Hunter-gatherer energetics and human obesity.

Science.gov (United States)

Pontzer, Herman; Raichlen, David A; Wood, Brian M; Mabulla, Audax Z P; Racette, Susan B; Marlowe, Frank W

2012-01-01

Western lifestyles differ markedly from those of our hunter-gatherer ancestors, and these differences in diet and activity level are often implicated in the global obesity pandemic. However, few physiological data for hunter-gatherer populations are available to test these models of obesity. In this study, we used the doubly-labeled water method to measure total daily energy expenditure (kCal/day) in Hadza hunter-gatherers to test whether foragers expend more energy each day than their Western counterparts. As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners after controlling for body size. The metabolic cost of walking (kcal kg(-1) m(-1)) and resting (kcal kg(-1) s(-1)) were also similar among Hadza and Western groups. The similarity in metabolic rates across a broad range of cultures challenges current models of obesity suggesting that Western lifestyles lead to decreased energy expenditure. We hypothesize that human daily energy expenditure may be an evolved physiological trait largely independent of cultural differences.

The Higgs hunter's guide

CERN Document Server

Gunion, John F; Haber, Howard E; Kane, Gordon L

1989-01-01

The Higgs Hunter's Guide is a definitive and comprehensive guide to the physics of Higgs bosons. In particular, it discusses the extended Higgs sectors required by those recent theoretical approaches that go beyond the Standard Model, including supersymmetry and superstring-inspired models.

WAITING TIME IN THE WAITING ROOM IN FAMILY PRACTICE AND PATIENT SATISFACTION

Directory of Open Access Journals (Sweden)

Janko Kersnik

2001-05-01

Full Text Available Background: Appointment system shortens the waiting time in the waiting room for the patient and allows better use of time for the doctor. We wanted to examine how long patients are willing to wait in the waiting room, how long they waited at the last visit, patient satisfaction with the last visit, the satisfaction with the length of waiting in the past 12 months and the overall patient satisfaction score for the last 12 months. Appointment system proved to be effective means of organising practice time. Waiting time in the waiting room with appointment system was considerably shorter (mean 18.5 minutes as compared to the waiting time in the practices without appointment system (mean 55.4 minutes, the fact which is reflected also in higher satisfaction with waiting in the waiting room in the past 12 months. Three quarters of patients in practices with appointment system waited standard 20 minutes or less, as opposed to the other practices where only one quarter of patients waited 20 minutes or less.Conclusions: The overall satisfaction with the doctor with the appointment system does not differ in both types of practices. The patients from practices with appointment system evaluated better possibility to get an appointment to suit the patients, but worse help of the doctors’ staff, possibility to get through to the office by phone, the length of time during the consultation and the doctors’ thoroughness.

Wealth Transmission and Inequality Among Hunter-Gatherers

Science.gov (United States)

Hill, Kim; Marlowe, Frank; Nolin, David; Wiessner, Polly; Gurven, Michael; Bowles, Samuel; Mulder, Monique Borgerhoff; Hertz, Tom; Bell, Adrian

2010-01-01

We report quantitative estimates of intergenerational transmission and population-wide inequality for wealth measures in a set of hunter-gatherer populations. Wealth is defined broadly as factors that contribute to individual or household well-being, ranging from embodied forms such as weight and hunting success to material forms such household goods, as well as relational wealth in exchange partners. Intergenerational wealth transmission is low to moderate in these populations, but is still expected to have measurable influence on an individual’s life chances. Wealth inequality (measured with Gini coefficients) is moderate for most wealth types, matching what qualitative ethnographic research has generally indicated (if not the stereotype of hunter-gatherers as extreme egalitarians). We discuss some plausible mechanisms for these patterns, and suggest ways in which future research could resolve questions about the role of wealth in hunter-gatherer social and economic life. PMID:21151711

Motivations of female Black Hills deer hunters

Science.gov (United States)

Gigliotti, Larry M.; Covelli Metcalf, Elizabeth

2016-01-01

State fish and wildlife agencies are particularly interested in attracting female participation because of the potential to offset declining participation in hunting. Understanding female hunters’ motivations will be critical for designing effective recruitment and retention programs for women hunters. Although female participation in hunting is increasing, males still outnumber females by about tenfold. Gender differences in deer hunters were explored by comparing ratings of eight motivations (social, nature, excitement, meat, challenge, trophy, extra hunting opportunity, and solitude). Hunter types were defined by hunters’ selection of the most important motivation for why they like Black Hills deer hunting. Overall, females and males were relatively similar in their ratings of the eight motivations, and we found 85% gender similarity in the selection of the most important motivation. Women were slightly more motivated by the food aspect of the hunt while men placed slightly more value on the hunt as a sporting activity.

Hunter-gatherer energetics and human obesity.

Directory of Open Access Journals (Sweden)

Herman Pontzer

Full Text Available Western lifestyles differ markedly from those of our hunter-gatherer ancestors, and these differences in diet and activity level are often implicated in the global obesity pandemic. However, few physiological data for hunter-gatherer populations are available to test these models of obesity. In this study, we used the doubly-labeled water method to measure total daily energy expenditure (kCal/day in Hadza hunter-gatherers to test whether foragers expend more energy each day than their Western counterparts. As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners after controlling for body size. The metabolic cost of walking (kcal kg(-1 m(-1 and resting (kcal kg(-1 s(-1 were also similar among Hadza and Western groups. The similarity in metabolic rates across a broad range of cultures challenges current models of obesity suggesting that Western lifestyles lead to decreased energy expenditure. We hypothesize that human daily energy expenditure may be an evolved physiological trait largely independent of cultural differences.

Waiting for surgery: is waiting bad for anyone or everyone?

Science.gov (United States)

Sutherland, J M; Liu, G; Crump, R T; Karimuddin, A A

2017-12-01

For Canadians, as in many countries, waiting for elective surgery is expected. The duration of the wait raises questions about the maximum amount of time patients should wait for their surgery. The primary objective of this study was to test for a relationship between the length of time patients waited for elective hernia repair surgery and change in patients' self-reported health. This study was based on a prospectively recruited longitudinal cohort of patients waiting for elective hernia repair surgery. Participants completed the PHQ-9, PEG, EQ-5D(3L) generic instruments, and the condition-specific COMI-hernia. Multivariate regression models explored associations between patient-reported outcomes and potential confounders, including age, sex, socio-economic status, and medical comorbidities. There were 118 participants and the modal age group was 61-70 years. The average wait time for participants was 22.5 weeks. There were no relationships between the duration of participants' wait for hernia repair and the change in patients' self-reported health for hernia-specific outcomes or overall health-related quality of life. There are gains in health-related quality of life to be realized by prioritizing symptomatic patients. Participants with greater pre-operative depression, pain, and hernia-related symptoms experienced an improvement in health prior to surgery, though more clarity is needed on the mechanisms that led to improved health. Many countries face problems with wait lists for elective surgery-and few have effective processes for triaging patients. This study shows that duration of time on the wait list was not associated with change in hernia patients' self-reported health.

Hot subduction: Magmatism along the Hunter Ridge, SW Pacific

International Nuclear Information System (INIS)

Crawford, A.J.; Verbeeten, A.; Danyushevsky, L.V.; Sigurdsson, I.A.; Maillet, P.; Monzier, M.

1997-01-01

The Hunter 'fracture zone' is generally regarded as a transform plate boundary linking the oppositely dipping Tongan and Vanuatu subduction systems. Dredging along the Hunter Ridge and sampling of its northernmost extent, exposed as the island of Kadavu in Fiji, has yielded a diversity of magmatic suites, including arc tholeiites and high-Ca boninites, high-Mg lavas with some affinities to boninites and some affinities to adakites, and true adakitic lavas associated with remarkable low-Fe, high-Na basalts with 8-16 ppm Nb (herein high-Nb basalts). Lavas which show clear evidence of slab melt involvement in their petrogenesis occur at either end of the Hunter Ridge, whereas the arc tholeiites and high-Ca boninites appear to be restricted to the south central part of the ridge. Mineralogical and whole rock geochemical data for each of these suites are summarized, and a tectono-magmatic model for their genesis and distribution is suggested. Trace element features and radiogenic isotope data for the Hunter Ridge lavas indicate compositions analogue to Pacific MORB-like mantle

Factors of Perceived Waiting Time and Implications on Passengers’ Satisfaction with Waiting Time

Directory of Open Access Journals (Sweden)

Shumin Feng

2016-04-01

Full Text Available In order to explore the influence factors on perceived waiting time, a multiple linear regression model has been used to quantitatively describe the relationship between perceived waiting time and various factors. The model is established with 234 data, which is surveyed with questionnaire at three stops in Harbin, China. The results show that several certain factors (“trip purpose - where to”, “presence of a companion - whether one has a companion or not”, “having a timing device - whether one has a timing device or not”, “riding frequency - how many times one takes one line per week” and “waiting behaviour - what one does while waiting for a bus” have significant influence on perceived waiting time, which confirms previous findings and supports transferability of results. The significance of “waiting mood - howabout the mood while waiting for a bus” and “reserved waiting time - how long one will wait” are confirmed for the first time in this study. In contrast to previous studies, “waiting time interval - for how long in one day” is a negative variable and socioeconomic variables are non-significant. And it is found that the relationship between perceived waiting time and passengers’ satisfaction with the waiting time follows a decreasing exponential distribution. With this model, the variation trend of the section, where passenger satisfaction value is larger than 0 is obviously steeper than the section smaller than 0. Such result proves that passenger mood with short waiting time is more sensitive than with longer waiting time. And the borderline perceived waiting time, distinguishing satisfied from dissatisfied passengers is proven to be 7.87 minutes when assignment interval of satisfaction is (-25.25], when satisfaction is positive (larger than 0, the accuracy being 70.30%, while the accuracy is 82.71% fornegative satisfaction (less than 0.

Two Effective Ways to Implement Wait Time. A Symposium on Wait Time.

Science.gov (United States)

Swift, J. Nathan; And Others

The effects of instructional guides and a wait time feedback device (called a "Wait Timer") on the classroom interaction of middle school science teachers are examined. The Wait Timer, an unobtrusive indicator of wait time, is an automatic device that activates a light when a person speaks. The duration of the light at the end of a…

Learning to wait

DEFF Research Database (Denmark)

Dungey, Claire Elisabeth; Meinert, Lotte

2017-01-01

enforced through discipline, prepare young people to expect that waiting and enduring hardship will pay off in the end. This expectation makes the status of adulthood particularly vulnerable because the jobs and opportunities that young men learn to wait for often do not come into being by waiting....

General medicine advanced training: lessons from the John Hunter training programme.

Science.gov (United States)

Jackel, D; Attia, J; Pickles, R

2014-03-01

Recent years have seen a rapid growth in the number of advanced trainees pursuing general medicine as a specialty. This reflects an awareness of the need for broader training experiences to equip future consultant physicians with the skills to manage the healthcare challenges arising from the demographic trends of ageing and increasing comorbidity. The John Hunter Hospital training programme in general medicine has several characteristics that have led to the success in producing general physicians prepared for these challenges. These include support from a core group of committed general physicians, an appropriate and sustainable funding model, flexibility with a focus on genuine training and developing awareness of a systems approach, and strong links with rural practice. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Honey, Hadza, hunter-gatherers, and human evolution.

Science.gov (United States)

Marlowe, Frank W; Berbesque, J Colette; Wood, Brian; Crittenden, Alyssa; Porter, Claire; Mabulla, Audax

2014-06-01

Honey is the most energy dense food in nature. It is therefore not surprising that, where it exists, honey is an important food for almost all hunter-gatherers. Here we describe and analyze widespread honey collecting among foragers and show that where it is absent, in arctic and subarctic habitats, honey bees are also rare to absent. Second, we focus on one hunter-gatherer society, the Hadza of Tanzania. Hadza men and women both rank honey as their favorite food. Hadza acquire seven types of honey. Hadza women usually acquire honey that is close to the ground while men often climb tall baobab trees to raid the largest bee hives with stinging bees. Honey accounts for a substantial proportion of the kilocalories in the Hadza diet, especially that of Hadza men. Cross-cultural forager data reveal that in most hunter-gatherers, men acquire more honey than women but often, as with the Hadza, women do acquire some. Virtually all warm-climate foragers consume honey. Our closest living relatives, the great apes, take honey when they can. We suggest that honey has been part of the diet of our ancestors dating back to at least the earliest hominins. The earliest hominins, however, would have surely been less capable of acquiring as much honey as more recent, fully modern human hunter-gatherers. We discuss reasons for thinking our early ancestors would have acquired less honey than foragers ethnographically described, yet still significantly more than our great ape relatives. Copyright © 2014 Elsevier Ltd. All rights reserved.

Legitimization of regulatory norms: Waterfowl hunter acceptance of changing duck bag limits

Science.gov (United States)

Schroeder, Susan A.; Fulton, David C.; Lawrence, Jeffrey S.; Cordts, Steven D.

2014-01-01

Few studies have examined response to regulatory change over time, or addressed hunter attitudes about changes in hunting bag limits. This article explores Minnesota waterfowl hunters’ attitudes about duck bag limits, examining attitudes about two state duck bag limits that were initially more restrictive than the maximum set by the U.S. Fish and Wildlife Service (USFWS), but then increased to match federal limits. Results are from four mail surveys that examined attitudes about bag limits over time. Following two bag limit increases, a greater proportion of hunters rated the new bag limit “too high” and a smaller proportion rated it “too low.” Several years following the first bag limit increase, the proportion of hunters who indicated that the limit was “too high” had declined, suggesting hunter acceptance of the new regulation. Results suggest that waterfowl bag limits may represent legal norms that influence hunter attitudes and gain legitimacy over time.

Mental health perspectives of Hunter syndrome: Case reports of two biological siblings

Directory of Open Access Journals (Sweden)

Kabir Garg

2016-01-01

Full Text Available Hunter syndrome is a rare X-linked recessive disorder caused by deficiency of the lysosomal enzyme iduronate-2-sulphatase, leading to progressive accumulation of a substance called glycosaminoglycans in nearly all cell types, tissues, and organs. Hunter syndrome presents with facial dysmorphism, airway diseases, skeletal defects, cardiomyopathies, and neuropsychiatric manifestations. Mental subnormality is a cardinal feature in Hunter syndrome. This is a progressive cognitive decline that is not amenable to enzyme replacement therapy. Due to progressive cognitive decline, training the children to improve the adaptive functioning is a challenge that creates immense stress for the caregivers. Patients with Hunter syndrome should undergo serial assessment of intellectual ability and may be trained accordingly.

75 FR 32877 - Financial Assistance: Wildlife Restoration, Sport Fish Restoration, Hunter Education and Safety

Science.gov (United States)

2010-06-10

... resources, aquatic-life forms, and sport fishing; and (e) develop responsible attitudes and ethics toward..., Sport Fish Restoration, Hunter Education and Safety AGENCY: Fish and Wildlife Service, Interior. ACTION... governing the Wildlife Restoration, Sport Fish Restoration, and Hunter Education and Safety (Enhanced Hunter...

Core Hunter 3: flexible core subset selection.

Science.gov (United States)

De Beukelaer, Herman; Davenport, Guy F; Fack, Veerle

2018-05-31

Core collections provide genebank curators and plant breeders a way to reduce size of their collections and populations, while minimizing impact on genetic diversity and allele frequency. Many methods have been proposed to generate core collections, often using distance metrics to quantify the similarity of two accessions, based on genetic marker data or phenotypic traits. Core Hunter is a multi-purpose core subset selection tool that uses local search algorithms to generate subsets relying on one or more metrics, including several distance metrics and allelic richness. In version 3 of Core Hunter (CH3) we have incorporated two new, improved methods for summarizing distances to quantify diversity or representativeness of the core collection. A comparison of CH3 and Core Hunter 2 (CH2) showed that these new metrics can be effectively optimized with less complex algorithms, as compared to those used in CH2. CH3 is more effective at maximizing the improved diversity metric than CH2, still ensures a high average and minimum distance, and is faster for large datasets. Using CH3, a simple stochastic hill-climber is able to find highly diverse core collections, and the more advanced parallel tempering algorithm further increases the quality of the core and further reduces variability across independent samples. We also evaluate the ability of CH3 to simultaneously maximize diversity, and either representativeness or allelic richness, and compare the results with those of the GDOpt and SimEli methods. CH3 can sample equally representative cores as GDOpt, which was specifically designed for this purpose, and is able to construct cores that are simultaneously more diverse, and either are more representative or have higher allelic richness, than those obtained by SimEli. In version 3, Core Hunter has been updated to include two new core subset selection metrics that construct cores for representativeness or diversity, with improved performance. It combines and outperforms the

Hunter-Gatherers and the Origins of Religion.

Science.gov (United States)

Peoples, Hervey C; Duda, Pavel; Marlowe, Frank W

2016-09-01

Recent studies of the evolution of religion have revealed the cognitive underpinnings of belief in supernatural agents, the role of ritual in promoting cooperation, and the contribution of morally punishing high gods to the growth and stabilization of human society. The universality of religion across human society points to a deep evolutionary past. However, specific traits of nascent religiosity, and the sequence in which they emerged, have remained unknown. Here we reconstruct the evolution of religious beliefs and behaviors in early modern humans using a global sample of hunter-gatherers and seven traits describing hunter-gatherer religiosity: animism, belief in an afterlife, shamanism, ancestor worship, high gods, and worship of ancestors or high gods who are active in human affairs. We reconstruct ancestral character states using a time-calibrated supertree based on published phylogenetic trees and linguistic classification and then test for correlated evolution between the characters and for the direction of cultural change. Results indicate that the oldest trait of religion, present in the most recent common ancestor of present-day hunter-gatherers, was animism, in agreement with long-standing beliefs about the fundamental role of this trait. Belief in an afterlife emerged, followed by shamanism and ancestor worship. Ancestor spirits or high gods who are active in human affairs were absent in early humans, suggesting a deep history for the egalitarian nature of hunter-gatherer societies. There is a significant positive relationship between most characters investigated, but the trait "high gods" stands apart, suggesting that belief in a single creator deity can emerge in a society regardless of other aspects of its religion.

Worth the wait? How restaurant waiting time influences customer behavior and revenue

NARCIS (Netherlands)

de Vries, J.; Roy, Debjit; De Koster, Rene

2018-01-01

In many service industries, customers have to wait for service. When customers have a choice, this waiting may influence their service experience, sojourn time, and ultimately spending, reneging, and return behavior. Not much is known however, about the system-wide impact of waiting on customer

PALEOLITHIC HUNTER-GATHERERS' DIETARY PATTERNS ...

African Journals Online (AJOL)

Dr. Al-Domi

the main aspects of Paleolithic hunter-gatherers' dietary patterns and its main long-term ... Hence, people in developing countries have been exposed to certain ... as food habits, which prompted possible negative impacts on health status leading to ... costs [5, 7]. .... Agricultural revolution with efficient production of grains,.

Wait times in Canada.

Science.gov (United States)

MacKinnon, Janice Christine

2017-07-01

A significant barrier to accessing healthcare in Canada is long waiting lists, which can be linked to the way that Medicare was structured. After significant pressure, provincial governments began to address wait times. An example of a successful strategy to reduce wait times for elective surgery is the Saskatchewan Surgical Initiative, which saw wait times in the province change from being among the longest in Canada to the shortest.

Ride, shoot, and call: wildlife use among contemporary urban hunters in Três Fronteiras, Brazilian Amazon

Directory of Open Access Journals (Sweden)

Nathalie van Vliet

2015-09-01

Full Text Available Most bushmeat studies in the Amazon region focus on hunting patterns of indigenous populations in rural settings. Our study describes the existence of urban hunters in medium-sized towns. Using a variety of data collection methods, we describe the main socioeconomic characteristics of urban hunters in Benjamin Constant and Atalaia do Norte, Brazil. We analyze the patterns and motivations of urban hunters as well as the type of prey harvested and quantities traded. All interviewed hunters are caboclos, people of mixed Brazilian indigenous and European origins from rural areas who now live in urban and peri-urban areas. Living in these more populated spaces allows these hunters better market options for their harvest and allows them to alternate hunting with other economic activities. Only 29% of the interviewed hunters relied solely on hunting. In total, 11.6 tons of bushmeat were harvested (of which 97% was traded by four hunters during the monitoring period (60 days. The most hunted species were terecay (Podocnemis unifilis, curassow (Crax sp., paca (Cuniculus paca, and tapir (Tapirus terrestris. The ratio of bushmeat sold to that consumed, as well as the level of participation in the bushmeat market chain, allowed us to differentiate between specialized and diversified hunters. Specialized hunters sell 81% of the bushmeat caught to known wholesalers in the city. Diversified hunters sell 21% of their total catch to families, neighbors, or friends directly as fresh meat, avoiding intermediaries. For all hunters, hunting localities are associated with peri-urban roadways that are easily reached by motorbike or bicycle from the hunters' houses in the urban areas or city fringes. Our results show that urban hunters in medium-sized towns exemplify how traditional hunting systems can be adapted in the face of globalization, by living close to the market, at relatively manageable distances from hunting grounds, and using modern methods of

Cooperation and the evolution of hunter-gatherer storytelling.

Science.gov (United States)

Smith, Daniel; Schlaepfer, Philip; Major, Katie; Dyble, Mark; Page, Abigail E; Thompson, James; Chaudhary, Nikhil; Salali, Gul Deniz; Mace, Ruth; Astete, Leonora; Ngales, Marilyn; Vinicius, Lucio; Migliano, Andrea Bamberg

2017-12-05

Storytelling is a human universal. From gathering around the camp-fire telling tales of ancestors to watching the latest television box-set, humans are inveterate producers and consumers of stories. Despite its ubiquity, little attention has been given to understanding the function and evolution of storytelling. Here we explore the impact of storytelling on hunter-gatherer cooperative behaviour and the individual-level fitness benefits to being a skilled storyteller. Stories told by the Agta, a Filipino hunter-gatherer population, convey messages relevant to coordinating behaviour in a foraging ecology, such as cooperation, sex equality and egalitarianism. These themes are present in narratives from other foraging societies. We also show that the presence of good storytellers is associated with increased cooperation. In return, skilled storytellers are preferred social partners and have greater reproductive success, providing a pathway by which group-beneficial behaviours, such as storytelling, can evolve via individual-level selection. We conclude that one of the adaptive functions of storytelling among hunter gatherers may be to organise cooperation.

Evaluation of PHI Hunter in Natural Language Processing Research.

Science.gov (United States)

Redd, Andrew; Pickard, Steve; Meystre, Stephane; Scehnet, Jeffrey; Bolton, Dan; Heavirland, Julia; Weaver, Allison Lynn; Hope, Carol; Garvin, Jennifer Hornung

2015-01-01

We introduce and evaluate a new, easily accessible tool using a common statistical analysis and business analytics software suite, SAS, which can be programmed to remove specific protected health information (PHI) from a text document. Removal of PHI is important because the quantity of text documents used for research with natural language processing (NLP) is increasing. When using existing data for research, an investigator must remove all PHI not needed for the research to comply with human subjects' right to privacy. This process is similar, but not identical, to de-identification of a given set of documents. PHI Hunter removes PHI from free-form text. It is a set of rules to identify and remove patterns in text. PHI Hunter was applied to 473 Department of Veterans Affairs (VA) text documents randomly drawn from a research corpus stored as unstructured text in VA files. PHI Hunter performed well with PHI in the form of identification numbers such as Social Security numbers, phone numbers, and medical record numbers. The most commonly missed PHI items were names and locations. Incorrect removal of information occurred with text that looked like identification numbers. PHI Hunter fills a niche role that is related to but not equal to the role of de-identification tools. It gives research staff a tool to reasonably increase patient privacy. It performs well for highly sensitive PHI categories that are rarely used in research, but still shows possible areas for improvement. More development for patterns of text and linked demographic tables from electronic health records (EHRs) would improve the program so that more precise identifiable information can be removed. PHI Hunter is an accessible tool that can flexibly remove PHI not needed for research. If it can be tailored to the specific data set via linked demographic tables, its performance will improve in each new document set.

Humans as predators: an overview of predation strategies of hunters with contrasting motivational drivers

Directory of Open Access Journals (Sweden)

Fredrik Dalerum

2018-01-01

Full Text Available Predator-prey theory suggests that generalist predators are linked to demographic stability of prey whereas specialists are destabilizing. We overview the demographic consequences of different predation strategies and hypothesize that subsistence hunting occurs opportunistically, persecution hunters behave like specialist predators, and recreational hunters behave like generalist predators. Under this hypothesis, persecution hunting would have destabilizing effects, whereas the effects of subsistence and recreational hunting would be neutral or stabilizing. We found poor empirical support for this hypothesis, but there was scarce empirical data. Recreational hunters mainly hunted opportunistically and hunting as managed persecution followed a type III functional response, i.e. with low hunting intensity at low game abundances and a switch to an increased intensity at some level of abundance. We suggest that recreational hunters have limited destabilizing effects on game populations and that hunting may be an ineffective way of complete the removal of invasive species. We urge for further studies quantifying the responses of hunters to game abundances, in particular studies evaluating the responses of subsistence hunters and illegal persecution.

The Enchanted Hunters in Nabokov’s Lolita

Directory of Open Access Journals (Sweden)

Justine Shu- Ting Kao

2017-06-01

Full Text Available In Nabokov’s Lolita, Humbert Humbert’s The Enchanted Hunters, as a quest for love, aims to reconstruct a felicitous world or integrate various fragmentary details into an organic unity that revives a lost love, experiencing it on the basis of irony, and revealing a simulation of the desire, violence, and despondency which have been expressed in myths of nymphs and Persephone. The protagonist never reaches this unity, but his narrative of erotic and romantic love reveals him as a pathetic addict engaged in mechanical reproduction related to the phenomena of desire, seduction, violence, and sex. His The Enchanted Hunters does not simulate what he expects of his childhood love with Annabel; rather, it simulates the erotic imagination suggested in Mary D. Sheriff’s term “nymphomania,” in which artists fall degenerately to a model of tragedy. Keywords: simulation, nymph, nymphomania, The Enchanted Hunters The Enchanted Hunters in Nabokov’s Lolita refers to the name of a hotel and the title of a play. This seeming coincidence is actually not coincidental: Nabokov weaves a story concerning a pedophile’s seduction of a prepubescent child into a “story within a story,” in which the girl is imagined as a seducer who bewitches a number of hunters. Just as the girl in the play is a figment of a poet’s imagination, so Lolita in the novel Lolita is an imaginary production of a middle-aged pedophile. Yet Lolita is not so much a novel revealing guilt and mental disorder, but a mélange of art and reality, or more specifically, it is about a coinage in which the author fabricates art and myth in real life. Parallel to the protagonist who simulates what he expects of his childhood love, Annabel, in the form of the nymphet, Lolita, Nabokov replicates the beauty of butterflies in the pursuit of beauty and immortality, and develops the world of art with a pathetic tone whereby we gradually perceive a simulation of the desire, violence, and

Waiting for a pacemaker

DEFF Research Database (Denmark)

Risgaard, Bjarke; Elming, Hanne; Jensen, Gunnar

2012-01-01

AIMS: To determine waiting period-related morbidity, mortality, and adverse events in acute patients waiting for a permanent pacemaker (PPM).METHODS AND RESULTS: A retrospective chart review of all PPM implantations in Region Zealand, Denmark, in 2009 was conducted. Patients were excluded...... at least one adverse event during the waiting period. The present study indicates that a waiting period is dangerous as it is associated with an increased risk of adverse events. Acute PPMs should be implanted with a 24-h pacemaker implantation service capacity....

Influence of Age and Educational Level on the Behavior of Hunters in Vojvodina Province (Serbia

Directory of Open Access Journals (Sweden)

Vladimir Marković

2011-07-01

Full Text Available Education as an important factor in the development of economy has a major impact on the development of hunting and hunting tourism. In this research, it has conducted a survey of hunters from the territory of Vojvodina Province regarding their attitude and motives for hunting, importance of education, importance of GIS in hunting, poaching as well as their level of hunting ethics. Using SPSS program, it was cross-referenced the individual responses in relation to age category and level of education. The results show that the youngest hunters (18 to 35 years compared to middle age hunters (35-59 years and old hunters (over 60 visit hunting events more, they are the most informed about GIS and they are most willing to learn about these technologies. The number of hunters that took part in the poaching is proportional with their level of education, so that most hunters that participate in poaching hold a university degree. However, hunters holding a university degree in the highest percentage believe that GIS can contribute to the development of hunting largely, and are willing to participate in training.

Core Self-Evaluations as a Mediator between Functional Disability and Life Satisfaction in College Students with Disabilities Majoring in Science and Technology

Science.gov (United States)

Smedema, Susan Miller; Pfaller, Joseph S.; Yaghmaian, Rana A.; Weaver, Hayley; da Silva Cardoso, Elizabeth; Chan, Fong

2015-01-01

Purpose: To examine the mediational effect of core self-evaluations (CSE) on the relationship between functional disability and life satisfaction. Methods: A quantitative descriptive design using multiple regression analysis. The participants were 97 college students with disabilities receiving services through Hunter College's Minority-Disability…

Hunter-gatherer genomic diversity suggests a southern African origin for modern humans.

Science.gov (United States)

Henn, Brenna M; Gignoux, Christopher R; Jobin, Matthew; Granka, Julie M; Macpherson, J M; Kidd, Jeffrey M; Rodríguez-Botigué, Laura; Ramachandran, Sohini; Hon, Lawrence; Brisbin, Abra; Lin, Alice A; Underhill, Peter A; Comas, David; Kidd, Kenneth K; Norman, Paul J; Parham, Peter; Bustamante, Carlos D; Mountain, Joanna L; Feldman, Marcus W

2011-03-29

Africa is inferred to be the continent of origin for all modern human populations, but the details of human prehistory and evolution in Africa remain largely obscure owing to the complex histories of hundreds of distinct populations. We present data for more than 580,000 SNPs for several hunter-gatherer populations: the Hadza and Sandawe of Tanzania, and the ≠Khomani Bushmen of South Africa, including speakers of the nearly extinct N|u language. We find that African hunter-gatherer populations today remain highly differentiated, encompassing major components of variation that are not found in other African populations. Hunter-gatherer populations also tend to have the lowest levels of genome-wide linkage disequilibrium among 27 African populations. We analyzed geographic patterns of linkage disequilibrium and population differentiation, as measured by F(ST), in Africa. The observed patterns are consistent with an origin of modern humans in southern Africa rather than eastern Africa, as is generally assumed. Additionally, genetic variation in African hunter-gatherer populations has been significantly affected by interaction with farmers and herders over the past 5,000 y, through both severe population bottlenecks and sex-biased migration. However, African hunter-gatherer populations continue to maintain the highest levels of genetic diversity in the world.

Third degree waiting time discrimination: optimal allocation of a public sector healthcare treatment under rationing by waiting.

Science.gov (United States)

Gravelle, Hugh; Siciliani, Luigi

2009-08-01

In many public healthcare systems treatments are rationed by waiting time. We examine the optimal allocation of a fixed supply of a given treatment between different groups of patients. Even in the absence of any distributional aims, welfare is increased by third degree waiting time discrimination: setting different waiting times for different groups waiting for the same treatment. Because waiting time imposes dead weight losses on patients, lower waiting times should be offered to groups with higher marginal waiting time costs and with less elastic demand for the treatment.

PLANET HUNTERS: ASSESSING THE KEPLER INVENTORY OF SHORT-PERIOD PLANETS

International Nuclear Information System (INIS)

Schwamb, Megan E.; Lintott, Chris J.; Lynn, Stuart; Smith, Arfon M.; Simpson, Robert J.; Fischer, Debra A.; Giguere, Matthew J.; Brewer, John M.; Parrish, Michael; Schawinski, Kevin

2012-01-01

We present the results from a search of data from the first 33.5 days of the Kepler science mission (Quarter 1) for exoplanet transits by the Planet Hunters citizen science project. Planet Hunters enlists members of the general public to visually identify transits in the publicly released Kepler light curves via the World Wide Web. Over 24,000 volunteers reviewed the Kepler Quarter 1 data set. We examine the abundance of ≥2 R ⊕ planets on short-period ( ⊕ Planet Hunters ≥85% efficient at identifying transit signals for planets with periods less than 15 days for the Kepler sample of target stars. Our high efficiency rate for simulated transits along with recovery of the majority of Kepler ≥4 R ⊕ planets suggests that the Kepler inventory of ≥4 R ⊕ short-period planets is nearly complete.

It's worth the wait: optimizing questioning methods for effective intraoperative teaching.

Science.gov (United States)

Barrett, Meredith; Magas, Christopher P; Gruppen, Larry D; Dedhia, Priya H; Sandhu, Gurjit

2017-07-01

The use of questioning to engage learners is critical to furthering resident education intraoperatively. Previous studies have demonstrated that higher level questioning and optimal wait times (>3 s) result in learner responses reflective of higher cognition and retention. Given the importance of intraoperative learning, we investigated question delivery in the operating room. A total of 12 laparoscopic cholecystectomies were observed and recorded. All questions were transcribed and classified using Bloom's Taxonomy, a framework associated with hierarchical levels of learning outcomes. Wait time between question end and response was recorded. Six faculty attendings and seven house officers at our institution were observed. A total of 133 questions were recorded with an average number of questions per case of 11.2. The majority of questions 112 out of 133 (84%) were classified as Bloom's levels 1-3, with only 6% of questions of the highest level. The wait time before the resident answered the question averaged 1.75 s, with attendings interceding after 2.50 s. Question complexity and wait time did not vary based on resident postgraduate year level suggesting limited tailoring of question to learner. Intraoperative questioning is not aligned with higher level thinking. The majority of questions were Bloom's level 3 or below, limiting the complexity of answer formulation. Most responses were given within 2 s, hindering opportunity to pursue higher-order thinking. This suggests including higher level questions and tailoring questions to learner level may improve retention and maximize gains. In addition, with attendings answering 20% of their own questions, increasing their wait time offers another area for teaching development. © 2017 Royal Australasian College of Surgeons.

Drivers of change in hunter offtake and hunting strategies in Sendje, Equatorial Guinea.

