Emerging Issues in the Utilization of Weblogs in Higher Education Classrooms

Science.gov (United States)

Ayao-ao, Shirley

2014-01-01

This paper examines the emerging issues in the utilization of weblogs in Philippine higher education and how these issues affect the performance of students. This study used a modified Delphi method. The Delphi panel consisted of 12 experts in the integration of technology, particularly blogs, in their teaching. The study yielded the following…

Recovery of Utility Fixed Costs: Utility, Consumer, Environmental and Economist Perspectives

Energy Technology Data Exchange (ETDEWEB)

Wood, Lisa [Inst. for Electric Innovation and The Edison Foundation, Washington DC (United States); Hemphill, Ross [RCHemphill Solutions, Columbus, OH (United States); Howat, John [National Consumer Law Center, Boston, MA (United States); Cavanagh, Ralph [Natural Resources Defense Council, New York, NY (United States); Borenstein, Severin [Univ. of California, Berkeley, CA (United States); Deason, Jeff [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-06-14

Utilities recover costs for providing electric service to retail customers through a combination of rate components that together comprise customers’ monthly electric bills. Rates and rate designs are set by state regulators and vary by jurisdiction, utility and customer class. In addition to the fundamental tenet of setting fair and reasonable rates, rate design balances economic efficiency, equity and fairness, customer satisfaction, utility revenue stability, and customer price and bill stability.1 At the most basic level, retail electricity bills in the United States typically include a fixed monthly customer charge — a set dollar amount regardless of energy usage — and a volumetric energy charge for each kilowatt-hour consumed.2 The energy charge may be flat across all hours, vary by usage level (for example, higher rates at higher levels of usage), or vary based on time of consumption.3 While some utility costs, such as fuel costs, clearly vary according to electricity usage, other costs are “fixed” over the short run — generally, those that do not vary over the course of a year. Depending on your point of view, and whether the state’s electricity industry has been restructured or remains vertically integrated, the set of costs that are “fixed” may be quite limited. Or the set may extend to all capacity costs for generation, transmission and distribution. In the long run, all costs are variable. In the context of flat or declining loads in some regions, utilities are proposing a variety of changes to retail rate designs, particularly for residential customers, to recover fixed costs. In this report, authors representing utility (Chapter 1), consumer (Chapter 2), environmentalist (Chapter 3) and economist (Chapter 4) perspectives discuss fixed costs for electric utilities and set out their principles for recovering those costs. The table on the next page summarizes each author’s relative preferences for various options for fixed cost

Social motivation in prospective memory: higher importance ratings and reported performance rates for social tasks.

Science.gov (United States)

Penningroth, Suzanna L; Scott, Walter D; Freuen, Margaret

2011-03-01

Few studies have addressed social motivation in prospective memory (PM). In a pilot study and two main studies, we examined whether social PM tasks possess a motivational advantage over nonsocial PM tasks. In the pilot study and Study 1, participants listed their real-life important and less important PM tasks. Independent raters categorized the PM tasks as social or nonsocial. Results from both studies showed a higher proportion of tasks rated as social when important tasks were requested than when less important tasks were requested. In Study 1, participants also reported whether they had remembered to perform each PM task. Reported performance rates were higher for tasks rated as social than for those rated as nonsocial. Finally, in Study 2, participants rated the importance of two hypothetical PM tasks, one social and one nonsocial. The social PM task was rated higher in importance. Overall, these findings suggest that social PM tasks are viewed as more important than nonsocial PM tasks and they are more likely to be performed. We propose that consideration of the social relevance of PM will lead to a more complete and ecologically valid theoretical description of PM performance. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Rich or poor: Who should pay higher tax rates?

Science.gov (United States)

Murilo Castro de Oliveira, Paulo

2017-08-01

A dynamic agent model is introduced with an annual random wealth multiplicative process followed by taxes paid according to a linear wealth-dependent tax rate. If poor agents pay higher tax rates than rich agents, eventually all wealth becomes concentrated in the hands of a single agent. By contrast, if poor agents are subject to lower tax rates, the economic collective process continues forever.

[Effects of different nitrogen application rates on 15N-urea absorption, utilization, loss and fruit yield and quality of dwarf apple].

Science.gov (United States)

Chen, Qian; Ding, Ning; Peng, Ling; Ge, Shun Feng; Jiang, Yuan Mao

2017-07-18

Seven-year-old 'Yanfu3'/M 26 /M. hupehensis Rehd. seedlings and 15 N trace technique were used to explore the characteristics of 15 N-urea absorption, utilization, loss and fruit yield and quality under different nitrogen application rates (N 100 , N 200 and N 300 ). The main results were as follows: the plant growth, 15 N absorption, utilization and loss differed significantly under different treatments. The plant leaf chlorophyll content (SPAD value), photosynthetic rate (P n ), total N content of leaves and the biomass, as well as the root-shoot ratio of N 200 treatment were obviously higher than the N 100 and N 300 treatments. Significant differences were observed in the 15 N derived from fertilizer (Ndff value) of different organs under different nitrogen application rates. The Ndff of fruits (flowers), leaves, one-year-old branch, and perennial branches in each measurement period was N 100 >N 200 ＞N 300 , while that of the roots at full-bloom and spring shoot growing slowly stage was N 100 >N 200 ＞N 300 , and in a trend of N 200 >N 100 ＞N 300 at autumn shoot growing stage, fruit rapid-swel-ling stage and fruit maturity stage. At fruit maturity stage, plant 15 N nitrogen utilization ratio of N 200 treatment was 23.6%, which was obviously higher than the N 100 (16.3%) and N 300 (14.4%) treatments, with the 15 N loss rate of 56.4%, obviously lower than the N 100 (60.6%) and N 300 (66.1%) treatments. There were significant differences among the treatments in fruit mass, yield per plant, soluble solid, fruit firmness, soluble sugar, titratable acids and sugar-acid ratio of different nitrogen rates, and the N 200 treatment showed the best performance, followed by the N 300 treatment, and then the N 100 treatment.

Individuals with Metabolically Healthy Overweight/Obesity Have Higher Fat Utilization than Metabolically Unhealthy Individuals

Directory of Open Access Journals (Sweden)

Arturo Pujia

2016-01-01

Full Text Available The mechanisms underlying the change in phenotype from metabolically healthy to metabolically unhealthy obesity are still unclear. The aim of this study is to investigate whether a difference in fasting fat utilization exists between overweight/obese individuals with a favorable cardiovascular risk profile and those with Metabolic Syndrome and Type 2 diabetes. Furthermore, we sought to explore whether there is an association between fasting fat utilization and insulin resistance. In this cross-sectional study, 172 overweight/obese individuals underwent a nutritional assessment. Those with fasting glucose ≥126 mg/dL or antidiabetic treatment were considered to be diabetics. If at least three of the NCEP criteria were present, they had Metabolic Syndrome, while those with less criteria were considered to be healthy overweight/obese. An indirect calorimetry was performed to estimate Respiratory Quotient, an index of nutrient utilization. A lower Respiratory Quotient (i.e., higher fat utilization was found in healthy overweight/obese individuals than in those with Metabolic Syndrome and Type 2 diabetes (0.85 ± 0.05; 0.87 ± 0.06; 0.88 ± 0.05 respectively, p = 0.04. The univariate and multivariable analysis showed a positive association between the Respiratory Quotient and HOMA-IR (slope in statistic (B = 0.004; β = 0.42; p = 0.005; 95% Confidence interval = 0.001–0.006. In this study, we find, for the first time, that the fasting Respiratory Quotient is significantly lower (fat utilization is higher in individuals who are metabolically healthy overweight/obese than in those with metabolically unhealthy obesity. In addition, we demonstrated the association between fat utilization and HOMA-IR, an insulin resistance index.

The Effects of Rising Interest Rates on Electric Utility Stock Prices: Regulatory Considerations and Approaches

Energy Technology Data Exchange (ETDEWEB)

Kihm, Steve [Seventhwave, Madison, WI (United States); Satchwell, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cappers, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-07-26

This technical brief identifies conditions under which utility regulators should consider implementing policy approaches that seek to mitigate negative outcomes due to an increase in interest rates. Interest rates are a key factor in determining a utility’s cost of equity and investors find value when returns exceed the cost of equity. Through historical observations of periods of rising and falling interest rates and application of a pro forma financial tool, we identify the key drivers of utility stock valuations and estimate the degree to which those valuations might be affected by increasing interest rates.3 We also analyze the efficacy of responses by utility regulators to mitigate potential negative financial impacts. We find that regulators have several possible approaches to mitigate a decline in value in an environment of increasing interest rates, though regulators must weigh the tradeoffs of improving investor value with potential increases in customer costs. Furthermore, the range of approaches reflects today’s many different electric utility regulatory models and regulatory responses to a decline in investor value will fit within state-specific models.

[Effects of phosphorus application rates and depths on P utilization and loss risk in a maize-soybean intercropping system].

Science.gov (United States)

Zhao, Wei; Song, Chun; Zhou, Pan; Wang, Jia Yu; Xui, Feng; Ye, Fang; Wang, Xiao Chun; Yang, Wen Yu

2018-04-01

In order to explore the advantage of intercropping on phosphorus (P) efficient utilization and the reduction of soil P loss, a field experiment in a maize-soybean intercropping system, which included three P application (P 2 O 5 ) rates (CP: 168 kg·hm -2 ; RP 1 : 135 kg·hm -2 ; RP 2 : 101 kg·hm -2 ) and three P application depths (D 1 : applied in 5 cm depth; D 2 : applied in 15 cm depth; D 3 : 1/2 of P fertilizer applied in 5 cm depth and another 1/2 in 15 cm depth) was carried out to analyze the effects of P application rates and depth on crop aboveground biomass, grain yield, crop P uptake, soil total and available P contents, and soil P adsorption-desorption characteristics. Compared with control treatment, the aboveground biomass, grain yield, crop P uptake, soil total P, and available P content were increased significantly by P application, regardless of P rate and application depth. Under the same application depth, RP 1 had similar grain yield but higher crop P uptake compared with CP, and thus higher P apparent utilization efficiency. Under the same P application rate, the application depth of D 2 had the highest crop aboveground biomass, grain yield, P uptake, soil total P, and available P. According to the characteristic of soil P adsorption-desorption, the treatment with the rate of RP 1 and the depth of D 2 had the strongest soil P retention capacity, which had advantage in alleviating P loss. These results suggested that reducing application rate but increasing application depth of P fertilizer could improve P use efficiency and reduce soil P loss without sacrifice in crop production in maize-soybean relay intercropping system.

The absorption and utilization of nitrogen and phosphate by rice in red earth

International Nuclear Information System (INIS)

Fu Zhijian; Wang Dexian

1992-01-01

The experimental results showed that the utilization rate of N and rice yield were significantly increased by applying P and K fertilizer when the same amount of N was applied. The maximum yield of grain and utilization rate of N were 29.78 gram per pot and 44.37%, which were 22.75% and 9.62% higher than those of control (using N only), respectively. The utilization rate of P was significantly increased by rational applied N and K fertilizer. The maximum utilization rate of P was 29.10%, which was 6.86% higher than that of using P fertilizer only

78 FR 36768 - Battery Utility of Ohio, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

Science.gov (United States)

2013-06-19

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER13-1667-000] Battery Utility of Ohio, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for... Battery Utility of Ohio, LLC's application for market-based rate authority, with an accompanying rate...

GPP Webinar: Solar Utilization in Higher Education Networking & Information Sharing Group: RFP, Contract, and Administrative Issues Discussion

Science.gov (United States)

This presentation from a Solar Utilization in Higher Education Networking and Information webinar covers contracts, Request for Proposals (RFPs), and administrative issues related to solar project development in the higher education sector.

Impact of Federal tax policy and electric utility rate schedules upon the solar building/electric utility interface. Executive summary

Energy Technology Data Exchange (ETDEWEB)

Feldman, S.L.; Wirtshafter, R.M.; Abrash, M.; Anderson, B.; Sullivan, P.; Kohler, J.

1978-10-01

An analysis is performed to show that a utility solar-passive strategy can be used rather effectively in aiding the utility to obtain more efficient load factors and lower costs. The objectives are to determine the impact of active and passive solar energy designs for space conditioning and hot water heating for the residential sector upon the diurnal and annual load curves for several utilities, to assess the effect of present utility pricing policies, and to examine alternative pricing schemes, as well as Federal and state tax credits, as they may affect the optimal sizing and configuration of active solar and passive solar building components. The methodology, the systems model, an overall building design, building cost determination, and a description of TRNSYS are presented. The major parameters discussed that distinguish variation in the cost-effectiveness of particular building design fall into 5 categories: the weather, building configurations, building costs, utility costs and rates, and financial parameters (inclusive of tax credits for solar and energy conservation investment). Five utilities are studied: Colorado Springs Department of Public Utilities; Public Service Co. of New Mexico; New England Electric System; Pacific Gas and Electric; and Georgia Power Co.

Utility of a Validated Rating Scale for Self-Assessment in Microsurgical Training.

Science.gov (United States)

Grant, Aaron L; Temple-Oberle, Claire

The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale. Self-assessment and preceptor scores were compared using the Pearson correlation coefficient (PCC). There was a significant agreement noted between the 32 preceptor assessments and 36 self-assessments that were completed. Correlation between scores for the knot-tying (PCC = 0.62) and anastomosis modules (PCC = 0.77) was good and excellent, respectively. Preceptor scores and self-scores improved over the duration of the course: for preceptors, knot-tying scores increased from 58% on day 1 to 78% on day 5 (p = 0.02) and anastomosis scores improved from 56% to 82% (p = 0.004); for self-scores, knot-tying scores increased from 44% to 81% (p = 0.001) and anastomosis scores from 49% to 84% (p = 0.001). Learners with greater experience (higher postgraduate year level) tended to have higher self as well as preceptor ratings, albeit not statistically significant. Self-assessment using the University of Western Ontario Microsurgical Acquisition/Assessment instrument has good to excellent agreement with preceptor-assessment scores suggesting good interrater reliability. Self-assessment using such tools may, therefore, be used along with preceptor supervision and assessment to potentially improve self-directed learning during these courses. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

Science.gov (United States)

Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

2012-01-01

Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

Effect of arsenic and cadmium on the growth rate and nutrient utilization rates of Asterionelia formosa

International Nuclear Information System (INIS)

Conway, H.L.; Yaguchi, E.M.

1975-01-01

Many volatile trace elements are released during combustion of fossil fuels. They may eventually be transported to aquatic ecosystems by wet or dry deposition, and some of them may be toxic to aquatic organisms. We are investigating the effects of arsenic and cadmium on an algal species found in Lake Michigan. Little information is available on chronic effects of these elements. Cadmium is widely used in the plating, pigment, and plastics industries. Arsenic and cadmium also enter the lake as a result of their use in agricultural pesticides and insecticides. Increased fossil fuel utilization in this region may result in increased arsenic and cadmium levels in the lake water if the present levels are not under geochemical control. We are using continuous culture techniques to assess biological effects of arsenic and cadmium concentrations between 2 and 20 times ambient levels. Uptake of arsenic and cadmium and their effects on nutrient utilization and growth rate are being measured for Astrerionella formaso, an important diatom, in spring and fall in Lake Michigan. Continuous culture techniques permit evaluation of subtle pollutant effects, such as physiological impairment and decreased reproductive rates, over many generations

Association between unemployment rates and prescription drug utilization in the United States, 2007–2010

Science.gov (United States)

2012-01-01

Background While extensive evidence suggests that the economic recession has had far reaching effects on many economic sectors, little is known regarding its impact on prescription drug utilization. The purpose of this study is to describe the association between state-level unemployment rates and retail sales of seven therapeutic classes (statins, antidepressants, antipsychotics, angiotensin-converting enzyme [ACE] inhibitors, opiates, phosphodiesterase [PDE] inhibitors and oral contraceptives) in the United States. Methods Using a retrospective mixed ecological design, we examined retail prescription sales using IMS Health Xponent™ from September 2007 through July 2010, and we used the Bureau of Labor Statistics to derive population-based rates and mixed-effects modeling with state-level controls to examine the association between unemployment and utilization. Our main outcome measure was state-level utilization per 100,000 people for each class. Results Monthly unemployment levels and rates of use of each class varied substantially across the states. There were no statistically significant associations between use of ACE inhibitors or SSRIs/SNRIs and average unemployment in analyses across states, while for opioids and PDE inhibitors there were small statistically significant direct associations, and for the remaining classes inverse associations. Analyses using each state as its own control collectively exhibited statistically significant positive associations between increases in unemployment and prescription drug utilization for five of seven areas examined. This relationship was greatest for statins (on average, a 4% increase in utilization per 1% increased unemployment) and PDE inhibitors (3% increase in utilization per 1% increased unemployment), and lower for oral contraceptives and atypical antipsychotics. Conclusion We found no evidence of an association between increasing unemployment and decreasing prescription utilization, suggesting that any

Performance efficiency of feed utilization, relative growth rate, and survival rate of common carp (Cyprinus carpio) through the addition of phytase in the feed

Science.gov (United States)

Rachmawati, D.; Samidjan, I.

2018-04-01

The purpose of this study was to determine the effect of adding phytase enzyme in the feed on digestibility of feed, efficiency of feed utilization, relative growth rate and survival rate of Common carp (Cyprinus carpio). Fish samples in this research were Common carp with an average - weight of 3.34 ± 0,16 g/fish. The treatments were adding the phytase enzyme in the feed with the different level of doses. Those were A (0 U kg-1 feed), B (500 U kg-1 feed), C (1.000 U kg-1 feed g) and D (1.500 U kg-1 feed). Observation was conducted on digestibility of protein (ADCP), digestibility of phosphor (ADCF), efficiency of feed utilization (EFU), relative growth rate (RGR), protein efficiency ratio (PER), feed conversion ratio (FCR), survival rate (SR) and water quality parameters. The results show that the addition of phytase enzyme significantly (P0.05) affected on SR of common carp. Based on results, it was concluded that optimum doses of phytase enzyme feed in terms of digestibility of feed, efficiency utilization of Feed and growth rate of Common carp ranges from 943 to 1100 U kg-1 feed

Factors Associated with Healthcare Utilization Among Arab Immigrants and Iraqi Refugees.

Science.gov (United States)

Elsouhag, D; Arnetz, B; Jamil, H; Lumley, M A; Broadbridge, C L; Arnetz, J

2015-10-01

Arab migrants-both immigrants and refugees-are exposed to pre- and post- migration stressors increasing their risk for health problems. Little is known, however, about rates of, or factors associated with, healthcare utilization among these two groups. A sample of 590 participants were interviewed approximately 1 year post-migration to the United States. Factors associated with healthcare utilization, including active and passive coping strategies, were examined using logistic regressions. Compared to national healthcare utilization data, immigrants had significantly lower, and refugees had significantly higher rates of healthcare utilization. Being a refugee, being married, and having health insurance were significantly associated with medical service utilization. Among refugees, less use of psychological services was associated with the use of medications and having problem-focused (active) strategies for dealing with stress. Healthcare utilization was significantly higher among refugees, who also reported a greater need for services than did immigrants.

Neutron diagnostics on TFTR utilizing the Campbelling technique

International Nuclear Information System (INIS)

England, A.C.; Hendel, H.W.; Neischmidt, E.B.

1986-01-01

The authors report modified commercial neutron counting equipment installed on a tokamak fusion test reactor (TFTR) which utilizes the Campbelling theorem to monitor the neutron source strength at very high neutron count rates. Campbelling utilizes the large amplitude fluctuation from neutron events in the detectors to discriminate against small amplitude noise events. Source strengths yielding equivalent count rates a factor of five higher than possible in the conventional count rate mode have been obtained to date. The concept of Campbelling is discussed and the particular application to TFTR is illustrated

Higher rates of sex evolve in spatially heterogeneous environments.

Science.gov (United States)

Becks, Lutz; Agrawal, Aneil F

2010-11-04

The evolution and maintenance of sexual reproduction has puzzled biologists for decades. Although this field is rich in hypotheses, experimental evidence is scarce. Some important experiments have demonstrated differences in evolutionary rates between sexual and asexual populations; other experiments have documented evolutionary changes in phenomena related to genetic mixing, such as recombination and selfing. However, direct experiments of the evolution of sex within populations are extremely rare (but see ref. 12). Here we use the rotifer, Brachionus calyciflorus, which is capable of both sexual and asexual reproduction, to test recent theory predicting that there is more opportunity for sex to evolve in spatially heterogeneous environments. Replicated experimental populations of rotifers were maintained in homogeneous environments, composed of either high- or low-quality food habitats, or in heterogeneous environments that consisted of a mix of the two habitats. For populations maintained in either type of homogeneous environment, the rate of sex evolves rapidly towards zero. In contrast, higher rates of sex evolve in populations experiencing spatially heterogeneous environments. The data indicate that the higher level of sex observed under heterogeneity is not due to sex being less costly or selection against sex being less efficient; rather sex is sufficiently advantageous in heterogeneous environments to overwhelm its inherent costs. Counter to some alternative theories for the evolution of sex, there is no evidence that genetic drift plays any part in the evolution of sex in these populations.

Relationship of vitamin A utilization rate to vitamin A status in the rat

International Nuclear Information System (INIS)

Lewis, K.C.; Green, J.B.; Green, M.H.

1986-01-01

Weanling male rats were fed diets providing either 45 μg retinal equivalents (REq)/d for 4 wks, then 12 μg/d for 11 wks (HI; n = 9); or 0 μg/d for 7 wks, then 2 μg/d for 6 wks (LO; n = 8); or 0 μg/d for 7 wks, then 2 μg REq + 240 μg retinoic acid/d for 6 wks (RA; n = 6). At this time, plasma retinol (ROH) concentrations averaged 48.9 +/- 7.2, 10.3 +/- 1.7 and 8.5 +/- 0.9 μg/dl, respectively; and liver retinoid levels were 984.9 +/- 146.2, 3 H-ROH in its physiological transport complex. Vitamin A utilization rates (disposal rates, DR) were estimated from the inverse of the area under the tracer disappearance curve obtained by nonlinear, least-squares regression. Group average DR were 12.2 (HI), 1.8 (LO), and 1.2 (RA) μg REq/d. Since in similar studies the DR was 6.9 μg/d in rats consuming approx. 9 μg REq/d, and with liver stores of approx. 73 μg, the authors data suggest that vitamin A utilization rate adjusts to stores and/or dietary input, and that rats with virtually no liver vitamin A reserves and chronically fed marginal levels of vitamin A, are able to adapt by decreasing vitamin A utilization

Patterns of Mental Health Care Utilization Among Sexual Orientation Minority Groups.

Science.gov (United States)

Platt, Lisa F; Wolf, Julia Kay; Scheitle, Christopher P

2018-01-01

Prior studies of the utilization of mental health professionals by sexual minority populations have relied on data that are now dated or not nationally representative. These studies have also provided mixed findings regarding gender differences in the utilization of mental health professionals among sexual minority individuals. Using data from the 2013-2015 National Health Interview Surveys, this study investigates (1) how sexual minority individuals compare to heterosexual participants in their utilization of mental health professionals; and (2) gender differences in that utilization. The results indicate sexual minority individuals utilize mental health care professionals at higher rates than heterosexual individuals even after controlling for measures of mental health and other demographic characteristics; this is true for both men and women. However, gender moderates the sexual minority effect on utilization rates. Sexual minority men utilize mental health professionals at a high rate, such that their utilization rates are similar to sexual minority women, contrary to the gender gap seen among heterosexuals.

User's guide to SERICPAC: A computer program for calculating electric-utility avoided costs rates

Energy Technology Data Exchange (ETDEWEB)

Wirtshafter, R.; Abrash, M.; Koved, M.; Feldman, S.

1982-05-01

SERICPAC is a computer program developed to calculate average avoided cost rates for decentralized power producers and cogenerators that sell electricity to electric utilities. SERICPAC works in tandem with SERICOST, a program to calculate avoided costs, and determines the appropriate rates for buying and selling of electricity from electric utilities to qualifying facilities (QF) as stipulated under Section 210 of PURA. SERICPAC contains simulation models for eight technologies including wind, hydro, biogas, and cogeneration. The simulations are converted in a diversified utility production which can be either gross production or net production, which accounts for an internal electricity usage by the QF. The program allows for adjustments to the production to be made for scheduled and forced outages. The final output of the model is a technology-specific average annual rate. The report contains a description of the technologies and the simulations as well as complete user's guide to SERICPAC.

Time utilization rate (TUR) of NTI-PGDE Students in self-study: the ...

African Journals Online (AJOL)

The purpose of this study was to find out the rate of time utilization in self-study among the Post-Graduate Diploma in Education (PGDE) students of the National Teachers' Institute. A sample of forty (40) students drawn from a population of sixty (60) by simple random sampling technique was used for the study.

Enabling Higher Data Rates for Planetary Science Missions

Science.gov (United States)

Deutsch, L. J.; Townes, S. A.; Lazio, J.; Bell, D. J.; Chahat, N. E.; Kovalik, J. M.; Kuperman, I.; Sauder, J.; Liebrecht, P. E.

2017-12-01

The data rate from deep space spacecraft has increased by more than 10 orders of magnitude since the first lunar missions in the 1960s. The demand for increased data rates has stemmed from the increasing sophistication of the science questions being addressed and the concomitant increase in the complexity of the missions themselves (from fly-by to orbit to land and rove). Projections for the next few decades suggest the demand for data rates for deep space missions will continue to increase by approximately one order of magnitude every decade, driven by these same factors. Achieving higher data rates requires a partnership between the spacecraft and the ground system. We describe a series of technology developments for flight telecommunications systems, both at radio frequency (RF) and optical, to enable spacecraft to transmit and receive larger data volumes. These technology developments include deployable high gain antennas for small spacecraft, re-programmable software-defined radios, and optical communication packages designed for CubeSat form factors. The intent is that these developments would provide enhancements in capability for both spacecraft-Earth and spacecraft-spacecraft telecommunications. We also describe the future planning for NASA's Deep Space Network (DSN), which remains the prime conduit for data from all planetary science missions. Through a combination of new antennas and backends being installed over the next five years and incorporation of optical communications, the DSN aims to ensure that the historical improvements in data rates and volumes will continue for many decades. Part of this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration.

Preferential and Non-Preferential Approaches to Trade Liberalization in East Asia: What Differences Do Utilization Rates and Reciprocity Make?

OpenAIRE

Menon, Jayant

2013-01-01

Previous studies on the impacts of free trade agreements (FTAs) in East Asia have assumed full utilization of preferences. The evidence suggests that this assumption is seriously in error, with the estimated uptake particularly low in East Asia. In this paper, we assume a more realistic utilization rate in estimating impacts. We find that actual utilization rates significantly diminish the benefits from preferential liberalization, but in a non-linear way. Reciprocity is an important motivati...

United States private schools have higher rates of exemptions to school immunization requirements than public schools.

Science.gov (United States)

Shaw, Jana; Tserenpuntsag, Boldtsetseg; McNutt, Louise-Anne; Halsey, Neal

2014-07-01

To compare medical, religious, and personal belief immunization exemption rates between private and public schools in US. Exemption rates were calculated using the Centers for Disease Control and Prevention School Immunization Assessment Surveys for the 2009-2010 school year excluding states with incomplete survey data. Standardized exemption rates weighted on enrollments in public and private schools were calculated. Differences in exemption rates between public and private schools were tested using Wilcoxon signed rank test. The overall state exemption rate was higher in US private than public schools, 4.25% (SD 4.27) vs 1.91% (1.67), P = .0001 and private schools had higher exemption rates for all types of exemptions; medical 0.58% (0.71) vs 0.34% (0.34) respectively (P = .0004), religious 2.09% (3.14) vs 0.83% (1.05) respectively (P = .0001), and personal belief 6.10% (4.12) vs 2.79% (1.57), respectively (P = .006). Overall exemption rates were significantly higher in states that allowed personal belief exemptions. Exemption rates were significantly higher in US private than in public schools. Children attending private schools may be at higher risk of vaccine-preventable diseases than public school children. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluating Whether Changes in Utilization of Hospital Outp..

Data.gov (United States)

U.S. Department of Health & Human Services — Data reported in Evaluating Whether Higher Utilization of Hospital Outpatient Services Contributed to Lower Readmission Rate in 2012, published in Volume 4, Issue 1,...

Higher dose rate Gamma Knife radiosurgery may provide earlier and longer-lasting pain relief for patients with trigeminal neuralgia.

Science.gov (United States)

Lee, John Y K; Sandhu, Sukhmeet; Miller, Denise; Solberg, Timothy; Dorsey, Jay F; Alonso-Basanta, Michelle

2015-10-01

Gamma Knife radiosurgery (GKRS) utilizes cobalt-60 as its radiation source, and thus dose rate varies as the fixed source decays over its half-life of approximately 5.26 years. This natural decay results in increasing treatment times when delivering the same cumulative dose. It is also possible, however, that the biological effective dose may change based on this dose rate even if the total dose is kept constant. Because patients are generally treated in a uniform manner, radiosurgery for trigeminal neuralgia (TN) represents a clinical model whereby biological efficacy can be tested. The authors hypothesized that higher dose rates would result in earlier and more complete pain relief but only if measured with a sensitive pain assessment tool. One hundred thirty-three patients were treated with the Gamma Knife Model 4C unit at a single center by a single neurosurgeon during a single cobalt life cycle from January 2006 to May 2012. All patients were treated with 80 Gy with a single 4-mm isocenter without blocking. Using an output factor of 0.87, dose rates ranged from 1.28 to 2.95 Gy/min. The Brief Pain Inventory (BPI)-Facial was administered before the procedure and at the first follow-up office visit 1 month from the procedure (mean 1.3 months). Phone calls were made to evaluate patients after their procedures as part of a retrospective study. Univariate and multivariate linear regression was performed on several independent variables, including sex, age in deciles, diagnosis, follow-up duration, prior surgery, and dose rate. In the short-term analysis (mean 1.3 months), patients' self-reported pain intensity at its worst was significantly correlated with dose rate on multivariate analysis (p = 0.028). Similarly, patients' self-reported interference with activities of daily living was closely correlated with dose rate on multivariate analysis (p = 0.067). A 1 Gy/min decrease in dose rate resulted in a 17% decrease in pain intensity at its worst and a 22% decrease

Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law

Science.gov (United States)

Delamater, Paul L.; Messina, Joseph P.; Grady, Sue C.; WinklerPrins, Vince; Shortridge, Ashton M.

2013-01-01

Background Roemer’s Law, a widely cited principle in health care policy, states that hospital beds that are built tend to be used. This simple but powerful expression has been invoked to justify Certificate of Need regulation of hospital beds in an effort to contain health care costs. Despite its influence, a surprisingly small body of empirical evidence supports its content. Furthermore, known geographic factors influencing health services use and the spatial structure of the relationship between hospital bed availability and hospitalization rates have not been sufficiently explored in past examinations of Roemer’s Law. We pose the question, “Accounting for space in health care access and use, is there an observable association between the availability of hospital beds and hospital utilization?” Methods We employ an ecological research design based upon the Anderson behavioral model of health care utilization. This conceptual model is implemented in an explicitly spatial context. The effect of hospital bed availability on the utilization of hospital services is evaluated, accounting for spatial structure and controlling for other known determinants of hospital utilization. The stability of this relationship is explored by testing across numerous geographic scales of analysis. The case study comprises an entire state system of hospitals and population, evaluating over one million inpatient admissions. Results We find compelling evidence that a positive, statistically significant relationship exists between hospital bed availability and inpatient hospitalization rates. Additionally, the observed relationship is invariant with changes in the geographic scale of analysis. Conclusions This study provides evidence for the effects of Roemer’s Law, thus suggesting that variations in hospitalization rates have origins in the availability of hospital beds. This relationship is found to be robust across geographic scales of analysis. These findings suggest

Vastus Lateralis Motor Unit Firing Rate Is Higher in Women With Patellofemoral Pain.

Science.gov (United States)

Gallina, Alessio; Hunt, Michael A; Hodges, Paul W; Garland, S Jayne

2018-05-01

To compare neural drive, determined from motor unit firing rate, in the vastus medialis and lateralis in women with and without patellofemoral pain. Cross-sectional study. University research laboratory. Women (N=56) 19 to 35 years of age, including 36 with patellofemoral pain and 20 controls. Not applicable. Participants sustained an isometric knee extension contraction at 10% of their maximal voluntary effort for 70 seconds. Motor units (N=414) were identified using high-density surface electromyography. Average firing rate was calculated between 5 and 35 seconds after recruitment for each motor unit. Initial firing rate was the inverse of the first 3 motor unit interspike intervals. In control participants, vastus medialis motor units discharged at higher rates than vastus lateralis motor units (P=.001). This was not observed in women with patellofemoral pain (P=.78) because of a higher discharge rate of vastus lateralis compared with control participants (P=.002). No between-group differences were observed for vastus medialis (P=.93). Similar results were obtained for the initial motor unit firing rate. These findings suggest that women with patellofemoral pain have a higher neural drive to vastus lateralis but not vastus medialis, which may be a contributor of the altered patellar kinematics observed in some studies. The different neural drive may be an adaptation to patellofemoral pain, possibly to compensate for decreased quadriceps force production, or a precursor of patellofemoral pain. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Utility rate equations of group population dynamics in biological and social systems.

Directory of Open Access Journals (Sweden)

Vyacheslav I Yukalov

Full Text Available We present a novel system of equations to describe the evolution of self-organized structured societies (biological or human composed of several trait groups. The suggested approach is based on the combination of ideas employed in the theory of biological populations, system theory, and utility theory. The evolution equations are defined as utility rate equations, whose parameters are characterized by the utility of each group with respect to the society as a whole and by the mutual utilities of groups with respect to each other. We analyze in detail the cases of two groups (cooperators and defectors and of three groups (cooperators, defectors, and regulators and find that, in a self-organized society, neither defectors nor regulators can overpass the maximal fractions of about [Formula: see text] each. This is in agreement with the data for bee and ant colonies. The classification of societies by their distance from equilibrium is proposed. We apply the formalism to rank the countries according to the introduced metric quantifying their relative stability, which depends on the cost of defectors and regulators as well as their respective population fractions. We find a remarkable concordance with more standard economic ranking based, for instance, on GDP per capita.

Utility Rate Equations of Group Population Dynamics in Biological and Social Systems

Science.gov (United States)

Yukalov, Vyacheslav I.; Yukalova, Elizaveta P.; Sornette, Didier

2013-01-01

We present a novel system of equations to describe the evolution of self-organized structured societies (biological or human) composed of several trait groups. The suggested approach is based on the combination of ideas employed in the theory of biological populations, system theory, and utility theory. The evolution equations are defined as utility rate equations, whose parameters are characterized by the utility of each group with respect to the society as a whole and by the mutual utilities of groups with respect to each other. We analyze in detail the cases of two groups (cooperators and defectors) and of three groups (cooperators, defectors, and regulators) and find that, in a self-organized society, neither defectors nor regulators can overpass the maximal fractions of about each. This is in agreement with the data for bee and ant colonies. The classification of societies by their distance from equilibrium is proposed. We apply the formalism to rank the countries according to the introduced metric quantifying their relative stability, which depends on the cost of defectors and regulators as well as their respective population fractions. We find a remarkable concordance with more standard economic ranking based, for instance, on GDP per capita. PMID:24386163

Preferences and Utilities for Health States after Treatment of Olfactory Groove Meningioma: Endoscopic versus Open.

Science.gov (United States)

Yao, Christopher M; Kahane, Alyssa; Monteiro, Eric; Gentili, Fred; Zadeh, Gelareh; de Almeida, John R

2017-08-01

Objectives  The purpose of this study is to report health utility scores for patients with olfactory groove meningiomas (OGM) treated with either the standard transcranial approach, or the expanded endonasal endoscopic approach. Design  The time trade-off technique was used to derive health utility scores. Setting  Healthy individuals without skull base tumors were surveyed. Main Outcome Measures  Participants reviewed and rated scenarios describing treatment (endoscopic, open, stereotactic radiation, watchful waiting), remission, recurrence, and complications associated with the management of OGMs. Results  There were 51 participants. The endoscopic approach was associated with higher utility scores compared with an open craniotomy approach (0.88 vs. 0.74; p  < 0.001) and watchful waiting (0.88 vs.0.74; p  = 0.002). If recurrence occurred, revision endoscopic resection continued to have a higher utility score compared with revision open craniotomy (0.68; p  = 0.008). On multivariate analysis, older individuals were more likely to opt for watchful waiting ( p  = 0.001), whereas participants from higher income brackets were more likely to rate stereotactic radiosurgery with higher utility scores ( p  = 0.017). Conclusion  The endoscopic approach was associated with higher utility scores than craniotomy for primary and revision cases. The present utilities can be used for future cost-utility analyses.

Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

Science.gov (United States)

O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

2016-06-01

Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

Utilization of Microalgal Biofractions for Bioethanol, Higher Alcohols, and Biodiesel Production: A Review

Directory of Open Access Journals (Sweden)

Marwa M. El-Dalatony

2017-12-01

Full Text Available Biomass is a crucial energy resource used for the generation of electricity and transportation fuels. Microalgae exhibit a high content of biocomponents which makes them a potential feedstock for the generation of ecofriendly biofuels. Biofuels derived from microalgae are suitable carbon-neutral replacements for petroleum. Fermentation is the major process for metabolic conversion of microalgal biocompounds into biofuels such as bioethanol and higher alcohols. In this review, we explored the use of all three major biocomponents of microalgal biomass including carbohydrates, proteins, and lipids for maximum biofuel generation. Application of several pretreatment methods for enhancement the bioavailability of substrates (simple sugar, amino acid, and fatty acid was discussed. This review goes one step further to discuss how to direct these biocomponents for the generation of various biofuels (bioethanol, higher alcohol, and biodiesel through fermentation and transesterification processes. Such an approach would result in the maximum utilization of biomasses for economically feasible biofuel production.

The Utility of the UTAUT Model in Explaining Mobile Learning Adoption in Higher Education in Guyana

Science.gov (United States)

Thomas, Troy Devon; Singh, Lenandlar; Gaffar, Kemuel

2013-01-01

In this paper, we compare the utility of modified versions of the unified theory of acceptance and use of technology (UTAUT) model in explaining mobile learning adoption in higher education in a developing country and evaluate the size and direction of the impacts of the UTAUT factors on behavioural intention to adopt mobile learning in higher…

Effect of regulation on the rate of adoption of cost saving scale technology in the electric utility industry: a portfolio approach

International Nuclear Information System (INIS)

Scheraga, C.A.

1984-01-01

This study presents a new analytical framework for examining the relationship between regulation and the investment behavior of electric utilities. The particular kind of investment behavior considered is the adoption of new as well as innovative electrical generation technology. The technologies of interest are large scale coal and nuclear generation plants. The theoretical model used in this study differs from traditional approaches in its utilization of a behavioral framework of analysis. The responsiveness of utilities to the required rate of return demanded by stockholders is demonstrated using an augmented form of the standard Capital Asset Pricing Model. Regulation is viewed as affecting utility investment behavior through the effect of the actions of regulatory commissions on the required rate of return that utilities must earn on equity. The particular regulatory policies considered are modification of existing rate structure, automatic adjustment clauses, and required efficiency standards. These policies are of particular interest both because their effects have not been previously examined in detail, and because they are recommended for adoption in the Public Utility Regulatory Policies Act of 1978. It is demonstrated empirically that the above policies do affect the required rate of return for utilities and hence their innovative investment behavior

Decadal analysis of deceased organ donation in Spain and the United States linking an increased donation rate and the utilization of older donors.

Science.gov (United States)

Halldorson, Jeff; Roberts, John Paul

2013-09-01

After the foundation of the National Transplant Organization, Spanish rates of deceased donor donation rapidly outpaced US growth over the decade from 1989 to 1999. An analysis of the following decade, 1999-2009, demonstrated a markedly flattened growth curve for Spanish deceased donor organ procurement, which increased only 2.4% from 33.6 to 34.4 donors per million population (pmp). In comparison, over the same decade in the United States, the rate of deceased donation increased from 20.9 to 26.3 donors pmp (25.8%). An age group comparison demonstrated a much higher donation rate among older donors in Spain. For example, the number of donors older than 70 years increased from 3.8 to 8.8 pmp (a 132% increase), and they now constitute 25.4% of all Spanish organ donors. In contrast, the number of US donors older than 70 years increased from 1.0 to 1.3 pmp, and they constitute only 4.4% of total deceased donors. Over the same decade, the number of younger donors (15-30 years old) decreased from 6.6 to 2.5 pmp (a 62% decrease) in Spain, and this contrasted with a slightly increased US donation rate for the same age subgroup (a 15.5% increase from 5.8 to 6.7 pmp). Although older donors were more rarely used in the United States, growth in donation over the 2 decades (1989-2009) was strongly associated with the utilization of donors aged 65 or older (P < 0.01). United Network for Organ Sharing regions demonstrated significant differences in utilization rates for older donors. In conclusion, strategies aimed toward achieving US donation rates equivalent to the Spanish benchmark should target improved utilization rates for older donors in the United States instead of emulating elements of the Spanish organ procurement system. © 2013 American Association for the Study of Liver Diseases.

A higher chest compression rate may be necessary for metronome-guided cardiopulmonary resuscitation.

Science.gov (United States)

Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Cho, Young Soon; Chung, Sung Phil; Park, Incheol

2012-01-01

Metronome guidance is a simple and economical feedback system for guiding cardiopulmonary resuscitation (CPR). However, a recent study showed that metronome guidance reduced the depth of chest compression. The results of previous studies suggest that a higher chest compression rate is associated with a better CPR outcome as compared with a lower chest compression rate, irrespective of metronome use. Based on this finding, we hypothesized that a lower chest compression rate promotes a reduction in chest compression depth in the recent study rather than metronome use itself. One minute of chest compression-only CPR was performed following the metronome sound played at 1 of 4 different rates: 80, 100, 120, and 140 ticks/min. Average compression depths (ACDs) and duty cycles were compared using repeated measures analysis of variance, and the values in the absence and presence of metronome guidance were compared. Both the ACD and duty cycle increased when the metronome rate increased (P = .017, metronome rates of 80 and 100 ticks/min were significantly lower than those for the procedures without metronome guidance. The ACD and duty cyle for chest compression increase as the metronome rate increases during metronome-guided CPR. A higher rate of chest compression is necessary for metronome-guided CPR to prevent suboptimal quality of chest compression. Copyright © 2012 Elsevier Inc. All rights reserved.

A utility theoretic view on probabilistic safety criteria

International Nuclear Information System (INIS)

Holmberg, J.E.

1997-03-01

A probabilistic safety criterion specifies the maximum acceptable hazard rates of various accidental consequences. Assuming that the criterion depends also on the benefit of the process to society and on the licensing time applied, we can regard such statements as preference relations. In this paper, a probabilistic safety criterion is interpreted to mean that if the accident hazard rate is higher than the accident hazard rate criterion, then the optimal stopping time of a hazardous process is shorter than the licensing time. This interpretation yields a condition for a feasible utility function. In particular, we derive such a condition for the parameters of a linear plus exponential utility function. (orig.) (12 refs.)

Speed over efficiency: locusts select body temperatures that favour growth rate over efficient nutrient utilization

DEFF Research Database (Denmark)

Miller, Gabriel A; Clissold, Fiona J; Mayntz, David

2009-01-01

to investigate relationships between growth/development and macronutrient utilization (conversion of ingesta to body mass) as a function of temperature. A range of macronutrient intake values for insects at 26, 32 and 38°C was achieved by offering individuals high-protein diets, high-carbohydrate diets......, but once digested both macronutrients were converted to growth most efficiently at the intermediate temperature (32°C). Body temperature preference thus yielded maximal growth rates at the expense of efficient nutrient utilization...

Sleep quality and health service utilization in Chinese general population: a cross-sectional study in Dongguan, China.

Science.gov (United States)

Zhang, Hui-Shan; Mai, Yan-Bing; Li, Wei-Da; Xi, Wen-Tao; Wang, Jin-Ming; Lei, Yi-Xiong; Wang, Pei-Xi

The aims of this study were to explore the Pittsburgh Sleep Quality Index (PSQI) and health service utilization in Chinese general population, to investigate the association between PSQI and health service utilization and to identify the independent contributions of social demographic variables, health related factors and PSQI to health service utilization. In a cross-sectional community-based health survey using a multi-instrument questionnaire, 4067 subjects (≥15 years old) were studied. The Chinese version of the PSQI was used to assess sleep quality. Health service utilization was measured by recent two-week physician visit and annual hospitalization rates. Higher PSQI scores were associated with more frequent health service utilization. Higher scores in subjective sleep quality were associated with higher rate of recent two-week physician visit (adjusted OR = 1.24 per SD increase, P = 0.015). Higher scores in habitual sleep efficiency (adjusted OR = 1.24 per SD increase, P = 0.038) and sleep disturbances (adjusted OR = 2.09 per SD increase, P quality predicted more frequent health service utilization. The independent contribution of PSQI on health service utilization was smaller than social demographic variables. Copyright © 2016. Published by Elsevier B.V.

The effects of rate of return and environmental regulations on the productivity performance in the US electric utility industry

International Nuclear Information System (INIS)

Durongkaveroj, P.

1991-01-01

Productivity growth in the US electric power industry has been declining since the late 1960's. Rate of return regulation and environmental regulations are hypothesized to adversely affect the productivity performance. Employing a Divisa index of the total factor productivity (TEP) an electric utility's performance is measured based on a profit maximization framework subject to both regulatory constraints. The empirical analysis attempts to analyze the effects of these regulations on the productivity growth employing data from privately-owned, fossil-fueled electric utilities. Results show a consistent decline in productivity growth over time averaging at 2% annually during 1977 and 1982, as well as the existence of regional differences in TFP growth among utilities. It shows positive and significant relationships between TFP growth and the rate of return, regulatory lag, the use of future test year, and deferred tax credit in the rate-making process. In the environmental case, results show that a stringent emission standard, using scrubbers for sulfur reduction and the utilization of aging power plants all contribute to the decline in productivity growth

Coevaporation of Y, BaF2, and Cu utilizing a quadrupole mass spectrometer as a rate measuring probe

International Nuclear Information System (INIS)

Hudner, J.; Oestling, M.; Ohlsen, H.; Stolt, L.

1991-01-01

An ultrahigh vacuum coevaporator equipped with three sources for preparation of Y--BaF 2 --Cu--O thin films is described. Evaporation rates of Y, BaF 2 , and Cu were controlled using a quadrupole mass spectrometer operating in a multiplexed mode. To evaluate the method depositions have been performed using different source configurations and evaporation rates. Utilizing Rutherford backscattering spectrometry absolute values of the actual evaporation rates were determined. It was observed that the mass-spectrometer sensitivity is highest for Y, followed by BaF 2 (BaF + is the measured ion) and Cu. A partial pressure of oxygen during evaporation of Y, BaF 2 , and Cu affected mainly the rate of Y. It is shown that the mass spectrometer can be utilized to precisely control the film composition

On the Path to SunShot - Utility Regulatory Business Model Reforms forAddressing the Financial Impacts of Distributed Solar on Utilities

Energy Technology Data Exchange (ETDEWEB)

None, None

2016-05-01

Net-energy metering (NEM) with volumetric retail electricity pricing has enabled rapid proliferation of distributed photovoltaics (DPV) in the United States. However, this transformation is raising concerns about the potential for higher electricity rates and cost-shifting to non-solar customers, reduced utility shareholder profitability, reduced utility earnings opportunities, and inefficient resource allocation. Although DPV deployment in most utility territories remains too low to produce significant impacts, these concerns have motivated real and proposed reforms to utility regulatory and business models, with profound implications for future DPV deployment. This report explores the challenges and opportunities associated with such reforms in the context of the U.S. Department of Energy’s SunShot Initiative. As such, the report focuses on a subset of a broader range of reforms underway in the electric utility sector. Drawing on original analysis and existing literature, we analyze the significance of DPV’s financial impacts on utilities and non-solar ratepayers under current NEM rules and rate designs, the projected effects of proposed NEM and rate reforms on DPV deployment, and alternative reforms that could address utility and ratepayer concerns while supporting continued DPV growth. We categorize reforms into one or more of four conceptual strategies. Understanding how specific reforms map onto these general strategies can help decision makers identify and prioritize options for addressing specific DPV concerns that balance stakeholder interests.

The absorption and utilization rates for different types of 3H-vitamin A by broiler

International Nuclear Information System (INIS)

Cai Huiyi; Zhang Shu

1992-01-01

165 newly hatched Arbor Acres broiler chickens were divided into three groups for studying the absorption speed and the utilization rate of different types and doses of 3 H-vitamin A through feeding and metabolizing experiments. The results obtained are as follows: 1. All types of vitamin A could be absorbed by first-week chicken, and water-dispersible vitamin A is the best one. 2. Utilization rates for three types of 3 H-vitamin A were: oil type 80.67%, power type 82.91%, water-dispersible type 89.43%. 3. Chikens absorbed 3 H-vitamin A more quickly when they were 1-3 days old. Moreover, the absorption was mainly performed at the 2-4 hours after the intake of vitamin A. 4. The absorption of vitamin A in intestine was a continuing process lasted about 72 hours, but most of it was absorbed within 24-28 hours

Method for enhancing microbial utilization rates of gases using perfluorocarbons

Science.gov (United States)

Turick, C.E.

1997-06-10

A method of enhancing the bacterial reduction of industrial gases using perfluorocarbons (PFCs) is disclosed. Because perfluorocarbons (PFCs) allow for a much greater solubility of gases than water does, PFCs have the potential to deliver gases in higher concentrations to microorganisms when used as an additive to microbial growth media thereby increasing the rate of the industrial gas conversion to economically viable chemicals and gases. 3 figs.

Brain metabolism in autism. Resting cerebral glucose utilization rates as measured with positron emission tomography

Energy Technology Data Exchange (ETDEWEB)

Rumsey, J.M.; Duara, R.; Grady, C.; Rapoport, J.L.; Margolin, R.A.; Rapoport, S.I.; Cutler, N.R.

1985-05-01

The cerebral metabolic rate for glucose was studied in ten men (mean age = 26 years) with well-documented histories of infantile autism and in 15 age-matched normal male controls using positron emission tomography and (F-18) 2-fluoro-2-deoxy-D-glucose. Positron emission tomography was completed during rest, with reduced visual and auditory stimulation. While the autistic group as a whole showed significantly elevated glucose utilization in widespread regions of the brain, there was considerable overlap between the two groups. No brain region showed a reduced metabolic rate in the autistic group. Significantly more autistic, as compared with control, subjects showed extreme relative metabolic rates (ratios of regional metabolic rates to whole brain rates and asymmetries) in one or more brain regions.

Brain metabolism in autism. Resting cerebral glucose utilization rates as measured with positron emission tomography

International Nuclear Information System (INIS)

Rumsey, J.M.; Duara, R.; Grady, C.; Rapoport, J.L.; Margolin, R.A.; Rapoport, S.I.; Cutler, N.R.

1985-01-01

The cerebral metabolic rate for glucose was studied in ten men (mean age = 26 years) with well-documented histories of infantile autism and in 15 age-matched normal male controls using positron emission tomography and (F-18) 2-fluoro-2-deoxy-D-glucose. Positron emission tomography was completed during rest, with reduced visual and auditory stimulation. While the autistic group as a whole showed significantly elevated glucose utilization in widespread regions of the brain, there was considerable overlap between the two groups. No brain region showed a reduced metabolic rate in the autistic group. Significantly more autistic, as compared with control, subjects showed extreme relative metabolic rates (ratios of regional metabolic rates to whole brain rates and asymmetries) in one or more brain regions

Health care utilization in patients with gout: a prospective multicenter cohort study.

