences in the populations of the practices included the ASTRO-PU for overall prescribing and the STAR-PU for prescribing in specific therapeutic areas. Differences between intervention and control practices were subjected to Wilcoxon matched-pairs, signed-ranks tests. The median (minimum to maximum) rise in prescribing costs per ASTRO-PU was 0.85 Pound (-1.95 Pounds to 2.05 Pounds) in the intervention practices compared with 2.55 Pounds (1.74 Pounds to 4.65 Pounds) in controls (P = 0.025). Had the cost growth of the intervention group been as high as that of the controls, their total prescribing expenditure would have been around 347,000 Pounds higher. This study suggests that the use of pharmacists did control prescribing expenditure sufficiently to offset their employment costs.

"iBIM"--internet-based interactive modules: an easy and interesting learning tool for general surgery residents.

Science.gov (United States)

Azer, Nader; Shi, Xinzhe; de Gara, Chris; Karmali, Shahzeer; Birch, Daniel W

2014-04-01

The increased use of information technology supports a resident- centred educational approach that promotes autonomy, flexibility and time management and helps residents to assess their competence, promoting self-awareness. We established a web-based e-learning tool to introduce general surgery residents to bariatric surgery and evaluate them to determine the most appropriate implementation strategy for Internet-based interactive modules (iBIM) in surgical teaching. Usernames and passwords were assigned to general surgery residents at the University of Alberta. They were directed to the Obesity101 website and prompted to complete a multiple-choice precourse test. Afterwards, they were able to access the interactive modules. Residents could review the course material as often as they wanted before completing a multiple-choice postcourse test and exit survey. We used paired t tests to assess the difference between pre- and postcourse scores. Out of 34 residents who agreed to participate in the project, 12 completed the project (35.3%). For these 12 residents, the precourse mean score was 50 ± 17.3 and the postcourse mean score was 67 ± 14 (p = 0.020). Most residents who participated in this study recommended using the iBIMs as a study tool for bariatric surgery. Course evaluation scores suggest this novel approach was successful in transferring knowledge to surgical trainees. Further development of this tool and assessment of implementation strategies will determine how iBIM in bariatric surgery may be integrated into the curriculum.

Phenotypic and Genotypic Characterization and Treatment of a Cohort with Familial Tumoral Calcinosis/Hyperostosis-Hyperphosphatemia Syndrome

Science.gov (United States)

Ramnitz, Mary Scott; Gourh, Pravitt; Goldbach-Mansky, Raphaela; Wodajo, Felasfa; Ichikawa, Shoji; Econs, Michael J.; White, Kenneth; Molinolo, Alfredo; Chen, Marcus Y.; Heller, Theo; Del Rivero, Jaydira; Seo-Mayer, Patricia; Arabshahi, Bita; Jackson, Malaka B.; Hatab, Sarah; McCarthy, Edward; Guthrie, Lori C.; Brillante, Beth A.; Gafni, Rachel I.; Collins, Michael T.