Science.gov (United States)

Gill, David J C; Fa, John E; Rowcliffe, J Marcus; Kümpel, Noëlle F

2012-12-01

Economic development in Africa is expected to increase levels of bushmeat hunting through rising demand for meat and improved transport infrastructure. However, few studies have tracked long-term changes in hunter behavior as a means of testing this prediction. We evaluated changes in hunter behavior in a rural community in Equatorial Guinea over a period of rapid national economic growth, during which time road access to the regional capital greatly improved. We conducted offtake surveys (Supporting Information) over 3 7-week periods at the same time of year in 1998, 2003, and 2010 and conducted hunter and household interviews (Supporting Information) in 2003 and 2010. We tested whether relations existed among catch, hunting effort, hunting strategy, and income earned through hunting and other livelihoods in 2003 and 2010. Although village offtake increased from 1775 kg in 1998 to 4172 kg in 2003, it decreased in 2010 to 1361 kg. Aggregate catch per unit effort (i.e., number of carcasses caught per hunter and per trap) decreased from 2003 to 2010, and the majority of hunters reported a decrease in abundance of local fauna. Although these results are indicative of unsustainable hunting, cumulative changes in offtake and catch per unit effort were driven by a contraction in the total area hunted following an out-migration of 29 of the village's hunters, most of whom left to gain employment in the construction industry, after 2003. Hunters operating in both 2003 and 2010 hunted closer to the village because an increased abundance of elephants posed a danger and because they desired to earn income through other activities. Our study provides an example of national economic development contributing to a reduction in the intensity and extent of hunting. ©2012 Society for Conservation Biology.

High adult mortality among Hiwi hunter-gatherers: implications for human evolution.

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Hill, Kim; Hurtado, A M; Walker, R S

2007-04-01

Extant apes experience early sexual maturity and short life spans relative to modern humans. Both of these traits and others are linked by life-history theory to mortality rates experienced at different ages by our hominin ancestors. However, currently there is a great deal of debate concerning hominin mortality profiles at different periods of evolutionary history. Observed rates and causes of mortality in modern hunter-gatherers may provide information about Upper Paleolithic mortality that can be compared to indirect evidence from the fossil record, yet little is published about causes and rates of mortality in foraging societies around the world. To our knowledge, interview-based life tables for recent hunter-gatherers are published for only four societies (Ache, Agta, Hadza, and Ju/'hoansi). Here, we present mortality data for a fifth group, the Hiwi hunter-gatherers of Venezuela. The results show comparatively high death rates among the Hiwi and highlight differences in mortality rates among hunter-gatherer societies. The high levels of conspecific violence and adult mortality in the Hiwi may better represent Paleolithic human demographics than do the lower, disease-based death rates reported in the most frequently cited forager studies.

Hunter-gatherers in southeast Asia: from prehistory to the present.

Science.gov (United States)

Higham, Charles

2013-01-01

Anatomically modern hunter-gatherers expanded from Africa into Southeast Asia at least 50,000 years ago, where they probably encountered and interacted with populations of Homo erectus and Homo floresiensis and the recently discovered Denisovans. Simulation studies suggest that these hunter-gatherers may well have followed a coastal route that ultimately led to the settlement of Sahul, while archaeology confirms that they also crossed significant seas and explored well into the interior. They also adapted to marked environmental changes that alternated between relatively cool and dry conditions and warmer, wetter interludes. During the former, the sea fell by up to 120 m below its present level, which opened up a vast low-lying area known as Sundaland. Three principal alignments can be identified: the first involved the occupation of rock shelters in upland regions, the second has identified settlement on broad riverine floodplains, and the last concentrated on the raised beaches formed from about five millennia ago when the sea level was elevated above its present position. This cultural sequence was dislocated about 4 kya when rice and millet farmers infiltrated the lowlands of Southeast Asia ultimately from the Yangtze River valley. It is suggested that this led to two forms of interaction. In the first, the indigenous hunter-gatherers integrated with intrusive Neolithic communities and, while losing their cultural identity, contributed their genes to the present population of Southeast Asia. In the second, hunter-gatherers withdrew to rainforest refugia and, through selective pressures inherent in such an environment, survived as the small-bodied, dark-skinned humans found to this day in the Philippines, Peninsular Malaysia and Thailand, and the Andaman Islands. Beyond the impact of expansive rice farmers in Melanesia and Australia, hunter-gatherers continued to dominate until they encountered European settlement. Copyright © 2013 Wayne State University Press

Future Discounting in Congo Basin Hunter-Gatherers Declines with Socio-Economic Transitions.

Directory of Open Access Journals (Sweden)

Gul Deniz Salali

Full Text Available Humans have a tendency to discount the future; that is we value small, short-term rewards over larger, long-term rewards. The degree of future discounting, however, changes in response to socio-ecological factors. Here, we study Mbendjele BaYaka hunter-gatherers of northern Congo and their farmer neighbours to investigate adaptations in inter-temporal preferences in humans. We argue that in immediate-return systems, where food storage is absent and egalitarianism is enforced through levelling mechanisms, future discounting is an adaptive strategy to prevent wealth accumulation and the emergence of hierarchies. This ensures food sharing and allows for survival in unpredictable environments where there is risk of an energy shortfall. On the other hand, when food storage is made possible by the emergence of agriculture or as seen in some delayed-return hunter-gatherer populations, wealth accumulation, hierarchies and lower discount rates become the adaptive strategy. Therefore, individuals in immediate-return, egalitarian societies will discount the future more than those in non-egalitarian, delayed-return societies. Consistent with the predictions we found that market integration and socio-economic transitions decrease the future discounting in Mbendjele hunter-gatherers. Our measures of socio-economic differences marked this transition in hunter-gatherers living in a logging town. The degree of future-discounting was the same between more market-integrated hunter-gatherers and their farmer neighbours.

Wild-harvested venison yields and sharing by Michigan deer hunters

Science.gov (United States)

Goguen, Amber D.; Riley, Shawn J.; Organ, John F.; Rudolph, Brent A.

2018-01-01

An increased societal focus on wildlife as food and recent policy deliberations regarding legal markets for wild-harvested meat are encouraging wildlife managers and researchers to examine the amount, use, and distribution of meat yielded through recreational hunting. We used responses to questions on the Michigan Deer Harvest Study to estimate the maximum yield of edible venison and assess hunters’ sharing behaviors. We estimated 11,402–14,473 metric tons of edible venison were procured during the 2013 hunting season. Of hunters who harvested a deer, 85% shared their venison. Hunters who shared did so with an average of 5.6 people (SD = 4.5). Sharing occurred most frequently within tight social networks: members of hunters’ households (69%), relatives (52%), and friends, neighbors, or coworkers (50%). In the absence of legal markets, venison is distributed widely by hunters and greatly amplifies the number of people benefiting from hunting. Nonetheless, we also identified the potential breadth of exposure to disease or contaminants from wild-harvested meat.

46 CFR 9.10 - Waiting time.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour. ...

Anterior Hypopituitarism and Treatment Response in Hunter Syndrome: A Comparison of Two Patients

Directory of Open Access Journals (Sweden)

Munier A. Nour

2016-01-01

Full Text Available Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid was seen; however, final adult height remained compromised. Patient 2, a 13-year-old male with Hunter syndrome, was evaluated for growth failure. He had a large empty sella turcica with posteriorly displaced pituitary. Functional endocrine testing was normal and a trial of GH-treatment yielded no significant effect. Panhypopituitarism associated with pituitary anomalies has not been previously reported in Hunter syndrome and was an incidental finding of significant clinical importance. In the setting of documented anterior hypopituitarism, while hormone replacement improved growth velocity, final height remained impaired. In patient 2 with equivocal GH-testing results, treatment had no effect on linear growth. These cases highlight the importance of careful clinical assessment in Hunter syndrome and that judicious hormone replacement may be indicated in individual cases.

A synergistic effort among geoscience, physics, computer science and mathematics at Hunter College of CUNY as a Catalyst for educating Earth scientists.

Science.gov (United States)

Salmun, H.; Buonaiuto, F. S.

2016-12-01

The Catalyst Scholarship Program at Hunter College of The City University of New York (CUNY) was established with a four-year award from the National Science Foundation (NSF) to fund scholarships for academically talented but financially disadvantaged students majoring in four disciplines of science, technology, engineering and mathematics (STEM). Led by Earth scientists the Program awarded scholarships to students in their junior or senior years majoring in computer science, geosciences, mathematics and physics to create two cohorts of students that spent a total of four semesters in an interdisciplinary community. The program included mentoring of undergraduate students by faculty and graduate students (peer-mentoring), a sequence of three semesters of a one-credit seminar course and opportunities to engage in research activities, research seminars and other enriching academic experiences. Faculty and peer-mentoring were integrated into all parts of the scholarship activities. The one-credit seminar course, although designed to expose scholars to the diversity STEM disciplines and to highlight research options and careers in these disciplines, was thematically focused on geoscience, specifically on ocean and atmospheric science. The program resulted in increased retention rates relative to institutional averages. In this presentation we will discuss the process of establishing the program, from the original plans to its implementation, as well as the impact of this multidisciplinary approach to geoscience education at our institution and beyond. An overview of accomplishments, lessons learned and potential for best practices will be presented.

Consumer behaviour in the waiting area.

Science.gov (United States)

Mobach, Mark P

2007-02-01

To determine consumer behaviour in the pharmacy waiting area. The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each waiting area (brochures, books, illuminated new trailer, children's play area, etc.). Per patient each activity was registered, and at each pharmacy the behaviour was studied for 2 weeks. Most patients only waited during the waiting time at the studied pharmacies. Few consumers obtained written information during their wait. The waiting area may have latent possibilities to expand the information function of the pharmacy and combine this with other activities that distract the consumer from the wait. Transdisciplinary research, combining knowledge from pharmacy practice research with consumer research, has been a useful approach to add information on queueing behaviour of consumers.

Clarifying beliefs underlying hunter intentions to support a ban on lead shot

Science.gov (United States)

Schroeder, Susan A.; Fulton, David C.; Doncarlos, Kathy

2016-01-01

Shot from hunting adds toxic lead to environments worldwide. Existing lead shot regulations have been instituted with little understanding of hunter beliefs and attitudes. This study applied the Theory of Reasoned Action, using a multilevel, multivariate approach, to clarify how positive and negative beliefs relate to attitudes about a ban on lead shot. Structure coefficients and commonality analysis were employed to further examine relationships between beliefs and attitudes. Results suggest that while both positive and negative outcomes influence attitudes, positive outcomes were more influential for supporters and negative beliefs for opposers. Management may need to focus on the results from hunters who indicated that they would be unlikely to support a ban, as these hunters include those who may actively oppose additional efforts to regulate lead.

Handgun waiting periods reduce gun deaths.

Science.gov (United States)

Luca, Michael; Malhotra, Deepak; Poliquin, Christopher

2017-11-14

Handgun waiting periods are laws that impose a delay between the initiation of a purchase and final acquisition of a firearm. We show that waiting periods, which create a "cooling off" period among buyers, significantly reduce the incidence of gun violence. We estimate the impact of waiting periods on gun deaths, exploiting all changes to state-level policies in the Unites States since 1970. We find that waiting periods reduce gun homicides by roughly 17%. We provide further support for the causal impact of waiting periods on homicides by exploiting a natural experiment resulting from a federal law in 1994 that imposed a temporary waiting period on a subset of states. Copyright © 2017 the Author(s). Published by PNAS.

Queues with waiting time dependent service

DEFF Research Database (Denmark)

Bekker, R.; Koole, G. M.; Nielsen, Bo Friis

2011-01-01

Motivated by service levels in terms of the waiting-time distribution seen, for instance, in call centers, we consider two models for systems with a service discipline that depends on the waiting time. The first model deals with a single server that continuously adapts its service rate based...... derive steady-state waiting-time distributions for both models. The results are illustrated with numerical examples....... on the waiting time of the first customer in line. In the second model, one queue is served by a primary server which is supplemented by a secondary server when the waiting of the first customer in line exceeds a threshold. Using level crossings for the waiting-time process of the first customer in line, we...

'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

Science.gov (United States)

Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

2017-05-05

Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

Ramsey waits: allocating public health service resources when there is rationing by waiting.

Science.gov (United States)

Gravelle, Hugh; Siciliani, Luigi

2008-09-01

The optimal allocation of a public health care budget across treatments must take account of the way in which care is rationed within treatments since this will affect their marginal value. We investigate the optimal allocation rules for public health care systems where user charges are fixed and care is rationed by waiting. The optimal waiting time is higher for treatments with demands more elastic to waiting time, higher costs, lower charges, smaller marginal welfare loss from waiting by treated patients, and smaller marginal welfare losses from under-consumption of care. The results hold for a wide range of welfarist and non-welfarist objective functions and for systems in which there is also a private health care sector. They imply that allocation rules based purely on cost effectiveness ratios are suboptimal because they assume that there is no rationing within treatments.

Does Lateral Transmission Obscure Inheritance in Hunter-Gatherer Languages?

Science.gov (United States)

Bowern, Claire; Epps, Patience; Gray, Russell; Hill, Jane; Hunley, Keith; McConvell, Patrick; Zentz, Jason

2011-01-01

In recent years, linguists have begun to increasingly rely on quantitative phylogenetic approaches to examine language evolution. Some linguists have questioned the suitability of phylogenetic approaches on the grounds that linguistic evolution is largely reticulate due to extensive lateral transmission, or borrowing, among languages. The problem may be particularly pronounced in hunter-gatherer languages, where the conventional wisdom among many linguists is that lexical borrowing rates are so high that tree building approaches cannot provide meaningful insights into evolutionary processes. However, this claim has never been systematically evaluated, in large part because suitable data were unavailable. In addition, little is known about the subsistence, demographic, ecological, and social factors that might mediate variation in rates of borrowing among languages. Here, we evaluate these claims with a large sample of hunter-gatherer languages from three regions around the world. In this study, a list of 204 basic vocabulary items was collected for 122 hunter-gatherer and small-scale cultivator languages from three ecologically diverse case study areas: northern Australia, northwest Amazonia, and California and the Great Basin. Words were rigorously coded for etymological (inheritance) status, and loan rates were calculated. Loan rate variability was examined with respect to language area, subsistence mode, and population size, density, and mobility; these results were then compared to the sample of 41 primarily agriculturalist languages in [1]. Though loan levels varied both within and among regions, they were generally low in all regions (mean 5.06%, median 2.49%, and SD 7.56), despite substantial demographic, ecological, and social variation. Amazonian levels were uniformly very low, with no language exhibiting more than 4%. Rates were low but more variable in the other two study regions, in part because of several outlier languages where rates of borrowing were

Comparing Road-Kill Datasets from Hunters and Citizen Scientists in a Landscape Context

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Florian Heigl

2016-10-01

Full Text Available Road traffic has severe effects on animals, especially when road-kills are involved. In many countries, official road-kill data are provided by hunters or police; there are also road-kill observations reported by citizen scientists. The aim of the current study was to test whether road-kill reports by hunters stem from similar landscapes than those reported by citizen scientists. We analysed the surrounding landscapes of 712 road-kill reportings of European hares in the province of Lower Austria. Our data showed that road-killed hares reported both by hunters and citizens are predominantly surrounded by arable land. No difference of hedges and solitary trees could be found between the two datasets. However, significant differences in landcover classes and surrounding road networks indicate that hunters’ and citizen scientists’ data are different. Hunters reported hares from landscapes with significantly higher percentages of arable land, and greater lengths of secondary roads. In contrast, citizens reported hares from landscapes with significantly higher percentages of urban or industrial areas and greater lengths of motorways, primary roads, and residential roads. From this we argue that hunters tend to report data mainly from their hunting areas, whereas citizens report data during their daily routine on the way to/from work. We conclude that a citizen science approach is an important source for road-kill data when used in addition to official data with the aim of obtaining an overview of road-kill events on a landscape scale.

Waiting when hospitalised

DEFF Research Database (Denmark)

Ludvigsen, Mette Spliid

2004-01-01

on participating observations during a period of one and a half year. The material is analysed with inspiration from Mattingly's ideas of narrative and time. ConclusionsAlthough waiting times is not a clinically serious problem, the satisfaction levels of patients with the care they receive have become...... increasingly important in today's health care environment. The indicative conclusions form this study suggest that nurses play an important role in ensuring that patients are satisfied and receive quality care when waiting....

Reactions to waiting online by men and women.

Science.gov (United States)

Chebat, Jean-Charles; Salem, Narjes Haj; Poirier, Jean-François; Gélinas-Chebat, Claire

2010-06-01

The goal of the present study was to identify factors which may affect the difference between the actual time participants expected to wait for downloading a web page and the perceived waiting time, i.e., the online waiting-time gap. The findings from an experiment in which the music tempo (fast vs. slow) and waiting-duration information (presence vs. absence) were manipulated showed that sex moderated the relation between the manipulated variables and waiting-time gap; emotional response was more important between the manipulated variables and waiting-time gap than was cognitive response. The type of emotional response with an effect on waiting-time gap varied by sex: pleasure for women and arousal for men. For women, pleasure was affected by their cognitive response, while cognitive response played no significant role for men. For both sexes, information on waiting duration increased the perceived waiting time. This study leads to reconsidering the role of emotional response and sex in evaluating waiting time.

"The Deer Hunter": Rhetoric of the Warrior.

Science.gov (United States)

Rushing, Janice Hocker; Frentz, Thomas S.

A psychological/ritual model of criticism is used to examine the movie "The Deer Hunter" as a rhetorical event in which males undergo psychological change through their war and postwar experiences. The critical model depends on understanding a Jungian interpretation of the human psyche, the form and function of initiation rituals, and…

Hunter versus CIE color measurement systems for analysis of milk-based beverages.

Science.gov (United States)

Cheng, Ni; Barbano, David M; Drake, Mary Anne

2018-06-01

The objective of our work was to determine the differences in sensitivity of Hunter and International Commission on Illumination (CIE) methods at 2 different viewer angles (2 and 10°) for measurement of whiteness, red/green, and blue/yellow color of milk-based beverages over a range of composition. Sixty combinations of milk-based beverages were formulated (2 replicates) with a range of fat level from 0.2 to 2%, true protein level from 3 to 5%, and casein as a percent of true protein from 5 to 80% to provide a wide range of milk-based beverage color. In addition, commercial skim, 1 and 2% fat high-temperature, short-time pasteurized fluid milks were analyzed. All beverage formulations were HTST pasteurized and cooled to 4°C before analysis. Color measurement viewer angle (2 vs. 10°) had very little effect on objective color measures of milk-based beverages with a wide range of composition for either the Hunter or CIE color measurement system. Temperature (4, 20, and 50°C) of color measurement had a large effect on the results of color measurement in both the Hunter and CIE measurement systems. The effect of milk beverage temperature on color measurement results was the largest for skim milk and the least for 2% fat milk. This highlights the need for proper control of beverage serving temperature for sensory panel analysis of milk-based beverages with very low fat content and for control of milk temperature when doing objective color analysis for quality control in manufacture of milk-based beverages. The Hunter system of color measurement was more sensitive to differences in whiteness among milk-based beverages than the CIE system, whereas the CIE system was much more sensitive to differences in yellowness among milk-based beverages. There was little difference between the Hunter and CIE system in sensitivity to green/red color of milk-based beverages. In defining milk-based beverage product specifications for objective color measures for dairy product

Suicide Intervention Training for College Staff: Program Evaluation and Intervention Skill Measurement

Science.gov (United States)

Shannonhouse, Laura; Lin, Yung-Wei Dennis; Shaw, Kelly; Wanna, Reema; Porter, Michael

2017-01-01

Objective: Suicide remains a pressing issue for college communities. Consequently, gatekeeper trainings are often provided for staff. This study examines the effect of one such program, Applied Suicide Intervention Skills Training (ASIST). Participants: 51 college employees received ASIST in August of 2014 and were compared to 30 wait-list control…

Time while waiting: patients' experiences of scheduled surgery.

Science.gov (United States)

Carr, Tracey; Teucher, Ulrich C; Casson, Alan G

2014-12-01

Research on patients' experiences of wait time for scheduled surgery has centered predominantly on the relative tolerability of perceived wait time and impacts on quality of life. We explored patients' experiences of time while waiting for three types of surgery with varied wait times--hip or knee replacement, shoulder surgery, and cardiac surgery. Thirty-two patients were recruited by their surgeons. We asked participants about their perceptions of time while waiting in two separate interviews. Using interpretative phenomenological analysis (IPA), we discovered connections between participant suffering, meaningfulness of time, and agency over the waiting period and the lived duration of time experience. Our findings reveal that chronological duration is not necessarily the most relevant consideration in determining the quality of waiting experience. Those findings helped us create a conceptual framework for lived wait time. We suggest that clinicians and policy makers consider the complexity of wait time experience to enhance preoperative patient care. © The Author(s) 2014.

Fiber-optic displacement sensors on the Hunters Trophy UGT impulse gauge experiments

Energy Technology Data Exchange (ETDEWEB)

Green, R.E.L.; Poutiatine, A.I.

1995-03-01

As part of a program to develop gauges for measurement of various mechanical properties in hostile environments, the authors fielded purely optical displacement sensors at the ends of long fiber-optic cables as supplements to the regular displacement sensors of four impulse gauges fielded as part of a materials study on the Hunters Trophy underground effects test at the Nevada Test Site. These fiber-optic sensor systems and their performance on the Hunters Trophy test are described in this report.

Targeting hunter distribution based on host resource selection and kill sites to manage disease risk.

Science.gov (United States)

Dugal, Cherie J; van Beest, Floris M; Vander Wal, Eric; Brook, Ryan K

2013-10-01

Endemic and emerging diseases are rarely uniform in their spatial distribution or prevalence among cohorts of wildlife. Spatial models that quantify risk-driven differences in resource selection and hunter mortality of animals at fine spatial scales can assist disease management by identifying high-risk areas and individuals. We used resource selection functions (RSFs) and selection ratios (SRs) to quantify sex- and age-specific resource selection patterns of collared (n = 67) and hunter-killed (n = 796) nonmigratory elk (Cervus canadensis manitobensis) during the hunting season between 2002 and 2012, in southwestern Manitoba, Canada. Distance to protected area was the most important covariate influencing resource selection and hunter-kill sites of elk (AICw = 1.00). Collared adult males (which are most likely to be infected with bovine tuberculosis (Mycobacterium bovis) and chronic wasting disease) rarely selected for sites outside of parks during the hunting season in contrast to adult females and juvenile males. The RSFs showed selection by adult females and juvenile males to be negatively associated with landscape-level forest cover, high road density, and water cover, whereas hunter-kill sites of these cohorts were positively associated with landscape-level forest cover and increasing distance to streams and negatively associated with high road density. Local-level forest was positively associated with collared animal locations and hunter-kill sites; however, selection was stronger for collared juvenile males and hunter-killed adult females. In instances where disease infects a metapopulation and eradication is infeasible, a principle goal of management is to limit the spread of disease among infected animals. We map high-risk areas that are regularly used by potentially infectious hosts but currently underrepresented in the distribution of kill sites. We present a novel application of widely available data to target hunter distribution based on host resource

Salinity and resource management in the Hunter Valley

Energy Technology Data Exchange (ETDEWEB)

Creelman, R.A.; Cooke, R.; Simons, M. [RA Creelman & Associates (Australia)

1995-08-01

If excess water salinity is to be managed in the Hunter Valley, its causes and behaviour must be understood. Although Hunter Valley hydrology, hydrogeology and hydrogeochemistry require further study, there is now enough information available to begin the development of both temporal and spatial models as valley management tools. Currently the Department of Water Resources is developing a model known as Integrated Water Quality and Quantity Model (IQQM). IQQM which includes a salinity module is essentially a surface water simulation model. It wll enable testing of alternate management and operation policies such as the salinity property rights trading scheme recently introduced by the EPA to manage salt release from coal mines and power stations. An overview is presented of the progress made to date on the salinity module for IQQM, and an outline is given of the geological and hydrogeochemical concepts that have been assembled to support the salinity module of IQQM. 17 refs., 3 figs., 1 tab.

Waiting for surgery from the patient perspective

Directory of Open Access Journals (Sweden)

Tracey Carr

2009-10-01

Full Text Available Tracey Carr1, Ulrich Teucher2, Jackie Mann4, Alan G Casson31Health Sciences, 2Department of Psychology, 3Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 4Acute Care, Saskatoon Health Region, Saskatoon, Saskatchewan, CanadaAbstract: The aim of this study was to perform a systematic review of the impact of waiting for elective surgery from the patient perspective, with a focus on maximum tolerance, quality of life, and the nature of the waiting experience. Searches were conducted using Medline, PubMed, CINAHL, EMBASE, and HealthSTAR. Twenty-seven original research articles were identified which included each of these three themes. The current literature suggested that first, patients tend to state longer wait times as unacceptable when they experienced severe symptoms or functional impairment. Second, the relationship between length of wait and health-related quality of life depended on the nature and severity of proposed surgical intervention at the time of booking. Third, the waiting experience was consistently described as stressful and anxiety provoking. While many patients expressed anger and frustration at communication within the system, the experience of waiting was not uniformly negative. Some patients experienced waiting as an opportunity to live full lives despite pain and disability. The relatively unexamined relationship between waiting, illness and patient experience of time represents an area for future research.Keywords: wait time, scheduled surgery, patient perspective, literature review

Waiting experience in railway environments

NARCIS (Netherlands)

van Hagen, M.; Galetzka, Mirjam; Pruyn, Adriaan T.H.

2014-01-01

At railway stations, waiting time is usually an unavoidable aspect of the journey for train passengers. According to the attentional model of time, pleasant surroundings and other forms of distraction reduce perceived waiting time. Not every individual reacts identically in the same surroundings.

perceptions and adaptations of beekeepers and honey hunters

African Journals Online (AJOL)

Prof. Adipala Ekwamu

honey sector (i.e. honey hunters) to climate change are, however, not adequately explored. The objective of .... The statistical software SPSS Version 16 was used for this purpose. ... content analysis is an effort of interpretation, that balances ... FORM. Discontinue. N o = 0 ; Yes = 1. ±. Creditavability. CRED. Discontinue. N.

Injury and Illness Among Deer Hunters

OpenAIRE

McRae, Shelagh M.

1989-01-01

General practice and out-patient emergency records for a five-year period were reviewed for injuries and illnesses that occurred during the week of deer rifle hunting on Manitoulin Island. Of 65 hunters who were identified, most had lacerations secondary to knife injuries. There were two deaths (one shooting and one in a motor vehicle accident), and 19 persons required hospitalization. More than half of these serious accidents occurred on the weekends immediately preceding or following the hu...

Project CHECO Southeast Asia Report. OV-1/AC-119 Hunter-Killer Team

Science.gov (United States)

1972-10-10

between Phan Rang, Phu Cat , and Danang in order to provide best coverage of the Vietnamese conflict. -- On 16 February 1970, three AC -ll9Ks and 70...SOUTHEAST ASIA D D DDiv AY/XDOSQA I OV-1/ AC -119 " i IWB I HUNTER-KILLER TEAM 19’.1’ CONTINUING REPORT CLASSIFIED Ey 7AFIDOOC DOWNGRADE TjU SECRET...xamination of C urrent, 0 per’tions I~ I fF!lr T I TII TIIII I OV=1/ AC -119 HUNTER-KILLER TEAMI 1 10 OCTOBER 1972 HQ PACAF Directorate of Operations

Ethical acceptability of recreational hunting - does the motive of the hunter matter?

DEFF Research Database (Denmark)

Gamborg, Christian; Jensen, Frank Søndergaard; Sandøe, Peter

2016-01-01

Recreational hunting can be a way of taking responsibility for acquiring one’s own meat. However, many recreational hunters focus instead on hunting as a hobby or sport. This distinction, between two rather different motives for hunting, is relevant to the activity’s moral justifiability. The pub......Recreational hunting can be a way of taking responsibility for acquiring one’s own meat. However, many recreational hunters focus instead on hunting as a hobby or sport. This distinction, between two rather different motives for hunting, is relevant to the activity’s moral justifiability...

Wait too long to talk about kidney disease and you could be waiting for a kidney.

Science.gov (United States)

... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

Radium issues at Hunters Point Annex

International Nuclear Information System (INIS)

Dean, S.M.

1994-01-01

Radium was a common source of illumination used in numerous instruments and gauges for military equipment prior to 1970. As a result of its many military applications radium 226 is now a principle radionuclide of concern at military base closures sites throughout the United States. This is an overview of the site characterization strategy employed and a potential site remediation technology being considered at a radium contaminated landfill at Hunters Point Annex, a former U.S. Navy shipyard in San Francisco, California

Comparing Road-Kill Datasets from Hunters and Citizen Scientists in a Landscape Context

OpenAIRE

Florian Heigl; Carina R. Stretz; Wolfgang Steiner; Franz Suppan; Thomas Bauer; Gregor Laaha; Johann G. Zaller

2016-01-01

Road traffic has severe effects on animals, especially when road-kills are involved. In many countries, official road-kill data are provided by hunters or police; there are also road-kill observations reported by citizen scientists. The aim of the current study was to test whether road-kill reports by hunters stem from similar landscapes than those reported by citizen scientists. We analysed the surrounding landscapes of 712 road-kill reportings of European hares in the province of Lower Aust...

Undergraduate Planet Hunters: Tools and Results

Science.gov (United States)

Buzasi, Derek L.; Carboneau, Lindsey; Ferrell, Laura; Green, Gilbert; Kaiser, Maya; Kreke, Kira; Lundy, Samantha; Merritt, William; Passino, Matlin; Paxton, Harrison; Podaril, Alexandria; Stansfield, Alexis

2018-06-01

One student "Honors Experience" option at Florida Gulf Coast University is a research experience, and we have developed a "Planet Hunters" course to provide an astronomical research track that satisfies that requirement. Students spend the first semester learning astronomical background and exoplanet detection techniques, while the second semester is primarily devoted to planet searches in K2 data using student-oriented software tools developed specifically for the task. In this poster, we illustrate those tools and show results obtained by class participants during this years experience.

Targeting hunter distribution based on host resource selection and kill sites to manage disease risk

DEFF Research Database (Denmark)

Dugal, Cherie; van Beest, Floris; Vander Wal, Eric

2013-01-01

Endemic and emerging diseases are rarely uniform in their spatial distribution or prevalence among cohorts of wildlife. Spatial models that quantify risk-driven differences in resource selection and hunter mortality of animals at fine spatial scales can assist disease management by identifying high-risk...... areas and individuals. We used resource selection functions (RSFs) and selection ratios (SRs) to quantify sex- and age-specific resource selection patterns of collared (n = 67) and hunter-killed (n = 796) nonmigratory elk (Cervus canadensis manitobensis) during the hunting season between 2002 and 2012...... juvenile males and hunter-killed adult females. In instances where disease infects a metapopulation and eradication is infeasible, a principle goal of management is to limit the spread of disease among infected animals. We map high-risk areas that are regularly used by potentially infectious hosts...

Stochastic nature of series of waiting times

Science.gov (United States)

Anvari, Mehrnaz; Aghamohammadi, Cina; Dashti-Naserabadi, H.; Salehi, E.; Behjat, E.; Qorbani, M.; Khazaei Nezhad, M.; Zirak, M.; Hadjihosseini, Ali; Peinke, Joachim; Tabar, M. Reza Rahimi

2013-06-01

Although fluctuations in the waiting time series have been studied for a long time, some important issues such as its long-range memory and its stochastic features in the presence of nonstationarity have so far remained unstudied. Here we find that the “waiting times” series for a given increment level have long-range correlations with Hurst exponents belonging to the interval 1/2waiting time distribution. We find that the logarithmic difference of waiting times series has a short-range correlation, and then we study its stochastic nature using the Markovian method and determine the corresponding Kramers-Moyal coefficients. As an example, we analyze the velocity fluctuations in high Reynolds number turbulence and determine the level dependence of Markov time scales, as well as the drift and diffusion coefficients. We show that the waiting time distributions exhibit power law tails, and we were able to model the distribution with a continuous time random walk.

The effects of immigration on NHS waiting times.

Science.gov (United States)

Giuntella, Osea; Nicodemo, Catia; Vargas-Silva, Carlos

2018-03-01

This paper analyzes the effects of immigration on waiting times for the National Health Service (NHS) in England. Linking administrative records from Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labour Force Survey, we find that immigration reduced waiting times for outpatient referrals and did not have significant effects on waiting times in accident and emergency departments (A&E) and elective care. The reduction in outpatient waiting times can be explained by the fact that immigration increases natives' internal mobility and that immigrants tend to be healthier than natives who move to different areas. Finally, we find evidence that immigration increased waiting times for outpatient referrals in more deprived areas outside of London. The increase in average waiting times in more deprived areas is concentrated in the years immediately following the 2004 EU enlargement and disappears in the medium term (e.g., 3-4 years). Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Medicinal and ethnoveterinary remedies of hunters in Trinidad

Directory of Open Access Journals (Sweden)

Georges Karla

2001-11-01

Full Text Available Abstract Background Ethnomedicines are used by hunters for themselves and their hunting dogs in Trinidad. Plants are used for snakebites, scorpion stings, for injuries and mange of dogs and to facilitate hunting success. Results Plants used include Piper hispidum, Pithecelobium unguis-cati, Bauhinia excisa, Bauhinia cumanensis, Cecropia peltata, Aframomum melegueta, Aristolochia rugosa, Aristolochia trilobata, Jatropha curcas, Jatropha gossypifolia, Nicotiana tabacum, Vernonia scorpioides, Petiveria alliacea, Renealmia alpinia, Justicia secunda, Phyllanthus urinaria,Phyllanthus niruri,Momordica charantia, Xiphidium caeruleum, Ottonia ovata, Lepianthes peltata, Capsicum frutescens, Costus scaber, Dendropanax arboreus, Siparuma guianensis, Syngonium podophyllum, Monstera dubia, Solanum species, Eclipta prostrata, Spiranthes acaulis, Croton gossypifolius, Barleria lupulina, Cola nitida, Acrocomia ierensis (tentative ID. Conclusion Plant use is based on odour, and plant morphological characteristics and is embedded in a complex cultural context based on indigenous Amerindian beliefs. It is suggested that the medicinal plants exerted a physiological action on the hunter or his dog. Some of the plants mentioned contain chemicals that may explain the ethnomedicinal and ethnoveterinary use. For instance some of the plants influence the immune system or are effective against internal and external parasites. Plant baths may contribute to the health and well being of the hunting dogs.

Medicinal and ethnoveterinary remedies of hunters in Trinidad.