Science.gov (United States)

Singh, Jasvinder A; Bharat, Aseem; Khanna, Dinesh; Aquino-Beaton, Cleopatra; Persselin, Jay E; Duffy, Erin; Elashoff, David; Khanna, Puja P

2017-05-31

All published studies of health care utilization in gout have been cross-sectional to date, and most used a patient-reported diagnosis of gout. Our objective was to assess health care utilization and its predictors in patients with physician-confirmed gout in a prospective cohort study. In a multi-center prospective cohort study of U.S. veterans with rheumatologist-confirmed gout (N = 186; two centers), we assessed patient self-reported overall and gout-specific health care utilization with the Gout Assessment Questionnaire (GAQ) every 3-months for a 9-month period. Comparisons were made using the student's t test or the chi-square, Wilcoxon rank sum test or Fisher exact test, as appropriate. Mixed effects Poisson regression was used to assess potential correlates of gout-related health care utilization. Mean age was 64.6 years, 98% were men, 13% Hispanic or Latino, 32% were African-American, 6% did not graduate high school, mean serum urate was 8.3 and mean Deyo-Charlson score was 3.1. During the past year, mean gout-related visits were as follows: rheumatologist, 1.5; primary care physician, 2 visits; ≥1 inpatient visits, 7%; ≥1 ER visits, 26%; and urgent care/walk-in visit, 33%. In longitudinal analyses, African-American race and gout flares in the last 3 months were associated with significantly higher rate ratio of gout-related outpatient visits. African-American race and lack of college education were associated with significantly higher rate ratio for gout-related urgent visits and overnight stays. African-American race and recent gout flares were associated with higher outpatient utilization and African-American race and no college education with higher urgent or inpatient utilization. Future studies should examine whether modifiable predictors of utilization can be targeted to reduce healthcare utilization in patients with gout.

Variations in Student Mental Health and Treatment Utilization Across US Colleges and Universities.

Science.gov (United States)

Ketchen Lipson, Sarah; Gaddis, S Michael; Heinze, Justin; Beck, Kathryn; Eisenberg, Daniel

2015-01-01

On US college campuses, mental health problems are highly prevalent, appear to be increasing, and are often untreated. Concerns about student mental health are well documented, but little is known about potential variations across the diversity of institutions of higher education. Participants were 43,210 undergraduates at 72 campuses that participated in the Healthy Minds Study from 2007 to 2013. Multivariable logistic regressions focus on associations between institutional characteristics and student mental health and treatment utilization. The following institutional characteristics are associated with worse mental health: doctoral-granting, public, large enrollment, nonresidential, less competitive, and lower graduation rates. Among students with apparent mental health problems, treatment utilization is higher at doctorate-granting institutions, baccalaureate colleges, institutions with small enrollments, and schools with strong residential systems. Although high rates of mental health problems and low treatment utilization are major concerns at all types of institutions of higher education, substantial variation occurs across campuses.

Strain rate effects in nuclear steels at room and higher temperatures

Energy Technology Data Exchange (ETDEWEB)

Solomos, G. E-mail: george.solomos@jrc.it; Albertini, C.; Labibes, K.; Pizzinato, V.; Viaccoz, B

2004-04-01

An investigation of strain rate, temperature and size effects in three nuclear steels has been conducted. The materials are: ferritic steel 20MnMoNi55 (vessel head), austenitic steel X6CrNiNb1810 (upper internal structure), and ferritic steel 26NiCrMo146 (bolting). Smooth cylindrical tensile specimens of three sizes have been tested at strain rates from 0.001 to 300 s{sup -1}, at room and elevated temperatures (400-600 deg. C). Full stress-strain diagrams have been obtained, and additional parameters have been calculated based on them. The results demonstrate a clear influence of temperature, which amounts into reducing substantially mechanical strengths with respect to RT conditions. The effect of strain rate is also shown. It is observed that at RT the strain rate effect causes up shifting of the flow stress curves, whereas at the higher temperatures a mild downshifting of the flow curves is manifested. Size effect tendencies have also been observed. Some implications when assessing the pressure vessel structural integrity under severe accident conditions are considered.

Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

Directory of Open Access Journals (Sweden)

Liu Xiaoyun

2012-02-01

Full Text Available Abstract Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance.

Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

Science.gov (United States)

2012-01-01

Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance. PMID:22376290

Down the slippery slop: Utility incorporation of environmental externalities

International Nuclear Information System (INIS)

Vandenberg, A.J.; Tempchin, R.S.; Mitnick, S.A.; Harron, A.L.

1993-01-01

Advocates of incorporating environmental externalities in electric utility decision-making have concentrated on new electric generating resources, with some success. Such public utility commission actions compel utilities to consider, explicitly, the cost of sulfur dioxide, carbon dioxide, nitrogen oxides and other emission of power-plants when comparing the economics of new generating resources with those of other resource options (e.g., demand-side management and gas-fired non-utility generator projects). This paper summarizes a study which estimated costs of incorporating externalities in utility system operations. We also present an analysis of the Tellus work in this area, and contrast Tellus' methodology, assumptions and results with our own. Estimates of the cost of incorporating externalities in system operations is rather large, in terms of the increased fuel and purchased power cost that ratepayers would have to bear. For the eight cases we examined, the incorporation of externalities caused fuel and purchased power cost to be 9.3 to 69.5 percent higher, relative to what it would have been under traditional generating unit commitment and dispatch. Furthermore, we believe that these estimates of fuel and purchased power cost increases are conservative. In particular, because our analyses focused on utility system operations in 1995, the key assumption about the fuel cost differential (i.e., coal versus natural gas) probably underestimates the differential in later years, significantly, when virtually all forecasters foresee faster cost escalation rates for gas. In general, the higher the fuel cost differential, the faster cost escalation rates for gas. In general, the higher the fuel cost differential, the greater the cost of an externality policy. Unless the record is set straight soon, the idea that incorporating externalities is virtually costless will further spread in the regulatory community and among government policy-makers

Estimating Discount Rates

Directory of Open Access Journals (Sweden)

Laurence Booth

2015-04-01

Full Text Available Discount rates are essential to applied finance, especially in setting prices for regulated utilities and valuing the liabilities of insurance companies and defined benefit pension plans. This paper reviews the basic building blocks for estimating discount rates. It also examines market risk premiums, as well as what constitutes a benchmark fair or required rate of return, in the aftermath of the financial crisis and the U.S. Federal Reserve’s bond-buying program. Some of the results are disconcerting. In Canada, utilities and pension regulators responded to the crash in different ways. Utilities regulators haven’t passed on the full impact of low interest rates, so that consumers face higher prices than they should whereas pension regulators have done the opposite, and forced some contributors to pay more. In both cases this is opposite to the desired effect of monetary policy which is to stimulate aggregate demand. A comprehensive survey of global finance professionals carried out last year provides some clues as to where adjustments are needed. In the U.S., the average equity market required return was estimated at 8.0 per cent; Canada’s is 7.40 per cent, due to the lower market risk premium and the lower risk-free rate. This paper adds a wealth of historic and survey data to conclude that the ideal base long-term interest rate used in risk premium models should be 4.0 per cent, producing an overall expected market return of 9-10.0 per cent. The same data indicate that allowed returns to utilities are currently too high, while the use of current bond yields in solvency valuations of pension plans and life insurers is unhelpful unless there is a realistic expectation that the plans will soon be terminated.

Why do younger women have higher breast cancer recurrence rates after breast-conserving surgery?

International Nuclear Information System (INIS)

Nishimura, Reiki; Matsuda, Masakazu; Miyayama, Haruhiko; Okazaki, Shinji; Kai, Chiharu; Ozaki, N.

2003-01-01

Preventing breast cancer recurrence after breast-conserving surgery is an important issue. The main factors contributing to such recurrence are positive margins, absence of radiotherapy and young age. To investigate the clinical significance of age in breast-conserving surgery, we examined the relationship between clinicopathological findings or outcome and age, especially young age. The cases were divided into three groups by age; 35 years old or less, 36-50y.o. and 51y.o. or higher. Between April 1989 and March 2003, 743 patients were treated with breast-conserving surgery. There were 49 patients aged 35 years old or less (6.6%). Younger age significantly correlated with positive surgical margin, lymph node metastases, higher proliferative activity, negative estrogen receptor (ER) or progesterone receptor (PgR), larger tumor size, and shorter nipple-tumor distances. Although younger patients had a higher recurrence rate irrespective of radiotherapy, margin status had an impact on recurrence rate. Thus, the reason young age was a significant factor for breast recurrence after breast-conserving surgery was that young patients frequently had numerous risk factors such as positive margin, higher proliferative activity, positive nodes, negative ER/PgR and larger tumor. However, negative surgical margins could reduce recurrence rates even in young women. These results suggest that more suitable criteria and strategies may be needed for young patients with breast cancer. (author)

Will ageing lead to a higher real exchange rate for the Netherlands?

NARCIS (Netherlands)

van Ewijk, C.; Volkerink, M.

2012-01-01

Long term projections for the Netherlands indicate that demand for nontradables—e.g. health care services—will increase relative to supply due to population ageing. If this leads to higher future real exchanges rates this will erode the return of the savings currently made to prepare for ageing.

Will ageing lead to a higher real exchange rate for the Netherlands?

NARCIS (Netherlands)

van Ewijk, C.; Volkerink, M.

2011-01-01

Long-term projections for the Netherlands indicate that demand for nontradables - e.g. health care services - will increase relative to supply due to population ageing. If this leads to higher future real exchanges rates this will erode the return of the savings currently made to prepare for ageing.

The Effectiveness of Experimental Diet with Varying Levels of Papain on The Growth Performance, Survival Rate and Feed Utilization of Keureling Fish (Tor tambra

Directory of Open Access Journals (Sweden)

Zainal Abidin Muchlisin

2016-09-01

Full Text Available The objective of present study was to determine the optimum level of papain in the diet of keureling fish (Tor tambra. The complete random design was utilized in this study. Six levels of papain dosage were tested in triplicates, i.e. 0 (control; 17.5 mg kg-1,  20.0 mg kg-1, 22.5 mg kg-1, 25.0 mg kg-1 and 27.5 mg kg-1 of feed. The experimental fish were fed the experimental diet two times a day at 8 AM and 5 PM at feeding level of 5% body weight for 90 days. The Anova test result showed that papain enzyme  gave a significant effect on the weight gain, daily growth rate, specific growth rate, survival rate, feed conversion ratio and feed efficiency (P<0.05. The Duncan multi-rage test result showed that the higher values for all measured parameters were obtained at the dosage of 27.5 mg kg-1. Therefore, it is concluded that the optimum dosage of papain enzyme for keureling fish was 27.5 mg kg-1 of feed.How to CiteMuchlisin, Z. A., Afrido, F., Murda, T., Fadli, N., Muhammadar, A. A., Jalil, Z., & Yulvizar, C. (2016. The Effectiveness of Experimental Diet with Varying Levels of Papain on The Growth Performance, Survival Rate and Feed Utilization of Keureling Fish (Tor tambra. Biosaintifika: Journal of Biology & Biology Education, 8(2, 172-177.

Evaluation of alternative institutional arrangements in public utilities

Directory of Open Access Journals (Sweden)

Ermishina Anna, V.

2015-06-01

Full Text Available Since early 2000s a policy of attracting private operators to public utilities, which should help to increase productivity, reduce costs, and as a result, reduce utility prices takes place in Russia. The aim of the study is to identify the relationship between institutional arrangements and pricing for water and wastewater services. Applying statistical and cluster analysis to empirical data on water utilities in 13 largest cities has revealed the differences in the level and dynamics of prices for water and wastewater services in the group of public utilities and public private water utilities. In 2011-2014 the level and growth price rates in the group of public private partnerships were higher than in group of municipal water utilities. Thus, the involvement of private operators has not yet lead to the expected reduction in prices.

Utilization of travel reimbursement in the Veterans Health Administration.

Science.gov (United States)

Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

2014-01-01

To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

Fiscal Policy and Welfare under Different Exchange Rate Regimes

DEFF Research Database (Denmark)

Østrup, Finn

a representativeindividual's utility, it is demonstrated that there are differences betweenexchange rate regimes with respect to the level of government spending. Thesedifferences arise first because a rise in government spending affects macroeconomicvariables differently under different exchange rate regimes......, and secondbecause the government's inclination to expand government spending is affectedby inflation which depends on the exchange rate regime. At low rates of inflation,the government is inclined to set a higher level of government spending under afixed exchange rate regime than under a floating exchange rate...... regime in whichthe monetary authority optimises preferences which include an employment targetand an inflation target. As government spending affects the representativeindividual's utility, the choice of exchange rate regime has an impact on welfare.Keywords: exchange rate regimes; fiscal policy...

Electric vehicle utilization for ancillary grid services

Science.gov (United States)

Aziz, Muhammad

2018-02-01

Electric vehicle has been developed through several decades as transportation mean, without paying sufficient attention of its utilization for other purposes. Recently, the utilization of electric vehicle to support the grid electricity has been proposed and studied intensively. This utilization covers several possible services including electricity storage, spinning reserve, frequency and voltage regulation, and emergency energy supply. This study focuses on theoretical and experimental analysis of utilization of electric vehicles and their used batteries to support a small-scale energy management system. Charging rate of electric vehicle under different ambient temperature (seasonal condition) is initially analyzed to measure the correlation of charging rate, charging time, and state-of-charge. It is confirmed that charging under warmer condition (such as in summer or warmer region) shows higher charging rate than one in colder condition, therefore, shorter charging time can be achieved. In addition, in the demonstration test, each five electric vehicles and used batteries from the same electric vehicles are employed and controlled to support the electricity of the office building. The performance of the system is evaluated throughout a year to measure the load leveling effect during peak-load time. The results show that the targeted peak-load can be shaved well under certain calculated peak-shaving threshold. The finding confirms that the utilization of electric vehicle for supporting the electricity of grid or certain energy management system is feasible and deployable in the future.

Sociodemographic characterization of ECT utilization in Hawaii.

Science.gov (United States)

Ona, Celia M; Onoye, Jane M; Goebert, Deborah; Hishinuma, Earl; Bumanglag, R Janine; Takeshita, Junji; Carlton, Barry; Fukuda, Michael

2014-03-01

Minimal research has been done on sociodemographic differences in utilization of electroconvulsive therapy (ECT) for refractory depression, especially among Asian Americans and Pacific Islanders. This study examined sociodemographic and diagnostic variables using retrospective data from Hawaii, an island state with predominantly Asian Americans and Pacific Islanders. Retrospective data were obtained from an inpatient and outpatient database of ECT patients from 2008 to 2010 at a tertiary care community hospital on O'ahu, Hawaii. There was a significant increase in overall ECT utilization from 2008 to 2009, with utilization remaining stable from 2009 to 2010. European Americans (41%) and Japanese Americans (29%) have relatively higher rates of receiving ECT, and Filipino Americans and Native Hawaiians have relatively lower rates in comparison with their population demographics. Japanese Americans received significantly more ECT procedures than European Americans. Electroconvulsive therapy is underutilized by certain sociodemographic groups that may benefit most from the treatment. There are significant differences in ECT usage based on ethnicity. Such differences may be related to help-seeking behavior, economic differences, and/or attitudes regarding mental illness. Further research is needed to elucidate the reasons for differences in utilization.

Efficiency of Photosynthesis in a Chl d-Utilizing Cyanobacterium is Comparable to or Higher than that in Chl a-Utilizing Oxygenic Species

Science.gov (United States)

Mielke, S. P.; Kiang, N. Y.; Blankenship, R. E.; Gunner, M. R.; Mauzerall, D.

2011-01-01

The cyanobacterium Acaryochloris marina uses chlorophyll d to carry out oxygenic photosynthesis in environments depleted in visible and enhanced in lower-energy, far-red light. However, the extent to which low photon energies limit the efficiency of oxygenic photochemistry in A. marina is not known. Here, we report the first direct measurements of the energy-storage efficiency of the photosynthetic light reactions in A. marina whole cells,and find it is comparable to or higher than that in typical, chlorophyll a-utilizing oxygenic species. This finding indicates that oxygenic photosynthesis is not fundamentally limited at the photon energies employed by A. marina, and therefore is potentially viable in even longer-wavelength light environments.

Fractional Delayer Utilizing Hermite Interpolation with Caratheodory Representation

Directory of Open Access Journals (Sweden)

Qiang DU

2018-04-01

Full Text Available Fractional delay is indispensable for many sorts of circuits and signal processing applications. Fractional delay filter (FDF utilizing Hermite interpolation with an analog differentiator is a straightforward way to delay discrete signals. This method has a low time-domain error, but a complicated sampling module than the Shannon sampling scheme. A simplified scheme, which is based on Shannon sampling and utilizing Hermite interpolation with a digital differentiator, will lead a much higher time-domain error when the signal frequency approaches the Nyquist rate. In this letter, we propose a novel fractional delayer utilizing Hermite interpolation with Caratheodory representation. The samples of differential signal are obtained by Caratheodory representation from the samples of the original signal only. So, only one sampler is needed and the sampling module is simple. Simulation results for four types of signals demonstrate that the proposed method has significantly higher interpolation accuracy than Hermite interpolation with digital differentiator.

Blastocyst utilization rates after continuous culture in two commercial single-step media: a prospective randomized study with sibling oocytes.

Science.gov (United States)

Sfontouris, Ioannis A; Kolibianakis, Efstratios M; Lainas, George T; Venetis, Christos A; Petsas, George K; Tarlatzis, Basil C; Lainas, Tryfon G

2017-10-01

The aim of this study is to determine whether blastocyst utilization rates are different after continuous culture in two different commercial single-step media. This is a paired randomized controlled trial with sibling oocytes conducted in infertility patients, aged ≤40 years with ≥10 oocytes retrieved assigned to blastocyst culture and transfer. Retrieved oocytes were randomly allocated to continuous culture in either Sage one-step medium (Origio) or Continuous Single Culture (CSC) medium (Irvine Scientific) without medium renewal up to day 5 post oocyte retrieval. Main outcome measure was the proportion of embryos suitable for clinical use (utilization rate). A total of 502 oocytes from 33 women were randomly allocated to continuous culture in either Sage one-step medium (n = 250) or CSC medium (n = 252). Fertilization was performed by either in vitro fertilization or intracytoplasmic sperm injection, and embryo transfers were performed on day 5. Two patients had all blastocysts frozen due to the occurrence of severe ovarian hyperstimulation syndrome. Fertilization and cleavage rates, as well as embryo quality on day 3, were similar in the two media. Blastocyst utilization rates (%, 95% CI) [55.4% (46.4-64.1) vs 54.7% (44.9-64.6), p = 0.717], blastocyst formation rates [53.6% (44.6-62.5) vs 51.9 (42.2-61.6), p = 0.755], and proportion of good quality blastocysts [36.8% (28.1-45.4) vs 36.1% (27.2-45.0), p = 0.850] were similar in Sage one-step and CSC media, respectively. Continuous culture of embryos in Sage one-step and CSC media is associated with similar blastocyst development and utilization rates. Both single-step media appear to provide adequate support during in vitro preimplantation embryo development. Whether these observations are also valid for other continuous single medium protocols remains to be determined. NCT02302638.

A Practice-Based Evaluation of Distress Screening Protocol Adherence and Medical Service Utilization.

Science.gov (United States)

Zebrack, Brad; Kayser, Karen; Bybee, Deborah; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Oktay, Julianne

2017-07-01

Background: This study examined the extent to which cancer programs demonstrated adherence to their own prescribed screening protocol, and whether adherence to that protocol was associated with medical service utilization. The hypothesis is that higher rates of service utilization are associated with lower rates of adherence to screening protocols. Methods: Oncology social workers at Commission on Cancer-accredited cancer programs reviewed electronic health records (EHRs) in their respective cancer programs during a 2-month period in 2014. Rates of overall adherence to a prescribed distress screening protocol were calculated based on documentation in the EHR that screening adherence and an appropriate clinical response had occurred. We examined documentation of emergency department (ED) use and hospitalization within 2 months after the screening visit. Results: Review of 8,409 EHRs across 55 cancer centers indicated that the overall adherence rate to screening protocols was 62.7%. The highest rates of adherence were observed in Community Cancer Programs (76.3%) and the lowest rates were in NCI-designated Cancer Centers (43.3%). Rates of medical service utilization were significantly higher than expected when overall protocol adherence was lacking. After controlling for patient and institutional characteristics, risk ratios for ED use (0.82) and hospitalization (0.81) suggest that when overall protocol adherence was documented, 18% to 19% fewer patients used these medical services. Conclusions: The observed associations between a mandated psychosocial care protocol and medical service utilization suggest opportunities for operational efficiencies and costs savings. Further investigations of protocol integrity, as well as the clinical care models by which psychosocial care is delivered, are warranted. Copyright © 2017 by the National Comprehensive Cancer Network.

Impact of socioeconomic status and medical conditions on health and healthcare utilization among aging Ghanaians.

Science.gov (United States)

Saeed, Bashiru Ii; Xicang, Zhao; Yawson, Alfred Edwin; Nguah, Samuel Blay; Nsowah-Nuamah, Nicholas N N

2015-03-20

This study attempts to examine the impact of socioeconomic and medical conditions in health and healthcare utilization among older adults in Ghana. Five separate models with varying input variables were estimated for each response variable. Data (Wave 1 data) were drawn from the World Health Organization Global Ageing and Adult Health (SAGE) conducted during 2007-2008 and included a total of 4770 respondents aged 50+ and 803 aged 18-49 in Ghana. Ordered logits was estimated for self-rated health, and binary logits for functional limitation and healthcare utilization. Our results show that the study provides enough grounds for further research on the interplay between socioeconomic and medical conditions on one hand and the health of the aged on the other. Controlling for socioeconomic status substantially contributes significantly to utilization. Also, aged women experience worse health than men, as shown by functioning assessment, self-rated health, chronic conditions and functional limitations. Women have higher rates of healthcare utilization, as shown by significantly higher rates of hospitalization and outpatient encounters. Expansion of the national health insurance scheme to cover the entire older population--for those in both formal and informal employments--is likely to garner increased access and improved health states for the older population.

Examining related influential factors for dental calculus scaling utilization among people with disabilities in Taiwan, a nationwide population-based study.

Science.gov (United States)

Lai, Hsien-Tang; Kung, Pei-Tseng; Su, Hsun-Pi; Tsai, Wen-Chen

2014-09-01

Limited studies with large samples have been conducted on the utilization of dental calculus scaling among people with physical or mental disabilities. This study aimed to investigate the utilization of dental calculus scaling among the national disabled population. This study analyzed the utilization of dental calculus scaling among the disabled people, using the nationwide data between 2006 and 2008. Descriptive analysis and logistic regression were performed to analyze related influential factors for dental calculus scaling utilization. The dental calculus scaling utilization rate among people with physical or mental disabilities was 16.39%, and the annual utilization frequency was 0.2 times. Utilization rate was higher among the female and non-aboriginal samples. Utilization rate decreased with increased age and disability severity while utilization rate increased with income, education level, urbanization of residential area and number of chronic illnesses. Related influential factors for dental calculus scaling utilization rate were gender, age, ethnicity (aboriginal or non-aboriginal), education level, urbanization of residence area, income, catastrophic illnesses, chronic illnesses, disability types, and disability severity significantly influenced the dental calculus scaling utilization rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does the Economic Crisis Have an Influence on the Higher Education Dropout Rate?

Science.gov (United States)

Leão Fernandes, Graça; Chagas Lopes, Margarida

2016-01-01

This research aims to identify the effects of the economic crisis on higher education (HE) dropout rates at Lisbon School of Economics and Management (ISEG)--Universidade de Lisboa, after having controlled for individual characteristics, family background, High School and HE trajectories. Our main hypothesis is that the economic crisis induces…

Calm Merino ewes have a higher ovulation rate and more multiple pregnancies than nervous ewes.

Science.gov (United States)

van Lier, E; Hart, K W; Viñoles, C; Paganoni, B; Blache, D

2017-07-01

In 1990, two selection lines of Merino sheep were established for low and high behavioural reactivity (calm and nervous temperament) at the University of Western Australia. Breeding records consistently showed that calm ewes weaned 10% to 19% more lambs than the nervous ewes. We hypothesise that calm ewes could have a higher ovulation rate than nervous ewes and/or calm ewes could have a lower rate of embryo mortality than nervous ewes. We tested these hypotheses by comparing the ovulation rate and the rate of embryo mortality between the calm and nervous lines before and after synchronisation and artificial insemination. Merino ewes from the temperament selection lines (calm, n=100; nervous, n=100) were synchronised (early breeding season) for artificial insemination (day 0) (intravaginal sponges containing fluogestone acetate and eCG immediately after sponge withdrawal). On day-17 and 11 ovarian cyclicity and corpora lutea, and on days 30 and 74 pregnancies and embryos/foetuses were determined by ultrasound. Progesterone, insulin and leptin concentrations were determined in blood plasma samples from days 5, 12 and 17. Ovarian cyclicity before and after oestrus synchronisation did not differ between the lines, but ovulation rate did (day-17: calm 1.63; nervous 1.26; Pewes was higher than on day-17. Loss of embryos by day 30 was high (calm: 71/150; nervous: 68/130); but nervous ewes had a lower proportion (15/47) of multiple pregnancies compared with calm ewes (30/46; Pewes had higher insulin (32.0 pmol/l±1.17 SEM; P=0.013) and lower leptin (1.18 μg/l±0.04 SEM; P=0.002) concentrations than calm ewes (insulin: 27.8 pmol/l±1.17 SEM; leptin: 1.35 μg/l±0.04 SEM). The differences in reproductive outcomes between the calm and nervous ewes were mainly due to a higher ovulation rate in calm ewes. We suggest that reproduction in nervous ewes is compromised by factors leading up to ovulation and conception, or the uterine environment during early pregnancy, that reflect

Metabolome analysis-based design and engineering of a metabolic pathway in Corynebacterium glutamicum to match rates of simultaneous utilization of D-glucose and L-arabinose.

Science.gov (United States)

Kawaguchi, Hideo; Yoshihara, Kumiko; Hara, Kiyotaka Y; Hasunuma, Tomohisa; Ogino, Chiaki; Kondo, Akihiko

2018-05-17

L-Arabinose is the second most abundant component of hemicellulose in lignocellulosic biomass, next to D-xylose. However, few microorganisms are capable of utilizing pentoses, and catabolic genes and operons enabling bacterial utilization of pentoses are typically subject to carbon catabolite repression by more-preferred carbon sources, such as D-glucose, leading to a preferential utilization of D-glucose over pentoses. In order to simultaneously utilize both D-glucose and L-arabinose at the same rate, a modified metabolic pathway was rationally designed based on metabolome analysis. Corynebacterium glutamicum ATCC 31831 utilized D-glucose and L-arabinose simultaneously at a low concentration (3.6 g/L each) but preferentially utilized D-glucose over L-arabinose at a high concentration (15 g/L each), although L-arabinose and D-glucose were consumed at comparable rates in the absence of the second carbon source. Metabolome analysis revealed that phosphofructokinase and pyruvate kinase were major bottlenecks for D-glucose and L-arabinose metabolism, respectively. Based on the results of metabolome analysis, a metabolic pathway was engineered by overexpressing pyruvate kinase in combination with deletion of araR, which encodes a repressor of L-arabinose uptake and catabolism. The recombinant strain utilized high concentrations of D-glucose and L-arabinose (15 g/L each) at the same consumption rate. During simultaneous utilization of both carbon sources at high concentrations, intracellular levels of phosphoenolpyruvate declined and acetyl-CoA levels increased significantly as compared with the wild-type strain that preferentially utilized D-glucose. These results suggest that overexpression of pyruvate kinase in the araR deletion strain increased the specific consumption rate of L-arabinose and that citrate synthase activity becomes a new bottleneck in the engineered pathway during the simultaneous utilization of D-glucose and L-arabinose. Metabolome analysis

Continuous fermentation and in-situ reed separation of butyric acid for higher sugar consumption rate and productivity

DEFF Research Database (Denmark)

Baroi, George Nabin; Skiadas, Ioannis; Westermann, Peter

that disconnection of the REED system resulted to much lower (48 and 83% for glucose and xylose, respectively) sugars consumption rates and consequently lower butyric acid production rates. It was also noticeable that continuous operation, even without the REED system, resulted to higher glucose consumption rates...

Estimating diversification rates for higher taxa: BAMM can give problematic estimates of rates and rate shifts.

Science.gov (United States)

Meyer, Andreas L S; Wiens, John J

2018-01-01

Estimates of diversification rates are invaluable for many macroevolutionary studies. Recently, an approach called BAMM (Bayesian Analysis of Macro-evolutionary Mixtures) has become widely used for estimating diversification rates and rate shifts. At the same time, several articles have concluded that estimates of net diversification rates from the method-of-moments (MS) estimators are inaccurate. Yet, no studies have compared the ability of these two methods to accurately estimate clade diversification rates. Here, we use simulations to compare their performance. We found that BAMM yielded relatively weak relationships between true and estimated diversification rates. This occurred because BAMM underestimated the number of rates shifts across each tree, and assigned high rates to small clades with low rates. Errors in both speciation and extinction rates contributed to these errors, showing that using BAMM to estimate only speciation rates is also problematic. In contrast, the MS estimators (particularly using stem group ages), yielded stronger relationships between true and estimated diversification rates, by roughly twofold. Furthermore, the MS approach remained relatively accurate when diversification rates were heterogeneous within clades, despite the widespread assumption that it requires constant rates within clades. Overall, we caution that BAMM may be problematic for estimating diversification rates and rate shifts. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

Links between social environment and health care utilization and costs.

Science.gov (United States)

Brault, Marie A; Brewster, Amanda L; Bradley, Elizabeth H; Keene, Danya; Tan, Annabel X; Curry, Leslie A

2018-01-01

The social environment influences health outcomes for older adults and could be an important target for interventions to reduce costly medical care. We sought to understand which elements of the social environment distinguish communities that achieve lower health care utilization and costs from communities that experience higher health care utilization and costs for older adults with complex needs. We used a sequential explanatory mixed methods approach. We classified community performance based on three outcomes: rate of hospitalizations for ambulatory care sensitive conditions, all-cause risk-standardized hospital readmission rates, and Medicare spending per beneficiary. We conducted in-depth interviews with key informants (N = 245) from organizations providing health or social services. Higher performing communities were distinguished by several aspects of social environment, and these features were lacking in lower performing communities: 1) strong informal support networks; 2) partnerships between faith-based organizations and health care and social service organizations; and 3) grassroots organizing and advocacy efforts. Higher performing communities share similar social environmental features that complement the work of health care and social service organizations. Many of the supportive features and programs identified in the higher performing communities were developed locally and with limited governmental funding, providing opportunities for improvement.

On multiple discount rates

OpenAIRE

Chambers, Christopher P.; Echenique, Federico

2016-01-01

We propose a theory of intertemporal choice that is robust to specific assumptions on the discount rate. One class of models requires that one utility stream be chosen over another if and only if its discounted value is higher for all discount factors in a set. Another model focuses on an average discount factor. Yet another model is pessimistic, and evaluates a flow by the lowest available discounted value.

Microbial utilization of dissolved organic matter from leaves of the red mangrove, Rhizophora mangle, in the Fresh Creek estuary, Bahamas

Science.gov (United States)

Benner, Ronald; Peele, Emily R.; Hodson, Robert E.

1986-11-01

Dissolved organic matter was leached from [ 14C]labeled leaves of the red mangrove, Rhizophora mangle, and used in studies to determine the rates and efficiencies of microbial utilization of the water-soluble components of mangrove leaves in the Fresh Creek estuary, Bahamas. Rates of microbial utilization (assimilation plus mineralization) of mangrove leachate ranged from 0·022 to 4·675 μg ml -1 h -1 depending on the concentration of leachate and the size or diversity of microbial populations. Microflora associated with decaying mangrove leaves utilized mangrove leachate at rates up to 18-fold higher than rates of leachate utilization by planktonic microflora. Chemical analyses indicated that tannins and other potentially inhibitory phenolic compounds made up a major fraction (18%) of the dissolved organic matter in mangrove leachate. Mangrove leachate did not appear to be inhibitory to the microbial uptake of leachate or the microbial degradation of the lignocellulosic component of mangrove leaves except at high concentrations (mg ml -1). The availability of molecular oxygen also was an important parameter affecting rates of leachate utilization; rates of microbial utilization of leachate were up to 8-fold higher under aerobic rather than anaerobic conditions. The overall efficiency of conversion of mangrove leachate into microbial biomass was high and ranged from 64% to 94%. As much as 42% of the added leachate was utilized during 2 to 12 h incubations, indicating that a major fraction of the leachable material from mangrove leaves is incorporated into microbial biomass, and thus available to animals in the estuarine food web.

Comparing post-deployment mental health services utilization in soldiers deployed to Balkan, Iraq and Afghanistan

DEFF Research Database (Denmark)

Madsen, T; Sadowa Vedtofte, M; Nordentoft, M

2017-01-01

OBJECTIVE: Insight on how different missions have impacted rates of mental health service (MHS) utilization is unexplored. We compared postdeployment MHS utilization in a national cohort of first-time deployed to missions in Balkan, Iraq, and Afghanistan respectively. METHODS: A prospective...... national cohort study of 13 246 first-time deployed in the period 1996 through 2012 to missions in Balkan area, Iraq, or Afghanistan respectively. Soldiers 'MHS utilization was also compared with a 5:1 sex-, age-, and calendar year-matched never-deployed background population. Postdeployment utilization...... of psychotropics. RESULTS: Utilizing of psychiatric outpatient services and psychotropics was significantly higher in first-time deployed to Iraq and Afghanistan compared with deployed to Balkan. However, the rate of postdeployment admission to psychiatric hospital did not differ between missions. Postdeployment...

Bicarbonate utilization by leaf protoplasts from Potamogeton

International Nuclear Information System (INIS)

Staal, M.; Elzenga, J.T.M.; Prins, H.B.A.

1987-01-01

Leaves from the submerged angiosperm P. lucens are able to assimilate bicarbonate. These leaves behave polarly: during bicarbonate utilization protons (H + ) are excreted by the cells of the lower epidermis, while hydroxyl (OH - ) ions are excreted by the upper epidermal cells. It has been proposed that acidification of the apoplast is a prerequisite for bicarbonate utilization. To test this hypothesis 14 C fixation by protoplasts was determined at different pH values. Also experiments, using the isotopic disequilibrium technique were performed. They showed that at pH values > 8, bicarbonate is a major carbon source for photosynthesis in protoplasts, despite the absence of cell walls and polarity. At pH values around 6, the rate of 14 C-fixation in protoplasts equals that of intact leaves. At pH values > 8, however, intact leaves show a higher rate. From this, and other experiments, the authors conclude that at least 2 processes contribute to bicarbonate utilization in P. lucens leaves: active transport (H + -HCO 3 - symport?) and acidification of the apoplast resulting in the conversion of bicarbonate into CO 2 . Polarity may increase the efficiency of both

Higher Magnitude Cash Payments Improve Research Follow-up Rates Without Increasing Drug Use or Perceived Coercion

Science.gov (United States)

Festinger, David S.; Marlowe, Douglas B.; Dugosh, Karen L.; Croft, Jason R.; Arabia, Patricia L.

2008-01-01

In a prior study (Festinger et al., 2005) we found that neither the mode (cash vs. gift card) nor magnitude ($10, $40, or $70) of research follow-up payments increased rates of new drug use or perceptions of coercion. However, higher payments and payments in cash were associated with better follow-up attendance, reduced tracking efforts, and improved participant satisfaction with the study. The present study extended those findings to higher payment magnitudes. Participants from an urban outpatient substance abuse treatment program were randomly assigned to receive $70, $100, $130, or $160 in either cash or a gift card for completing a follow-up assessment at 6 months post-admission (n ≅ 50 per cell). Apart from the payment incentives, all participants received a standardized, minimal platform of follow-up efforts. Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion. Consistent with our previous findings, higher payments and cash payments resulted in significantly higher follow-up rates and fewer tracking calls. In addition participants receiving cash vs. gift cards were more likely to use their payments for essential, non-luxury purchases. Follow-up rates for participants receiving cash payments of $100, $130, and $160 approached or exceeded the FDA required minimum of 70% for studies to be considered in evaluations of new medications. This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up samples without increasing new drug use or perceptions of coercion. PMID:18395365

Study on the placement of phosphorus fertilizer to improve fertilizer utilization by lowland rice

International Nuclear Information System (INIS)

Sisworo, W.H.; Riswantoro; Mardjo, M.

1976-01-01

An experiment for studying the placement of phosphorus fertilizer was carried out in the glass house by using 32 P-labelled superphosphate. The specific activity of the labelled fertilizer used was 0,25 mCi/g P 2 O 5 . Three placement methods were studied: (1) Hill placement: Fertilizer was burried at a distance of 5cm from the plants at the depth of 5 cm, (2) Surface placement: Fertilizer was spread on the surface, and (3) Soil mixed application: Fertilizer was mixed with the soil at the depth of 5 cm. Superphosphate was applied at the rates of 0, 30, 60, 90, and 120 kg P 25 /ha. Results obtained from the experiment showed that the dry matter production was significantly affected by the methods of placement of phosphorus fertilizer. Soil mixed placement gave the lowest yield of dry plant material. It differed significantly from the two other methods of placement. However, there was no significant difference between hill and surface placement. The placement of phosphorus fertilizer significantly affected the total uptake of phosphorus nutrient, uptake fertilizer phosphorus, and the percentage of fertilizer utilization. Surface placement gave the highest utilization of fertilizer when supplied at rates higher than 60 kg P 2 O 5 /ha. At low rate applications, hill placement was the best, but, at rates higher than 60 kg P 2 O 5 /ha the percentage of fertilizer utilization decreased. Soil mixed application was the least efficient fertilizer utilization. (author)

[Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class].

Science.gov (United States)

Aguilar-Palacio, Isabel; Carrera-Lasfuentes, Patricia; Solsona, Sofía; Sartolo, M Teresa; Rabanaque, M José

2016-04-01

to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend. cross sectional study in two phases. Spain. people surveyed in the National Health Surveys 2006 and 2011-12. Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity. the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes. inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

[Long-term effect of iodine deficiency on growth and food utilization rate in second filial generation rats].

Science.gov (United States)

Muyeseer, Ainiwaer; Zhang, G X; Wang, J; Liu, Y; Meng, X H; Liu, Q

2017-02-06

Objective: To study the effect of iodine deficiency on body weight, food consumption, and food utilization rate of second filial generation Wistar rats. Methods: According to the food pattern of a high-iodine deficient population, two types of low-iodine food have been produced using the main crops grown in this area (iodine levels of 50 and 20 μg/kg, respectively). Wistar rats were randomly divided into three groups, normal iodine group (NI group), low-iodine group one (LI group) and low-iodine group two (LII group), using the random number table method and fed diets containing 300, 50, and 20 μg/kg of iodine, respectively. Parental generation rats were fed until they reached reproductive age; first filial generation rats were allocated to the same diet as their mothers. After 3 months of feeding, first filial generation rats gave birth to second filial generation rats; second filial generation rats were allocated to the same diet as their mothers. After feeding for 90, 180, and 270 days, rats were sacrificed. One-way analysis of variance was used to analyze body weight, food intake, and food utilization rate data collected during the time of feeding and blood iodine hormone level, which was determined after sacrifice. Results: The LI and LII groups generally demonstrated decreased activity, slow reaction, and growth retardation compared with the NI group. After 270 days, the urine iodine levels of the LI and LII groups were 1.7 and 0.2 μg/L, respectively, which were significantly lower than the NI group (255.2 μg/L) ( Pfood intake of female and male rats after 270 days were (465.0±27.7), (658.4±28.6) and (423.0±13.2), (548.0±18.8) g, respectively, which were significantly lower than that of the NI group ((499.5±21.8), (760.8±33.0) g) ( Pfood utilization rate of female rats in the LI and LII groups was (8.7±0.4)% and (6.0±0.58)%, which was lower than that of the NI group ((11.7±3.5)%) ( Pfood intake, and food utilization rate among second filial

High utilizers of medical care: a crucial subgroup among somatizing patients.

Science.gov (United States)

Hiller, Wolfgang; Fichter, Manfred M

2004-04-01

Patients with somatoform disorders (SFD) are likely to overutilize healthcare services. This study investigates (a) whether extraordinarily high medical costs can be predicted from patient characteristics or psychopathology, and (b) whether high-utilizing patients respond differently to cognitive-behavioral treatment. We compared 42 SFD high utilizers with 53 SFD average utilizers and 29 patients suffering from other than SFD mental disorders. High utilization was defined by healthcare expenditures of > or = 2500 euros during the past 2 years. Costs were computed from medical and billing records of health insurance companies. Somatization distress, hypochondriasis, depression, dysfunctional cognitions related to bodily symptoms, general psychopathology, personality profiles, and psychosocial disabilities were assessed before treatment. High utilizers had higher levels of self- and observer-rated illness behavior, self-perceived bodily weakness, and psychosocial disabilities. Although they did not report more somatization symptoms, their subjective symptom distress was higher. There were no differences between high and average utilizers concerning general psychopathology, DSM-IV comorbidity, and personality profiles. Treatment improvements were similar. High- and average-utilizing somatizers represent distinguishable subgroups. The results emphasize the importance of mechanisms specifically related to SFD and may enhance the early detection of patients who are likely to develop overutilization. Copyright 2004 Elsevier Inc.

Higher resting heart rate variability predicts skill in expressing some emotions.

Science.gov (United States)

Tuck, Natalie L; Grant, Rosemary C I; Sollers, John J; Booth, Roger J; Consedine, Nathan S

2016-12-01

Vagally mediated heart rate variability (vmHRV) is a measure of cardiac vagal tone, and is widely viewed as a physiological index of the capacity to regulate emotions. However, studies have not directly tested whether vmHRV is associated with the ability to facially express emotions. In extending prior work, the current report tested links between resting vmHRV and the objectively assessed ability to facially express emotions, hypothesizing that higher vmHRV would predict greater expressive skill. Eighty healthy women completed self-reported measures, before attending a laboratory session in which vmHRV and the ability to express six emotions in the face were assessed. A repeated measures analysis of variance revealed a marginal main effect for vmHRV on skill overall; individuals with higher resting vmHRV were only better able to deliberately facially express anger and interest. Findings suggest that differences in resting vmHRV are associated with the objectively assessed ability to facially express some, but not all, emotions, with potential implications for health and well-being. © 2016 Society for Psychophysiological Research.

Utilization of negative beat-frequencies for maximizing the update-rate of OFDR

Science.gov (United States)

Gabai, Haniel; Botsev, Yakov; Hahami, Meir; Eyal, Avishay

2015-07-01

In traditional OFDR systems, the backscattered profile of a sensing fiber is inefficiently duplicated to the negative band of spectrum. In this work, we present a new OFDR design and algorithm that remove this redundancy and make use of negative beat frequencies. In contrary to conventional OFDR designs, it facilitates efficient use of the available system bandwidth and enables distributed sensing with the maximum allowable interrogation update-rate for a given fiber length. To enable the reconstruction of negative beat frequencies an I/Q type receiver is used. In this receiver, both the in-phase (I) and quadrature (Q) components of the backscatter field are detected. Following detection, both components are digitally combined to produce a complex backscatter signal. Accordingly, due to its asymmetric nature, the produced spectrum will not be corrupted by the appearance of negative beat-frequencies. Here, via a comprehensive computer simulation, we show that in contrast to conventional OFDR systems, I/Q OFDR can be operated at maximum interrogation update-rate for a given fiber length. In addition, we experimentally demonstrate, for the first time, the ability of I/Q OFDR to utilize negative beat-frequencies for long-range distributed sensing.

Weaker gun state laws are associated with higher rates of suicide secondary to firearms.

Science.gov (United States)

Alban, Rodrigo F; Nuño, Miriam; Ko, Ara; Barmparas, Galinos; Lewis, Azaria V; Margulies, Daniel R

2018-01-01

Firearm-related suicides comprise over two-thirds of gun-related violence in the United States, and gun laws and policies remain under scrutiny, with many advocating for revision of the regulatory map for lawful gun ownership, aiming at restricting access and distribution of these weapons. However, the quantitative relationship between how strict gun laws are and the incidence of firearm violence with their associated mortality is largely unknown. We therefore, sought to explore the impact of firearm law patterns among states on the incidence and outcomes of firearm-related suicide attempts, utilizing established objective criteria. The National Inpatient Sample for the years 1998-2011 was queried for all firearm-related suicides. Discharge facilities were stratified into five categories (A, B, C, D, and F, with A representing states with the most strict and F representing states with the least strict laws) based on the Brady Campaign to prevent Gun Violence that assigns scorecards for every state. The primary outcomes were suicide attempts and in-hospital mortality per 100,000 populations by Brady state grade. During the 14-year study period, 34,994 subjects met inclusion criteria. The mean age was 42.0 years and 80.1% were male. A handgun was utilized by 51.8% of patients. The overall mortality was 33.3%. Overall, 22.0% had reported psychoses and 19.3% reported depression. After adjusting for confounding factors and using group A as reference, there were higher adjusted odds for suicide attempts for patients admitted in group C, D, and F category states (1.73, 2.09, and 1.65, respectively, all P gun laws, and these injuries tend to be associated with a higher mortality. Efforts aimed at nationwide standardization of firearm state laws are warranted, particularly for young adults and suicide-prone populations. III. Trauma Outcomes study. Copyright © 2017 Elsevier Inc. All rights reserved.

Concerns and perceptions immediately following Superstorm Sandy: ratings for property damage were higher than for health issues.

Science.gov (United States)

Burger, Joanna; Gochfeld, Michael

Governmental officials, health and safety professionals, early responders, and the public are interested in the perceptions and concerns of people faced with a crisis, especially during and immediately after a disaster strikes. Reliable information can lead to increased individual and community preparedness for upcoming crises. The objective of this research was to evaluate concerns of coastal and central New Jersey residents within the first 100 days of Superstorm Sandy's landfall. Respondents living in central New Jersey and Jersey shore communities were differentially impacted by the storm, with shore residents having higher evacuation rates (47% vs. 13%), more flood waters in their homes, longer power outages (average 23 vs. 6 days), and longer periods without Internet (29 vs. 6 days). Ratings of concerns varied both among and within categories as a function of location (central vs. coastal New Jersey), stressor level (ranging from 1 to 3 for combinations of power outages, high winds, and flooding), and demographics. Respondents were most concerned about property damage, health, inconveniences, ecological services, and nuclear power plants in that order. Respondents from the shore gave higher ratings to the concerns within each major category, compared to those from central Jersey. Four findings have implications for understanding future risk, recovery, and resiliency: (1) respondents with the highest stressor level (level 3) were more concerned about water damage than others, (2) respondents with flood damage were more concerned about water drainage and mold than others, (3) respondents with the highest stressor levels rated all ecological services higher than others, and (4) shore respondents rated all ecological services higher than central Jersey residents. These data provide information to design future preparedness plans, improve resiliency for future severe weather events, and reduce public health risk.

Radiotherapy utilization in New South Wales from 1996 to 1998

International Nuclear Information System (INIS)

Barton, M.; University of New South Wales, Sydney, NSW

2000-01-01

The purpose of the present study was to examine utilization rates of radiotherapy by newly diagnosed cancer patients in New South Wales (NSW) from 1996 to 1998. The 1989 report of the Australian Health Ministers' Advisory Council (AHMAC) recommended that 50% of all newly diagnosed cancer patients should receive radiotherapy. Previous reports showed that the true rate was between 30 and 36%. In 1991 and 1995 the NSW Department of Health developed strategic plans that were intended to implement the AHMAC recommendation. An analysis was carried out of activity reports of radiation oncology departments in NSW and its component Area Health Services (AHS). All NSW patients newly diagnosed with cancer between 1996 and 1998 and treated by radiotherapy were included in the study. A total of 37% of newly diagnosed cancer patients received radiotherapy in NSW in 1998. This has increased from 30% since 1990-91. Rural AHS in 1998 had an identical average rate of 37% (range: 23-54%) when compared to urban AHS (average: 37%; range: 26-49%). Rural AHS have increased utilization from 19% in 1990-91. Area health services with a radiation oncology department had a slightly higher rate of utilization than those AHS without a radiation oncology department (39 and 36%, respectively). The rates of utilization of radiotherapy in NSW in 1998 continued to be well below the benchmark set by AHMAC and varied widely between AHS. Attention to and expansion of services should be focused on both rural and urban areas of need. Copyright (1999) Blackwell Science Pty Ltd

Inequities in utilization of reproductive and maternal health services in Ethiopia.

Science.gov (United States)

Bobo, Firew Tekle; Yesuf, Elias Ali; Woldie, Mirkuzie

2017-06-19

Disparities in health services utilization within and between regional states of countries with diverse socio-cultural and economic conditions such as Ethiopia is a frequent encounter. Understanding and taking measures to address unnecessary and avoidable differences in the use of reproductive and maternal health services is a key concern in Ethiopia. The aim of the study was to examine degree of equity in reproductive and maternal health services utilization in Ethiopia. Data from Ethiopia demographic health survey 2014 was analyzed. We assessed inequities in utilization of modern contraceptive methods, antenatal care, facility based delivery and postnatal checkup. Four standard equity measurement methods were used; equity gaps, rate-ratios, concertation curve and concentration index. Inequities in service utilization were exhibited favoring women in developed regions, urban residents, most educated and the wealthy. Antenatal care by skilled provider was three times higher among women with post-secondary education than mothers with no education. Women in the highest wealth quantile had about 12 times higher skilled birth attendance than those in lowest wealth quantile. The rate of postnatal care use among urban resident was about 6 times that of women in rural area. Use of modern contraceptive methods was more equitably utilized service while, birth at health facility was less equitable across all economic levels, favoring the wealthy. Considerable inequity between and within regions of Ethiopia in the use of maternal health services was demonstrated. Strategically targeting social determinants of health with special emphasis to women education and economic empowerment will substantially contribute for altering the current situation favorably.

Health Disparities in Adolescent Bariatric Surgery: Nationwide Outcomes and Utilization.

Science.gov (United States)

Nunez Lopez, Omar; Jupiter, Daniel C; Bohanon, Fredrick J; Radhakrishnan, Ravi S; Bowen-Jallow, Kanika A

2017-11-01

Bariatric surgery represents an appropriate treatment for adolescent severe obesity, but its utilization remains low in this patient population. We studied the impact of race and sex on preoperative characteristics, outcomes, and utilization of adolescent bariatric surgery. Retrospective analysis (2007-2014) of adolescent bariatric surgery using the Bariatric Outcomes Longitudinal Database, a national database that collects bariatric surgical care data. We assessed the relationships between baseline characteristics and outcomes (weight loss and remission of obesity-related conditions [ORCs]). Using the National Health and Nutrition Examination Survey and U.S. census data, we calculated the ratio of severe obesity and bariatric procedures among races and determined the ratio of ratios to assess for disparities. About 1,539 adolescents underwent bariatric surgery. Males had higher preoperative body mass index (BMI; 51.8 ± 10.5 vs. 47.1 ± 8.7, p adolescents underwent bariatric surgery at a higher proportion than blacks and Hispanics (2.5 and 2.3 times higher, respectively). Preoperative characteristics vary according to race and sex. Race and sex do not impact 12-month weight loss or ORC's remission rates. Minority adolescents undergo bariatric surgery at lower-than-expected rates. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Utilization of electromigration in civil and environmental engineering--processes, transport rates and matrix changes.

Science.gov (United States)

Ottosen, Lisbeth M; Christensen, Iben V; Rorig-Dalgård, Inge; Jensen, Pernille E; Hansen, Henrik K

2008-07-01

Electromigration (movement of ions in an applied electric field) is utilized for supply or extraction of ions from various porous materials within both civil and environmental engineering. In civil engineering, most research has been conducted on the removal of chlorides from concrete to hinder reinforcement corrosion while in environmental engineering remediation of heavy metal polluted soil is the issue most studied. Never the less, experiments have been conducted with utilization for several other materials and purposes within both engineering fields. Even though there are many topics of common interest in the use of electromigration for the two fields, there is no tradition for collaboration. The present paper is a review with the aim of pointing out areas of shared interest. Focus is laid on the purposes of the different processes, transport rates of various ions in different materials and on changes in the matrix itself. Desorption and dissolution of the target elements into ionic form is a key issue to most of the processes, and can be the limiting step. The removal rate is generally below 1 cm day(- 1), but it can be much less than 1 mm day(- 1) when desorption is slow and insufficient. Matrix changes occurs under the action of the applied electric field and it includes both physico-chemical and hydrological changes. Some of the solid phases is weathered and new can be formed. Increased fundamental understanding of the effects and side effects, when applying the electric field to a porous material, can lead to improvement of the known technologies and possibly to new applications.