2016-01-01

Familial tumoral calcinosis (FTC)/hyperostosis-hyperphosphatemia syndrome (HHS) is a rare disorder caused by mutations in the genes encoding fibroblast growth factor-23 (FGF23), N-acetylgalactosaminyltransferase 3 (GALNT3), or KLOTHO. The result is functional deficiency of, or resistance to, intact FGF23 (iFGF23), causing hyperphosphatemia, increased renal tubular reabsorption of phosphorus (TRP), elevated or inappropriately normal 1,25-dihydroxyvitamin D3 (1,25D), ectopic calcifications and/or diaphyseal hyperostosis. Eight subjects with FTC/HHS were studied and treated. Clinical manifestations varied, even within families, ranging from asymptomatic to large, disabling calcifications. All subjects had hyperphosphatemia, increased TRP, and elevated or inappropriately normal 1,25D. C-terminal FGF23 was markedly elevated while iFGF23 was comparatively low, consistent with increased FGF23 cleavage. Radiographs ranged from diaphyseal hyperostosis to massive calcification. Two subjects with severe calcifications also had overwhelming systemic inflammation and elevated C-reactive protein (CRP). GALNT3 mutations were identified in 7 subjects; no causative mutation was found in the eighth. Biopsies from 4 subjects showed ectopic calcification and chronic inflammation, with areas of heterotopic ossification observed in 1 subject. Treatment with low phosphate diet, phosphate binders, and phosphaturia-inducing therapies was prescribed with variable response. One subject experienced complete resolution of a calcific mass after 13 months of medical treatment. In the 2 subjects with systemic inflammation, interleukin-1 (IL-1) antagonists significantly decreased CRP levels with resolution of calcinosis cutis and peri-lesional inflammation in one subject and improvement of overall well-being in both subjects. This cohort expands the phenotype and genotype of FTC/HHS and demonstrates the range of clinical manifestations despite similar biochemical profiles and genetic mutations

Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC).

Science.gov (United States)

Slobogean, Gerard P; Stockton, David J; Zeng, Bing-Fang; Wang, Dong; Ma, Baotong; Pollak, Andrew N

2017-08-01

Young femoral neck fracture patients require surgical fixation to preserve the native hip joint and accommodate increased functional demands. Recent reports have identified a high incidence of fracture shortening and this may have negative functional consequences. We sought to determine if fracture shortening is associated with poor functional outcome in young femoral neck fracture patients. One hundred and forty-two patients with femoral neck fractures age 18-55 were recruited in this prospective cohort study across three Level 1 trauma hospitals in Mainland China. Patient-reported and objective functional outcomes were measured with the Harris Hip Score (HHS), Timed Up and Go (TUG), and SF-36 Physical Component Summary (SF-36 PCS) at 12 months. Radiographic fracture shortening was measured along the long axis of the femoral neck and corrected for magnification. Severe shortening was defined as ≥10mm. The primary analysis measured associations between severe radiographic shortening and HHS at one-year post-fixation. One hundred and two patients had complete radiographic and functional outcomes available for analysis at one year. The mean age of participants was 43.7±10.8years and 53% were male. Fifty-five percent of fractures were displaced and 37% were vertically orientated (Pauwels Type 3). The mean functional outcome scores were: HHS 90.0±10.8, TUG 12.0±5.1s, and PCS 48.5±8.6. Severe shortening occurred in 13% of patients and was associated with worse functional outcome scores: HHS mean difference 9.9 (p=0.025), TUG mean difference 3.2s (p=0.082), and PCS mean difference 5.4 (p=0.055). Severe shortening is associated with clinically important decreases in functional outcome as measured by HHS following fixation of young femoral neck fractures, occurring in 13% of patients in this population. The principle of fracture site compression utilized by modern constructs may promote healing; however, excessive shortening is associated with worse patient

Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score.

Science.gov (United States)

Hung, Man; Hon, Shirley D; Cheng, Christine; Franklin, Jeremy D; Aoki, Stephen K; Anderson, Mike B; Kapron, Ashley L; Peters, Christopher L; Pelt, Christopher E

2014-12-01

The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Cohort study (diagnosis); Level of evidence, 2. Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior in all psychometric aspects examined in this study. Future

IAEA Director General to visit Libya

International Nuclear Information System (INIS)