Science.gov (United States)

Lans, C; Harper, T; Georges, K; Bridgewater, E

2001-01-01

Ethnomedicines are used by hunters for themselves and their hunting dogs in Trinidad. Plants are used for snakebites, scorpion stings, for injuries and mange of dogs and to facilitate hunting success. Plants used include Piper hispidum, Pithecelobium unguis-cati, Bauhinia excisa, Bauhinia cumanensis, Cecropia peltata, Aframomum melegueta, Aristolochia rugosa, Aristolochia trilobata, Jatropha curcas, Jatropha gossypifolia, Nicotiana tabacum, Vernonia scorpioides, Petiveria alliacea, Renealmia alpinia, Justicia secunda, Phyllanthus urinaria,Phyllanthus niruri,Momordica charantia, Xiphidium caeruleum, Ottonia ovata, Lepianthes peltata, Capsicum frutescens, Costus scaber, Dendropanax arboreus, Siparuma guianensis, Syngonium podophyllum, Monstera dubia, Solanum species, Eclipta prostrata, Spiranthes acaulis, Croton gossypifolius, Barleria lupulina, Cola nitida, Acrocomia ierensis (tentative ID). Plant use is based on odour, and plant morphological characteristics and is embedded in a complex cultural context based on indigenous Amerindian beliefs. It is suggested that the medicinal plants exerted a physiological action on the hunter or his dog. Some of the plants mentioned contain chemicals that may explain the ethnomedicinal and ethnoveterinary use. For instance some of the plants influence the immune system or are effective against internal and external parasites. Plant baths may contribute to the health and well being of the hunting dogs.

Intergroup aggression in chimpanzees and war in nomadic hunter-gatherers: evaluating the chimpanzee model.

Science.gov (United States)

Wrangham, Richard W; Glowacki, Luke

2012-03-01

Chimpanzee and hunter-gatherer intergroup aggression differ in important ways, including humans having the ability to form peaceful relationships and alliances among groups. This paper nevertheless evaluates the hypothesis that intergroup aggression evolved according to the same functional principles in the two species-selection favoring a tendency to kill members of neighboring groups when killing could be carried out safely. According to this idea chimpanzees and humans are equally risk-averse when fighting. When self-sacrificial war practices are found in humans, therefore, they result from cultural systems of reward, punishment, and coercion rather than evolved adaptations to greater risk-taking. To test this "chimpanzee model," we review intergroup fighting in chimpanzees and nomadic hunter-gatherers living with other nomadic hunter-gatherers as neighbors. Whether humans have evolved specific psychological adaptations for war is unknown, but current evidence suggests that the chimpanzee model is an appropriate starting point for analyzing the biological and cultural evolution of warfare.

Outpatient waiting time in Jos University Teaching Hospital ...

African Journals Online (AJOL)

Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

Estimating the mercury exposure dose in a population of migratory bird hunters in the St. Lawrence River region, Quebec, Canada

International Nuclear Information System (INIS)

Duchesne, J.-F.; Levesque, B.; Gauvin, Denis; Braune, Birgit; Gingras, Suzanne; Dewailly, E.

2004-01-01

St. Lawrence River hunters (Quebec, Canada) are exposed to the pollutants, especially mercury, that contaminate birds and fish. However, the health risks of this have remained unclear because of a lack of information about the hunters' duck, geese, and sportfish consumption habits. A nutritional survey was set up to characterize waterfowl and sportfish consumption in St. Lawrence River duck hunters and to estimate their daily exposure to mercury. During the winter of 2000, 512 hunters selected from the Canadian Wildlife Service database completed a self-administered questionnaire. Daily exposure to contaminants was measured using data from the Canadian Wildlife Service (waterfowl) and available data on St. Lawrence River sportfish. The annual average consumption was 7.5 meals of ducks and geese and 8.7 meals of sportfish. The daily exposure to mercury related to waterfowl consumption was below the Canadian tolerable daily intake (TDI) of 0.47 μg/kg body wt/day for all participants. The daily mercury intake associated with fish consumption was greater than the TDI in 2 duck hunters. The daily exposure to mercury was higher than the TDI in 4 participants when both waterfowl and fish consumption were combined. Our results suggest that fish consumption (especially freshwater fish) represents the main source of exposure to pollutants in duck hunters

Electron Waiting Times of a Cooper Pair Splitter

Science.gov (United States)

Walldorf, Nicklas; Padurariu, Ciprian; Jauho, Antti-Pekka; Flindt, Christian

2018-02-01

Electron waiting times are an important concept in the analysis of quantum transport in nanoscale conductors. Here we show that the statistics of electron waiting times can be used to characterize Cooper pair splitters that create spatially separated spin-entangled electrons. A short waiting time between electrons tunneling into different leads is associated with the fast emission of a split Cooper pair, while long waiting times are governed by the slow injection of Cooper pairs from a superconductor. Experimentally, the waiting time distributions can be measured using real-time single-electron detectors in the regime of slow tunneling, where conventional current measurements are demanding. Our work is important for understanding the fundamental transport processes in Cooper pair splitters and the predictions may be verified using current technology.

Electron Waiting Times of a Cooper Pair Splitter

DEFF Research Database (Denmark)

Walldorf, Nicklas; Padurariu, Ciprian; Jauho, Antti-Pekka

2018-01-01

Electron waiting times are an important concept in the analysis of quantum transport in nanoscale conductors. Here we show that the statistics of electron waiting times can be used to characterize Cooper pair splitters that create spatially separated spin-entangled electrons. A short waiting time...... between electrons tunneling into different leads is associated with the fast emission of a split Cooper pair, while long waiting times are governed by the slow injection of Cooper pairs from a superconductor. Experimentally, the waiting time distributions can be measured using real-time single......-electron detectors in the regime of slow tunneling, where conventional current measurements are demanding. Our work is important for understanding the fundamental transport processes in Cooper pair splitters and the predictions may be verified using current technology....

Beyond the Cut Hunter: A Historical Epidemiology of HIV Beginnings in Central Africa.

Science.gov (United States)

Rupp, Stephanie; Ambata, Philippe; Narat, Victor; Giles-Vernick, Tamara

2016-12-01

In the absence of direct evidence, an imagined "cut hunter" stands in for the index patient of pandemic HIV/AIDS. During the early years of colonial rule, this explanation goes, a hunter was cut or injured from hunting or butchering a chimpanzee infected with simian immunodeficiency virus, resulting in the first sustained human infection with the virus that would emerge as HIV-1M. We argue here that the "cut hunter" relies on a historical misunderstanding and ecological oversimplification of human-chimpanzee (Pan Troglodytes troglodytes) interactions that facilitated pathogenic transmission. This initial host shift cannot explain the beginnings of the HIV/AIDS pandemic. Instead, we must understand the processes by which the virus became transmissible, possibly between Sangha basin inhabitants and ultimately reached Kinshasa. A historical epidemiology of the late nineteenth and twentieth centuries, provides a much-needed corrective to the major shortcomings of the cut hunter. Based on 62 oral historical interviews conducted in southeastern Cameroon and archival research, we show that HIV emerged from ecological, economic, and socio-political transformations of the late nineteenth and twentieth centuries. The gradual imposition of colonial rule built on and reoriented ecologies and economies, and altered older patterns of mobility and sociality. Certain changes may have contributed to the initial viral host shift, but more importantly, facilitated the adaptation of HIV-1M to human-to-human transmission. Our evidence suggests that the most critical changes occurred after 1920. This argument has important implications for public health policy, underscoring recent work emphasizing alternative pathways for zoonotic spillovers into human beings.

Firewood, food and human niche construction: the potential role of Mesolithic hunter-gatherers in actively structuring Scotland's woodlands

Science.gov (United States)

Bishop, Rosie R.; Church, Mike J.; Rowley-Conwy, Peter A.

2015-01-01

Over the past few decades the potential role of Mesolithic hunter-gatherers in actively constructing their own niches, through the management of wild plants, has frequently been discussed. It is probable that Mesolithic hunter-gatherers systematically exploited specific woodland resources for food and fuel and influenced the 'natural' abundance or distribution of particular species within Mesolithic environments. Though there has been considerable discussion of the pollen evidence for potential small-scale human-woodland manipulation in Mesolithic Scotland, the archaeobotanical evidence for anthropogenic firewood and food selection has not been discussed in this context. This paper assesses the evidence for the active role of Mesolithic hunter-gatherer communities in systematically exploiting and managing woodlands for food and fuel in Scotland. While taphonomic factors may have impacted on the frequency of specific species in archaeobotanical assemblages, it is suggested that hunter-gatherers in Mesolithic Scotland were systematically using woodland plants, and in particular hazel and oak, for food and fuel. It is argued that the pollen evidence for woodland management is equivocal, but hints at the role of hunter-gatherers in shaping the structure of their environments, through the maintenance or creation of woodland clearings for settlement or as part of vegetation management strategies. It is proposed that Mesolithic hunter-gatherers may have actively contributed to niche construction and that the systematic use of hazel and oak as a fuel may reflect the deliberate pruning of hazel trees to increase nut-yields and the inadvertent - or perhaps deliberate - coppicing of hazel and oak during greenwood collection.

Fundación Book Hunters: Atrévete a experimentar con la lectura

OpenAIRE

Cruz Mejía, Fernanda

2017-01-01

La fundación Book Hunters es una organización sin ánimo de lucro que busca fortalecer la relación de la lectura en los niños desde temprana edad, involucrando a la comunidad y promoviendo el entendimiento del entorno que rodea hoy en día la infancia. El equipo considera que, para lograr los objetivos es necesario transformar el significado ha perseguido a la lectura durante años, es decir, para Book Hunters leer va más allá de tomar un libro e involucrarse en la historia, en cambio, el si...

[Influence of waiting time on patient and companion satisfaction].

Science.gov (United States)

Fontova-Almató, A; Juvinyà-Canal, D; Suñer-Soler, R

2015-01-01

To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Prospective, observational study. Hospital de Figueres Emergency Department (Girona, Spain). sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). Perceived waiting time and the information about estimated waiting time determined overall satisfaction. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Radioactive caesium in hunters and their families

Energy Technology Data Exchange (ETDEWEB)

Aagren, G; Bergman, R [Natonal Defence Research Establishment, Umeaa (Sweden); Drottz-Sjoeberg, B M [Center for Risk Research, Stockholm (Sweden); Enander, A [National Defence Research Establishment, Karlstad (Sweden); Johansson, K J [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden)

1995-12-01

We have measured the whole-body content of radiocesium in men and women in households, where at least one member is a hunter. Hunter families live to a great extent on forest products, such as mushrooms, berries and meat from game. Measurements were performed in two areas in northern Sweden and in three areas in the middle part of Sweden with deposition levels between 7 to 80 kBq/m{sup 2}. The average whole body content of {sup 137}Cs varied between 0.3 to 1.9 kBq for women and 0.6 to 4.7 kBq for men, depending on the deposition level. Each individual in the measured group was also asked to fill in questionnaire and a food diary to provide complementary information of, e.g., food intake and other life conditions. The single dietary factor most clearly related to whole-body content in these groups is the intake of meat from moose. The best regression model with variables from the questionnaire explained 60% of the variance in the whole-body content of {sup 137}Cs in the measurement group. Some of the variables in this model were deposition level, sex, rate of intake and estimated consumption of moose meat and estimated amount of bilberries in the fridge. 6 refs, 5 figs, 14 tabs.

Radioactive caesium in hunters and their families

International Nuclear Information System (INIS)

Aagren, G.; Bergman, R.; Drottz-Sjoeberg, B.M.; Enander, A.; Johansson, K.J.

1995-12-01

We have measured the whole-body content of radiocesium in men and women in households, where at least one member is a hunter. Hunter families live to a great extent on forest products, such as mushrooms, berries and meat from game. Measurements were performed in two areas in northern Sweden and in three areas in the middle part of Sweden with deposition levels between 7 to 80 kBq/m 2 . The average whole body content of 137 Cs varied between 0.3 to 1.9 kBq for women and 0.6 to 4.7 kBq for men, depending on the deposition level. Each individual in the measured group was also asked to fill in questionnaire and a food diary to provide complementary information of, e.g., food intake and other life conditions. The single dietary factor most clearly related to whole-body content in these groups is the intake of meat from moose. The best regression model with variables from the questionnaire explained 60% of the variance in the whole-body content of 137 Cs in the measurement group. Some of the variables in this model were deposition level, sex, rate of intake and estimated consumption of moose meat and estimated amount of bilberries in the fridge. 6 refs, 5 figs, 14 tabs

Reducing Lead on the Landscape: Anticipating Hunter Behavior in Absence of a Free Nonlead Ammunition Program.

Directory of Open Access Journals (Sweden)

Loren Chase

Full Text Available Lead is a neurotoxin that has been documented to affect many forms of wildlife, and has been identified as a limiting factor in a population of California Condors in Northern Arizona. The Arizona Game and Fish Department provides vouchers for free nonlead ammunition to hunters selected to hunt within the distribution of California Condors, with the intention of having fewer lead-laden offal piles available to California Condors. Although wildlife agencies may reasonably assume voucher programs motivate hunters into choosing nonlead ammunition, the lead reduction efforts attributable to the voucher program has not been empirically quantified. Our intention was to compare a control group of hunters to a treatment group of hunters within California Condor occupied areas. Both groups received educational materials regarding the deleterious effects of lead, but the treatment group also received a voucher for a free initial box of ammunition. About half of the control group used nonlead ammunition, compared to about three-fourths of the treatment group. Prominent barriers to adoption of nonlead ammunition included a general difficulty of obtaining it, obtaining it in the desired caliber, and its costliness. Frequently mentioned motivations for using nonlead was the exhortation to use it by the Department, and the desire to aid California Condor recovery by hunters. The disparate compliance rates found herein confirm and quantify the success of nonlead ammunition voucher programs, but underscore the importance of working to increase the supply of nonlead ammunition with the end of facilitating its procurement and reducing its cost.

Diagnosis of Hunter's syndrome carriers; radioactive sulphate incorporation into fibroblasts in the presence of fructose 1-phosphate

International Nuclear Information System (INIS)

Toennesen, T.; Lykkelund, C.; Guettler, F.

1982-01-01

Mutual correction of co-cultivated fibroblasts from patients with Hunter's and Hurler's syndrome could be inhibited by either fructose 1-phosphate or mannose 6-phosphate. In the presence of fructose 1-phosphate a 50% mixture of fibroblasts from a patient with Hunter's syndrome and a normal homozygous individual showed an increased 35 S-sulphate incorporation into acid mucopolysaccharides. When fibroblast cultures from one obligate and two possible carriers of Hunter's syndrome were tested for 35 S-sulphate incorporation, the cultures showed either twice the normal 35 S-sulphate incorporation into acid mucopolysaccharides in the presence of fructose 1-phosphate or an abnormally high incorporation in the presence as well as in the absence of the sugar phosphate. (orig.)

Reducing wait time in a hospital pharmacy to promote customer service.

Science.gov (United States)

Slowiak, Julie M; Huitema, Bradley E; Dickinson, Alyce M

2008-01-01

The purpose of this study was to compare the effects of 2 different interventions on wait times at a hospital outpatient pharmacy: (1) giving feedback to employees about customer satisfaction with wait times and (2) giving a combined intervention package that included giving more specific feedback about actual wait times and goal setting for wait time reduction in addition to the customer satisfaction feedback. The relationship between customer satisfaction ratings and wait times was examined to determine whether wait times affected customer service satisfaction. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCBA' within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction; and A' was a follow-up condition that was similar to the original baseline condition. Wait times were reduced by approximately 20%, and there was concomitant increased shift in levels of customer satisfaction, as indicated by the correlation between these variables (r = -0.57 and P customer's wait time. Data from this study may provide useful preliminary benchmarking data for standard pharmacy wait times.

Hunters syndrom og hørenedsaettelse

DEFF Research Database (Denmark)

Kiaer, Eva Kirkegaard; Møller, Troels Reinholdt; Wetke, Randi

2010-01-01

A 30 month-old boy with delayed language development was referred to the Department of Audiology in Aarhus. At the time of referral he had had 19 cases of acute otitis media and had been tubulated four times. Furthermore, the boy had not developed according to age in several respects: his motor...... functions and language were delayed, and he made audible respiratory sounds and was obviously nasally congested. The boy was referred for further investigations at the Department of Paediatrics. The tests showed that the boy suffered from Hunter Syndrome (MPSII) and he underwent relevant treatment....

Analysis of emergency department waiting lines

Directory of Open Access Journals (Sweden)

Urška Močnik

2014-10-01

Full Text Available Background: Steady increase in the numbers of patients seeking medical assistance has recently been observed at the emergency department of the health center under study. This has led to increases in waiting times for patients. The management of the health center has been considering to implement certain measures to remedy this situation. One proposed solution is to add an additional physician to the emergency department. A computer model was constructed to simulate waiting lines and analyze the economic feasibility of employing an additional physician.Aim: This paper analyzes the waiting lines at the emergency department and performs an economic feasibility study to determine whether adding an additional physician to the department would be economically justified.Methods: Data about waiting times at the emergency department were collected to study the situation. For each patient, the arrival time at the waiting room and the starting and ending times of the examination were registered. The data were collected from 13 June 2011 to 25 September 2011. The sample included data on 65 nightly standbys, nine standbys on Saturdays, and 16 standbys on Sundays. Due to incomplete entries, data for nine weekly standbys and six Saturday standbys were excluded from the sample. Based on the data collected, we calculated the waiting and examination times per patient, average number of patients, average waiting time, average examination time, share of active standby teams in total standby time, and number of patients in different time periods. The study involved 1,039 patients. Using a synthesis method, we designed a computer model of waiting lines and economic feasibility. The model was validated using comparative analysis. A what-if analysis was performed using various computer simulations with various scenarios to consider the outcomes of decision alternatives. We applied economic analysis to select the best possible solution.Results: The research results

Improving Patient Satisfaction with Waiting Time

Science.gov (United States)

Eilers, Gayleen M.

2004-01-01

Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and…

Bell inequalities and waiting times

Energy Technology Data Exchange (ETDEWEB)

Poeltl, Christina; Governale, Michele [School of Chemical and Physical Sciences and MacDiarmid Institute for Advanced Materials and Nanotechnology, Victoria University of Wellington, PO Box 600, Wellington 6140 (New Zealand)

2015-07-01

We propose a Bell test based on waiting time distributions for spin entangled electron pairs, which are generated and split in mesoscopic Coulomb blockade structures, denoted as entanglers. These systems have the advantage that quantum point contacts enable a time resolved observation of the electrons occupying the system, which gives access to quantities such as full counting statistics and waiting time distributions. We use the partial waiting times to define a CHSH-Bell test, which is a purely electronic analogue of the test used in quantum optics. After the introduction of the Bell inequality we discuss the findings on the two examples of a double quantum dot and a triple quantum dot. This Bell test allows the exclusion of irrelevant tunnel processes from the statistics normally used for the Bell correlations. This can improve the parameter range for which a violation of the Bell inequality can be measured significantly.

Patients' perceptions of waiting for bariatric surgery: a qualitative study.

Science.gov (United States)

Gregory, Deborah M; Temple Newhook, Julia; Twells, Laurie K

2013-10-18

In Canada waiting lists for bariatric surgery are common, with wait times on average > 5 years. The meaning of waiting for bariatric surgery from the patients' perspective must be understood if health care providers are to act as facilitators in promoting satisfaction with care and quality care outcomes. The aims of this study were to explore patients' perceptions of waiting for bariatric surgery, the meaning and experience of waiting, the psychosocial and behavioral impact of waiting for treatment and identify health care provider and health system supportive measures that could potentially improve the waiting experience. Twenty-one women and six men engaged in in-depth interviews that were digitally recorded, transcribed verbatim and analysed using a grounded theory approach to data collection and analysis between June 2011 and April 2012. The data were subjected to re-analysis to identify perceived health care provider and health system barriers to accessing bariatric surgery. Thematic analysis identified inequity as a barrier to accessing bariatric surgery. Three areas of perceived inequity were identified from participants' accounts: socioeconomic inequity, regional inequity, and inequity related to waitlist prioritization. Although excited about their acceptance as candidates for surgery, the waiting period was described as stressful, anxiety provoking, and frustrating. Anger was expressed towards the health care system for the long waiting times. Participants identified the importance of health care provider and health system supports during the waiting period. Recommendations on how to improve the waiting experience included periodic updates from the surgeon's office about their position on the wait list; a counselor who specializes in helping people going through this surgery, dietitian support and further information on what to expect after surgery, among others. Patients' perceptions of accessing and waiting for bariatric surgery are shaped by perceived

Waiting list in a public health facility in Santiago, Chile

Directory of Open Access Journals (Sweden)

Alejandro Letelier

2014-07-01

Full Text Available Introduction Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. Purpose This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. Methods A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. Results There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation. There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests

Contrasts in livelihoods and protein intake between commercial and subsistence bushmeat hunters in two villages on Bioko Island, Equatorial Guinea.

Science.gov (United States)

Vega, María Grande; Carpinetti, Bruno; Duarte, Jesús; Fa, John E

2013-06-01

Across West and Central Africa, wildlife provides a source of food and income. We investigated the relation between bushmeat hunting and household wealth and protein consumption in 2 rural communities in Bioko Island, Equatorial Guinea. One village was dedicated to commercial hunting, the other trapped game primarily for food. We tested whether commercial-hunter households were nutritionally advantaged over subsistence-hunter households due to their higher income from the bushmeat trade and greater access to wild-animal protein. We conducted bushmeat-offtake surveys in both villages (captures by hunters and carcasses arriving to each village). Mammals (including threatened primates: black colobus [Colobus satanas], Preussi's guenon [Allochrocebus preussi], and russet-eared guenon [Cercopithecus erythrotis]), birds, and reptiles were hunted. The blue duiker (Philantomba monticola), giant pouched rat (Cricetomys emini), and brush-tailed porcupine (Atherurus africanus) contributed almost all the animal biomass hunted, consumed, or sold in both villages. Monkeys and Ogilbyi's duikers (Cephalophus ogilbyi) were hunted only by commercial hunters. Commercial hunters generated a mean of US$2000/year from bushmeat sales. Households with commercial hunters were on average wealthier, generated more income, spent more money on nonessential goods, and bought more products they did not grow. By contrast, households with subsistence hunters spent less on market items, spent more on essential products, and grew more of their own food. Despite these differences, average consumption of vegetable protein and domestic meat and bushmeat protein did not differ between villages. Our results highlight the importance of understanding the socioeconomic and nutritional context of commercial and subsistence bushmeat hunting to correctly interpret ways of reducing their effects on threatened species and to enable the sustainable offtake of more productive taxa. © 2013 Society for Conservation

Colour Consideration for Waiting areas in hospitals

Science.gov (United States)

Zraati, Parisa

2012-08-01

Colour is one the most important factors in the nature that can have some affects on human behaviour. Many years ago, it was proven that using colour in public place can have some affect on the users. Depend of the darkness and lightness; it can be vary from positive to negative. The research will mainly focus on the colour and psychological influences and physical factors. The statement of problem in this research is what is impact of colour usually applied to waiting area? The overall aim of the study is to explore the visual environment of hospitals and to manage the colour psychological effect of the hospital users in the waiting area by creating a comfortable, pleasant and cozy environment for users while spend their time in waiting areas. The analysisconcentrate on satisfaction and their interesting regarding applied colour in two private hospital waiting area in Malaysia.

Ultrasound waiting lists: rational queue or extended capacity?

Science.gov (United States)

Brasted, Christopher

2008-06-01

The features and issues regarding clinical waiting lists in general and general ultrasound waiting lists in particular are reviewed, and operational aspects of providing a general ultrasound service are also discussed. A case study is presented describing a service improvement intervention in a UK NHS hospital's ultrasound department, from which arises requirements for a predictive planning model for an ultrasound waiting list. In the course of this, it becomes apparent that a booking system is a more appropriate way of describing the waiting list than a conventional queue. Distinctive features are identified from the literature and the case study as the basis for a predictive model, and a discrete event simulation model is presented which incorporates the distinctive features.

Project CHECO Southeast Asia Report. OV-1/AC-119 Hunter-Killer Team

National Research Council Canada - National Science Library

Sexton, Richard R; Hodgson, William M

1972-01-01

Hunter-Killer operations were but a logical extension of the resourceful thinking behind the development of gunships as a solution to some of the tactical problems of the unique war in Southeast Asia...

Linking Hunter Knowledge with Forest Change to Understand Changing Deer Harvest Opportunities in Intensively Logged Landscapes

Directory of Open Access Journals (Sweden)

Todd J. Brinkman

2009-06-01

Full Text Available The effects of landscape changes caused by intensive logging on the availability of wild game are important when the harvest of wild game is a critical cultural practice, food source, and recreational activity. We assessed the influence of extensive industrial logging on the availability of wild game by drawing on local knowledge and ecological science to evaluate the relationship between forest change and opportunities to harvest Sitka black-tailed deer (Odocoileus hemionus sitkensis on Prince of Wales Island, Alaska. We used data collected through interviews with local deer hunters and GIS analysis of land cover to determine relationships among landscape change, hunter access, and habitat for deer hunting over the last 50 yr. We then used these relationships to predict how harvest opportunities may change in the future. Intensive logging from 1950 into the 1990s provided better access to deer and habitat that facilitated deer hunting. However, successional changes in intensively logged forests in combination with a decline in current logging activity have reduced access to deer and increased undesirable habitat for deer hunting. In this new landscape, harvest opportunities in previously logged landscapes have declined, and hunters identify second-growth forest as one of the least popular habitats for hunting. Given the current state of the logging industry in Alaska, it is unlikely that the logging of the remaining old-growth forests or intensive management of second-growth forests will cause hunter opportunities to rebound to historic levels. Instead, hunter opportunities may continue to decline for at least another human generation, even if the long-term impacts of logging activity and deer harvest on deer numbers are minimal. Adapting hunting strategies to focus on naturally open habitats such as alpine and muskeg that are less influenced by external market forces may require considerably more hunting effort but provide the best option for

Sacrificing Steve: How I Killed the Crocodile Hunter

Directory of Open Access Journals (Sweden)

Luke Carman

2010-09-01

Full Text Available Bob Hodge and Vijay Mishra argue that the complex issues of illegitimacy at the core of Australian identity are repressed through a continual process of cyclical silencing, where traces of a shameful past are exorcised by a focus on images of a mythologised ‘legend’, embodied in characters such as 'The Man from Snowy River'. This article explores such a 'schizophrenic' cycle in relation to the life, death and resurrection of Steve 'Crocodile Hunter' Irwin.

The Effects of Immigration on NHS Waiting Times

OpenAIRE

Giuntella, Osea; Nicodemo, Catia; Vargas-Silva, Carlos

2015-01-01

This paper analyses the effects of immigration on waiting times in the National Health Service (NHS) in England. Linking administrative records from the Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labour Force Survey, we find that immigration reduced waiting times for outpatient referrals and did not have significant effects on waiting times in Accident and Emergency (A&E) and elective care. These results are explained by the fact that immigration increases...

Hide Tanning and Its Use in Taiga: The Case of the Orochen-Evenki Reindeer Herders and Hunters of Zabaikalye (East Siberia)

OpenAIRE

Donatas Brandišauskas

2010-01-01

This article documents the way in which the Orochen-Evenki hunters and herders in northern part of Zabaikalye tan hides and produce gear in the post-Soviet era. Here, I wish to present the argument that it is difficult to understand the reviving of hide tanning in remote villages and the taiga without understanding how hunters and herders in this region adapt to the unstable post-Soviet environment. I suggest that hunters and herders aim to maintain their autonomy from goods and resources imp...

Waiting time distribution in M/D/1 queueing systems

DEFF Research Database (Denmark)

Iversen, Villy Bæk; Staalhagen, Lars

1999-01-01

The well-known formula for the waiting time distribution of M/D/1 queueing systems is numerically unsuitable when the load is close to 1.0 and/or the results for a large waiting time are required. An algorithm for any load and waiting time is presented, based on the state probabilities of M/D/1...

The boarding experience from the patient perspective: the wait.

Science.gov (United States)

Liu, Shan; Milne, Leslie; Yun, Brian; Walsh, Kathleen

2015-11-01

We sought to better understand the experience of being a boarder patient. We conducted a qualitative study between March and August 2012 to examine the experience of boarding in an urban, teaching hospital emergency department (ED). We included boarder patients and selected patients based on a convenience sample. Interviews were semistructured, consisting of eight main open-ended questions. Interviews were transcribed; codes were generated and then organised into categorises and subsequently into one theme. We concluded analysis when we achieved thematic saturation. Our institutional review board approved this study. Our final sample included 18 patients. The average age was 62.3 years. Patients characterised waiting as central to their experience as a boarder patient. One patient stated, "Well if you have to wait for a bed you have to wait for a bed, it's terrible." Three categories exemplified this waiting experience: (1) there was often lack of communication; (2) patients experienced frustration during this waiting period; and yet (3) patients often differentiated the experience of waiting from the care they were receiving. Being a boarder patient was characterised as a waiting experience associated with poor communication and frustration. However, patients may still differentiate their feelings towards the wait from those towards the medical care they are receiving. Our data add more reason to eradicate the practice of ED boarding. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Preliminary assessment of channel stability and bed-material transport along Hunter Creek, southwestern Oregon

Science.gov (United States)

Jones, Krista L.; Wallick, J. Rose; O'Connor, Jim E.; Keith, Mackenzie K.; Mangano, Joseph F.; Risley, John C.

2011-01-01

This preliminary assessment of (1) bed-material transport in the Hunter Creek basin, (2) historical changes in channel condition, and (3) supplementary data needed to inform permitting decisions regarding instream gravel extraction revealed the following: Along the lower 12.4 km (kilometers) of Hunter Creek from its confluence with the Little South Fork Hunter Creek to its mouth, the river has confined and unconfined segments and is predominately alluvial in its lowermost 11 km. This 12.4-km stretch of river can be divided into two geomorphically distinct study reaches based primarily on valley physiography. In the Upper Study Reach (river kilometer [RKM] 12.4-6), the active channel comprises a mixed bed of bedrock, boulders, and smaller grains. The stream is confined in the upper 1.4 km of the reach by a bedrock canyon and in the lower 2.4 km by its valley. In the Lower Study Reach (RKM 6-0), where the area of gravel bars historically was largest, the stream flows over bed material that is predominately alluvial sediments. The channel alternates between confined and unconfined segments. The primary human activities that likely have affected bed-material transport and the extent and area of gravel bars are (1) historical and ongoing aggregate extraction from gravel bars in the study area and (2) timber harvest and associated road construction throughout the basin. These anthropogenic activities likely have varying effects on sediment transport and deposition throughout the study area and over time. Although assessing the relative effects of these anthropogenic activities on sediment dynamics would be challenging, the Hunter Creek basin may serve as a case study for such an assessment because it is mostly free of other alterations to hydrologic and geomorphic processes such as flow regulation, dredging, and other navigation improvements that are common in many Oregon coastal basins. Several datasets are available that may support a more detailed physical assessment

HiggsHunters - a citizen science project for ATLAS

CERN Document Server

Haas, Andrew; The ATLAS collaboration

2016-01-01

Since the launch of HiggsHunters.org in November 2014, citizen science volunteers have classified more than a million points of interest in images from the ATLAS experiment at the LHC. Volunteers have been looking for displaced vertices and unusual features in images recorded during LHC Run-1. We discuss the design of the project, its impact on the public, and the surprising results of how the human volunteers performed relative to the computer algorithms in identifying displaced secondary vertices.

JEFX 10 demonstration of Cooperative Hunter Killer UAS and upstream data fusion

Science.gov (United States)

Funk, Brian K.; Castelli, Jonathan C.; Watkins, Adam S.; McCubbin, Christopher B.; Marshall, Steven J.; Barton, Jeffrey D.; Newman, Andrew J.; Peterson, Cammy K.; DeSena, Jonathan T.; Dutrow, Daniel A.; Rodriguez, Pedro A.

2011-05-01

The Johns Hopkins University Applied Physics Laboratory deployed and demonstrated a prototype Cooperative Hunter Killer (CHK) Unmanned Aerial System (UAS) capability and a prototype Upstream Data Fusion (UDF) capability as participants in the Joint Expeditionary Force Experiment 2010 in April 2010. The CHK capability was deployed at the Nevada Test and Training Range to prosecute a convoy protection operational thread. It used mission-level autonomy (MLA) software applied to a networked swarm of three Raven hunter UAS and a Procerus Miracle surrogate killer UAS, all equipped with full motion video (FMV). The MLA software provides the capability for the hunter-killer swarm to autonomously search an area or road network, divide the search area, deconflict flight paths, and maintain line of sight communications with mobile ground stations. It also provides an interface for an operator to designate a threat and initiate automatic engagement of the target by the killer UAS. The UDF prototype was deployed at the Maritime Operations Center at Commander Second Fleet, Naval Station Norfolk to provide intelligence analysts and the ISR commander with a common fused track picture from the available FMV sources. It consisted of a video exploitation component that automatically detected moving objects, a multiple hypothesis tracker that fused all of the detection data to produce a common track picture, and a display and user interface component that visualized the common track picture along with appropriate geospatial information such as maps and terrain as well as target coordinates and the source video.

Waiting Online: A Review and Research Agenda.

Science.gov (United States)

Ryan, Gerard; Valverde, Mireia

2003-01-01

Reviews 21 papers based on 13 separate empirical studies on waiting on the Internet, drawn from the areas of marketing, system response time, and quality of service studies. The article proposes an agenda for future research, including extending the range of research methodologies, broadening the definition of waiting on the Internet, and…

Co-residence patterns in hunter-gatherer societies show unique human social structure.

Science.gov (United States)

Hill, Kim R; Walker, Robert S; Bozicević, Miran; Eder, James; Headland, Thomas; Hewlett, Barry; Hurtado, A Magdalena; Marlowe, Frank; Wiessner, Polly; Wood, Brian

2011-03-11

Contemporary humans exhibit spectacular biological success derived from cumulative culture and cooperation. The origins of these traits may be related to our ancestral group structure. Because humans lived as foragers for 95% of our species' history, we analyzed co-residence patterns among 32 present-day foraging societies (total n = 5067 individuals, mean experienced band size = 28.2 adults). We found that hunter-gatherers display a unique social structure where (i) either sex may disperse or remain in their natal group, (ii) adult brothers and sisters often co-reside, and (iii) most individuals in residential groups are genetically unrelated. These patterns produce large interaction networks of unrelated adults and suggest that inclusive fitness cannot explain extensive cooperation in hunter-gatherer bands. However, large social networks may help to explain why humans evolved capacities for social learning that resulted in cumulative culture.