How Perceptions of Mental Illness Impact EAP Utilization.

Science.gov (United States)

McRee, Jayme

2017-01-01

Studies of employee assistance program (EAP) clinical use across multiple industries and multiple EAP delivery models range from highs greater than 5% to lows of less than 1 %. Despite the range in utilization, the rates of employee behaviors that indicate a behavioral health issue are significantly higher, suggesting far too little use of EAPs overall. Studies of the costs to an employer for an employee with a mental health issue are as high as 37% lost annual productivity. EAPs have attempted to raise utilization through a variety of efforts, with mixed results. Most EAP utilization initiatives fail to address the impact of stigma, misunderstandings about mental illness and the reluctance of many employees to seek counseling as an option for better management of stress, work-life balance and overall mental wellness. For both employers and EAPs, addressing the impact of stigma and perceptions of mental illness is costly, requiring greater direct employee engagement and education. However, it is a more effective means of increasing EAP use than current practices and, ultimately, can result in significantly higher net gains in productivity while reducing employers' direct costs.

Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006-2013.

Science.gov (United States)

Lipska, Kasia J; Yao, Xiaoxi; Herrin, Jeph; McCoy, Rozalina G; Ross, Joseph S; Steinman, Michael A; Inzucchi, Silvio E; Gill, Thomas M; Krumholz, Harlan M; Shah, Nilay D

2017-04-01

To examine temporal trends in utilization of glucose-lowering medications, glycemic control, and rate of severe hypoglycemia among patients with type 2 diabetes (T2DM). Using claims data from 1.66 million privately insured and Medicare Advantage patients with T2DM from 2006 to 2013, we estimated the annual 1 ) age- and sex-standardized proportion of patients who filled each class of agents; 2 ) age-, sex-, race-, and region-standardized proportion with hemoglobin A 1c (HbA 1c ) use increased for metformin (from 47.6 to 53.5%), dipeptidyl peptidase 4 inhibitors (0.5 to 14.9%), and insulin (17.1 to 23.0%) but declined for sulfonylureas (38.8 to 30.8%) and thiazolidinediones (28.5 to 5.6%; all P use of glucose-lowering drugs has changed dramatically among patients with T2DM. Overall glycemic control has not improved and remains poor among nearly a quarter of the youngest patients. The overall rate of severe hypoglycemia remains largely unchanged. © 2017 by the American Diabetes Association.

Reduction Rates for Higher Americium Oxidation States in Nitric Acid

Energy Technology Data Exchange (ETDEWEB)

Grimes, Travis Shane [Idaho National Lab. (INL), Idaho Falls, ID (United States); Mincher, Bruce Jay [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schmitt, Nicholas C [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-09-30

The stability of hexavalent americium was measured using multiple americium concentrations and nitric acid concentrations after contact with the strong oxidant sodium bismuthate. Contrary to our hypotheses Am(VI) was not reduced faster at higher americium concentrations, and the reduction was only zero-order at short time scales. Attempts to model the reduction kinetics using zero order kinetic models showed Am(VI) reduction in nitric acid is more complex than the autoreduction processes reported by others in perchloric acid. The classical zero-order reduction of Am(VI) was found here only for short times on the order of a few hours. We did show that the rate of Am(V) production was less than the rate of Am(VI) reduction, indicating that some Am(VI) undergoes two electron-reduction to Am(IV). We also monitored the Am(VI) reduction in contact with the organic diluent dodecane. A direct comparison of these results with those in the absence of the organic diluent showed the reduction rates for Am(VI) were not statistically different for both systems. Additional americium oxidations conducted in the presence of Ce(IV)/Ce(III) ions showed that Am(VI) is reduced without the typical growth of Am(V) observed in the systems sans Ce ion. This was an interesting result which suggests a potential new reduction/oxidation pathway for Am in the presence of Ce; however, these results were very preliminary, and will require additional experiments to understand the mechanism by which this occurs. Overall, these studies have shown that hexavalent americium is fundamentally stable enough in nitric acid to run a separations process. However, the complicated nature of the reduction pathways based on the system components is far from being rigorously understood.

Reputation in Higher Education

DEFF Research Database (Denmark)

Plewa, Carolin; Ho, Joanne; Conduit, Jodie

2016-01-01

Reputation is critical for institutions wishing to attract and retain students in today's competitive higher education setting. Drawing on the resource based view and configuration theory, this research proposes that Higher Education Institutions (HEIs) need to understand not only the impact...... of independent resources but of resource configurations when seeking to achieve a strong, positive reputation. Utilizing fuzzy set qualitative comparative analysis (fsQCA), the paper provides insight into different configurations of resources that HEIs can utilize to build their reputation within their domestic...

Excess Stress Fractures, Musculoskeletal Injuries, and Health Care Utilization Among Unfit and Overweight Female Army Trainees.

Science.gov (United States)

Krauss, Margot R; Garvin, Nadia U; Boivin, Michael R; Cowan, David N

2017-02-01

Musculoskeletal injuries are prevalent among military trainees and certain occupations. Fitness and body mass index (BMI) have been associated with musculoskeletal conditions, including stress fractures. The incidence of, and excess health care utilization for, stress fracture and non-stress fracture overuse musculoskeletal injuries during the first 6 months of service is higher among unfit female recruits. Those who exceeded body fat limits are at a greater risk of incident stress fractures, injuries, or health care utilization compared with weight-qualified recruits. Cohort study; Level of evidence, 3. All applicants to the United States Army were required to take a preaccession fitness test during the study period (February 2005-September 2006). The test included a 5-minute step test scored as pass or fail. BMI was recorded at application. There were 2 distinct comparisons made in this study: (1) between weight-qualified physically fit and unfit women and (2) between weight-qualified physically fit women and those who exceeded body fat limits. We compared the incidence of, and excess health care utilization for, musculoskeletal injuries, including stress fractures and physical therapy visits, during the first 183 days of military service. Among the weight-qualified women, unfit participants had a higher non-stress fracture injury incidence and related excess health care utilization rate compared with fit women, with rate ratios of 1.32 (95% CI, 1.14-1.53) and 1.18 (95% CI, 1.10-1.27), respectively. Among fit women, compared with the weight-qualified participants, those exceeding body fat limits had higher rate ratios for non-stress fracture injury incidence and related excess health care utilization of 1.27 (95% CI, 1.07-1.50) and 1.20 (95% CI, 1.11-1.31), respectively. Weight-qualified women who were unfit had a higher incidence of stress fractures and related excess health care utilization compared with fit women, with rate ratios of 1.62 (95% CI, 1

Estimation of the Optimal Brachytherapy Utilization Rate in the Treatment of Gynecological Cancers and Comparison With Patterns of Care

International Nuclear Information System (INIS)

Thompson, Stephen R.; Delaney, Geoff P.; Gabriel, Gabriel S.; Jacob, Susannah; Das, Prabir; Barton, Michael B.

2013-01-01

Purpose: We aimed to estimate the optimal proportion of all gynecological cancers that should be treated with brachytherapy (BT)—the optimal brachytherapy utilization rate (BTU)—to compare this with actual gynecological BTU and to assess the effects of nonmedical factors on access to BT. Methods and Materials: The previously constructed inter/multinational guideline-based peer-reviewed models of optimal BTU for cancers of the uterine cervix, uterine corpus, and vagina were combined to estimate optimal BTU for all gynecological cancers. The robustness of the model was tested by univariate and multivariate sensitivity analyses. The resulting model was applied to New South Wales (NSW), the United States, and Western Europe. Actual BTU was determined for NSW by a retrospective patterns-of-care study of BT; for Western Europe from published reports; and for the United States from Surveillance, Epidemiology, and End Results data. Differences between optimal and actual BTU were assessed. The effect of nonmedical factors on access to BT in NSW were analyzed. Results: Gynecological BTU was as follows: NSW 28% optimal (95% confidence interval [CI] 26%-33%) compared with 14% actual; United States 30% optimal (95% CI 26%-34%) and 10% actual; and Western Europe 27% optimal (95% CI 25%-32%) and 16% actual. On multivariate analysis, NSW patients were more likely to undergo gynecological BT if residing in Area Health Service equipped with BT (odds ratio 1.76, P=.008) and if residing in socioeconomically disadvantaged postcodes (odds ratio 1.12, P=.05), but remoteness of residence was not significant. Conclusions: Gynecological BT is underutilized in NSW, Western Europe, and the United States given evidence-based guidelines. Access to BT equipment in NSW was significantly associated with higher utilization rates. Causes of underutilization elsewhere were undetermined. Our model of optimal BTU can be used as a quality assurance tool, providing an evidence-based benchmark against

Utilization and preference rating of various subtropical pasture ...

African Journals Online (AJOL)

The percentage utilization and preference demonstrated by Bonsmara beef cows was measrued twice (December 1976 and March 1977) on 18 subtropical grasses, legumes and grass-legume mixtures under supplemental spray irrigation. Clipping before and after grazing, with a two to three day period of stay, was carried ...

[Public hospital utilization by the foreign population in Aragon, Spain (2004-2007)].

Science.gov (United States)

Ben Cheikh, Wafa; Abad, José María; Arribas, Federico; Andrés, Eva; Rabanaque, María José

2011-01-01

To describe hospitalization rates and hospital morbidity among the foreign population residing in Aragon (Spain) by country of birth, between 2004 and 2007, and to compare these rates with those in the autochthonous population. A retrospective longitudinal study was carried out of hospital discharges of the foreign population in public hospitals in Aragon. Utilization rates were estimated by sex, age, country of birth and main diagnosis. Poisson regression was used to estimate the utilization rate ratios and their 95% confidence intervals. Hospitalization rates were lower in the foreign population (adjusted RR: 0.52; 95% CI: 0.51-0.56), except in women aged between 15 and 24 years (RR: 2.9; 95% CI: 2.8-3.0) and among those born in the Maghreb (RR: 1.8; 95% CI: 1.7; 1.9), sub-Saharan Africa (RR: 2.0; 95% CI: 1.9-2.1) and Asia (RR=1.4; 95% CI: 1.3-1.6). When hospital discharges related to obstetrics and gynecology were excluded, only women born in sub-Saharan Africa continued to have adjusted RR greater than 1. These women had higher hospitalization rates in groups of infectious and parasitic diseases (RR: 2.5) and blood and blood-forming organs (RR: 2.8). In Aragon (Spain), public hospital utilization is lower in foreigners than in the autochthonous population. The diseases treated varied by country of birth. The diseases prevalent in these countries, together with hereditary diseases, can increase hospital utilization rates. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

With age a lower individual breathing reserve is associated with a higher maximal heart rate.

Science.gov (United States)

Burtscher, Martin; Gatterer, Hannes; Faulhaber, Martin; Burtscher, Johannes

2018-01-01

Maximal heart rate (HRmax) is linearly declining with increasing age. Regular exercise training is supposed to partly prevent this decline, whereas sex and habitual physical activity do not. High exercise capacity is associated with a high cardiac output (HR x stroke volume) and high ventilatory requirements. Due to the close cardiorespiratory coupling, we hypothesized that the individual ventilatory response to maximal exercise might be associated with the age-related HRmax. Retrospective analyses have been conducted on the results of 129 consecutively performed routine cardiopulmonary exercise tests. The study sample comprised healthy subjects of both sexes of a broad range of age (20-86 years). Maximal values of power output, minute ventilation, oxygen uptake and heart rate were assessed by the use of incremental cycle spiroergometry. Linear multivariate regression analysis revealed that in addition to age the individual breathing reserve at maximal exercise was independently predictive for HRmax. A lower breathing reserve due to a high ventilatory demand and/or a low ventilatory capacity, which is more pronounced at a higher age, was associated with higher HRmax. Age explained the observed variance in HRmax by 72% and was improved to 83% when the variable "breathing reserve" was entered. The presented findings indicate an independent association between the breathing reserve at maximal exercise and maximal heart rate, i.e. a low individual breathing reserve is associated with a higher age-related HRmax. A deeper understanding of this association has to be investigated in a more physiological scenario. Copyright © 2017 Elsevier B.V. All rights reserved.

Stittco Utilities Man Ltd. application for an interim ex parte order under section 45 of the Public Utilities Board Act for the approval of a change to its schedule of rates

Energy Technology Data Exchange (ETDEWEB)

1990-11-15

Stittco Utilities, a company distributing propane in Manitoba, applied to the Manitoba Public Utilities Board for an interim order authorizing an increase in rates for all domestic and commercial customers in 3 Manitoba localities. The rate increase requested is based on the increase in the commodity price of propane and related changes in freight rates. If approved, the average rate will increase by ca 28% for residential customers and 27% for commercial customers. With the expectation that the price of propane would decrease in the near future, Stittco proposed to base its rates on a propane price lower than the current market price, in an effort to retain existing customers. Stittco also proposed to establish a variance account, in which the difference between the cost of propane built into the rates and the actual market price would be accumulated. From time to time Stittco would apply to adjust the rate schedule to refund overages or collect shortfalls contained in this variance account. It is Stittco's intention to cancel its new propane supply contract when propane prices stabilize and enter into a new fixed-price contract. Stittco would then apply for a new rate schedule based on the long-term price of propane. Based on the evidence, the Board decided that a prima facie case has been made showing a 105% increase in Stittco's cost of product and delivery, and that this increase should be passed through to Stittco customers effective November 16, 1990. Status reports were required for the variance account starting December 1990.

Comparison of electricity prices in major North American cities : rates effective May 1, 2001

International Nuclear Information System (INIS)

2002-01-01

This report presents the major findings of a comparative evaluation of electricity prices in major North American cities, by customer category, based on rates in effect on May 1, 2001. Besides Hydro-Quebec, the comparison includes 21 utilities, of which 11 serve the major cities across Canada and 10 utilities located in 10 American states. Hydro-Quebec is one of the largest electric utilities in North America with one of the most extensive systems. Of the 190 billion kilowatt-hours delivered annually, 37 billion are exported to neighbouring provinces in Canada and to the United States. 93 per cent of the generating facilities are hydroelectric. The report covers consumption levels, taxes, optional programs, location, time-of-use rates, exchange rates, and other factors that affect electricity prices such as fuel adjustment clauses for utilities that produce electricity in thermal power plants. It was noted that Hydro-Quebec has frozen its rates until April 2002, keeping them at the same level as those set on May 1, 1998. The report showed that Hydro-Quebec has maintained a competitive position at a level similar to or better than previous years. Three of the 11 Canadian utilities implemented rate increases between May 1, 2000 and May 1, 2001, and 2 utilities reduced their rates. Two utilities modified their rate structure following deregulation. During the same time period, 3 of the 10 utilities in the United States increased their rates, and one reduced them. The rates in the United States varied regardless of increases or freezes because many utilities had incorporated adjustment clauses. Quebec residential consumers enjoy the second lowest rates in North America. Only Winnipeg ranked higher. Hydro-Quebec has also remained competitive when it comes to small, medium and large power customers. It ranked fifth for small power customers, third for medium power customers, and third for large power customers. tabs., figs., appendices

[Characteristics of dry matter production and nitrogen accumulation in barley genotypes with high nitrogen utilization efficiency].

Science.gov (United States)

Huang, Yi; Li, Ting-Xuan; Zhang, Xi-Zhou; Ji, Lin

2014-07-01

A pot experiment was conducted under low (125 mg x kg-1) and normal (250 mg x kg(-1)) nitrogen treatments. The nitrogen uptake and utilization efficiency of 22 barley cultivars were investigated, and the characteristics of dry matter production and nitrogen accumulation in barley were analyzed. The results showed that nitrogen uptake and utilization efficiency were different for barley under two nitrogen levels. The maximal values of grain yield, nitrogen utilization efficiency for grain and nitrogen harvest index were 2.87, 2.91 and 2.47 times as those of the lowest under the low nitrogen treatment. Grain yield and nitrogen utilization efficiency for grain and nitrogen harvest index of barley genotype with high nitrogen utilization efficiency were significantly greater than low nitrogen utilization efficiency, and the parameters of high nitrogen utilization efficiency genotype were 82.1%, 61.5% and 50.5% higher than low nitrogen utilization efficiency genotype under the low nitrogen treatment. Dry matter mass and nitrogen utilization of high nitrogen utilization efficiency was significantly higher than those of low nitrogen utilization efficiency. A peak of dry matter mass of high nitrogen utilization efficiency occurred during jointing to heading stage, while that of nitrogen accumulation appeared before jointing. Under the low nitrogen treatment, dry matter mass of DH61 and DH121+ was 34.4% and 38.3%, and nitrogen accumulation was 54. 8% and 58.0% higher than DH80, respectively. Dry matter mass and nitrogen accumulation seriously affected yield before jointing stage, and the contribution rates were 47.9% and 54.7% respectively under the low nitrogen treatment. The effect of dry matter and nitrogen accumulation on nitrogen utilization efficiency for grain was the largest during heading to mature stages, followed by sowing to jointing stages, with the contribution rate being 29.5% and 48.7%, 29.0% and 15.8%, respectively. In conclusion, barley genotype with high

ICG Utilities (Manitoba) Ltd. application for an order determining rate base, rate of return and rates based on a 1989 mid-year historic test year and confirmation of Board orders 1/90 and 2/90

Energy Technology Data Exchange (ETDEWEB)

1990-08-28

In the fall of 1989, ICG Utilities (Manitoba) Ltd. and Greater Winnipeg Gas Company (collectively referred to as the Company) applied to the Public Utilities Board for Interim Refundable Rate increases effective January 1, 1990. The Board was satisfied that the Company had proved a prima facie case for financial need and, accordingly, the Board approved rates on an interim basis to become effective on January 1, 1990. On March 1, 1990, the Company filed its General Rate Application with the Board on the basis of a 1989 mid-year historic test year with rates to be effective September 1, 1990. In the amended application, the Company sought the Board's approval to recover a total revenue deficiency of $17.0 million and earn an overall rate of return of 12.9%, which includes a requested return on shareholders' equity of 14%, an increase from 13% previously approved. The Company stated that absent confirmation of the interim rates and approval of increased rates effective September 1, 1990, the overall rate of return would be 8.2% which would yield a return on shareholders' equity of 2.27%. On an overall basis, the Board reduced the Company's requested increase in revenue requirement from 7.12% to 5.24%. Of the 5.24% increase allowed by the Board, 3.07% is currently being recovered through rates which took effect on January 1, 1990, and the remaining 2.17% increase is accommodated by this order. The Board also dealt with several other matters including the following: a change in the due date for bill payment; the Company's request for Board endorsement of a lock-off policy; the Company's capital expenditure program; the efficiencies in the Company's operations and capital program; and retroactive recovery of the revenue deficiency from January 1, 1990 to August 31,1990. 33 tabs.

Development of photopolymerizable clay nanocomposites utilizing reactive dispersants

Science.gov (United States)

Owusu-Adom, Kwame

Nanocomposites hold tremendous promise for expanding the utility of polymeric materials. However, accessing particulate sizes in the nanoscale domain continues to be a scientific challenge, especially in highly cross-linked photopolymerizable systems. In this study, photopolymerizable nanocomposites utilizing clay nanoparticles and reactive dispersants have been developed. The influence of particle size, dispersant-clay interactions, and surfactant concentration on photopolymerization behavior and nanoparticle dispersion has been elucidated. Clay particles serve as templates upon which surfactants aggregate during photopolymerization. This results in higher photopolymerization rates with addition of increasing concentrations of polymerizable surfactants. Furthermore, polymerizable surfactants induce faster photopolymerization rates compared to non-polymerizable analogues in systems that have ionically-bound dispersants on the particle surface. Utilizing reactive organoclays induces significant changes to the photopolymerization behavior depending on the choice of reactive functionality employed. Faster acrylate photopolymerization rates occur in photopolymer systems containing thiol-modified clays, while much slower rates occur for nonpolymerizable organoclay systems. In addition, chemical compatibility between monomer and clay dispersant (based on chemical similarity or polarity) allows enhancement of exfoliation in photopolymerizable formulations. With polymerizable dispersants, exfoliation is readily achieved in various multifunctional acrylate systems. The degree of exfoliation depends on the position of the reactive group relative to the surfactant's cationic site and the type of functionality. Thiolated organoclays exfoliate during polymerization, while methacrylated clays show substantially less dependence on polymerization behavior. Interestingly, changes in the physical properties of the resulting nanocomposite are independent of the degree of exfoliation

Fuel Class Higher Alcohols

KAUST Repository

Sarathy, Mani

2016-08-17

This chapter focuses on the production and combustion of alcohol fuels with four or more carbon atoms, which we classify as higher alcohols. It assesses the feasibility of utilizing various C4-C8 alcohols as fuels for internal combustion engines. Utilizing higher-molecular-weight alcohols as fuels requires careful analysis of their fuel properties. ASTM standards provide fuel property requirements for spark-ignition (SI) and compression-ignition (CI) engines such as the stability, lubricity, viscosity, and cold filter plugging point (CFPP) properties of blends of higher alcohols. Important combustion properties that are studied include laminar and turbulent flame speeds, flame blowout/extinction limits, ignition delay under various mixing conditions, and gas-phase and particulate emissions. The chapter focuses on the combustion of higher alcohols in reciprocating SI and CI engines and discusses higher alcohol performance in SI and CI engines. Finally, the chapter identifies the sources, production pathways, and technologies currently being pursued for production of some fuels, including n-butanol, iso-butanol, and n-octanol.

[Water utilization characteristics of the degraded poplar shelterbelts in Zhangbei, Hebei, China.

Science.gov (United States)

Zhang, Huan; Cao, Jun; Wang, Hua Bing; Song, Bo; Jia, Guo Dong; Liu, Zi Qiang; Yu, Xin Xiao; Zeng, Jia

2018-05-01

In Zhangbei County, Hebei Province, poplar-dominated shelterbelts are degraded to different extents. Water availability is the main limiting factor for plant survival in arid areas. The purpose of this study was to reveal the relationship between water availability and poplar degradation. Based on the hydrogen and oxygen stable isotope techniques, we explored the water sources of Populus simonii under different degradation degrees by comparing the isotopic values of P. simonii xylem water with that in potential water source, and calculated the utilization ratio of each water source. The results showed that the water sources of poplar trees varied with degradation degree. The water sources of P. simonii gradually transferred from the deep layer to the surface layer with the increases of degradation. P. simonii with no degradation mainly absorbed soil water in the range of 320-400 cm, with the utilization rate being 25.1%. P. simonii with slight degradation mainly used soil water at depth of 120-180, 180-240 and 240-320 cm. The total utilization rate of three layers was close to 50.0%, with less utilization of water from other layers. The moderately degraded P. simonii mainly used soil water at depth of 20-40, 40-60 and 60-80 cm. The utilization rate of each layer was 17.5%-20.9%, and the contribution rate of soil water under 120 cm was less than 10.0%. The severely degraded P. simonii mainly used water from surface soil layer (0-20 cm), with the utilization rate being 30.4%, which was significantly higher than that of other water sources. The water sources of poplar shelter forests were gradually shallower during the process of degradation. However, the low soil water content in the shallow layer could not meet the normal water demand of poplar, which would accelerate the degradation and even decline of poplar.

Resource utilization after introduction of a standardized clinical assessment and management plan.

Science.gov (United States)

Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

2010-01-01

A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

Analysis of heart rate variability and possibility of its utilization in psychology and psycho-physiology

Directory of Open Access Journals (Sweden)

Kovaleva A.V.

2013-03-01

Full Text Available Indices of heart rate variability are reliable and objective indicators of autonomic nervous systemtonus (of its sympathetic and parasympathetic divisions which in its turn reflect the changes in psycho-emotional state of a person, development of stress or any kind of tension. The purpose of this article was to describethe contemporary methods of objective study of a person’s functional state by the definition of autonomic regulation of heart rate and also the review of foreign studies which discuss the possibility of utilizing this method in psychology and psychophysiology. The review describes two approaches to the analysis of heart rate variability: temporal and frequency-response analyses. The indices used for temporal analysis include average duration of RR-intervalsand percentage of couples of RR-intervals, differing in more than 50ms(рNN50. The indices of frequency-response analysis included intensity of HF component, reflecting influences of parasympathetic outflow; intensity of LF component, reflecting sympathetic influences; intensity of VLF components; correlation of LF and HF waves, reflecting vegetal balance.

Utilization of multi-band OFDM modulation to increase traffic rate of phosphor-LED wireless VLC.

Science.gov (United States)

Yeh, Chien-Hung; Chen, Hsing-Yu; Chow, Chi-Wai; Liu, Yen-Liang

2015-01-26

To increase the traffic rate in phosphor-LED visible light communication (VLC), a multi-band orthogonal frequency division multiplexed (OFDM) modulation is first proposed and demonstrated. In the measurement, we do not utilize optical blue filter to increase modulation bandwidth of phosphor-LED in the VLC system. In this proposed scheme, different bands of OFDM signals are applied to different LED chips in a LED lamp, this can avoid the power fading and nonlinearity issue by applying the same OFDM signal to all the LED chips in a LED lamp. Here, the maximum increase percentages of traffic rates are 41.1%, 17.8% and 17.8% under received illuminations of 200, 500 and 1000 Lux, respectively, when the proposed three-band OFDM modulation is used in the VLC system. In addition, the analysis and verification by experiments are also performed.

Examination of roundwood utilization rates in West Virginia

Science.gov (United States)

Shawn T. Grushecky; Jan Wiedenbeck; Curt C. Hassler

2013-01-01

Forest harvesting is an integral part of the West Virginia forest economy. This component of the supply chain supports a diverse array of primary and secondary processors. A key metric used to describe the efficiency of the roundwood extraction process is the logging utilization factor (LUF). The LUF is one way managers can discern the overall use of harvested...

The Effects of Increased Accountability Standards on Graduation Rates for Students with Disabilities

Science.gov (United States)

Moore, Mitzi Lee

2012-01-01

This research sought to determine if unintended effects of increased accountability standards on graduation rates for students with disabilities existed. Data from one southeastern state were utilized in order to determine if graduation rates were impacted as a result of higher accountability standards. In addition, administrator attitudes on…

Used frying oils and fats and their utilization in the production of methyl esters of higher fatty acids

Energy Technology Data Exchange (ETDEWEB)

Cvengros, J. Jan; Cvengrosova, Zuzana [Slovak Univ. of Technology, Faculty of Chemical and Food Technology, Bratislava (Slovakia)

2004-08-01

From the point of view price and available capacity used frying oils or fats (UFO) represent an attractive raw material for the production of methyl esters (ME) of higher fatty acids as alternative fuels for diesel engines. If they are treated such that the required quality, with an acidity number up to 3.0 mg KOH/g and a water content up to 0.1 wt%, is achieved they can be processed to ME using standard techniques of alkali-catalysed transesterification with methanol which are utilized for production of the ME from new oils/fats. The problematic waste can thus be converted to an ecologically friendly fuel. Vacuum distillation of free fatty acids in a film evaporator is an effective method for simultaneously decreasing the content of FFA and water in UFO. Final distillation of raw ME in a film vacuum evaporator results in practically all parameters required by the standard, in the final ME being achieved. Undesirable low-temperature properties of ME derived from UFO, due to higher fraction of saturated acyls, can be adjusted by the addition of depressants-flow improvers for winterization. Some simplified methods for the quality control of UFO and ME are discussed. The conversion of acylglycerols to ME is monitored by GLC with a packed column, where the peak areas of ME in the sample before and after the reaction with an effective methylation agent are compared. The method for the determination of the water content in esters utilizes the reaction of calcium carbide with water, the volume of acetylene being measured. (Author)

(Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany.

Science.gov (United States)

Kietzmann, Diana; Knuth, Daniela; Schmidt, Silke

2017-01-01

This study was designed to explore the utilization and non-utilization of pre-hospital emergency care by migrants and non-migrants, and the factors that influence this behaviour. A cross-sectional representative German survey was conducted in a sample of 2.175 people, 295 of whom had a migration background. An additional sample of 50 people with Turkish migration background was conducted, partially in the Turkish language. Apart from socio-demographics, the utilization of emergency services and the reasons for non-utilization were assessed. Migrants had a higher utilization rate of pre-hospital emergency care (RR = 1.492) than non-migrants. Furthermore, migrants who were not born in Germany had a lower utilization rate (RR = 0.793) than migrants who were born in Germany. Regarding non-utilization, the most frequently stated reasons belonged to the categories initial misjudgment of the emergency situation and acting on one's own behalf, with the latter stated more frequently by migrants than by non-migrants. To prevent over-, under-, and lack of supply, it is necessary to transfer knowledge about the functioning of the medical emergency services, including first aid knowledge.

Energy economics: impacts on electric utilities' future decisions

International Nuclear Information System (INIS)

Smith, S.H.

1983-01-01

Despite financial and regulatory pressures that have led electric utilities to slow construction and minimize capital expenditures, Carolina Power and Light Company is proceeding with two new nuclear and two new coal facilities because it believes the commitment to expand must be made in the 1980s. The economic slowdown has given utilities a breathing period, but not enough to allow a complete stop in expansion if the utilities are to be ready for the expected economic growth of the 1990s. Financing this expansion is a slower process for regulated industries and leads to strained relations between customers and suppliers. The two can work together to promote conservation and load management, but higher rates must finance new construction to avoid a shortfall later. The costs of environmentally sound coal combustion and nuclear plant construction must both be reduced to help keep the recovery from being inflationary

Focus on vulnerable populations and promoting equity in health service utilization--an analysis of visitor characteristics and service utilization of the Chinese community health service.

Science.gov (United States)

Dong, Xiaoxin; Liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xu, Xing; Xie, Jun; Sun, Yi; Lu, Zuxun

2014-05-26

Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors. The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs. The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.

Knowledge, attitudes, practices, and barriers related to research utilization: a survey among pharmacists in Malaysia.

Science.gov (United States)

Tan, Sin Yee; Hatah, Ernieda

2017-04-01

Background Research utilization is part of evidence-based practice referring to the process of reviewing and critiquing scientific research and applying the findings to one's own clinical practice. Many studies on research utilization have been conducted with doctors and nurses, but to our knowledge, none have been investigated amongst pharmacists. Objective To assess research utilization and its barriers among pharmacists and identify potential influencing factors. Setting Malaysia. Methods This cross-sectional survey was administered online and by mail to a convenient sample of pharmacists working in hospitals, health clinics, and retail pharmacies in rural and urban areas. Main outcome measure Pharmacists' research utilization knowledge, attitudes, and practices. Results Six hundred surveys were mailed to potential respondents, and 466 were returned (77.7% response rate). Twenty-eight respondents completed the survey online. The respondents' research utilization knowledge, attitudes, and practices were found to be moderate. Research utilization was associated with respondents' knowledge and attitude scores (P < 0.001). When factors related to research utilization were modelled, higher educational level was associated with higher level of research utilization (P < 0.001) while less involvement in journal clubs, more years of service (3-7 years and more than 7 years) were associated with low and moderate research utilization, respectively. The main reported barrier to research utilization was lack of sufficient authority to change patient care procedures. Conclusion Pharmacists' research utilization knowledge, attitudes, and practices can be improved by encouraging pharmacists to pursue higher degrees, promoting active participation in institutions' journal clubs, and introducing senior clinical pharmacist specialization.

Comorbidity profile and healthcare utilization in elderly patients with serious mental illnesses.

Science.gov (United States)

Hendrie, Hugh C; Lindgren, Donald; Hay, Donald P; Lane, Kathleen A; Gao, Sujuan; Purnell, Christianna; Munger, Stephanie; Smith, Faye; Dickens, Jeanne; Boustani, Malaz A; Callahan, Christopher M

2013-12-01

Patients with serious mental illness are living longer. Yet, there remain few studies that focus on healthcare utilization and its relationship with comorbidities in these elderly mentally ill patients. Comparative study. Information on demographics, comorbidities, and healthcare utilization was taken from an electronic medical record system. Wishard Health Services senior care and community mental health clinics. Patients age 65 years and older-255 patients with serious mental illness (schizophrenia, major recurrent depression, and bipolar illness) attending a mental health clinic and a representative sample of 533 nondemented patients without serious mental illness attending primary care clinics. Patients having serious mental illness had significantly higher rates of medical emergency department visits (p = 0.0027) and significantly longer lengths of medical hospitalizations (p mentally ill group (p seriously mentally ill. The differences in healthcare utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population requiring an integrated model of healthcare. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Hydrogen utilization potential in subsurface sediments

Directory of Open Access Journals (Sweden)

Rishi Ram Adhikari

2016-01-01

Full Text Available Subsurface microbial communities undertake many terminal electron-accepting processes, often simultaneously. Using a tritium-based assay, we measured the potential hydrogen oxidation catalyzed by hydrogenase enzymes in several subsurface sedimentary environments (Lake Van, Barents Sea, Equatorial Pacific and Gulf of Mexico with different predominant electron-acceptors. Hydrogenases constitute a diverse family of enzymes expressed by microorganisms that utilize molecular hydrogen as a metabolic substrate, product or intermediate. The assay reveals the potential for utilizing molecular hydrogen and allows qualitative detection of microbial activity irrespective of the predominant electron-accepting process. Because the method only requires samples frozen immediately after recovery, the assay can be used for identifying microbial activity in subsurface ecosystems without the need to preserve live material.We measured potential hydrogen oxidation rates in all samples from multiple depths at several sites that collectively span a wide range of environmental conditions and biogeochemical zones. Potential activity normalized to total cell abundance ranges over five orders of magnitude and varies, dependent upon the predominant terminal electron acceptor. Lowest per-cell potential rates characterize the zone of nitrate reduction and highest per-cell potential rates occur in the methanogenic zone. Possible reasons for this relationship to predominant electron acceptor include (i increasing importance of fermentation in successively deeper biogeochemical zones and (ii adaptation of H2ases to successively higher concentrations of H2 in successively deeper zones.

Graduation Rates and the Higher Education Demographic Evolution

Science.gov (United States)

Hunsaker, B. Tom; Thomas, Douglas E.

2013-01-01

In his 1918 orienting work, The Higher Learning in America, Veblen highlights two primary aims of the higher education institution: (a) scientific and scholarly inquiry, and (b) the instruction of students (Veblen, 1918). As of 2006, this overarching mission remained intact. In contemporary literature, a common measure of the efficacy of the…

Comparison of higher order spectra in heart rate signals during two techniques of meditation: Chi and Kundalini meditation.

Science.gov (United States)

Goshvarpour, Ateke; Goshvarpour, Atefeh

2013-02-01

The human heartbeat is one of the important examples of complex physiologic fluctuations. For the first time in this study higher order spectra of heart rate signals during meditation have explored. Specifically, the aim of this study was to analysis and compares the contribution of quadratic phase coupling of human heart rate variability during two forms of meditation: (1) Chinese Chi (or Qigong) meditation and (2) Kundalini Yoga meditation. For this purpose, Bispectrum was estimated by using biased, parametric and the direct (FFT) method. The results show that the mean Bispectrum magnitude of heart rate signals increased during Kundalini Yoga meditation, but it decreased significantly during Chi meditation. However, in both meditation techniques phase-coupled harmonics are shifted to the higher frequencies during meditation. In addition, it has shown that not only there are significant differences between rest and meditation states, but also heart rate patterns appear to be influenced by different types of meditation.

Utilization and success rates of unstimulated in vitro fertilization in the United States: an analysis of the Society for Assisted Reproductive Technology database.

Science.gov (United States)

Gordon, John David; DiMattina, Michael; Reh, Andrea; Botes, Awie; Celia, Gerard; Payson, Mark

2013-08-01

To examine the utilization and outcomes of natural cycle (unstimulated) IVF as reported to the Society of Assisted Reproductive Technology (SART) in 2006 and 2007. Retrospective analysis. Dataset analysis from the SART Clinical Outcome Reporting System national database. All patients undergoing IVF as reported to SART in 2006 and 2007. None. Utilization of unstimulated IVF; description of patient demographics; and comparison of implantation and pregnancy rates between unstimulated and stimulated IVF cycles. During 2006 and 2007 a total of 795 unstimulated IVF cycles were initiated. Success rates were age dependent, with patients Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Higher dosage nicotine patches increase one-year smoking cessation rates : results from the European CEASE trial

NARCIS (Netherlands)

Tonnesen, P; Paoletti, P; Gustavsson, G; Russell, MA; Saracci, R; Gulsvik, A; Rijcken, B

The Collaborative European Anti-Smoking Evaluation (CEASE) was a European multicentre, randomized, double-blind placebo controlled smoking cessation study, The objectives were to determine whether higher dosage and longer duration of nicotine patch therapy would increase the success rate. Thirty-six

The utility target market model

International Nuclear Information System (INIS)

Leng, G.J.; Martin, J.

1994-01-01

A new model (the Utility Target Market Model) is used to evaluate the economic benefits of photovoltaic (PV) power systems located at the electrical utility customer site. These distributed PV demand-side generation systems can be evaluated in a similar manner to other demand-side management technologies. The energy and capacity values of an actual PV system located in the service area of the New England Electrical System (NEES) are the two utility benefits evaluated. The annual stream of energy and capacity benefits calculated for the utility are converted to the installed cost per watt that the utility should be willing to invest to receive this benefit stream. Different discount rates are used to show the sensitivity of the allowable installed cost of the PV systems to a utility's average cost of capital. Capturing both the energy and capacity benefits of these relatively environmentally friendly distributed generators, NEES should be willing to invest in this technology when the installed cost per watt declines to ca $2.40 using NEES' rated cost of capital (8.78%). If a social discount rate of 3% is used, installation should be considered when installed cost approaches $4.70/W. Since recent installations in the Sacramento Municipal Utility District have cost between $7-8/W, cost-effective utility applications of PV are close. 22 refs., 1 fig., 2 tabs

New system for higher recovery rate of water borne Cryptosporidium oocysts and Giardia cysts

DEFF Research Database (Denmark)

Al-Sabi, Mohammad Nafi Solaiman; Gad, Jens; Klinting, Mette

2012-01-01

Background: The two most common water borne pathogenic protozoa, Cryptosporidium and Giardia, cause diarrhea worldwide. Detecting these parasites in water samples depends on effective parasite recovery from the water matrix. The reported low recovery rates of the currently used filter methods...... motivate the development of systems with higher recovery rates. Materials and methods: Five replicates of IMS purified Cryptosporidium oocysts and Giardia cysts (N=2x103) were injected into a specially coated filter unit with a carefully chosen pore size. Following filtration, sonication was performed...... were 85% were recorded when the filter was sonicated. Sonication usually affects parasite viability but could be tuned into a useful tool for enhanced backwash collection of parasites using a specially constructed filter unit and a sonication protocol. The filtration...

A System-Wide Approach to Physician Efficiency and Utilization Rates for Non-Operating Room Anesthesia Sites.

Science.gov (United States)

Tsai, Mitchell H; Huynh, Tinh T; Breidenstein, Max W; O'Donnell, Stephen E; Ehrenfeld, Jesse M; Urman, Richard D

2017-07-01

There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients. Using the time stamps from WiseOR® (Palo Alto, CA), we calculated site utilization and physician efficiency for each day. We defined scheduling efficiency (SE) as the number of staffed anesthesiologists divided by the number of staffed sites and stratified the data into three categories (SE 1). The mean physician efficiency was 0.293 (95% CI, [0.281, 0.305]), and the mean site utilization was 0.328 (95% CI, [0.314, 0.343]). When days were stratified by scheduling efficiency (SE 1), we found differences between physician efficiency and site utilization. On days where scheduling efficiency was less than 1, that is, there are more sites than physicians, mean physician efficiency (95% CI, [0.326, 0.402]) was higher than mean site utilization (95% CI, [0.250, 0.296]). We demonstrate that scheduling efficiency vis-à-vis physician efficiency as an OR management metric diverge when anesthesiologists travel between NORA sites. When the opportunity to scale operational efficiencies is limited, increasing scheduling efficiency by incorporating different NORA sites into a "block" allocation on any given day may be the only suitable tactical alternative.

Evolutionary Adaptation of Kluyveromyces marxianus NIRE-K3 for Enhanced Xylose Utilization

International Nuclear Information System (INIS)

Sharma, Nilesh Kumar; Behera, Shuvashish; Arora, Richa; Kumar, Sachin

2017-01-01

The evolutionary adaptation was approached on the thermotolerant yeast Kluyveromyces marxianus NIRE-K3 at 45°C on xylose as a sole source of carbon for enhancement of xylose uptake. After 60 cycles, evolved strain K. marxianus NIRE-K3.1 showed comparatively 3.75- and 3.0-fold higher specific growth and xylose uptake rates, respectively, than that of native strain. Moreover, the short lag phase was also observed on adapted strain. During batch fermentation with xylose concentration of 30 g l −1 , K. marxianus NIRE-K3.1 could utilize about 96% of xylose in 72 h and produced 4.67 and 15.7 g l −1 of ethanol and xylitol, respectively, which were 9.72- and 4.63-fold higher than that of native strain. Similarly, specific sugar consumption rate, xylitol, and ethanol yields were 5.07-, 1.15-, and 2.44-fold higher as compared to the native strain, respectively. The results obtained after evolutionary adaptation of K. marxianus NIRE-K3 show the significant improvement in the xylose utilization, ethanol and xylitol yields, and productivities. By understanding the results obtained, the significance of evolutionary adaptation has been rationalized, since the adapted culture could be more stable and could enhance the productivity.

Evolutionary Adaptation of Kluyveromyces marxianus NIRE-K3 for Enhanced Xylose Utilization

Energy Technology Data Exchange (ETDEWEB)

Sharma, Nilesh Kumar [Biochemical Conversion Division, Sardar Swaran Singh National Institute of Bio-Energy, Kapurthala (India); I. K. Gujral Punjab Technical University, Kapurthala (India); Behera, Shuvashish; Arora, Richa; Kumar, Sachin, E-mail: sachin.biotech@gmail.com [Biochemical Conversion Division, Sardar Swaran Singh National Institute of Bio-Energy, Kapurthala (India)

2017-12-12

The evolutionary adaptation was approached on the thermotolerant yeast Kluyveromyces marxianus NIRE-K3 at 45°C on xylose as a sole source of carbon for enhancement of xylose uptake. After 60 cycles, evolved strain K. marxianus NIRE-K3.1 showed comparatively 3.75- and 3.0-fold higher specific growth and xylose uptake rates, respectively, than that of native strain. Moreover, the short lag phase was also observed on adapted strain. During batch fermentation with xylose concentration of 30 g l{sup −1}, K. marxianus NIRE-K3.1 could utilize about 96% of xylose in 72 h and produced 4.67 and 15.7 g l{sup −1} of ethanol and xylitol, respectively, which were 9.72- and 4.63-fold higher than that of native strain. Similarly, specific sugar consumption rate, xylitol, and ethanol yields were 5.07-, 1.15-, and 2.44-fold higher as compared to the native strain, respectively. The results obtained after evolutionary adaptation of K. marxianus NIRE-K3 show the significant improvement in the xylose utilization, ethanol and xylitol yields, and productivities. By understanding the results obtained, the significance of evolutionary adaptation has been rationalized, since the adapted culture could be more stable and could enhance the productivity.

Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection.

Science.gov (United States)

Shea, Katherine M; Hobbs, Athena L V; Jaso, Theresa C; Bissett, Jack D; Cruz, Christopher M; Douglass, Elizabeth T; Garey, Kevin W

2017-06-01

Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States despite their association with adverse consequences, including Clostridium difficile infection (CDI). We sought to evaluate the impact of a health care system antimicrobial stewardship-initiated respiratory fluoroquinolone restriction program on utilization, appropriateness of quinolone-based therapy based on institutional guidelines, and CDI rates. After implementation, respiratory fluoroquinolone utilization decreased from a monthly mean and standard deviation (SD) of 41.0 (SD = 4.4) days of therapy (DOT) per 1,000 patient days (PD) preintervention to 21.5 (SD = 6.4) DOT/1,000 PD and 4.8 (SD = 3.6) DOT/1,000 PD posteducation and postrestriction, respectively. Using segmented regression analysis, both education (14.5 DOT/1,000 PD per month decrease; P = 0.023) and restriction (24.5 DOT/1,000 PD per month decrease; P cost of moxifloxacin, the formulary respiratory fluoroquinolone, was observed postrestriction compared to preintervention within the health care system ($123,882 versus $12,273; P = 0.002). Implementation of a stewardship-initiated respiratory fluoroquinolone restriction program can increase appropriate use while reducing overall utilization, acquisition cost, and CDI rates within a health care system. Copyright © 2017 American Society for Microbiology.

Why the EU-15 Maintains Higher CIT Rates than the New Member States?

Directory of Open Access Journals (Sweden)

Karpowicz Andrzej

2014-11-01

Full Text Available The European Union is not a homogenous area. This lack of homogeneity extends to taxes, which vary across jurisdictions. On average, Western Europe imposes significantly higher taxes on capital than New Member States, which joined the Community in 2004 and 2007. Often this fact is simply taken for granted. However, there are several arguments that can explain this variance. Although several of these arguments are well known and have been researched, they have not been assessed in combination, or used in a comparative analysis of corporate income tax (CIT rates between EU member states. Because of interest in harmonizing CIT throughout the EU, the roots of divergent CIT is of particular and timely value. Therefore, this article we attempts to demonstrate the differences in CIT rates in the EU-15 and New Member States. In so doing the general characteristics of these country grouping is identified, and then discussed in the context of the taxation theory.

Rabies Vaccination: Higher Failure Rates in Imported Dogs than in those Vaccinated in Italy.

Science.gov (United States)

Rota Nodari, E; Alonso, S; Mancin, M; De Nardi, M; Hudson-Cooke, S; Veggiato, C; Cattoli, G; De Benedictis, P

2017-03-01

The current European Union (EU) legislation decrees that pets entering the EU from a rabies-infected third country have to obtain a satisfactory virus-neutralizing antibody level, while those moving within the EU require only rabies vaccination as the risk of moving a rabid pet within the EU is considered negligible. A number of factors driving individual variations in dog vaccine response have been previously reported, including a high rate of vaccine failure in puppies, especially those subject to commercial transport. A total of 21 001 observations collected from dogs (2006-2012) vaccinated in compliance with the current EU regulations were statistically analysed to assess the effect of different risk factors related to rabies vaccine efficacy. Within this framework, we were able to compare the vaccination failure rate in a group of dogs entering the Italian border from EU and non-EU countries to those vaccinated in Italy prior to international travel. Our analysis identified that cross-breeds and two breed categories showed high vaccine success rates, while Beagles and Boxers were the least likely to show a successful response to vaccination (88.82% and 90.32%, respectively). Our analysis revealed diverse performances among the commercially available vaccines, in terms of serological peak windows, and marked differences according to geographical area. Of note, we found a higher vaccine failure rate in imported dogs (13.15%) than in those vaccinated in Italy (5.89%). Our findings suggest that the choice of vaccine may influence the likelihood of an animal achieving a protective serological level and that time from vaccination to sampling should be considered when interpreting serological results. A higher vaccine failure in imported compared to Italian dogs highlights the key role that border controls still have in assessing the full compliance of pet movements with EU legislation to minimize the risk of rabies being reintroduced into a disease-free area. �

Utilization of a Sobering Center for Acute Alcohol Intoxication.

Science.gov (United States)

Smith-Bernardin, Shannon; Carrico, Adam; Max, Wendy; Chapman, Susan

2017-09-01

The objective was to describe the population utilizing a sobering center for public alcohol intoxication and compare between single-visit users, repeat users, and high users. We conducted a secondary analysis of 1,271 adults cared for in a sobering center from July 2014 to June 2015. We divided the population into three groups-single use (one visit), repeat users (two to five visits), and high (six or more) users-and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs. The population was primarily male, middle-aged, and ethnically diverse. Compared to single-visit users (n = 869), repeat (n = 287) and high users (n = 115) were older, were more likely to be currently homeless, and had spent more time homeless. Repeat and high users had significantly higher rates of hypertension, liver disease, diabetes, depression, psychoses, and drug abuse diagnoses compared to single-visit users. In addition to sobering visits, utilization of ambulance and ED and related costs were significantly greater for the high users compared to repeat and single-visit users. From an overall heterogeneous population, more frequent utilizers of the sobering center, both high and repeat users compared to low users, had significantly greater prevalence of chronic disorders, service utilization, and homelessness. Findings indicate that a sobering center can have a prominent role in the care for those with acute alcohol intoxication, particularly those individuals with chronic public intoxication who are likewise homeless. Further longitudinal research could offer important insights as to the population served over time, investigating changes in utilization and efforts toward health and housing stabilization. © 2017 by the Society for Academic Emergency Medicine.

Youth and young adults with spina bifida: their utilization of physician and hospital services.

Science.gov (United States)

Young, Nancy L; Anselmo, Lianne A; Burke, Tricia A; McCormick, Anna; Mukherjee, Shubhra

2014-03-01

To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population. We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes. Participants were identified from 6 publicly funded children's treatment centers. Health records from youth (n=164; age range, 13.0-17.9y) and adults (n=120; age range, 23.0-32.9y) with SB contributed to this study. Not applicable. The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a "medical home" was also calculated. The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, respectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population. It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Predicting SF-6D utility scores from the Oswestry disability index and numeric rating scales for back and leg pain.

Science.gov (United States)

Carreon, Leah Y; Glassman, Steven D; McDonough, Christine M; Rampersaud, Raja; Berven, Sigurd; Shainline, Michael

2009-09-01

Cross-sectional cohort. The purpose of this study is to provide a model to allow estimation of utility from the Short Form (SF)-6D using data from the Oswestry Disability Index (ODI), Back Pain Numeric Rating Scale (BPNRS), and the Leg Pain Numeric Rating Scale (LPNRS). Cost-utility analysis provides important information about the relative value of interventions and requires a measure of utility not often available from clinical trial data. The ODI and numeric rating scales for back (BPNRS) and leg pain (LPNRS), are widely used disease-specific measures for health-related quality of life in patients with lumbar degenerative disorders. The purpose of this study is to provide a model to allow estimation of utility from the SF-6D using data from the ODI, BPNRS, and the LPNRS. SF-36, ODI, BPNRS, and LPNRS were prospectively collected before surgery, at 12 and 24 months after surgery in 2640 patients undergoing lumbar fusion for degenerative disorders. Spearman correlation coefficients for paired observations from multiple time points between ODI, BPNRS, and LPNRS, and SF-6D utility scores were determined. Regression modeling was done to compute the SF-6D score from the ODI, BPNRS, and LPNRS. Using a separate, independent dataset of 2174 patients in which actual SF-6D and ODI scores were available, the SF-6D was estimated for each subject and compared to their actual SF-6D. In the development sample, the mean age was 52.5 +/- 15 years and 34% were male. In the validation sample, the mean age was 52.9 +/- 14.2 years and 44% were male. Correlations between the SF-6D and the ODI, BPNRS, and LPNRS were statistically significant (P < 0.0001) with correlation coefficients of 0.82, 0.78, and 0.72, respectively. The regression equation using ODI, BPNRS,and LPNRS to predict SF-6D had an R of 0.69 and a root mean square error of 0.076. The model using ODI alone had an R of 0.67 and a root mean square error of 0.078. The correlation coefficient between the observed and estimated

Evaluating the underlying factors behind variable rate debt.

Science.gov (United States)

McCue, Michael J; Kim, Tae Hyun Tanny

2007-01-01

Recent trends show a greater usage of variable rate debt among health care bond issues. In 2004, 63.4% of the total health care bonds issued were variable rate compared with 30.6% in 1995 (Fitch Ratings, 2005). The purpose of this study is to gain a better understanding of the underlying factors, credit spread, issue characteristics, and issuer factors behind why hospitals and health system borrowers select variable rate debt compared with fixed rate debt. From 2000 to 2004, this study sampled 230 newly issued tax-exempt bonds issued by acute care hospitals and health care systems that included both variable and fixed rate debt issues. Using a logistic regression model, hospitals with variable rate debt issues were assigned a value of 1, whereas hospitals with fixed rate debt issues were assigned a value of 0. This study found a positive association between bond insurance and variable rate debt and a negative association between callable feature and variable rate debt. Facilities located in certificate-of-need states that possessed higher case mix acuity, earned higher profit margins, generated higher debt service coverage, and held less debt were more likely to issue variable rate debt. Overall, hospital managers and board members of hospitals possessing a strong financial performance have an interest in utilizing variable rate debt to lower their cost of capital. In addition, this outcome may also reflect that investment bankers are doing a better job in educating senior hospital management about the interest rate savings benefit of variable rate compared with fixed rate debt.