2003-01-01

Full text: Dr. Mohamed ElBaradei announced today that he will visit the Libyan Arab Jamahiriya (Libya) in the immediate future with a team of senior IAEA technical experts. 'The purpose of my visit will be to initiate an in-depth process of verification of all of Libya's past and present nuclear activities', Dr. ElBaradei said in a news conference. 'We shall define the corrective actions that need to be taken and consult on the necessary steps to eliminate any weapons related activities.' The announcement follows a meeting held in Vienna on 20 December 2003 between Dr. ElBaradei and H.E. Engineer Matooq Mohamed Matooq, Assistant Secretary for Services Affairs of the General People's Committee of Libya. In that meeting, Mr. Matooq informed Dr. ElBaradei of Libya's decision to eliminate 'materials, equipments and programmes which lead to the production of internationally proscribed weapons'. The Agency was also informed that Libya had been engaged for more than a decade in the development of a uranium enrichment capability. This included importing natural uranium and centrifuge and conversion equipment and the construction of now dismantled pilot scale centrifuge facilities. Some of these activities should have been, but were not, reported to the IAEA under Libya's Safeguards Agreement with the IAEA. Mr. Matooq stated, however, that Libya's nuclear enrichment programme was at an early stage of development and that no industrial scale facility had been built, nor any enriched uranium produced. Libya has asked the IAEA to ensure through verification that all of Libya's nuclear activities will henceforth be under safeguards and exclusively for peaceful purposes. In that regard, Libya has agreed to take the necessary steps to conclude an Additional Protocol to its NPT Safeguards Agreement, which will provide the IAEA with broader inspection rights, and to pursue with the IAEA a policy of full transparency and active co-operation. Dr. ElBaradei said, 'Libya's decision to

Engineering a General Education Program: Designing Mechanical Engineering General Education Courses

Science.gov (United States)

Fagette, Paul; Chen, Shih-Jiun; Baran, George R.; Samuel, Solomon P.; Kiani, Mohammad F.

2013-01-01

The Department of Mechanical Engineering at our institution created two engineering courses for the General Education Program that count towards second level general science credit (traditional science courses are first level). The courses were designed for the general student population based upon the requirements of our General Education Program…

Generalized product

OpenAIRE

Greco, Salvatore; Mesiar, Radko; Rindone, Fabio

2014-01-01

Aggregation functions on [0,1] with annihilator 0 can be seen as a generalized product on [0,1]. We study the generalized product on the bipolar scale [–1,1], stressing the axiomatic point of view. Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas and bipolar copulas.

Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.

Science.gov (United States)

Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina

2009-01-01

The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.

Calfornia General Plans

Data.gov (United States)

California Natural Resource Agency — We undertook creating the first ever seamless statewide General Plan map for California. All county general plans and many city general plans were integrated into 1...

Generalized Predictive Control and Neural Generalized Predictive Control

Directory of Open Access Journals (Sweden)

Sadhana CHIDRAWAR

2008-12-01

Full Text Available As Model Predictive Control (MPC relies on the predictive Control using a multilayer feed forward network as the plants linear model is presented. In using Newton-Raphson as the optimization algorithm, the number of iterations needed for convergence is significantly reduced from other techniques. This paper presents a detailed derivation of the Generalized Predictive Control and Neural Generalized Predictive Control with Newton-Raphson as minimization algorithm. Taking three separate systems, performances of the system has been tested. Simulation results show the effect of neural network on Generalized Predictive Control. The performance comparison of this three system configurations has been given in terms of ISE and IAE.

Holiday Heart Syndrome Revisited after 34 Years

Energy Technology Data Exchange (ETDEWEB)

Tonelo, David [Faculty of Medicine, University of Coimbra, Coimbra (Portugal); Providência, Rui, E-mail: rui-providencia@yahoo.com; Gonçalves, Lino [Faculty of Medicine, University of Coimbra, Coimbra (Portugal); Coimbras Hospital Centre and University, Coimbra (Portugal)

2013-01-01

The cardiovascular effects of alcohol are well known. However, most research has focused on the beneficial effects (the 'French paradox') of moderate consumption or the harmful consequences, such as dilated cardiomyopathy, associated with heavy consumption over an extended period. An association between the ingestion of acute alcohol and onset of cardiac arrhythmias was first reported in the early 70's. In 1978, Philip Ettinger described 'Holiday heart syndrome' (HHS) for the first time, as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking. The name is derived from the fact that episodes were initially observed more frequently after weekends or public holidays. Since the original description of HHS, 34 years have passed and new research in this field has increased the volume of knowledge related to this syndrome. Throughout this paper the authors will comprehensively review most of the available data concerning HHS and highlight the questions that remain unresolved.