VHA Support Service Center Electronic Wait List (EWL)

Data.gov (United States)

Department of Veterans Affairs — The goal of the Electronic Wait List (EWL) is to provide care to the patient as quickly as possible. To facilitate this goal, patients may be placed on a Wait List...

Parental strategies for assisting children to wait.

Science.gov (United States)

Cuskelly, Monica; Jobling, Anne; Gilmore, Linda; Glenn, Sheila

2006-09-01

This study examined parents' behaviours as they waited with their child. Children were presented with an attractively wrapped gift and then asked not to touch it until the experimenter returned from finishing some work in another room. Three parent groups and their children participated in the study - parents of children with Down syndrome, parents of children with intellectual disability from another cause, and parents of children who were developing typically. There were no significant differences between children in how long they were able to wait before touching the gift. The data from the first two groups were combined for all analyses after it was established that there were no significant differences between them. There were few significant differences between parents of a child with intellectual disability and comparison parents. The former group were more likely to be classified as Authoritarian than were comparison parents, however with one exception, parenting style was unrelated to the strategies parents used in the waiting situation. Very few parents in either group used the opportunity to teach or explicitly praise effective waiting strategies in their children.

Heuristics for no-wait flow shop scheduling problem

Directory of Open Access Journals (Sweden)

Kewal Krishan Nailwal

2016-09-01

Full Text Available No-wait flow shop scheduling refers to continuous flow of jobs through different machines. The job once started should have the continuous processing through the machines without wait. This situation occurs when there is a lack of an intermediate storage between the processing of jobs on two consecutive machines. The problem of no-wait with the objective of minimizing makespan in flow shop scheduling is NP-hard; therefore the heuristic algorithms are the key to solve the problem with optimal solution or to approach nearer to optimal solution in simple manner. The paper describes two heuristics, one constructive and an improvement heuristic algorithm obtained by modifying the constructive one for sequencing n-jobs through m-machines in a flow shop under no-wait constraint with the objective of minimizing makespan. The efficiency of the proposed heuristic algorithms is tested on 120 Taillard’s benchmark problems found in the literature against the NEH under no-wait and the MNEH heuristic for no-wait flow shop problem. The improvement heuristic outperforms all heuristics on the Taillard’s instances by improving the results of NEH by 27.85%, MNEH by 22.56% and that of the proposed constructive heuristic algorithm by 24.68%. To explain the computational process of the proposed algorithm, numerical illustrations are also given in the paper. Statistical tests of significance are done in order to draw the conclusions.

Methodology for Analysis, Modeling and Simulation of Airport Gate-waiting Delays

Science.gov (United States)

Wang, Jianfeng

This dissertation presents methodologies to estimate gate-waiting delays from historical data, to identify gate-waiting-delay functional causes in major U.S. airports, and to evaluate the impact of gate operation disruptions and mitigation strategies on gate-waiting delay. Airport gates are a resource of congestion in the air transportation system. When an arriving flight cannot pull into its gate, the delay it experiences is called gate-waiting delay. Some possible reasons for gate-waiting delay are: the gate is occupied, gate staff or equipment is unavailable, the weather prevents the use of the gate (e.g. lightning), or the airline has a preferred gate assignment. Gate-waiting delays potentially stay with the aircraft throughout the day (unless they are absorbed), adding costs to passengers and the airlines. As the volume of flights increases, ensuring that airport gates do not become a choke point of the system is critical. The first part of the dissertation presents a methodology for estimating gate-waiting delays based on historical, publicly available sources. Analysis of gate-waiting delays at major U.S. airports in the summer of 2007 identifies the following. (i) Gate-waiting delay is not a significant problem on majority of days; however, the worst delay days (e.g. 4% of the days at LGA) are extreme outliers. (ii) The Atlanta International Airport (ATL), the John F. Kennedy International Airport (JFK), the Dallas/Fort Worth International Airport (DFW) and the Philadelphia International Airport (PHL) experience the highest gate-waiting delays among major U.S. airports. (iii) There is a significant gate-waiting-delay difference between airlines due to a disproportional gate allocation. (iv) Gate-waiting delay is sensitive to time of a day and schedule peaks. According to basic principles of queueing theory, gate-waiting delay can be attributed to over-scheduling, higher-than-scheduled arrival rate, longer-than-scheduled gate-occupancy time, and reduced gate

AllerHunter: a SVM-pairwise system for assessment of allergenicity and allergic cross-reactivity in proteins.

Directory of Open Access Journals (Sweden)

Hon Cheng Muh

Full Text Available Allergy is a major health problem in industrialized countries. The number of transgenic food crops is growing rapidly creating the need for allergenicity assessment before they are introduced into human food chain. While existing bioinformatic methods have achieved good accuracies for highly conserved sequences, the discrimination of allergens and non-allergens from allergen-like non-allergen sequences remains difficult. We describe AllerHunter, a web-based computational system for the assessment of potential allergenicity and allergic cross-reactivity in proteins. It combines an iterative pairwise sequence similarity encoding scheme with SVM as the discriminating engine. The pairwise vectorization framework allows the system to model essential features in allergens that are involved in cross-reactivity, but not limited to distinct sets of physicochemical properties. The system was rigorously trained and tested using 1,356 known allergen and 13,449 putative non-allergen sequences. Extensive testing was performed for validation of the prediction models. The system is effective for distinguishing allergens and non-allergens from allergen-like non-allergen sequences. Testing results showed that AllerHunter, with a sensitivity of 83.4% and specificity of 96.4% (accuracy = 95.3%, area under the receiver operating characteristic curve AROC = 0.928+/-0.004 and Matthew's correlation coefficient MCC = 0.738, performs significantly better than a number of existing methods using an independent dataset of 1443 protein sequences. AllerHunter is available at (http://tiger.dbs.nus.edu.sg/AllerHunter.

Maternity waiting homes in Rural Health Centers of Ethiop: The ...

African Journals Online (AJOL)

Conclusions: It is necessary to prepare guidelines for the establishment and management of waiting homes as well as set up admission and discharge criteria and to initiate quality control mechanisms. Keywords: Maternity waiting homes, waiting homes, prenatal care, intention to stay postpartum, postpartum care, Ethiopia, ...

Ethics in radiology: wait lists queue jumping.

Science.gov (United States)

Cunningham, Natalie; Reid, Lynette; MacSwain, Sarah; Clarke, James R

2013-08-01

Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

wait and wipe

African Journals Online (AJOL)

and wipe strategy” as an alternative to circumcision for HIV prevention. In this paper, we argue that waiting for ten minutes and wiping with a dry cloth does not prevent men from becoming infected by HIV. We ... HIV infected despite having reported no sex or 100% condom .... In a qualitative study conducted in Kenya, men.

Energy expenditure and activity among Hadza hunter-gatherers.

Science.gov (United States)

Pontzer, Herman; Raichlen, David A; Wood, Brian M; Emery Thompson, Melissa; Racette, Susan B; Mabulla, Audax Z P; Marlowe, Frank W

2015-01-01

Studies of total energy expenditure, (TEE; kcal/day) among traditional populations have challenged current models relating habitual physical activity to daily energy requirements. Here, we examine the relationship between physical activity and TEE among traditional Hadza hunter-gatherers living in northern Tanzania. Hadza adults were studied at two camps, with minimal intervention so as to monitor energy expenditure and activity during normal daily life. We measured daily walking distance and walking speed using wearable GPS units for 41 adults. For a subset of 30 adults, we measured TEE using doubly labeled water, three indices of work load (foraging return rate, maternal status, and number of dependent children), and urinary biomarkers of metabolic activity and stress (8-hydroxydeoxyguanosine, cortisol, and testosterone). Fat-free mass was the single strongest predictor of TEE among Hadza adults (r(2)  = 0.66, P < 0.001). Hadza men used greater daily walking distances and faster walking speeds compared with that of Hadza women, but neither sex nor any measure of physical activity or work load were correlated with TEE in analyses controlling for fat-free mass. Compared with developed, industrial populations, Hadza adults had similar TEE but elevated levels of metabolic stress as measured by 8-hydroxydeoxyguanosine. Our results indicate that daily physical activity may not predict TEE within traditional hunter-gatherer populations like the Hadza. Instead, adults with high levels of habitual physical activity may adapt by reducing energy allocation to other physiological activity. © 2015 Wiley Periodicals, Inc.

Children's preferences concerning ambiance of dental waiting rooms.

Science.gov (United States)

Panda, A; Garg, I; Shah, M

2015-02-01

Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and have a child patient to accept dental treatment readily. Minor changes made in the waiting room design can have a major effect on the way any child perceives the upcoming dental experience. This study was carried out to determine children's preferences regarding the dental waiting area so as to improve their waiting experience and reduce their preoperative anxiety before a dental appointment. This was a cross-sectional descriptive study using survey methodology. A questionnaire designed to evaluate children's preferences regarding the waiting room was distributed to new paediatric patients, aged between 6 and 11 years of age, attending an outpatient dental facility and was completed by 212 children (127 males, 85 females). The analyses were carried out on cross-tables using Phi (for 2×2 tables) or Cramer's V (for larger than 2×2 tables) to assess responses to the questionnaire items across age groups and gender. A majority of children preferred music and the ability to play in a waiting room. They also preferred natural light and walls with pictures. They preferred looking at an aquarium or a television and sitting on beanbags and chairs and also preferred plants and oral hygiene posters Repetious. The results obtained from this study may help the dental team decide on an appropriate design of their paediatric waiting room so as to make children comfortable in the dental environment and improve delivery of health care.

Canadian Consensus on Medically Acceptable Wait Times for Digestive Health Care

Directory of Open Access Journals (Sweden)

William G Paterson

2006-01-01

Full Text Available BACKGROUND: Delays in access to health care in Canada have been reported, but standardized systems to manage and monitor wait lists and wait times, and benchmarks for appropriate wait times, are lacking. The objective of the present consensus was to develop evidence- and expertise-based recommendations for medically appropriate maximal wait times for consultation and procedures by a digestive disease specialist.

Mortality, fertility, and the OY ratio in a model hunter-gatherer system.

Science.gov (United States)

White, Andrew A

2014-06-01

An agent-based model (ABM) is used to explore how the ratio of old to young adults (the OY ratio) in a sample of dead individuals is related to aspects of mortality, fertility, and longevity experienced by the living population from which the sample was drawn. The ABM features representations of rules, behaviors, and constraints that affect person- and household-level decisions about marriage, reproduction, and infant mortality in hunter-gatherer systems. The demographic characteristics of the larger model system emerge through human-level interactions playing out in the context of "global" parameters that can be adjusted to produce a range of mortality and fertility conditions. Model data show a relationship between the OY ratios of living populations (the living OY ratio) and assemblages of dead individuals drawn from those populations (the dead OY ratio) that is consistent with that from empirically known ethnographic hunter-gatherer cases. The dead OY ratio is clearly related to the mean ages, mean adult mortality rates, and mean total fertility rates experienced by living populations in the model. Sample size exerts a strong effect on the accuracy with which the calculated dead OY ratio reflects the actual dead OY ratio of the complete assemblage. These results demonstrate that the dead OY ratio is a potentially useful metric for paleodemographic analysis of changes in mortality and mean age, and suggest that, in general, hunter-gatherer populations with higher mortality, higher fertility, and lower mean ages are characterized by lower dead OY ratios. Copyright © 2014 Wiley Periodicals, Inc.

Effect of emergency physician burnout on patient waiting times.

Science.gov (United States)

De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

2018-04-01

Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24-49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39-1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.

Moderate alcohol consumption and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbaek, Morten

2001-01-01

BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time to pregna...

Enhancing outpatient clinics management software by reducing patients’ waiting time

Directory of Open Access Journals (Sweden)

Iman Almomani

2016-11-01

Full Text Available Summary: The Kingdom of Saudi Arabia (KSA gives great attention to improving the quality of services provided by health care sectors including outpatient clinics. One of the main drawbacks in outpatient clinics is long waiting time for patients—which affects the level of patient satisfaction and the quality of services. This article addresses this problem by studying the Outpatient Management Software (OMS and proposing solutions to reduce waiting times. Many hospitals around the world apply solutions to overcome the problem of long waiting times in outpatient clinics such as hospitals in the USA, China, Sri Lanka, and Taiwan. These clinics have succeeded in reducing wait times by 15%, 78%, 60% and 50%, respectively. Such solutions depend mainly on adding more human resources or changing some business or management policies. The solutions presented in this article reduce waiting times by enhancing the software used to manage outpatient clinics services. Both quantitative and qualitative methods have been used to understand current OMS and examine level of patient’s satisfaction. Five main problems that may cause high or unmeasured waiting time have been identified: appointment type, ticket numbering, doctor late arrival, early arriving patient and patients’ distribution list. These problems have been mapped to the corresponding OMS components. Solutions to the above problems have been introduced and evaluated analytically or by simulation experiments. Evaluation of the results shows a reduction in patient waiting time. When late doctor arrival issues are solved, this can reduce the clinic service time by up to 20%. However, solutions for early arriving patients reduces 53.3% of vital time, 20% of the clinic time and overall 30.3% of the total waiting time. Finally, well patient-distribution lists make improvements by 54.2%. Improvements introduced to the patients’ waiting time will consequently affect patients’ satisfaction and improve

Fairy tales? Marion Jones, C.J. Hunter and the framing of doping in American newspapers

DEFF Research Database (Denmark)

Pfister, Gertrud Ursula; Gems, Gerald

2015-01-01

This article deals with the images, metaphors and narratives in the media coverage of doping in the United States. It presents a case study with a focus on Marion Jones, the most celebrated track athlete of the turn of the millennium, and her husband, C.J. Hunter, a shot put world champion...... under suspicion. At the same time, the 2000 Olympics can be considered a watershed in American anti-doping policy. The media portrayed Jones and Hunter as the Beauty and the Beast or Svengali and his victim, using a famous fairy tale and a well-known novel to capture attention, label the protagonists...

Wait times for gastroenterology consultation in Canada: The patients’ perspective

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Paterson, WG; Barkun, AN; Hopman, WM; Leddin, DJ; Paré, P; Petrunia, DM; Sewitch, MJ; Switzer, C; van Zanten, S Veldhuyzen

2010-01-01

Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms. PMID:20186353

Towards decision support for waiting lists: an operations management view.

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Vissers, J M; Van Der Bij, J D; Kusters, R J

2001-06-01

This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.

Reducing pharmacy wait time to promote customer service: a follow-up study.

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Slowiak, Julie M; Huitema, Bradley E

2015-01-01

The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

Moderate alcohol consumption and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbæk, Morten

2001-01-01

BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time...... to pregnancy (0-2, 3-5, 6-12 and >12 months) was used for 39 612 pregnant women, recruited to the Danish National Birth Cohort within the first 24 weeks of pregnancy from 1997 to 2000. Main outcome measures were odds ratios (OR) for a prolonged waiting time to pregnancy according to alcohol intake. RESULTS......: In nulliparous women neither moderate nor high alcohol intake was related with longer waiting time to pregnancy compared with a low intake. In parous women, a modest association was seen only among those with an intake of >14 drinks per week (subfecundity OR 1.3; 95% confidence interval 1.0-1.7). Women who...

Game meat consumption by hunters and their relatives: A probabilistic approach.

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Sevillano Morales, Jesus; Moreno-Ortega, Alicia; Amaro Lopez, Manual Angel; Arenas Casas, Antonio; Cámara-Martos, Fernando; Moreno-Rojas, Rafael

2018-06-18

This study aimed to estimate the consumption of meat and products derived from hunting by the consumer population and, specifically, by hunters and their relatives. For this purpose, a survey was conducted on the frequency of consuming meat from the four most representative game species in Spain, two of big game, wild boar (Sus scrofa) and red deer (Cervus elaphus) and two of small game, rabbit (Oryctolagus cunulucus) and red partridge (Alectoris rufa), as well as of processed meat products (salami-type sausage) made from those big game species. The survey was carried out on 337 habitual consumers of these types of products (hunters and their relatives). The total mean game meat consumption, per capita in this population group, is 6.87 kg/person/year of meat and 8.57 kg/person/year if the processed meat products are also considered. Consumption of rabbit, red partridge, red deer and wild boar, individually, was 1.85, 0.82, 2.28 and 1.92 kg/person/year, respectively. It was observed that hunters generally registered a larger intake of game meat, this being statistically significant in the case of rabbit meat consumption. Using probabilistic methods, the meat consumption frequency distributions for each hunting species studied were estimated, as well as the products made from big game species and the total consumption both of meat by itself and that including the products made from it. The consumption frequency distributions were adjusted to exponential ones, verified by the test suitable for it according to Akaike Information Criterion, Bayesian Information Criterion, the Chi-Squared and Kolmogorov-Smirnov statistics. In addition, the consumption percentiles of the different distributions were obtained. The latter could be a good tool when making nutrition or contaminant studies since they permit the assessment of exposure to the compound in question.

Space, place and (waiting) time: reflections on health policy and politics.

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Sheard, Sally

2018-02-19

Health systems have repeatedly addressed concerns about efficiency and equity by employing trans-national comparisons to draw out the strengths and weaknesses of specific policy initiatives. This paper demonstrates the potential for explicit historical analysis of waiting times for hospital treatment to add value to spatial comparative methodologies. Waiting times and the size of the lists of waiting patients have become key operational indicators. In the United Kingdom, as National Health Service (NHS) financial pressures intensified from the 1970s, waiting times have become a topic for regular public and political debate. Various explanations for waiting times include the following: hospital consultants manipulate NHS waiting lists to maintain their private practice; there is under-investment in the NHS; and available (and adequate) resources are being used inefficiently. Other countries have also experienced ongoing tensions between the public and private delivery of universal health care in which national and trans-national comparisons of waiting times have been regularly used. The paper discusses the development of key UK policies, and provides a limited Canadian comparative perspective, to explore wider issues, including whether 'waiting crises' were consciously used by policymakers, especially those brought into government to implement new economic and managerial strategies, to diminish the autonomy and authority of the medical professional in the hospital environment.

Hide Tanning and Its Use in Taiga: The Case of the Orochen-Evenki Reindeer Herders and Hunters of Zabaikalye (East Siberia

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Donatas Brandišauskas

2011-05-01

Full Text Available This article documents the way in which the Orochen-Evenki hunters and herders in northern part of Zabaikalye tan hides and produce gear in the post-Soviet era. Here, I wish to present the argument that it is difficult to understand the reviving of hide tanning in remote villages and the taiga without understanding how hunters and herders in this region adapt to the unstable post-Soviet environment. I suggest that hunters and herders aim to maintain their autonomy from goods and resources imported from cities, and, in spending little effort connecting with state powers in this way, securing their lives from socio-economic constraints.

Hide Tanning and Its Use in Taiga: The Case of the Orochen-Evenki Reindeer Herders and Hunters of Zabaikalye (East Siberia

Directory of Open Access Journals (Sweden)

Donatas Brandišauskas

2010-12-01

Full Text Available This article documents the way in which the Orochen-Evenki hunters and herders in northern part of Zabaikalye tan hides and produce gear in the post-Soviet era. Here, I wish to present the argument that it is difficult to understand the reviving of hide tanning in remote villages and the taiga without understanding how hunters and herders in this region adapt to the unstable post-Soviet environment. I suggest that hunters and herders aim to maintain their autonomy from goods and resources imported from cities, and, in spending little effort connecting with state powers in this way, securing their lives from socio-economic constraints.

Effect of Piper chaba Hunter, Piper sarmentosum Roxb. and Piper interruptum Opiz. on natural killer cell activity and lymphocyte proliferation.

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Panthong, Sumalee; Itharat, Arunporn

2014-08-01

Immune system is the most important system ofhuman body. Thaifolk doctors have used some medicinal plants as an adaptogenic drug or immunomodulatory agent. Piper chaba Hunter, Piper sarmentosum Roxb. and Piper interruptum Opiz. are used by folk doctors to activate immune response in cancer patients. To investigate the effect on natural killer cell activity and on lymphocyte proliferation activity of water extract of P chaba Hunter P. sarmentosum Roxb. and P interruptum Opiz. MATERIAL ANDMETHOD: Plant materials were extracted by decoction method. All extracts were testedfor an immunomodulatory effect using PBMCs from twelve healthy donors by chromium release assay. Lymphocyte proliferation was also determined by 3H-thymidine uptake assay. The degree of activation was expressed as the stimulation index. The water extract of P chaba Hunter significantly increased lymphocyte proliferation at concentrations ofl ng/ml, 10 ng/ml, 1 μg/ml, 5 μg/ml, 10 μg/ml and 100 μg/ml. P sarmentosum Roxb., and P interruptum Opiz. extracts at those concentrations significantly stimulated lymphocyteproliferation. P sarmentosum Roxb. extractsignificantly increased natural killer (NK) cell activity at a concentration of 100 μg/ml but P chaba Hunter and P interruptum Opiz. extracts did not significantly stimulate natural killer cell activity. P chaba Hunter, P interruptum Opiz. andP sarmentosum Roxb. have an immunomodulatory effect especially for P sarmentosum Roxb. extract which can activate both lymphocyte proliferation and NK cell activity.

Learning from the mistakes of others: How female elk (Cervus elaphus) adjust behaviour with age to avoid hunters.

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Thurfjell, Henrik; Ciuti, Simone; Boyce, Mark S

2017-01-01

In animal behaviour, there is a dichotomy between innate behaviours (e.g., temperament or personality traits) versus those behaviours shaped by learning. Innate personality traits are supposedly less evident in animals when confounded by learning acquired with experience through time. Learning might play a key role in the development and adoption of successful anti-predator strategies, and the related adaptation has the potential to make animals that are more experienced less vulnerable to predation. We carried out a study in a system involving a large herbivorous mammal, female elk, Cervus elaphus, and their primary predator, i.e., human hunters. Using fine-scale satellite telemetry relocations, we tested whether differences in behaviour depending on age were due solely to selection pressure imposed by human hunters, meaning that females that were more cautious were more likely to survive and become older. Or whether learning also was involved, meaning that females adjusted their behaviour as they aged. Our results indicated that both human selection and learning contributed to the adoption of more cautious behavioural strategies in older females. Whereas human selection of behavioural traits has been shown in our previous research, we here provide evidence of additive learning processes being responsible for shaping the behaviour of individuals in this population. Female elk are indeed almost invulnerable to human hunters when older than 9-10 y.o., confirming that experience contributes to their survival. Female elk monitored in our study showed individually changing behaviours and clear adaptation as they aged, such as reduced movement rates (decreased likelihood of encountering human hunters), and increased use of secure areas (forest and steeper terrain), especially when close to roads. We also found that elk adjusted behaviours depending on the type of threat (bow and arrow vs. rifle hunters). This fine-tuning by elk to avoid hunters, rather than just

Hunter disease eClinic: interactive, computer-assisted, problem-based approach to independent learning about a rare genetic disease

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Moldovan Laura

2010-10-01

Full Text Available Abstract Background Computer-based teaching (CBT is a well-known educational device, but it has never been applied systematically to the teaching of a complex, rare, genetic disease, such as Hunter disease (MPS II. Aim To develop interactive teaching software functioning as a virtual clinic for the management of MPS II. Implementation and Results The Hunter disease eClinic, a self-training, user-friendly educational software program, available at the Lysosomal Storage Research Group (http://www.lysosomalstorageresearch.ca, was developed using the Adobe Flash multimedia platform. It was designed to function both to provide a realistic, interactive virtual clinic and instantaneous access to supporting literature on Hunter disease. The Hunter disease eClinic consists of an eBook and an eClinic. The eClinic is the interactive virtual clinic component of the software. Within an environment resembling a real clinic, the trainee is instructed to perform a medical history, to examine the patient, and to order appropriate investigation. The program provides clinical data derived from the management of actual patients with Hunter disease. The eBook provides instantaneous, electronic access to a vast collection of reference information to provide detailed background clinical and basic science, including relevant biochemistry, physiology, and genetics. In the eClinic, the trainee is presented with quizzes designed to provide immediate feedback on both trainee effectiveness and efficiency. User feedback on the merits of the program was collected at several seminars and formal clinical rounds at several medical centres, primarily in Canada. In addition, online usage statistics were documented for a 2-year period. Feedback was consistently positive and confirmed the practical benefit of the program. The online English-language version is accessed daily by users from all over the world; a Japanese translation of the program is also available. Conclusions The

Hunter disease eClinic: interactive, computer-assisted, problem-based approach to independent learning about a rare genetic disease.

Science.gov (United States)

Al-Jasmi, Fatma; Moldovan, Laura; Clarke, Joe T R

2010-10-25

Computer-based teaching (CBT) is a well-known educational device, but it has never been applied systematically to the teaching of a complex, rare, genetic disease, such as Hunter disease (MPS II). To develop interactive teaching software functioning as a virtual clinic for the management of MPS II. The Hunter disease eClinic, a self-training, user-friendly educational software program, available at the Lysosomal Storage Research Group (http://www.lysosomalstorageresearch.ca), was developed using the Adobe Flash multimedia platform. It was designed to function both to provide a realistic, interactive virtual clinic and instantaneous access to supporting literature on Hunter disease. The Hunter disease eClinic consists of an eBook and an eClinic. The eClinic is the interactive virtual clinic component of the software. Within an environment resembling a real clinic, the trainee is instructed to perform a medical history, to examine the patient, and to order appropriate investigation. The program provides clinical data derived from the management of actual patients with Hunter disease. The eBook provides instantaneous, electronic access to a vast collection of reference information to provide detailed background clinical and basic science, including relevant biochemistry, physiology, and genetics. In the eClinic, the trainee is presented with quizzes designed to provide immediate feedback on both trainee effectiveness and efficiency. User feedback on the merits of the program was collected at several seminars and formal clinical rounds at several medical centres, primarily in Canada. In addition, online usage statistics were documented for a 2-year period. Feedback was consistently positive and confirmed the practical benefit of the program. The online English-language version is accessed daily by users from all over the world; a Japanese translation of the program is also available. The Hunter disease eClinic employs a CBT model providing the trainee with realistic

Learning from the mistakes of others: How female elk (Cervus elaphus adjust behaviour with age to avoid hunters.

Directory of Open Access Journals (Sweden)

Henrik Thurfjell

Full Text Available In animal behaviour, there is a dichotomy between innate behaviours (e.g., temperament or personality traits versus those behaviours shaped by learning. Innate personality traits are supposedly less evident in animals when confounded by learning acquired with experience through time. Learning might play a key role in the development and adoption of successful anti-predator strategies, and the related adaptation has the potential to make animals that are more experienced less vulnerable to predation. We carried out a study in a system involving a large herbivorous mammal, female elk, Cervus elaphus, and their primary predator, i.e., human hunters. Using fine-scale satellite telemetry relocations, we tested whether differences in behaviour depending on age were due solely to selection pressure imposed by human hunters, meaning that females that were more cautious were more likely to survive and become older. Or whether learning also was involved, meaning that females adjusted their behaviour as they aged. Our results indicated that both human selection and learning contributed to the adoption of more cautious behavioural strategies in older females. Whereas human selection of behavioural traits has been shown in our previous research, we here provide evidence of additive learning processes being responsible for shaping the behaviour of individuals in this population. Female elk are indeed almost invulnerable to human hunters when older than 9-10 y.o., confirming that experience contributes to their survival. Female elk monitored in our study showed individually changing behaviours and clear adaptation as they aged, such as reduced movement rates (decreased likelihood of encountering human hunters, and increased use of secure areas (forest and steeper terrain, especially when close to roads. We also found that elk adjusted behaviours depending on the type of threat (bow and arrow vs. rifle hunters. This fine-tuning by elk to avoid hunters, rather

Advertising Emergency Department Wait Times

Directory of Open Access Journals (Sweden)

Scott G. Weiner

2013-03-01

Full Text Available Advertising emergency department (ED wait times has become a common practice in the UnitedStates. Proponents of this practice state that it is a powerful marketing strategy that can help steerpatients to the ED. Opponents worry about the risk to the public health that arises from a patient withan emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standarddefinition of the reported time, and directing lower acuity patients to the higher cost ED setting insteadto primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times arediscussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects tothe public health, caution about its use is advised

The British Columbia Nephrologists' Access Study (BCNAS) - a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations.

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Schachter, Michael E; Romann, Alexandra; Djurdev, Ognjenka; Levin, Adeera; Beaulieu, Monica

2013-08-29

Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists', FPs', and patients' perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an influence on triaging behavior. Further research is needed to determine whether this effect is sustainable.

Pricing in M/M/1 queues when cost of waiting in queue differs from cost of waiting in service

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Görkem Sarıyer

2016-11-01

Full Text Available Service providers can adjust the entrance price to the state of the demand in real life service systems where the customers' decision to receive the service, is based on this price, state of demand and other system parameters. We analyzed service provider's short and long term pricing problems in unobservable M/M/1 queues having the rational customers, where, for customers, the unit cost of waiting in the queue is higher than unit cost of waiting in the service. We showed that waiting in the queue has a clear negative effect on customers’ utilities, hence the service provider's price values. We also showed that, in the short term, monopolistic pricing is optimal for congested systems with high server utilization levels, whereas in the long term, market capturing pricing is more profitable.

Levels and sources of forest fire prevention knowledge of California hunters

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William S. Folkman

1963-01-01

Males 30-50 years of age from the smaller urban centers (under 25,000 population) make up the bulk of the California hunter population. They are mainly from the skilled-semiskilled and professional-managerial occupations. Their level of knowledge about forest fire prevention is generally high, but their knowledge is weak in some pertinent areas. Most frequently...

Setting wait times to achieve targeted left-without-being-seen rates.

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Lucas, Jared; Batt, Robert J; Soremekun, Olanrewaju A

2014-04-01

Although several studies have demonstrated that wait time is a key factor that drives high leave-without-being-seen (LWBS) rates, limited data on ideal wait times and impact on LWBS rates exist. We studied the LWBS rates by triage class and target wait times required to achieve various LWBS rates. We conducted a 3-year retrospective analysis of patients presenting to an urban, tertiary, academic, adult emergency department (ED). We divided the 3-year study period into 504 discrete periods by year, day of the week, and hour of the day. Patients of same triage level arriving in the same bin were exposed to similar ED conditions. For each bin, we calculate the mean actual wait time and the proportion of patients that abandoned. We performed a regression analysis on the abandonment proportion on the mean wait time using weighted least squares regression. A total of 143,698 patients were included for analysis during the study period. The R(2) value was highest for Emergency Severity Index (ESI) 3 (R(2) = 0.88), suggesting that wait time is the major factor driving LWBS of ESI 3 patients. Assuming that ESI 2 patients wait less than 10 minutes, our sensitivity analysis shows that the target wait times for ESI 3 and ESI 4/5 patients should be less than 45 and 60 minutes, respectively, to achieve an overall LWBS rate of less than 2%. Achieving target LWBS rates requires analysis to understand the abandonment behavior and redesigning operations to achieve the target wait times. Copyright © 2014 Elsevier Inc. All rights reserved.

Favorable ecological circumstances promote life expectancy in chimpanzees similar to that of human hunter-gatherers.

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Wood, Brian M; Watts, David P; Mitani, John C; Langergraber, Kevin E

2017-04-01

Demographic data on wild chimpanzees are crucial for understanding the evolution of chimpanzee and hominin life histories, but most data come from populations affected by disease outbreaks and anthropogenic disturbance. We present survivorship data from a relatively undisturbed and exceptionally large community of eastern chimpanzees (Pan troglodytes schweinfurthii) at Ngogo, Kibale National Park, Uganda. We monitored births, deaths, immigrations, and emigrations in the community between 1995 and 2016. Using known and estimated ages, we calculated survivorship curves for the whole community, for males and females separately, and for individuals ≤2 years old when identified. We used a novel method to address age estimation error by calculating stochastic survivorship curves. We compared Ngogo life expectancy, survivorship, and mortality rates to those from other chimpanzee communities and human hunter-gatherers. Life expectancy at birth for both sexes combined was 32.8 years, far exceeding estimates of chimpanzee life expectancy in other communities, and falling within the range of human hunter-gatherers (i.e., 27-37 years). Overall, the pattern of survivorship at Ngogo was more similar to that of human hunter-gatherers than to other chimpanzee communities. Maximum lifespan for the Ngogo chimpanzees, however, was similar to that reported at other chimpanzee research sites and was less than that of human-hunter gatherers. The absence of predation by large carnivores may contribute to some of the higher survivorship at Ngogo, but this cannot explain the much higher survivorship at Ngogo than at Kanyawara, another chimpanzee community in the same forest, which also lacks large carnivores. Higher survivorship at Ngogo appears to be an adaptive response to a food supply that is more abundant and varies less than that of Kanyawara. Future analyses of hominin life history evolution should take these results into account. Copyright © 2017 Elsevier Ltd. All rights

Longer wait times affect future use of VHA primary care.

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Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2017-07-29

Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

Waiting Endurance Time Estimation of Electric Two-Wheelers at Signalized Intersections

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Mei Huan

2014-01-01

Full Text Available The paper proposed a model for estimating waiting endurance times of electric two-wheelers at signalized intersections using survival analysis method. Waiting duration times were collected by video cameras and they were assigned as censored and uncensored data to distinguish between normal crossing and red-light running behavior. A Cox proportional hazard model was introduced, and variables revealing personal characteristics and traffic conditions were defined as covariates to describe the effects of internal and external factors. Empirical results show that riders do not want to wait too long to cross intersections. As signal waiting time increases, electric two-wheelers get impatient and violate the traffic signal. There are 12.8% of electric two-wheelers with negligible wait time. 25.0% of electric two-wheelers are generally nonrisk takers who can obey the traffic rules after waiting for 100 seconds. Half of electric two-wheelers cannot endure 49.0 seconds or longer at red-light phase. Red phase time, motor vehicle volume, and conformity behavior have important effects on riders’ waiting times. Waiting endurance times would decrease with the longer red-phase time, the lower traffic volume, or the bigger number of other riders who run against the red light. The proposed model may be applicable in the design, management and control of signalized intersections in other developing cities.

Waiting endurance time estimation of electric two-wheelers at signalized intersections.