Demand-side management pricing options in electric utilities

International Nuclear Information System (INIS)

Sardana, P.; Herman, P.

1990-01-01

In 1989 Ontario Hydro implemented optional time-of-use (TOU) rates at the wholesale level for all municipal utilities in the province. At the same time, mandatory TOU rates were implemented for large users (customers with loads in excess of 5 MW) served by municipal utilities and Ontario Hydro's direct customers. To fully explore the potential of rate structures as demand-side management (DSM) tools, Ontario Hydro retained a consulting firm to carry out a survey of innovative rate structures in other jurisdications. The survey was intended to identify: the status quo of rate structures in other jurisdictions that were designed specifically to encourage DSM; a profile of the cost basis of the rate structures, for example whether traditional embedded cost of service analyses or contentious methods such as marginal cost pricing were used; whether innovative rates have been successful, and customer reactions and attitudes; and how innovative rates fit into the overall strategy of the utilities. It was found that TOU, interruptible and end-use targeted rates are the rate structures of choice for many utilities. Most are concerned with deferring capacity, reducing peak demand, and shifting load out of peak periods. Most utilities report success with their programs and satisfaction with the present form of the programs. 5 tabs

Cost-Utility Analysis of a Cardiac Telerehabilitation Program

DEFF Research Database (Denmark)

Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper

2016-01-01

Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR...... was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than (sic)400,000 per QALY gained. Conclusions: Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself...

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Science.gov (United States)

2010-04-01

... (of the type affected by the energy conservation measure) after implementation of the energy...) Utility benchmarking. HUD will pursue benchmarking utility consumption at the project level as part of the... convene a meeting with representation of appropriate stakeholders to review utility benchmarking options...

Higher order constraints on the Higgs production rate from fixed-target DIS data

International Nuclear Information System (INIS)

Alekhin, S.; Bluemlein, J.; Moch, S.

2011-01-01

The constraints of fixed-target DIS data in fits of parton distributions including QCD corrections to next-to-next-to leading order are studied. We point out a potential problem in the analysis of the NMC data which can lead to inconsistencies in the extracted value for α s (M Z ) and the gluon distribution at higher orders in QCD. The implications for predictions of rates for Standard Model Higgs boson production at hadron colliders are investigated. We conclude that the current range of excluded Higgs boson masses at the Tevatron appears to be much too large. (orig.)

Impact of residential PV adoption on Retail Electricity Rates

International Nuclear Information System (INIS)

Cai, Desmond W.H.; Adlakha, Sachin; Low, Steven H.; De Martini, Paul; Mani Chandy, K.

2013-01-01

The price of electricity supplied from home rooftop photo voltaic (PV) solar cells has fallen below the retail price of grid electricity in some areas. A number of residential households have an economic incentive to install rooftop PV systems and reduce their purchases of electricity from the grid. A significant portion of the costs incurred by utility companies are fixed costs which must be recovered even as consumption falls. Electricity rates must increase in order for utility companies to recover fixed costs from shrinking sales bases. Increasing rates will, in turn, result in even more economic incentives for customers to adopt rooftop PV. In this paper, we model this feedback between PV adoption and electricity rates and study its impact on future PV penetration and net-metering costs. We find that the most important parameter that determines whether this feedback has an effect is the fraction of customers who adopt PV in any year based solely on the money saved by doing so in that year, independent of the uncertainties of future years. These uncertainties include possible changes in rate structures such as the introduction of connection charges, the possibility of PV prices dropping significantly in the future, possible changes in tax incentives, and confidence in the reliability and maintainability of PV. -- Highlights: •Households who install PV reduce their electricity consumption from the grid. •Electricity rates must increase for utility companies to recover its fixed costs. •However, higher electricity rates give households more incentives to adopt PV. •We find that this feedback has significant impact on PV uptake only in later years. •Utility companies could lose a significant fraction of high consumption customers

Invasive acacias experience higher ant seed removal rates at the invasion edges

Directory of Open Access Journals (Sweden)

D. Montesinos

2012-06-01

Full Text Available Seed dispersal is a key process for the invasion of new areas by exotic species. Introduced plants often take advantage of native generalist dispersers. Australian acacias are primarily dispersed by ants in their native range and produce seeds bearing a protein and lipid rich reward for ant mutualists (elaiosome. Nevertheless, the role of myrmecochory in the expansion of Australian acacias in European invaded areas is still not clear. We selected one European population of Acacia dealbata and another of A. longifolia and offered elaiosome-bearing and elaiosome-removed seeds to local ant communities. For each species, seeds were offered both in high-density acacia stands and in low-density invasion edges. For both acacia species, seed removal was significantly higher at the low-density edges. For A. longifolia, manual elimination of elaiosomes reduced the chance of seed removal by 80% in the low-density edges, whereas it made no difference on the high-density stands. For A. dealbata, the absence of elaiosome reduced seed removal rate by 52%, independently of the acacia density. Our data suggests that invasive acacias have found effective ant seed dispersers in Europe and that the importance of such dispersers is higher at the invasion edges.

Effect of selective and nonselective beta-blockers on resting energy production rate and total body substrate utilization in chronic heart failure.

Science.gov (United States)

Podbregar, Matej; Voga, Gorazd

2002-12-01

In chronic heart failure (CHF) beta-blockers reduce myocardial oxygen consumption and improve myocardial efficiency by shifting myocardial substrate utilization from increased free fatty acid oxidation to increased glucose oxidation. The effect of selective and nonselective beta-blockers on total body resting energy production rate (EPR) and substrate utilization is not known. Twenty-six noncachectic patients with moderately severe heart failure (New York Heart Association class II or III, left ventricular ejection fraction < 0.40) were treated with carvedilol (37.5 +/- 13.5 mg/12 h) or bisoprolol (5.4 +/- 3.0 mg/d) for 6 months. Indirect calorimetry was performed before and after 6 months of treatment. Resting EPR was decreased in carvedilol (5.021 +/- 0.803 to 4.552 +/- 0.615 kJ/min, P <.001) and bisoprolol group (5.230 +/- 0.828 to 4.978 +/- 0.640 kJ/min, P <.05; nonsignificant difference between groups). Lipid oxidation rate decreased in carvedilol and remained unchanged in bisoprolol group (2.4 +/- 1.4 to 1.5 +/- 0.9 mg m(2)/kg min versus 2.7 +/- 1.1 to 2.5 +/- 1.1 mg m(2)/kg min, P <.05). Glucose oxidation rate was increased only in carvedilol (2.6 +/- 1.4 to 4.4 +/- 1.6 mg m(2)/kg min, P <.05), but did not change in bisoprolol group. Both selective and nonselective beta-blockers reduce total body resting EPR in noncachectic CHF patients. Carvedilol compared to bisoprolol shifts total body substrate utilization from lipid to glucose oxidation.

The rate of cerebral utilization of glucose, ketone bodies, and oxygen: a comparative in vivo study of infant and adult rats.

Science.gov (United States)

Dahlquist, G; Persson, B

1976-11-01

Cerebral blood flow (CBF) was measured by means of Celabeled microspheres in infant (20-day-old) and adult (3-month-old) rats, anesthetised with Na-5-ethyl-5-(1-methylpropyl)2-thiobarbituric acid. Cerebral arteriovenous differences of acetoacetate, D-beta-hydroxybutyrate, glucose, lactate, and oxygen and brain DNA content were determined in other groups of similarly treated infant and adult animals fed or starved for 48 or 72 hr. The mean CBF values of 0.48+/-0.04 and 0.62+/-0.07 ml/(g X min), +/- SEM, in infant and adult animals, respectively, were not significantly different. CBF was unaffected by starvation. At any given arterial concentration the cerebral arteriovenous difference of acetoacetate was significantly higher in infant than adult rats. The same was true for D-beta-hydroxybutyrate at arterial concentrations above 1 mmol/liter. There was an approximately linear relationship between arterial concentration of acetoacetate and its cerebral arteriovenous difference in both infant and adult rats. A similar relationship was found for D-beta-hydroxybutyrate only in infant animals. In the fed state, the cerebral uptake of glucose and ketone bodies (micromoles per (mg DNA X min)) was not different in infant and adult rats. During starvation, cerebral uptake of ketone bodies expressed as micromoles per (mg DNA X min) was higher in infant than adult rats, indicating a higher rate of utilization of ketone bodies per cell in these animals. For glucose, no such difference was found in either fed or starved groups (Table 3). The average percentage of the total cerebral uptake of substrates (micromoles per min) accounted for by ketone bodies increased in both infant and adult rats during starvation. This percentage value was clearly higher in infant than adult rats during starvation. After 72 hr of starvation the values were 38.8% and 15.2% in infant and adult rats, respectively (Fig. 3). Calculated cerebral metabolic rate for oxygen (CMRO2), assuming complete

Conversion rate of para-hydrogen to ortho-hydrogen by oxygen: implications for PHIP gas storage and utilization.

Science.gov (United States)

Wagner, Shawn

2014-06-01

To determine the storability of para-hydrogen before reestablishment of the room temperature thermal equilibrium mixture. Para-hydrogen was produced at near 100% purity and mixed with different oxygen quantities to determine the rate of conversion to the thermal equilibrium mixture of 75: 25% (ortho: para) by detecting the ortho-hydrogen (1)H nuclear magnetic resonance using a 9.4 T imager. The para-hydrogen to ortho-hydrogen velocity constant, k, near room temperature (292 K) was determined to be 8.27 ± 1.30 L/mol · min(-1). This value was calculated utilizing four different oxygen fractions. Para-hydrogen conversion to ortho-hydrogen by oxygen can be minimized for long term storage with judicious removal of oxygen contamination. Prior calculated velocity rates were confirmed demonstrating a dependence on only the oxygen concentration.

The effect of the rate and method of nitrogen application on nitrogen uptake and utilization by broccoli (Brassica oleracea var. italica)

NARCIS (Netherlands)

Everaarts, A.P.; Willigen, de P.

1999-01-01

The effect of the rate and method of nitrogen application on nitrogen uptake and utilization by broccoli (Brassica oleracea var. italica) was studied in four field experiments. The methods of application were broadcast application vs band placement and split application. Maximum uptake of nitrogen

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

Science.gov (United States)

Bronkhorst, Babette

2017-08-01

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

Effect of Lactobacillus sporogenes on survival, growth, biochemical constituents and energy utilization of freshwater prawn Macrobrachium rosenbergii post larvae

Directory of Open Access Journals (Sweden)

C. Seenivasan

2014-03-01

Full Text Available The present study was conducted to investigate the optimization of probiotic, Lactobacillus sporogenes on survival, growth, biochemical constituents and energy utilization of the freshwater prawn Macrobrachium rosenbergii post larvae (PL. Experimental diets were the same in all, except for the variation in probiotic levels. The probiotic L. sporogenes was used at 0%, 1%, 2%, 3% and 4% inclusion in the experimental diets. These diets were fed to M. rosenbergii PL for a period of 90 days. The food index parameters, such as SR, WG, SGR, FCE and PER were significantly (P < 0.05 higher in 4% L. sporogenes incorporated diet fed PL, whereas the FCR was significantly (P < 0.05 lower in 4% L. sporogenes incorporated diet fed PL. This indicates the fact that this feed produced higher growth rate than that of other experimental diets. Similarly the proximate composition of the total protein, total free amino acid, total carbohydrate, and total lipid content was significantly (P < 0.05 higher in 4% L. sporogenes incorporated diet fed PL. However, insignificant differences were recorded in ash and moisture contents between control and experimental groups. Energy utilization parameters, such as feeding rate, absorption rate, conversion rate and excretory rate were significantly (P < 0.05 higher in 4% L. sporogenes incorporated diet fed PL. Statistically insignificant differences were recorded in metabolic rate between control and experimental groups. This indicates that there were no differences in energy loss between control and experimental groups. However, L. sporogenes incorporated diet fed PL produced better growth performance.

Evaluation of higher distribution and/or utilization voltages. Final report

Energy Technology Data Exchange (ETDEWEB)

Hazelrigg, Jr, George A.

1981-01-01

An electric energy distribution/utilization system cost analysis model is presented for exploring cost tradeoffs (capital innvestment, operation and maintenance and cost of losses) and optimizing system configuration. The model focuses on the treatment of residential and light commercial service areas with time-varying load characteristics, including customer load profile changes, per customer load growth and service area population growth. Applications of the model are discussed. These include providing insight on: the selection of primary and secondary voltages; conductor sizing; distribution transformer sizing, change out policies and copper-to-core-loss ratio; and limits on allowable voltage variation at the service entrance. Examples are provided to illustrate model capabilities.

Utilization of the emergency room: impact of geographic distance

Directory of Open Access Journals (Sweden)

Jae Eun Lee

2007-05-01

Full Text Available The aim of this study was to estimate the distance Mississippi patients must travel to access hospital-based emergency rooms (ERs and to determine whether an association exists between geographic distance and ER utilization. To that end, great circle distances between Census Block Group Centroid Points and 89 hospitals with emergency departments were calculated for the State of Mississippi. Data on the socio-demographic characteristics of each block group came from the 2000 US Census data. Logistic regression analyses were conducted to test if there was any association between ER utilization and travel distance. Compared to the national benchmark of 35.7%, more than one in two (56.7%, or 1,612,762 Mississippians visited ERs in 2003 with an estimated 6.1 miles per person annual travel for this purpose. The majority of the target population (54.9% was found to live within 5 miles of hospitals with ERs. Logistic analyses revealed that block groups associated with less miles traveled to hospitals with ERs had a higher proportion of African Americans, impoverished people, female householders, people with more than 12 years education, people older than 65 years, people with high median house values, and people without employment. Twenty-nine of the 89 hospitals (33% providing ER care in Mississippi were found to be in areas with above-average ER utilization rates. These hospitals served a smaller geographical area (28% of the total but had a greater proportion of visitors (57% and served a higher percentage (37% of the state population. People in areas served by the less utilized ERs traveled more miles to be cared for (7.1 miles vs 5.4 miles; p<0.0001. Logistic regression analysis revealed that shorter distances were associated with increased use of the ERs, even after controlling for socio-demographic factors. The conclusion is that Mississippi ERs are typically located in block groups with higher percentages of disadvantaged residents and that

Comparison of nitrate accumulation, nitrogen uptake and utilization efficiency among different spinach (Spinacia oleracea L. genotypes

Directory of Open Access Journals (Sweden)

Zhou Jianjian

2017-10-01

Full Text Available A hydroponic experiment was conducted to study the difference of nitrate accumulation,nitrogen uptake and utilization efficiency between four spinach (Spinacia oleracea L. genotypes (So10,So13,So18 and So57. Results showed that So13 had the highest nitrate contents under two nitrate (NO3--N level (0.5 mmol·L-1,15 mmol·L-1 conditions,whereas So10 had the lowest nitrate contents. So18 had the similar nitrate contents with So13 under low NO3- level,while it showed no significant difference of nitrate contents with So57 under high NO3- treatment. The 15NO3--N uptake rates of So13 were the highest one among four genotypes,while the N utilization efficiency (NutE and N utilization ratio (NUR of So13 were significantly lower than those of So18 and So57. The shoot dry mass,nitrate reductase activity,NutE,NUR of So18 and So57 were higher than those of So13 and So10,while their 15NO3--N uptake rates were lower than those of So13. The shoot dry mass,nitrate reductase activity,NutE,N utilization ratio of So10 were significantly lower than those of So18 and So57,and its 15NO3--N uptake rate was significantly lower than those of So13. Among the four spinach genotypes,the So57 can be selected as elite germplasm using for spinach production for its relatively lower nitrate content and higher N efficiency.

Burden of emergency conditions and emergency care utilization: New estimates from 40 countries

Science.gov (United States)

Chang, Cindy Y.; Abujaber, Samer; Reynolds, Teri A.; Camargo, Carlos A.; Obermeyer, Ziad

2016-01-01

Objective To estimate the global and national burden of emergency conditions, and compare them to emergency care utilization rates. Methods We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care utilization rates were obtained from a systematic literature review on emergency care facilities in low- and middle-income countries (LMICs), supplemented by national health system reports. Findings All 15 leading causes of death and DALYs globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency utilization. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47,728 per 100,000 population (IQR 45,253-50,085) in low-income, 25,186 (IQR 21,982-40,480) in middle-income, and 15,691 (IQR 14,649-16,382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency utilization rates were the lowest in low-income countries, with median 8 visits per 1,000 population (IQR 6-10), 78 (IQR 25-197) in middle-income, and 264 (IQR 177-341) in high-income countries. Conclusion Despite higher burden of emergency conditions, emergency utilization rates are substantially lower in LMICs, likely due to limited access to emergency care. PMID:27334758

ESTIMATING RETURN RATE OF HIGHER EDUCATION FUND IN RUSSIA

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Semenikhina V. A.

2014-06-01

Full Text Available Currently, the Russian government pays great attention to the field of higher and postgraduate education. But in the Russian scientific literature there are gaps related to the effectiveness of the overall evaluation of the higher education sector. The article dwells upon the problem of interregional income spread of the Russian population. Empirical estimator of difference influence accounting for human capital accumulated in Russian regions on wage levels and maximum increase of total wage levels and population income for 2001-2011 is carried out. Higher education, exceeding the influence of accumulated volume of the main funds, has a great influence on income spread in Russian regions. Besides, increase of higher education fund in Russian regions contributes to the population’s wage increase and growth in income, but at the same time it decreases legal wages. Results of the study extend knowledge of the economics of education of the Russian Federation.

Does adding metformin to clomifene citrate lead to higher pregnancy rates in a subset of women with polycystic ovary syndrome?

OpenAIRE

Moll, E.; Korevaar, J.C.; Bossuyt, P.M.M.; van der Veen, F.

2008-01-01

BACKGROUND An RCT among newly diagnosed, therapy naive women with polycystic ovary syndrome (PCOS) showed no significant differences in ovulation rate, ongoing pregnancy rate or spontaneous abortion rate in favour of clomifene citrate plus metformin compared with clomifene citrate. We wanted to assess whether there are specific subgroups of women with PCOS in whom clomifene citrate plus metformin leads to higher pregnancy rates. METHODS Subgroup analysis based on clinical and biochemical para...

The Incremental Utility of Behavioral Rating Scales and a Structured Diagnostic Interview in the Assessment of Attention-Deficit/Hyperactivity Disorder

Science.gov (United States)

Vaughn, Aaron J.; Hoza, Betsy

2013-01-01

The current study examined the incremental utility of rating scales, a structured diagnostic interview, and multiple informants in a comprehensive assessment of attention-deficit/hyperactivity disorder (ADHD). The sample included 185 children with ADHD (M[subscript age] = 9.22, SD = 0.95) and 82 children without ADHD (M[subscript age] = 9.24, SD =…

Impact of power purchases from non-utilities on the utility cost of capital

International Nuclear Information System (INIS)

Kahn, E.; Stoft, S.; Belden, T.

1995-01-01

The bond rating agencies in the USA have asserted that long-term power purchase contracts between non-utility generators and utilities are the equivalent of debt to the utilities, and therefore raise the cost of capital to the purchaser. Non-Utility generators claim that these contracts reduce risk to the utilities. This debate is reflected in the 1992 Energy Policy Act. This paper investigates this controversy from the perspective of the equity markets. Using a CAPM framework, various specifications of the cost of equity capital are estimated, to shed light on this question. No evidence is found for the hypothesis that non-utility generation contracts raise the cost of capital. There does appear to be a slight increase in this cost for those utilities seeking to build their own generation capacity as opposed to purchasing it from non-utility suppliers. (author)

The Active Management of Risk in Multiparous Pregnancy at Term: association between a higher preventive labor induction rate and improved birth outcomes

Science.gov (United States)

Nicholson, James M.; Caughey, Aaron; Stenson, Ms. Morghan H.; Cronholm, Peter; Kellar, Lisa; Bennett, Ian; Margo, Katie; Stratton, Joseph

2009-01-01

Objective To determine if exposure of multiparous women to a high rate of preventive labor induction was associated with a significantly lower cesarean delivery rate. Study Design Retrospective cohort study involving 123 multiparas, who were exposed to the frequent use of preventive labor induction, and 304 multiparas, who received standard management. Rates of cesarean delivery and other adverse birth outcomes were compared in the two groups. Logistic regression controlled for confounding covariates. Results The exposed group had a lower cesarean delivery rate (aOR 0.09, 0.8% vs. 9.9%, p = 0.02) and a higher uncomplicated vaginal delivery rate (OR 0.53, 78.9% vs. 66.4%, p=0.01). Exposure was not associated with higher rates of other adverse birth outcomes. Conclusion Exposure of multiparas to a high rate of preventive labor induction was significantly associated with improved birth outcomes including a very low cesarean delivery rate. A prospective randomized trial is needed to determine causality. PMID:19254584

Cometabolic degradation of ethyl mercaptan by phenol-utilizing Ralstonia eutropha in suspended growth and gas-recycling trickle-bed reactor.

Science.gov (United States)

Sedighi, Mahsa; Zamir, Seyed Morteza; Vahabzadeh, Farzaneh

2016-01-01

The degradability of ethyl mercaptan (EM), by phenol-utilizing cells of Ralstonia eutropha, in both suspended and immobilized culture systems, was investigated in the present study. Free-cells experiments conducted at EM concentrations ranging from 1.25 to 14.42 mg/l, showed almost complete removal of EM at concentrations below 10.08 mg/l, which is much higher than the maximum biodegradable EM concentration obtained in experiments that did not utilize phenol as the primary substrate, i.e. 2.5 mg/l. The first-order kinetic rate constant (kSKS) for EM biodegradation by the phenol-utilizing cells (1.7 l/g biomass/h) was about 10 times higher than by cells without phenol utilization. Immobilized-cells experiments performed in a gas recycling trickle-bed reactor packed with kissiris particles at EM concentrations ranging from 1.6 to 36.9 mg/l, showed complete removal at all tested concentrations in a much shorter time, compared with free cells. The first-order kinetic rate constant (rmaxKs) for EM utilization was 0.04 l/h for the immobilized system compared to 0.06 for the suspended-growth culture, due to external mass transfer diffusion. Diffusion limitation was decreased by increasing the recycling-liquid flow rate from 25 to 65 ml/min. The removed EM was almost completely mineralized according to TOC and sulfate measurements. Shut down and starvation experiments revealed that the reactor could effectively handle the starving conditions and was reliable for full-scale application. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Compound Detection System Based on Ultrasonic Flow Rate and Concentration

Directory of Open Access Journals (Sweden)

Qing-Hui WANG

2014-02-01

Full Text Available This paper proposes a new detection system for monitoring gas concentration and flow rate. Velocity difference of ultrasonic wave in bi-directional propagation in measured gas is recorded and utilized for computing the online gas concentration and flow rate. Meanwhile, the temperature compensation, return signal processing and error analysis algorithms are applied to improve the accuracy. The experimental results show that, compared with the single sensor measurement of gas flow rate or concentration, the proposed detection system with lower cost and higher accuracy can be applied in the occasion which needs simultaneous monitoring of gas concentration and flow rate.

[Ophthalmologic healthcare utilization of people in need of long-term care : Analyses of health insurance data of the AOK Baden-Württemberg].

Science.gov (United States)

Schuster, Alexander K; Pick, Julia; Saalmann, Frauke; Pfeiffer, Norbert

2018-04-10

Eye diseases causing visual impairment increase with age. Thus, seeking eye care has a higher probability in older people. In this study, the rate of utilization of outpatient eye care services in Germany was analyzed. The analyses focused on older persons and persons in need of either home-based or facility-based long-term care. A descriptive secondary data analysis of health insurance data of the AOK Baden-Württemberg from 2016 was conducted. The study population comprised all insured persons on 1 January 2016. The cohort of older persons (60 years+) was further stratified by the type of care (home-based/facility-based) and the level of care (0-3). The utilization of outpatient eye care services was defined by the reimbursement for an ophthalmologist's provision of service. While 39.3% of the study population 60+ years old sought eye care, the utilization rate was lower among people in need of home-based (33.0%) and facility-based care (19.3%). The utilization rates showed comparable age-dependent patterns, except for persons in need of facility-based care where rates were similar for all age groups. Utilization rates were negatively associated with increasing care levels. Only people with care level 0 showed lower utilization rates than people with care level 1. Utilization rates of eye healthcare services among older persons are considerably influenced by the need of long-term care, by the form of care as well as by the level of care.

Higher Rates of DZ Twinning in a Twenty-First Century Birth Cohort.

Science.gov (United States)

Rhea, Sally Ann; Corley, Robin P; Heath, Andrew C; Iacono, William G; Neale, Michael C; Hewitt, John K

2017-09-01

The Colorado Twin Registry is a population based registry initiated in 1984 with the involvement of the Colorado Department of Health, Division of Vital Statistics. Recruitment includes birth cohorts several years prior to 1984 and all subsequent years. As part of a recent evaluation of Colorado birth records for the years 2006 through 2008 we became aware of a shifting trend in the proportion of MZ and DZ twins in the Colorado population. Historically (Bulmer 1970 The biology of twinning in man, Clarendon, Oxford) we have expected a 1/3, 1/3, 1/3 ratio of MZ, same-sex DZ and opposite sex DZ twins in Caucasian populations. An excess of MZ pairs in most studies was assumed to be due to selection bias. Somewhat more recently, Hur et al.(1995 Behav Genet 25, 337-340) provided evidence that the DZ twinning rate was falling and that therefore selection bias was not the reason for higher MZ enrollment in most twin studies. They suggested that twin researchers might consider strategies to over-enroll DZ pairs to maximize statistical power. In contrast, we now find that of the 3217 twin births in Colorado from 2006 to 2008 with identified sex information the MZ rate is estimated at only 22%, and we have corroborating reports from other states of similar estimates. These were calculated applying Weinberg's rule which assumes an equal birth rate for same sex and opposite sex DZ pairs so that the proportion of MZ in a sample is the proportion of same sex (MM + FF) minus the proportion of opposite-sex (MF, FM). We explore factors, such as an increase in the proportion of non-Caucasian parents and an increase in average maternal age, which may contribute to this shift.

Utilization of Plutonium and Higher Actinides in the HTGR as Possibility to Maintain Long-Term Operation on One Fuel Loading

International Nuclear Information System (INIS)

Tsvetkova, Galina V.; Peddicord, Kenneth L.

2002-01-01

Promising existing nuclear reactor concepts together with new ideas are being discussed worldwide. Many new studies are underway in order to identify prototypes that will be analyzed and developed further as systems for Generation IV. The focus is on designs demonstrating full inherent safety, competitive economics and proliferation resistance. The work discussed here is centered on a modularized small-size High Temperature Gas-cooled Reactor (HTGR) concept. This paper discusses the possibility of maintaining long-term operation on one fuel loading through utilization of plutonium and higher actinides in the small-size pebble-bed reactor (PBR). Acknowledging the well-known flexibility of the PBR design with respect to fuel composition, the principal limitations of the long-term burning of plutonium and higher actinides are considered. The technological challenges and further research are outlined. The results allow the identification of physical features of the PBR that significantly influence flexibility of the design and its applications. (authors)

A Comparison of Internet Marketing Methods Utilized by Higher Education Institutions

Science.gov (United States)

McCoy, Joseph C.

2011-01-01

Use of Internet marketing techniques in higher education to attract prospective students is relatively new. While the research is recent, there are several studies that identify what is most valuable to students seeking information on college web sites. Higher education is now facing increasing competition from for-profit schools and reduced…

Evaluation of Resource Utilization and Treatment Patterns in Patients with Actinic Keratosis in the United States.

Science.gov (United States)

Asche, Carl V; Zografos, Panagiotis; Norlin, Jenny M; Urbanek, Bill; Mamay, Carl; Makin, Charles; Erntoft, Sandra; Chen, Chi-Chang; Hines, Dionne M; Mark Siegel, Daniel

2016-01-01

To compare health care resource utilization and treatment patterns between patients with actinic keratosis (AK) treated with ingenol mebutate gel (IngMeb) and those treated with other field-directed AK therapies. A retrospective, propensity-score-matched, cohort study compared refill/repeat and adding-on/switching patterns and outpatient visits and prescriptions (health care resource utilization) over 6 months in patients receiving IngMeb versus those receiving imiquimod, 5-fluorouracil, diclofenac sodium, and methyl aminolevulinate or aminolevulinic acid photodynamic therapy (MAL/ALA-PDT). The final sample analyzed included four matched treatment cohort pairs (IngMeb and comparator; n = 790-971 per treatment arm). Refill rates were similar except for imiquimod (15% vs. 9% for imiquimod and IngMeb, respectively; P < 0.05). MAL/ALA-PDT treatment repetition rates were higher than IngMeb refill rates (20% vs. 10%; P < 0.05). Topical agent add-on/switch rates were comparable. PDT had higher switch rates than did IngMeb (5% vs. 2%; P < 0.05). The IngMeb cohort had a significantly lower proportion of patients with at least one AK-related outpatient visit during the 6-month follow-up than did any other cohort: versus imiquimod (50% vs. 66%; P < 0.0001), versus 5-fluorouracil (50% vs. 69%; P < 0.0001), versus diclofenac sodium (51% vs. 56%; P = 0.034), and versus MAL/ALA-PDT (50% vs. 100%; P < 0.0001). There were significantly fewer AK-related prescriptions among patients receiving IngMeb than among patients in other cohorts. Results based on the first 6 months after treatment initiation suggested that most field-directed AK therapies had clinically comparable treatment patterns except imiquimod, which was associated with higher refill rates, and PDT, which was associated with significantly more frequent treatment sessions and higher switching rates. IngMeb was also associated with significantly fewer outpatient visits than were other field-directed therapies. Copyright �

Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample.

Science.gov (United States)

Allen, Junior Lloyd; Mowbray, Orion

2016-04-01

Gay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. Using data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. Findings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. These findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Individual discount rates and smoking: evidence from a field experiment in Denmark.

Science.gov (United States)

Harrison, Glenn W; Lau, Morten I; Rutström, E Elisabet

2010-09-01

We elicit measures of individual discount rates from a representative sample of the Danish population and test two substantive hypotheses. The first hypothesis is that smokers have higher individual discount rates than non-smokers. The second hypothesis is that smokers are more likely to have time inconsistent preferences than non-smokers, where time inconsistency is indicated by a hyperbolic discounting function. We control for the concavity of the utility function in our estimates of individual discount rates and find that male smokers have significantly higher discount rates than male non-smokers. However, smoking has no significant association with discount rates among women. This result is robust across exponential and hyperbolic discounting functions. We consider the sensitivity of our conclusions to a statistical specification that allows each observation to potentially be generated by more than one latent data-generating process. Copyright 2010 Elsevier B.V. All rights reserved.

Discovery of temporal and disease association patterns in condition-specific hospital utilization rates.

Directory of Open Access Journals (Sweden)

Julian S Haimovich

Full Text Available Identifying temporal variation in hospitalization rates may provide insights about disease patterns and thereby inform research, policy, and clinical care. However, the majority of medical conditions have not been studied for their potential seasonal variation. The objective of this study was to apply a data-driven approach to characterize temporal variation in condition-specific hospitalizations. Using a dataset of 34 million inpatient discharges gathered from hospitals in New York State from 2008-2011, we grouped all discharges into 263 clinical conditions based on the principal discharge diagnosis using Clinical Classification Software in order to mitigate the limitation that administrative claims data reflect clinical conditions to varying specificity. After applying Seasonal-Trend Decomposition by LOESS, we estimated the periodicity of the seasonal component using spectral analysis and applied harmonic regression to calculate the amplitude and phase of the condition's seasonal utilization pattern. We also introduced four new indices of temporal variation: mean oscillation width, seasonal coefficient, trend coefficient, and linearity of the trend. Finally, K-means clustering was used to group conditions across these four indices to identify common temporal variation patterns. Of all 263 clinical conditions considered, 164 demonstrated statistically significant seasonality. Notably, we identified conditions for which seasonal variation has not been previously described such as ovarian cancer, tuberculosis, and schizophrenia. Clustering analysis yielded three distinct groups of conditions based on multiple measures of seasonal variation. Our study was limited to New York State and results may not directly apply to other regions with distinct climates and health burden. A substantial proportion of medical conditions, larger than previously described, exhibit seasonal variation in hospital utilization. Moreover, the application of clustering

Changes in alanine turnover rate due to nutritional and genetic obesity in the rat.

Science.gov (United States)

Yebras, M; Salvadó, J; Arola, L; Remesar, X; Segués, T

1994-08-01

The changes in alanine turnover were determined in Zucker rats, which were either genetically obese (fa/fa) or rendered obese by dietary treatment (cafeteria fed). The whole body rate of alanine turnover was higher in genetically obese rats than in rats in which obesity was induced by diet (cafeteria). This is possibly due to variations in the rate of the amino acid incorporation into proteins, since the rate of whole body alanine degradation is the same for both groups. Thus, the different pattern followed by alanine turnover rate in these types of obese animals reflects the differences in the nitrogen economy of these animals, pointing to a higher alanine utilization in the genetically obese animals and a conservative management of alanine in the cafeteria-fed animals.

Regulator preferences and utility prices: evidence from natural gas distribution utilities

International Nuclear Information System (INIS)

Klein, C.C.; Sweeney, G.H.

1999-01-01

We investigate the determinants of regulators' relative weighting of the social welfare of customer groups and utilities using panel data on natural gas distribution utilities in the US state of Tennessee. In contrast to previous empirical work on cross-sections of electric utilities, our results are statistically robust and consistent with the interest group theory of regulation. Intervention in rate cases, settlement vs. litigation of cases, and prices of alternative energy sources, as well as the size characteristics of customer groups and the firm, are significant determinants of the elasticity-weighted price-cost margin (Ramsey number) for each group. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

Toxicity and utilization of chemical weapons: does toxicity and venom utilization contribute to the formation of species communities?

Science.gov (United States)

Westermann, Fabian L; McPherson, Iain S; Jones, Tappey H; Milicich, Lesley; Lester, Philip J

2015-08-01

Toxicity and the utilization of venom are essential features in the ecology of many animal species and have been hypothesized to be important factors contributing to the assembly of communities through competitive interactions. Ants of the genus Monomorium utilize a variety of venom compositions, which have been reported to give them a competitive advantage. Here, we investigate two pairs of Monomorium species, which differ in the structural compositions of their venom and their co-occurrence patterns with the invasive Argentine ant. We looked at the effects of Monomorium venom toxicity, venom utilization, and aggressive physical interactions on Monomorium and Argentine ant survival rates during arena trials. The venom toxicity of the two species co-occurring with the invasive Argentine ants was found to be significantly higher than the toxicity of the two species which do not. There was no correlation between venom toxicity and Monomorium survival; however, three of the four Monomorium species displayed significant variability in their venom usage which was associated with the number of Argentine ant workers encountered during trials. Average Monomorium mortality varied significantly between species, and in Monomorium smithii and Monomorium antipodum, aggressive interactions with Argentine ants had a significant negative effect on their mortality. Our study demonstrates that different factors and strategies can contribute to the ability of a species to withstand the pressure of a dominant invader at high abundance, and venom chemistry appears to be only one of several strategies utilized.

MEA [Municipal Electric Association] declares opposition to 1991 Ontario Hydro rate increase

International Nuclear Information System (INIS)

Anon.

1991-01-01

In hearings before the Ontario Energy Board, the Municipal Electric Association (MEA) called for an average 1992 rate increase of 10.3%, lower than Ontario Hydro's revised figure of 10.4%, and a $129 million reduction in its operations, maintenance and administration budget. As it has been noted that Hydro pays considerably higher wages than the surrounding reference community, MEA recommended that the utility reduce and eventually eliminate the premium paid to employees, and also called for staff reductions and layoffs for 1991 and 1992. In the area of transmission reliability, MEA stated that Ontario Hydro's transmission maintenance is suffering at the expense of other priorities, and called for reorganizing its transmission plan to achieve target performance by 1996 rather than 1999. In 1991, only 65-70% of maintenance targets were being achieved. MEA also accused Hydro of deferring operational expenditures into deferment and capitalization, creating a false picture of the utility's financial condition. Also discussed at the hearing were the possible overestimating of the effects of Ontario Hydro's demand management programs, the possibility that a shift to time-of-use rates for industrial customers may increase demand, a downgrading of the province's and the utility's credit rating, and the unpleasant side effects of the non-utility generation program

Potential for increased wind-generated electricity utilization using heat pumps in urban areas

International Nuclear Information System (INIS)

Waite, Michael; Modi, Vijay

2014-01-01

Highlights: • Large-scale wind power and increased electric heat pumps were evaluated. • A deterministic model of wind power and electricity demand was developed. • Sub-models for space heating and domestic hot water demand were developed. • Increased use of heat pumps can improve the viability of large-scale wind power. • Larger wind power capacity can meet a target utilization rate with more heat pumps. - Abstract: The U.S. has substantial wind power potential, but given wind’s intermittent availability and misalignment with electricity demand profiles, large-scale deployment of wind turbines could result in high electricity costs due to energy storage requirements or low utilization rates. While fuel switching and heat pumps have been proposed as greenhouse gas (GHG) emissions and energy reduction strategies at the building scale, this paper shows that heat pump adoption could have additional system-wide benefits by increasing the utilization of wind-generated electricity. A model was developed to evaluate the effects of coupling large-scale wind power installations in New York State with increased use of electric heat pumps to meet a portion of space heating and domestic hot water (DHW) demands in New York City. The analysis showed significant increases in wind-generated electricity utilization with increased use of heat pumps, allowing for higher installed capacity of wind power. One scenario indicates that 78.5% annual wind-generated electricity utilization can be achieved with 3 GW of installed wind power capacity generated electricity equal to 20% of existing NYC annual electricity demand; if 20% of space heating and DHW demands are provided by heat pumps, the 78.5% utilization rate can be achieved with an increase of total wind power capacity to 5 GW. Therefore, this integrated supply–demand approach could provide additional system-wide emissions reductions

Fuel Class Higher Alcohols

KAUST Repository

Sarathy, Mani

2016-01-01

This chapter focuses on the production and combustion of alcohol fuels with four or more carbon atoms, which we classify as higher alcohols. It assesses the feasibility of utilizing various C4-C8 alcohols as fuels for internal combustion engines

Life cycle assessment of various cropping systems utilized for producing biofuels: Bioethanol and biodiesel

International Nuclear Information System (INIS)

Kim, Seungdo; Dale, Bruce E.

2005-01-01

A life cycle assessment of different cropping systems emphasizing corn and soybean production was performed, assuming that biomass from the cropping systems is utilized for producing biofuels (i.e., ethanol and biodiesel). The functional unit is defined as 1 ha of arable land producing biomass for biofuels to compare the environmental performance of the different cropping systems. The external functions are allocated by introducing alternative product systems (the system expansion allocation approach). Nonrenewable energy consumption, global warming impact, acidification and eutrophication are considered as potential environmental impacts and estimated by characterization factors given by the United States Environmental Protection Agency (EPA-TRACI). The benefits of corn stover removal are (1) lower nitrogen related environmental burdens from the soil, (2) higher ethanol production rate per unit arable land, and (3) energy recovery from lignin-rich fermentation residues, while the disadvantages of corn stover removal are a lower accumulation rate of soil organic carbon and higher fuel consumption in harvesting corn stover. Planting winter cover crops can compensate for some disadvantages (i.e., soil organic carbon levels and soil erosion) of removing corn stover. Cover crops also permit more corn stover to be harvested. Thus, utilization of corn stover and winter cover crops can improve the eco-efficiency of the cropping systems. When biomass from the cropping systems is utilized for biofuel production, all the cropping systems studied here offer environmental benefits in terms of nonrenewable energy consumption and global warming impact. Therefore utilizing biomass for biofuels would save nonrenewable energy, and reduce greenhouse gases. However, unless additional measures such as planting cover crops were taken, utilization of biomass for biofuels would also tend to increase acidification and eutrophication, primarily because large nitrogen (and phosphorus

Optional time-of-use prices for electricity: Analysis of PG&E`s experimental TOU rates. Final report

Energy Technology Data Exchange (ETDEWEB)

Train, K.; Mehrez, G.

1992-07-01

We examine customers` time-of-use (TOU) demand for electricity and their choice between standard and TOU rate schedules. We specify an econometric model in which the customer`s demand curves determine the customer`s choice of rate schedule. We estimate the model on data from Pacific Gas & Electric Company`s experiment with optional TOU prices in the residential sector. With the model, we compare the TOU consumption and price elasticities of customers who chose TOU rates with those who chose standard rates. We also estimate the impact of the TOU rates on the utility`s revenues and costs. The analysis suggests that the TOU rates offered under PG&E`s experiment decreased PG&E`s profits and hence contributed to higher general rate levels. The model can be used, however, to design optional TOU rates that increase profits and lower general rate levels.

Health care utilization

DEFF Research Database (Denmark)

Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

Utility impact on STARFIRE design

International Nuclear Information System (INIS)

DeFreece, D.A.; Waganer, L.M.; Woklenhauer, W.C.

1981-01-01

A primary objective of STARFIRE has been to design a tokamak fusion power plant that was attractive to the utilities. To achieve this goal, several utility representatives were directly involved in the decision-making processes as the design evolved. An initial step was to establish the relative importance to the utilities for an extensive list of economic, performance, safety and environmental issues. The top twenty issues were ranked. Cost of electricity was clearly most important with very little spread in the ratings of individual evaluators. Licensing is a go/no-go factor and must be accomplished for the other factors to have meaning. The top nine factors were judged to be very important by all evaluators, as was shown by the spread of ratings from 5 to 10. There is considerably more spread in the bottom eleven, which reflects a lack of consensus as to the relative importance of the evaluation factors. This evaluation was utilized in establishing the initial design concept

All-fiber Raman Probe using Higher Order Modes

DEFF Research Database (Denmark)

Larsen, Stine Højer Møller; Rishøj, Lars Søgaard; Rottwitt, Karsten

2013-01-01

We demonstrate the first all-fiber Raman probe utilizing higher order modes for the excitation. The spectrum of cyclohexane is measured using both the fundamental mode as well as in-fiber-generated Bessel-like modes.......We demonstrate the first all-fiber Raman probe utilizing higher order modes for the excitation. The spectrum of cyclohexane is measured using both the fundamental mode as well as in-fiber-generated Bessel-like modes....

Consumer's Guide to the economics of electric-utility ratemaking

Energy Technology Data Exchange (ETDEWEB)

1980-05-01

This guide deals primarily with the economics of electric utilities, although certain legal and organizational aspects of utilities are discussed. Each of the seven chapters addresses a particular facet of public-utility ratemaking. Chapter One contains a discussion of the evolution of the public-utility concept, as well as the legal and economic justification for public utilities. The second chapter sets forth an analytical economic model which provides the basis for the next four chapters. These chapters contain a detailed examination of total operating costs, the rate base, the rate of return, and the rate structure. The final chapter discusses a number of current issues regarding electric utilities, mainly factors related to fuel-adjustment costs, advertising, taxes, construction work in progress, and lifeline rates. Some of the examples used in the Guide are from particular states, such as Illinois and California. These examples are used to illustrate specific points. Consumers in other states can generalize them to their states and not change the meaning or significance of the points. 27 references, 8 tables.

How often do sensitivity analyses for economic parameters change cost-utility analysis conclusions?

Science.gov (United States)

Schackman, Bruce R; Gold, Heather Taffet; Stone, Patricia W; Neumann, Peter J

2004-01-01

There is limited evidence about the extent to which sensitivity analysis has been used in the cost-effectiveness literature. Sensitivity analyses for health-related QOL (HR-QOL), cost and discount rate economic parameters are of particular interest because they measure the effects of methodological and estimation uncertainties. To investigate the use of sensitivity analyses in the pharmaceutical cost-utility literature in order to test whether a change in economic parameters could result in a different conclusion regarding the cost effectiveness of the intervention analysed. Cost-utility analyses of pharmaceuticals identified in a prior comprehensive audit (70 articles) were reviewed and further audited. For each base case for which sensitivity analyses were reported (n = 122), up to two sensitivity analyses for HR-QOL (n = 133), cost (n = 99), and discount rate (n = 128) were examined. Article mentions of thresholds for acceptable cost-utility ratios were recorded (total 36). Cost-utility ratios were denominated in US dollars for the year reported in each of the original articles in order to determine whether a different conclusion would have been indicated at the time the article was published. Quality ratings from the original audit for articles where sensitivity analysis results crossed the cost-utility ratio threshold above the base-case result were compared with those that did not. The most frequently mentioned cost-utility thresholds were $US20,000/QALY, $US50,000/QALY, and $US100,000/QALY. The proportions of sensitivity analyses reporting quantitative results that crossed the threshold above the base-case results (or where the sensitivity analysis result was dominated) were 31% for HR-QOL sensitivity analyses, 20% for cost-sensitivity analyses, and 15% for discount-rate sensitivity analyses. Almost half of the discount-rate sensitivity analyses did not report quantitative results. Articles that reported sensitivity analyses where results crossed the cost-utility

Utility franchises reconsidered

Energy Technology Data Exchange (ETDEWEB)

Weidner, B.

1981-11-01

It is easier to obtain a public utility franchise than one for a fast food store because companies like Burger King value the profit share and control available with a franchise arrangement. The investor-owned utilities (IOUs) in Chicago and elsewhere gets little financial or regulatory benefit, although they do have an alternative because the franchise can be taken over by the city with a one-year notice. As IOUs evolved, the annual franchise fee has been incorporated into the rate in a move that taxes ratepayers and maximizes profits. Cities that found franchising unsatisfactory are looking for ways to terminate the franchise and finance a takeover, but limited-term and indeterminate franchises may offer a better mechanism when public needs and utility aims diverge. A directory lists franchised utilities by state and comments on their legal status. (DCK)

Effect of additives for higher removal rate in lithium niobate chemical mechanical planarization

International Nuclear Information System (INIS)

Jeong, Sukhoon; Lee, Hyunseop; Cho, Hanchul; Lee, Sangjik; Kim, Hyoungjae; Kim, Sungryul; Park, Jaehong; Jeong, Haedo

2010-01-01

High roughness and a greater number of defects were created by lithium niobate (LN; LiNbO 3 ) processes such as traditional grinding and mechanical polishing (MP), should be decreased for manufacturing LN device. Therefore, an alternative process for gaining defect-free and smooth surface is needed. Chemical mechanical planarization (CMP) is suitable method in the LN process because it uses a combination approach consisting of chemical and mechanical effects. First of all, we investigated the LN CMP process using commercial slurry by changing various process conditions such as down pressure and relative velocity. However, the LN CMP process time using commercial slurry was long to gain a smooth surface because of lower material removal rate (MRR). So, to improve the material removal rate (MRR), the effects of additives such as oxidizer (hydrogen peroxide; H 2 O 2 ) and complexing agent (citric acid; C 6 H 8 O 7 ) in a potassium hydroxide (KOH) based slurry, were investigated. The manufactured slurry consisting of H 2 O 2 -citric acid in the KOH based slurry shows that the MRR of the H 2 O 2 at 2 wt% and the citric acid at 0.06 M was higher than the MRR for other conditions.

Heroin and cocaine abusers have higher discount rates for delayed rewards than alcoholics or non-drug-using controls.

Science.gov (United States)

Kirby, Kris N; Petry, Nancy M

2004-04-01

To test a prediction of the discounting model of impulsiveness that discount rates would be positively associated with addiction. The delay-discount rate refers to the rate of reduction in the present value of a future reward as the delay to that reward increases. We estimated participants' discount rates on the basis of their pattern of choices between smaller immediate rewards ($11-80) and larger, delayed rewards ($25-85; at delays from 1 week to 6 months) in a questionnaire format. Participants had a one-in-six chance of winning a reward that they chose on one randomly selected trial. Heroin (n = 27), cocaine (n = 41) and alcohol (n = 33) abusers and non-drug-using controls (n = 44) were recruited from advertisements. They were tested in a drug abuse research clinic at a medical school. On average, the cocaine and heroin groups had higher rates than controls (both P rates for heroin abusers (P = 0.03), but not for cocaine or alcohol abusers (both P > 0.50). These data suggest that discount rates vary with the preferred drug of abuse, and that high discount rates should be considered in the development of substance abuse prevention and treatment efforts.

Mental Health Service Utilization Among Lesbian, Gay, Bisexual, and Questioning or Queer College Students.

Science.gov (United States)

Dunbar, Michael S; Sontag-Padilla, Lisa; Ramchand, Rajeev; Seelam, Rachana; Stein, Bradley D

2017-09-01

College students are at high risk for mental health problems, yet many do not receive treatment even when services are available. Treatment needs may be even higher among sexual minority students, but little is known about how these students differ from heterosexual peers in terms of mental health needs and service utilization. A total of 33,220 California college students completed an online survey on mental health needs (e.g., current serious psychological distress and mental health-related academic impairment) and service utilization. Using logistic regressions, we examined differences in student characteristics, mental health service use, and perceived barriers to using on-campus services by sexual minority status. Approximately 7% of students self-identified as sexual minorities. Compared with heterosexual students, sexual minority students endorsed higher rates of psychological distress (18% vs. 26%, p mental health-related academic impairment (11% vs. 17%, p mental health services. Sexual minority students were also more likely to report using off-campus services and to endorse barriers to on-campus service use (e.g., embarrassed to use services and uncertainty over eligibility for services). Sexual minority individuals represent a sizeable minority of college students; these students use mental health services at higher rates than heterosexual peers but have high rates of unmet treatment need. Efforts to address commonly reported barriers to on-campus service use, foster sexual minority-affirmative campus environments, and promote awareness of campus services may help reduce unmet treatment need in this population. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Hospital utilization, costs and mortality rates during the first 5 years of life: a population study of ART and non-ART singletons.

Science.gov (United States)

Chambers, G M; Lee, E; Hoang, V P; Hansen, M; Bower, C; Sullivan, E A

2014-03-01

Do singletons conceived following assisted reproduction technologies (ARTs) have significantly different hospital utilization, and therefore costs, compared with non-ART children during the first 5 years of life? ART singletons have longer hospital birth-admissions and a small increased risk of re-admission during the first 5 years of life resulting in higher costs of hospital care. ART singletons are at greater risk of adverse perinatal outcomes compared with non-ART singletons. Long-term physical and mental health outcomes of ART singletons are generally reassuring. There is a scarcity of information on health service utilization and the health economic impact of ART conceived children. A population cohort study using linked birth, hospital and death records. Perinatal outcomes, hospital utilization and costs, and mortality rates were compared for non-ART and ART singletons to 5 years. Adjustments were made for maternal age, parity, sex, birth year, socioeconomic status and funding source. Australian Diagnosis Related Groups cost-weights were used to derive costs. All costs are reported in 2009/2010 Australian dollars. All babies born in Western Australia between 1994 and 2003 were included; 224 425 non-ART singletons and 2199 ART conceived singletons. Hospital admission and death records in Western Australia linked to 2008 were used. Overall, ART singletons had a significantly longer length of stay during the birth-admission (mean difference 1.8 days, P birth-admission ($1473). The independent residual cost associated with ART conception was $342 during the birth-admission and an additional $548 up to 5 years of age, indicating that being conceived as an ART child predicts not only higher birth-admission costs but excess costs to at least 5 years of age. This study could not investigate the impact of different ART practices and techniques on perinatal outcomes or hospital utilization, nor could it adjust for parental characteristics such as cause of infertility

Disease Patterns and Socioeconomic Status Associated with Utilization of Computed Tomography in Taiwan, 1997–2003

Directory of Open Access Journals (Sweden)

Pei-Tseng Kung

2008-02-01

Conclusion: Neoplasm, diseases of the circulatory system, congenital malformations, and poor socioeconomic status were significantly associated with a higher rate of CT utilization. The distribution of disease patterns varied with gender, age groups, salary levels, and health care region's household income levels. Further study is needed to better understand the nature of the findings.

Higher Growth Rate of Branch Duct Intraductal Papillary Mucinous Neoplasms Associates With Worrisome Features.