Holiday Heart Syndrome Revisited after 34 Years

International Nuclear Information System (INIS)

Tonelo, David; Providência, Rui; Gonçalves, Lino

2013-01-01

The cardiovascular effects of alcohol are well known. However, most research has focused on the beneficial effects (the 'French paradox') of moderate consumption or the harmful consequences, such as dilated cardiomyopathy, associated with heavy consumption over an extended period. An association between the ingestion of acute alcohol and onset of cardiac arrhythmias was first reported in the early 70's. In 1978, Philip Ettinger described 'Holiday heart syndrome' (HHS) for the first time, as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking. The name is derived from the fact that episodes were initially observed more frequently after weekends or public holidays. Since the original description of HHS, 34 years have passed and new research in this field has increased the volume of knowledge related to this syndrome. Throughout this paper the authors will comprehensively review most of the available data concerning HHS and highlight the questions that remain unresolved

General Nuclear Medicine

Science.gov (United States)

... Resources Professions Site Index A-Z General Nuclear Medicine Nuclear medicine imaging uses small amounts of radioactive ... of General Nuclear Medicine? What is General Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

The use of generalized functions and distributions in general relativity

International Nuclear Information System (INIS)

Steinbauer, R; Vickers, J A

2006-01-01

We review the extent to which one can use classical distribution theory in describing solutions of Einstein's equations. We show that there are a number of physically interesting cases which cannot be treated using distribution theory but require a more general concept. We describe a mathematical theory of nonlinear generalized functions based on Colombeau algebras and show how this may be applied in general relativity. We end by discussing the concept of singularity in general relativity and show that certain solutions with weak singularities may be regarded as distributional solutions of Einstein's equations. (topical review)

Application of a Lifestyle-Based Tool to Estimate Premature Cardiovascular Disease Events in Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Science.gov (United States)

Gooding, Holly C; Ning, Hongyan; Gillman, Matthew W; Shay, Christina; Allen, Norrina; Goff, David C; Lloyd-Jones, Donald; Chiuve, Stephanie

2017-09-01

Few tools exist for assessing the risk for early atherosclerotic cardiovascular disease (ASCVD) events in young adults. To assess the performance of the Healthy Heart Score (HHS), a lifestyle-based tool that estimates ASCVD events in older adults, for ASCVD events occurring before 55 years of age. This prospective cohort study included 4893 US adults aged 18 to 30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants underwent measurement of lifestyle factors from March 25, 1985, through June 7, 1986, and were followed up for a median of 27.1 years (interquartile range, 26.9-27.2 years). Data for this study were analyzed from February 24 through December 12, 2016. The HHS includes age, smoking status, body mass index, alcohol intake, exercise, and a diet score composed of self-reported daily intake of cereal fiber, fruits and/or vegetables, nuts, sugar-sweetened beverages, and red and/or processed meats. The HHS in the CARDIA study was calculated using sex-specific equations produced by its derivation cohorts. The ability of the HHS to assess the 25-year risk for ASCVD (death from coronary heart disease, nonfatal myocardial infarction, and fatal or nonfatal ischemic stroke) in the total sample, in race- and sex-specific subgroups, and in those with and without clinical ASCVD risk factors at baseline. Model discrimination was assessed with the Harrell C statistic; model calibration, with Greenwood-Nam-D'Agostino statistics. The study population of 4893 participants included 2205 men (45.1%) and 2688 women (54.9%) with a mean (SD) age at baseline of 24.8 (3.6) years; 2483 (50.7%) were black; and 427 (8.7%) had at least 1 clinical ASCVD risk factor (hypertension, hyperlipidemia, or diabetes types 1 and 2). Among these participants, 64 premature ASCVD events occurred in women and 99 in men. The HHS showed moderate discrimination for ASCVD risk assessment in this diverse population of mostly healthy young adults (C statistic, 0

General Ultrasound Imaging

Medline Plus

Full Text Available ... News Physician Resources Professions Site Index A-Z General Ultrasound Ultrasound imaging uses sound waves to produce ... the limitations of General Ultrasound Imaging? What is General Ultrasound Imaging? Ultrasound is safe and painless, and ...