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Huan, Mei; Yang, Xiao-bao

2014-01-01

The paper proposed a model for estimating waiting endurance times of electric two-wheelers at signalized intersections using survival analysis method. Waiting duration times were collected by video cameras and they were assigned as censored and uncensored data to distinguish between normal crossing and red-light running behavior. A Cox proportional hazard model was introduced, and variables revealing personal characteristics and traffic conditions were defined as covariates to describe the effects of internal and external factors. Empirical results show that riders do not want to wait too long to cross intersections. As signal waiting time increases, electric two-wheelers get impatient and violate the traffic signal. There are 12.8% of electric two-wheelers with negligible wait time. 25.0% of electric two-wheelers are generally nonrisk takers who can obey the traffic rules after waiting for 100 seconds. Half of electric two-wheelers cannot endure 49.0 seconds or longer at red-light phase. Red phase time, motor vehicle volume, and conformity behavior have important effects on riders' waiting times. Waiting endurance times would decrease with the longer red-phase time, the lower traffic volume, or the bigger number of other riders who run against the red light. The proposed model may be applicable in the design, management and control of signalized intersections in other developing cities.

The seed hunter in het spoor van Vavilov (interview met C. Kik)

NARCIS (Netherlands)

Zanderink, R.; Kik, C.

2013-01-01

Er moet voor een veredelaar een grote variatie aan plantmateriaal aanwezig zijn om uit te kunnen putten zodat onze gewassen, die vaak bestaan uit monoculturen, voor de toekomst veiliggesteld worden. Het vinden van die variatie is het werk van seed hunters of zadenverzamelaars. Eén van die seed

The hunter a scientific novel

CERN Document Server

Genta, Giancarlo

2013-01-01

The 24th century: humankind has become a spacefaring civilization, colonizing the solar system and beyond. While no alien forms of life have yet been encountered in this expansion into space, colonists suddenly encounter machines of alien origin - huge robots able to reproduce themselves.  Called replicators by the colonists, they seem to have but a single goal: to destroy all organic life they come in contact with. Since the colonial governments have no means to fight this menace directly, they instead promise huge rewards to whoever destroys a replicator. As a result, the frontier attracts a new kind of adventurers, the Hunters, who work to find and destroy the replicators. Mike Edwards, a skilled young maintenance technician and robotics expert at a faraway outpost, will not only become one of them - but be the very first one to unlock the secret behind the replicators’ origin and mission.   The scientific and technical aspects underlying the plot - in particular space travel, robotics and self-replica...

Shooting history and presence of high-frequency hearing impairment in swedish hunters: A cross-sectional internet-based observational study.

Science.gov (United States)

Honeth, Louise; Ström, Peter; Ploner, Alexander; Bagger-Sjöbäck, Dan; Rosenhall, Ulf; Nyrén, Olof

2015-01-01

The aim of this cross-sectional study among Swedish hunters was to examine the association between shooting history and presence of high-frequency hearing impairment (HFHI). All hunters registered with an e-mail address in the membership roster of the Swedish Hunters' Association were invited via e-mail to a secure website with a questionnaire and an Internet-based audiometry test. Associations, expressed as prevalence ratio (PR), were multivariately modelled using Poisson regression. The questionnaire was answered by 1771 hunters (age 11-91 years), and 202 of them also completed the audiometry test. Subjective severe hearing loss was reported by 195/1771 (11%), while 23/202 (11%) exhibited HFHI upon testing with Internet-based audiometry. As many as 328/1771 (19%) had never used hearing protection during hunting. In the preceding 5 years, 785/1771 (45%), had fired >6 unprotected gunshots with hunting rifle calibers. The adjusted PR of HFHI when reporting 1-6 such shots, relative to 0, was 1.5 [95% confidence interval (CI) 1.1-2.1; P = 0.02]. We could not verify any excessive HFHI prevalence among 89 hunters reporting unprotected exposure to such gunshot noise >6 times. Nor did the total number of reported rifle shots seem to matter. These findings support the notion of a wide variation in individual susceptibility to impulse noise; that significant sound energy, corresponding to unprotected noise from hunting rifle calibers, seems to be required; that susceptible individuals may sustain irreversible damage to the inner ear from just one or a few shots; and that use of hearing protection should be encouraged from the first shot with such weapons.

SU-F-P-20: Predicting Waiting Times in Radiation Oncology Using Machine Learning

International Nuclear Information System (INIS)

Joseph, A; Herrera, D; Hijal, T; Kildea, J; Hendren, L; Leung, A; Wainberg, J; Sawaf, M; Gorshkov, M; Maglieri, R; Keshavarz, M

2016-01-01

Purpose: Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful. In the present era of electronic health records (EHRs), waiting times need not be so uncertain. Extensive EHRs provide unprecedented amounts of data that can statistically cluster towards representative values when appropriate patient cohorts are selected. Predictive modelling, such as machine learning, is a powerful approach that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The application of a machine learning algorithm to waiting time data has the potential to produce personalized waiting time predictions such that the uncertainty may be removed from the patient’s waiting experience. Methods: In radiation oncology, patients typically experience several types of waiting (eg waiting at home for treatment planning, waiting in the waiting room for oncologist appointments and daily waiting in the waiting room for radiotherapy treatments). A daily treatment wait time model is discussed in this report. To develop a prediction model using our large dataset (with more than 100k sample points) a variety of machine learning algorithms from the Python package sklearn were tested. Results: We found that the Random Forest Regressor model provides the best predictions for daily radiotherapy treatment waiting times. Using this model, we achieved a median residual (actual value minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes

SU-F-P-20: Predicting Waiting Times in Radiation Oncology Using Machine Learning

Energy Technology Data Exchange (ETDEWEB)

Joseph, A; Herrera, D; Hijal, T; Kildea, J [McGill University Health Centre, Montreal, Quebec (Canada); Hendren, L; Leung, A; Wainberg, J; Sawaf, M; Gorshkov, M; Maglieri, R; Keshavarz, M [McGill University, Montreal, Quebec (Canada)

2016-06-15

Purpose: Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful. In the present era of electronic health records (EHRs), waiting times need not be so uncertain. Extensive EHRs provide unprecedented amounts of data that can statistically cluster towards representative values when appropriate patient cohorts are selected. Predictive modelling, such as machine learning, is a powerful approach that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The application of a machine learning algorithm to waiting time data has the potential to produce personalized waiting time predictions such that the uncertainty may be removed from the patient’s waiting experience. Methods: In radiation oncology, patients typically experience several types of waiting (eg waiting at home for treatment planning, waiting in the waiting room for oncologist appointments and daily waiting in the waiting room for radiotherapy treatments). A daily treatment wait time model is discussed in this report. To develop a prediction model using our large dataset (with more than 100k sample points) a variety of machine learning algorithms from the Python package sklearn were tested. Results: We found that the Random Forest Regressor model provides the best predictions for daily radiotherapy treatment waiting times. Using this model, we achieved a median residual (actual value minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes

75 FR 62838 - Award of a Single-Source Expansion Supplement to the Research Foundation of CUNY on Behalf of...

Science.gov (United States)

2010-10-13

...-Source Expansion Supplement to the Research Foundation of CUNY on Behalf of Hunter College School of... single-source program expansion supplement to the Research Foundation of CUNY on behalf of Hunter College... removal, of the relative's options to become a placement resource for the child. The supplemental funding...

Advertising emergency department wait times.

Science.gov (United States)

Weiner, Scott G

2013-03-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

Advertising Emergency Department Wait Times

Science.gov (United States)

Weiner, Scott G.

2013-01-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

Indication criteria for cataract extraction and gender differences in waiting time.

Science.gov (United States)

Smirthwaite, Goldina; Lundström, Mats; Albrecht, Susanne; Swahnberg, Katarina

2014-08-01

The purpose of this study was to investigate national indication criteria tool for cataract extraction (NIKE), a clinical tool for establishing levels of indications for cataract surgery, in relation to gender differences in waiting times for cataract extraction (CE). Data were collected by The Swedish National Cataract Register (NCR). Eye clinics report to NCR voluntarily and on regular basis (98% coverage). Comparisons regarding gender difference in waiting times were performed between NIKE-categorized and non-NIKE-categorized patients, as well as between different indication groups within the NIKE-system. All calculations were performed in spss version 20. Multivariate analyses were carried out using logistic regression, and single variable analyses were carried out by Student's t-test or chi square as appropriate. Gender, age, visual acuity and NIKE-categorization were associated with waiting time. Female patients had a longer waiting time to CE than male, both within and outside the NIKE-system. Gender difference in waiting time was somewhat larger among patients who had not been categorized by NIKE. In the non-NIKE-categorized group, women waited 0.20 months longer than men. In the group which was NIKE-categorized, women waited 0.18 months longer than men. It is reasonable to assume that prioritizing patients by means of NIKE helps to reduce the gender differences in waiting time. Gender differences in waiting time have decreased as NIKE was introduced and there may be a variety of explanations for this. However, with the chosen study design, we could not distinguish between effects related to NIKE and those due to other factors which occurred during the study period. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Using Facebook and text messaging to deliver a weight loss program to college students.

Science.gov (United States)

Napolitano, Melissa A; Hayes, Sharon; Bennett, Gary G; Ives, Allison K; Foster, Gary D

2013-01-01

Between 31 and 35% of the college-aged population is overweight or obese, yet few weight loss trials for this population have been conducted. This study examined the feasibility, acceptability, and initial efficacy of a technology-based 8-week weight loss intervention among college students. Students (N = 52) were randomly assigned to one of the three arms: Facebook (n = 17); Facebook Plus text messaging and personalized feedback (n = 18); Waiting List control (n = 17), with assessments at 4 weeks and 8 weeks (post-treatment). Participants were 20.47 ± 2.19 years old, 86.45 ± 17.11 kg, with a body mass index of 31.36 ± 5.3 kg/m(2) . Participants were primarily female (86.5%), and the sample was racially diverse (57.7% Caucasian, 30.8% African American, 5.8% Hispanic, and 5.7% other races). The primary outcome was weight loss after 8 weeks (post-treatment); 96.0% of the participants completed this assessment. At 8 weeks, the Facebook Plus group had significantly greater weight loss (-2.4 ± 2.5 kg) than the Facebook (-0.63 ± 2.4 kg) and Waiting List (-0.24 ± 2.6 kg) (both Ps Facebook and Waiting List groups. Results show preliminary efficacy and acceptability of the two active intervention arms (97.0% found the program helpful, 81.3% found the videos/handouts helpful, and 100% would recommend the program to others). Results indicate the potential for an innovative weight loss intervention that uses technology platforms (Facebook and text messaging) that are frequently used and already integrated into the cultural life of college students. Copyright © 2012 The Obesity Society.

Waiting for Merlot: anticipatory consumption of experiential and material purchases.

Science.gov (United States)

Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

2014-10-01

Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases. © The Author(s) 2014.

Waiting Lists for Radiation Therapy: A Case Study

Directory of Open Access Journals (Sweden)

Singer Peter A

2001-04-01

Full Text Available Abstract Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.

Settlement-Size Scaling among Prehistoric Hunter-Gatherer Settlement Systems in the New World.

Directory of Open Access Journals (Sweden)

W Randall Haas

Full Text Available Settlement size predicts extreme variation in the rates and magnitudes of many social and ecological processes in human societies. Yet, the factors that drive human settlement-size variation remain poorly understood. Size variation among economically integrated settlements tends to be heavy tailed such that the smallest settlements are extremely common and the largest settlements extremely large and rare. The upper tail of this size distribution is often formalized mathematically as a power-law function. Explanations for this scaling structure in human settlement systems tend to emphasize complex socioeconomic processes including agriculture, manufacturing, and warfare-behaviors that tend to differentially nucleate and disperse populations hierarchically among settlements. But, the degree to which heavy-tailed settlement-size variation requires such complex behaviors remains unclear. By examining the settlement patterns of eight prehistoric New World hunter-gatherer settlement systems spanning three distinct environmental contexts, this analysis explores the degree to which heavy-tailed settlement-size scaling depends on the aforementioned socioeconomic complexities. Surprisingly, the analysis finds that power-law models offer plausible and parsimonious statistical descriptions of prehistoric hunter-gatherer settlement-size variation. This finding reveals that incipient forms of hierarchical settlement structure may have preceded socioeconomic complexity in human societies and points to a need for additional research to explicate how mobile foragers came to exhibit settlement patterns that are more commonly associated with hierarchical organization. We propose that hunter-gatherer mobility with preferential attachment to previously occupied locations may account for the observed structure in site-size variation.

Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America

Directory of Open Access Journals (Sweden)

Roberto Giugliani

2014-06-01

Full Text Available This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S, an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S (Elaprase®, Shire enzyme replacement therapy (ERT, designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses.

Wait watchers: the application of a waiting list active management program in ambulatory care.

Science.gov (United States)

de Belvis, Antonio Giulio; Marino, Marta; Avolio, Maria; Pelone, Ferruccio; Basso, Danila; Dei Tos, Gian Antonio; Cinquetti, Sandro; Ricciardi, Walter

2013-04-01

This study describes and evaluates the application of a waiting list management program in ambulatory care. Waiting list active management survey (telephone call and further contact); before and after controlled trial. Local Health Trust in Veneto Region (North-East of Italy) in 2008-09. Five hundred and one people on a 554 waiting list for C Class ambulatory care diagnostic and/or clinical investigations (electrocardiography plus cardiology ambulatory consultation, eye ambulatory consultation, carotid vessels Eco-color-Doppler, legs Eco-color-Doppler or colonoscopy, respectively). Active list management program consisting of a telephonic interview on 21 items to evaluate socioeconomic features, self-perceived health status, social support, referral physician, accessibility and patients' satisfaction. A controlled before-and-after study was performed to evaluate anonymously the overall impact on patients' self-perceived quality of care. The rate of patients with deteriorating healthcare conditions; rate of dropout; interviewed degree of satisfaction about the initiative; overall impact on citizens' perceived quality of care. 95.4% patients evaluated the initiative as useful. After the intervention, patients more likely to have been targeted with the program showed a statistically significant increase in self-reported quality of care. Positive impact of the program on some dimensions of ambulatory care quality (health status, satisfaction, willingness to remain in the queue), thus confirming the outstanding value of 'not to leave people alone' and 'not to leave them feeling themselves alone' in healthcare delivery.

The British Columbia Nephrologists’ Access Study (BCNAS) – a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations

Science.gov (United States)

2013-01-01

Background Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. Methods We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists’, FPs’, and patients’ perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. Results In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an influence on triaging behavior. Further research is needed to determine whether this effect is sustainable. PMID:23988113

Built spaces and features associated with user satisfaction in maternity waiting homes in Malawi.

Science.gov (United States)

McIntosh, Nathalie; Gruits, Patricia; Oppel, Eva; Shao, Amie

2018-07-01

To assess satisfaction with maternity waiting home built spaces and features in women who are at risk for underutilizing maternity waiting homes (i.e. residential facilities that temporarily house near-term pregnant mothers close to healthcare facilities that provide obstetrical care). Specifically we wanted to answer the questions: (1) Are built spaces and features associated with maternity waiting home user satisfaction? (2) Can built spaces and features designed to improve hygiene, comfort, privacy and function improve maternity waiting home user satisfaction? And (3) Which built spaces and features are most important for maternity waiting home user satisfaction? A cross-sectional study comparing satisfaction with standard and non-standard maternity waiting home designs. Between December 2016 and February 2017 we surveyed expectant mothers at two maternity waiting homes that differed in their design of built spaces and features. We used bivariate analyses to assess if built spaces and features were associated with satisfaction. We compared ratings of built spaces and features between the two maternity waiting homes using chi-squares and t-tests to assess if design features to improve hygiene, comfort, privacy and function were associated with higher satisfaction. We used exploratory robust regression analysis to examine the relationship between built spaces and features and maternity waiting home satisfaction. Two maternity waiting homes in Malawi, one that incorporated non-standardized design features to improve hygiene, comfort, privacy, and function (Kasungu maternity waiting home) and the other that had a standard maternity waiting home design (Dowa maternity waiting home). 322 expectant mothers at risk for underutilizing maternity waiting homes (i.e. first-time mothers and those with no pregnancy risk factors) who had stayed at the Kasungu or Dowa maternity waiting homes. There were significant differences in ratings of built spaces and features between the

Waiting in the surgery.

Science.gov (United States)

Fry, F

1994-07-01

The concise Oxford English Dictionary defines 'dilemma' as an argument forcing one to choose one of two alternatives, both of which are unfavourable. This is a situation that frequently confronts the general practitioner. This paper will present one practitioner's view on the subject of patients waiting to see the doctor.

Waiting narratives of lung transplant candidates.

Science.gov (United States)

Yelle, Maria T; Stevens, Patricia E; Lanuza, Dorothy M

2013-01-01

Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman's concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients' stories and hear what is most meaningful in their lives.

Waiting Narratives of Lung Transplant Candidates

Directory of Open Access Journals (Sweden)

Maria T. Yelle

2013-01-01

Full Text Available Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman’s concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients’ stories and hear what is most meaningful in their lives.

Estimating bus passenger waiting times from incomplete bus arrivals data

OpenAIRE

McLeod, F.N.

2007-01-01

This paper considers the problem of estimating bus passenger waiting times at bus stops using incomplete bus arrivals data. This is of importance to bus operators and regulators as passenger waiting time is a key performance measure. Average waiting times are usually estimated from bus headways, that is, time gaps between buses. It is both time-consuming and expensive to measure bus arrival times manually so methods using automatic vehicle location systems are attractive; however, these syste...

Protocol to Exploit Waiting Resources for UASNs

Directory of Open Access Journals (Sweden)

Li-Ling Hung

2016-03-01

Full Text Available The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols.

Coccidioidomycosis in armadillo hunters from the state of Ceará, Brazil

OpenAIRE

Brillhante, Raimunda Sâmia Nogueira; Moreira Filho, Renato Evando; Rocha, Marcos Fábio Gadelha; Castelo-Branco, Débora de Souza Collares Maia; Fechine, Maria Auxiliadora Bezerra; Lima, Rita Amanda Chaves de; Picanço, Yuri Vieira Cunha; Cordeiro, Rossana de Aguiar; Camargo, Zoilo Pires de; Queiroz, José Ajax Nogueira; Araujo, Roberto Wagner Bezerra de; Mesquita, Jacó Ricarte Lima de; Sidrim, José Júlio Costa

2012-01-01

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in pa...

Human behavior. Sex equality can explain the unique social structure of hunter-gatherer bands.

Science.gov (United States)

Dyble, M; Salali, G D; Chaudhary, N; Page, A; Smith, D; Thompson, J; Vinicius, L; Mace, R; Migliano, A B

2015-05-15

The social organization of mobile hunter-gatherers has several derived features, including low within-camp relatedness and fluid meta-groups. Although these features have been proposed to have provided the selective context for the evolution of human hypercooperation and cumulative culture, how such a distinctive social system may have emerged remains unclear. We present an agent-based model suggesting that, even if all individuals in a community seek to live with as many kin as possible, within-camp relatedness is reduced if men and women have equal influence in selecting camp members. Our model closely approximates observed patterns of co-residence among Agta and Mbendjele BaYaka hunter-gatherers. Our results suggest that pair-bonding and increased sex egalitarianism in human evolutionary history may have had a transformative effect on human social organization. Copyright © 2015, American Association for the Advancement of Science.

HiggsHunters - a citizen science project for ATLAS

CERN Document Server

AUTHOR|(INSPIRE)INSPIRE-00053405; The ATLAS collaboration

2017-01-01

Since the launch of HiggsHunters.org in November 2014, citizen science volunteers have classified more than a million points of interest in images from the ATLAS experiment at the LHC. Volunteers have been looking for displaced vertices and unusual features in images recorded during LHC Run-1. We discuss the design of the project, its impact on the public, and the results of how the human volunteers performed relative to the computer algorithms in identifying displaced secondary vertices. People were better than existing algorithms at identifying displaced vertices for some masses and lifetimes, and showed good ability to recognize unexpected new features in the data.

Deer hunting and television: are tv shows creating expectations among deer hunters?

Science.gov (United States)

Joshua D. Agee; Craig A. Miller

2009-01-01

Throughout the past two decades new media outlets emphasizing trophy deer hunting have come to dominate hunting culture. Using data collected through a mail survey of Illinois deer hunters (n = 2,683, 78.5-percent response), we tested two hypotheses to determine factors that contribute to preference for hunting trophy deer. In particular, we examined the relationship...

Cadmium, lead, and chromium in large game: a local-scale exposure assessment for hunters consuming meat and liver of wild boar.

Science.gov (United States)

Danieli, P P; Serrani, F; Primi, R; Ponzetta, M P; Ronchi, B; Amici, A

2012-11-01

Heavy metals are ubiquitous in soil, water, and air. Their entrance into the food chain is an important environmental issue that entails risks to humans. Several reports indicate that game meat can be an important source of heavy metals, particularly because of the increasing consumption of game meat, mainly by hunters. We performed an exposure assessment of hunters and members of their households, both adults and children, who consumed wild boar (WB) meat and offal. We estimated the amount of cadmium, lead, and chromium in the tissues of WB hunted in six areas within Viterbo Province (Italy) and gathered data on WB meat and offal consumption by conducting specific diet surveys in the same areas. The exposure to cadmium, lead, and chromium was simulated with specifically developed Monte Carlo simulation models. Cadmium and lead levels in WB liver and meat harvested in Viterbo Province (Italy) were similar to or lower than the values reported in other studies. However, some samples contained these metals at levels greater then the EU limits set for domestic animals. The chromium content of meat or liver cannot be evaluated against any regulatory limit, but our results suggest that the amounts of this metal found in WB products may reflect a moderate environmental load. Our survey of the hunter population confirmed that their consumption of WB meat and liver was greater than that of the general Italian population. This level of consumption was comparable with other European studies. Consumption of WB products contributes significantly to cadmium and lead exposure of both adults and children. More specifically, consumption of the WB liver contributed significantly to total cadmium and lead exposure of members of the households of WB hunters. As a general rule, liver consumption should be kept to a minimum, especially for children living in these hunter households. The exposure to chromium estimated for this population of hunters may be considered to be safe. However

How Tolerable is Delay? Consumers' Evaluations of Internet Web Sites After Waiting

NARCIS (Netherlands)

Dellaert, B.G.C.; Kahn, B.

1998-01-01

How consumers’ waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative effects of waiting

Challenging "Waiting for Superman"

Science.gov (United States)

Bruhn, Molle

2014-01-01

A group of New York City public school teachers, angry about the depiction of public schools in 'Waiting for Superman," decide to make their own film about the realities of the current education reform movement. They persevered even though they had no budget when they started and lacked a background in filmmaking. "The Inconvenient Truth…

Chances of late surgery in relation to length of wait lists

Directory of Open Access Journals (Sweden)

Levy Adrian R

2005-09-01

Full Text Available Abstract Background The proportion of patients who undergo surgery within a clinically safe time is an important performance indicator in health systems that use wait lists to manage access to care. However, little is known about chances of on-time surgery according to variations in existing demand. We sought to determine what proportion of patients have had late coronary bypass surgery after registration on wait lists of different size in a network of hospitals with uniform standards for timing of surgery. Methods Using records from a population-based registry, we studied wait-list times prospectively collected in a cohort of patients registered on wait lists for coronary artery bypass grafting procedures. We compared the number of weeks from registration to surgery against target access times established for three urgency groups. The chances of undergoing surgery within target time have been evaluated in relation to wait-list size at registration and the number of surgeries performed without registration on a wait list. Results In 1991–2001, two in three patients were at risk of late surgery when registered on wait lists for isolated coronary bypass procedures in British Columbia, Canada. Although urgent patients had never seen a wait list with clearance time exceeding one week, the odds of on-time surgery were reduced by 25%, odds ratio [OR] = 0.75 (95% confidence interval [CI] 0.65–0.87 for every additional operation performed without registration on a list. When the wait list at registration required a clearance time of over one month, semi-urgent patients had 51% lower odds of on-time surgery as compared to lists with clearance time less than one week, OR = 0.49 (95%CI 0.41–0.60, after adjustment for age, sex, comorbidity, calendar period, hospital and week on the list. In the non-urgent group, the odds were 69% lower, OR = 0.31 (95%CI 0.20–0.47. Every time an operation in the same hospital was performed without registration on a

Blood, guts and knife cuts: reducing the risk of swine brucellosis in feral pig hunters in north-west New South Wales, Australia.

Science.gov (United States)

Massey, P D; Polkinghorne, B G; Durrheim, D N; Lower, T; Speare, R

2011-01-01

Humans who have close contact with livestock, wild or feral animals can risk acquiring zoonotic infections such as brucellosis, Q fever, and leptospirosis. Human infection with Brucella suis (swine brucellosis) usually follows occupational or recreational exposure to infected animals. Worldwide, many cases of human infection follow contact with infected feral pigs. In Australia there is a growing market for the export of 'wild boar' and a considerable number of people are involved in feral pig hunting. However, feral pig hunters are often hard to reach with health strategies. According to Australian authorities the most important means of preventing disease in humans includes covering cuts; wearing gloves; washing hands; and avoiding blood when coming into contact with feral pigs. There has not been an evaluation of the acceptability of these recommended risk-reduction strategies in the settings where feral pig hunting and evisceration occurs. Semi-structured interviews and small focus groups were conducted with feral pig hunters in north-west New South Wales (NSW), Australia, to explore their hunting experiences and views on the brucellosis prevention strategies. Interview and focus group notes were thematically analysed. There was a range of experiences of feral pig hunting, from a very professional approach to a purely recreational approach. The main domains that emerged from participants' experiences during their most recent feral pig hunting activity and their reflections on current swine brucellosis risk reduction strategies were: 'you've gotta be tough to be a feral pig hunter'; 'most of the suggested strategies won't work as they are'; 'reducing risk in the scrub'; and 'how to let pig hunters know'. The recreational nature and prevailing macho perspective of participants demand a pragmatic approach to risk reduction if it is going to prove acceptable to feral pig hunters. The 'you've gotta be tough to be a feral pig hunter' context of the activity and the

The determinants of patient waiting time in the general outpatient department of Debre Markos and Felege Hiwot hospitals in Amhara regional state, North West, Ethiopia

Directory of Open Access Journals (Sweden)

Melesse Belayneh

2017-01-01

Full Text Available Background Patient waiting time is defined as the total time from registration until consultation with a doctor. Experiences of waiting in general are perceived as complex, subjective, and culturally influenced. Registration time, payment process/cash billing, recording classification/triaged time, few human resources and work process are the determinants of patient waiting time in the general outpatient departments. However, the complexity of wait time is poorly understood and has been explored only to a limited extent. The main objective of this study to assess patient waiting time and its determinants in Debre Markos and Felge Hiwot Referral hospitals of Amhara Regional State in North West, Ethiopia. Methods A hospital based comparative cross sectional study design was employed from October 20‐ November 20, 2014. The study population was patients presenting to general outpatient departments, from which 464 patients was selected using systematic random sampling technique. Quantitative Data was collected using structured questionnaire and A check list adopted from studies. Quantitative data was coded, entered, cleaned and analyzed using SPSS Software for windows version 20.0. Linear regression and bivariate logistic regression was applied to identify the determinants of each explanatory variable on outcome (patient waiting time. Finally data was interpreted by referring to the pertinent findings from the relevant literature reviewed. Ethical approval and clearance was obtained from ethical clearance committee of the Jimma University College of Public Health & Medical Sciences Result The measured waiting time in Felge Hiwot referral hospital mean waiting time was and its standard deviation 149.2±72.1 minutes whereas 94.2±58.3 minutes in debere markos referral hospital. The major causes of the long patient waiting time was large numbers of patient with a few doctors 94(40.5%,67(28.9% ,long searching of the cards 67(28.9%,73(31.5,and long

Waiting time for cataract surgery and its influence on patient attitudes.

Science.gov (United States)

Chan, Frank Wan-kin; Fan, Alex Hoi; Wong, Fiona Yan-yan; Lam, Philip Tsze-ho; Yeoh, Eng-kiong; Yam, Carrie Ho-kwan; Griffiths, Sian; Lam, Dennis Shun-chiu; Congdon, Nathan

2009-08-01

To characterize willingness to pay for private operations and preferred waiting time among patients awaiting cataract surgery in Hong Kong. This was a cross-sectional survey. Subjects randomly selected from cataract surgical waiting lists in Hong Kong (n = 467) underwent a telephone interview based on a structured, validated questionnaire. Data were collected on private insurance coverage, preferred waiting time, amount willing to pay for surgery, and self-reported visual function and health status. Among 300 subjects completing the interview, 144 (48.2%) were 76 years of age or older, 177 (59%) were women, and mean time waiting for surgery was 17 +/- 15 months. Among 220 subjects (73.3%) willing to pay anything for surgery, the mean amount was US$552 +/- 443. With adjustment for age, education, and monthly household income, subjects willing to pay anything were less willing to wait 12 months for surgery (OR = 4.34; P = 0.002), more likely to know someone having had cataract surgery (OR = 2.20; P = 0.03), and more likely to use their own savings to pay for the surgery (OR = 2.21; P = 0.04). Subjects considering private cataract surgery, knowing people who have had cataract surgery, using nongovernment sources to pay for surgery, and having lower visual function were willing to pay more. Many patients wait significant periods for cataract surgery in Hong Kong, and are willing to pay substantial amounts for private operations. These results may have implications for other countries with cataract waiting lists.

Respiratory viral RNA on toys in pediatric office waiting rooms.

Science.gov (United States)

Pappas, Diane E; Hendley, J Owen; Schwartz, Richard H

2010-02-01

Toys in pediatric office waiting rooms may be fomites for transmission of viruses. Eighteen samples were taken from office objects on 3 occasions. Samples were tested for presence of picornavirus (either rhinovirus or enterovirus) on all 3 sample days; in addition, January samples were tested for respiratory syncytial virus and March samples were tested for influenza A and B. In addition, 15 samples were obtained from the sick waiting room before and after cleaning. Polymerase chain reaction was used to detect picornavirus, respiratory syncytial virus, and influenza A or B virus. Finally, 20 samples were obtained from the fingers of a researcher after handling different toys in the sick waiting room, and samples were then obtained from all the same toys; all samples were tested for picornavirus by polymerase chain reaction. Viral RNA was detected on 11 of 52 (21%) of toys sampled. Ten of the positives were picornavirus; 1 was influenza B virus. Three (30%) of 10 toys from the new toy bag, 6 of 30 (20%) in the sick child waiting room, and 2 of 12 (17%) in the well child waiting room were positive. Six (40%) of 15 toys in the sick waiting room were positive for picornaviral RNA before cleaning; after cleaning, 4 (27%) of 15 were positive in spite of the fact that RNA was removed from 4 of 6 of the original positives. Three (15%) of 20 toys in the sick waiting room were positive for picornaviral RNA, but RNA was not transferred to the fingers of the investigator who handled these toys. About 20% of the objects in a pediatric office may be contaminated with respiratory viral RNA, most commonly picornavirus RNA. Cleaning with a disinfectant cloth was only modestly effective in removing the viral RNA from the surfaces of toys, but transfer of picornaviral RNA from toys to fingers was inefficient.

Heart Surgery Waiting Time: Assessing the Effectiveness of an Action.

Science.gov (United States)

Badakhshan, Abbas; Arab, Mohammad; Gholipour, Mahin; Behnampour, Naser; Saleki, Saeid

2015-08-01

Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient's problems. The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for reducing waiting time and increasing the quality of services from this perspective. This cross-sectional study was performed in 2013. After searching articles on PubMed, Elsevier, Google Scholar, Ovid, Magiran, IranMedex, and SID, a list of several criteria, which relate to waiting time, was provided. Afterwards, the data on waiting time were collected by a researcher-structured checklist from 156 hospitalized patients. The data were analyzed by SPSS 16. The Kolmogorov Smirnov and Shapiro tests were used for determination of normality. Due to the non-normal distribution, non-parametric tests, such as Kruskal-Wallis and Mann-Whitney were chosen for reporting significance. Parametric tests also used reporting medians. Among the studied variables, just economic status had a significant relation with waiting time (P = 0.37). Fifty percent of participants had diabetes, whereas this estimate was 43.58% for high blood pressure. As the cause of delay, 28.2% of patients reported financial problems, 18.6% personal problem and 13.5% a delay in providing equipment by the hospital. It seems the studied hospital should review its waiting time arrangements and detach them, as far as possible, from subjective and personal (specialists) decisions. On the other hand, ministries of health and insurance companies should consider more financial support. It is also recommend that hospitals should arrange preoperational psychiatric consultation for increasing patients' emotionally readiness.

Period Determination of Binary Asteroid Targets Observed at Hunters Hill Observatory: May-September 2009

Science.gov (United States)

Higgins, David; Oey, Julian; Pravec, Petr

2011-01-01

Lightcurves for seven confirmed or possible binary asteroids were obtained at the Hunters Hill Observatory (HHO) and Leura Observatory from 2009 May through 2010 September: 1453 Fennia, 2501 Lohja, 3076 Garbor, 4029 Bridges, 5325 Silver, 6244 Okamoto, and (6265) 1985 TW3.

Waiting time and the psychosocial consequences of false-positive mammography

DEFF Research Database (Denmark)

Heleno, Bruno M.; Siersma, Volkert; Brodersen, John

2015-01-01

Background: There is wide variation in the psychosocial response to false-positive mammography. We aimed to assess whether women having to wait longer to exclude cancer had increased psychosocial consequences that persisted after cancer was ruled out. Findings: We selected women with false......-positive mammography (n = 272), screened for breast cancer in Copenhagen and Funen (Denmark) over a 1-year period. We measured psychosocial consequences immediately before women attended their recall visit and 1, 6, 18 and 36 months after women received their final diagnosis. After women were told that cancer had been...... ruled out, adverse psychosocial consequences decreased with time. We found no statistically significant differences between women who had cancer ruled out immediately at the recall visit (waiting time of 0) and women who had to wait longer before cancer was ruled out (waiting times 1-30, 30...

Fulltext PDF

Indian Academy of Sciences (India)

holding a quivering mouse deer (Tragulus memmina), Asia's small- est deer, in it's mouth. .... pack members waiting in the open area. A frequent manoeuvre ... The Whistling Hunters: Field Studies of the Asiatic Wild Dog. (Cuon alpinus).

No-waiting dentine self-etch concept-Merit or hype.