Science.gov (United States)

Kolb, Jennifer M; Argiriadi, Pamela; Lee, Karen; Liu, Xiaoyu; Bagiella, Emilia; Lucas, Aimee L; Kim, Michelle Kang; Kumta, Nikhil A; Nagula, Satish; Sarpel, Umut; DiMaio, Christopher J

2018-03-11

or invasive cancers. BD-IPMNs that developed worrisome features were associated with a significantly higher rate of growth than lesions with low-risk features. Low risk BD-IPMNs that grow more than 2.5 mm/year might require surveillance. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Privatization of municipal electrical utilities

International Nuclear Information System (INIS)

Carr, J.

1998-01-01

The challenges and special issues which arise through the sale of a municipal electric utility were discussed. The recent sales of two utilities, the Kentville Electric Commission in Nova Scotia and Cornwall Electric in Ontario, were used as examples to show how the sale of an electric utility differs from the sale of most business enterprises. Municipal utilities are integral parts of the communities they serve which introduces several complexities into the sale. Factors that require special attention in the sale of the utilities, including electricity rates, local accountability, treatment of employees and local economic development, and the need for a comprehensive communication program to deal with the substantial public interest that sale of a municipal utility will engender, were reviewed

The healthcare utilization and cost of treating patients experiencing inappropriate implantable cardioverter defibrillator shocks: a propensity score study.

Science.gov (United States)

Bhavnani, Sanjeev P; Giedrimiene, Dalia; Coleman, Craig I; Guertin, Danette; Azeem, Meena; Kluger, Jeffrey

2014-10-01

Inappropriate shocks (IASs) from implantable cardioverter defibrillators (ICDs) are associated with decreased quality of life, but whether they increase healthcare utilization and treatment costs is unknown. We sought to determine the impact of IASs on subsequent healthcare utilization and treatment costs. We conducted a case-control analysis of ICD patients at a single institution from 1997 to 2010 and who had ≥12 months of post-ICD implant follow-up. Cases included all patients experiencing an IAS during the first 12 months after implantation. Eligible control patients did not receive a shock of any kind during the 12 months after implantation. Propensity scores based on 36 covariates (area under curve = 0.78) were used to match cases to controls. We compared the rate (occurrences/person year [PY]) of healthcare utilization immediately following IAS to the end of the 12-month follow-up period to the rate in the no-shock group over 12 months of follow-up. We also compared 12-month postimplant treatment (outpatient clinic, emergency room, and hospitalization) costs in both groups. A total of 76 patients experiencing ≥1 IAS during the first 12 months after implant (contributing 48 PYs) were matched to 76 no-shock patients (contributing 76 PYs). Cardiovascular (CV)-related clinic visit and hospitalization rates were increased following an IAS compared to those not receiving a shock (4.0 vs 3.3 and 0.7 vs 0.5, respectively, P = 0.02 for both). CV-related emergency room visitation (0.15 vs 0.08) rates were also numerically higher following an IAS, but did not reach statistical significance (P = 0.26). Patients experiencing an IAS accrued greater treatment costs during the 12 months postimplant compared to no-shock patients ($13,973 ± $46,345 vs $6,790 ± $19,091, P = 0.001). Recipients of IAS utilize the healthcare system more frequently following an IAS than patients not experiencing a shock. This increased utilization results in higher costs of treating IAS

78 FR 73821 - Publication of Depreciation Rates

Science.gov (United States)

2013-12-09

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Publication of Depreciation Rates AGENCY: Rural Utilities Service. ACTION: Notice of Depreciation Rates for Telecommunications Plant. SUMMARY: The United... programs, including the Telecommunications Program. RUS announces the depreciation rates for...

Student Ratings of Instruction in Turkish Higher Education

Directory of Open Access Journals (Sweden)

Nehir Sert

2013-05-01

Full Text Available The end-of-term student evaluations have a twofold purpose: to provide information for administrators to make personnel decisions, and to help instructors to improve the quality of their teaching. The aim of this study is to investigate the ‘utility’ of the Student Ratings of Instruction (SRI. To that end, the concerns of the administrators, instructors and students regarding the use of the SRI in formative and summative evaluations are questioned. This study also investigates possible variables associated with the SRI: 1 what are the differences in ratings among the below-average, average and the above-average students? and 2 what is the correlation between the students’ grades and ratings? The participants of the study consisted of 5 administrators, 17 instructors and 292 students from the faculty of education of a foundation university in Ankara. A triangulation of quantitative and qualitative methods was adopted. In the first phase, causal comparative and correlation research methods were implemented. In the second phase, qualitative data were collected through semi-structured interviews. The results revealed that there was no significant difference in the SRI among the below-average, average and above-average students. The correlation between the student grades and the SRI was significant at a low level. The SRI were reportedly utilised to make teaching more effective and to make decisions when employing part-time personnel only. The permanent personnel were not affected by the SRI. Suggestions have been put forward to verify the usefulness of SRI.

Achieving low anastomotic leak rates utilizing clinical perfusion assessment.

Science.gov (United States)

Kream, Jacob; Ludwig, Kirk A; Ridolfi, Timothy J; Peterson, Carrie Y

2016-10-01

Anastomotic leak after colorectal resection increases morbidity, mortality, and in the setting of cancer, increases recurrences rates and reduces survival odds. Recent reports suggest that fluorescence evaluation of perfusion after colorectal anastomosis creation is associated with low anastomotic leak rates (1.4%). The purpose of this work was to evaluate whether a similar low anastomotic leak rate after left-sided colorectal resections could be achieved using standard assessment of blood flow to the bowel ends. We performed a retrospective chart review at an academic tertiary referral center, evaluating 317 consecutive patients who underwent a pelvic anastomosis after sigmoid colectomy, left colectomy, or low anterior resection. All operations were performed by a single surgeon from March 2008 to January 2015 with only standard clinical measures used to assess perfusion to the bowel ends. The primary outcome measure was the anastomotic leak rate as diagnosed by clinical symptoms, exam, or routine imaging. The average patient age was 59.7 years with an average body mass index of 28.8 kg/m(2). Rectal cancer (128, 40.4%) was the most common indication for operation while hypertension (134, 42.3%) was the most common comorbidity. In total, 177 operations were laparoscopic (55.8%), 13 were reoperative resections (4.1%), and 108 were protected with a loop ileostomy (34.1%). Preoperative chemotherapy was administered to 25 patients (7.9%) while preoperative chemo/radiation was administered to 64 patients (20.2%). The anastomotic leak rate was 1.6% (5/317). Our data suggests that standard, careful evaluation of adequate blood flow via inspection and confirmation of pulsatile blood flow to the bowel ends and meticulous construction of the colorectal or coloanal anastomoses can result in very low leak rates, similar to the rate reported when intraoperative imaging is used to assess perfusion. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of growth rates in the tissues of primal cuts of Canadian ...

African Journals Online (AJOL)

Information Technology

the growth rates (GR) of muscle (M) and fat (F) in the primal cuts of serially harvested Beefbooster® C ... There is a move to reduce saturated fats (such as beef fat) in human diets, ... primarily utilized to produce fat, which requires a higher energy input (McDonald et al., 1988). ..... will provide more M than fatter carcasses.

Certified Nursing Assistants Balancing Family Caregiving Roles: Health Care Utilization Among Double- and Triple-Duty Caregivers.

Science.gov (United States)

DePasquale, Nicole; Bangerter, Lauren R; Williams, Jessica; Almeida, David M

2016-12-01

This study examines how certified nursing assistants (CNAs) balancing family caregiving roles-child care (double-duty child caregivers), elder care (double-duty elder caregivers), and both child and elder care (triple-duty caregivers)-utilize health care services relative to nonfamily caregiving counterparts (formal-only caregivers). A sample of 884 CNAs from the Work, Family and Health Study was drawn on to assess the number of acute care (i.e., emergency room or urgent care facility) and other health care (i.e., outpatient treatment or counseling) visits made during the past 6 months. Double-duty elder and triple-duty caregivers had higher acute care utilization rates than formal-only caregivers. CNAs with and without family caregiving roles had similar rates of other health care visits. CNAs providing informal care for older adults have higher acute care visit rates. Given the increasing need for family caregivers and the vital importance of the health of the nursing workforce for the health of others, future research on how double- and triple-duty caregivers maintain their health amidst constant caregiving should be a priority. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Decision E90057 re: ICG Utilities (Alberta) Ltd

Energy Technology Data Exchange (ETDEWEB)

1990-10-10

ICG Utilities applied before the Alberta Public Utilities Board for determining a rate base and for fixing and approving interim and final rates for gas supplied to its customers in Alberta. A hearing was held to consider issues related to the application. In determining the rate base, the company's capital expenditures, acquisition of reserves, capitalization of administrative expenses, accumulated depreciation and related expense, and necessary working capital were taken into account. The fair return on the rate base was then fixed by considering the company's capital structure, long- and short- term debt rates, return on common equity, and foreign exchange rates. Utility revenue requirements were discussed in terms of cash operating expenses, cost of gas, income taxes, and non-cash operating expenses. Other matters treated at the hearing were the allocation of costs among ICG and affiliated companies, proposed amendments to ICG standards, regulations and practices, and the hearing costs reserve account. 5 tabs.

Effects of Geographic Diversification on Risk Pooling to Mitigate Drought-Related Financial Losses for Water Utilities

Science.gov (United States)

Baum, Rachel; Characklis, Gregory W.; Serre, Marc L.

2018-04-01

As the costs and regulatory barriers to new water supply development continue to rise, drought management strategies have begun to rely more heavily on temporary conservation measures. While these measures are effective, they often lead to intermittent and unpredictable reductions in revenues that are financially disruptive to water utilities, raising concerns over lower credit ratings and higher rates of borrowing for this capital intensive sector. Consequently, there is growing interest in financial risk management strategies that reduce utility vulnerabilities. This research explores the development of financial index insurance designed to compensate a utility for drought-related losses. The focus is on analyzing candidate hydrologic indices that have the potential to be used by utilities across the US, increasing the potential for risk pooling, which would offer the possibility of both lower risk management costs and more widespread implementation. This work first analyzes drought-related financial risks for 315 publicly operated water utilities across the country and examines the effectiveness of financial contracts based on several indices both in terms of their correlation with utility revenues and their spatial autocorrelation across locations. Hydrologic-based index insurance contracts are then developed and tested over a 120 year period. Results indicate that risk pooling, even under conditions in which droughts are subject to some level of spatial autocorrelation, has the potential to significantly reduce the cost of managing financial risk.

Characteristics of utility cyclists in Queensland, Australia: an examination of the associations between individual, social, and environmental factors and utility cycling.

Science.gov (United States)

Sahlqvist, Shannon L; Heesch, Kristiann C

2012-08-01

Initiatives to promote utility cycling in countries like Australia and the US, which have low rates of utility cycling, may be more effective if they first target recreational cyclists. This study aimed to describe patterns of utility cycling and examine its correlates, among cyclists in Queensland, Australia. An online survey was administered to adult members of a state-based cycling community and advocacy group (n=1813). The survey asked about demographic characteristics and cycling behavior, motivators and constraints. Utility cycling patterns were described, and logistic regression modeling was used to examine associations between utility cycling and other variables. Forty-seven percent of respondents reported utility cycling: most did so to commute (86%). Most journeys (83%) were >5 km. Being male, younger, employed full-time, or university-educated increased the likelihood of utility cycling (P<.05). Perceiving cycling to be a cheap or a convenient form of transport was associated with utility cycling (P<.05). The moderate rate of utility cycling among recreational cyclists highlights a potential to promote utility cycling among this group. To increase utility cycling, strategies should target female and older recreational cyclists and focus on making cycling a cheap and convenient mode of transport.

Comparison of diabetes-associated secondary healthcare utilization between alternative oral antihyperglycaemic dual therapy combinations with metformin in patients with type 2 diabetes: an observational cohort study.

Science.gov (United States)

Strongman, H; D'Oca, K; Langerman, H; Das, R

2015-06-01

To compare diabetes-associated secondary healthcare utilization in patients with type 2 diabetes (T2DM) prescribed sulphonylureas (SUs) versus other oral antihyperglycaemic agents (OHAs) as an add-on to metformin monotherapy (metformin + SU vs metformin + OHA). This retrospective cohort study used data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics. Adults with T2DM initiated on metformin + SU or metformin + OHA from April 2003 to March 2012 were identified. Patients were matched using propensity scores. Diabetes-associated secondary healthcare visits were counted from >6 months post-initiation of dual therapy until treatment change or end of follow-up. Outcomes were calculated as rate ratios, adjusted for over-dispersion using negative binomial regression and propensity score for covariates. After propensity score matching, 1704 patients were included in each cohort. For the primary objective (diabetes-associated inpatient and outpatient visits combined), the metformin + SU cohort had a directionally higher rate of diabetes-associated secondary healthcare utilization than the metformin + OHA cohort [adjusted rate ratio 1.12, 95% confidence interval (CI) 0.97-1.29]. For the secondary outcomes, the adjusted rate ratio was 1.38 (95% CI 0.95-2.00) for inpatient admissions and 1.10 (95% CI 0.95-1.28) for outpatient visits. Macrovascular complications, accounting for 77.2% of inpatient admissions, occurred at a statistically significantly higher rate in the metformin + SU cohort than in the metformin + OHA cohort (adjusted rate ratio 1.77, 95% CI 1.15-2.71). This study found a statistically significant higher rate of inpatient admissions for macrovascular complications and cardiology outpatient visits and, overall, a directionally higher rate of secondary healthcare utilization for patients prescribed metformin + SU than for those prescribed metformin + OHA. This adds to the evidence that long

Plant genotypic diversity reduces the rate of consumer resource utilization.

Science.gov (United States)

McArt, Scott H; Thaler, Jennifer S

2013-07-07

While plant species diversity can reduce herbivore densities and herbivory, little is known regarding how plant genotypic diversity alters resource utilization by herbivores. Here, we show that an invasive folivore--the Japanese beetle (Popillia japonica)--increases 28 per cent in abundance, but consumes 24 per cent less foliage in genotypic polycultures compared with monocultures of the common evening primrose (Oenothera biennis). We found strong complementarity for reduced herbivore damage among plant genotypes growing in polycultures and a weak dominance effect of particularly resistant genotypes. Sequential feeding by P. japonica on different genotypes from polycultures resulted in reduced consumption compared with feeding on different plants of the same genotype from monocultures. Thus, diet mixing among plant genotypes reduced herbivore consumption efficiency. Despite positive complementarity driving an increase in fruit production in polycultures, we observed a trade-off between complementarity for increased plant productivity and resistance to herbivory, suggesting costs in the complementary use of resources by plant genotypes may manifest across trophic levels. These results elucidate mechanisms for how plant genotypic diversity simultaneously alters resource utilization by both producers and consumers, and show that population genotypic diversity can increase the resistance of a native plant to an invasive herbivore.

Association Between Number of Preventive Care Guidelines and Preventive Care Utilization by Patients.

Science.gov (United States)

Taksler, Glen B; Pfoh, Elizabeth R; Stange, Kurt C; Rothberg, Michael B

2018-05-08

The number of preventive care guidelines is rapidly increasing. It is unknown whether the number of guideline-recommended preventive services is associated with utilization. The authors used Poisson regression of 390,778 person-years of electronic medical records data from 2008 to 2015, in 80,773 individuals aged 50-75 years. Analyses considered eligibility for 11 preventive services most closely associated with guidelines: tobacco cessation; control of obesity, hypertension, lipids, or blood glucose; influenza vaccination; and screening for breast, cervical, or colorectal cancers, abdominal aortic aneurysm, or osteoporosis. The outcome was the rate of preventive care utilization over the following year. Results were adjusted for demographics and stratified by the number of disease risk factors (smoking, obesity, hypertension, hyperlipidemia, diabetes). Data were collected in 2016 and analyzed in 2017. Preventive care utilization was lower when the number of guideline-recommended preventive services was higher. The adjusted rate of preventive care utilization decreased from 38.67 per 100 (95% CI=38.16, 39.18) in patients eligible for one guideline-recommended service to 31.59 per 100 (95% CI=31.29, 31.89) in patients eligible for two services and 25.43 per 100 (95% CI=24.68, 26.18) in patients eligible for six or more services (p-trendvalue services. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Hospital Evaluations by Social Media: A Comparative Analysis of Facebook Ratings among Performance Outliers.

Science.gov (United States)

Glover, McKinley; Khalilzadeh, Omid; Choy, Garry; Prabhakar, Anand M; Pandharipande, Pari V; Gazelle, G Scott

2015-10-01

An increasing number of hospitals and health systems utilize social media to allow users to provide feedback and ratings. The correlation between ratings on social media and more conventional hospital quality metrics remains largely unclear, raising concern that healthcare consumers may make decisions on inaccurate or inappropriate information regarding quality. The purpose of this study was to examine the extent to which hospitals utilize social media and whether user-generated metrics on Facebook(®) correlate with a Hospital Compare(®) metric, specifically 30-day all cause unplanned hospital readmission rates. This was a retrospective cross-sectional study conducted among all U.S. hospitals performing outside the confidence interval for the national average on 30-day hospital readmission rates as reported on Hospital Compare. Participants were 315 hospitals performing better than U.S. national rate on 30-day readmissions and 364 hospitals performing worse than the U.S. national rate. The study analyzed ratings of hospitals on Facebook's five-star rating scale, 30-day readmission rates, and hospital characteristics including beds, teaching status, urban vs. rural location, and ownership type. Hospitals performing better than the national average on 30-day readmissions were more likely to use Facebook than lower-performing hospitals (93.3 % vs. 83.5 %; p Facebook rating was associated with increased odds of the hospital belonging to the low readmission rate group by a factor of 5.0 (CI: 2.6-10.3, p Facebook-related variables. Hospitals with lower rates of 30-day hospital-wide unplanned readmissions have higher ratings on Facebook than hospitals with higher readmission rates. These findings add strength to the concept that aggregate measures of patient satisfaction on social media correlate with more traditionally accepted measures of hospital quality.

Hydraulic conductance as well as nitrogen accumulation plays a role in the higher rate of leaf photosynthesis of the most productive variety of rice in Japan.

Science.gov (United States)

Taylaran, Renante D; Adachi, Shunsuke; Ookawa, Taiichiro; Usuda, Hideaki; Hirasawa, Tadashi

2011-07-01

An indica variety Takanari is known as one of the most productive rice varieties in Japan and consistently produces 20-30% heavier dry matter during ripening than Japanese commercial varieties in the field. The higher rate of photosynthesis of individual leaves during ripening has been recognized in Takanari. By using pot-grown plants under conditions of minimal mutual shading, it was confirmed that the higher rate of leaf photosynthesis is responsible for the higher dry matter production after heading in Takanari as compared with a japonica variety, Koshihikari. The rate of leaf photosynthesis and shoot dry weight became larger in Takanari after the panicle formation and heading stages, respectively, than in Koshihikari. Roots grew rapidly in the panicle formation stage until heading in Takanari compared with Koshihikari. The higher rate of leaf photosynthesis in Takanari resulted not only from the higher content of leaf nitrogen, which was caused by its elevated capacity for nitrogen accumulation, but also from higher stomatal conductance. When measured under light-saturated conditions, stomatal conductance was already decreased due to the reduction in leaf water potential in Koshihikari even under conditions of a relatively small difference in leaf-air vapour pressure difference. In contrast, the higher stomatal conductance was supported by the maintenance of higher leaf water potential through the higher hydraulic conductance in Takanari with the larger area of root surface. However, no increase in root hydraulic conductivity was expected in Takanari. The larger root surface area of Takanari might be a target trait in future rice breeding for increasing dry matter production.

Biodegradation testing of chemicals with high Henry’s constants – separating mass and effective concentration reveals higher rate constants

DEFF Research Database (Denmark)

Birch, Heidi; Andersen, Henrik Rasmus; Comber, Mike

Microextraction (HS-SPME) was applied directly on the test systems to measure substrate depletion by biodegradation relative to abiotic controls. HS-SPME was also applied to determine air to water partitioning ratios. Water phase biodegradation rate constants, kwater, were up to 72 times higher than test system...

Urea utilization in protein deficient rats

Energy Technology Data Exchange (ETDEWEB)

Tanaka, N [Hyogo College of Medicine, Nishinomiya, Hyogo (Japan)

1982-06-01

Three experiments were performed to investigate the mechanism of urea utilization and the nutritional roles of intestinal flora on the utilization of urea by rats fed with a protein deficient diet. Ammonia content in the small intestine in LPD(low protein diet) group fed with a low protein diet for 2 or 5 weeks was about three of five times higher than that of control group fed with SPD(standard protein diet) after administration of urea (0.2gN/100gB.W.). The /sup 15/N incorporation into plasma protein of LPD group was significantly higher than that of the control group two hours after the administration of /sup 15/N-urea (10 mg/100gB.W.) and higher level of /sup 15/N concentration in plasma protein in LPD group was maintained thereafter. The /sup 15/N incorporation into the amino acids of plasma protein was higher in LPD group than in control group. The /sup 15/N incorporation into the amino acids in portal plasma seemed to be higher in LPD group than in control group one hour after the administration of /sup 15/N-urea (10mg/100gB.W.). However, the /sup 15/N incorporation into each free amino acids was suppressed considerably by the administration of antibiotic mixture. it follows that amino acids may be synthesized from urea in the intestine by intestinal-bacterial action and absorbed from portal vein. From these results, it may be concluded that the ammonia nitrogen converted from urea by the action of intestinal-bacterial urease in the intestine is utilized for the synthesis of essential and nonessential amino acids in protein deficient rats and transfered to the liver through portal vein and utilized for protein synthesis.

Urea utilization in protein deficient rats

International Nuclear Information System (INIS)

Tanaka, Noriko

1982-01-01

Three experiments were performed to investigate the mechanism of urea utilization and the nutritional roles of intestinal flora on the utilization of urea by rats fed with a protein deficient diet. Ammonia content in the small intestine in LPD(low protein diet) group fed with a low protein diet for 2 or 5 weeks was about three of five times higher than that of control group fed with SPD(standard protein diet) after administration of urea (0.2gN/100gB.W.). The 15 N incorporation into plasma protein of LPD group was significantly higher than that of the control group two hours after the administration of 15 N-urea (10 mg/100gB.W.) and higher level of 15 N concentration in plasma protein in LPD group was maintained thereafter. The 15 N incorporation into the amino acids of plasma protein was higher in LPD group than in control group. The 15 N incorporation into the amino acids in portal plasma seemed to be higher in LPD group than in control group one hour after the administration of 15 N-urea (10mg/100gB.W.). However, the 15 N incorporation into each free amino acids was suppressed considerably by the administration of antibiotic mixture. it follows that amino acids may be synthesized from urea in the intestine by intestinal-bacterial action and absorbed from portal vein. From these results, it may be concluded that the ammonia nitrogen converted from urea by the action of intestinal-bacterial urease in the intestine is utilized for the synthesis of essential and nonessential amino acids in protein deficient rats and transfered to the liver through portal vein and utilized for protein synthesis. (J.P.N.)

Utility of heart rate turbulence and T-Wave alternans to assess risk for Re-admission and cardiac death in hospitalized heart failure patients.

Science.gov (United States)

Yamada, Shinya; Yoshihisa, Akiomi; Sato, Yu; Sato, Takamasa; Kamioka, Masashi; Kaneshiro, Takashi; Oikawa, Masayoshi; Kobayashi, Atsushi; Suzuki, Hitoshi; Ishida, Takafumi; Takeishi, Yasuchika

2018-05-18

Heart failure (HF) patients have a higher risk of recurrent HF and cardiac death, and electrical remodeling is considered to be an important factor for HF progression. The present study aimed to validate the utility of electrocardiogram and Holter monitoring for the risk stratification of HF patients. Our study comprised 215 patients (144 males, mean age 62 years) who had been hospitalized due to acute decompensated HF. Electrocardiogram (QRS duration and QTc interval) and 24-hour Holter monitoring (heart rate variability, heart rate turbulence and T-wave alternans [TWA]) were performed in stable condition before discharge. The clinical characteristics and outcomes were then investigated. During a median follow-up period of 2.7 years, there were 83 (38.6%) cardiac events (re-hospitalization due to worsening HF [n = 51] or cardiac death [n = 32]). The patients with cardiac events had a lower turbulence slope (TS) and higher TWA compared to those without cardiac events (TS, 3.0±5.5 ms/RR vs. 5.3±5.6 ms/RR, P = 0.001; TWA, 66.1±19.6 μV vs. 54.7±15.1 μV, P < 0.001). Univariable analysis showed that TS, TWA, QRS duration, and QTc interval were associated with cardiac events (P = 0.004, P < 0.001, P = 0.037 and P = 0.024, respectively), while the multivariable analysis after the adjustment of multiple confounders showed that TS and TWA were independent predictive factors of cardiac events with a hazard ratio of 0.936 and 1.015 (95% confidence interval [CI]: 0.860-0.974, P = 0.006; and 95% CI: 1.003-1.027, p = 0.016), respectively. The measurement of TS and TWA is useful for assessing risk for re-hospitalization and cardiac death in HF patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A Comparison of Dependent Primary Care Utilization Rates Based on Deployments

Science.gov (United States)

2009-03-09

analysis to obtain the deployment data was completed by ASMR , another contractor used to Health Care Utilization and Deployments 15 complete...2007. The deployment dataset was created by ASMR using all encounter data for active duty Soldiers and running the Social Security numbers of these

On the Path to SunShot. Utility Regulatory and Business Model Reforms for Addressing the Financial Impacts of Distributed Solar on Utilities

Energy Technology Data Exchange (ETDEWEB)

Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Miller, John [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sigrin, Ben [National Renewable Energy Lab. (NREL), Golden, CO (United States); Reiter, Emerson [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cory, Karlynn [National Renewable Energy Lab. (NREL), Golden, CO (United States); McLaren, Joyce [National Renewable Energy Lab. (NREL), Golden, CO (United States); Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, Naim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Satchwell, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-05-01

Net-energy metering (NEM) has helped drive the rapid growth of distributed PV (DPV) but has raised concerns about electricity cost shifts, utility financial losses, and inefficient resource allocation. These concerns have motivated real and proposed reforms to utility regulatory and business models. This report explores the challenges and opportunities associated with such reforms in the context of the U.S. Department of Energy's SunShot Initiative. Most of the reforms to date address NEM concerns by reducing the benefits provided to DPV customers and thus constraining DPV deployment. Eliminating NEM nationwide, by compensating exports of PV electricity at wholesale rather than retail rates, could cut cumulative DPV deployment by 20% in 2050 compared with a continuation of current policies. This would slow the PV cost reductions that arise from larger scale and market certainty. It could also thwart achievement of the SunShot deployment goals even if the initiative's cost targets are achieved. This undesirable prospect is stimulating the development of alternative reform strategies that address concerns about distributed PV compensation without inordinately harming PV economics and growth. These alternatives fall into the categories of facilitating higher-value DPV deployment, broadening customer access to solar, and aligning utility profits and earnings with DPV. Specific strategies include utility ownership and financing of DPV, community solar, distribution network operators, services-driven utilities, performance-based incentives, enhanced utility system planning, pricing structures that incentivize high-value DPV configurations, and decoupling and other ratemaking reforms that reduce regulatory lag. These approaches represent near- and long-term solutions for preserving the legacy of the SunShot Initiative.

Favorable bed utilization and readmission rates for emergency department observation unit heart failure patients.

Science.gov (United States)

Schrager, Justin; Wheatley, Matthew; Georgiopoulou, Vasiliki; Osborne, Anwar; Kalogeropoulos, Andreas; Hung, Olivia; Butler, Javed; Ross, Michael

2013-06-01

The objective was to compare readmission rates and hospital bed-days between acute decompensated heart failure (AHF) patients admitted or discharged following accelerated treatment protocol (ATP)-driven care in an emergency department observation unit (OU). This was a retrospective cohort study conducted at two urban university-affiliated hospitals. A total of 358 selected AHF patients received treatment on an ATP in the OU between October 1, 2007, and June 30, 2011. The comparison of interest was admission or discharge following OU treatment. The outcome of interest was readmission within 30 and 90 days of hospital discharge following care in the OU. We also examined resource use (inpatient, inpatient plus outpatient-days) between the admitted and discharged groups. Time to readmission analysis was performed with Cox proportional hazards regression. Discharged and admitted patients were similar with respect to age, race, sex, ED length of stay (LOS), and OU LOS. Patients admitted from the OU had a higher median B-type natriuretic peptide (BNP; 1,063 pg/mL [interquartile range {IQR} = 552 to 2,067 pg/mL] vs. 708 pg/mL [IQR = 254 to 1,683 pg/mL]; p = 0.002) and blood urea nitrogen (BUN; 19 mg/dL [IQR = 14 to 26 mg/dL] vs. 17 mg/dL [IQR = 13 to 23 mg/dL]) than those discharged (p = 0.04) and a lower median ejection fraction (EF; 22.5% [15% to 43%] vs. 35% [IQR 20% to 55%]; p = 0.002). In models controlling for age, race, sex, clinical site, BNP, BUN, creatinine, and EF, the 30-day readmission rate (13.8% in the study population as a whole) was not significantly different between the patients discharged or admitted following OU care (hazard ratio [HR] = 0.99; 95% confidence interval [CI] = 0.47 to 2.10). The readmission rates were also not significantly different at 90 days (HR = 1.07; 95% CI = 0.65 to 1.77). Within 30 days of discharge from the OU, patients spent a median of 1.7 days (IQR = 0.0 to 5.1 days) as inpatients, compared to 3.5 days (IQR = 2.3 to 5.8 days

Quantifying Risk of Financial Incapacity and Financial Exploitation in Community-dwelling Older Adults: Utility of a Scoring System for the Lichtenberg Financial Decision-making Rating Scale.

Science.gov (United States)

Lichtenberg, Peter A; Gross, Evan; Ficker, Lisa J

2018-06-08

This work examines the clinical utility of the scoring system for the Lichtenberg Financial Decision-making Rating Scale (LFDRS) and its usefulness for decision making capacity and financial exploitation. Objective 1 was to examine the clinical utility of a person centered, empirically supported, financial decision making scale. Objective 2 was to determine whether the risk-scoring system created for this rating scale is sufficiently accurate for the use of cutoff scores in cases of decisional capacity and cases of suspected financial exploitation. Objective 3 was to examine whether cognitive decline and decisional impairment predicted suspected financial exploitation. Two hundred independently living, non-demented community-dwelling older adults comprised the sample. Participants completed the rating scale and other cognitive measures. Receiver operating characteristic curves were in the good to excellent range for decisional capacity scoring, and in the fair to good range for financial exploitation. Analyses supported the conceptual link between decision making deficits and risk for exploitation, and supported the use of the risk-scoring system in a community-based population. This study adds to the empirical evidence supporting the use of the rating scale as a clinical tool assessing risk for financial decisional impairment and/or financial exploitation.

A proposed method for determining long term optimum utilization ...

African Journals Online (AJOL)

Application of utilization intensity as an experimental variable by the use of the pasture disc meter and the put- and take technique is recommended as an alternative to stocking rate experiments. Utilization intensity allows stocking rate to be used as a measure of pasture productivity and consequently the relationship ...

Preliminary evaluation of child self-rating using the Child Tourette Syndrome Impairment Scale.

Science.gov (United States)

Cloes, Kelly Isaacs; Barfell, Kara S Francis; Horn, Paul S; Wu, Steve W; Jacobson, Sarah E; Hart, Kathleen J; Gilbert, Donald L

2017-03-01

To evaluate and compare how children with Tourette syndrome and parents rate tic and non-tic behavioral related impairment in home, school, and social domains; to compare these with clinician tic ratings; and to identify factors that may predict greater impairment. In a sample of 85 Tourette syndrome and 92 healthy control families, the Child Tourette Syndrome Impairment Scale, designed for parent-report and which includes 37 items rated for tic and non-tic impairment, was administered to parents and, with the referent modified, to children ages 9 to 17 years. Tic severity was rated using the Yale Global Tic Severity Scale (YGTSS). Analyses utilized descriptive and multivariate statistics. Tourette syndrome children's and parents' impairment ratings were higher than HC (ptic impairment ratings correlated with YGTSS (r=0.36 to 0.37; ptic and all 37 non-tic impairment items. For 29 items, children self-rated impairment higher for tics than non-tics. Diagnoses of attention-deficit-hyperactivity disorder and obsessive-compulsive disorder had larger effects on parent impairment ratings. The Child Tourette Syndrome Impairment Scale appears informative for child self-rating in Tourette syndrome. © 2016 Mac Keith Press.

Utility of late summer transient snowline migration rate on Taku Glacier, Alaska

Directory of Open Access Journals (Sweden)

M. Pelto

2011-12-01

Full Text Available On Taku Glacier, Alaska a combination of field observations of snow water equivalent (SWE from snowpits and probing in the vicinity of the transient snowline (TSL are used to quantify the mass balance gradient. The balance gradient derived from the TSL and SWE measured in snowpits at 1000 m from 1998–2010 ranges from 2.6–3.8 mm m⁻¹. Probing transects from 950 m–1100 m directly measure SWE and yield a slightly higher balance gradient of 3.3–3.8 mm m⁻¹. The TSL on Taku Glacier is identified in MODIS and Landsat 4 and 7 Thematic Mapper images for 31 dates during the 2004–2010 period to assess the consistency of its rate of rise and reliability in assessing ablation for mass balance assessment. For example, in 2010, the TSL was 750 m on 28 July, 800 m on 5 August, 875 m on 14 August, 925 m on 30 August, and 975 m on 20 September. The mean observed probing balance gradient was 3.3 mm m⁻¹, combined with the TSL rise of 3.7 m day⁻¹ yields an ablation rate of 12.2 mm day⁻¹ from mid-July to mid-Sept, 2010. The TSL rise in the region from 750–1100 m on Taku Glacier during eleven periods each covering more than 14 days during the ablation season indicates a mean TSL rise of 3.7 m day⁻¹, the rate of rise is relatively consistent ranging from 3.1 to 4.4 m day⁻¹. This rate is useful for ascertaining the final ELA if images or observations are not available near the end of the ablation season. The mean ablation from 750–1100 m during the July–September period determined from the TSL rise and the observed balance gradient is 11–13 mm day⁻¹ on Taku Glacier during the 2004–2010 period. The potential for providing an estimate of b_n from TSL observations late in the melt season from satellite images combined with the frequent availability of such images provides a means for efficient mass balance assessment in many years and on many

Time-of-Use Rates and Electricity Costs of Representative New York Dairy Farms

OpenAIRE

Boisvert, Richard N.; Bills, Nelson L.; Middagh, Mark C.; Schenkel, Mark

1992-01-01

Electric utilities throughout the Nation are experimenting with strategies to reduce total electricity consumption or to alter the timing of electrical power use by their customers. This report focuses on one such strategy, time-of-use (TaU) electric rates, and the likely effect of this pricing option on the New York dairy sector. The purpose of the study is to assess the change in farm electrical energy costs when power is sold to dairymen at higher rates for periods of peak power demand and...

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

Directory of Open Access Journals (Sweden)

Hyun-Soo Kim

2016-01-01

Full Text Available Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation.

Science.gov (United States)

Kim, Hyun-Soo; Lee, Moo-Sik; Hong, Jee-Young

2016-01-01

The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

Obese Japanese adults with type 2 diabetes have higher basal metabolic rates than non-diabetic adults.

Science.gov (United States)

Miyake, Rieko; Ohkawara, Kazunori; Ishikawa-Takata, Kazuko; Morita, Akemi; Watanabe, Shaw; Tanaka, Shigeho

2011-01-01

Several cross-sectional studies in Pima Indians and Caucasians have indicated that obese individuals with type 2 diabetes have a higher basal metabolic rate (BMR) than healthy, obese individuals. However, no study has investigated this comparison in Japanese subjects, who are known to be susceptible to type 2 diabetes due to genetic characteristics. Thirty obese Japanese adults with pre-type 2 diabetes (n=7) or type 2 diabetes (n=13) or without diabetes (n=10) participated in this study. BMR was measured using indirect calorimetry. The relationships between residual BMR (calculated as measured BMR minus BMR adjusted for fat-free mass, fat mass, age, and sex) and biomarkers including fasting glucose, glycosylated hemoglobin (HbA(1c)), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-R), triglycerides, and free fatty acids were examined using Pearson's correlation. BMR in diabetic subjects adjusted for fat-free mass, fat mass, age, and sex was 7.1% higher than in non-diabetic subjects. BMR in diabetic subjects was also significantly (pBMR and fasting glucose (r=0.391, p=0.032). These results indicate that in the Japanese population, obese subjects with type 2 diabetes have higher BMR compared with obese non-diabetic subjects. The fasting glucose level may contribute to these differences.

Chiropractic and CAM utilization: a descriptive review.

Science.gov (United States)

Lawrence, Dana J; Meeker, William C

2007-01-22

To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

Understanding the Effect of Response Rate and Class Size Interaction on Students Evaluation of Teaching in a Higher Education

Science.gov (United States)

Al Kuwaiti, Ahmed; AlQuraan, Mahmoud; Subbarayalu, Arun Vijay

2016-01-01

Objective: This study aims to investigate the interaction between response rate and class size and its effects on students' evaluation of instructors and the courses offered at a higher education Institution in Saudi Arabia. Study Design: A retrospective study design was chosen. Methods: One thousand four hundred and forty four different courses…

Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy

Directory of Open Access Journals (Sweden)

Shu-Jung Chen

2015-04-01

Full Text Available Transfer metatarsalgia (TM is a common forefoot disorder secondary to hallux valgus (HV. Some authors suggest that a combined lesser metatarsal osteotomy while undergoing HV surgery improves metatarsalgia, whereas others concluded that isolated HV corrective osteotomy can improve symptomatic metatarsalgia. The main purpose of this retrospective study was to compare clinical outcomes in patients with and without combined lesser metatarsal osteotomy while receiving HV correction surgery. We retrospectively reviewed the patients who underwent osteotomy for HV correction between January 2000 and December 2010. All patients underwent HV correction with modified Mitchell osteotomy. Clinical evaluations including the American Orthopaedic Foot and Ankle Society score and residual metatarsalgia were assessed, and radiographic measurements were carried out. Sixty-five patients (83 feet meeting the selection criteria were enrolled. Thirty feet receiving a combined lesser metatarsal osteotomy were classified as the combined surgery (CS group, and the others were classified as the control (CN group (53 feet. The overall rate of persistent symptomatic metatarsalgia was 19.28% after operative treatment. There were six feet with residual metatarsalgia in the CS group, and 10 feet in the CN group. There was no significant difference in the rate of persistent symptoms between the two groups (p = 0.9. According to this result, modified Mitchell osteotomy alone did not have a higher rate of residual metatarsalgia than CS. We also found that the average recovery rate of TM was about 80.7% and those patients whose preoperative HV angle was > 30° had the higher risk of residual metatarsalgia after surgery.

Staff background paper on performance-based rate making

International Nuclear Information System (INIS)

Fraser, J.; Brownell, B.

1998-10-01

An alternative to the traditional cost of service (COS) regulation for electric utilities in British Columbia has been proposed. The alternative to pure COS regulation is performance-based rate making (PBR). PBR partially decouples a utility's rates from its costs and ties utility profits to performance relative to specific benchmarks. The motivation underlying PBR is that ideally, it provides incentives for utilities to cost-effectively achieve pre-defined goals. This report describes the design of PBR mechanisms, base rate PBR formulas, base rate PBR in other jurisdictions including New York, California, Maine and New Jersey. The report also describes gas procurement PBR in other jurisdictions, as well as British Columbia Utilities' Commission's own experience with PBR. In general, PBR has the potential to provide resource efficiency, allocative efficiency, support for introduction of new services, and reduced regulatory administrative costs. 15 refs., 4 tabs

Understanding utility regulation : a participants' guide to the British Columbia Utilities Commission

International Nuclear Information System (INIS)

1996-10-01

Information regarding British Columbia's regulated energy industries is presented with particular emphasis on the regulatory functions of the British Columbia Utilities Commission (BCUC). The objective of providing the information is to make the regulatory process as transparent as possible and to make it easy for ratepayers to effectively and economically participate in the regulation of energy utilities. The issue of why electricity and natural gas utilities are regulated is addressed, but the greater part of the report is devoted to describing opportunities for public participation at the BCUC, explaining how to get involved in the Commission's proceedings and the nature of the hearings used by the Commission. An introduction to rate making is also presented, along with an overview of other institutions involved in energy regulation. Appendices contain the text of the Utilities Commission Act (App. A), the Negotiated Settlement Process Policy, Procedures and Guidelines (App. B), Participant Funding and Cost Awards (App. C), and the Integrated Resource Planning Guide (App. D). tabs., figs., 4 appendices

Utilization of maternal health care services in slum areas of Dhaka city, Bangladesh

Directory of Open Access Journals (Sweden)

Housne Ara Begum

2010-07-01

Full Text Available Bangladesh has one of the highest maternal mortality rates (MMR in the world. The estimated lifetime risk of dying from pregnancy and childbirth related causes in Bangladesh is about 100 times higher compare to developed countries. However, utilization of maternal health care services (MHCS is notably low. This study examines the socio-economic determinants of utilization of MHCS in some slum areas of Dhaka city. The overall utilization was 86.3% of women; however, utilization of different sorts of MHCS was very low, i.e., the mean utilization was found to be 2.25 out of 5 MHCS. Indicator wise, ANC, TT, institutional delivery, delivery assistance by health professional and PNC were received by 61.3%, 80.4%, 12.6%, 33.2% and 55.4% of women respectively. Variation was observed with different socio-economic variables. Multiple regression model could explain 38% of variance (P<0.001. Among the significant determinants, order of last birth negatively explained the most variance (15.2%. Similarly, distance between home and clinic was found to affect the utilization negatively. Besides, some respondents’ socio economic variables had a significant positive effect on MHCS utilization. To reduce maternal mortality in disadvantaged women in slum areas, this study might suggest a few pointers while considering formulation of policies and planning. Ibrahim Med. Coll. J. 2010; 4(2: 44-48

ACR BI-RADS Assessment Category 4 Subdivisions in Diagnostic Mammography: Utilization and Outcomes in the National Mammography Database.

Science.gov (United States)

Elezaby, Mai; Li, Geng; Bhargavan-Chatfield, Mythreyi; Burnside, Elizabeth S; DeMartini, Wendy B

2018-05-01

Purpose To determine the utilization and positive predictive value (PPV) of the American College of Radiology (ACR) Breast Imaging Data and Reporting System (BI-RADS) category 4 subdivisions in diagnostic mammography in the National Mammography Database (NMD). Materials and Methods This study involved retrospective review of diagnostic mammography data submitted to the NMD from January 1, 2008 to December 30, 2014. Utilization rates of BI-RADS category 4 subdivisions were compared by year, facility (type, location, census region), and examination (indication, finding type) characteristics. PPV3 (positive predictive value for biopsies performed) was calculated overall and according to category 4 subdivision. The χ 2 test was used to test for significant associations. Results Of 1 309 950 diagnostic mammograms, 125 447 (9.6%) were category 4, of which 33.3% (41 841 of 125 447) were subdivided. Subdivision utilization rates were higher (P use, subdivisions were utilized in the minority (33.3% [41 841 of 125 447]) of category 4 diagnostic mammograms, with variability based on facility and examination characteristics. When subdivisions were used, PPV3s were in BI-RADS-specified malignancy ranges. This analysis supports the use of subdivisions in broad practice and, given benefits for patient care, should motivate increased utilization. © RSNA, 2018 Online supplemental material is available for this article.

British Columbia Utilities Commission 2001 annual report

International Nuclear Information System (INIS)

2002-06-01

The main responsibility of the British Columbia Utilities Commission is to regulate energy utilities under its jurisdiction to ensure that energy rates are fair and that utility operators in the province provide safe, adequate and secure service to their customers. The Commission also approves the construction of new facilities planned by utilities. It also participates in the review of utility and energy projects under the Environmental Assessment Act. Several successes were achieved in 2001 as the utility implemented its first performance plan. Oral public hearings were held for applications by Pacific Northern Gas and by Pembina Pipelines, owners of the common carrier oil pipeline from Taylor to Kamloops. A review of BC Gas' rate design to apportion utility revenue requirements fairly to different classes of customers was successfully achieved by a negotiated settlement process. In 2001, there was also a high level of proposed mergers, acquisitions and divestitures. Duke Energy Corporation's share acquisition of Westcoast Energy's two affiliated gas utilities was approved. BC Gas' application to divest its customer care activities to a joint venture company with Enbridge was also reviewed, and an oral hearing was held to review a West Kootenay Power application to sell its Kootenay River hydroelectric generation assets to Columbia Basin Trust and the Columbia Power Corp. In this case, the decision rendered was that the sale terms had to be changed so that customers could share the proceeds. The utility therefore, decided not to proceed with the sale under these conditions. The BC Hydro legislated rate freeze, which was due to expire on September 30, 2001, was extended for an additional 18 months to allow the new provincial government time to implement a new energy policy. The new energy policy is expected to give the province an energy advantage by facilitating growth and diversification in energy production while providing competition and more choice for

Endometrial Scratch Injury Induces Higher Pregnancy Rate for Women With Unexplained Infertility Undergoing IUI With Ovarian Stimulation: A Randomized Controlled Trial.

Science.gov (United States)

Maged, Ahmed M; Al-Inany, Hesham; Salama, Khaled M; Souidan, Ibrahim I; Abo Ragab, Hesham M; Elnassery, Noura

2016-02-01

To explore the impact of endometrial scratch injury (ESI) on intrauterine insemination (IUI) success. One hundred and fifty four infertile women received 100 mg of oral clomiphene citrate for 5 days starting on day 3 of the menstrual cycle. Patients were randomized to 2 equal groups: Group C received IUI without ESI and group S had ESI. Successful pregnancy was confirmed by ultrasound. 13, 21, and 10 women got pregnant after the first, second, and third IUI trials, respectively, with 28.6% cumulative pregnancy rate (PR). The cumulative PR was significantly higher in group S (39%) compared to group C (18.2%). The PR in group S was significantly higher compared to that in group C at the second and third trials. The PR was significantly higher in group S at the second trial compared to that reported in the same group at the first trial but nonsignificantly higher compared to that reported during the third trial, while in group C, the difference was nonsignificant. Eight pregnant women had first trimester abortion with 18.2% total abortion rate with nonsignificant difference between studied groups. The ESI significantly improves the outcome of IUI in women with unexplained infertility especially when conducted 1 month prior to IUI. © The Author(s) 2015.

Prediction of community mental health service utilization by individual and ecological level socio-economic factors.

Science.gov (United States)

Donisi, Valeria; Tedeschi, Federico; Percudani, Mauro; Fiorillo, Andrea; Confalonieri, Linda; De Rosa, Corrado; Salazzari, Damiano; Tansella, Michele; Thornicroft, Graham; Amaddeo, Francesco

2013-10-30

Individuals with a more deprived socioeconomic status (SES) are more likely to have higher rates of psychiatric morbidity and use of psychiatric services. Such service use is also influenced by socioeconomic factors at the ecological level. The aim of this article is to investigate the influence of these variables on service utilization. All patients in contact with three Italian community psychiatric services (CPS) were included. Community and hospital contacts over 6 months were investigated. Socio-economic characteristics were described using a SES Index and two new Resources Accessibility Indexes. Low SES was found to be associated with more community service contacts. When other individual and ecological variables were controlled for, SES was negatively associated only with the number of home visits, which was about half the rate in deprived areas. An association between service utilization and the resources of the catchment area was also detected. The economic crisis in Europe is increasing inequality of access, so paying attention to SES characteristics at both the individual and the ecological levels is likely to become increasingly important in understanding patterns of psychiatric service utilization and planning care accordingly. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

APPRAISAL OF STUDENT RATING AS A MEASURE TO MANAGE THE QUALITY OF HIGHER EDUCATION IN INDIA: AN INSTITUTIONAL STUDY USING SIX SIGMA MODEL APPROACH

Directory of Open Access Journals (Sweden)

Arun Vijay

2013-12-01

Full Text Available Students' rating of teaching is one of the most widely accepted methods of measuring the quality in Higher Education worldwide. The overall experience gained by the students during their academic journey in their respective college is a key factor to determine the Institutional Quality. This study was conducted among the Physical Therapy students with an objective to capture the overall experience related to various aspects of their Academic environment including teaching and learning process adopted in their college. To facilitate that, a unique questionnaire called,"Academic Environment Evaluation Questionnaire (AEEQ was developed covering all the important teaching elements of the Higher Education Institutions. The students' opinion was captured and analyzed through six sigma analytical tool using Poisson distribution model. From the non-conformance level captured through the responses from the students about the various categories of teaching and learning elements, the corresponding Sigma rating for each teaching element was measured. Accordingly, a six point Quality rating system was developed customizing to each sigma values. This study brings a new, innovative student driven Quality rating system for the Higher Education Institutions in India.

Symptomatic Avascular Necrosis: An Understudied Risk Factor for Acute Care Utilization by Patients with SCD

Science.gov (United States)

Yu, Tiffany; Campbell, Timothy; Ciuffetelli, Isabella; Haywood, Carlton; Carroll, C. Patrick; Resar, Linda M.S.; Strouse, John J.; Lanzkron, Sophie

2016-01-01

Objectives Sickle cell disease (SCD) is associated with high healthcare utilization rates and poor outcomes in a subset of patients, although the underlying factors that predict this phenotype are poorly understood. Prior studies suggest that comorbid avascular necrosis (AVN) contributes to high healthcare utilization. We sought to clarify whether AVN independently predicts acute care utilization in adults with SCD and to identify characteristics of those with AVN that predict higher utilization. Methods We reviewed the medical records of 87 patients with SCD with symptomatic AVN and compared acute care utilization and clinical characteristics with 87 sex- and age-matched patients with SCD without symptomatic AVN. Patients with ≥2 years of follow-up were included. Outcomes were compared using bivariate analysis and multivariate regression. Results Our study included 1381 follow-up years, with a median of 7 years per patient. The AVN cohort had greater median rates of urgent care visits (3.2/year vs 1.3/year; P = 0.0155), admissions (1.3/year vs 0.4/year; P = 0.0002), and admission days (5.1 days/year vs 1.8 days/year; P = 0.0007). History of high utilization (odds ratio [OR] 4.28; P = 0.001), acute chest syndrome (OR 3.12; P = 0.005), pneumonia (OR 3.20; P = 0.023), hydroxyurea therapy (OR 2.23; P = 0.0136), and long-term transfusion (OR 2.33; P = 0.014) were associated with AVN. In a median regression model, AVN, acute chest syndrome, and pneumonia were independently associated with greater urgent care visits and admissions. Conclusions Symptomatic AVN was found to be an independent risk factor for acute care utilization in patients with SCD. Because this is a potentially modifiable factor, further studies are urgently needed to determine whether AVN prevention/early treatment interventions will alter utilization and improve outcomes for patients with SCD. PMID:27598353

Markets: green utilities

International Nuclear Information System (INIS)

Wood, Elisa

2006-01-01

Publicly owned utilities have consistently led the United States in the rate of customer participation in green power programmes. The US has about 2000 community and state-owned utilities, which serve 43 million customers and account for about 16.6% of kilowatt-hour sales to consumers. In all, public power is responsible for about 10% of the nation's installed electric capacity. Investor owned utilities account for 39%, with the remainder of the nation's power mostly from independent power generators. Although IOUs have almost four times as much electric capacity as public power, they edge out public power by only a small margin when it comes to renewable capacity. IOUs are responsible for 24,577.5 MW of renewable capacity, compared to the 21,338 MW installed by public power. The reasons discussed by the author range from small town advantage to clean and cheap power. (Author)

Project financing consequences on cogeneration: industrial plant and municipal utility co-operation in Sweden

International Nuclear Information System (INIS)

Sundberg, Gunnel; Sjoedin, J.Joergen

2003-01-01

The liberalisation of the European electricity market influences investment decisions in combined heat and power plants. Energy companies modify their business strategies and their criteria for investments in power generation capacity. In this paper, the gains from a co-operation between a paper mill and municipal utility are studied. We find that a widened system boundary, including both the industrial plant and the district heating company, increases cost-effectiveness by 7-11%, compared to a situation with two separately optimised systems. Furthermore, optimal investments are strongly influenced by the actors' different required returns. With a relatively low required rate of return on energy investments, typical for a municipally owned utility, the most profitable investment is a wood chips-fuelled cogeneration plant. With a higher rate of return on capital, typical for a competitive industry, the optimal investment is mainly a heat-only steam boiler. Finally, some general influences on required rate of return caused by electricity market deregulation are observed. Whilst tending to increase companies' required returns, deregulation may, besides extending the outlet for locally generated electricity, also obstruct long-term high-cost investments such as cogeneration based on conventional technology

Kidneys at Higher Risk of Discard: Expanding the Role of Dual Kidney Transplantation

Science.gov (United States)

Tanriover, B.; Mohan, S.; Cohen, D. J.; Radhakrishnan, J.; Nickolas, T. L.; Stone, P. W.; Tsapepas, D. S.; Crew, R. J.; Dube, G. K.; Sandoval, P. R.; Samstein, B.; Dogan, E.; Gaston, R. S.; Tanriover, J. N.; Ratner, L. E.; Hardy, M. A.