Circular orbits and acceleration of particles by near-extremal dirty rotating black holes: general approach

International Nuclear Information System (INIS)

Zaslavskii, Oleg B

2012-01-01

We study the effect of collisions of ultrahigh energy particles near the black hole horizon (BSW effect) for two scenarios: when one of the particles either (i) moves on a circular orbit or (ii) plunges from it toward the horizon. It is shown that such circular near-horizon orbits can exist for near-extremal black holes only. This includes the innermost stable orbit (ISCO), marginally bound orbit (MBO) and photon one (PhO). We consider generic ‘dirty’ rotating black holes not specifying the metric and show that the energy in the center-of-mass frame has the universal scaling dependence on the surface gravity κ. Namely, E c.m. ∼ κ −n where for the ISCO, n= 1/3 in case (i) or n= 1/2 in case (ii). For the MBO and PhCO, n= 1/2 in both scenarios that agrees with recent calculations of Harada and Kimura for the Kerr metric. We also generalize the Grib and Pavlov observations made for the Kerr metric. The magnitude of the BSW effect on the location of collision has a somewhat paradoxical character: it decreases when approaching the horizon. (paper)

Circular orbits and acceleration of particles by near-extremal dirty rotating black holes: general approach

Science.gov (United States)

Zaslavskii, Oleg B.

2012-10-01

We study the effect of collisions of ultrahigh energy particles near the black hole horizon (BSW effect) for two scenarios: when one of the particles either (i) moves on a circular orbit or (ii) plunges from it toward the horizon. It is shown that such circular near-horizon orbits can exist for near-extremal black holes only. This includes the innermost stable orbit (ISCO), marginally bound orbit (MBO) and photon one (PhO). We consider generic ‘dirty’ rotating black holes not specifying the metric and show that the energy in the center-of-mass frame has the universal scaling dependence on the surface gravity κ. Namely, Ec.m. ˜ κ-n where for the ISCO, n=\\frac{1}{3} in case (i) or n=\\frac{1}{2} in case (ii). For the MBO and PhCO, n=\\frac{1}{2} in both scenarios that agrees with recent calculations of Harada and Kimura for the Kerr metric. We also generalize the Grib and Pavlov observations made for the Kerr metric. The magnitude of the BSW effect on the location of collision has a somewhat paradoxical character: it decreases when approaching the horizon.

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

Directory of Open Access Journals (Sweden)

Cheryl Dye

2018-04-01

Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

US Department of Energy Office of Inspector General report on audit of program administration by the Office of Energy Research

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-02

The objective of the audit was to determine whether Energy Research had established performance expectations, including performance criteria and metrics, and used these expectations to monitor progress for basic and applied research performed at the Department`s national laboratories. Congressional and Departmental initiatives envision improved contract and program performance by requiring program managers to set measurable performance expectations. Even though research outcomes are inherently unpredictable, performance expectations can and should be established for scopes of work, milestones, resource limits and deliverables. However, Energy Research generally did not clearly specify--at either an aggregated program or individual task level--such expectations for research at the Department`s national laboratories. While information was available in the contractor`s research proposals, Energy Research essentially relied on the contractors to initiate and execute the research without agreement on expectations. This practice provided the Department with little basis to measure and evaluate contractor performance. Energy Research agreed in part with the finding and will take action on the recommendations in the report.

General relativity

International Nuclear Information System (INIS)

Kenyon, I.R.