Science.gov (United States)

Huang, Xue-Qing; Pucci, César R; Luo, Tao; Breschi, Lorenzo; Pashley, David H; Niu, Li-Na; Tay, Franklin R

2017-07-01

A recently-launched universal adhesive, G-Premio Bond, provides clinicians with the alternative to use the self-etch technique for bonding to dentine without waiting for the adhesive to interact with the bonding substrate (no-waiting self-etch; Japanese brochure), or after leaving the adhesive undisturbed for 10s (10-s self-etch; international brochure). The present study was performed to examine in vitro performance of this new universal adhesive bonded to human coronal dentine using the two alternative self-etch modes. One hundred and ten specimens were bonded using two self-etch application modes and examined with or without thermomechanical cycling (10,000 thermal cycles and 240,000 mechanical cycles) to simulate one year of intraoral functioning. The bonded specimens were sectioned for microtensile bond testing, ultrastructural and nanoleakage examination using transmission electron microscopy. Changes in the composition of mineralised dentine after adhesive application were examined using Fourier transform infrared spectroscopy. Both reduced application time and thermomechanical cycling resulted in significantly lower bond strengths, thinner hybrid layers, and significantly more extensive nanoleakage after thermomechanical cycling. Using the conventional 10-s application time improved bonding performance when compared with the no-waiting self-etch technique. Nevertheless, nanoleakage was generally extensive under all testing parameters employed for examining the adhesive. Although sufficient bond strength to dentine may be achieved using the present universal adhesive in the no-waiting self-etch mode that does not require clinicians to wait prior to polymerisation of the adhesive, this self-etch concept requires further technological refinement before it can be recommended as a clinical technique. Although the surge for cutting application time to increase user friendliness remains the most frequently sought conduit for advancement of dentine bonding

Minimizing makespan for a no-wait flowshop using genetic algorithm

Indian Academy of Sciences (India)

This paper explains minimization of makespan or total completion time .... lead to a natural reduction of the no-wait flow shop problem to the travelling sales- ... FCH can also be applied in real time scheduling and rescheduling for no-wait flow.

The Psychosocial Influences of Waiting Periods on Patients Undergoing Endoscopic Submucosal Dissection.

Science.gov (United States)

Nagao, Noriko; Tsuchiya, Aya; Ando, Sae; Arita, Mizue; Toyonaga, Takashi; Miyawaki, Ikuko

This study aimed to clarify psychosocial influences of waiting periods on patients undergoing endoscopic submucosal dissection for cancer at an advanced medical care facility in Japan. Subjects were consenting patients hospitalized from 2009 to 2010. Qualitative and quantitative data were gathered about patients' characteristics, disease and stage, and waiting period. Qualitative content analysis was used to analyze free statements and interview data. Subjects included 154 patients with an average wait period of 46.28 days for admission. Qualitative analysis revealed the following wait period perceptions. For calmness, results indicated (1) no anxiety, (2) relief based on doctors' positive judgment, (3) whatever happens/no choice, and (4) trust in doctor. For uneasiness, perceptions included (1) the sooner, the better/eagerly waiting, (2) anxiety and concern, and (3) emotional instability. Four waiting period coping types were identified: (1) making phone inquiries, (2) busy and forgot about the medical procedure, (3) relief from anxiety, and (4) unable to function well in daily life. Patients need to be educated about cancer progression and provided an estimated wait time. They also require more information about how to manage daily life such as monitoring factors from the nursing domain including physical condition, digestive symptoms, diet, and exercise.

Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

Energy Technology Data Exchange (ETDEWEB)

Kildea, John; Hijal, Tarek [McGill University Health Center (Canada)

2016-08-15

We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

International Nuclear Information System (INIS)

Kildea, John; Hijal, Tarek

2016-01-01

We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

Inferring the demographic history of African farmers and pygmy hunter-gatherers using a multilocus resequencing data set.

Directory of Open Access Journals (Sweden)

Etienne Patin

2009-04-01

Full Text Available The transition from hunting and gathering to farming involved a major cultural innovation that has spread rapidly over most of the globe in the last ten millennia. In sub-Saharan Africa, hunter-gatherers have begun to shift toward an agriculture-based lifestyle over the last 5,000 years. Only a few populations still base their mode of subsistence on hunting and gathering. The Pygmies are considered to be the largest group of mobile hunter-gatherers of Africa. They dwell in equatorial rainforests and are characterized by their short mean stature. However, little is known about the chronology of the demographic events-size changes, population splits, and gene flow--ultimately giving rise to contemporary Pygmy (Western and Eastern groups and neighboring agricultural populations. We studied the branching history of Pygmy hunter-gatherers and agricultural populations from Africa and estimated separation times and gene flow between these populations. We resequenced 24 independent noncoding regions across the genome, corresponding to a total of approximately 33 kb per individual, in 236 samples from seven Pygmy and five agricultural populations dispersed over the African continent. We used simulation-based inference to identify the historical model best fitting our data. The model identified included the early divergence of the ancestors of Pygmy hunter-gatherers and farming populations approximately 60,000 years ago, followed by a split of the Pygmies' ancestors into the Western and Eastern Pygmy groups approximately 20,000 years ago. Our findings increase knowledge of the history of the peopling of the African continent in a region lacking archaeological data. An appreciation of the demographic and adaptive history of African populations with different modes of subsistence should improve our understanding of the influence of human lifestyles on genome diversity.

Optimising radiation outcomes, scheduling patient waiting lists for maximum population tumour control

International Nuclear Information System (INIS)

Ebert, M.A.; Jennings, L.; Kearvell, R.; Bydder, S.

2011-01-01

Full text: Delays in the commencement of radiotherapy, possibly due to resource constraints, are known to impact on control-related outcomes. We sought an objective solution for patient prioritisation based on tumour control probability (TCP). With a utilitarian objective for maximising TCP in a population of M patients, with patient i waiting a time between diagnosis and treatment of Ti and a mean wait time of TMean, the optimisation problem is as shown. A linear-quadratic/Poissonian model for cell survival/TCP was considered including cell doubling during the wait time. Solutions to several distributions of patient population characteristics were examined together with the expected change in TCP for the population and individuals. An analytical solution to the optimisation problem was found which gives the optimal wait time for each patient as a function of the distribution of radiobiological characteristics in the population. This solution does not allow a negativity constraint on an individual's optimised waiting time so a waiting list simulation was developed to enforce that. Optimal wait time distributions were calculated for situations where patients are allocated distinct diagnostic groups (sharing radiobiological parameters) and for a (log-normal) distribution of doubling times in the population. In order to meet the utilitarian objective, the optimal solutions require patients with rapid cell doubling times to be accelerated up the waiting list at the expense of those with slowly proliferating tumours. The net population benefit however is comparable to or greater then the expected benefit from beam intensity modulation or dose escalation.

From Head-hunter to Organ-thief: Verisimilitude, Doubt and Plausible Worlds in Indonesia and Beyond

DEFF Research Database (Denmark)

Bubandt, Nils Ole

2017-01-01

their victims and using the human heads in construction rituals as they used to do, head-hunters are now allegedly harvesting the victims’ organs for sale on the international organ market. Based on a comparison of ethnographic material from North Maluku, a province in the eastern part of Indonesia, and news...... reports I trace the shift from head-hunting to organ theft and suggest that this plasticity is not merely a symbolic representation of changing political and economic realities. Rather, I argue, the organ-stealing head-hunters are part of a global travelling package that includes and entangles organ...... trafficking practices, media accounts, political imaginaries, and social anxieties within the same field of reality and possibility, a field of verisimilitude in which fiction and fact, rumour and reality, are fundamentally blurred. The article proposes a ‘more-than-representational’ approach to the organ...

Public views on a wait time management initiative: a matter of communication.

Science.gov (United States)

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2010-08-05

Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative--the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

[Waiting time for the first colposcopic examination in women with abnormal Papanicolaou test].

Science.gov (United States)

Nascimento, Maria Isabel do; Rabelo, Irene Machado Moraes Alvarenga; Cardoso, Fabrício Seabra Polidoro; Musse, Ricardo Neif Vieira

2015-08-01

To evaluate the waiting times before obtaining the first colposcopic examination for women with abnormal Papanicolaou smears. Retrospective cohort study conducted on patients who required a colposcopic examination to clarify an abnormal pap test, between 2002 January and 2008 August, in a metropolitan region of Brazil. The waiting times were defined as: Total Waiting Time (interval between the date of the pap test result and the date of the first colposcopic examination); Partial A Waiting Time (interval between the date of the pap test result and the date of referral); Partial B Waiting Time (interval between the date of referral and the date of the first colposcopic examination). Means, medians, relative and absolute frequencies were calculated. The Kruskal-Wallis test and Pearson's chi-square test were used to determine statistical significance. A total of 1,544 women with mean of age of 34 years (SD=12.6 years) were analyzed. Most of them had access to colposcopic examination within 30 days (65.8%) or 60 days (92.8%) from referral. Mean Total Waiting Time, Partial A Waiting Time, and Partial B Waiting Time were 94.5 days (SD=96.8 days), 67.8 days (SD=95.3 days) and 29.2 days (SD=35.1 days), respectively. A large part of the women studied had access to colposcopic examination within 60 days after referral, but Total waiting time was long. Measures to reduce the waiting time for obtaining the first colposcopic examination can help to improve the quality of care in the context of cervical cancer control in the region, and ought to be addressed at the phase between the date of the pap test results and the date of referral to the teaching hospital.

Assessment of risk to aquatic biota from elevated salinity -- a case study from the Hunter River, Australia.

Science.gov (United States)

Muschal, Monika

2006-05-01

An ecological risk assessment was performed on salinity levels of the Hunter River and its tributaries to respond to concerns that high salinity may be damaging aquatic ecosystems. Probabilistic techniques were used to assess likelihood and consequence, and hence the risk to aquatic biota from salinity. Continuous electrical conductivity distributions were used to describe the likelihood that high salinity would occur (exposure dataset) and toxicity values were compiled from the limited literature sources available to describe the consequence of high salinity (effects dataset). The assessment was preliminary in the sense that it modelled risk on the basis of existing data and did not undertake site-specific toxicity testing. Some sections of the Hunter River catchment have geologies that are saline because of their marine origins. Catchment development has increased the liberation rates of salts into surface-waters. Such modifying activities include coal-mining, power generation and land clearing. The aquatic biota of tributaries had a greater risk of impairment from high salinity than that of the Hunter River. High salinities in the tributaries were attributed to the combined factors of naturally saline geologies, increased liberation of salts due to modification of the landscape, and reduced dilution by flushing flows. A salinity guideline trigger value of 1100 mg L(-1) was recommended.

Brazil well worth the wait

Energy Technology Data Exchange (ETDEWEB)

Duey, R.

1999-11-01

Oil companies weren't the only ones waiting for Brazil to make up its mind about privatizing its oil and gas industry. Seismic firms are flocking to the area in droves to work their spec magic. Exploratory activities in these large offshore blocks are described.

Approaching stationarity: competition between long jumps and long waiting times

International Nuclear Information System (INIS)

Dybiec, Bartłomiej

2010-01-01

Within the continuous-time random walk (CTRW) scenarios, properties of the overall motion are determined by the waiting time and the jump length distributions. In the decoupled case, with power-law distributed waiting times and jump lengths, the CTRW scenario is asymptotically described by the double (space and time) fractional Fokker–Planck equation. Properties of a system described by such an equation are determined by the subdiffusion parameter and the jump length exponent. Nevertheless, the stationary state is determined solely by the jump length distribution and the potential. The waiting time distribution determines only the rate of convergence to the stationary state. Here, we inspect the competition between long waiting times and long jumps and how this competition is reflected in the way in which a stationary state is reached. In particular, we show that the distance between a time-dependent and a stationary solution changes in time as a double power law

Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

Directory of Open Access Journals (Sweden)

Jurgita Januleviciute Gangstøe

2016-06-01

Full Text Available Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i high priority with assigned individual maximum waiting time; (ii low priority without a maximum waiting time; and (iii refusal (not in need for specialized services. We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual

Should I stay or should I go? Hospital emergency department waiting times and demand.

Science.gov (United States)

Sivey, Peter

2018-03-01

In the absence of the price mechanism, hospital emergency departments rely on waiting times, alongside prioritisation mechanisms, to restrain demand and clear the market. This paper estimates by how much the number of treatments demanded is reduced by a higher waiting time. I use variation in waiting times for low-urgency patients caused by rare and resource-intensive high-urgency patients to estimate the relationship. I find that when waiting times are higher, more low-urgency patients are deterred from treatment and leave the hospital during the waiting period without being treated. The waiting time elasticity of demand for low-urgency patients is approximately -0.25 and is highest for the lowest-urgency patients. Copyright © 2017 John Wiley & Sons, Ltd.

A Comparison of Cognitive and Interpersonal-Process Group Therapies in the Treatment of Depression among College Students.

Science.gov (United States)

Hogg, James A.; Deffenbacher, Jerry L.

1988-01-01

Compared cognitive and interpersonal-process group therapies in treatment of depression among college students to each other and to waiting-list control group. Both treatments led to significant reductions in depression and depressed thinking and to increments in self-esteem at midtreatment, posttreatment, and follow-up assessments but did not…

Near-source surface seismic measurements for the NPE, NPE Calibration, Hunter`s Trophy, and Mineral Quarry

Energy Technology Data Exchange (ETDEWEB)

Reinke, R.E.; Leverette, J.A. [Field Command Defense Nuclear Agency, Kirtland AFB, NM (United States); Stump, B.W. [Los Alamos National Laboratory, NM (United States)] [and others

1994-12-31

An extensive seismic network was deployed on the surface of Rainier Mesa for both the Non-Proliferation Experiment (NPE) Calibration shot as well as the full scale NPE event. This network was very similar to previous deployments for the nuclear events MISTY ECHO, MINERAL QUARRY, and HUNTERS TROPHY. For the full scale NPE event three-component accelerometers and seismometers were fielded at 32 sites across the mesa. A slightly smaller network with 28 stations was in operation for the 300 pound NPE calibration event. The mesa top array included both accelerometers and seismometers. The accelerometers were used to obtain data from the main NPE event while the seismometers with their higher sensitivity were used to record the 300 pound cal shot and several hundred after events from the NPE. Large spatial variations in ground motion are evident in both the full mesa data set as well as a small (80 m on a side) aperture, 9-element triangular array. This paper summarizes the data and discusses wave propagation effects. A companion paper presents a comparative source analysis.

Maternity waiting homes in Rural Health Centers of Ethiop: The ...

African Journals Online (AJOL)

kim

1 The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis ... The main aim of this study was to assess the situation of maternity waiting ... experiences and challenges of mothers using waiting homes. ..... education on MWHs were home visits by HEWs ... travel long distances to deliver food, which meant.

Public views on a wait time management initiative: a matter of communication

Directory of Open Access Journals (Sweden)

Laupacis Andreas

2010-08-01

Full Text Available Abstract Background Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative - the Ontario Wait Time Strategy (OWTS (Canada. Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Methods Two qualitative studies: 1 an analysis of all emails sent by the public to the (OWTS email address; and 2 in-depth interviews with members of the Ontario public. Results Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Conclusions Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study.

Science.gov (United States)

Jiang, Shan; Powers, Matthew; Allison, David; Vincent, Ellen

2017-07-01

This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people's preference scores. The factor analysis indicated additional supportive features that may affect people's preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.

Do individual differences in use of cover habitat affect red deer`s (Cervus elaphus) probability of being shot by hunters?

OpenAIRE

Stamnes, Inga

2014-01-01

The purpose of this study was to test if red deer (Cervus elaphus) habitat use affects their risk of being shot by hunters. I compared habitat use of 20 GPS-marked red deer that survived the hunting season with 20 individuals that were shot. I predicted that shot red deer used open areas within forested habitats with a better visibility for hunters than surviving red deer. I also predicted that the use of less risky habitat is costly in terms of foraging opportunity, with shot animals using b...

Waiting time guarantee - an update

DEFF Research Database (Denmark)

Socha, Karolina; Bech, Mickael

2008-01-01

The rule of extended free choice of hospital, in force since 2002, provides patients with an option to choose a private hospital if the public system is unable to provide a treatment within the guaranteed waiting time of one month. In June 2008 the Government declared in their yearly budget agree...

A state of limbo: the politics of waiting in neo-liberal Latvia.

Science.gov (United States)

Ozoliņa-Fitzgerald, Liene

2016-09-01

This article presents an ethnographic study of politics of waiting in a post-Soviet context. While activation has been explored in sociological and anthropological literature as a neo-liberal governmental technology and its application in post-socialist context has also been compellingly documented, waiting as a political artefact has only recently been receiving increased scholarly attention. Drawing on ethnographic fieldwork at a state-run unemployment office in Riga, this article shows how, alongside activation, state welfare policies also produce passivity and waiting. Engaging with the small but developing field of sociological literature on the politics of waiting, I argue that, rather than interpreting it as a clash between 'neo-liberal' and 'Soviet' regimes, we should understand the double-move of activation and imposition of waiting as a key mechanism of neo-liberal biopolitics. This article thus extends the existing theorizations of the temporal politics of neo-liberalism. © London School of Economics and Political Science 2016.

Evidence for early hunters beneath the Great Lakes.

Science.gov (United States)

O'Shea, John M; Meadows, Guy A

2009-06-23

Scholars have hypothesized that the poorly understood and rarely encountered archaeological sites from the terminal Paleoindian and Archaic periods associated with the Lake Stanley low water stage (10,000-7,500 BP) are lost beneath the modern Great Lakes. Acoustic and video survey on the Alpena-Amberley ridge, a feature that would have been a dry land corridor crossing the Lake Huron basin during this time period, reveals the presence of a series of stone features that match, in form and location, structures used for caribou hunting in both prehistoric and ethnographic times. These results present evidence for early hunters on the Alpena-Amberley corridor, and raise the possibility that intact settlements and ancient landscapes are preserved beneath Lake Huron.

Origin and diet of the prehistoric hunter-gatherers on the mediterranean island of Favignana (Ègadi Islands, Sicily.

Directory of Open Access Journals (Sweden)

Marcello A Mannino

Full Text Available Hunter-gatherers living in Europe during the transition from the late Pleistocene to the Holocene intensified food acquisition by broadening the range of resources exploited to include marine taxa. However, little is known on the nature of this dietary change in the Mediterranean Basin. A key area to investigate this issue is the archipelago of the Ègadi Islands, most of which were connected to Sicily until the early Holocene. The site of Grotta d'Oriente, on the present-day island of Favignana, was occupied by hunter-gatherers when Postglacial environmental changes were taking place (14,000-7,500 cal BP. Here we present the results of AMS radiocarbon dating, palaeogenetic and isotopic analyses undertaken on skeletal remains of the humans buried at Grotta d'Oriente. Analyses of the mitochondrial hypervariable first region of individual Oriente B, which belongs to the HV-1 haplogroup, suggest for the first time on genetic grounds that humans living in Sicily during the early Holocene could have originated from groups that migrated from the Italian Peninsula around the Last Glacial Maximum. Carbon and nitrogen isotope analyses show that the Upper Palaeolithic and Mesolithic hunter-gatherers of Favignana consumed almost exclusively protein from terrestrial game and that there was only a slight increase in marine food consumption from the late Pleistocene to the early Holocene. This dietary change was similar in scale to that at sites on mainland Sicily and in the rest of the Mediterranean, suggesting that the hunter-gatherers of Grotta d'Oriente did not modify their subsistence strategies specifically to adapt to the progressive isolation of Favignana. The limited development of technologies for intensively exploiting marine resources was probably a consequence both of Mediterranean oligotrophy and of the small effective population size of these increasingly isolated human groups, which made innovation less likely and prevented transmission of

Origin and Diet of the Prehistoric Hunter-Gatherers on the Mediterranean Island of Favignana (Ègadi Islands, Sicily)

Science.gov (United States)

Mannino, Marcello A.; Catalano, Giulio; Talamo, Sahra; Mannino, Giovanni; Di Salvo, Rosaria; Schimmenti, Vittoria; Lalueza-Fox, Carles; Messina, Andrea; Petruso, Daria; Caramelli, David; Richards, Michael P.; Sineo, Luca

2012-01-01

Hunter-gatherers living in Europe during the transition from the late Pleistocene to the Holocene intensified food acquisition by broadening the range of resources exploited to include marine taxa. However, little is known on the nature of this dietary change in the Mediterranean Basin. A key area to investigate this issue is the archipelago of the Ègadi Islands, most of which were connected to Sicily until the early Holocene. The site of Grotta d’Oriente, on the present-day island of Favignana, was occupied by hunter-gatherers when Postglacial environmental changes were taking place (14,000-7,500 cal BP). Here we present the results of AMS radiocarbon dating, palaeogenetic and isotopic analyses undertaken on skeletal remains of the humans buried at Grotta d’Oriente. Analyses of the mitochondrial hypervariable first region of individual Oriente B, which belongs to the HV-1 haplogroup, suggest for the first time on genetic grounds that humans living in Sicily during the early Holocene could have originated from groups that migrated from the Italian Peninsula around the Last Glacial Maximum. Carbon and nitrogen isotope analyses show that the Upper Palaeolithic and Mesolithic hunter-gatherers of Favignana consumed almost exclusively protein from terrestrial game and that there was only a slight increase in marine food consumption from the late Pleistocene to the early Holocene. This dietary change was similar in scale to that at sites on mainland Sicily and in the rest of the Mediterranean, suggesting that the hunter-gatherers of Grotta d’Oriente did not modify their subsistence strategies specifically to adapt to the progressive isolation of Favignana. The limited development of technologies for intensively exploiting marine resources was probably a consequence both of Mediterranean oligotrophy and of the small effective population size of these increasingly isolated human groups, which made innovation less likely and prevented transmission of fitness

Development of an Information Model for Kidney Transplant Wait List.

Science.gov (United States)

Bircan, Hüseyin Yüce; Özçelik, Ümit; Uysal, Nida; Demirağ, Alp; Haberal, Mehmet

2015-11-01

Deceased-donor kidney transplant is unique among surgical procedures that are an urgent procedure performed in an elective population. It has not been possible to accurately determine when a given patient will be called for transplant. Patients on the active transplant list can be called for a transplant at any time. As a result, every effort must be made to optimize their health according to best practices and published clinical practice guidelines. Once the patient is placed on the transplant wait list after undergoing an initial extensive evaluation, continued surveillance is required. Therefore, we developed a kidney transplant wait list surveillance software program that alerts organ transplant coordinator on time regarding which patients need a work-up. The new designed software has a database of our waiting patients with their completed and pending controls. The software also has built-in functions to warn the responsible staff with an E-mail. If one of the controls of a recipient delayed, the software sends an automated E-mail to the staff regarding the patients delayed controls. The software is a Web application that works on any platform with a Web browser and Internet connection and allows access by multiple users. The software has been developed with NET platform. The database is SQL server. The software has the following functions: patient communication info, search, alert list, alert E-mail, control entry, and system management. As of January 2014, a total of 21 000 patients were registered on the National Kidney Transplant wait list in Turkey and the kidney transplant wait list had been expanding by 2000 to 3000 patients each year. Therefore computerized wait list programs are crucial to help to transplant centers to keep their patients up-to-date on time.

General practice cooperatives: long waiting times for home visits due to long distances?

Science.gov (United States)

Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

2007-02-12

The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minutes decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance.

76 FR 46149 - Financial Assistance: Wildlife Restoration, Sport Fish Restoration, Hunter Education and Safety

Science.gov (United States)

2011-08-01

... these regulations on June 10, 2010, to address changes in law, regulation, policy, technology, and... Service 50 CFR Part 80 Financial Assistance: Wildlife Restoration, Sport Fish Restoration, Hunter... 80 [Docket No. FWS-R9-WSR-2009-0088; 91400-5110-POLI-7B; 91400-9410-POLI- 7B] RIN 1018-AW65 Financial...

The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients

Directory of Open Access Journals (Sweden)

Knol Dirk L

2007-02-01

Full Text Available Abstract Background Problematic waiting lists in public health care threaten the equity and timeliness of care provision in several countries. This study assesses different stakeholders' views on the acceptability of waiting lists in health care, their preferences for priority care of patients, and their judgements on acceptable waiting times for surgical patients. Methods A questionnaire survey was conducted among 257 former patients (82 with varicose veins, 86 with inguinal hernia, and 89 with gallstones, 101 surgeons, 95 occupational physicians, and 65 GPs. Judgements on acceptable waiting times were assessed using vignettes of patients with varicose veins, inguinal hernia, and gallstones. Results Participants endorsed the prioritisation of patients based on clinical need, but not on ability to benefit. The groups had significantly different opinions (p Acceptable waiting times ranged between 2 and 25 weeks depending on the type of disorder (p Conclusion The explicit prioritisation of patients seems an accepted means for reducing the overall burden from waiting lists. The disagreement about appropriate prioritisation criteria and the need for uniformity, however, raises concern about equity when implementing prioritisation in daily practice. Single factor waiting time thresholds seem insufficient for securing timely care provision in the presence of long waiting lists as they do not account for the different consequences of waiting between patients.

Gut microbiome of the Hadza hunter-gatherers.

Science.gov (United States)

Schnorr, Stephanie L; Candela, Marco; Rampelli, Simone; Centanni, Manuela; Consolandi, Clarissa; Basaglia, Giulia; Turroni, Silvia; Biagi, Elena; Peano, Clelia; Severgnini, Marco; Fiori, Jessica; Gotti, Roberto; De Bellis, Gianluca; Luiselli, Donata; Brigidi, Patrizia; Mabulla, Audax; Marlowe, Frank; Henry, Amanda G; Crittenden, Alyssa N

2014-04-15

Human gut microbiota directly influences health and provides an extra means of adaptive potential to different lifestyles. To explore variation in gut microbiota and to understand how these bacteria may have co-evolved with humans, here we investigate the phylogenetic diversity and metabolite production of the gut microbiota from a community of human hunter-gatherers, the Hadza of Tanzania. We show that the Hadza have higher levels of microbial richness and biodiversity than Italian urban controls. Further comparisons with two rural farming African groups illustrate other features unique to Hadza that can be linked to a foraging lifestyle. These include absence of Bifidobacterium and differences in microbial composition between the sexes that probably reflect sexual division of labour. Furthermore, enrichment in Prevotella, Treponema and unclassified Bacteroidetes, as well as a peculiar arrangement of Clostridiales taxa, may enhance the Hadza's ability to digest and extract valuable nutrition from fibrous plant foods.

The control of deliberate waiting strategies in a stop-signal task

Directory of Open Access Journals (Sweden)

R.P. Sylwan

2004-06-01

Full Text Available To inhibit an ongoing flow of thoughts or actions has been largely considered to be a crucial executive function, and the stop-signal paradigm makes inhibitory control measurable. Stop-signal tasks usually combine two concurrent tasks, i.e., manual responses to a primary task (go-task are occasionally countermanded by a stimulus which signals participants to inhibit their response in that trial (stop-task. Participants are always instructed not to wait for the stop-signal, since waiting strategies cause the response times to be unstable, invalidating the data. The aim of the present study was to experimentally control the strategies of waiting deliberately for the stop-signal in a stop-task by means of an algorithm that measured the variation in the reaction times to go-stimuli on-line, and displayed a warning legend urging participants to be faster when their reaction times were more than two standard deviations of the mean. Thirty-four university students performed a stop-task with go- and stop-stimuli, both of which were delivered in the visual modality and were lateralized within the visual field. The participants were divided into two groups (group A, without the algorithm, vs group B, with the algorithm. Group B exhibited lower variability of reaction times to go-stimuli, whereas no significant between-group differences were found in any of the measures of inhibitory control, showing that the algorithm succeeded in controlling the deliberate waiting strategies. Differences between deliberate and unintentional waiting strategies, and anxiety as a probable factor responsible for individual differences in deliberate waiting behavior, are discussed.

Sustainability: orthopaedic surgery wait time management strategies.

Science.gov (United States)

Amar, Claudia; Pomey, Marie-Pascale; SanMartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2015-01-01

The purpose of this paper is to examine Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months. The research design is a multiple cases study. The paper selected three cases: Case 1 - staff were able to maintain compliance with requirements for more than 18 months; Case 2 - staff were able to meet requirements for 18 months, but unable to sustain this level; Case 3 - staff were never able to meet the requirements. For each case the authors interviewed persons involved in the strategies and collected documents. The paper analysed systemic and organizational-level factors; including governance and leadership, culture, resources, methods and tools. Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: an exclusive mandate to do only hip and knee replacement surgery; motivated staff who were not distracted by other concerns; and a strong team spirit. The authors' research highlights an important gradient between three cases regarding the factors that sustain waiting times. The paper show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.

Use of maternity waiting home in rural Zambia.

Science.gov (United States)

van Lonkhuijzen, Luc; Stegeman, Margreet; Nyirongo, Rebecca; van Roosmalen, Jos

2003-04-01

This study was conducted to assess the results from the use of a maternity waiting home, a health facility to which women with high risk pregnancies are referred during the last weeks of pregnancy in rural Zambia. It compared the risk status and pregnancy outcome in women staying as waiters with those women who give birth in hospital after direct admission (non-waiters). Forty seven per-cent of the non-waiters (n = 292) had no maternal risk factors and 85% had no antenatal risk factors as compared to 17% and 78% among the waiters (n = 218). Eighty six per cent of waiters had spontaneous vaginal vertex delivery as compared to 95% of non-waiters. Although the differences in risk status were statistically significant, no differences were found in birth weight and maternal and perinatal mortality. The similar obstetric outcome among waiters with more high risk pregnancies and non-waiters could be interpreted as a possible outcome of the maternity waiting home. When dependent on a proper functioning referral system, such waiting homes can reduce perinatal mortality.

Avian influenza prevalence among hunter-harvested birds in a remote Canadian First Nation community.

Science.gov (United States)

Liberda, Eric N; Meldrum, Richard; Charania, Nadia A; Davey, Robert; Tsuji, Leonard Js

2017-01-01

Avian influenza virus (AIV) prevalence has been associated with wild game and other bird species. The contamination of these birds may pose a greater risk to those who regularly hunt and consumed infected species. Due to resident concerns communicated by local Band Council, hunter-harvested birds from a remote First Nation community in subArctic Ontario, Canada were assessed for AIV. Hunters, and especially those who live a subsistence lifestyle, are at higher risk of AIV exposure due to their increased contact with wild birds, which represent an important part of their diet. Cloacal swabs from 304 harvested game birds representing several species of wild birds commonly hunted and consumed in this First Nation community were analyzed for AIV using real-time reverse transcription polymerase chain reaction. Subtyping was performed using reverse transcription polymerase chain reaction. Sequences were assembled using Lasergene, and the sequences were compared to Genbank. In total, 16 of the 304 cloacal swab samples were positive for AIV. Of the 16 positive samples, 12 were found in mallard ducks, 3 were found in snow geese (wavies), and 1 positive sample was found in partridge. The AIV samples were subtyped, when possible, and found to be positive for the low pathogenic avian influenza virus subtypes H3 and H4. No samples were positive for subtypes of human concern, namely H5 and H7. This work represents the first AIV monitoring program results of hunter-harvested birds in a remote subsistence First Nation community. Community-level surveillance of AIV in remote subsistence hunting communities may help to identify future risks, while educating those who may have the highest exposure about proper handling of hunted birds. Ultimately, only low pathogenic strains of AIV were found, but monitoring should be continued and expanded to safeguard those with the highest exposure risk to AIV.

Sex differences in Nintendo Wii performance as expected from hunter-gatherer selection.

Science.gov (United States)

Cherney, Isabelle D; Poss, Jordan L

2008-06-01

To test the hunter-gatherer theory of cognitive sex differences, men and women each played four video games on a Wii console: two games simulating skills necessary for hunting (navigation and shooting) and two games simulating skills necessary for gathering (fine motor and visual search). Men outperformed women on the two hunting games, whereas there were no sex differences on the gathering skill games. The findings are discussed in terms of evolutionary psychology theory.

A RFID-based JIT Application for Least Waiting Time for Dynamic Smart Diet Customers

Directory of Open Access Journals (Sweden)

Chen Long-Fei

2017-01-01

Full Text Available Waiting in queue is part of everyone’s life. A day may include several different waiting in queue. Waiting in line is always a bit of phenomena for a prosperous restaurant at dinner time. How to manage the queues and keep their feet into customers is the operating challenge facing everyone manager. In addition, rising energy costs and growing demand for protection of the environment call for a shorter waiting queue. Thus, we devise a dynamic smart diet App manager to reduce customer waiting time through radio frequency identification (RFID and just in time (JIT principle to reduce inventory of restaurant food materials, thereby increasing customer satisfaction and loyalty, and improving revenue and social responsibility.

High frequency of lactose intolerance in a prehistoric hunter-gatherer population in northern Europe

Directory of Open Access Journals (Sweden)

Holmlund Gunilla

2010-03-01

Full Text Available Abstract Background Genes and culture are believed to interact, but it has been difficult to find direct evidence for the process. One candidate example that has been put forward is lactase persistence in adulthood, i.e. the ability to continue digesting the milk sugar lactose after childhood, facilitating the consumption of raw milk. This genetic trait is believed to have evolved within a short time period and to be related with the emergence of sedentary agriculture. Results Here we investigate the frequency of an allele (-13910*T associated with lactase persistence in a Neolithic Scandinavian population. From the 14 individuals originally examined, 10 yielded reliable results. We find that the T allele frequency was very low (5% in this Middle Neolithic hunter-gatherer population, and that the frequency is dramatically different from the extant Swedish population (74%. Conclusions We conclude that this difference in frequency could not have arisen by genetic drift and is either due to selection or, more likely, replacement of hunter-gatherer populations by sedentary agriculturalists.

Seasonal and Long-term Variations in 137Cs Among Adults from Swedish Hunter Families

International Nuclear Information System (INIS)

Agren, G.

2001-01-01

To study seasonal variations in 137 Cs, whole-body content measurements of adults from Swedish hunter families have been performed in autumn 1997 and spring 1998. Measurements were performed in three locations, By, Harbo and Gavle, geographically close (within 100 km of each other) but with large differences in ground deposition levels. The hunter families at these three locations were previously measured in 1994. The measured persons were also asked for their frequency of intake of moose, roe-deer, freshwater fish, mushrooms and berries. A statistically significant lower frequency of intake of mushrooms and berries in By, moose, roe-deer and mushrooms in Harbo, and moose in Gavle was found in springtime compared to autumn. In one of the locations, there was a statistically significant lower average 137 Cs whole-body content in spring 1998 than in autumn 1997 while in the other two locations no such effects could be seen. The 137 Cs whole-body content has decreased by 37% from 1994 and to 1998 (including physical decay) correlated to an effective ecological half time of 6 years. (author)

Service seeking experiences of college-aged sexual and intimate partner violence victims with a mental health and/or behavioral disability.