2014-01-01

Half of the recovered expanded criteria donor (ECD) kidneys are discarded in the United States. A new kidney allocation system offers kidneys at higher risk of discard, Kidney Donor Profile Index (KDPI) >85%, to a wider geographic area to promote broader sharing and expedite utilization. Dual kidney transplantation (DKT) based on the KDPI is a potential option to streamline allocation of kidneys which otherwise would have been discarded. To assess the clinical utility of the KDPI in kidneys at higher risk of discard, we analyzed the OPTN/UNOS Registry that included the deceased donor kidneys recovered between 2002 and 2012. The primary outcomes were allograft survival, patient survival and discard rate based on different KDPI categories (90%). Kidneys with KDPI >90% were associated with increased odds of discard (OR = 1.99, 95% CI 1.74–2.29) compared to ones with KDPI 90% were associated with lower overall allograft failure (HR = 0.74, 95% CI 0.62–0.89) and better patient survival (HR = 0.79, 95% CI 0.64–0.98) compared to single ECD kidneys with KDPI >90%. Kidneys at higher risk of discard may be offered in the up-front allocation system as a DKT. Further modeling and simulation studies are required to determine a reasonable KDPI cutoff percentile. PMID:24472195

Differences in energy expenditures and growth dilution explain higher PCB concentrations in male summer flounder

Science.gov (United States)

Madenjian, Charles P.; Jensen, Olaf P.; Rediske, Richard R.; O'Keefe, James P.; Vastano, Anthony R.; Pothoven, Steven A.

2016-01-01

Comparison of polychlorinated biphenyl (PCB) concentrations between the sexes of mature fish may reveal important behavioral and physiological differences between the sexes. We determined whole-fish PCB concentrations in 23 female summer flounder Paralichthys dentatus and 27 male summer flounder from New Jersey coastal waters. To investigate the potential for differences in diet or habitat utilization between the sexes, carbon and nitrogen stable isotope ratios were also determined. In 5 of the 23 female summer flounder, PCB concentrations in the somatic tissue and ovaries were determined. In addition, we used bioenergetics modeling to assess the contribution of the growth dilution effect to the observed difference in PCB concentrations between the sexes. Whole-fish PCB concentrations for females and males averaged 87 and 124 ng/g, respectively; thus males were 43% higher in PCB concentration compared with females. Carbon and nitrogen stable isotope ratios did not significantly differ between the sexes, suggesting that diet composition and habitat utilization did not vary between the sexes. Based on PCB determinations in the somatic tissue and ovaries, we predicted that PCB concentration of females would increase by 0.6%, on average, immediately after spawning due to release of eggs. Thus, the change in PCB concentration due to release of eggs did not explain the higher PCB concentrations observed in males. Bioenergetics modeling results indicated that the growth dilution effect could account for males being 19% higher in PCB concentration compared with females. Thus, the bulk of the observed difference in PCB concentrations between the sexes was not explained by growth dilution. We concluded that a higher rate of energy expenditure in males, stemming from greater activity and a greater resting metabolic rate, was most likely the primary driver for the observed difference in PCB concentrations between the sexes.

Differences in Energy Expenditures and Growth Dilution Explain Higher PCB Concentrations in Male Summer Flounder.

Directory of Open Access Journals (Sweden)

Charles P Madenjian

Full Text Available Comparison of polychlorinated biphenyl (PCB concentrations between the sexes of mature fish may reveal important behavioral and physiological differences between the sexes. We determined whole-fish PCB concentrations in 23 female summer flounder Paralichthys dentatus and 27 male summer flounder from New Jersey coastal waters. To investigate the potential for differences in diet or habitat utilization between the sexes, carbon and nitrogen stable isotope ratios were also determined. In 5 of the 23 female summer flounder, PCB concentrations in the somatic tissue and ovaries were determined. In addition, we used bioenergetics modeling to assess the contribution of the growth dilution effect to the observed difference in PCB concentrations between the sexes. Whole-fish PCB concentrations for females and males averaged 87 and 124 ng/g, respectively; thus males were 43% higher in PCB concentration compared with females. Carbon and nitrogen stable isotope ratios did not significantly differ between the sexes, suggesting that diet composition and habitat utilization did not vary between the sexes. Based on PCB determinations in the somatic tissue and ovaries, we predicted that PCB concentration of females would increase by 0.6%, on average, immediately after spawning due to release of eggs. Thus, the change in PCB concentration due to release of eggs did not explain the higher PCB concentrations observed in males. Bioenergetics modeling results indicated that the growth dilution effect could account for males being 19% higher in PCB concentration compared with females. Thus, the bulk of the observed difference in PCB concentrations between the sexes was not explained by growth dilution. We concluded that a higher rate of energy expenditure in males, stemming from greater activity and a greater resting metabolic rate, was most likely the primary driver for the observed difference in PCB concentrations between the sexes.

Predicting higher education graduation rates from institutional characteristics and resource allocation

Directory of Open Access Journals (Sweden)

Florence A. Hamrick

2004-05-01

Full Text Available This study incorporated institutional characteristics (e.g., Carnegie type, selectivity and resource allocations (e.g., instructional expenditures, student affairs expenditures into a statistical model to predict undergraduate graduation rates. Instructional expenditures, library expenditures, and a number of institutional classification variables were significant predictors of graduation rates. Based on these results, recommendations as well as warranted cautions are included about allocating academic financial resources to optimize graduation rates

[Comparison of potential yield and resource utilization efficiency of main food crops in three provinces of Northeast China under climate change].

Science.gov (United States)

Wang, Xiao-yu; Yang, Xiao-guang; Sun, Shuang; Xie, Wen-juan

2015-10-01

Based on the daily data of 65 meteorological stations from 1961 to 2010 and the crop phenology data in the potential cultivation zones of thermophilic and chimonophilous crops in Northeast China, the crop potential yields were calculated through step-by-step correction method. The spatio-temporal distribution of the crop potential yields at different levels was analyzed. And then we quantified the limitations of temperature and precipitation on the crop potential yields and compared the differences in the climatic resource utilization efficiency. The results showed that the thermal potential yields of six crops (including maize, rice, spring wheat, sorghum, millet and soybean) during the period 1961-2010 deceased from west to east. The climatic potential yields of the five crops (spring wheat not included) were higher in the south than in the north. The potential yield loss rate due to temperature limitations of the six crops presented a spatial distribution pattern and was higher in the east than in the west. Among the six main crops, the yield potential loss rate due to temperature limitation of the soybean was the highest (51%), and those of the other crops fluctuated within the range of 33%-41%. The potential yield loss rate due to water limitation had an obvious regional difference, and was high in Songnen Plain and Changbai Mountains. The potential yield loss rate of spring wheat was the highest (50%), and those of the other four rainfed crops fluctuated within the range of 8%-10%. The solar energy utilization efficiency of the six main crops ranged from 0.9% to 2.7%, in the order of maize> sorghum>rice>millet>spring wheat>soybean. The precipitation utilization efficiency of the maize, sorghum, spring wheat, millet and soybean under rainfed conditions ranged from 8 to 35 kg . hm-2 . mm-1, in the order of maize>sorghum>spring wheat>millet>soybean. In those areas with lower efficiency of solar energy utilization and precipitation utilization, such as Changbai

Development of high capacity, high rate lithium ion batteries utilizing metal fiber conductive additives

Science.gov (United States)

Ahn, Soonho; Kim, Youngduk; Kim, Kyung Joon; Kim, Tae Hyung; Lee, Hyungkeun; Kim, Myung H.

As lithium ion cells dominate the battery market, the performance improvement is an utmost concern among developers and researchers. Conductive additives are routinely employed to enhance electrode conductivity and capacity. Carbon particulates—graphite or carbon black powders—are conventional and popular choices as conductive fillers. However, percolation requirements of particles demand significant volumetric content of impalpable, and thereby high area conductive fillers. As might be expected, the electrode active surface area escalates unnecessarily, resulting in overall increase in reaction with electrolytes and organic solvents. The increased reactions usually manifest as an irreversible loss of anode capacity, gradual oxidation and consumption of electrolyte on the cathode—which causes capacity decline during cycling—and an increased threat to battery safety by gas evolution and exothermic solvent oxidation. In this work we have utilized high aspect ratio, flexible, micronic metal fibers as low active area and high conductivity additives. The metal fibers appear well dispersed within the electrode and to satisfy percolation requirements very efficiently at very low volumetric content compared to conventional carbon-based conductive additives. Results from 18650-type cells indicate significant enhancements in electrode capacity and high rate capability while the irreversible capacity loss is negligible.

Higher Education Support Services and Graduation Rates of Structured Education Program Students

Science.gov (United States)

Hepner, Seth

2017-01-01

The 1st-year retention rate of the Structured Education Program (SEP) is 90%, yet the 6-year graduation rate of SEP students is 29%. The gap between SEP 1st-year retention and graduation rates is the problem that this study addressed. The low graduation rate of SEP students is an important issue because graduation rates are used to measure the…

Effect of temperature during ion sputtering on the surface segregation rate of antimony in an iron-antimony alloy at higher temperatures

International Nuclear Information System (INIS)

Oku, M.; Hirokawa, K.; Kimura, H.; Suzuki, S.

1986-01-01

The surface segregation of antimony in an iron-0.23 at% antimony alloy was studied by XPS. The segregation rate in the temperature range between 800 and 900 K depends on the temperature during sputtering with argon ion of kinetic energy of 1 keV. The sputtering at room temperature or 473 K gives higher values of the segregation rate than those at 673 K. Both cases give the activation energy of 170 kJmol -1 for the surface segregation rate. The segregation of antimony is not observed after the sample is heated at 1000 K. (author)

Thermophilic anaerobic degradation of butyrate by a butyrate-utilizing bacterium in coculture and triculture with methanogenic bacteria.

Science.gov (United States)

Ahring, B K; Westermann, P

1987-02-01

We studied syntrophic butyrate degradation in thermophilic mixed cultures containing a butyrate-degrading bacterium isolated in coculture with Methanobacterium thermoautotrophicum or in triculture with M. thermoautotrophicum and the TAM organism, a thermophilic acetate-utilizing methanogenic bacterium. Butyrate was beta-oxidized to acetate with protons as the electron acceptors. Acetate was used concurrently with its production in the triculture. We found a higher butyrate degradation rate in the triculture, in which both hydrogen and acetate were utilized, than in the coculture, in which acetate accumulated. Yeast extract, rumen fluid, and clarified digestor fluid stimulated butyrate degradation, while the effect of Trypticase was less pronounced. Penicillin G, d-cycloserine, and vancomycin caused complete inhibition of butyrate utilization by the cultures. No growth or degradation of butyrate occurred when 2-bromoethanesulfonic acid or chloroform, specific inhibitors of methanogenic bacteria, was added to the cultures and common electron acceptors such as sulfate, nitrate, and fumarate were not used with butyrate as the electron donor. Addition of hydrogen or oxygen to the gas phase immediately stopped growth and butyrate degradation by the cultures. Butyrate was, however, metabolized at approximately the same rate when hydrogen was removed from the cultures and was metabolized at a reduced rate in the cultures previously exposed to hydrogen.

Estimation of Viable Biomass In Wastewater And Activated Sludge By Determination of ATP, Oxygen Utilization Rate And FDA Hydrolysis

DEFF Research Database (Denmark)

Jørgensen, Poul-Erik; Eriksen, T.; Jensen, B.K.

1992-01-01

ATP content, oxygen utilization rate (OUR) and fluorescein diacetate (FDA) hydrolysis were tested for the ability to express the amount of viable biomass in wastewater and activated sludge. The relationship between biomass and these activity parameters was established in growth cultures made...... with biomass, while FDA hydrolysis in the sludge failed to show any such correlation. Conversion factors of 3 mg ATP/g dw, 300 mg O2/h g dw and 0.4 A/h (mg dw/ml) for ATP, OUR and FDA methods, respectively, were calculated. When the methods were applied for in situ determinations in four different wastewater...... plants, it was found that ATP content and respiration rate estimated viable biomass to range from 81 to 293 mg dw/g SS for raw wastewater and from 67 to 187 mg dw/g SS for activated sludge with a rather weak correlation between ATP and respiration measurements. The FDA hydrolysis estimated viable biomass...

Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.

Science.gov (United States)

Ruderman, Michael A; Wilson, Deirdra F; Reid, Savanna

2015-01-01

This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17), drug violations (HR 2.44 95% CI: 2.00-2.98), non-violent violations (HR 2.14 95% CI: 1.73-2.64), violent and serious violations (HR 1.88 95% CI: 1.45-2.43), and technical violations (HR 1.86 95% CI: 1.37-2.53). Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.

Thermophilic Anaerobic Degradation of Butyrate by a Butyrate-Utilizing Bacterium in Coculture and Triculture with Methanogenic Bacteria

OpenAIRE

Ahring, Birgitte K.; Westermann, Peter

1987-01-01

We studied syntrophic butyrate degradation in thermophilic mixed cultures containing a butyrate-degrading bacterium isolated in coculture with Methanobacterium thermoautotrophicum or in triculture with M. thermoautotrophicum and the TAM organism, a thermophilic acetate-utilizing methanogenic bacterium. Butyrate was β-oxidized to acetate with protons as the electron acceptors. Acetate was used concurrently with its production in the triculture. We found a higher butyrate degradation rate in th...

The relationship of post-acute home care use to Medicaid utilization and expenditures.

Science.gov (United States)

Payne, Susan M C; DiGiuseppe, David L; Tilahun, Negussie

2002-06-01

To describe the use of post-acute home care (PAHC) and total Medicaid expenditures among hospitalized nonelderly adult Medicaid eligibles and to test whether health services utilization rates or total Medicaid expenditures were lower among Medicaid eligibles who used PAHC compared to those who did not. 5,299 Medicaid patients aged 18-64 discharged in 1992-1996 from 29 hospitals in the Cleveland Health Quality Choice (CHQC) project. Linked Ohio Medicaid claims and CHQC medical record abstract data. One stay per patient was randomly selected. Observational study. To control for treatment selection bias, we developed a model predicting the probability (propensity) a patient would be referred to PAHC, as a proxy for the patient's need for PAHC. We matched 430 patients who used Medicaid-covered PAHC ("USE") to patients who did not ("NO USE") by their propensity scores. Study outcomes were inpatient re-admission rates and days of stay (DOS), nursing home admission rates and DOS, and mean total Medicaid expenditures 90 and 180 days after discharge. Of 3,788 medical patients, 12.1 percent were referred to PAHC; 64 percent of those referred used PAHC. Of 1,511 surgical patients, 10.9 percent were referred; 99 percent of those referred used PAHC. In 430 pairs of patients matched by propensity score, mean total Medicaid expenditures within 90 days after discharge were $7,649 in the USE group and $5,761 in the NO USE group. Total Medicaid expenditures were significantly higher in the USE group compared to the NO USE group for medical patients after 180 days (p analysis indicates the results may be influenced by unmeasured variables, most likely functional status and/or care-giver support. Thirty-six percent of the medical patients referred to PAHC did not receive Medicaid-covered services. This suggests potential underuse among medical patients. The high post-discharge expenditures suggest opportunities for reducing costs through coordinating utilization or diverting it to

Chiropractic and CAM Utilization: A Descriptive Review

Directory of Open Access Journals (Sweden)

Meeker William C

2007-01-01

Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

Not So Fast: How Slower Utilities Regulation Can Reduce Prices and Increase Profits

Directory of Open Access Journals (Sweden)

G. Kent Fellows

2013-05-01

Full Text Available Energy consumers are facing cost pressures from multiple directions. Wholesale natural gas prices have been climbing substantially from their record lows. Oil prices have only recently cooled slightly after reaching nearly $100 a barrel (WTI earlier this year. That makes it that much more important to minimize costs to wholesale consumers of energy, and ultimately, retail buyers, wherever possible. There is little room in the energy network for unnecessary costs. But in a regulated system, profits for utilities must remain healthy, too, if we expect them to stay active in the market. But the way that government agencies regulate oil and gas pipelines in Canada, and elsewhere, appears to be increasing costs beyond where they need to be in order to fairly serve both utilities and customers. By relying on traditional rate-of-return regulation models — which calculate price-rates based on the regulated firm’s cost of capital (that is, how much it costs the company to finance its operations — regulators, including the National Energy Board and the Alberta Utilities Commission, reward firms for over-investing in their operations, rather than reducing costs. Utilities are motivated to prolong the period in which they can earn a return on their capital, since it is one of the few opportunities they have to increase profits under the widely used rateof-return regulatory model. That results in utilities keeping assets on the books — and paying for them — longer than they might otherwise need to be. The end result is a distortion of the decisions made by regulated firms and higher prices for consumers than might occur under a different regulatory model. Regulators that take a more passive role in setting the rate of return for their client industries, however, are likely to see their idleness pay off. Firms with a freer hand to do so will seek to accelerate the depreciation of capital assets, reducing costs more quickly. The result may see end

Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort.

Science.gov (United States)

Fogel, Anna; Goh, Ai Ting; Fries, Lisa R; Sadananthan, Suresh A; Velan, S Sendhil; Michael, Navin; Tint, Mya-Thway; Fortier, Marielle V; Chan, Mei Jun; Toh, Jia Ying; Chong, Yap-Seng; Tan, Kok Hian; Yap, Fabian; Shek, Lynette P; Meaney, Michael J; Broekman, Birit F P; Lee, Yung Seng; Godfrey, Keith M; Chong, Mary F F; Forde, Ciarán G

2017-04-01

Faster eating rates are associated with increased energy intake, but little is known about the relationship between children's eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children's BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity.

Hualapai Tribal Utility Development Project

Energy Technology Data Exchange (ETDEWEB)

Hualapai Tribal Nation

2008-05-25

The first phase of the Hualapai Tribal Utility Development Project (Project) studied the feasibility of establishing a tribally operated utility to provide electric service to tribal customers at Grand Canyon West (see objective 1 below). The project was successful in completing the analysis of the energy production from the solar power systems at Grand Canyon West and developing a financial model, based on rates to be charged to Grand Canyon West customers connected to the solar systems, that would provide sufficient revenue for a Tribal Utility Authority to operate and maintain those systems. The objective to establish a central power grid over which the TUA would have authority and responsibility had to be modified because the construction schedule of GCW facilities, specifically the new air terminal, did not match up with the construction schedule for the solar power system. Therefore, two distributed systems were constructed instead of one central system with a high voltage distribution network. The Hualapai Tribal Council has not taken the action necessary to establish the Tribal Utility Authority that could be responsible for the electric service at GCW. The creation of a Tribal Utility Authority (TUA) was the subject of the second objective of the project. The second phase of the project examined the feasibility and strategy for establishing a tribal utility to serve the remainder of the Hualapai Reservation and the feasibility of including wind energy from a tribal wind generator in the energy resource portfolio of the tribal utility (see objective 2 below). It is currently unknown when the Tribal Council will consider the implementation of the results of the study. Objective 1 - Develop the basic organizational structure and operational strategy for a tribally controlled utility to operate at the Tribe’s tourism enterprise district, Grand Canyon West. Coordinate the development of the Tribal Utility structure with the development of the Grand Canyon

The electric utilities in 1989 - A perspective

International Nuclear Information System (INIS)

Studness, C.M.

1990-01-01

This article presents the performance of electric utilities financially and in the stock market. The performance of the utility stocks compared with industrial stocks and long term government bonds is addressed as well as an analysis of the reasons for the differences. The effect of rate increases granted versus the rate of inflation on per share earnings is examined. A concern was expressed that increases in demand substantially larger than those projected by the industry for 1989 may result in excess capacity disappearing much sooner than predicted by industry managements

Effects of increasing dietary protein levels on growth, feed utilization ...

African Journals Online (AJOL)

Yomi

2012-01-05

Jan 5, 2012 ... The effect of different dietary protein levels on growth performance and on feed utilization of catfish. (Heterobranchus ... (Legendre, 1991) because of its taste, fast growth rate ..... diet containing 40% protein had high growth with low food intake and feed ... protein rate (45%) combined with a bad utilization of.

Factors associated with the utilization of institutional delivery services in Bangladesh.

Directory of Open Access Journals (Sweden)

Sanni Yaya

Full Text Available Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A. However, the provision of universal access to reproductive healthcare (MDG-5B and the utilization of maternal healthcare services (MHS such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh.Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011; participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression.According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604, and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437. Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624, and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional

Utility of the Conners' Adult ADHD Rating Scale validity scales in identifying simulated attention-deficit hyperactivity disorder and random responding.

Science.gov (United States)

Walls, Brittany D; Wallace, Elizabeth R; Brothers, Stacey L; Berry, David T R

2017-12-01

Recent concern about malingered self-report of symptoms of attention-deficit hyperactivity disorder (ADHD) in college students has resulted in an urgent need for scales that can detect feigning of this disorder. The present study provided further validation data for a recently developed validity scale for the Conners' Adult ADHD Rating Scale (CAARS), the CAARS Infrequency Index (CII), as well as for the Inconsistency Index (INC). The sample included 139 undergraduate students: 21 individuals with diagnoses of ADHD, 29 individuals responding honestly, 54 individuals responding randomly (full or half), and 35 individuals instructed to feign. Overall, the INC showed moderate sensitivity to random responding (.44-.63) and fairly high specificity to ADHD (.86-.91). The CII demonstrated modest sensitivity to feigning (.31-.46) and excellent specificity to ADHD (.91-.95). Sequential application of validity scales had correct classification rates of honest (93.1%), ADHD (81.0%), feigning (57.1%), half random (42.3%), and full random (92.9%). The present study suggests that the CII is modestly sensitive (true positive rate) to feigned ADHD symptoms, and highly specific (true negative rate) to ADHD. Additionally, this study highlights the utility of applying the CAARS validity scales in a sequential manner for identifying feigning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A software reconfigurable optical multiband UWB system utilizing a bit-loading combined with adaptive LDPC code rate scheme

Science.gov (United States)

He, Jing; Dai, Min; Chen, Qinghui; Deng, Rui; Xiang, Changqing; Chen, Lin

2017-07-01

In this paper, an effective bit-loading combined with adaptive LDPC code rate algorithm is proposed and investigated in software reconfigurable multiband UWB over fiber system. To compensate the power fading and chromatic dispersion for the high frequency of multiband OFDM UWB signal transmission over standard single mode fiber (SSMF), a Mach-Zehnder modulator (MZM) with negative chirp parameter is utilized. In addition, the negative power penalty of -1 dB for 128 QAM multiband OFDM UWB signal are measured at the hard-decision forward error correction (HD-FEC) limitation of 3.8 × 10-3 after 50 km SSMF transmission. The experimental results show that, compared to the fixed coding scheme with the code rate of 75%, the signal-to-noise (SNR) is improved by 2.79 dB for 128 QAM multiband OFDM UWB system after 100 km SSMF transmission using ALCR algorithm. Moreover, by employing bit-loading combined with ALCR algorithm, the bit error rate (BER) performance of system can be further promoted effectively. The simulation results present that, at the HD-FEC limitation, the value of Q factor is improved by 3.93 dB at the SNR of 19.5 dB over 100 km SSMF transmission, compared to the fixed modulation with uncoded scheme at the same spectrum efficiency (SE).

Integrated biogas upgrading and hydrogen utilization in an anaerobic reactor containing enriched hydrogenotrophic methanogenic culture

DEFF Research Database (Denmark)

Luo, Gang; Angelidaki, Irini

2012-01-01

Biogas produced by anaerobic digestion, is mainly used in a gas motor for heat and electricity production. However, after removal of CO2, biogas can be upgraded to natural gas quality, giving more utilization possibilities, such as utilization as autogas, or distant utilization by using...... the existing natural gas grid. The current study presents a new biological method for biogas upgrading in a separate biogas reactor, containing enriched hydrogenotrophic methanogens and fed with biogas and hydrogen. Both mesophilic- and thermophilic anaerobic cultures were enriched to convert CO2 to CH4...... by addition of H2. Enrichment at thermophilic temperature (55°C) resulted in CO2 and H2 bioconversion rate of 320 mL CH4/(gVSS h), which was more than 60% higher than that under mesophilic temperature (37°C). Different dominant species were found at mesophilic- and thermophilic-enriched cultures, as revealed...

Youth Mental Health Services Utilization Rates After a Large-Scale Social Media Campaign: Population-Based Interrupted Time-Series Analysis.

Science.gov (United States)

Booth, Richard G; Allen, Britney N; Bray Jenkyn, Krista M; Li, Lihua; Shariff, Salimah Z

2018-04-06

Despite the uptake of mass media campaigns, their overall impact remains unclear. Since 2011, a Canadian telecommunications company has operated an annual, large-scale mental health advocacy campaign (Bell Let's Talk) focused on mental health awareness and stigma reduction. In February 2012, the campaign began to explicitly leverage the social media platform Twitter and incented participation from the public by promising donations of Can $0.05 for each interaction with a campaign-specific username (@Bell_LetsTalk). The intent of the study was to examine the impact of this 2012 campaign on youth outpatient mental health services in the province of Ontario, Canada. Monthly outpatient mental health visits (primary health care and psychiatric services) were obtained for the Ontario youth aged 10 to 24 years (approximately 5.66 million visits) from January 1, 2006 to December 31, 2015. Interrupted time series, autoregressive integrated moving average modeling was implemented to evaluate the impact of the campaign on rates of monthly outpatient mental health visits. A lagged intervention date of April 1, 2012 was selected to account for the delay required for a patient to schedule and attend a mental health-related physician visit. The inclusion of Twitter into the 2012 Bell Let's Talk campaign was temporally associated with an increase in outpatient mental health utilization for both males and females. Within primary health care environments, female adolescents aged 10 to 17 years experienced a monthly increase in the mental health visit rate from 10.2/1000 in April 2006 to 14.1/1000 in April 2015 (slope change of 0.094 following campaign, Pcampaign, Pcampaign (slope change of 0.005, P=.02; slope change of 0.003, P=.005, respectively). For young adults aged 18 to 24 years, females who used primary health care experienced the most significant increases in mental health visit rates from 26.5/1000 in April 2006 to 29.2/1000 in April 2015 (slope change of 0.17 following

Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.

Directory of Open Access Journals (Sweden)

Michael A Ruderman

Full Text Available This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004.Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees.Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs with 95% confidence intervals (CIs were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis.Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17, drug violations (HR 2.44 95% CI: 2.00-2.98, non-violent violations (HR 2.14 95% CI: 1.73-2.64, violent and serious violations (HR 1.88 95% CI: 1.45-2.43, and technical violations (HR 1.86 95% CI: 1.37-2.53.Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.

Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis

Science.gov (United States)

Ruderman, Michael A.; Wilson, Deirdra F.; Reid, Savanna

2015-01-01

Objective This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Background Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Methods Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Results Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05–4.17), drug violations (HR 2.44 95% CI: 2.00–2.98), non-violent violations (HR 2.14 95% CI: 1.73–2.64), violent and serious violations (HR 1.88 95% CI: 1.45–2.43), and technical violations (HR 1.86 95% CI: 1.37–2.53). Conclusions Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted. PMID:26492490

Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe

Science.gov (United States)

Marx, Florian M.; Fiebig, Lena; Hauer, Barbara; Brodhun, Bonita; Glaser-Paschke, Gisela; Haas, Walter

2015-01-01

Background In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents. Methods A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data. Results Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0–32.6) in first-, 10.2 (95%CI: 6.1–16.6) in second generation migrants, and 4.6 (95%CI: 3.7–5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%. Conclusions There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group. PMID:26061733

Determinants of Maternal Healthcare Utilization in Nigeria ...

African Journals Online (AJOL)

Reproductive healthcare has remained a point of concern in sub-Saharan Africa due to the prevailing high maternal mortality rate. Despite the fact that the utilization of maternal healthcare services is a curbing solution, the records of utilization still remains low. This paper examined the determinants of the decision to use ...

Theoretical and computational study of the energy dependence of the muon transfer rate from hydrogen to higher-Z gases

Energy Technology Data Exchange (ETDEWEB)

Bakalov, Dimitar, E-mail: dbakalov@inrne.bas.bg [Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, Tsarigradsko chaussée 72, Sofia 1784 (Bulgaria); Adamczak, Andrzej [Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Krakow (Poland); Stoilov, Mihail [Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, Tsarigradsko chaussée 72, Sofia 1784 (Bulgaria); Vacchi, Andrea [Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Via A. Valerio 2, 34127 Trieste (Italy)

2015-01-23

The recent PSI Lamb shift experiment and the controversy about proton size revived the interest in measuring the hyperfine splitting in muonic hydrogen as an alternative possibility for comparing ordinary and muonic hydrogen spectroscopy data on proton electromagnetic structure. This measurement critically depends on the energy dependence of the muon transfer rate to heavier gases in the epithermal range. The available data provide only qualitative information, and the theoretical predictions have not been verified. We propose a new method by measurements of the transfer rate in thermalized target at different temperatures, estimate its accuracy and investigate the optimal experimental conditions. - Highlights: • Method for measuring the energy dependence of muon transfer rate to higher-Z gases. • Thermalization and depolarization of muonic hydrogen studied by Monte Carlo method. • Optimal experimental conditions determined by Monte Carlo simulations. • Mathematical model and for estimating the uncertainty of the experimental results.

Regulation of energy substrate utilization and hepatic insulin sensitivity by phosphatidylcholine transfer protein/StarD2.

Science.gov (United States)

Scapa, Erez F; Pocai, Alessandro; Wu, Michele K; Gutierrez-Juarez, Roger; Glenz, Lauren; Kanno, Keishi; Li, Hua; Biddinger, Sudha; Jelicks, Linda A; Rossetti, Luciano; Cohen, David E

2008-07-01

Phosphatidylcholine transfer protein (PC-TP, also known as StarD2) is a highly specific intracellular lipid binding protein with accentuated expression in oxidative tissues. Here we show that decreased plasma concentrations of glucose and free fatty acids in fasting PC-TP-deficient (Pctp(-/-)) mice are attributable to increased hepatic insulin sensitivity. In hyperinsulinemic-euglycemic clamp studies, Pctp(-/-) mice exhibited profound reductions in hepatic glucose production, gluconeogenesis, glycogenolysis, and glucose cycling. These changes were explained in part by the lack of PC-TP expression in liver per se and in part by marked alterations in body fat composition. Reduced respiratory quotients in Pctp(-/-) mice were indicative of preferential fatty acid utilization for energy production in oxidative tissues. In the setting of decreased hepatic fatty acid synthesis, increased clearance rates of dietary triglycerides and increased hepatic triglyceride production rates reflected higher turnover in Pctp(-/-) mice. Collectively, these data support a key biological role for PC-TP in the regulation of energy substrate utilization.

Emotional Competence and Drop-Out Rates in Higher Education

Science.gov (United States)

Kingston, Emma

2008-01-01

Purpose: The purpose of this paper is to compare the emotional competence of first year undergraduates enrolled on a high or low drop-out rate (HDR and LDR, respectively) course, at a newly established university within the UK. Design/methodology/approach: A mixed methods approach using both quantitative and qualitative data collection methods was…

Octopus: LLL's computing utility

International Nuclear Information System (INIS)

Anon.

1978-01-01

The Laboratory's Octopus network constitutes one of the greatest concentrations of computing power in the world. This power derives from the network's organization as well as from the size and capability of its computers, storage media, input/output devices, and communication channels. Being in a network enables these facilities to work together to form a unified computing utility that is accessible on demand directly from the users' offices. This computing utility has made a major contribution to the pace of research and development at the Laboratory; an adequate rate of progress in research could not be achieved without it. 4 figures

To the problem of utilization of nuclear submarines

International Nuclear Information System (INIS)

Tarakanov, E.; Larin, V.

1999-01-01

Paper discusses a concept of step-by-step utilization of nuclear submarines in Russia. By the late 2000 minimum 160 nuclear submarines with over 300 nuclear reactors should be removed. Unloading of spent nuclear fuel from reactors, dismounting of nuclear submarines, efforts to arrange storage facilities for liquid and solid radioactive waste are the main steps of nuclear submarine utilization. Under the rates of nuclear submarine utilization being as they are, the utilization of 160 nuclear submarines will take about 30 years. Paper analyzes the alternative variants of nuclear submarine utilization and discusses the social and ecological aspects of utilization of nuclear submarines [ru

Activity-Based Costing Systems for Higher Education.

Science.gov (United States)

Day, Dennis H.

1993-01-01

Examines traditional costing models utilized in higher education and pinpoints shortcomings related to proper identification of costs. Describes activity-based costing systems as a superior alternative for cost identification, measurement, and allocation. (MLF)

Are American utilities sorry they went nuclear

International Nuclear Information System (INIS)

Dallaire, E.E.

1981-01-01

The future of nuclear power in the U.S. will be determined in large measure by what the electric utilities decide to do. Very few electric utilities are planning to build more nuclear power plants. Most utilities feel the 12 to 14 years it takes to build a nuclear plant is simply too long, especially when construction money must be borrowed at record interest rates. Also, there are too many uncertainties regarding what an acceptable plant design is. On the other hand, these utilities also strongly believe that the U.S. needs nuclear power and that it would be imprudent for a utility to put all its energy eggs in one basket, coal

High-gravity brewing utilizing factorial design

Directory of Open Access Journals (Sweden)

R. B. Almeida

2000-06-01

Full Text Available A number of factors can influence the behavior of yeast during fermentation. Some of these factors (initial wort concentration, initial pH and percentage of corn syrup in the composition of the wort were studied in order to determine their influence on the productivity of fermentation. Fermentations were carried out at 25ºC utilizing a 2³ factorial design of these factors. The results showed that the percentage of corn syrup had no influence on process productivity, whereas initial pH and especially initial wort concentration did. It can be concluded that using pH and initial wort concentration values higher than those utilized in this work (5.5 and 20ºP, respectively will result in a higher productivity.

Calculating utility prudency issue costs

International Nuclear Information System (INIS)

Nielsen, K.R.

1985-01-01

The nuclear industry, particularly utilities and their construction, engineering and vendor agents, is faced with a surging increase in prudency management audits. What started as primarily a nuclear project-oriented requirement has spread to encompass most significant utility capital construction projects. Such audits are often a precedent condition to commencement of rate hearings. The cost engineer, a primary major capital construction project participant, is required to develop or critique ''prudency issue'' costs as part of such audits. Although utility costs in the broadest sense are potentially at issue, this paper concentrates on the typical project/construction management costs. The costs of design, procurement and construction are all subject to the calculation process

Effect of adaptive abilities on utilities, direct or mediated by mental health?

NARCIS (Netherlands)

Peeters, Yvette; Ranchor, Adelita V.; Vlieland, Thea P. M. Vliet; Stiggelbout, Anne M.

2010-01-01

Background: In cost-utility analyses gain in health can be measured using health state utilities. Health state utilities can be elicited from members of the public or from patients. Utilities given by patients tend to be higher than utilities given by members of the public. This difference is often

Evaluating Utility Gloves as a Potential Reservoir for Pathogenic Bacteria.

Science.gov (United States)

Grant, Kathy L; Naber, E Donald; Halteman, William A

2015-08-01

This pilot study sought to determine the rate and degree to which gram-negative Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa and gram-positive Staphylococcus aureus occurred on the inside of utility gloves used at University of Maine at Augusta, Dental Health Programs' dental hygiene clinic. Five steam autoclave utility gloves were randomly selected to serve as control and a convenience sample of 10 used utility gloves were selected from the sterilization area. A sample was collected from a predetermined surface area from the inside of each steam autoclave utility glove and used utility glove. Each sample was used to inoculate a Petri plate containing 2 types of culture media. Samples were incubated at 37° C for 30 to 36 hours in aerobic conditions. Colony forming units (CFU) were counted. Confidence intervals (CI) estimated the rate of contamination with gram-negative K. pneumoniae, E. coli and P. aeruginosa on the inside of steam autoclave utility gloves to be n=33 95% CL [0.000, 0.049], used utility gloves to be n=70, 95% CL [0.000, 0.0303]. Data estimated the rate of contamination with gram-positive S. aureus on the inside of steam autoclave utility gloves to be n=35, 95% CL [0.233, 0.530], used utility gloves to be n=70, 95% CL [0.2730, 0.4975]. Culture media expressed a wide range of CFU from 0 to over 200. The risk of utility glove contamination with gram-negative bacteria is likely low. The expressed growth of S. aureus from steam autoclave utility gloves controls raises questions about the effectiveness and safety of generally accepted sterilization standards for the governmentally mandated use of utility gloves. Copyright © 2015 The American Dental Hygienists’ Association.

Higher USA State Resident Neuroticism Is Associated With Lower State Volunteering Rates.

Science.gov (United States)

McCann, Stewart J H

2017-12-01

Highly neurotic persons have dispositional characteristics that tend to precipitate social anxiety that discourages formal volunteering. With the 50 American states as analytical units, Study 1 found that state resident neuroticism correlated highly ( r = -.55) with state volunteering rates and accounted for another 26.8% of the volunteering rate variance with selected state demographics controlled. Study 2 replicated Study 1 during another period and extended the association to college student, senior, secular, and religious volunteering rates. Study 3 showed state resident percentages engaged in other social behaviors involving more familiarity and fewer demands than formal volunteering related to state volunteering rates but not to neuroticism. In Study 4, state resident neuroticism largely accounted statistically for relations between state volunteering rates and state population density, collectivism, social capital, Republican preference, and well-being. This research is the first to show that state resident neuroticism is a potent predictor of state volunteering rates.

Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings.

Science.gov (United States)

Siddiqi, Arjumand; Jones, Marcella K; Erwin, Paul Campbell

2015-04-01

As the struggle continues to explain the relatively high rates of infant mortality (IMR) exhibited in the United States, a renewed emphasis is being placed on the role of possible 'contextual' determinants. Cross-sectional and short time-series studies have found that higher income inequality is associated with higher IMR at the state level. Yet, descriptively, the longer-term trends in income inequality and in IMR seem to call such results into question. To assess whether, over the period 1990-2007, state-level income inequality is associated with state-level IMR; to examine whether the overall effect of income inequality on IMR over this period varies by state; to test whether the association between income inequality and IMR varies across this time period. IMR data--number of deaths per 1000 live births in a given state and year--were obtained from the U.S. Centers for Disease Control Wonder database. Income inequality was measured using the Gini coefficient, which varies from zero (complete equality) to 100 (complete inequality). Covariates included state-level poverty rate, median income, and proportion of high school graduates. Fixed and random effects regressions were conducted to test hypotheses. Fixed effects models suggested that, overall, during the period 1990-2007, income inequality was inversely associated with IMR (β = -0.07, SE (0.01)). Random effects models suggested that when the relationship was allowed to vary at the state-level, it remained inverse (β = -0.05, SE (0.01)). However, an interaction between income inequality and time suggested that, as time increased, the effect of income inequality had an increasingly positive association with total IMR (β = 0.009, SE (0.002)). The influence of state income inequality on IMR is dependent on time, which may proxy for time-dependent aspects of societal context. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of high-voltage pulsed electric field (HPEF pretreatment on biogas production rates of hybrid Pennisetum by anaerobic fermentation

Directory of Open Access Journals (Sweden)

Baijuan Wang

2018-02-01

Full Text Available In this paper, the raw materials of hybrid Pennisetum were pretreated in different conditions of high voltage pulsed electric field (HPEF to improve its material utilization ratios and biogas production rates of anaerobic fermentation. Then, anaerobic digestion experiments were conducted within 32 days at moderate temperature (35 °C with TS mass fraction (6%, inoculation rate (20% and initial pH (7.0. It is indicated that compared with the control group, 9 groups of hybrid Pennisetum pretreated by HPEF are obviously superior in gas production efficiency of anaerobic fermentation, and higher in cumulative gas production, peak daily gas production and maximum methane concentration; that the most remarkable stimulation occurs in the HPEF condition of 15 kV/120 Hz/60 min, in that situation, the cumulative gas production in the fermentation period of 32 days is up to 9587 mL, 26.95% higher than that of the control group, the peak daily gas production increases and the range of peak period extends. It is demonstrated that the optimal HPEF pretreatment time is 60 min and three HPEF parameters have a better effect on gas production in the order of voltage > time > frequency; and that the effect degree of treatment parameters on peak daily gas production is voltage, frequency and time in turn. It is concluded that HPEF can improve material utilization ratio and gas production rate of hybrid Pennisetum by anaerobic fermentation and shorten the gas production cycle. By virtue of this physical pretreatment method, the resource of Pennisetum is utilized sufficiently and the classes of energy plants are enlarged effectively. Keywords: Hybrid Pennisetum, Anaerobic fermentation, High voltage pulsed electric field (HPEF, Biogas, Material utilization ratio, Gas generation rate, Model, Stimulation

CEZ utility's coal-fired power plants: towards a higher environmental friendliness

International Nuclear Information System (INIS)

Kindl, V.; Spilkova, T.; Vanousek, I.; Stehlik, J.

1996-01-01

Environmental efforts of the major Czech utility, CEZ a.s., are aimed at reducing air pollution arising from electricity and heat generating facilities. There are 3 main kinds of activity in this respect: phasing out of coal fired power plants; technological provisions to reduce emissions of particulate matter, sulfur dioxide, and nitrogen oxides from those coal fired units that are to remain in operation after 1998; and completion of the Temelin nuclear power plant. In 1995, emissions of particulate matter, sulfur dioxide, nitrogen oxides, and carbon monoxide from CEZ's coal fired power plants were 19%, 79%, 59%, and 60%, respectively, with respect to the situation in 1992. The break-down of electricity generation by CEZ facilities (in GWh) was as follows in 1995: hydroelectric power plants 1673, nuclear power plants 12230, coal fired power plants without desulfurization equipment 30181, and coal fired power plants with desulfurization equipment 2277. Provisions implemented to improve the environmental friendliness of the individual CEZ's coal fired power plants are described in detail. (P.A.). 5 tabs., 1 fig

Factors that influence the selection and utilization of children’s medical insurance

Directory of Open Access Journals (Sweden)

Shishu Zhang

2015-12-01

Full Text Available The researchers analyzed how different regions in the USA, family structure, ethnicity, and family income levels influenced the selection and utilization of medical care programs and services by American children. To prevent any possible bias in the analysis and to produce reliable results, an endogenous switching model was utilized in the study. The researchers found no statistically significant differences in the number of doctor visits and hospital stays between children with insurance and children without insurance. However, significant differences were determined regarding family structure, family income, geographic regions, and ethnicity. Children from single-parent families with insurance coverage (private, Medicaid, or SCHIP had statistically higher rates of doctor visits and hospital stays than children from two-parent families with insurance coverage. Family income, region, and ethnicity variables all had significant impacts on the type of health insurance coverage that was reported for children.

Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

Science.gov (United States)

Campbell, Alistair; Hemsley, Samantha

2009-01-01

The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…

Community energy systems and the law of public utilities

Energy Technology Data Exchange (ETDEWEB)

Feurer, D.A.; Weaver, C.L.

1981-01-01

A detailed description is given of the laws and programs of the State of Nebraska governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitiled ''Community Energy Systems and the Law of Public Utilities--Volume One: An Overview.'' This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

Soil and applied sulphur utilization by sunflower grown on vertisol under rainfed conditions

International Nuclear Information System (INIS)

Sreemannarayana, B.; Sreenivasa Raju, A.

1993-01-01

In a field experiment, conducted with sunflower genotypes viz., Morden, APSH-11, and EC 68414 grown on a local black clay loam soil, fertilizer sulphur (labelled with 35 S) was applied at the rate of 0, 20, 40 and 60 kg S/ha through gypsum and ammonium sulphate. Among the sunflower genotypes, EC 68414 utilized maximum sulphur from the sources at any given growth stage i.e., star, bud, flowering and maturity. Sulphur applied through ammonium sulphate resulted in highest S utilization by all the genotypes at all the stages of growth. Though, sulphur uptake showed an increase, the S utilization decreased with increase in levels of S. The S uptake was highest at 60 kg S/ha level applied through any of the sources. The soil S uptake was higher than fertilizer S uptake at any given stage of crop. Maximum yields were recorded at 40 kg S/ha level signifying that this dose is optimum for sunflower grown on black clay loam soils. (author). 17 refs., 3 tabs

A Distributed Flow Rate Control Algorithm for Networked Agent System with Multiple Coding Rates to Optimize Multimedia Data Transmission

Directory of Open Access Journals (Sweden)

Shuai Zeng

2013-01-01

Full Text Available With the development of wireless technologies, mobile communication applies more and more extensively in the various walks of life. The social network of both fixed and mobile users can be seen as networked agent system. At present, kinds of devices and access network technology are widely used. Different users in this networked agent system may need different coding rates multimedia data due to their heterogeneous demand. This paper proposes a distributed flow rate control algorithm to optimize multimedia data transmission of the networked agent system with the coexisting various coding rates. In this proposed algorithm, transmission path and upload bandwidth of different coding rate data between source node, fixed and mobile nodes are appropriately arranged and controlled. On the one hand, this algorithm can provide user nodes with differentiated coding rate data and corresponding flow rate. On the other hand, it makes the different coding rate data and user nodes networked, which realizes the sharing of upload bandwidth of user nodes which require different coding rate data. The study conducts mathematical modeling on the proposed algorithm and compares the system that adopts the proposed algorithm with the existing system based on the simulation experiment and mathematical analysis. The results show that the system that adopts the proposed algorithm achieves higher upload bandwidth utilization of user nodes and lower upload bandwidth consumption of source node.

Techniques of analyzing the impacts of certain electric-utility ratemaking and regulatory-policy concepts. Bibliography

Energy Technology Data Exchange (ETDEWEB)

None

1980-08-01

This bibliography provides documentation for use by state public utility commissions and major nonregulated utilities in evaluating the applicability of a wide range of electric utility rate design and regulatory concepts in light of certain regulatory objectives. Part I, Utility Regulatory Objectives, contains 2084 citations on conservation of energy and capital; efficient use of facilities and resources; and equitable rates to electricity consumers. Part II, Rate Design Concepts, contains 1238 citations on time-of-day rates; seasonally-varying rates; cost-of-service rates; interruptible rates (including the accompanying use of load management techniques); declining block rates; and lifeline rates. Part III, Regulatory Concepts, contains 1282 references on restrictions on master metering; procedures for review of automatic adjustment clauses; prohibitions of rate or regulatory discrimination against solar, wind, or other small energy systems; treatment of advertising expenses; and procedures to protect ratepayers from abrupt termination of service.

Apparent oxygen utilization rates calculated from tritium and helium-3 profiles at the Bermuda Atlantic Time-series Study site

Directory of Open Access Journals (Sweden)

R. H. R. Stanley

2012-06-01

Full Text Available We present three years of Apparent Oxygen Utilization Rates (AOUR estimated from oxygen and tracer data collected over the ocean thermocline at monthly resolution between 2003 and 2006 at the Bermuda Atlantic Time-series Study (BATS site. We estimate water ages by calculating a transit time distribution from tritium and helium-3 data. The vertically integrated AOUR over the upper 500 m, which is a regional estimate of export, during the three years is 3.1 ± 0.5 mol O₂ m⁻² yr⁻¹. This is comparable to previous AOUR-based estimates of export production at the BATS site but is several times larger than export estimates derived from sediment traps or ²³⁴Th fluxes. We compare AOUR determined in this study to AOUR measured in the 1980s and show AOUR is significantly greater today than decades earlier because of changes in AOU, rather than changes in ventilation rates. The changes in AOU are likely a methodological artefact associated with problems with early oxygen measurements.

[Educational differences in health care utilization in the last year of life among South Korean cancer patients].

Science.gov (United States)

Choo, Soo-Young; Lee, Sang-Yi; Kim, Chul-Woung; Kim, Su Young; Yoon, Tae-Ho; Shin, Hai Rim; Moon, Ok Ryun

2007-01-01

There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n = 60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n = 57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.

Trends in utilization: has extremity MR imaging replaced diagnostic arthroscopy?

International Nuclear Information System (INIS)

Glynn, Nicole; Morrison, William B.; Parker, Laurence; Schweitzer, Mark E.; Carrino, John A.

2004-01-01

To examine the relative change in utilization of magnetic resonance (MR) imaging of the extremities versus diagnostic and therapeutic arthroscopy. Using the 1993, 1996, and 1999 nationwide Medicare Part B databases, utilization rates (per 100,000) were determined for upper and lower extremity MR imaging, diagnostic arthroscopy and therapeutic arthroscopy using CPT-4 codes. Utilization of extremity MR imaging was compared with that of diagnostic and therapeutic arthroscopy in 10 geographic regions of the United States and tracked over time. Combined lower and upper extremity MR imaging utilization per 100,000 increased from 393 to 1,056 in 1999 (+168.7%). Utilization of diagnostic arthroscopy of the extremities decreased from 18 in 1993 to 8 in 1999 (-55.6%); therapeutic arthroscopy rates increased from 461 in 1993 to 636 in 1999 (+40.0%). Specifically, from 1993 to 1999, utilization of lower extremity MR imaging increased from 270 to 661 (+144.8%). Utilization of diagnostic arthroscopy of the knee over the same time period decreased from 11 to 5 (-54.5%); therapeutic arthroscopy increased from 394 to 501 (+27.2%). Similarly, utilization rates for upper extremity MR imaging increased from 123 to 395 (+221.1%). Utilization of diagnostic arthroscopy of the shoulder over the same time period decreased from 7 to 2 (-71.4%); therapeutic arthroscopy increased from 44 to 104 (+136.4%). No specific geographic trends were ascertained. The utilization of MR imaging of the extremities has markedly increased from 1993 to 1999. During the same time period the utilization of diagnostic arthroscopy has decreased and that of therapeutic arthroscopy has increased. These findings support the hypothesis that there is increased reliance of clinical practitioners on the diagnostic information provided by MR imaging in preoperative clinical decision-making. (orig.)

Trends in Medicaid fee-for-service outpatient drug utilization ...

African Journals Online (AJOL)

utilization, expenditures, and pharmacy reimbursement rates (2010–2012) .... the factors that affect drug utilization and .... Impact of a generic substitution reform on patients' and society's ... Journal of Law & Economics 1993; 36(1): 71-97. 22.

When the 'soft-path' gets hard: demand management and financial instability for water utilities

Science.gov (United States)

Zeff, H. B.; Characklis, G. W.

2014-12-01

In the past, cost benefit analysis (CBA) has been viewed as an effective means of evaluating water utility strategies, particularly those that were dependent on the construction of new supply infrastructure. As water utilities have begun to embrace 'soft-path' approaches as a way to reduce the need for supply-centric development, CBA fails to recognize some important financial incentives affected by reduced water consumption. Demand management, both as a short-term response to drought and in longer-term actions to accommodate demand growth, can introduce revenue risks that adversely affect a utility's ability to repay debt, re-invest in aging infrastructure, or maintain reserve funds for use in a short-term emergency. A utility that does not generate sufficient revenue to support these functions may be subject to credit rating downgrades, which in turn affect the interest rate it pays on its debt. Interest rates are a critical consideration for utility managers in the capital-intensive water sector, where debt payments for infrastructure often account for a large portion of a utility's overall costs. Even a small increase in interest rates can add millions of dollars to the cost of new infrastructure. Recent studies have demonstrated that demand management techniques can lead to significant revenue variability, and credit rating agencies have begun to take notice of drought response plans when evaluating water utility credit ratings, providing utilities with a disincentive to fully embrace soft-path approaches. This analysis examines the impact of demand management schemes on key credit rating metrics for a water utility in Raleigh, North Carolina. The utility's consumer base is currently experiencing rapid population growth, and demand management has the potential to reduce the dependence on costly new supply infrastructure but could lead to financial instability that will significantly increase the costs of financing future projects. This work analyzes how 'soft

Predicting higher education graduation rates from institutional characteristics and resource allocation

OpenAIRE

Florence A. Hamrick; John H. Schuh; Mack C. Shelley

2004-01-01

This study incorporated institutional characteristics (e.g., Carnegie type, selectivity) and resource allocations (e.g., instructional expenditures, student affairs expenditures) into a statistical model to predict undergraduate graduation rates. Instructional expenditures, library expenditures, and a number of institutional classification variables were significant predictors of graduation rates. Based on these results, recommendations as well as warranted cautions are included about allocat...