1990-01-01

General relativity is discussed in this book at a level appropriate to undergraduate students of physics and astronomy. It describes concepts and experimental results, and provides a succinct account of the formalism. A brief review of special relativity is followed by a discussion of the equivalence principle and its implications. Other topics covered include the concepts of curvature and the Schwarzschild metric, test of the general theory, black holes and their properties, gravitational radiation and methods for its detection, the impact of general relativity on cosmology, and the continuing search for a quantum theory of gravity. (author)

Annexe A. Principes généraux des contrats du commerce international. Unidroit - 1994

OpenAIRE

2015-01-01

PRINCIPLES OF INTERNATIONAL COMMERCIAL CONTRACTS [1994] PREAMBLE (Purpose of the Principles) These Principles set forth general rules for international commercial contracts. They shall be applied when the parties have agreed that their contract be governed by them. They may be applied when the parties have agreed that their contract be governed by general principles of law, the lex mercatoria or the like. They may provide a solution to an issue raised when it proves impossible to establish th...

General Relativity

CERN Document Server

Straumann, Norbert

2013-01-01

This book provides a completely revised and expanded version of the previous classic edition ‘General Relativity and Relativistic Astrophysics’. In Part I the foundations of general relativity are thoroughly developed, while Part II is devoted to tests of general relativity and many of its applications. Binary pulsars – our best laboratories for general relativity – are studied in considerable detail. An introduction to gravitational lensing theory is included as well, so as to make the current literature on the subject accessible to readers. Considerable attention is devoted to the study of compact objects, especially to black holes. This includes a detailed derivation of the Kerr solution, Israel’s proof of his uniqueness theorem, and a derivation of the basic laws of black hole physics. Part II ends with Witten’s proof of the positive energy theorem, which is presented in detail, together with the required tools on spin structures and spinor analysis. In Part III, all of the differential geomet...

A national comparison of burnout and work-life balance among internal medicine hospitalists and outpatient general internists.

Science.gov (United States)

Roberts, Daniel L; Shanafelt, Tait D; Dyrbye, Liselotte N; West, Colin P

2014-03-01

General internists suffer higher rates of burnout and lower satisfaction with work-life balance than most specialties, but the impact of inpatient vs outpatient practice location is unclear. Physicians in the American Medical Association Physician Masterfile were previously surveyed about burnout, depression, suicidal ideation, quality of life, fatigue, work-life balance, career plans, and health behaviors. We extracted and compared data for these variables for the 130 internal medicine hospitalists and 448 outpatient general internists who participated. Analyses were adjusted for age, sex, hours worked, and practice setting. There were 52.3% of the hospitalists and 54.5% of the outpatient internists affected by burnout (P = 0.86). High scores on the emotional exhaustion subscale (43.8% vs 48.1%, P = 0.71) and on the depersonalization subscale (42.3% vs 32.7%, P = 0.17) were common but similar in frequency in the 2 groups. Hospitalists were more likely to score low on the personal accomplishment subscale (20.3% vs 9.6%, P = 0.04). There were no differences in symptoms of depression (40.3% for hospitalists vs 40.0% for outpatient internists, P = 0.73) or recent suicidality (9.2% vs 5.8%, P = 0.15). Rates of reported recent work-home conflict were similar (48.4% vs 41.3%, P = 0.64), but hospitalists were more likely to agree that their work schedule leaves enough time for their personal life and family (50.0% vs 42.0%, P = 0.007). Burnout was common among both hospitalists and outpatient general internists, although hospitalists were more satisfied with work-life balance. A better understanding of the causes of distress and identification of solutions for all internists is needed. © 2014 Society of Hospital Medicine.

10 CFR 503.9 - Use of mixtures-general requirement for certain permanent exemptions.

Science.gov (United States)

2010-01-01

... exemptions. 503.9 Section 503.9 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES... and petroleum and an alternate fuel for which an exemption under 10 CFR 503.38 (Fuel mixtures) would... substitute mixture, such other alternate fuels as OFE and the petitioner agree are reasonable to petitioner's...