Vigorous physical activity predicts higher heart rate variability among younger adults.

Science.gov (United States)

May, Richard; McBerty, Victoria; Zaky, Adam; Gianotti, Melino

2017-06-14

Baseline heart rate variability (HRV) is linked to prospective cardiovascular health. We tested intensity and duration of weekly physical activity as predictors of heart rate variability in young adults. Time and frequency domain indices of HRV were calculated based on 5-min resting electrocardiograms collected from 82 undergraduate students. Hours per week of both moderate and vigorous activity were estimated using the International Physical Activity Questionnaire. In regression analyses, hours of vigorous physical activity, but not moderate activity, significantly predicted greater time domain and frequency domain indices of heart rate variability. Adjusted for weekly frequency, greater daily duration of vigorous activity failed to predict HRV indices. Future studies should test direct measurements of vigorous activity patterns as predictors of autonomic function in young adulthood.

Utilization of electromigration in civil and environmental engineering - Processes, transport rates and matrix changes

DEFF Research Database (Denmark)

Ottosen, Lisbeth M.; Christensen, Iben Vernegren; Rörig-Dalgaard, Inge

2008-01-01

Electromigration (movement of ions in an applied electric field) is utilized for supply or extraction of ions from various porous materials within both civil and environmental engineering. In civil engineering, most research has been conducted on the removal of chlorides from concrete to hinder...... reinforcement corrosion while in environmental engineering remediation of heavy metal polluted soil is the issue most studied. Never the less, experiments have been conducted with utilization for several other materials and purposes within both engineering fields. Even though there are many topics of common...

Utilization of medical care following the Three Mile Island crisis

International Nuclear Information System (INIS)

Houts, P.S.; Hu, T.W.; Henderson, R.A.; Cleary, P.D.; Tokuhata, G.

1984-01-01

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small

Utilization of medical care following the Three Mile Island crisis.

Science.gov (United States)

Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

1984-02-01

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small.

Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program.

Science.gov (United States)

Moradiya, Yogesh; Crystal, Howard; Valsamis, Helen; Levine, Steven R

2013-12-03

We aimed to compare the rates of thrombolysis utilization for acute ischemic stroke in hospitals with neurology residency (NR) to those of other teaching (OT) and nonteaching (NT) hospitals. A retrospective serial cross-sectional cohort study of a nationally representative sample of stroke patients was conducted. Accreditation Council for Graduate Medical Education-accredited NR program-affiliated hospitals in the United States were cross-matched to the hospitals in the Nationwide Inpatient Sample from 2000 to 2010. ICD-9-CM codes were used for case ascertainment. A total of 712,433 adult ischemic stroke patients from 6,839 hospital samples were included, of whom 10.1%, 29.1%, and 60.8% were treated in NR, OT, and NT hospitals, respectively. Stroke patients in NR received thrombolysis more frequently (3.74% ± 0.24% [standard error]) than in OT (2.28% ± 0.11%, p < 0.001) and NT hospitals (1.44% ± 0.06%, p < 0.001). The adjusted odds ratios (ORs) of thrombolysis rates in NR vs OT and NR vs NT increased with each decade increment in age. In multivariate analysis, NR was independently predictive of higher thrombolysis rate (adjusted OR 1.51; 95% confidence interval [CI] 1.44-1.59 [NR vs OT], and adjusted OR 1.82; 95% CI 1.73-1.91 [NR vs NT]). Acute stroke care in NR hospitals is associated with an increased thrombolytic utilization. The disparities between the thrombolysis rate in NR and that in OT and NT hospitals are greater among elderly patients.

Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders.

Science.gov (United States)

Westermair, Anna Lisa; Schaich, Anja; Willenborg, Bastian; Willenborg, Christina; Nitsche, Stefan; Schunkert, Heribert; Erdmann, Jeanette; Schweiger, Ulrich

2018-01-01

Comorbid mental disorders in patients with coronary artery disease (CAD) are common and associated with adverse somatic outcomes. However, data on utilization rates of mental health care and treatment efficiency are scarce and inconsistent, which we tried to remedy with the present preliminary study on Northern German CAD patients. A total of 514 German CAD patients, as diagnosed by cardiac catheterization, were assessed using the Mini International Neuropsychiatric Interview and the Global Assessment of Functioning (GAF) scale. Global utilization of mental health care since onset of CAD was 21.0%. Depressive disorders, younger age, and lower GAF at onset of CAD were associated with higher utilization rates, while anxiety disorders and gender were not. Lower GAF at onset of CAD, female gender, and psychotherapy was positively associated with higher gains in GAF, while younger age and anxiety disorders were negatively associated. The majority of CAD patients with comorbid depression reported to have received mental health treatment and seemed to have benefited from it. However, we found preliminary evidence of insufficiencies in the diagnosis and treatment of anxiety disorders in CAD patients. Further studies, preferably prospective and with representative samples, are needed to corroborate or falsify these findings and explore possible further mediators of health-care utilization by CAD patients such as race, ethnicity, and socioeconomic status.

A P2P Query Algorithm for Opportunistic Networks Utilizing betweenness Centrality Forwarding

Directory of Open Access Journals (Sweden)

Jianwei Niu

2013-01-01

Full Text Available With the proliferation of high-end mobile devices that feature wireless interfaces, many promising applications are enabled in opportunistic networks. In contrary to traditional networks, opportunistic networks utilize the mobility of nodes to relay messages in a store-carry-forward paradigm. Thus, the relay process in opportunistic networks faces several practical challenges in terms of delay and delivery rate. In this paper, we propose a novel P2P Query algorithm, namely Betweenness Centrality Forwarding (PQBCF, for opportunistic networking. PQBCF adopts a forwarding metric called Betweenness Centrality (BC, which is borrowed from social network, to quantify the active degree of nodes in the networks. In PQBCF, nodes with a higher BC are preferable to serve as relays, leading to higher query success rate and lower query delay. A comparison with the state-of-the-art algorithms reveals that PQBCF can provide better performance on both the query success Ratio and query delay, and approaches the performance of Epidemic Routing (ER with much less resource consumption.

Is the higher rate of parental child homicide in stepfamilies an effect of non-genetic relatedness?

Institute of Scientific and Technical Information of China (English)

Hans TEMRIN; Johanna NORDLUND; Mikael RYING; Birgitta S. TULLBERG

2011-01-01

In an evolutionary perspective individuals are expected to vary the degree of parental love and care in relation to the fitness value that a child represents. Hence, stepparents are expected to show less solicitude than genetically related parents, and this lack of genetic relatedness has been used to explain the higher frequencies of child abuse and homicide found in stepfamilies.However, other factors than non-genetic relatedness may cause this over-representation in stepfamilies. Here we use a 45-year data set of parental child homicides in Sweden to test two hypotheses related to the higher incidence in stepfamilies: 1) adults in different types of family differ in their general disposition to use violence, and 2) parents are more likely to kill stepchildren than genetically related children. Of the 152 perpetrators in biparental families there was an overrepresentation of perpetrators in stepfamilies (n=27) compared with the general population. We found support for the first hypothesis in that both general and violent crime rates were higher in stepfamilies, both in the general population and among perpetrators of child homicide. However, we found no support for the second hypothesis because of the 27 perpetrators in stepfamilies the perpetrator killed a genetically related child in 13 cases, a stepchild in 13 cases and both types of children in one case. Moreover, out of the 12 families where the perpetrator lived with both stepchildren and genetic children, there was no bias towards killing stepchildren. Thus, we found no evidence for an effect of non-genetic relatedness per se [Current Zoology 57 (3): 253-59, 2011].

Understanding Rig Rates

OpenAIRE

Petter Osmundsen; Knut Einar Rosendahl; Terje Skjerpen

2013-01-01

We examine the largest cost component in offshore development projects, drilling rates, which have been high over the last years. To our knowledge, rig rates have not been analysed empirically before in the economic literature. By econometric analysis we examine the effects on Gulf of Mexico rig rates of gas and oil prices, rig capacity utilization, contract length and lead time, and rig specific characteristics. Having access to a unique data set containing contract information, we are able ...

Productivity, utilization efficiency and sward targets for mixed pastures of marandugrass, forage peanut and tropical kudzu

Directory of Open Access Journals (Sweden)

Carlos Mauricio Soares de Andrade

2012-03-01

Full Text Available This study was carried out to evaluate the productivity and utilization efficiency of a mixed marandugrass (Brachiaria brizantha cv. Marandu, forage peanut (Arachis pintoi cv. Mandobi and tropical kudzu (Pueraria phaseoloides pasture, rotationally stocked at four daily forage allowance levels (6.6, 10.3, 14.3 and 17.9% of live weight, in order to define sward management targets for these mixtures. In each stocking cycle, dry matter (DM accumulation rates, defoliation intensity (%, grazing depth (% and grazed horizon (cm were evaluated. Sward targets were defined according to the sward condition that best conciliated the grass-legume balance and the equilibrium between forage production and utilization. Pastures submitted to higher forage allowance levels showed higher productivity, but were less efficiently utilized. It was not possible to establish sward management targets for marandugrass-tropical kudzu pastures. For marandugrass-forage peanut pastures the best sward state was set with forage allowance of 10.3% of live weight. Under rotational stocking, the following sward targets were suggested for these pastures in the Western Amazon: pre-grazing height of 30-35 cm (June to September or 45-50 cm (October to May and post-grazing sward height of 20-25 cm (June to September or 25-30 cm (October to May.

Eliciting and Combining Decision Criteria Using a Limited Palette of Utility Functions and Uncertainty Distributions: Illustrated by Application to Pest Risk Analysis.

Science.gov (United States)

Holt, Johnson; Leach, Adrian W; Schrader, Gritta; Petter, Françoise; MacLeod, Alan; van der Gaag, Dirk Jan; Baker, Richard H A; Mumford, John D

2014-01-01

Utility functions in the form of tables or matrices have often been used to combine discretely rated decision-making criteria. Matrix elements are usually specified individually, so no one rule or principle can be easily stated for the utility function as a whole. A series of five matrices are presented that aggregate criteria two at a time using simple rules that express a varying degree of constraint of the lower rating over the higher. A further nine possible matrices were obtained by using a different rule either side of the main axis of the matrix to describe situations where the criteria have a differential influence on the outcome. Uncertainties in the criteria are represented by three alternative frequency distributions from which the assessors select the most appropriate. The output of the utility function is a distribution of rating frequencies that is dependent on the distributions of the input criteria. In pest risk analysis (PRA), seven of these utility functions were required to mimic the logic by which assessors for the European and Mediterranean Plant Protection Organization arrive at an overall rating of pest risk. The framework enables the development of PRAs that are consistent and easy to understand, criticize, compare, and change. When tested in workshops, PRA practitioners thought that the approach accorded with both the logic and the level of resolution that they used in the risk assessments. © 2013 Society for Risk Analysis.

Decentralized method for utility regulation

Energy Technology Data Exchange (ETDEWEB)

Loeb, M. (North Carolina State Univ., Raleigh); Magat, W.A.

1979-10-01

A new institutional arrangement for regulating utilities is suggested that minimizes the costs of natural monopolies. A mixture of regulation and franchising, the plan draws on the advantages of each and eliminates many of the problems. The proposal allows utilities to set their own price on the basis of demand and marginal-cost projections. Subsidies are provided by the regulatory agency if there is a consumer surplus. The system encourages the utility to select a competitive price and to produce only the amount of service needed. Operating efficiency is encouraged by rewarding cost reductions and discouraging cost overstatement at the rate review. The regulatory agency would not need to take action to bring price and marginal costs into equality. The franchise sale can be made by competitive bidding, in which the bidders would capitalize part or all of the subsidy or the regulatory agency could recover the subsidy in a lump-sum tax on the utility.

Rates of change of the earth's magnetic field measured by recent analyses

Science.gov (United States)

Harrison, C. G. A.; Huang, Qilin

1990-01-01

Typical rates of change of the earth's magnetic field are presented as a function of the earth's spherical harmonics. Harmonics up to the eight degree are analyzed. With the increase in the degree of the harmonics an increase in the relative rate of change can be observed. For higher degrees, the rate of change can be predicted. This enables a differentiation between harmonics originating in the core and harmonics caused by crustal magnetization. The westward drift of the magnetic field depends on the longitudinal gradient of the field. In order to determine the longitudinal motions, harmonics up to degree 20 can be utilized. The average rate of secular acceleration increases with the degree of harmonics from 0.001 deg/sq yr for a dipole term to an average of 0.05 deg/sq yr for degree eight harmonics.

Rate shock crisis faces completed nukes

International Nuclear Information System (INIS)

Utroska, D.

1982-01-01

Political reluctance on the part of regulators to grant utilities a full rate base for large generating plants is a new crisis facing utilities with newly completed nuclear plants. Zero- or partial-rate treatment for large new plants will increase the financial strains of electric companies if they cannot recover their investment. Such rate decisions will affect the commitment to uncompleted and planned nuclear plants as the economic advantage is removed. Economists warn that consumer resistance to large rate increases to cover construction periods could lead to an overhaul of regulatory practices. Alternatives to sudden rate shocks could be moderated with phased-in increases or rate trending. Analysts disagree on whether consumer opposition is the beginning of a national movement or a regional response, but if other states follow Alabama's example of turning rate decisions over to the courts, it may confirm their assessment that the trending approach is unworkable

DSM and electric utility competitiveness: An Illinois perspective

Energy Technology Data Exchange (ETDEWEB)

Jackson, P.W.

1994-12-31

A predominant theme in the current electric utility industry literature is that competitive forces have emerged and may become more prominent. The wholesale bulk power market is alreadly competitive, as non-utility energy service providers already have had a significant impact on that market; this trend was accelerated by the Energy Policy Act of 1992. Although competition at the retail level is much less pervasive, electric utility customers increasingly have greater choice in selecting energy services. These choices may include, depending on the customer, the ability to self-generate, switch fuels, move to a new location, or rely more heavily on demand-side management as a means of controlling electric energy use. This paper explores the subject of how demand-side management (DSM) programs, which are often developed by a utility to satisfy resource requirements as a part of its least-cost planning process, can affect the utility`s ability to compete in the energy services marketplace. In this context, the term `DSM` is used in this paper to refer to those demand-side services and programs which provide resources to the utility`s system. Depending on one`s perspective, DSM programs (so defined) can be viewed either as an enhancement to the competitive position of a utility by enabling it to provide its customers with a broader menu of energy services, simultaneously satisfying the objectives of the utility as well as those of the customers, or as a detractor to a utility`s ability to compete. In the latter case, the concern is with respect to the potential for adverse rate impacts on customers who are not participants in DSM programs. The paper consists of an identification of the pros and cons of DSM as a competitive strategy, the tradeoff which can occur between the cost impacts and rate impacts of DSM, and an examination of alternative strategies for maximizing the utilization of DSM both as a resource and as a competitive strategy.

Music Genre as a Predictor of Resource Utilization at Outdoor Music Concerts.

Science.gov (United States)

Westrol, Michael S; Koneru, Susmith; McIntyre, Norah; Caruso, Andrew T; Arshad, Faizan H; Merlin, Mark A

2017-06-01

The aim of this study was to examine the various modern music genres and their effect on the utilization of medical resources with analysis and adjustment for potential confounders. A retrospective review of patient logs from an open-air, contemporary amphitheater over a period of 10 years was performed. Variables recorded by the medical personnel for each concert included the attendance, description of the weather, and a patient log in which nature and outcome were recorded. The primary outcomes were associations of genres with the medical usage rate (MUR). Secondary outcomes investigated were the association of confounders and the influences on the level of care provided, the transport rate, and the nature of medical complaint. A total of 2,399,864 concert attendees, of which 4,546 patients presented to venue Emergency Medical Services (EMS) during 403 concerts with an average of 11.4 patients (annual range 7.1-17.4) each concert. Of potential confounders, only the heat index ≥90°F (32.2°C) and whether the event was a festival were significant (P=.027 and .001, respectively). After adjustment, the genres with significantly increased MUR in decreasing order were: alternative rock, hip-hop/rap, modern rock, heavy metal/hard rock, and country music (Pmusic (P=.033). Alternative rock, hip-hop/rap, modern rock, heavy metal/hard rock, and country music concerts had higher levels of medical resource utilization. High heat indices and music festivals also increase the MUR. This information can assist event planners with preparation and resource utilization. Future research should focus on prospective validation of the regression equation. Westrol MS , Koneru S , McIntyre N , Caruso AT , Arshad FH , Merlin MA . Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):289-296.

Studies on nitrogen uptake and utilization by rape (Brassica napus L.) under different sowing dates

International Nuclear Information System (INIS)

Liu Qixin; Nie Guangming

1992-01-01

The nitrogen uptake and utilization by low erucic acid variety, Zhong You Di Gai No.2, of rape (Brassica napus L.) under different sowing dates were studied. Total N uptake, the percentage N derived from the fertilizer, the rate of utilization of nitrogenous fertilizer, the production efficiency of N-fertilizer (seed yield g/gN derived by rape plant from the fertilizer), total P uptake and the production efficiency of phosphorus (seed yield g/gP derived by rape plant from fertilizer and soil) were all significantly higher at early sowing than that at later sowing within the range of normal sowing dates. Therefore, the biomass yield, the seed yield and oil content all increased significantly at early sowing treatment, but erucic acid content showed no significant difference

Removal of boron(III) by N-methylglucamine-type cellulose derivatives with higher adsorption rate

International Nuclear Information System (INIS)

Inukai, Yoshinari; Tanaka, Yoshiharu; Matsuda, Toshio; Mihara, Nobutake; Yamada, Kouji; Nambu, Nobuyoshi; Itoh, Osamu; Doi, Takao; Kaida, Yasuhiko; Yasuda, Seiji

2004-01-01

To obtain adsorbents for boron(III) derived from a natural polymer, two forms (powder and fiber) of N-methylglucamine-type cellulose derivatives were newly synthesized. After the graft polymerization of two forms of cellulose with vinyl monomer having epoxy groups, the N-methylglucamine-type cellulose derivatives were obtained by the reaction of the grafted cellulose with N-methylglucamine. The adsorption capacities of the cellulose derivatives for boron(III) were the same levels as that of a commercially available N-methylglucamine-type polystyrene resin. However, the cellulose derivatives adsorbed boron(III) more quickly than the polystyrene resin. The adsorption and desorption of boron(III) with a column method using the cellulose fiber were achieved at a higher flow rate than that using the polystyrene resin. In addition, the boron(III), adsorbed on the cellulose fiber column, was quantitatively recovered with dilute hydrochloric acid in 20- and 200-fold increased concentrations. Consequently, it was found that the cellulose derivatives were superior to the polystyrene resin as adsorbents for boron(III) for treatment of a large quantity of wastewater

Trends in Utility Green Pricing Programs (2006)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Kaiser, M.

2007-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities--or about 25% of all utilities nationally--provide their customers a "green power" option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic.

Science.gov (United States)

Losina, Elena; Thornhill, Thomas S; Rome, Benjamin N; Wright, John; Katz, Jeffrey N

2012-02-01

Total knee replacement utilization in the United States more than doubled from 1999 to 2008. Although the reasons for this increase have not been examined rigorously, some have attributed the increase to population growth and the obesity epidemic. Our goal was to investigate whether the rapid increase in total knee replacement use over the past decade can be sufficiently attributed to changes in these two factors. We used data from the Nationwide Inpatient Sample to estimate changes in total knee replacement utilization rates from 1999 to 2008, stratified by age (eighteen to forty-four years, forty-five to sixty-four years, and sixty-five years or older). We obtained data on obesity prevalence and U.S. population growth from federal sources. We compared the rate of change in total knee replacement utilization with the rates of population growth and change in obesity prevalence from 1999 to 2008. In 2008, 615,050 total knee replacements were performed in the United States adult population, 134% more than in 1999. During the same time period, the overall population size increased by 11%. While the population of forty-five to sixty-four-year-olds grew by 29%, the number of total knee replacements in this age group more than tripled. The number of obese and non-obese individuals in the United States increased by 23% and 4%, respectively. Assuming unchanged indications for total knee replacement among obese and non-obese individuals with knee osteoarthritis over the last decade, these changes fail to account for the 134% growth in total knee replacement use. Population growth and obesity cannot fully explain the rapid expansion of total knee replacements in the last decade, suggesting that other factors must also be involved. The disproportionate increase in total knee replacements among younger patients may be a result of a growing number of knee injuries and expanding indications for the procedure.

A case study of utility PV economics

International Nuclear Information System (INIS)

Wenger, H.; Hoff, T.; Osborn, D.E.

1997-01-01

This paper presents selected results from a detailed study of grid-connected photovoltaic (PV) applications within the service area of the Sacramento Municipal Utility District. The intent is to better understand the economics and markets for grid-connected PV systems in a utility setting. Research results include: Benefits calculations for utility-owned PV systems at transmission and distribution voltages; How the QuickScreen software package can help utilities investigate the viability of distributed PV; Energy production and capacity credit estimates for fixed and tracking PV systems; Economics and rate impacts of net metering residential PV systems; Market potential estimates for residential rooftop PV systems; and Viability and timing of grid-connected PV commercialization paths

Do place of residence and ethnicity affect health services utilization? evidence from greece.

Science.gov (United States)

Lahana, Eleni; Pappa, Evelina; Niakas, Dimitris

2011-04-26

Equal utilization of health services for equal need, is one of the main targets for public health systems. Given the public-private structure of the Greek NHS, the main aim of the study was to investigate the impact of underlying factors, such as health care needs, socio-demographic characteristics and ethnicity, on the utilization of primary and hospital health care in an urban and rural population of the Greek region, Thessaly. A cross-sectional study was carried out in 2006 in Thessaly, a Greek region of Central Greece, in a representative sample of 1372 individuals (18+ years old, response rate 91.4%) via face-to-face interview. Health care needs were determined by self-perceived health status estimated by the SF-36 Health Survey, using the summary scores of physical and mental health. The utilization of primary care was measured by last month visits to 1) primary public services and 2) private practitioners visits and utilization of secondary care was measured by past year visits to 3) public hospital emergency departments and 4) admissions to public hospitals. Multivariable stepwise logistic regression analysis was applied in the whole sample and separately for the urban and rural population, in order to determine the predictors of health services utilization. Statistical significance was determined with a p value services utilization in both the urban and rural areas. Poor physical and mental health was associated with higher likelihood of use. In the urban areas middle-aged, elderly and Greeks were more likely to use primary health services, whereas primary education was associated with more visits to the emergency departments. Wealthier individuals were two times more likely to be admitted to hospitals. Individuals from the rural areas with university education visited more the public primary services, while wealthier individuals visited more the private practitioners. Immigrants had a higher likelihood of visiting emergency departments. Although health

Bladder Preservation for Localized Muscle-Invasive Bladder Cancer: The Survival Impact of Local Utilization Rates of Definitive Radiotherapy

International Nuclear Information System (INIS)

Kozak, Kevin R.; Hamidi, Maryam; Manning, Matthew; Moody, John S.

2012-01-01

Purpose: This study examines the management and outcomes of muscle-invasive bladder cancer in the United States. Methods and Materials: Patients with muscle-invasive bladder cancer diagnosed between 1988 and 2006 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Patients were classified according to three mutually exclusive treatment categories based on the primary initial treatment: no local management, radiotherapy, or surgery. Overall survival was assessed with Kaplan-Meier analysis and Cox models based on multiple factors including treatment utilization patterns. Results: The study population consisted of 26,851 patients. Age, sex, race, tumor grade, histology, and geographic location were associated with differences in treatment (all p < 0.01). Patients receiving definitive radiotherapy tended to be older and have less differentiated tumors than patients undergoing surgery (RT, median age 78 years old and 90.6% grade 3/4 tumors; surgery, median age 71 years old and 77.1% grade 3/4 tumors). No large shifts in treatment were seen over time, with most patients managed with surgical resection (86.3% for overall study population). Significant survival differences were observed according to initial treatment: median survival, 14 months with no definitive local treatment; 17 months with radiotherapy; and 43 months for surgery. On multivariate analysis, differences in local utilization rates of definitive radiotherapy did not demonstrate a significant effect on overall survival (hazard ratio, 1.002; 95% confidence interval, 0.999–1.005). Conclusions: Multiple factors influence the initial treatment strategy for muscle-invasive bladder cancer, but definitive radiotherapy continues to be used infrequently. Although patients who undergo surgery fare better, a multivariable model that accounted for patient and tumor characteristics found no survival detriment to the utilization of definitive radiotherapy. These results support continued

Calculating the marginal costs of a district-heating utility

International Nuclear Information System (INIS)

Sjoedin, Joergen; Henning, Dag

2004-01-01

District heating plays an important role in the Swedish heat-market. At the same time, the price of district heating varies considerably among different district-heating utilities. A case study is performed here in which a Swedish utility is analysed using three different methods for calculating the marginal costs of heat supply: a manual spreadsheet method, an optimising linear-programming model, and a least-cost dispatch simulation model. Calculated marginal-costs, obtained with the three methods, turn out to be similar. The calculated marginal-costs are also compared to the actual heat tariff in use by the utility. Using prices based on marginal costs should be able to bring about an efficient resource-allocation. It is found that the fixed rate the utility uses today should be replaced by a time-of-use rate, which would give a more accurate signal for customers to change their heat consumptions. (Author)

Enhancement of collaboration activities utilizing 21st century learning design rubric

Science.gov (United States)

Cubero, Dave D.; Gargar, Clare V., Lady; Nallano, Gerlett Grace D.; Magsayo, Joy R.; Guarin, Rica Mae B.; Lahoylahoy, Myrna E.

2018-01-01

Twenty first century learners have incredibly diverse learning interests, needs, and aspirations. Engaging middle school students and sculpting successful, confident, and creative learners is a constant endeavor for educators [4]. In the 21st century classroom environments in which students can develop the skills they need in workplace. Collaboration occurs when students work together to create, discuss challenge and develop deeper critical thinking. In today's workplace, collaboration is essential as only few tasks are completed alone (Calgary and Park, 2016). The collaborative project-based curriculum used in this classroom develops the higher order thinking skills, effective communication skills, and knowledge of technology that students will need in the 21st century workplace. The study therefore aims to promote collaboration skills among learners as it is deemed as one of the top 21st century skills. Collaborative learning unleashes a unique intellectual and social synergy. This study aims to enhance the collaborative skills of students through conducting collaboration activities in learning the Ecosystem. This research utilizes pretest-posttest and employs descriptive research designs. It uses modified activities about the lesson on Ecosystem and utilizes a Collaboration Rubric to rate the modified activities. The activities were rated by ten In-Service teachers and there are 105 students who participated in doing the activities. The paired t-test is then used to analyze the data. The In-Service teachers evaluated the 1st and 2nd adapted activity and are rated as fair. Thus, the modified activities were enhanced since the ratings of each activity did not meet the criterion of the collaboration rubric. As for the 3rd adapted activity is rated as excellent and is ready for implementation. The evaluators provided comments and suggestions such as producing colored pictures on the activities, omitting some questions, and making the words simpler to enhance the

Electric utilities in Illinois

Energy Technology Data Exchange (ETDEWEB)

1978-01-01

Although the conference dealt specifically with concerns of the electric utilities in Illinois, the issues were dealt with in the national context as well. A separate abstract was prepared for each of the 5 sections of this proceeding. A total of 25 papers were presented. Section titles are: Forecasting, Planning and Siting, Reliability, Rates and Financing, and Future Developments.

Is the higher rate of parental child homicide in stepfamilies an effect of non-genetic relatedness?

Directory of Open Access Journals (Sweden)

Hans TEMRIN, Johanna NORDLUND, Mikael RYING, Birgitta S. TULLBERG

2011-06-01

Full Text Available In an evolutionary perspective individuals are expected to vary the degree of parental love and care in relation to the fitness value that a child represents. Hence, stepparents are expected to show less solicitude than genetically related parents, and this lack of genetic relatedness has been used to explain the higher frequencies of child abuse and homicide found in stepfamilies. However, other factors than non-genetic relatedness may cause this over-representation in stepfamilies. Here we use a 45-year data set of parental child homicides in Sweden to test two hypotheses related to the higher incidence in stepfamilies: 1 adults in different types of family differ in their general disposition to use violence, and 2 parents are more likely to kill stepchildren than genetically related children. Of the 152 perpetrators in biparental families there was an overrepresentation of perpetrators in stepfamilies (n=27 compared with the general population. We found support for the first hypothesis in that both general and violent crime rates were higher in stepfamilies, both in the general population and among perpetrators of child homicide. However, we found no support for the second hypothesis because of the 27 perpetrators in stepfamilies the perpetrator killed a genetically related child in 13 cases, a stepchild in 13 cases and both types of children in one case. Moreover, out of the 12 families where the perpetrator lived with both stepchildren and genetic children, there was no bias towards killing stepchildren. Thus, we found no evidence for an effect of non-genetic relatedness per se [Current Zoology 57 (3: 253–259, 2011].

A relative rate utility based distributed power allocation algorithm for Cognitive Radio Networks

DEFF Research Database (Denmark)

Mahmood, Nurul Huda; Øien, G.E.; Lundheim, L.

2012-01-01

In an underlay Cognitive Radio Network, multiple secondary users coexist geographically and spectrally with multiple primary users under a constraint on the maximum received interference power at the primary receivers. Given such a setting, one may ask "how to achieve maximum utility benefit...

Investigation on the effect of blending ratio and airflow rate on syngas profile produced from co-gasification of blended feedstock

Directory of Open Access Journals (Sweden)

Inayat Muddasser

2017-01-01

Full Text Available Shortages of feedstock supply due to seasonal availability, high transportation costs, and lack of biomass market are creating serious problems in continues operation of bioenergy industry. Aiming at this problem, utilization of blended feedstock is proposed. In this work blends of two different biomasses (wood and coconut shells were co-gasified using externally heated downdraft gasifier. The effects of varying biomass blending ratio and airflow rate on gaseous components of syngas and its heating value were investigated. The results obtained from the experiments revealed that W20:CS80 blend yielded higher values for H2 (20 Vol.% and HHV (18 MJ/Nm3 as compared to the other blends. The higher airflow rate has a negative effect on syngas profile and heating value. The CO and CH4 were observed higher at the start of the process, however, CO was observed decreasing afterward, and the CH4 dropped to 5.0 Vol.%. The maximum H2 and CH4 were obtained at 2.5 LPM airflow rate. The process was noticed more stable at low air flow rates. The HHV was observed higher at the start of process at low airflow rate. It is concluded that low airflow rate and a higher ratio of coconut shells can improve the syngas quality during co-gasification.

Utility green pricing programs: a statistical analysis of program effectiveness

International Nuclear Information System (INIS)

Ryan, W.; Scott, O.; Lori, B.; Blair, S.

2005-01-01

Utility green pricing programs represent one way in which consumers can voluntarily support the development of renewable energy. The design features and effectiveness of these programs varies considerably. Based on a survey of utility program managers in the United States, this article provides insight into which program features might help maximize both customer participation in green pricing programs and the amount of renewable energy purchased by customers in those programs. We find that program length has a substantial impact on customer participation and purchases; to achieve higher levels of success, utilities will need to remain committed to their product offering for some time. Our findings also suggest that utilities should consider higher renewable energy purchase thresholds for residential customers in order to maximize renewable energy sales. Smaller utilities are found to be more successful than larger utilities, and we find some evidence that providing private benefits to nonresidential participants can enhance success. Interestingly, we find little evidence that the cost of the green pricing product greatly impacts customer participation and renewable energy sales, at least over the narrow range of premiums embedded in our data set, and for the initial set of green power purchasers. (author)

Improving the ablation efficiency of excimer laser systems with higher repetition rates through enhanced debris removal and optimized spot pattern.

Science.gov (United States)

Arba-Mosquera, Samuel; Klinner, Thomas

2014-03-01

To evaluate the reasons for the required increased radiant exposure for higher-repetition-rate excimer lasers and determine experimentally possible compensations to achieve equivalent ablation profiles maintaining the same single-pulse energies and radiant exposures for laser repetition rates ranging from 430 to 1000 Hz. Schwind eye-tech-solutions GmbH and Co. KG, Kleinostheim, Germany. Experimental study. Poly(methyl methacrylate) (PMMA) plates were photoablated. The pulse laser energy was maintained during all experiments; the effects of the flow of the debris removal, the shot pattern for the correction, and precooling the PMMA plates were evaluated in terms of achieved ablation versus repetition rate. The mean ablation performance ranged from 88% to 100%; the variability between the profile measurements ranged from 1.4% to 6.2%. Increasing the laser repetition rate from 430 Hz to 1000 Hz reduced the mean ablation performance from 98% to 91% and worsened the variability from 1.9% to 4.3%. Increasing the flow of the debris removal, precooling the PMMA plates to -18°C, and adapting the shot pattern for the thermal response of PMMA to excimer ablation helped stabilize the variability. Only adapting the shot pattern for the thermal response of PMMA to excimer ablation helped stabilize the mean ablation performance. The ablation performance of higher-repetition-rate excimer lasers on PMMA improved with improvements in the debris removal systems and shot pattern. More powerful debris removal systems and smart shot patterns in terms of thermal response improved the performance of these excimer lasers. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Neuron-Type-Specific Utility in a Brain-Machine Interface: a Pilot Study.

Science.gov (United States)

Garcia-Garcia, Martha G; Bergquist, Austin J; Vargas-Perez, Hector; Nagai, Mary K; Zariffa, Jose; Marquez-Chin, Cesar; Popovic, Milos R

2017-11-01

Firing rates of single cortical neurons can be volitionally modulated through biofeedback (i.e. operant conditioning), and this information can be transformed to control external devices (i.e. brain-machine interfaces; BMIs). However, not all neurons respond to operant conditioning in BMI implementation. Establishing criteria that predict neuron utility will assist translation of BMI research to clinical applications. Single cortical neurons (n=7) were recorded extracellularly from primary motor cortex of a Long-Evans rat. Recordings were incorporated into a BMI involving up-regulation of firing rate to control the brightness of a light-emitting-diode and subsequent reward. Neurons were classified as 'fast-spiking', 'bursting' or 'regular-spiking' according to waveform-width and intrinsic firing patterns. Fast-spiking and bursting neurons were found to up-regulate firing rate by a factor of 2.43±1.16, demonstrating high utility, while regular-spiking neurons decreased firing rates on average by a factor of 0.73±0.23, demonstrating low utility. The ability to select neurons with high utility will be important to minimize training times and maximize information yield in future clinical BMI applications. The highly contrasting utility observed between fast-spiking and bursting neurons versus regular-spiking neurons allows for the hypothesis to be advanced that intrinsic electrophysiological properties may be useful criteria that predict neuron utility in BMI implementation.

Decomposing the social discount rate

OpenAIRE

Scarborough, Helen

2010-01-01

Recent modelling of the costs and benefits of climate change has renewed debate surrounding assumptions regarding the social discount rate in analysing the impacts of environmental change. Previous literature segments the social discount rate into being influenced by two key factors; the rate of pure time preference and the elasticity of marginal utility of future consumption. These components of the social discount rate reinforce the linkages between the choice of social discount rate and in...

Immediate and sustained effects of user fee exemption on healthcare utilization among children under five in Burkina Faso: A controlled interrupted time-series analysis.

Science.gov (United States)

Zombré, David; De Allegri, Manuela; Ridde, Valéry

2017-04-01

Little is known about the long-term effects of user fee exemption policies on health care use in developing countries. We examined the association between user fee exemption and health care use among children under five in Burkina Faso. We also examined how factors related to characteristics of health facilities and their environment moderate this association. We used a multilevel controlled interrupted time-series design to examine the strength of effect and long term effects of user fee exemption policy on the rate of health service utilization in children under five between January 2004 and December 2014. The initiation of the intervention more than doubled the utilization rate with an immediate 132.596% increase in intervention facilities (IRR: 2.326; 95% CI: 1.980 to 2.672). The effect of the intervention was 32.766% higher in facilities with higher workforce density (IRR: 1.328; 95% CI (1.209-1.446)) and during the rainy season (IRR:1.2001; 95% CI: 1.0953-1.3149), but not significant in facilities with higher dispersed populations (IRR: 1.075; 95% CI: (0.942-1.207)). Although the intervention effect was substantially significant immediately following its inception, the pace of growth, while positive over a first phase, decelerated to stabilize itself three years and 7 months later before starting to decrease slowly towards the end of the study period. This study provides additional evidence to support user fee exemption policies complemented by improvements in health care quality. Future work should include an assessment of the impact of user fee exemption on infant morbidity and mortality and better discuss factors that could explain the slowdown in this upward trend of utilization rates three and a half years after the intervention onset. Copyright © 2017. Published by Elsevier Ltd.

The Three R's of Utility Savings: Rate Reduction, Rebates and Retrofit.

Science.gov (United States)

Petiunas, Raymond V.

1993-01-01

An effective way to increase electricity energy savings for school districts is to integrate rate case participation (rate reduction) with conservation and load-management efforts (rebates) and retrofit operations, to obtain a total energy cost reduction package. Describes how a Pennsylvania consortium of school districts saved its member…

Mergers, acquisitions, divestitures, and applications for market-based rates in a deregulating electric utility industry

International Nuclear Information System (INIS)

Cox, A.J.

1999-01-01

In this article, the author reviews FERC's current procedures for undertaking competitive analysis. The current procedure for evaluating the competitive impact of transactions in the electric utility industry is described in Order 592, in particular Appendix A. These procedures effectively revised criteria that had been laid out in Commonwealth Edison and brought its merger policy in line with the EPAct and the provisions of Order 888. Order 592 was an attempt to provide more certainty and expedition in handling mergers. It established three criteria that had to be satisfied for a merger to be approved: Post-merger market power must be within acceptable thresholds or be satisfactorily mitigated, acceptable customer protections must be in place (to ensure that rates will not go up as a result of increased costs) and any adverse effect on regulation must be addressed. FERC states that its Order 592 Merger Policy Statement is based upon the Horizontal Merger Guidelines issued jointly by the Federal Trade Commission and the Antitrust Division Department of Justice (FTC/DOJ Merger Guidelines). While it borrows much of the language and basic concepts of the Merger Guidelines, FERC's procedures have been criticized as not following the methodology closely enough, leaving open the possibility of mistakes in market definition

Mergers, acquisitions, divestitures, and applications for market-based rates in a deregulating electric utility industry

Energy Technology Data Exchange (ETDEWEB)

Cox, A.J.

1999-05-01

In this article, the author reviews FERC's current procedures for undertaking competitive analysis. The current procedure for evaluating the competitive impact of transactions in the electric utility industry is described in Order 592, in particular Appendix A. These procedures effectively revised criteria that had been laid out in Commonwealth Edison and brought its merger policy in line with the EPAct and the provisions of Order 888. Order 592 was an attempt to provide more certainty and expedition in handling mergers. It established three criteria that had to be satisfied for a merger to be approved: Post-merger market power must be within acceptable thresholds or be satisfactorily mitigated, acceptable customer protections must be in place (to ensure that rates will not go up as a result of increased costs) and any adverse effect on regulation must be addressed. FERC states that its Order 592 Merger Policy Statement is based upon the Horizontal Merger Guidelines issued jointly by the Federal Trade Commission and the Antitrust Division Department of Justice (FTC/DOJ Merger Guidelines). While it borrows much of the language and basic concepts of the Merger Guidelines, FERC's procedures have been criticized as not following the methodology closely enough, leaving open the possibility of mistakes in market definition.

Trends in Utility Green Pricing Programs (2004)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Brown, E.

2005-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, nearly 600 utilities in regulated electricity markets--or almost 20% of all utilities nationally--provide their customers a "green power" option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals about 125. Through these programs, more than 40 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2004 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities as benchmarks by which to gauge the success of their green power programs.

Trends in Utility Green Pricing Programs (2003)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Cardinal, K.

2004-09-01

Utilities first began offering consumers a choice of purchasing electricity generated from renewable energy sources in the early 1990s. Since then, the number of U.S. utilities offering green pricing programs has steadily grown. Today, more than 500 utilities in regulated electricity markets--or about 16% of all utilities nationally--offer their customers green power options. Because some of these utilities offer programs in conjunction with cooperative associations or other public power entities, the number of distinct programs is slightly more than 100. Through these programs, more than 33 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs, or make contributions to support the development of renewable energy resources. Typically, customers must pay a premium above standard electricity rates for this service. This report presents year-end 2003 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data provided in this report can be used by utilities as benchmarks by which to gauge the success of their green power programs.

The Effects of Gun Ownership Rates and Gun Control Laws on Suicide Rates

OpenAIRE

Mark Gius

2011-01-01

The purpose of the present study is to determine the effects of gun control laws and gun ownership rates on state-level suicide rates. Using the most recent data on suicide rates, gun control measures, and gun ownership rates, the results of the present study suggest that states that require handgun permits have lower gun-related suicide rates, and states that have higher gun ownership rates have higher gun-related suicide rates. Regarding non-gun suicides, results suggest that stricter gun c...

The Rate of Sepsis in a National Pediatric Population, 2006 to 2012.

Science.gov (United States)

Schuller, Kristin A; Hsu, Benson S; Thompson, Allyson B

2017-10-01

The rate of pediatric severe sepsis is reported to be on the rise in the United States, increasing by approximately 6000 cases annually. The goal of this study was to determine the rate of pediatric sepsis per 100 000 inpatient discharges over time. The 2006, 2009, and 2012 Agency for Healthcare Research and Quality Healthcare Cost Utilization Project Kid's Inpatient Databases were used to analyze the rate of sepsis in children over time. The rate of pediatric sepsis has increased over time from 92.8 per 100 000 in 2006 to 158.7 per 100 000 in 2012. Children less than a year old with Medicaid coverage and 3 or more procedures during hospitalization have significantly higher rates than their counterparts. This study helps clarify the population demographics that are at greater risk for sepsis infections. Understanding the at-risk population aids policymakers and care providers in targeting these populations and make drastic changes to sepsis policies.

Biomass ash utilization

Energy Technology Data Exchange (ETDEWEB)

Bristol, D.R.; Noel, D.J.; O`Brien, B. [HYDRA-CO Operations, Inc., Syracuse, NY (United States); Parker, B. [US Energy Corp., Fort Fairfield, ME (United States)

1993-12-31

This paper demonstrates that with careful analysis of ash from multiple biomass and waste wood fired power plants that most of the ash can serve a useful purpose. Some applications require higher levels of consistency than others. Examples of ash spreading for agricultural purposes as a lime supplement for soil enhancement in Maine and North Carolina, as well as a roadbase material in Maine are discussed. Use of ash as a horticultural additive is explored, as well as in composting as a filtering media and as cover material for landfills. The ash utilization is evaluated in a framework of environmental responsibility, regulations, handling and cost. Depending on the chemical and physical properties of the biomass derived fly ash and bottom ash, it can be used in one or more applications. Developing a program that utilizes ash produced in biomass facilities is environmentally and socially sound and can be financially attractive.

Public Utility Regulatory Policies Act of 1978. Annual report to Congress

Energy Technology Data Exchange (ETDEWEB)

None,

1980-05-01

Titles I and III of the Public Utility Regulatory Policies Act of 1978 (PURPA) establish retail regulatory policies for electric and natural gas utilities, respectively, aimed at achieving three purposes: conservation of energy supplied by electric and gas utilities; efficiency in the use of facilities and resources by these utilities; equitable rates to electricity and natural gas consumers. PURPA also continues the pilot utility implementation program, authorized under Title II of the Energy Conservation and Production ACT (ECPA), to encourage adoption of cost-based rates and efficient energy-management practices. The purpose of this report is twofold: (1) to summarize and analyze the progress that state regulatory authorities and certain nonregulated utilities have made in their consideration of the PURPA standards; and (2) to summarize the Department of Energy (DOE) activities relating to PURPA and ECPA. The report provides a broad overview and assessment of the status of electric and gas regulation nationwide, and thus helps provide the basis for congressional and DOE actions targeted on the utility industry to address pressing national energy problems.

Lung Focused Resuscitation at a Specialized Donor Care Facility Improves Lung Procurement Rates.

Science.gov (United States)

Chang, Stephanie H; Kreisel, Daniel; Marklin, Gary F; Cook, Lindsey; Hachem, Ramsey; Kozower, Benjamin D; Balsara, Keki R; Bell, Jennifer M; Frederiksen, Christine; Meyers, Bryan F; Patterson, G Alexander; Puri, Varun

2018-05-01

Lung procurement for transplantation occurs in approximately 20% of brain dead donors and is a major impediment to wider application of lung transplantation. We investigated the effect of lung protective management at a specialized donor care facility on lung procurement rates from brain dead donors. Our local organ procurement organization instituted a protocol of lung protective management at a freestanding specialized donor care facility in 2008. Brain dead donors from 2001 to 2007 (early period) were compared with those from 2009 to 2016 (current period) for lung procurement rates and other solid-organ procurement rates using a prospectively maintained database. An overall increase occurred in the number of brain dead donors during the study period (early group, 791; late group, 1,333; p procurement rate (lung donors/all brain dead donors) improved markedly after the introduction of lung protective management (early group, 157 of 791 [19.8%]; current group, 452 of 1,333 [33.9%]; p procurement rate (total number of organs procured/donor) also increased during the study period (early group, 3.5 organs/donor; current group, 3.8 organs/donor; p = 0.006). Lung protective management in brain dead donors at a specialized donor care facility is associated with higher lung utilization rates compared with conventional management. This strategy does not adversely affect the utilization of other organs in a multiorgan donor. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Discount rates, equity weights and the social cost of carbon

International Nuclear Information System (INIS)

Hope, Chris

2008-01-01

Equity weighting has been proposed as a way of allowing welfare equivalents to be included in the social cost of carbon since a dollar to a poor person is worth more than a dollar to a rich one. Here we use the PAGE2002 integrated assessment model to show that the social cost of carbon is higher without equity weights (an elasticity of marginal utility with respect to income of 0) than with them. This might seem counter-intuitive, but it comes about because of the logical link between equity weights and discount rates; as the elasticity goes from 0 to - 0.5 to - 1.0, the social rate of time preference rises, and the drop in present values that results far outweighs the small increase in impacts that equity weights bring. (author)

Cardiopulmonary Resuscitation Training Rates in the United States

Science.gov (United States)

Anderson, Monique L.; Cox, Margueritte; Al-Khatib, Sana M.; Nichol, Graham; Thomas, Kevin L.; Chan, Paul S.; Saha-Chaudhuri, Paramita; Fosbol, Emil L.; Eigel, Brian; Clendenen, Bill; Peterson, Eric D.

2014-01-01

Context Bystander cardiopulmonary resuscitation (CPR) improves the likelihood of surviving out-of-hospital cardiac arrest (OHCA), yet treatment rates differ by a community’s racial and income composition. Objective To determine if CPR training differs by the race and income of communities across the United States (U.S.). Design, Setting, and Participants We analyzed county-level CPR training rates from 2010–2011 using CPR training data from the American Heart Association, the American Red Cross, and the Health and Safety Institute. We utilized multivariable logistic regression models to examine the association of annual adult CPR training rates with a county’s proportion of black residents and median household income (categorized as tertiles), as well as other demographic, geographic, and healthcare characteristics. Main Outcome Measure CPR training rate. Results From 07/01/2010–06/30/2011, 13.1 million persons in 3143 U.S. counties received CPR training. The median county training rate ranged from 0.00%–1.29% (median=0.51%) in the lower tertile, 1.29%–4.07% (median=2.39%) in the middle tertile, and >4.07% (median=6.81%) in the upper tertile. Counties that were most likely to have CPR training rates in the lower tertile included those with a higher proportion of rural (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.10, 1.15 per 5 percentage point [PP] change), black (OR 1.09, 95% CI 1.06, 1.13 per 5 PP change), and Hispanic residents (OR 1.06, 95% CI 1.02, 1.11 per 5 PP change); those with a lower median household income (OR 1.18, 95% CI 1.04, 1.34 per $10,000 decrease); those with a higher median age (OR 1.28, 95% CI 1.04, 1.53 per 10 year change); and those located in the South. Conclusions Counties with a higher proportion of rural, black, Hispanic, and lower income residents had lower CPR training rates. Differences in CPR training by race and income may contribute to recognized disparities in bystander CPR treatment and OHCA survival, and

The rating reliability calculator

Directory of Open Access Journals (Sweden)

Solomon David J

2004-04-01

Full Text Available Abstract Background Rating scales form an important means of gathering evaluation data. Since important decisions are often based on these evaluations, determining the reliability of rating data can be critical. Most commonly used methods of estimating reliability require a complete set of ratings i.e. every subject being rated must be rated by each judge. Over fifty years ago Ebel described an algorithm for estimating the reliability of ratings based on incomplete data. While his article has been widely cited over the years, software based on the algorithm is not readily available. This paper describes an easy-to-use Web-based utility for estimating the reliability of ratings based on incomplete data using Ebel's algorithm. Methods The program is available public use on our server and the source code is freely available under GNU General Public License. The utility is written in PHP, a common open source imbedded scripting language. The rating data can be entered in a convenient format on the user's personal computer that the program will upload to the server for calculating the reliability and other statistics describing the ratings. Results When the program is run it displays the reliability, number of subject rated, harmonic mean number of judges rating each subject, the mean and standard deviation of the averaged ratings per subject. The program also displays the mean, standard deviation and number of ratings for each subject rated. Additionally the program will estimate the reliability of an average of a number of ratings for each subject via the Spearman-Brown prophecy formula. Conclusion This simple web-based program provides a convenient means of estimating the reliability of rating data without the need to conduct special studies in order to provide complete rating data. I would welcome other researchers revising and enhancing the program.

Analysis of small-scale biogas utilization systems on Ontario cattle farms

International Nuclear Information System (INIS)

White, Andrew J.; Kirk, Donald W.; Graydon, John W.

2011-01-01

The production of biogas through the anaerobic digestion of cattle manure and its subsequent use in the generation of electricity on larger farms in Ontario is currently economically attractive. This is a result of the Ontario Feed-In Tariff (FIT) program, which provides incentivized rates for the production of electricity from biogas. Although larger farms can take advantage of the higher rates for electricity, there are substantially more smaller farms for which individually designed and engineered biogas systems would be prohibitively expensive. By employing the concept of modular biogas plants, this analysis evaluates the economics of small-scale biogas utilization systems. Dairy farms with at least 33 animals and beef farms with at least 78 animals can operate economically attractive biogas systems. This analysis shows that approximately 9000 additional Ontario cattle farms would be able to take advantage of the FIT program, which would add 120 MW e of renewable energy capacity to the Ontario electrical grid. (author)

Impact of an alcohol misuse intervention for health care workers --2: Employee assistance programme utilization, on-the-job injuries, job loss and health services utilization.

Science.gov (United States)

Lapham, Sandra C; McMillan, Garnett; Gregory, Cindy

2003-01-01

We evaluated the effects of an enhanced substance misuse (SM) prevention/early intervention programme on referrals to an employee assistance programme, health care utilization rates, on-the-job injury rates and job termination rates among health care professionals employed in a managed care organization. The intervention was implemented at one site, with the remaining sites serving as the comparison group. Existing data from hospital databases were used to compare events occurring in the periods before and after initiation of the intervention. To account for baseline differences in age, gender and job class, logistic regression models produced adjusted means for events per employee month-at-risk. We found that employee assistance referrals and non-SM-related in-patient hospitalizations increased significantly post-intervention, while rates of total out-patient SM-related visits decreased at both the intervention and comparison sites post-intervention. There was a small, statistically significant decrease in the monthly rate (OR = 0.92) of non-SM out-patient utilization at the intervention site, once the intervention was in place. No differences potentially attributable to the intervention were detected in job turnover or injury rates. We conclude that, while the intervention did not appear to affect health care utilization for SM-related problems, it was associated with increased referrals for employee assistance.

Simultaneous measurement of glucose transport and utilization in the human brain

Science.gov (United States)

Shestov, Alexander A.; Emir, Uzay E.; Kumar, Anjali; Henry, Pierre-Gilles; Seaquist, Elizabeth R.

2011-01-01

Glucose is the primary fuel for brain function, and determining the kinetics of cerebral glucose transport and utilization is critical for quantifying cerebral energy metabolism. The kinetic parameters of cerebral glucose transport, KMt and Vmaxt, in humans have so far been obtained by measuring steady-state brain glucose levels by proton (1H) NMR as a function of plasma glucose levels and fitting steady-state models to these data. Extraction of the kinetic parameters for cerebral glucose transport necessitated assuming a constant cerebral metabolic rate of glucose (CMRglc) obtained from other tracer studies, such as 13C NMR. Here we present new methodology to simultaneously obtain kinetic parameters for glucose transport and utilization in the human brain by fitting both dynamic and steady-state 1H NMR data with a reversible, non-steady-state Michaelis-Menten model. Dynamic data were obtained by measuring brain and plasma glucose time courses during glucose infusions to raise and maintain plasma concentration at ∼17 mmol/l for ∼2 h in five healthy volunteers. Steady-state brain vs. plasma glucose concentrations were taken from literature and the steady-state portions of data from the five volunteers. In addition to providing simultaneous measurements of glucose transport and utilization and obviating assumptions for constant CMRglc, this methodology does not necessitate infusions of expensive or radioactive tracers. Using this new methodology, we found that the maximum transport capacity for glucose through the blood-brain barrier was nearly twofold higher than maximum cerebral glucose utilization. The glucose transport and utilization parameters were consistent with previously published values for human brain. PMID:21791622

The kinetics of Scenedesmus obliquus microalgae growth utilizing carbon dioxide gas from biogas

International Nuclear Information System (INIS)

Thiansathit, Worrarat; Keener, Tim C.; Khang, Soon-Jai; Ratpukdi, Thunyalux; Hovichitr, Patcharee

2015-01-01

Microalgae Scenedesmus obliquus was cultured in a laboratory photobioreactor to determine the efficacy of using biogas as a carbon source for the microalgae's growth. The biogas contained ∼60% CH 4 and ∼40% CO 2 , and was derived from an anaerobic digester operating from animal wastes, and an anaerobic reactor utilizing high strength wastewater. The results showed that biogas is a viable carbon source for microalgae growth and that significant portions of the biogas' CO 2 can be utilized for algae growth, resulting in a biogas having a high concentration of methane. This paper develops the kinetic expressions for the algae's growth by assuming an autocatalytic reaction between carbon substrate and microalgae. The maximum specific growth rate and biomass productivity of S. obliquus were 0.56 d −1 and 0.145 g L −1 d −1 respectively. The biomass contained 51.8% carbon and higher heating value (HHV) was 22.9 MJ kg −1 . - Highlights: • Biogas is a viable carbon source for microalgae growth. • Biomass production rate and characteristics were assessed. • Scenedesmus obliquus can adjust to grow with high concentration of CO 2 in the carbon source

Biowaste utilization in the process of co-gasification with bituminous coal and lignite

International Nuclear Information System (INIS)

Howaniec, Natalia; Smoliński, Adam

2017-01-01

Biowaste utilization in co-gasification with bituminous coal and lignite gives the benefits of stable supplies of a primary energy source – coal and utilization of a zero-emission, waste material (i.e. agriculture waste, sewage sludge, etc.) with higher process efficiency and lower negative environmental impact than biomass or coal gasification, respectively. The main focus of the study presented is co-gasification of bituminous coal or lignite with biowaste to hydrogen-rich gas. The experiments were performed in the laboratory scale fixed-bed reactor installation at 700 and 900 °C. The Hierarchical Clustering Analysis complemented with a color map of studied data were applied in the selection of the optimal operating parameters for biowaste utilization in the co-gasification process based on the experimental data of gasification/co-gasification process as well as physical and chemical properties of fuels tested. The experimental results showed that the carbon conversion rate in co-gasification increased with increasing biomass content in a fuel. The total gas volume and hydrogen volume in co-gasification were higher than the values expected based on the results of the gasification process of the fuels analyzed. - Highlights: • Biowaste co-gasification with bituminous coal/lignite to hydrogen-rich gas. • Steam co-gasification in laboratory scale fixed-bed reactor at 700 and 900 °C. • Hierarchical Clustering Analysis complemented with color map of experimental data. • Carbon conversion increase with increasing biomass content. • The highest total gas and hydrogen volume in co-gasification of C-B20 blend at 900C.

Investigation of Effect of Machine Layout on Productivity and Utilization Level: What If Simulation Approach

Directory of Open Access Journals (Sweden)

Islam Faisal Bourini

2018-03-01

Full Text Available Designing and selecting the material handling system is a vital factor for any production line, and as result for the whole manufacturing system. Poor design and unsuitable handling equipment may increase the risk of having bottlenecks, longer production time and as a result the higher total production cost. One of the useful and effective tools are using “what if” simulation techniques. However, this technique needs effective simulation software. The main objective for this research is to simulate different types of handling system using what if scenario. To achieve the objective of the research, Delmia Quest software has been used to simulate two different systems: manual system and conveyers system for the same production line and analyses the differences in terms of utilization and production rate. The results obtained have been analysed and appraised to induce the bottleneck locations, productivity and utilizations of the machines and material handling systems used in the design system. Finally, the best model have been developed to increase the productivity, utilizations of the machines, material handling systems and to minimize the bottleneck locations.

Trends in Utility Green Pricing Programs (2006)

Energy Technology Data Exchange (ETDEWEB)

Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Kaiser, Marshall [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2007-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities—or about 25% of all utilities nationally—provide their customers a “green power” option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

The Higher Order Structure of Environmental Attitudes: A Cross-Cultural Examination

Directory of Open Access Journals (Sweden)

Taciano L. Milfont

2010-01-01

Full Text Available Past research has suggested that Preservation and Utilization are the two higher order dimensions forming the hierarchical structure of environmental attitudes. This means that these two higher order dimensions could group all kinds of perceptions or beliefs regarding the natural environment people have. A crosscultural study was conducted in Brazil, New Zealand, and South Africa to test this hierarchical structure of environmental attitudes. Results from single- and multi-group confirmatory factor analyses demonstrated that environmental attitudes are a multidimensional construct, and that their first-order factors associate to each other to form a vertical structure. However, the question whether the vertical structure comprise a single higher order factor or two higher order factors still remains unanswered. These results are discussed and directions for future research trying to demonstrate that Preservation and Utilization, taken as distinct second-order environmental attitudes factors, are more empirically meaningful than a single and generalised environmental attitudes higher order factor are presented.

Higher Dialysate Matrix Metalloproteinase-2 Levels Are Associated with Peritoneal Membrane Dysfunction

Science.gov (United States)

Cho, Yeoungjee; Johnson, David W.; Vesey, David A.; Hawley, Carmel M.; Pascoe, Elaine M.; Clarke, Margaret; Topley, Nicholas

2016-01-01

♦ Background: Peritoneal dialysis (PD) patients develop progressive and cumulative peritoneal injury with longer time spent on PD. The present study aimed to a) describe the trend of peritoneal injury biomarkers, matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1), in incident PD patients, b) to explore the capacity of dialysate MMP-2 to predict peritoneal solute transport rate (PSTR) and peritonitis, and c) to evaluate the influence of neutral pH, low glucose degradation product (GDP) PD solution on these outcomes. ♦ Methods: The study included 178 participants from the balANZ trial who had at least 1 stored dialysate sample. Changes in PSTR and peritonitis were primary outcome measures, and the utility of MMP-2 in predicting these outcomes was analyzed using multilevel linear regression and multilevel Poisson regression, respectively. ♦ Results: Significant linear increases in dialysate MMP-2 and TIMP-1 concentrations were observed (p < 0.001), but neither was affected by the type of PD solutions received (MMP-2: p = 0.07; TIMP-1: p = 0.63). An increase in PSTR from baseline was associated with higher levels of MMP-2 (p = 0.02), and the use of standard solutions over longer PD duration (p = 0.001). The risk of peritonitis was independently predicted by higher dialysate MMP-2 levels (incidence rate ratio [IRR] per ng/mL 1.01, 95% confidence interval [CI] 1.005 – 1.02, p = 0.002) and use of standard solutions (Biocompatible solution: IRR 0.45, 95% CI 0.24 – 0.85, p = 0.01). ♦ Conclusion: Dialysate MMP-2 and TIMP-1 concentrations increased with longer PD duration. Higher MMP-2 levels were associated with faster PSTR and future peritonitis risk. Administration of biocompatible solutions exerted no significant effect on dialysate levels of MMP-2 or TIMP-1, but did counteract the increase in PSTR and the risk of peritonitis associated with the use of standard PD solutions. This is the first longitudinal study to examine

Optional time-of-use prices for electricity: Analysis of PG E's experimental TOU rates

Energy Technology Data Exchange (ETDEWEB)

Train, K.; Mehrez, G.

1992-07-01

We examine customers' time-of-use (TOU) demand for electricity and their choice between standard and TOU rate schedules. We specify an econometric model in which the customer's demand curves determine the customer's choice of rate schedule. We estimate the model on data from Pacific Gas Electric Company's experiment with optional TOU prices in the residential sector. With the model, we compare the TOU consumption and price elasticities of customers who chose TOU rates with those who chose standard rates. We also estimate the impact of the TOU rates on the utility's revenues and costs. The analysis suggests that the TOU rates offered under PG E's experiment decreased PG E's profits and hence contributed to higher general rate levels. The model can be used, however, to design optional TOU rates that increase profits and lower general rate levels.

Higher speciation and lower extinction rates influence mammal diversity gradients in Asia.

Science.gov (United States)

Tamma, Krishnapriya; Ramakrishnan, Uma

2015-02-04

Little is known about the patterns and correlates of mammal diversity gradients in Asia. In this study, we examine patterns of species distributions and phylogenetic diversity in Asia and investigate if the observed diversity patterns are associated with differences in diversification rates between the tropical and non-tropical regions. We used species distribution maps and phylogenetic trees to generate species and phylogenetic diversity measures for 1° × 1° cells across mainland Asia. We constructed lineage-through-time plots and estimated diversification shift-times to examine the temporal patterns of diversifications across orders. Finally, we tested if the observed gradients in Asia could be associated with geographical differences in diversification rates across the tropical and non-tropical biomes. We estimated speciation, extinction and dispersal rates across these two regions for mammals, both globally and for Asian mammals. Our results demonstrate strong latitudinal and longitudinal gradients of species and phylogenetic diversity with Southeast Asia and the Himalayas showing highest diversity. Importantly, our results demonstrate that differences in diversification (speciation, extinction and dispersal) rates between the tropical and the non-tropical biomes influence the observed diversity gradients globally and in Asia. For the first time, we demonstrate that Asian tropics act as both cradles and museums of mammalian diversity. Temporal and spatial variation in diversification rates across different lineages of mammals is an important correlate of species diversity gradients observed in Asia.

Risk management in higher education and research in the Netherlands

NARCIS (Netherlands)

Helsloot, I.; Jong, W

2006-01-01

This study examines risk in higher education and research on the basis of a classification into three domains. The practical utility of this division into three domains is that it makes it easier to see what risks are unique to higher education (custodianship of knowledge), what risks are dependent

Stock price change rate prediction by utilizing social network activities.

Science.gov (United States)

Deng, Shangkun; Mitsubuchi, Takashi; Sakurai, Akito

2014-01-01

Predicting stock price change rates for providing valuable information to investors is a challenging task. Individual participants may express their opinions in social network service (SNS) before or after their transactions in the market; we hypothesize that stock price change rate is better predicted by a function of social network service activities and technical indicators than by a function of just stock market activities. The hypothesis is tested by accuracy of predictions as well as performance of simulated trading because success or failure of prediction is better measured by profits or losses the investors gain or suffer. In this paper, we propose a hybrid model that combines multiple kernel learning (MKL) and genetic algorithm (GA). MKL is adopted to optimize the stock price change rate prediction models that are expressed in a multiple kernel linear function of different types of features extracted from different sources. GA is used to optimize the trading rules used in the simulated trading by fusing the return predictions and values of three well-known overbought and oversold technical indicators. Accumulated return and Sharpe ratio were used to test the goodness of performance of the simulated trading. Experimental results show that our proposed model performed better than other models including ones using state of the art techniques.

Stock Price Change Rate Prediction by Utilizing Social Network Activities

Directory of Open Access Journals (Sweden)

Shangkun Deng

2014-01-01

Full Text Available Predicting stock price change rates for providing valuable information to investors is a challenging task. Individual participants may express their opinions in social network service (SNS before or after their transactions in the market; we hypothesize that stock price change rate is better predicted by a function of social network service activities and technical indicators than by a function of just stock market activities. The hypothesis is tested by accuracy of predictions as well as performance of simulated trading because success or failure of prediction is better measured by profits or losses the investors gain or suffer. In this paper, we propose a hybrid model that combines multiple kernel learning (MKL and genetic algorithm (GA. MKL is adopted to optimize the stock price change rate prediction models that are expressed in a multiple kernel linear function of different types of features extracted from different sources. GA is used to optimize the trading rules used in the simulated trading by fusing the return predictions and values of three well-known overbought and oversold technical indicators. Accumulated return and Sharpe ratio were used to test the goodness of performance of the simulated trading. Experimental results show that our proposed model performed better than other models including ones using state of the art techniques.

Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection.

LENUS (Irish Health Repository)

O'Seaghdha, C M

2011-04-06

We analyzed the association between whole-blood trough tacrolimus (TAC) levels in the first days post-kidney transplant and acute cellular rejection (ACR) rates. Four hundred and sixty-four consecutive, deceased-donor kidney transplant recipients were included. All were treated with a combination of TAC, mycophenolate mofetil and prednisolone. Patients were analyzed in four groups based on quartiles of the mean TAC on days 2 and 5 post-transplant: Group 1: median TAC 11 ng\\/mL (n = 122, range 2-13.5 ng\\/mL), Group 2: median 17 ng\\/mL (n = 123, range 14-20 ng\\/mL), Group 3: median 24 ng\\/mL (n = 108, range 20.5-27 ng\\/mL) and Group 4: median 33.5 ng\\/mL (n = 116, range 27.5-77.5 ng\\/mL). A graded reduction in the rates of ACR was observed for each incremental days 2-5 TAC. The one-yr ACR rate was 24.03% (95% CI 17.26-32.88), 22.20% (95% CI 15.78-30.70), 13.41% (95% CI 8.15-21.63) and 8.69% (95% CI 4.77-15.55) for Groups 1-4, respectively (p = 0.003). This study suggests that higher early TACs are associated with reduced rates of ACR at one yr.

Cost-utility analysis of antithyroid drug therapy versus 131I therapy for Graves' disease

International Nuclear Information System (INIS)

Hayashi, Katsumi; Abe, Katsumi; Sakata, Ikuko; Sakaguchi, Chiharu; Yamamoto, Kentaro; Kosuda, Shigeru

2005-01-01

There is no comparative cost-utility study between 131 I therapy and antithyroid drugs (ATD) therapy for Graves' disease, though 131 I therapy has higher remission rate and less side effects. The objective of the study was to analyze the cost-utility of ATD therapy versus 131 I therapy by calculating life-long medical costs and utility, based on the responses of Graves' disease patients to questionnaires. To determine the expected cost and expected utility, a decision tree analysis was designed on the basis of the 2 competing strategies of ATD therapy versus 131 I therapy. A simulation of 1,000 female patients weighing≥50 kg who assumed to experience the onset of Graves' disease at the age of 30, to first complain of thyrotoxic symptoms and moderate goiter 2-3 mo. previously, and to undergo a 40-years-long cohort study, was created for each strategy using a decision tree and baselines of other relevant variables. The variables and costs were based on the literature and hospital bills. The maximum and minimum values of utility were defined as 1.0 and 0.0, respectively. Future costs and utilities were discounted 5%. The medical costs and utilities were 85,739-88,650 yen/patient/40 years and 16.47-16.56/patient/40 years, respectively, for the ATD therapy strategy, and 81,842 yen/patient/40 years and 17.41/patient/40 years, respectively, for the 131 I therapy strategy. These results quantitatively demonstrated that the 131 I therapy strategy was superior to the ATD therapy strategy in terms of both cost and utility. 131 I therapy should be used more widely in Japan because of its greater utility and lower cost. (author)

A PRESSURE ULCER AND FALL RATE QUALITY COMPOSITE INDEX FOR ACUTE CARE UNITS: A MEASURE DEVELOPMENT STUDY

Science.gov (United States)

Jayawardhana, Ananda; Burman, Mary E.; Dunton, Nancy E.; Staggs, Vincent S.; Bergquist-Beringer, Sandra; Gajewski, Byron J.

2016-01-01

Background Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. Objective The study objective was to develop a unit-level inpatient composite nursing care quality performance index – the Pressure Ulcer and Fall Rate Quality Composite Index. Design Two-phase measure development study. Settings 5,144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013. Methods The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. Results The Pressure Ulcer and Fall Rate Quality Composite Index = 100 − PUR − FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of

Primary health care utilization prior to suicide: a retrospective case-control study among active-duty military personnel.

Science.gov (United States)

Hochman, Eldar; Shelef, Leah; Mann, J John; Portugese, Shirly; Krivoy, Amir; Shoval, Gal; Weiser, Mark; Fruchter, Eyal

2014-08-01

About 45% of civilians who died by suicide had contact with a doctor within 1 month of death. Thus, educating primary care physicians (PCP) to detect and mitigate depression is an important suicide-prevention strategy. However, the PCP consulting rate before suicide has not been examined in a military population. We investigated the utilization of primary health care and mental health services by active-duty military personnel suicide cases prior to death in comparison to matched military controls. All suicides (N = 170) were extracted from a cohort of all active-duty Israeli military male personnel between 2002 and 2012. Applying a retrospective, nested case-control design, we compared primary care services utilization by suicide cases with demographic and occupationally matched military controls (N = 500). Whereas 38.3% of suicide cases contacted a PCP within the last month before death, only 27.6% of suicide cases contacted a mental health specialist during their entire service time. The PCP contact rate within 1 month before death or index day did not differ between suicide cases and military controls (38.3% vs. 33.8%, χ²₁ = 1.05, P = .3). More suicide cases contacted a mental health specialist within service time than did military controls (27.6% vs. 13.6%, χ²₁ = 10.85, P = .001). Even though PCP contact rate by military personnel who died by suicide is slightly lower than that reported for civilians who died by suicide prior to their death, it is higher than mental health specialist contact rate and higher than that by age-matched civilians who died by suicide. These results imply that PCPs education is a viable approach to suicide prevention in a military setting. © Copyright 2014 Physicians Postgraduate Press, Inc.

Telecommunications: international opportunities for power utilities

Energy Technology Data Exchange (ETDEWEB)

Lewis, A. [Teleglobe Canada, Ottawa, ON (Canada)

1996-08-01

International telecommunications services markets and trends were reviewed in an effort to identify business opportunities for Canadian power utilities. With increasing deregulation in the U.S. and Canada, and other countries around the globe, market opportunities are beginning to open up. In monopoly markets opportunities exist in providing dual infrastructures to upgrade both the power delivery services (frequently poor), and telecommunications. Billing, collection and customer service expertise might be other marketable commodities, perhaps packaged as part of a network provision project as a service to existing power and telecommunications service providers. In countries with directed competition markets local partnerships may be the only vehicle for entering the market. In managed competition markets opportunities were said to exist in cellular radio technology, as well as in switched telephone service, local, long distance, or international. In general, opportunities outside telecommunications-rich North America were considered to have better potential, due to rapid deregulation and higher current growth rates in telecommunications. Careful examination and research of the political and business environment prior to entering any of the potentially fertile areas was advised.

Dental Services and Attitudes towards its regular Utilization ... - Ibadan

African Journals Online (AJOL)

Background: Regular utilization of dental services is key to the attainment of optimal oral health state, an integral component of general health and well being needed for effective productivity by working personnel. Objective: This study assessed the rate and pattern of dental service utilization among civil servants and their ...

Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City.

Science.gov (United States)

Kupprat, Sandra A; Dayton, Alex; Guschlbauer, Andrea; Halkitis, Perry N

2009-07-01

A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

Primordial lithium: New reaction rates, new abundances, new constraints

International Nuclear Information System (INIS)

Kawano, L.; Schramm, D.; Steigman, G.

1986-12-01

Newly measured nuclear reaction rates for 3 H(α,γ) 7 Li (higher than previous values) and 7 Li(p,α) 4 He (lower than previous values) are shown to increase the 7 Li yield from big bang nucleosynthesis for lower baryon to photon ratio (eta ≤ 4 x 10 -10 ); the yield for higher eta is not affected. New, independent determinations of Li abundances in extreme Pop II stars are in excellent agreement with the earlier work of the Spites and give continued confidence in the use of 7 Li in big bang baryon density determinations. The new 7 Li constraints imply a lower limit on eta of 2 x 10 -10 and an upper limit of 5 x 10 -10 . This lower limit to eta is concordant with that obtained from considerations of D + 3 He. The upper limit is consistent with, but even more restrictive than, the D bound. With the new rates, any observed primordial Li/H ratio below 10 -10 would be inexplicable by the standard big bang nucleosynthesis. A review is made of the strengths and possible weaknesses of utilizing conclusions drawn from big bang lithium considerations. An appendix discusses the null effect of a factor of 32 increase in the experimental rate for the D(d,γ) 4 He reaction. 28 refs., 1 fig

Factors associated with the utilization of institutional delivery services in Bangladesh.

Science.gov (United States)

Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael

2017-01-01

Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; pdelivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; pservice utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; pdelivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2

DSM and electric utility competitiveness: An Illinois perspective

International Nuclear Information System (INIS)

Jackson, P.W.

1994-01-01

A predominant theme in the current electric utility industry literature is that competitive forces have emerged and may become more prominent. The wholesale bulk power market is alreadly competitive, as non-utility energy service providers already have had a significant impact on that market; this trend was accelerated by the Energy Policy Act of 1992. Although competition at the retail level is much less pervasive, electric utility customers increasingly have greater choice in selecting energy services. These choices may include, depending on the customer, the ability to self-generate, switch fuels, move to a new location, or rely more heavily on demand-side management as a means of controlling electric energy use. This paper explores the subject of how demand-side management (DSM) programs, which are often developed by a utility to satisfy resource requirements as a part of its least-cost planning process, can affect the utility's ability to compete in the energy services marketplace. In this context, the term 'DSM' is used in this paper to refer to those demand-side services and programs which provide resources to the utility's system. Depending on one's perspective, DSM programs (so defined) can be viewed either as an enhancement to the competitive position of a utility by enabling it to provide its customers with a broader menu of energy services, simultaneously satisfying the objectives of the utility as well as those of the customers, or as a detractor to a utility's ability to compete. In the latter case, the concern is with respect to the potential for adverse rate impacts on customers who are not participants in DSM programs. The paper consists of an identification of the pros and cons of DSM as a competitive strategy, the tradeoff which can occur between the cost impacts and rate impacts of DSM, and an examination of alternative strategies for maximizing the utilization of DSM both as a resource and as a competitive strategy

Enhanced tortuosity for electrolytes in microwave irradiated self-organized carbon-doped Ni/Co hydroxide nanocomposite electrodes with higher Ni/Co atomic ratio and rate capability for an asymmetric supercapacitor.

Science.gov (United States)

Kumar, Niraj; Kumar, Viresh; Panda, H S

2017-11-03

We demonstrate a green, facile and rapid microwave-mediated process for fabricating carbon black (CB) incorporated Ni/Co hydroxide porous nanocomposites and study the effect of various mass loading of CB on supercapacitor performance. The structure and interactions between CB and Ni/Co hydroxide are characterized by using x-ray diffraction, Fourier-transform infrared spectroscopy and x-ray photoelectron spectroscopy, which suggest the miniaturization of the single-phase Ni/Co hydroxide formation time. A morphology study reveals that the addition of CB into Ni/Co hydroxide develops a loose network structure with well-defined architectural pores. In addition, the nanocomposites demonstrate noticeable improvements in porosity and atomic ratio of Ni/Co with an increasing percentage of carbon, which results in a higher diffusion of electrolytes, and hence electrical conduction. The developed electrode materials exhibit a maximum specific capacitance value of 1526 Fg -1 at current density 1 Ag -1 with excellent cyclic stability (92% retention at 5000 cycles), energy density (76 Wh Kg -1 ), power density (250 W Kg -1 ) and rate capability. A solid state asymmetric supercapacitor device is fabricated and utilized to brighten a commercial LED effectively for validating real usage.

Enhanced tortuosity for electrolytes in microwave irradiated self-organized carbon-doped Ni/Co hydroxide nanocomposite electrodes with higher Ni/Co atomic ratio and rate capability for an asymmetric supercapacitor

Science.gov (United States)

Kumar, Niraj; Kumar, Viresh; Panda, H. S.

2017-11-01

We demonstrate a green, facile and rapid microwave-mediated process for fabricating carbon black (CB) incorporated Ni/Co hydroxide porous nanocomposites and study the effect of various mass loading of CB on supercapacitor performance. The structure and interactions between CB and Ni/Co hydroxide are characterized by using x-ray diffraction, Fourier-transform infrared spectroscopy and x-ray photoelectron spectroscopy, which suggest the miniaturization of the single-phase Ni/Co hydroxide formation time. A morphology study reveals that the addition of CB into Ni/Co hydroxide develops a loose network structure with well-defined architectural pores. In addition, the nanocomposites demonstrate noticeable improvements in porosity and atomic ratio of Ni/Co with an increasing percentage of carbon, which results in a higher diffusion of electrolytes, and hence electrical conduction. The developed electrode materials exhibit a maximum specific capacitance value of 1526 Fg-1 at current density 1 Ag-1 with excellent cyclic stability (92% retention at 5000 cycles), energy density (76 Wh Kg-1), power density (250 W Kg-1) and rate capability. A solid state asymmetric supercapacitor device is fabricated and utilized to brighten a commercial LED effectively for validating real usage.

Does adding metformin to clomifene citrate lead to higher pregnancy rates in a subset of women with polycystic ovary syndrome?

Science.gov (United States)

Moll, E; Korevaar, J C; Bossuyt, P M M; van der Veen, F

2008-08-01

An RCT among newly diagnosed, therapy naive women with polycystic ovary syndrome (PCOS) showed no significant differences in ovulation rate, ongoing pregnancy rate or spontaneous abortion rate in favour of clomifene citrate plus metformin compared with clomifene citrate. We wanted to assess whether there are specific subgroups of women with PCOS in whom clomifene citrate plus metformin leads to higher pregnancy rates. Subgroup analysis based on clinical and biochemical parameters of 111 women randomized to clomifene citrate plus metformin compared with 114 women randomized to clomifene citrate plus placebo. The data for age, BMI, waist-hip ratio (WHR) and plasma testosterone were available in all women, 2 h glucose in 80% of women and homeostatic model assessment for assessing insulin sensitivity (HOMA) in 50% of women. Of the women who were allocated to the metformin group, 44 women (40%) reached an ongoing pregnancy. In the placebo group, 52 women (46%) reached an ongoing pregnancy. There was a significantly different chance of an ongoing pregnancy for metformin versus placebo between subgroups based on age and WHR (P = 0.014). There was a positive effect of metformin versus placebo on pregnancy rate in older women (>or=28 years) with a high WHR, a negative effect of metformin versus placebo in young women (Metformin may be an effective addition to clomifene citrate in infertile women with PCOS, especially in older and viscerally obese patients.

Power Sales to Electric Utilities

Energy Technology Data Exchange (ETDEWEB)

None

1989-02-01

The Public Utilities Regulatory Policies Act (PURPA) of 1979 requires that electrical utilities interconnect with qualifying facilities and purchase electricity at a rate based upon their full avoided costs (i.e., costs of providing both capacity and energy). Qualifying facilities (QF) include solar or geothermal electric units, hydropower, municipal solid waste or biomass-fired power plants, and cogeneration projects that satisfy maximum size, fuel use, ownership, location, and/or efficiency criteria. In Washington State, neither standard power purchase prices based upon a proxy ''avoided plant'', standard contracts, or a standard offer process have been used. Instead, a variety of power purchase contracts have been negotiated by developers of qualifying facilities with investor-owned utilities, public utility districts, and municipally-owned and operated utilities. With a hydro-based system, benefits associated with resource acquisition are determined in large part by how compatible the resource is with a utility's existing generation mix. Power purchase rates are negotiated and vary according to firm energy production, guarantees, ability to schedule maintenance or downtime, rights of refusal, power plant purchase options, project start date and length of contract; front-loading or levelization provisions; and the ability of the project to provide ''demonstrated'' capacity. Legislation was also enacted which allows PURPA to work effectively. Initial laws established ownership rights and provided irrigation districts, PUDs, and municipalities with expanded enabling powers. Financial processes were streamlined and, in some cases, simplified. Finally, laws were passed which are designed to ensure that development proceeds in an environmentally acceptable manner. In retrospect, PURPA has worked well within Washington. In the state of Washington, 20 small-scale hydroelectric projects with a combined generating capacity of

Reducing operating costs: A collaborative approach between industry and electric utilities

International Nuclear Information System (INIS)

Tyers, B.; Sibbald, L.

1993-01-01

The unit cost of electricity to industrial consumers is expected to increase at a rate of 5% annually in the 1990s. The partnership that has been created between Amoco Canada Petroleum Company and TransAlta Utilities to control the cost of electricity is described. To allow the company to receive lower rates for interruptible power, a number of measures have been taken. The Amoco Whitecourt plant has standby generators in reserve that can be used when utility power is not available. A Pembina compressor can be turned off for up to 12 hours, at 30 minutes notice, without affecting field pressure. At the East Crossfield plant sales gas can be compressed using electricity or a gas-driven engine. Spot market energy is used in a number of plants allowing electric drive alternatives to plant operators and offering short term energy markets. TransAlta invests in electrical equipment such as switchgear as well as transmission lines and transformers. New rate alternatives offered by TransAlta Utilities include review of the need for a demand ratchet, additional time of use rates, unbundling of rates allowing power purchase from alternative sources, rates that follow product costs, reduced rates for conversion of gas to electric drives certain circumstances, energy audits, and power factor credits. 5 figs

Results of a pilot scale melter test to attain higher production rates

International Nuclear Information System (INIS)

Elliott, M.L.; Perez, J.M. Jr.; Chapman, C.C.

1991-01-01

A pilot-scale melter test was completed as part of the effort to enhance glass production rates. The experiment was designed to evaluate the effects of bulk glass temperature and feed oxide loading. The maximum glass production rate obtained, 86 kg/hr-m 2 , was over 200% better than the previous record for the melter used

Optimal pricing of non-utility generated electric power

International Nuclear Information System (INIS)

Siddiqi, S.N.; Baughman, M.L.

1994-01-01

The importance of an optimal pricing policy for pricing non-utility generated power is pointed out in this paper. An optimal pricing policy leads to benefits for all concerned: the utility, industry, and the utility's other customers. In this paper, it is shown that reliability differentiated real-time pricing provides an optimal non-utility generated power pricing policy, from a societal welfare point of view. Firm capacity purchase, and hence an optimal price for purchasing firm capacity, are an integral part of this pricing policy. A case study shows that real-time pricing without firm capacity purchase results in improper investment decisions and higher costs for the system as a whole. Without explicit firm capacity purchase, the utility makes greater investment in capacity addition in order to meet its reliability criteria than is socially optimal. It is concluded that the non-utility generated power pricing policy presented in this paper and implied by reliability differentiated pricing policy results in social welfare-maximizing investment and operation decisions

Horizontal Inequity in Elderly Health Care Utilization: Evidence from India

Science.gov (United States)

Rudra, Shalini; Subramanian, S V

2015-01-01

Against the backdrop of population aging, this paper presents the analysis of need-standardised health care utilization among elderly in India. Based on nationally representative morbidity and health care survey 2004, we demonstrate that the need for health care utilization is indeed pro-poor in nature. However, the actual health care utilization is concentrated among richer sections of the population. Further, the decomposition analysis reveals that income has a very strong role in shifting the distribution of health care away from the poor elderly. The impact of income on utilization is well-demonstrated even at the ecological-level as states with higher per capita incomes have higher elderly health care utilization even as the levels of need-predicted distribution across these states are similar. We also find that the distribution of elderly across social groups and their educational achievements favours the rich and significantly contributes to overall inequality. Nevertheless, contribution of need-related self-assessed health clearly favours pro-poor inequality. In concluding, we argue that to reduce such inequities in health care utilization it is necessary to increase public investments in health care infrastructure including geriatric care particularly in rural areas and underdeveloped regions to enhance access and quality of health care for the elderly. PMID:26617450

Cutting-Edge Technologies and Social Media Use in Higher Education

Science.gov (United States)

Benson, Vladlena, Ed.; Morgan, Stephanie

2014-01-01

The inclusion of social media in higher education has transformed the way instructors teach and students learn. In order to effectively reach their students in this networked world, teachers must learn to utilize the latest technologies in their classrooms. "Cutting-Edge Technologies and Social Media Use in Higher Education" brings…

An Update on Ethanol Production and Utilization in Thailand

Energy Technology Data Exchange (ETDEWEB)

Bloyd, Cary N.

2009-10-01

Thailand has continued to promote domestic biofuel utilization. Production and consumption of biofuel in Thailand have continued to increase at a fast rate due to aggressive policies of the Thai government in reducing foreign oil import and increasing domestic renewable energy utilization. This paper focuses on ethanol production and consumption, and the use of gasohol in Thailand. The paper is an update on the previous paper--Biofuel Infrastructure Development and Utilization in Thailand--in August 2008.

Multiattribute utility theory without expected utility foundations

NARCIS (Netherlands)

Wakker, P.P.; Miyamoto, J.

1996-01-01

Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

Multiattribute Utility Theory without Expected Utility Foundations

NARCIS (Netherlands)

Stiggelbout, A.M.; Wakker, P.P.

1995-01-01

Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

Constipation severity is associated with productivity losses and healthcare utilization in patients with chronic constipation.

Science.gov (United States)

Neri, Luca; Basilisco, Guido; Corazziari, Enrico; Stanghellini, Vincenzo; Bassotti, Gabrio; Bellini, Massimo; Perelli, Ilaria; Cuomo, Rosario

2014-04-01

We sought to evaluate the association between constipation severity, productivity losses and healthcare utilization in a national sample of Italian patients with chronic non-organic constipation (CC). We enrolled 878 outpatients with CC. Clinical and demographic data were collected by physicians during clinical examinations. Patients completed a self-administered questionnaire (Patient Assessment of Constipation-Symptoms, PAC-SYM; Work Productivity and Activity Impairment; healthcare utilization, and Symptoms Checklist 90 Revised - Somatization Scale, SCL-90 R). Mean PAC-SYM score was 1.62 ± 0.69. Mean weekly sick time due to constipation was 2.7 ± 8.6 h and productivity losses due to presenteeism was 19.7% ± 22.3%. Adjusted productivity losses in patients with severe CC (PAC-SYM score 2.3-4.0) compared to patients with mild symptoms (PAC-SYM score 0.0-1.0) was Italian Purchase Power Parity US$ 6160. Constipation severity (PAC-SYM quintiles) was associated with higher healthcare utilization (RRPAC-SYM 4/01.84; p-value for linear trend <0.01). After adjustment for somatization scores, the association of constipation severity with productivity losses and healthcare utilization rates was attenuated yet statistically significant. We observed a graded increase in productivity losses and healthcare utilization with increasing constipation severity. Further studies should evaluate whether significant savings might be achieved with regimens aimed at reducing the constipation severity.

Health care utilization in a sample of Canadian lesbian women: predictors of risk and resilience.

Science.gov (United States)

Bergeron, Sherry; Senn, Charlene Y

2003-01-01

This study was designed to test an exploratory path model predicting health care utilization by lesbian women. Using structural equation modeling we examined the joint influence of internalized homophobia, feminism, comfort with health care providers (HCPs), education, and disclosure of sexual identity both in one's life and to one's HCP on health care utilization. Surveys were completed by 254 Canadian lesbian women (54% participation rate) recruited through snowball sampling and specialized media. The majority (95%) of women were White, 3% (n = 7) were women of colour, and the remaining six women did not indicate ethnicity. Participants ranged in age from 18 to 67 with a mean age of 38.85 years (SD = 9.12). In the final path model, higher education predicted greater feminism, more disclosure to HCPs, and better utilization of health services. Feminism predicted both decreased levels of internalized homophobia and increased disclosure across relationships. Being more open about one's sexual identity was related to increased disclosure to HCPs, which in turn, led to better health care utilization. Finally, the more comfortable women were with their HCP the more likely they were to seek preventive care. All paths were significant at p < .01. The path model offers insight into potential target areas for intervention with the goal of improving health care utilization in lesbian women.

3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

Directory of Open Access Journals (Sweden)

Alexandre Peltier

2013-01-01

Full Text Available Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice. Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol. Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05. There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection. Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

Trends in Utility Green Pricing Programs (2005)

Energy Technology Data Exchange (ETDEWEB)

Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brown, Elizabeth [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2006-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 600 utilities—or about 20% of all utilities nationally—provide their customers a “green power” option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals more than 130. Through these programs, more than 50 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2005 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.

Science.gov (United States)

Lisonkova, S; Sabr, Y; Butler, B; Joseph, K S

2012-12-01

To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. Ecological study. Canada, USA and 26 countries in Europe. All deliveries in 2004. Information on preterm birth (Statistics Canada, the EURO-PERISTAT project and the National Center for Health Statistics. Pearson correlation coefficients and random-intercept Poisson regression were used to examine the association between preterm birth rates and gestational age-specific stillbirth and neonatal death rates. Rate ratios with 95% confidence intervals were estimated after adjustment for maternal age, parity and multiple births. Stillbirths and neonatal deaths ≥ 32 and ≥ 37 weeks of gestation. International rates of preterm birth (births. Preterm birth rates at 32-36 weeks were inversely associated with stillbirths at ≥ 32 weeks (adjusted rate ratio 0.94, 95% CI 0.92-0.96) and ≥ 37 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) of gestation and inversely associated with neonatal deaths at ≥ 32 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) and ≥ 37 weeks (adjusted rate ratio 0.82, 95% CI 0.78-0.86) of gestation. Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

How gender, age, and geography influence the utilization of radiation therapy in the management of malignant melanoma

International Nuclear Information System (INIS)

French, John; McGahan, Colleen; Duncan, Graeme; Lengoc, Sonca; Soo, Jenny; Cannon, Jerry

2006-01-01

Purpose: Comparing radiation therapy utilization rates (RTUR) to those predicted by best evidence is a useful measure of the equity and accessibility of service delivery. In this study the RTUR for melanoma was established for British Columbia, Canada, and compared with the rate suggested by the evidence. Demographic variables, specifically age, gender, and geography that influenced the RTUR were examined with a view to identifying methods of improving underutilization. Methods and Materials: The RTUR in the management of malignant melanoma was taken from British Columbia Cancer registry data for 1986 to 1998. Variations in utilization based on age, gender, health authority, stage of disease, and referral patterns were analyzed. Results: An RTUR of 11% was identified. This was consistent over time. Referral rates decreased between 1986 and 1998. RT is used mostly for later stage disease. Males were more likely to receive RT than females, related to later stage of disease in men. Referral rates decreased, but RTUR for referred cases increased, in health authorities that did not have a cancer center. Conclusions: Use of RT is influenced by age and by stage of disease. Overall RTUR in British Columbia is lower than suggested by best evidence. Referral patterns are influenced by geography. RTUR was higher in males, consistent with a different pattern of disease in males compared with females

Cleveland, Toledo utilities merge to aid N-projects

International Nuclear Information System (INIS)

Utroska, D.

1985-01-01

A decision by the Cleveland Electric Illuminating Co. and Toledo Edison to merge was spurred by the need to strengthen their access to capital markets in order to complete several nuclear power plants now under construction and to possibly mitigate the impact of large rate increases on Ohio ratepayers. The two utilities will continue as local companies. If they obtain approval from the Securities and Exchange, the Ohio Public Utilities, and the Nuclear Regulatory Commissions for the $8 million affiliation, the new holding company will be among the 20 largest electric utilities in terms of the market value of its common stock. Some industry observers see this as a harbinger of more utility mergers. 1 figure

The burden of selected cancers in the US: health behaviors and health care resource utilization

Directory of Open Access Journals (Sweden)

Iadeluca L

2017-11-01

Full Text Available Laura Iadeluca,1 Jack Mardekian,1 Pratibha Chander,2 Markay Hopps,1 Geoffrey T Makinson1 1Pfizer Inc., 2Atrium Staffing, New York, NY, USA Objective: To characterize the disease burden among survivors of those cancers having the highest incidence in the US.Methods: Adult (≥18 years survivors of the 11 most frequently diagnosed cancers were identified from publically available data sources, including the Surveillance Epidemiology and End Results 9 1973–2012, National Health Interview Survey 2013, and the Medical Expenditure Panel Survey 2011. Chi-square tests and one-way analyses of variance were utilized to assess differences between cancer survivors and non-cancer controls in behavioral characteristics, symptoms and functions, preventative screenings, and health care costs.Results: Hematologic malignancies, melanoma, and breast, prostate, lung, colon/rectal, bladder, kidney/renal, uterine, thyroid, and pancreatic cancers had the highest incidence rates. Breast cancer had the highest incidence among women (156.4 per 100,000 and prostate cancer among men (167.2 per 100,000. The presence of pain (P=0.0003, fatigue (P=0.0005, and sadness (P=0.0012 was consistently higher in cancer survivors 40–64 years old vs. non-cancer controls. Cancer survivors ≥65 years old had higher rates of any functional limitations (P=0.0039 and reported a lack of exercise (P<0.0001 compared with the non-cancer controls. However, obesity rates were similar between cancer survivors and non-cancer controls. Among cancer survivors, an estimated 13.5 million spent $169.4 billion a year on treatment, with the highest direct expenditures for breast cancer ($39 billion, prostate cancer ($37 billion, and hematologic malignancies ($25 billion. Prescription medications and office-based visits contributed equally as the cost drivers of direct medical spending for breast cancer, while inpatient hospitalization was the driver for prostate (52.8% and lung (38.6% cancers

Methods of determining incremental energy costs for economic dispatch and inter-utility interchange in Canadian utilities

International Nuclear Information System (INIS)

El-Hawary, M.E.; El-Hawary, F.; Mbamalu, G.A.N.

1991-01-01

A questionnaire was mailed to ten Canadian utilities to determine the methods the utilities use in determining the incremental cost of delivering energy at any time. The questionnaire was divided into three parts: generation, transmission and general. The generation section dealt with heat rates, fuel, operation and maintenance, startup and shutdown, and method of prioritizing and economic evaluation of interchange transactions. Transmission dealt with inclusion of transmission system incremental maintenance costs, and transmission losses determination. The general section dealt with incremental costs aspects, and various other economic considerations. A summary is presented of responses to the questionnaire

Expected utility without utility

OpenAIRE

Castagnoli, E.; Licalzi, M.

1996-01-01

This paper advances an interpretation of Von Neumann–Morgenstern’s expected utility model for preferences over lotteries which does not require the notion of a cardinal utility over prizes and can be phrased entirely in the language of probability. According to it, the expected utility of a lottery can be read as the probability that this lottery outperforms another given independent lottery. The implications of this interpretation for some topics and models in decision theory are considered....

[Effect of high magnesium ion concentration on the electron transport rate and proton exchange in thylakoid membranes in higher plants].

Science.gov (United States)

Ignat'ev, A R; Khorobrykh, S A; Ivanov, B N

2001-01-01

The effects of magnesium ion concentration on the rate of electron transport in isolated pea thylakoids were investigated in the pH range from 4.0 up to 8.0. In the absence of magnesium ions in the medium and in the presence of 5 mM MgCl2 in the experiments not only without added artificial acceptors but also with ferricyanide or methylviologen as an acceptor, this rate had a well-expressed maximum at pH 5.0. It was shown that, after depression to minimal values at pH 5.5-6.5, it gradually rose with increasing pH. An increase in magnesium ion concentration up to 20 mM essentially affected the electron transfer rate: it decreased somewhat at pH 4.0-5.0 but increased at higher pH values. At this magnesium ion concentration, the maximum rate was at pH 6.0-6.5 and the minimum, at pH 7.0. Subsequent rise upon increasing pH to 8.0 was expressed more sharply. The influence of high magnesium ion concentration on the rate of electron transport was not observed in the presence of gramicidin D. It was found that without uncoupler, the changes in the electron transfer rate under the influence of magnesium ions correlated to the changes in the first-order rate constant of the proton efflux from thylakoids. It is supposed that the change in the ability of thylakoids to keep protons by the action of magnesium ions is the result of electrostatic interactions of these ions with the charges on the external surface of membranes. A possible role of regulation of the electron transport rate by magnesium ions in vivo is discussed.

Hatching rate and growth rate of Nothobranchius guentheri fertilized eggs after space flight

International Nuclear Information System (INIS)

Guo Mingzhong; Zheng Leyun; Lin Guangji; Zhong Jianxing; Yang Huosheng; Zheng Yangfu

2012-01-01

Hatching, abnormal, growth and survival rate of the fertilized eggs of Nothobranchius guentheri were carried by Shenzhou 7 spacecraft were studied. The results indicated that the hatching and abnormal rate were no significant difference between the spaceflight group (99.3% and 16.8%) and ground group (97.2% and 10.4%); but the growth rate of male fish from spaceflight group was significant higher (0.094 g/d) than that of ground group (0.059 g/d), leading to the significant bigger of the male fish from spaceflight group. The survival rate of spaceflight group (66.7%) was higher than the ground group (47.9%). It was concluded that there was a higher growth and survival rate of Nothobranchius guentheri fertilized eggs after space flight. (authors)

Effects of a catheter-associated urinary tract infection prevention campaign on infection rate, catheter utilization, and health care workers' perspective at a community safety net hospital.

Science.gov (United States)

Gray, Dorinne; Nussle, Richard; Cruz, Abner; Kane, Gail; Toomey, Michael; Bay, Curtis; Ostovar, Gholamabbas Amin

2016-01-01

Preventing catheter-associated urinary tract infections is in the forefront of health care quality. However, nurse and physician engagement is a common barrier in infection prevention efforts. After implementation of a multidisciplinary catheter-associated urinary tract infection (CAUTI) prevention campaign, we studied the impact of our campaign and showed its association with reducing the CAUTI rate and catheter utilization and the positive effect on health care workers' engagement and perspectives. CAUTI prevention campaigns can lead to lower infection rates and change health care workers' perspective. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Community Energy Systems and the Law of Public Utilities. Volume Nine. Connecticut

Energy Technology Data Exchange (ETDEWEB)

Feurer, D A; Weaver, C L

1981-01-01

A detailed description of the laws and programs of the State of Connecticut governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

Community Energy Systems and the Law of Public Utilities. Volume Twelve. Georgia

Energy Technology Data Exchange (ETDEWEB)

Feurer, D A; Weaver, C L

1981-01-01

A detailed description of the laws and programs of the State of Georgia governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

Comparison of WIC benefit redemptions in Michigan indicates higher utilization among Arab American families.

Science.gov (United States)

Pooler, Jennifer; Gleason, Stacy F

2014-01-01

To assess Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefit use across Arab American, Hispanic, and non-Arab/non-Hispanic families participating in the Michigan WIC program using point-of-sale Electronic Benefits Transfer data. Cross-sectional analysis using administrative data obtained from the Michigan WIC program, which collects Arab American ethnicity in addition to Hispanic ethnicity and race. Michigan. Families participating in the Michigan WIC program in March, 2012 (n = 152,989). Families redeeming all WIC benefits. Bivariate frequencies and multivariate logistic regression model identified characteristics of families associated with full redemption of WIC food benefits. About 12% of WIC families fully redeemed their benefits in March, 2012. Compared with non-Arab/non-Hispanic families, Arab American WIC families were significantly more likely to use all of their monthly WIC benefits, even after controlling for family characteristics (adjusted odds ratio, 3.6; 95% confidence interval, 3.4-3.8). Rates of redemption for Hispanic families, however, were the same as for non-Arab/non-Hispanic families (adjusted odds ratio, 1.0; 95% confidence interval, 0.9-1.0). State WIC programs moving toward implementation of Electronic Benefits Transfer should consider ways to enhance systems that would allow for more opportunities to conduct targeted analyses of benefit use across participant subpopulations. Findings point to low overall WIC benefit use. Additional research is needed to explore methods to increase benefit use among all WIC populations, including whether specific factors may contribute to higher redemptions among ethnic minorities, and whether they can be translated to other subpopulations. Copyright © 2014 Society for Nutrition Education and Behavior. All rights reserved.

Mental Health Service Utilization before and after Receipt of a Service-Connected Disability Award for PTSD: Findings from a National Sample.

Science.gov (United States)

Sripada, Rebecca K; Hannemann, Claire M; Schnurr, Paula P; Marx, Brian P; Pollack, Stacey J; McCarthy, John F

2018-04-17

To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Aquatic food production modules in bioregenerative life support systems based on higher plants

Science.gov (United States)

Bluem, V.; Paris, F.

Most bioregenerative life support systems (BLSS) are based on gravitropic higher plants which exhibit growth and seed generation disturbances in microgravity. Even when used for a lunar or martian base the reduced gravity may induce a decreased productivity in comparison to Earth. Therefore, the implementation of aquatic biomass production modules in higher plant and/or hybrid BLSS may compensate for this and offer, in addition, the possibility to produce animal protein for human nutrition. It was shown on the SLS-89 and SLS-90 space shuttle missions with the C.E.B.A.S.-MINI MODULE that the edible non gravitropic rootless higher aquatic plant Ceratophyllum demeresum exhibits an undisturbed high biomass production rate in space and that the teleost fish species, Xiphophorus helleri, adapts rapidly to space conditions without loss of its normal reproductive functions. Based on these findings a series of ground-based aquatic food production systems were developed which are disposed for utilization in space. These are plant production bioreactors for the species mentioned above and another suitable candidate, the lemnacean (duckweed) species, Wolffia arrhiza. Moreover, combined intensive aquaculture systems with a closed food loop between herbivorous fishes and aquatic and land plants are being developed which may be suitable for integration into a BLSS of higher complexity.

Violence against women from different relationship contexts and health care utilization in Spain.

Science.gov (United States)

Montero, Isabel; Ruiz-Perez, Isabel; Martín-Baena, David; Talavera, Marta; Escribà-Agüir, Vicenta; Vives-Cases, Carmen

2011-01-01

Studies reported an excess of health services utilization among women with violence by an intimate partner (IPV). However, little is known about health utilization by women victims of other forms of interpersonal violence than IPV. This study aimed to determine the effect of violence from different relationship contexts on health care utilization. A cross-sectional study following a multistage cluster sampling scheme was conducted. Women aged 18 to 70 years were randomly selected according to their scheduled health care visit. The number of women invited to participate was 16,419 and 73% accepted. After exclusion, the final sample consisted of 10,815 women. The outcome variables were health care utilization (primary care, specialty services, emergency rooms, and hospital admissions) and the predictor variable was interpersonal violence from different relationship contexts. Multivariable adjusted logistic regression models were conducted to assess the independent effect of each violence relationship context on health care utilization. Compared with never abused women, use of health services was significantly higher for abused women, although the rates varied depending on the violence relationship context. The greatest probability of service use was among women whose abuse was perpetrated by both a partner and others. Comparing the magnitude of effect of each violence category by perpetrators other than a partner, this effect was stronger for violence in a social context in the case of emergency rooms only. Regardless of the perpetrator, lifetime violence increased health services utilization. Violence affects women's behavior in terms of how they use health services. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

76 FR 6762 - Publication of Depreciation Rates

Science.gov (United States)

2011-02-08

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Publication of Depreciation Rates AGENCY: Rural... States Department of Agriculture (USDA), announces the depreciation rates for telecommunications plant...) explains the depreciation rates that are used by RUS in its feasibility studies. Sec. 1737.70(e)(2) refers...