Science.gov (United States)

Nichols, Emily M; Bonomi, Amy; Kammes, Rebecca; Miller, Elizabeth

2018-02-15

To examine mental health service experiences following sexual violence (SV) and intimate partner violence (IPV) victimization among college women with a disability. College women (n = 27, ages 19 to 24) with a disability who experienced at least one SV/IPV occurrence; interviewed July/August 2016. Qualitative study using in-depth interviews, with thematic analysis. Women tended to wait several months (or did not seek care at all) following SV/IPV, because they downplayed their experience (e.g., not wanting to label an experience as "rape"). Those seeking services primarily did so because of escalating mental health concerns. Among service seekers, women were satisfied when professionals validated their experiences/concerns; and were dissatisfied when faced with extended wait time for care and/or professionals unskilled with SV/IPV and mental health. However, women still sought care following negative experiences. Improved access to integrated care for SV/IPV and mental health, along with skilled professionals, is essential.

[Reducing patient waiting time for the outpatient phlebotomy service using six sigma].

Science.gov (United States)

Kim, Yu Kyung; Song, Kyung Eun; Lee, Won Kil

2009-04-01

One of the challenging issues of the outpatient phlebotomy services at most hospitals is that patients have a long wait. The outpatient phlebotomy team of Kyungpook National University Hospital applied six sigma breakthrough methodologies to reduce the patient waiting time. The DMAIC (Define, Measure, Analyze, Improve, and Control) model was employed to approach the project. Two hundred patients visiting the outpatient phlebotomy section were asked to answer the questionnaires at inception of the study to ascertain root causes. After correction, we surveyed 285 patients for same questionnaires again to follow-up the effects. A defect was defined as extending patient waiting time so long and at the beginning of the project, the performance level was 2.61 sigma. Using fishbone diagram, all the possible reasons for extending patient waiting time were captured, and among them, 16 causes were proven to be statistically significant. Improvement plans including a new receptionist, automatic specimen transport system, and adding one phlebotomist were put into practice. As a result, the number of patients waited more than 5 min significantly decreased, and the performance level reached 3.0 sigma in December 2007 and finally 3.35 sigma in July 2008. Applying the six sigma, the performance level of waiting times for blood drawing exceeding five minutes were improved from 2.61 sigma to 3.35 sigma.

Waiting time distribution revealing the internal spin dynamics in a double quantum dot

Science.gov (United States)

Ptaszyński, Krzysztof

2017-07-01

Waiting time distribution and the zero-frequency full counting statistics of unidirectional electron transport through a double quantum dot molecule attached to spin-polarized leads are analyzed using the quantum master equation. The waiting time distribution exhibits a nontrivial dependence on the value of the exchange coupling between the dots and the gradient of the applied magnetic field, which reveals the oscillations between the spin states of the molecule. The zero-frequency full counting statistics, on the other hand, is independent of the aforementioned quantities, thus giving no insight into the internal dynamics. The fact that the waiting time distribution and the zero-frequency full counting statistics give a nonequivalent information is associated with two factors. Firstly, it can be explained by the sensitivity to different timescales of the dynamics of the system. Secondly, it is associated with the presence of the correlation between subsequent waiting times, which makes the renewal theory, relating the full counting statistics and the waiting time distribution, no longer applicable. The study highlights the particular usefulness of the waiting time distribution for the analysis of the internal dynamics of mesoscopic systems.

Teaching Experientially with the Madeline Hunter Method: An Application in a Marketing Research Course

Science.gov (United States)

Burns, Alvin C.

2006-01-01

Due to concerns about the disparity of learning and the high nonresponse rates encountered by student marketing research teams working with sponsors, the author adopted the Hunter Method to restructure his course. This method requires the use of a model onto which students can map their learning via guided practice as well as independent practice.…

Waiting for sparks

Indian Academy of Sciences (India)

Lawrence

college in a village offer? My sister and I were utterly disappointed and resigned to the fact that this would be the end of our foray into science. But surprisingly this was not to be. This undergraduate college, hardly two years into existence in a nondescript village ... cultural evenings helped us forge great friendships!

Survey of Access to GastroEnterology in Canada: The SAGE wait times program

Science.gov (United States)

Leddin, Desmond; Bridges, Ronald J; Morgan, David G; Fallone, Carlo; Render, Craig; Plourde, Victor; Gray, Jim; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E Jan

2010-01-01

BACKGROUND: Assessment of current wait times for specialist health services in Canada is a key method that can assist government and health care providers to plan wisely for future health needs. These data are not readily available. A method to capture wait time data at the time of consultation or procedure has been developed, which should be applicable to other specialist groups and also allows for assessment of wait time trends over intervals of years. METHODS: In November 2008, gastroenterologists across Canada were asked to complete a questionnaire (online or by fax) that included personal demographics and data from one week on at least five consecutive new consultations and five consecutive procedure patients who had not previously undergone a procedure for the same indication. Wait times were collected for 18 primary indications and results were then compared with similar survey data collected in 2005. RESULTS: The longest wait times observed were for screening colonoscopy (201 days) and surveillance of previous colon cancer or polyps (272 days). The shortest wait times were for cancer-likely based on imaging or physical examination (82 days), severe or rapidly progressing dysphagia or odynophagia (83 days), documented iron-deficiency anemia (90 days) and dyspepsia with alarm symptoms (99 days). Compared with 2005 data, total wait times in 2008 were lengthened overall (127 days versus 155 days; Pgastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005. PMID:20186352

Bottlenecks and Waiting Points in Nucleosynthesis in X-ray bursts and Novae

Science.gov (United States)

Smith, Michael S.; Sunayama, Tomomi; Hix, W. Raphael; Lingerfelt, Eric J.; Nesaraja, Caroline D.

2010-08-01

To better understand the energy generation and element synthesis occurring in novae and X-ray bursts, we give quantitative definitions to the concepts of ``bottlenecks'' and ``waiting points'' in the thermonuclear reaction flow. We use these criteria to search for bottlenecks and waiting points in post-processing element synthesis explosion simulations. We have incorporated these into the Computational Infrastructure for Nuclear Astrophysics, a suite of nuclear astrophysics codes available online at nucastrodata.org, so that anyone may perform custom searches for bottlenecks and waiting points.

Consumer behaviour in the waiting area

NARCIS (Netherlands)

Mobach, M.P.

Objective of the study: To determine consumer behaviour in the pharmacy waiting area. Method: The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each

Estimation of the tourism climate in the Hunter Region, Australia, in the early twenty-first century

Science.gov (United States)

Shiue, Ivy; Matzarakis, Andreas

2011-07-01

Existing tourism-related climate information and evaluation are typically based on mean monthly conditions of air temperature and precipitation and do not include thermal perception and other climate parameters relevant for tourists. Here, we quantify climate based on the climate facets relevant to tourism (thermal, physical, aesthetical), and apply the results to the Climate-Tourism-Information-Scheme (CTIS). This paper presents bioclimatic and tourism climatological conditions in the Hunter Region—one of Australia's most popular tourist destinations. In the Hunter Region, generally, temperatures below 15°C occur from April through October, temperatures less than 25°C are expected throughout the whole year, while humidity sits around 50%. As expected, large differences between air temperature and physiologically equivalent temperature (PET) were clearly identified. The widest differences were seen in summer time rather than in the winter period. In addition, cold stress was observed less than 10% of the time in winter while around 40-60% of heat stress was observed in summer time. This correlates with the highest numbers of international visitors, who usually seek a warmer weather, at the beginning of summer time (November and December) and also to the number of domestic visitors, who tend to seek cooler places for recreation and leisure, in late summer (January-March). It was concluded that thermal bioclimate assessment such as PET and CTIS can be applied in the Hunter region, and that local governments and the tourism industry should take an integrated approach to providing more relevant weather and climate information for both domestic and international tourists in the near future.

Patient Satisfaction Is Associated With Time With Provider But Not Clinic Wait Time Among Orthopedic Patients.

Science.gov (United States)

Patterson, Brendan M; Eskildsen, Scott M; Clement, R Carter; Lin, Feng-Chang; Olcott, Christopher W; Del Gaizo, Daniel J; Tennant, Joshua N

2017-01-01

Clinic wait time is considered an important predictor of patient satisfaction. The goal of this study was to determine whether patient satisfaction among orthopedic patients is associated with clinic wait time and time with the provider. The authors prospectively enrolled 182 patients at their outpatient orthopedic clinic. Clinic wait time was defined as the time between patient check-in and being seen by the surgeon. Time spent with the provider was defined as the total time the patient spent in the examination room with the surgeon. The Consumer Assessment of Healthcare Providers and Systems survey was used to measure patient satisfaction. Factors associated with increased patient satisfaction included patient age and increased time with the surgeon (P=.024 and P=.037, respectively), but not clinic wait time (P=.625). Perceived wait time was subject to a high level of error, and most patients did not accurately report whether they had been waiting longer than 15 minutes to see a provider until they had waited at least 60 minutes (P=.007). If the results of the current study are generalizable, time with the surgeon is associated with patient satisfaction in orthopedic clinics, but wait time is not. Further, the study findings showed that patients in this setting did not have an accurate perception of actual wait time, with many patients underestimating the time they waited to see a provider. Thus, a potential strategy for improving patient satisfaction is to spend more time with each patient, even at the expense of increased wait time. [Orthopedics. 2017; 40(1):43-48.]. Copyright 2016, SLACK Incorporated.

Toys are a potential source of cross-infection in general practitioners' waiting rooms.

Science.gov (United States)

Merriman, Eileen; Corwin, Paul; Ikram, Rosemary

2002-01-01

The waiting rooms of general practitioners' surgeries usually have toys provided for children. The level of contamination of these toys and the effectiveness of toy decontamination was investigated in this study. Hard toys from general practitioners' waiting rooms had relatively low levels of contamination, with only 13.5% of toys showing any coliform counts. There were no hard toys with heavy contamination by coliforms or other bacteria. Soft toys were far more likely to be contaminated, with 20% of toys showing moderate to heavy coliform contamination and 90% showing moderate to heavy bacterial contamination. Many waiting-room toys are not cleaned routinely. Soft toys are hard to disinfect and tend to rapidly become recontaminated after cleaning. Conversely, hard toys can be cleaned and disinfected easily. Soft toys in general practitioners' waiting rooms pose an infectious risk and it is therefore recommended that soft toys are unsuitable for doctors' waiting rooms. PMID:11885823

Waiting times for prostate cancer diagnosis in KwaZulu-Natal, South ...

African Journals Online (AJOL)

prostate cancer (an elevated prostate-specific antigen level or abnormal findings on digital rectal examination) wait to have a prostate biopsy. Objectives. To improve the overall efficiency of the prostate biopsy service offered at St Aidan's Regional Hospital, Durban, SA, by quantifying the burden of disease and waiting times ...

Food Sharing among Hadza Hunter-Gatherer Children.

Directory of Open Access Journals (Sweden)

Alyssa N Crittenden

Full Text Available Human prosociality is one of the defining characteristics of our species, yet the ontogeny of altruistic behavior remains poorly understood. The evolution of widespread food sharing in humans helped shape cooperation, family formation, life history, language, and the development of economies of scale. While the behavioral and ecological correlates of food sharing among adults are widely studied, very little is known about food sharing among children. Here, in the first study to analyze the food sharing patterns of hunter-gatherer children, we show that while sharing may be biased towards kin, reciprocity characterizes the majority of all sharing dyads, both related and unrelated. These data lend support to the recent claim that discrimination among kin might be linked with reciprocal altruism theory. Furthermore, we show that age positively correlates with an increase in sharing, both in frequency and amount, supporting recent suggestions that prosocial behaviors and egalitarianism develop strongly in middle childhood when children acquire the normative rules of their society.

Food Sharing among Hadza Hunter-Gatherer Children.

Science.gov (United States)

Crittenden, Alyssa N; Zes, David A

2015-01-01

Human prosociality is one of the defining characteristics of our species, yet the ontogeny of altruistic behavior remains poorly understood. The evolution of widespread food sharing in humans helped shape cooperation, family formation, life history, language, and the development of economies of scale. While the behavioral and ecological correlates of food sharing among adults are widely studied, very little is known about food sharing among children. Here, in the first study to analyze the food sharing patterns of hunter-gatherer children, we show that while sharing may be biased towards kin, reciprocity characterizes the majority of all sharing dyads, both related and unrelated. These data lend support to the recent claim that discrimination among kin might be linked with reciprocal altruism theory. Furthermore, we show that age positively correlates with an increase in sharing, both in frequency and amount, supporting recent suggestions that prosocial behaviors and egalitarianism develop strongly in middle childhood when children acquire the normative rules of their society.

Coccidioidomycosis in armadillo hunters from the state of Ceará, Brazil.

Science.gov (United States)

Brillhante, Raimunda Sâmia Nogueira; Moreira Filho, Renato Evando; Rocha, Marcos Fábio Gadelha; Castelo-Branco, Débora de Souza Collares Maia; Fechine, Maria Auxiliadora Bezerra; Lima, Rita Amanda Chaves de; Picanço, Yuri Vieira Cunha; Cordeiro, Rossana de Aguiar; Camargo, Zoilo Pires de; Queiroz, José Ajax Nogueira; Araujo, Roberto Wagner Bezerra de; Mesquita, Jacó Ricarte Lima de; Sidrim, José Júlio Costa

2012-09-01

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.

Coccidioidomycosis in armadillo hunters from the state of Ceará, Brazil

Directory of Open Access Journals (Sweden)

Raimunda Sâmia Nogueira Brillhante

2012-09-01

Full Text Available Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.

The effect of waiting times on demand and supply for elective surgery: Evidence from Italy.

Science.gov (United States)

Riganti, Andrea; Siciliani, Luigi; Fiorio, Carlo V

2017-09-01

Waiting times are a major policy concern in publicly funded health systems across OECD countries. Economists have argued that, in the presence of excess demand, waiting times act as nonmonetary prices to bring demand for and supply of health care in equilibrium. Using administrative data disaggregated by region and surgical procedure over 2010-2014 in Italy, we estimate demand and supply elasticities with respect to waiting times. We employ linear regression models with first differences and instrumental variables to deal with endogeneity of waiting times. We find that demand is inelastic to waiting times while supply is more elastic. Estimates of demand elasticity are between -0.15 to -0.24. Our results have implications on the effectiveness of policies aimed at increasing supply and their ability to reduce waiting times. Copyright © 2017 John Wiley & Sons, Ltd.

Beyond the drip-line: a high-resolution open-air Holocene hunter-gatherer sequence from highland Lesotho

CSIR Research Space (South Africa)

Mitchell, P

2011-03-01

Full Text Available the drip-line: a high-resolution open-air Holocene hunter-gatherer sequence from highland Lesotho Peter Mitchell1, Ina Plug2, Geoff Bailey3, Ruth Charles4, Amanda Esterhuysen5, Julia Lee Thorp6, Adrian Parker7 & Stephan Woodborne8 The activities...

Surface evolution and carbon sequestration in disturbed and undisturbed wetland soils of the Hunter estuary, southeast Australia

Science.gov (United States)

Howe, A. J.; Rodríguez, J. F.; Saco, P. M.

2009-08-01

The aim of this work was to quantify the soil carbon storage and sequestration rates of undisturbed natural wetlands and disturbed wetlands subject to restriction of tidal flow and subsequent rehabilitation in an Australian estuary. Disturbed and undisturbed estuarine wetlands of the Hunter estuary, New South Wales, Australia were selected as the study sites for this research. Vertical accretion rates of estuarine substrates were combined with soil carbon concentrations and bulk densities to determine the carbon store and carbon sequestration rates of the substrates tested. Relationships between estuary water level, soil evolution and vertical accretion were also examined. The carbon sequestration rate of undisturbed wetlands was lower (15% for mangrove and 55% for saltmarsh) than disturbed wetlands, but the carbon store was higher (65% for mangrove and 60% for saltmarsh). The increased carbon sequestration rate of the disturbed wetlands was driven by substantially higher rates of vertical accretion (95% for mangrove and 345% for saltmarsh). Estuarine wetland carbon stores were estimated at 700-1000 Gg C for the Hunter estuary and 3900-5600 Gg C for New South Wales. Vertical accretion and carbon sequestration rates of estuarine wetlands in the Hunter are at the lower end of the range reported in the literature. The comparatively high carbon sequestration rates reported for the disturbed wetlands in this study indicate that wetland rehabilitation has positive benefits for regulation of atmospheric carbon concentrations, in addition to more broadly accepted ecosystem services.

Iran - waiting and watching

International Nuclear Information System (INIS)

Malhotra, T. C.

2007-01-01

Global oil companies are reported to be divided on the issue of possible energy deals in Iran. Some companies may adopt wait and watch policy before singing a fresh deal with Iran, but there are some oil companies, those are still interested to sign a deal with Iran, despite the risks, even as Tehran decided to expand its uranium enrichment programme rather than complying with a UN Security Council ultimatum to freeze it, which clears the path for further harsher sanctions (author) (ml)

Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

Science.gov (United States)

Liu, Jiming; Tao, Li; Xiao, Bo

2011-01-01

Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU). This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p relationships among different characteristics (except for the effect of throughput on wait time in SU). Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

An improved assay for iduronate 2-sulphate sulphatase in serum and its use in the detection of carriers of the Hunter syndrome

International Nuclear Information System (INIS)

Archer, I.M.; Harper, P.S.; Wusteman, F.S.

1981-01-01

A more sensitive assay procedure has been developed for the enzyme iduronate 2-sulphate sulphatase which is deficient in the Hunter syndrome. The substrate is O-(α-L-idopyranosyluronic acid 2-sulphate)-(1 → 4)-2,5 anhydro-D-[ 3 H-1)mannitol 6-sulphate, which, after incubation, is separated from the product by ion-exchange chromatography on a micro-columnn of Dowex 1 X 2 (Cl - ). Serum analyses can be used to supplement those on hair roots in the detection of carriers of the Hunter syndrome. (Auth.)

Did Not Wait Patient Management Strategy (DNW PMS) Study.

LENUS (Irish Health Repository)

O'Keeffe, Fran

2011-06-14

Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

Did Not Wait Patient Management Strategy (DNW PMS) Study.

LENUS (Irish Health Repository)

2012-02-01

Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

How tolerable is delay? : Consumers' evaluations of internet web sites after waiting

NARCIS (Netherlands)

B.G.C. Dellaert (Benedict); B.E. Kahn

1998-01-01

textabstractHow consumer's waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative

The coexistence of Baird's tapir (Tapirus bairdii) and indigenous hunters in northeastern Honduras.

Science.gov (United States)

Dunn, Marc; Estrada, Nereyda; Smith, Derek A

2012-12-01

The Baird's tapir (Tapirus bairdii) is a popular game species throughout Central America, particularly among indigenous populations, and is currently endangered. Research on Miskitu hunting was conducted over 4 months in a remote region in northeastern Honduras that overlaps with the Río Plátano Biosphere Reserve. The hunting zone was mapped together with hunters and interviews were conducted with elders and other community members about tapir hunting. Results show that tapir harvesting is targeted toward specific habitats at specific times of year. Harvest rates for one year suggest that tapir hunting in the area exceeds estimates of maximum sustainable production. Nevertheless, field surveys reveal the presence of tapir within 1 km of the community, and its harvest tends to be nearby, in both forested and agricultural landscapes, suggesting that the animal has not been depleted in the area. It appears that the existence of forest areas adjacent to the hunting zone that do not experience hunting, together with the anthropogenic habitats created through shifting cultivation, are factors that help explain the presence of tapirs in the area. The article concludes with a discussion regarding the potential positive role of indigenous hunters in tapir conservation throughout its distribution range. © 2012 Wiley Publishing Asia Pty Ltd, ISZS and IOZ/CAS.

Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

Directory of Open Access Journals (Sweden)

Jiming Liu

Full Text Available INTRODUCTION: Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU on the wait time of cardiac surgery unit (SU. METHODS: This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. RESULTS: Results show that: (i wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01; (ii capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01; (iii within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU. CONCLUSION: Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

Heart Surgery Waiting Time: Assessing the Effectiveness of an Action

OpenAIRE

Badakhshan, Abbas; Arab, Mohammad; Gholipour, Mahin; Behnampour, Naser; Saleki, Saeid

2015-01-01

Background: Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient’s problems. Objectives: The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for r...

Impact of visual art on patient behavior in the emergency department waiting room.

Science.gov (United States)

Nanda, Upali; Chanaud, Cheryl; Nelson, Michael; Zhu, Xi; Bajema, Robyn; Jansen, Ben H

2012-07-01

Wait times have been reported to be one of the most important concerns for people visiting emergency departments (EDs). Affective states significantly impact perception of wait time. There is substantial evidence that art depicting nature reduces stress levels and anxiety, thus potentially impacting the waiting experience. To analyze the effect of visual art depicting nature (still and video) on patients' and visitors' behavior in the ED. A pre-post research design was implemented using systematic behavioral observation of patients and visitors in the ED waiting rooms of two hospitals over a period of 4 months. Thirty hours of data were collected before and after new still and video art was installed at each site. Significant reduction in restlessness, noise level, and people staring at other people in the room was found at both sites. A significant decrease in the number of queries made at the front desk and a significant increase in social interaction were found at one of the sites. Visual art has positive effects on the ED waiting experience. Copyright © 2012 Elsevier Inc. All rights reserved.

Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France.

Science.gov (United States)

Molinié, F; Leux, C; Delafosse, P; Ayrault-Piault, S; Arveux, P; Woronoff, A S; Guizard, A V; Velten, M; Ganry, O; Bara, S; Daubisse-Marliac, L; Tretarre, B

2013-10-01

Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France. Copyright © 2013 Elsevier Ltd. All rights reserved.

Reasons for dropping out from a waiting list for in vitro fertilization

NARCIS (Netherlands)

van Dongen, Angelique J. C. M.; Verhagen, Tamara E. M.; Dumoulin, John C. M.; Land, Jolande A.; Evers, Johannes L. H.

2010-01-01

Objective: To determine the incidence of couples dropping out of the in vitro fertilization (IVF) waiting list and to describe the couples' reasons. Design: Prospective cohort study. Setting: Fertility center in an academic hospital. Patient(s): 674 women placed consecutively on the IVF waiting list

Impact of waiting on the perception of service quality in nuclear medicine

NARCIS (Netherlands)

De Man, S; Vlerick, P; Gemmel, P; De Bondt, P; Matthys, D; Dierckx, RA

Background This is the first study examining the link between waiting and various dimensions of perceived service quality in nuclear medicine. Methods We tested the impact of selected waiting experience variables on the evaluation of service quality, measured using the Servqual tool, of 406 patients

Ancient DNA reveals lack of continuity between neolithic hunter-gatherers and contemporary Scandinavians

DEFF Research Database (Denmark)

Malmström, Helena; Gilbert, M Thomas P; Thomas, Mark G

2009-01-01

of the two cultures in Scandinavia has been cited as an argument against population replacement between the Mesolithic and the present [7, 8]. Through analysis of DNA extracted from ancient Scandinavian human remains, we show that people of the Pitted Ware culture were not the direct ancestors of modern......]. Furthermore, our data are consistent with the view that the eastern Baltic represents a genetic refugia for some of the European hunter-gatherer populations....

Worth the Wait? Using Past Patterns to Determine Wait Periods for E-Books Released after Print

Science.gov (United States)

Kohn, Karen

2018-01-01

This paper asks if there is an optimal wait period for e-books that balances libraries' desire to acquire books soon after their publication with the frequent desire to purchase books electronically whenever feasible. Analyzing 13,043 titles that Temple University Libraries received on its e-preferred approval plan in 2014-15, the author looks at…

Effect of socioeconomic deprivation on waiting time for cardiac surgery: retrospective cohort study

Science.gov (United States)

Pell, Jill P; Pell, Alastair C H; Norrie, John; Ford, Ian; Cobbe, Stuart M

2000-01-01

Objective To determine whether the priority given to patients referred for cardiac surgery is associated with socioeconomic status. Design Retrospective study with multivariate logistic regression analysis of the association between deprivation and classification of urgency with allowance for age, sex, and type of operation. Multivariate linear regression analysis was used to determine association between deprivation and waiting time within each category of urgency, with allowance for age, sex, and type of operation. Setting NHS waiting lists in Scotland. Participants 26 642 patients waiting for cardiac surgery, 1 January 1986 to 31 December 1997. Main outcome measures Deprivation as measured by Carstairs deprivation category. Time spent on NHS waiting list. Results Patients who were most deprived tended to be younger and were more likely to be female. Patients in deprivation categories 6 and 7 (most deprived) waited about three weeks longer for surgery than those in category 1 (mean difference 24 days, 95% confidence interval 15 to 32). Deprived patients had an odds ratio of 0.5 (0.46 to 0.61) for having their operations classified as urgent compared with the least deprived, after allowance for age, sex, and type of operation. When urgent and routine cases were considered separately, there was no significant difference in waiting times between the most and least deprived categories. Conclusions Socioeconomically deprived patients are thought to be more likely to develop coronary heart disease but are less likely to be investigated and offered surgery once it has developed. Such patients may be further disadvantaged by having to wait longer for surgery because of being given lower priority. PMID:10617517

Big game hunting practices, meanings, motivations and constraints: a survey of Oregon big game hunters

Science.gov (United States)

Suresh K. Shrestha; Robert C. Burns

2012-01-01

We conducted a self-administered mail survey in September 2009 with randomly selected Oregon hunters who had purchased big game hunting licenses/tags for the 2008 hunting season. Survey questions explored hunting practices, the meanings of and motivations for big game hunting, the constraints to big game hunting participation, and the effects of age, years of hunting...

Using obsidian transfer distances to explore social network maintenance in late Pleistocene hunter-gatherers.

Science.gov (United States)

Pearce, Eiluned; Moutsiou, Theodora

2014-12-01

Social behaviour is notoriously difficult to study archaeologically and it is unclear how large the networks of prehistoric humans were, or how they remained connected. Maintaining social cohesion was crucial for early humans because social networks facilitate cooperation and are imperative for survival and reproduction. Recent hunter-gatherer social organisation typically comprises a number of nested layers, ranging from the nuclear family through to the ~1500-strong ethnolinguistic tribe. Here we compare maximum obsidian transfer distances from the late Pleistocene with ethnographic data on the size of the geographic areas associated with each of these social grouping layers in recent hunter-gatherers. The closest match between the two is taken to indicate the maximum social layer within which contact could be sustained by Pleistocene hominins. Within both the (sub)tropical African and Subarctic biomes, the maximum obsidian transfer distances for Pleistocene modern humans (~200km and ~400km respectively) correspond to the geographic ranges of the outermost tribal layer in recent hunter-gatherers. This suggests that modern humans could potentially sustain the cohesion of their entire tribe at all latitudes, even though networks are more dispersed nearer the poles. Neanderthal obsidian transfer distances (300km) indicate that although Neanderthal home ranges are larger than those of low latitude hominins, Neanderthals travelled shorter distances than modern humans living at the same high latitudes. We argue that, like modern humans, Neanderthals could have maintained tribal cohesion, but that their tribes were substantially smaller than those of contemporary modern humans living in similar environments. The greater time taken to traverse the larger modern human tribal ranges may have limited the frequency of their face-to-face interactions and thus necessitated additional mechanisms to ensure network connectivity, such as the exchange of symbolic artefacts

TSA Security Checkpoint Wait Times – API (PMIS)

Data.gov (United States)

Department of Homeland Security — TSA operational data including: Airport wait time (hourly) data Airport throughput (hourly) data Prohibited item (hourly) data Monthly Objectives Report (MOR) data...

Analysing passenger arrivals rates and waiting time at bus stops

OpenAIRE

Kaparias, I.; Rossetti, C.; Trozzi, V.

2015-01-01

The present study investigates the rather under-explored topic of passenger waiting times at public transport facilities. Using data collected from part of London’s bus network by means of physical counts, measurements and observations, and complemented by on-site passenger interviews, the waiting behaviour is analysed for a number of bus stops served by different numbers of lines. The analysis employs a wide range of statistical methods and tools, and concentrates on three aspects: passenger...

Posted wait times an added advantage to multi-facility systems?

Science.gov (United States)

2011-04-01

Methodist Le Bonheur Healthcare in Memphis, TN, is investigating whether posting ED wait times via the internet can positively impact patient flow in the six EDs the health system operates in the Memphis region. The health system began posting wait times in August 2010, resulting in increases in ED volume ranging from 6% to 10%. The health system is monitoring ED arrivals by zip code to assess any impact on load balancing between its busy EDs. One marketing challenge is that a competitor is posting ED wait times as well, but it is posting the time it takes for a patient to be placed in a bed as opposed to the door-to-provider time that Methodist Le Bonheur is posting. The approach has the most impact on lower-acuity patients, but experts worry that in the future, payers may not be reimbursed for ED care for these patients.

Waiting for Art: The Experience of Real Time in Sculpture

Directory of Open Access Journals (Sweden)

Elizabeth Buhe

2011-05-01

Full Text Available Why and how does some contemporary art make us wait, and why does the beholder choose to stay? This study seeks to answer this question by exploring what happens to the viewer while waiting in front of a “time sculpture,” a term coined here to mean a three-dimensional artwork that is dynamic over a set period of time. Through an analysis of select works by artists Anish Kapoor, Amelia Whitelaw, Michael Sailstorfer, and Roman Signer, the article posits that while in front of these time sculptures, the viewer experiences an anxiety of waiting and temporal confusion that glues him to the spot. Ultimately, by drawing upon Henri Bergson’s concept of duration, the essay suggests that the viewership of time sculpture allows for a heightened state of perception. Normal 0 false false false EN-US X-NONE X-NONE

MRI findings in the mild type of mucopolysaccharidosis II (Hunter's syndrome)

International Nuclear Information System (INIS)

Shimoda-Matsubayashi, S.; Ito, T.; Hattori, N.; Okuma, Y.; Mizuno, Y.; Kuru, Y.; Sumie, H.

1990-01-01

Neuroradiological findings in a 44-year-old male with the typical mild type of Hunter's disease are reported. Cranial MRI revealed patchy areas of increased and decreased signals in T1- and T2-weighted images in the thalamus and the basal ganglia giving rise to a honey comb-like appearance as a whole. The deep white matter showed high signals in the T2-weighted image. To our knowledge, the honey comb-like appearance has never been reported in this disorder. Deposition of mucopolysaccharides and/or glycolipids and increase in fluid content seem to be responsible for these changes. (orig.)

The formation of fire residues associated with hunter-gatherers in humid tropical environments: A geo-ethnoarchaeological perspective

Science.gov (United States)

Friesem, David E.; Lavi, Noa; Madella, Marco; Boaretto, Elisabetta; Ajithparsad, P.; French, Charles

2017-09-01

Tropical forests have been an important human habitat and played a significant role in early human dispersal and evolution. Likewise, the use of fire, besides being one of the exceptional characteristics of humans, serves as a marker for human evolution. While the use of fire by prehistoric hunter-gatherers is relatively well documented in arid and temperate environments, the archaeological evidence in humid tropical environment is to date very limited. We first review the archaeological evidence for hunter-gatherer use of fire in humid tropical environments and suggest that better understanding of formation processes is required. We present a geo-ethnoarchaeological study from South India, involving ethnography, excavations and laboratory-based analyses in order to build a new framework to study fire residues in humid tropical forests associated with hunter-gatherer's use of fire. Ethnographic observations point to a dynamic and ephemeral use of hearths. Hearths location were dictated by the social and ever-changing social dynamics of the site. The hearths deposited small amount of residues which were later swept on a daily basis, re-depositing ash and charcoal in waste areas and leaving only a microscopic signal in the original location. Particular acidic conditions and intensive biological activity within tropical sediments result in the complete dissolution of ash and bones while favouring the preservation of charcoal and phytoliths. Consequently, the identification of fire residues in humid tropical forests and the reconstruction of the human use of fire must involve multi-proxy microscopic analysis to detect its micro-signatures.

Transition in the waiting-time distribution of price-change events in a global socioeconomic system

Science.gov (United States)

Zhao, Guannan; McDonald, Mark; Fenn, Dan; Williams, Stacy; Johnson, Nicholas; Johnson, Neil F.

2013-12-01

The goal of developing a firmer theoretical understanding of inhomogeneous temporal processes-in particular, the waiting times in some collective dynamical system-is attracting significant interest among physicists. Quantifying the deviations between the waiting-time distribution and the distribution generated by a random process may help unravel the feedback mechanisms that drive the underlying dynamics. We analyze the waiting-time distributions of high-frequency foreign exchange data for the best executable bid-ask prices across all major currencies. We find that the lognormal distribution yields a good overall fit for the waiting-time distribution between currency rate changes if both short and long waiting times are included. If we restrict our study to long waiting times, each currency pair’s distribution is consistent with a power-law tail with exponent near to 3.5. However, for short waiting times, the overall distribution resembles one generated by an archetypal complex systems model in which boundedly rational agents compete for limited resources. Our findings suggest that a gradual transition arises in trading behavior between a fast regime in which traders act in a boundedly rational way and a slower one in which traders’ decisions are driven by generic feedback mechanisms across multiple timescales and hence produce similar power-law tails irrespective of currency type.

Costly waiting for the future gas energy

International Nuclear Information System (INIS)

1999-01-01

The article discusses solutions while waiting for the pollution free gas power plant and points out that Norway will have to import Danish power from coal and Swedish nuclear energy for a long time yet. Various future scenarios are mentioned

The impact of different prioritisation policies on waiting times: case studies of Norway and Scotland.

Science.gov (United States)

Januleviciute, Jurgita; Askildsen, Jan Erik; Kaarboe, Oddvar; Holmås, Tor Helge; Sutton, Matt

2013-11-01

We investigate the distributional consequences of two different waiting times initiatives, one in Norway, and one in Scotland. The primary focus of Scotland's recent waiting time reforms, introduced in 2003, and modified in 2005 and 2007, has been on reducing maximum waiting times through the imposition of high profile national targets accompanied by increases in resources. In Norway, the focus of the reform introduced in September 2004, has been on assigning patients referred to hospital a maximum waiting time based on disease severity, the expected benefit and the cost-effectiveness of the treatment. We use large, national administrative datasets from before and after each of these reforms and assign priority groups based on the maximum waiting times stipulated in medical guidelines. The analysis shows that the lowest priority patients benefited most from both reforms. This was at the cost of longer waiting times for patients that should have been given higher priority in Norway, while Scotland's high priority patients remained unaffected. Copyright © 2013 Elsevier Ltd. All rights reserved.

Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study

Directory of Open Access Journals (Sweden)

Petrelli Alessio

2012-08-01

Full Text Available Abstract Background Widespread literature on inequity in healthcare access and utilization has been published, but research on socioeconomic differences in waiting times is sparse and the evidence is fragmentary and controversial. The objective of the present study is the analysis of the relationship between individual socioeconomic level and waiting times for in-hospital elective surgery. Methods We retrospectively studied the waiting times experienced by patients registered on hospital waiting lists for 6 important surgical procedures by using the Hospital Discharge Database (HDD of the Piedmont Region (4,000,000 inhabitants in the North West of Italy from 2006 to 2008. The surgical procedures analyzed were: coronary artery by-pass (CABG, angioplasty, coronarography, endarterectomy, hip replacement and cholecystectomy. Cox regression models were estimated to study the relationship between waiting times and educational level taking into account the confounding effect of the following factors: sex, age, comorbidity, registration period, and Local Health Authorities (LHA as a proxy of supply. Results Median waiting times for low educational level were higher than for high educational level for all the selected procedures. Differences were particularly high for endarterectomy and hip replacement. For all considered procedures, except CABG, an inverse gradient between waiting times and educational level was observed: the conditional probabilities of undergoing surgery were lower among individuals with a low to middle level education than for individuals with a higher level of education after adjustment for sex, age, comorbidities, registration period, and LHAs. For most procedures the effect decreases over the follow up period. Conclusions The results of the study show evidence of inequalities in access to elective surgery in Italy. Implementation of policies aimed to promote national information initiatives that guarantee wider access to those

How Do Hunter-Gatherer Children Learn Subsistence Skills? : A Meta-Ethnographic Review.

Science.gov (United States)

Lew-Levy, Sheina; Reckin, Rachel; Lavi, Noa; Cristóbal-Azkarate, Jurgi; Ellis-Davies, Kate

2017-12-01

Hunting and gathering is, evolutionarily, the defining subsistence strategy of our species. Studying how children learn foraging skills can, therefore, provide us with key data to test theories about the evolution of human life history, cognition, and social behavior. Modern foragers, with their vast cultural and environmental diversity, have mostly been studied individually. However, cross-cultural studies allow us to extrapolate forager-wide trends in how, when, and from whom hunter-gatherer children learn their subsistence skills. We perform a meta-ethnography, which allows us to systematically extract, summarize, and compare both quantitative and qualitative literature. We found 58 publications focusing on learning subsistence skills. Learning begins early in infancy, when parents take children on foraging expeditions and give them toy versions of tools. In early and middle childhood, children transition into the multi-age playgroup, where they learn skills through play, observation, and participation. By the end of middle childhood, most children are proficient food collectors. However, it is not until adolescence that adults (not necessarily parents) begin directly teaching children complex skills such as hunting and complex tool manufacture. Adolescents seek to learn innovations from adults, but they themselves do not innovate. These findings support predictive models that find social learning should occur before individual learning. Furthermore, these results show that teaching does indeed exist in hunter-gatherer societies. And, finally, though children are competent foragers by late childhood, learning to extract more complex resources, such as hunting large game, takes a lifetime.

Hepatitis E virus antibody prevalence in hunters from a district in Central Germany, 2013: a cross-sectional study providing evidence for the benefit of protective gloves during disembowelling of wild boars.

Science.gov (United States)

Schielke, A; Ibrahim, V; Czogiel, I; Faber, M; Schrader, C; Dremsek, P; Ulrich, R G; Johne, R

2015-10-22

In Germany, 17% of the general human population have antibodies to hepatitis E virus (HEV) (recomLine HEV-IgG/IgM immunoassay [Mikrogen GmbH]). Wild boars represent an animal reservoir for HEV genotype 3, which is the common genotype in Germany. We estimated the seroprevalence among hunters with contact to wild boars to identify factors that may be associated with past or present HEV infection. In 2013, the local veterinarian authority in a district in Central Germany attended meetings of hunters who provided blood specimens and completed a questionnaire collecting information on age, sex, hunting-related activities and consumption of wild boar meat. Specimens of wild boars were taken during drive hunts in this district during the season 2012/2013. All specimens were tested for HEV RNA and anti-HEV IgM and IgG antibodies. Log-binomial regression was used to estimate prevalence ratios (PR) for the hunters. Of 126 hunters (median age 55; 94% male) 21% tested positive for anti-HEV IgG antibodies (95% confidence interval [CI] 13-28%) (recomWell HEV IgG assay [Mikrogen GmbH]). Anti-HEV prevalence was highest in the age group of the 70-79-year-olds (67%; 95% CI 39-95%). Wild boars showed an average anti-HEV prevalence of 41%. HEV RNA was detected in 4/22 (18%) liver specimens and in 1/22 (4.5%) muscle specimens. Most wild boars were tested positive for HEV RNA (3/10; 30%) and HEV-specific antibodies (7/15; 47%) in the southwestern part of the district. Hunters preferring this hunting ground had a lower anti-HEV prevalence when gloves were frequently used during disembowelling of wild boars compared to hunters using gloves never or infrequently (age-adjusted PR 0.12; 95% CI 0.02-0.86). Hunters may benefit from wearing gloves when in contact with blood or body fluids of HEV animal reservoirs. Anti-HEV prevalence among the hunters of this study did not significantly differ from that of the general population suggesting that other factors play a major role in the

Sci-Fri AM: Quality, Safety, and Professional Issues 04: Predicting waiting times in Radiation Oncology using machine learning

International Nuclear Information System (INIS)

Joseph, Ackeem; Herrera, David; Hijal, Tarek; Hendren, Laurie; Leung, Alvin; Wainberg, Justin; Sawaf, Marya; Maxim, Gorshkov; Maglieri, Robert; Keshavarz, Mehryar; Kildea, John

2016-01-01

We describe a method for predicting waiting times in radiation oncology. Machine learning is a powerful predictive modelling tool that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The patient waiting experience remains one of the most vexing challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick and in pain, to worry about when they will receive the care they need. In radiation oncology, patients typically experience three types of waiting: Waiting at home for their treatment plan to be prepared Waiting in the waiting room for daily radiotherapy Waiting in the waiting room to see a physician in consultation or follow-up These waiting periods are difficult for staff to predict and only rough estimates are typically provided, based on personal experience. In the present era of electronic health records, waiting times need not be so uncertain. At our centre, we have incorporated the electronic treatment records of all previously-treated patients into our machine learning model. We found that the Random Forest Regression model provides the best predictions for daily radiotherapy treatment waiting times (type 2). Using this model, we achieved a median residual (actual minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes. The main features that generated the best fit model (from most to least significant) are: Allocated time, median past duration, fraction number and the number of treatment fields.

Sci-Fri AM: Quality, Safety, and Professional Issues 04: Predicting waiting times in Radiation Oncology using machine learning

Energy Technology Data Exchange (ETDEWEB)

Joseph, Ackeem; Herrera, David; Hijal, Tarek; Hendren, Laurie; Leung, Alvin; Wainberg, Justin; Sawaf, Marya; Maxim, Gorshkov; Maglieri, Robert; Keshavarz, Mehryar; Kildea, John [McGill University Health Centre (Canada)

2016-08-15

We describe a method for predicting waiting times in radiation oncology. Machine learning is a powerful predictive modelling tool that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The patient waiting experience remains one of the most vexing challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick and in pain, to worry about when they will receive the care they need. In radiation oncology, patients typically experience three types of waiting: Waiting at home for their treatment plan to be prepared Waiting in the waiting room for daily radiotherapy Waiting in the waiting room to see a physician in consultation or follow-up These waiting periods are difficult for staff to predict and only rough estimates are typically provided, based on personal experience. In the present era of electronic health records, waiting times need not be so uncertain. At our centre, we have incorporated the electronic treatment records of all previously-treated patients into our machine learning model. We found that the Random Forest Regression model provides the best predictions for daily radiotherapy treatment waiting times (type 2). Using this model, we achieved a median residual (actual minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes. The main features that generated the best fit model (from most to least significant) are: Allocated time, median past duration, fraction number and the number of treatment fields.

Wait times in the emergency department for patients with mental illness

Science.gov (United States)

Atzema, Clare L.; Schull, Michael J.; Kurdyak, Paul; Menezes, Natasja M.; Wilton, Andrew S.; Vermuelen, Marian J.; Austin, Peter C.

2012-01-01

Background: It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department. Methods: We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period. Results: The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41–147 min v. median 75 [IQR 36–140] min; p < 0.001). The median time from the decision to admit the patient to hospital to ward transfer was markedly shorter for patients with mental illness than for other patients (median 74 [IQR 15–215] min v. median 152 [IQR 45–605] min; p < 0.001). After adjustment for other variables, patients with mental illness waited 10 minutes longer to see a physician compared with other patients during noncrowded periods (95% confidence interval [CI] 8 to 11), but they waited significantly less time than other patients as crowding increased (mild crowding: −14 [95% CI −12 to −15] min; moderate crowding: −38 [95% CI −35 to −42] min; severe crowding: −48 [95% CI −39 to −56] min; p < 0.001). Interpretation: Patients with mental illness were triaged appropriately in Ontario’s emergency departments. These patients waited less time than other patients to see a physician under crowded conditions and only slightly longer under noncrowded conditions. PMID:23148052

Reading of Waiting, Time and Social Change in S. N. A. Agoro's ...

African Journals Online (AJOL)

It is against this backdrop that we attempt to explore the depiction and treatment of waiting, time and social change in the dramatic universe of existentialism created by some playwrights who have not been given scholarly attention. The study shall therefore undertake a dialectical consideration of the concept of waiting and ...

Research on the waiting time of passengers and escalator energy consumption at the railway station

Energy Technology Data Exchange (ETDEWEB)

Ma, Wei-wu; Liu, Xiao-yan; Li, Liqing; Shi, Xiangnan; Zhou, Chenn Q. [School of Energy Science and Engineering, Central South University, Changsha 410083 (China)

2009-12-15

Based on the Little Formula and the classical queuing model of multi-channel M vertical stroke D vertical stroke n, the relation of the average queue length, the maximum waiting time and the escalator service intensity were identified and the waiting time simulation model was established. With the passenger delivery data at A railway station in China and the probability distribution model of waiting time, a detailed analysis was made on the escalator allocation, power and energy consumption on holidays, ordinary working days and the largest-passengers-volume days; meanwhile, the fixed and variable energy consumption were compared and studied when the waiting time are 5, 10 and 30 s. The result shows that the waiting time settings affect the allocation and the energy consumption of the escalators and the fixed energy consumption takes 70%. (author)

Patient satisfaction with wait times at an emergency ophthalmology on-call service.

Science.gov (United States)

Chan, Brian J; Barbosa, Joshua; Moinul, Prima; Sivachandran, Nirojini; Donaldson, Laura; Zhao, Lily; Mullen, Sarah J; McLaughlin, Christopher R; Chaudhary, Varun

2018-04-01

To assess patient satisfaction with emergency ophthalmology care and determine the effect provision of anticipated appointment wait time has on scores. Single-centre, randomized control trial. Fifty patients triaged at the Hamilton Regional Eye Institute (HREI) from November 2015 to July 2016. Fifty patients triaged for next-day appointments at the HREI were randomly assigned to receive standard-of-care preappointment information or standard-of-care information in addition to an estimated appointment wait time. Patient satisfaction with care was assessed postvisit using the modified Judgements of Hospital Quality Questionnaire (JHQQ). In determining how informing patients of typical wait times influenced satisfaction, the Mann-Whitney U test was performed. As secondary study outcomes, we sought to determine patient satisfaction with the intervention material using the Fisher exact test and the effect that wait time, age, sex, education, mobility, and number of health care providers seen had on satisfaction scores using logistic regression analysis. The median JHQQ response was "very good" (4/5) and between "very good" and "excellent" (4.5/5) in the intervention and control arms, respectively. There was no difference in patient satisfaction between the cohorts (Mann-Whitney U = 297.00, p = 0.964). Logistic regression analysis demonstrated that wait times influenced patient satisfaction (OR = 0.919, 95% CI 0.864-0.978, p = 0.008). Of the intervention arm patients, 92.0% (N = 23) found the preappointment information useful, whereas only 12.5% (N = 3) of the control cohort patients noted the same (p < 0.001). Provision of anticipated wait time information to patients in an emergency on-call ophthalmology clinic did not influence satisfaction with care as captured by the JHQQ. Copyright © 2018 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Influence patterns of transportation parameters in suburban traffic on fatigue of passengers during bus waiting

Directory of Open Access Journals (Sweden)

Тетяна Михайлівна Григорова

2015-05-01

Full Text Available The change of transport fatigue of suburban traffic passengers during waiting transport waiting is investigated. The results of the processing site examinations allow defining the regularities of the influence of parameters of transportation process of passengers to change index activity of regulatory systems in passenger waiting at stopping points of suburban traffic. The discovered patterns were mathematically formalized

The Impact of Patient-to-Patient Interaction in Health Facility Waiting Rooms on Their Perception of Health Professionals.

Science.gov (United States)

Willis, William Kent; Ozturk, Ahmet Ozzie; Chandra, Ashish

2015-01-01

Patients have to wait in waiting rooms prior to seeing the physician. But there are few studies that demonstrate what they are actually doing in the waiting room. This exploratory study was designed to investigate the types of discussions that patients in the waiting room typically engage in with other patients and how the conversations affected their opinion on general reputation of the clinic, injections/blocks as treatment procedures, waiting time, time spent with the caregiver, overall patient satisfaction, and the pain medication usage policy. The study demonstrates that patient interaction in the waiting room has a positive effect on patient opinion of the pain clinic and the caregivers.

Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

Science.gov (United States)

Charoenthanakit, C; Junchotikul, P; Sittiudomsuk, R; Saiyud, A; Pratumphai, P

2016-04-01

A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P multimedia program had good average, 4.58. Copyright © 2016 Elsevier Inc. All rights reserved.

Client waiting time in an urban primary health care centre in Lagos ...

African Journals Online (AJOL)

Background: Primary Health Care is the usual entry point into the health system and has the potential to touch the lives of most people. However one of the reasons for poor uptake of health services at primary health care facilities in Nigeria is long waiting time. This study was carried out to assess client waiting time and ...

Intake of wine, beer and spirits and waiting time to pregnancy.

Science.gov (United States)

Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo; Grønbaek, Morten

2003-09-01

A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. Self-reported data were used for 29,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. All levels of wine intake compared with non-wine drinking or with consumption of beer or spirits had subfecundity odds ratios between 0.7 and 0.9. No association was seen regarding beer drinking, while the association with spirits was J-shaped. Our findings suggest that wine drinkers have slightly shorter waiting times to pregnancy than both non-wine drinkers and consumers of other alcoholic beverages. Whether this is an effect of wine itself or the characteristics of the wine drinker is not known.

Intake of wine, beer and spirits and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

2003-01-01

BACKGROUND: A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers...... appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. METHODS: Self-reported data were used for 29......,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. RESULTS: All levels of wine intake compared with non-wine drinking or with consumption of beer...

The waiting time distribution as a graphical approach to epidemiologic measures of drug utilization

DEFF Research Database (Denmark)

Hallas, J; Gaist, D; Bjerrum, L

1997-01-01

that effectively conveys some essential utilization parameters for a drug. The waiting time distribution for a group of drug users is a charting of their first prescription presentations within a specified time window. For a drug used for chronic treatment, most current users will be captured at the beginning...... of the window. After a few months, the graph will be dominated by new, incident users. As examples, we present waiting time distributions for insulin, ulcer drugs, systemic corticosteroids, antidepressants, and disulfiram. Appropriately analyzed and interpreted, the waiting time distributions can provide...... information about the period prevalence, point prevalence, incidence, duration of use, seasonality, and rate of prescription renewal or relapse for specific drugs. Each of these parameters has a visual correlate. The waiting time distributions may be an informative supplement to conventional drug utilization...

Decreasing Psychiatric Admission Wait Time in the Emergency Department by Facilitating Psychiatric Discharges.

Science.gov (United States)

Stover, Pamela R; Harpin, Scott

2015-12-01

Limited capacity in a psychiatric unit contributes to long emergency department (ED) admission wait times. Regulatory and accrediting agencies urge hospitals nationally to improve patient flow for better access to care for all types of patients. The purpose of the current study was to decrease psychiatric admission wait time from 10.5 to 8 hours and increase the proportion of patients discharged by 11 a.m. from 20% to 50%. The current study compared pre- and post-intervention data. Plan-Do-Study-Act cycles aimed to improve discharge processes and timeliness through initiation of new practices. Admission wait time improved to an average of 5.1 hours (t = 3.87, p = 0.006). The proportion of discharges occurring by 11 a.m. increased to 46% (odds ratio = 3.42, p planning processes and timeliness in a psychiatric unit significantly decreased admission wait time from the ED, improving access to psychiatric care. Copyright 2015, SLACK Incorporated.

Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping

Directory of Open Access Journals (Sweden)

Tara Sampalli

2015-07-01

Full Text Available Background Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions.

Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost.

Science.gov (United States)

Kim, Byungjoon B J; Delbridge, Theodore R; Kendrick, Dawn B

2017-07-10

Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value A new streaming scheme of patients' flow may improve the performance of fast track system.

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department.

Science.gov (United States)

Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

2016-01-01

Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the "bed area" server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study.

Science.gov (United States)

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2007-11-16

As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

Directory of Open Access Journals (Sweden)

Laupacis Andreas

2007-11-01

Full Text Available Abstract Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1 over 25 documents (e.g. strategic planning reports, public updates, and (2 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario

Advertising Emergency Department Wait Times

OpenAIRE

Weiner, Scott G

2013-01-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED se...

WAITING FOR GODOT - ABSURD TEATER

OpenAIRE

Thorup, Rasmus; Leitthof, Anneliese; Kock, Felizia; Johansson, Lars; Moustgaard, Mie; Rosenkrands, Tobias; Staalhøj, Sarah; Jeppesen, Freja

2013-01-01

This project aims to reassess and discuss the different interpretations of Samuel Beckett’s play Waiting for Godot, made by Martin Esslin and Michael Y. Bennett. The analytical tools needed to enable the reassessment is found in the dimensional courses of Philosophy and Scientific theory (Da: Filosofi og Videnskabsteori) and Text-analysis (Da: Tekst og Tegn) and the discussion is based on Esslin’s The Theatre of The Absurd and Bennett’s Reassessing The Theatre of The Absurd. The conclusion is...

Urgency coding as a dynamic tool in management of waiting lists for psychogeriatric nursing home care in The Netherlands

NARCIS (Netherlands)

Meiland, F. J. M.; Danse, J. A. C.; Wendte, J. F.; Gunning-Schepers, L. J.; Klazinga, N. S.

2002-01-01

Criteria are used to prioritise patients on waiting lists for health care services. This is also true for waiting lists for admission to psychogeriatric nursing homes. A patient's position on these latter waiting lists is determined by (changes in) urgency and waiting time. The present article

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

Directory of Open Access Journals (Sweden)

Geeta Yadav

Full Text Available Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services.A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service.Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05. Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR = 0.4-3.4, followed by Urgent care (9.0 weeks; IQR = 2.1-12.9, then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4. Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks.Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

Science.gov (United States)

Yadav, Geeta; Goldberg, Hanna R; Barense, Morgan D; Bell, Chaim M

2016-01-01

Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4-3.4), followed by Urgent care (9.0 weeks; IQR = 2.1-12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

To Construction and Standardization of the Waiting Anxiety Questionnaire (WAQ in Iran.

Directory of Open Access Journals (Sweden)

Sodeh Tavakkoli

2014-09-01

Full Text Available This study aimed to develop and validate a questionnaire to measure waiting anxiety.This was a cross-sectional study. Extensive review of literature and expert opinions were used to develop and validate the waiting anxiety questionnaire. A sample of 321 participants was recruited through random cluster sampling (n= 190 Iranian men and n= 131 women. The participants filled out WAQ, the Speilberger's State-Trait Anxiety Inventory (STAI, Burtner Rating scale (BRS and Eysenk Personality questionnaire (EPQ for adults.Internal consistency of WAQ was revealed, meaning that all the 20 items were highly correlated with the total score. The Cronbach alpha equaled 0.83 for the Waiting Anxiety Questionnaire. The Pearson correlation coefficient of the questionnaire with the STAI, BRS and extraversion and neuroticism subscales of EPQ was 0.65, 0.78, - 0.47 and 0.43, respectively, which confirmed its convergent and divergent validity. Factors analysis extracting four cognitive, behavioral, sentimental and physiological factors could explain 67% of the total variance with an Eigen value of greater than 1.Our findings suggest that WAQ possesses appropriate validity and reliability to measure the individuals' anxiety during the waiting time.

Burst wait time simulation of CALIBAN reactor at delayed super-critical state

International Nuclear Information System (INIS)

Humbert, P.; Authier, N.; Richard, B.; Grivot, P.; Casoli, P.

2012-01-01

In the past, the super prompt critical wait time probability distribution was measured on CALIBAN fast burst reactor [4]. Afterwards, these experiments were simulated with a very good agreement by solving the non-extinction probability equation [5]. Recently, the burst wait time probability distribution has been measured at CEA-Valduc on CALIBAN at different delayed super-critical states [6]. However, in the delayed super-critical case the non-extinction probability does not give access to the wait time distribution. In this case it is necessary to compute the time dependent evolution of the full neutron count number probability distribution. In this paper we present the point model deterministic method used to calculate the probability distribution of the wait time before a prescribed count level taking into account prompt neutrons and delayed neutron precursors. This method is based on the solution of the time dependent adjoint Kolmogorov master equations for the number of detections using the generating function methodology [8,9,10] and inverse discrete Fourier transforms. The obtained results are then compared to the measurements and Monte-Carlo calculations based on the algorithm presented in [7]. (authors)

Burst wait time simulation of CALIBAN reactor at delayed super-critical state

Energy Technology Data Exchange (ETDEWEB)

Humbert, P. [Commissariat a l' Energie Atomique CEA, Centre de Bruyeres-le-Chatel, 91297 Arpajon (France); Authier, N.; Richard, B.; Grivot, P.; Casoli, P. [Commissariat a l' Energie Atomique CEA, Centre de Valduc, 21120 Is-sur-Tille (France)

2012-07-01

In the past, the super prompt critical wait time probability distribution was measured on CALIBAN fast burst reactor [4]. Afterwards, these experiments were simulated with a very good agreement by solving the non-extinction probability equation [5]. Recently, the burst wait time probability distribution has been measured at CEA-Valduc on CALIBAN at different delayed super-critical states [6]. However, in the delayed super-critical case the non-extinction probability does not give access to the wait time distribution. In this case it is necessary to compute the time dependent evolution of the full neutron count number probability distribution. In this paper we present the point model deterministic method used to calculate the probability distribution of the wait time before a prescribed count level taking into account prompt neutrons and delayed neutron precursors. This method is based on the solution of the time dependent adjoint Kolmogorov master equations for the number of detections using the generating function methodology [8,9,10] and inverse discrete Fourier transforms. The obtained results are then compared to the measurements and Monte-Carlo calculations based on the algorithm presented in [7]. (authors)

The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada

Science.gov (United States)

Leddin, Desmond; Armstrong, David; Borgaonkar, Mark; Bridges, Ronald J; Fallone, Carlo A; Telford, Jennifer J; Chen, Ying; Colacino, Palma; Sinclair, Paul

2013-01-01

BACKGROUND: Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time. METHODS: During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005. RESULTS: Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (Pgastroenterology services continue to exceed recommended targets, remain unchanged since 2008 and exceed wait times reported in 2005. PMID:23472243

24 CFR 982.203 - Special admission (non-waiting list): Assistance targeted by HUD.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Special admission (non-waiting list... Admission to Tenant-Based Program § 982.203 Special admission (non-waiting list): Assistance targeted by HUD... family residing in a multifamily rental housing project when HUD sells, forecloses or demolishes the...

Randomized controlled trial on promoting influenza vaccination in general practice waiting rooms.

Directory of Open Access Journals (Sweden)

Christophe Berkhout

Full Text Available Most of general practitioners (GPs use advertising in their waiting rooms for patient's education purposes. Patients vaccinated against seasonal influenza have been gradually lessening. The objective of this trial was to assess the effect of an advertising campaign for influenza vaccination using posters and pamphlets in GPs' waiting rooms.Registry based 2/1 cluster randomized controlled trial, a cluster gathering the enlisted patients of 75 GPs aged over 16 years. The trial, run during the 2014-2015 influenza vaccination campaign, compared patient's awareness from being in 50 GPs' standard waiting rooms (control group versus that of waiting in 25 rooms from GPs who had received and exposed pamphlets and one poster on influenza vaccine (intervention group, in addition to standard mandatory information. The main outcome was the number of vaccination units delivered in pharmacies. Data were extracted from the SIAM-ERASME claim database of the Health Insurance Fund of Lille-Douai (France. The association between the intervention (yes/no and the main outcome was assessed through a generalized estimating equation. Seventy-five GPs enrolled 10,597 patients over 65 years or suffering from long lasting diseases (intervention/control as of 3781/6816 patients from October 15, 2014 to February 28, 2015. No difference was found regarding the number of influenza vaccination units delivered (Relative Risk (RR = 1.01; 95% Confidence interval: 0.97 to 1.05; p = 0.561.Effects of the monothematic campaign promoting vaccination against influenza using a poster and pamphlets exposed in GPs' waiting rooms could not be demonstrated.

Willingness to Pay for a Maternity Waiting Home Stay in Zambia

Science.gov (United States)

White, Emily E.; Biemba, Godfrey; Mataka, Kaluba; Scott, Nancy

2016-01-01

Introduction Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability. Methods We conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context. Results The maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use. Discussion While Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households. PMID:28419708

Hunter-gatherer adaptations and environmental change in the southern Great Basin: The evidence from Pahute and Rainier mesas

Energy Technology Data Exchange (ETDEWEB)

Pippin, L.C.

1998-06-01

This paper reviews the evidence for fluctuations in past environments in the southern Great Basin and examines how these changes may have affected the strategies followed by past hunter and gatherers in their utilization of the resources available on a highland in this region. The evidence used to reconstruct past environments for the region include botanical remains from packrat middens, pollen spectra from lake and spring deposits, faunal remains recovered from archaeological and geologic contexts, tree-ring indices from trees located in sensitive (tree-line) environments, and eolian, alluvial and fluvial sediments deposited in a variety of contexts. Interpretations of past hunter and gatherer adaptive strategies are based on a sample of 1,311 archaeological sites recorded during preconstruction surveys on Pahute and Rainier mesas in advance of the US Department of Energy`s nuclear weapons testing program. Projectile point chronologies and available tree-ring, radiocarbon, thermoluminescence and obsidian hydration dates were used to assign these archaeological sites to specific periods of use.

Vessel guardians: sculpture and graphics related to the ceramics of NorthEastern European hunter-gatherers

Directory of Open Access Journals (Sweden)

Ekaterina Aleksandrovna Kashina

2015-12-01

Full Text Available North-Eastern European hunter-gatherer ceramic sculptures, relief sculptures and graphic images on vessels are discussed. Five groups of finds are distinguished according to their chronology (4000–2500 BC cal and represented subject (birds, human head, human figure, mammal head etc.. Their production believes to be a female craft, their making had ritual aims and their emerging was independent from any influences of pastoral/agricultural societies.

The association between waiting for psychological therapy and therapy outcomes as measured by the CORE-OM.

Science.gov (United States)

Beck, Alison; Burdett, Mark; Lewis, Helen

2015-06-01

To investigate the impact of waiting for psychological therapy on client well-being as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) global distress (GD) score. Global distress scores were retrieved for all clients referred for psychological therapy in a secondary care mental health service between November 2006 and May 2013 and who had completed a CORE-OM at assessment and first session. GD scores for a subgroup of 103 clients who had completed a CORE-OM during the last therapy session were also reviewed. The study sample experienced a median wait of 41.14 weeks between assessment and first session. The relationship between wait time from referral acceptance to assessment, and assessment GD score was not significant. During the period between assessment and first session no significant difference in GD score was observed. Nevertheless 29.1% of the sample experienced reliable change; 16.0% of clients reliably improved and 13.1% reliably deteriorated whilst waiting for therapy. Demographic factors were not found to have a significant effect on the change in GD score between assessment and first session. Waiting time was associated with post-therapy outcomes but not to a degree which was meaningful. The majority of individuals (54.4%), regardless of whether they improved or deteriorated whilst waiting for therapy, showed reliable improvement at end of therapy as measured by the CORE-OM. The majority of GD scores remained stable while waiting for therapy; however, 29.1% of secondary care clients experienced either reliable improvement or deterioration. Irrespective of whether they improved, deteriorated or remained unchanged whilst waiting for therapy, most individuals who had a complete end of therapy assessment showed reliable improvements following therapy. There was no significant difference in GD score between assessment and first session recordings. A proportion of clients (29.1%) showed reliable change, either improvement or

Social networks and cooperation in hunter-gatherers.

Science.gov (United States)

Apicella, Coren L; Marlowe, Frank W; Fowler, James H; Christakis, Nicholas A

2012-01-25

Social networks show striking structural regularities, and both theory and evidence suggest that networks may have facilitated the development of large-scale cooperation in humans. Here, we characterize the social networks of the Hadza, a population of hunter-gatherers in Tanzania. We show that Hadza networks have important properties also seen in modernized social networks, including a skewed degree distribution, degree assortativity, transitivity, reciprocity, geographic decay and homophily. We demonstrate that Hadza camps exhibit high between-group and low within-group variation in public goods game donations. Network ties are also more likely between people who give the same amount, and the similarity in cooperative behaviour extends up to two degrees of separation. Social distance appears to be as important as genetic relatedness and physical proximity in explaining assortativity in cooperation. Our results suggest that certain elements of social network structure may have been present at an early point in human history. Also, early humans may have formed ties with both kin and non-kin, based in part on their tendency to cooperate. Social networks may thus have contributed to the emergence of cooperation.

Intake of wine, beer and spirits and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

2003-01-01

A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to have...... fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy....

The ecology of the patient visit: physical attractiveness, waiting times, and perceived quality of care.

Science.gov (United States)

Becker, Franklin; Douglass, Stephanie

2008-01-01

This study examined the relationship between the attractiveness of the physical environment of healthcare facilities and patient perceptions of quality, service, and waiting time through systematic observations and patient satisfaction surveys at 7 outpatient practices at Weill Cornell Medical Center. Findings indicate positive correlations between more attractive environments and higher levels of perceived quality, satisfaction, staff interaction, and reduction of patient anxiety. The comparison of actual observed time and patients' perception of time showed that patients tend to overestimate shorter waiting times and underestimate longer waiting times in both the waiting area and the examination room. Further examinations of the way outpatient-practice environments impact patient and staff perceptions and how those perceptions impact behavior and medical outcomes are suggested.

Study on the interaction between the food and beverage servicescape and customer waiting experience

Directory of Open Access Journals (Sweden)

Yang, Chih-Yun

2014-11-01

Full Text Available Past research on the customer waiting experience tended to focus on two primary areas, namely managing the wait and managing the perception of the wait. Very few studies conducted in-depth analysis and discus¬sion of how external environmental factors affect the experience of customer waiting, which it was also viewed as a negative factor that decreases customer satisfaction toward service. However, in reality, the waiting experience can be positive as a result of certain environmental factors, and subsequently increases customer satisfaction toward the service. This study aimed to further examine the potential influencing factors arising from the servicescape during the customer waiting process, and the interaction between the servicescape and customers during their wait time. This paper is based on the causal feedback loop. A system dynamics perspective was applied to construct a conceptual systems model showing the interaction between the servi¬cescape and the customer waiting experience.Estudios previos sobre la experiencia de espera de los clients suelen centrarse sobre todo en dos áreas: la gestión de la espera y la gestión de la experiencia de espera. Existen muy pocos estudios que hayan realizado análisis y discusiones en profundidad sobre cómo los factores ambientales externos afectan a la experiencia de espera de los clientes, que se ha considerado siempre como un factor negativo que reduce la satisfacción del cliente hacia el servicio. Sin embargo, la experiencia de espera puede incrementar en reali¬dad la satisfacción del cliente hacia el servicio. Este estudio pretende profundizar en la influencia potencial de los factores que surgen del “servicescape” durante el proceso de espera del cliente, así como la interacción entre el “servicescape” y los clientes durante el tiempo de espera. Ese artículo se basa en el bucle de retroa¬limentación causal. Desde la perspectiva de la dinámica de sistemas se construye un

A model to prioritize access to elective surgery on the basis of clinical urgency and waiting time

Directory of Open Access Journals (Sweden)

Santori Gregorio

2009-01-01

Full Text Available Abstract Background Prioritization of waiting lists for elective surgery represents a major issue in public systems in view of the fact that patients often suffer from consequences of long waiting times. In addition, administrative and standardized data on waiting lists are generally lacking in Italy, where no detailed national reports are available. This is true although since 2002 the National Government has defined implicit Urgency-Related Groups (URGs associated with Maximum Time Before Treatment (MTBT, similar to the Australian classification. The aim of this paper is to propose a model to manage waiting lists and prioritize admissions to elective surgery. Methods In 2001, the Italian Ministry of Health funded the Surgical Waiting List Info System (SWALIS project, with the aim of experimenting solutions for managing elective surgery waiting lists. The project was split into two phases. In the first project phase, ten surgical units in the largest hospital of the Liguria Region were involved in the design of a pre-admission process model. The model was embedded in a Web based software, adopting Italian URGs with minor modifications. The SWALIS pre-admission process was based on the following steps: 1 urgency assessment into URGs; 2 correspondent assignment of a pre-set MTBT; 3 real time prioritization of every referral on the list, according to urgency and waiting time. In the second project phase a prospective descriptive study was performed, when a single general surgery unit was selected as the deployment and test bed, managing all registrations from March 2004 to March 2007 (1809 ordinary and 597 day cases. From August 2005, once the SWALIS model had been modified, waiting lists were monitored and analyzed, measuring the impact of the model by a set of performance indexes (average waiting time, length of the waiting list and Appropriate Performance Index (API. Results The SWALIS pre-admission model was used for all registrations in the

The design and testing of interactive hospital spaces to meet the needs of waiting children.

Science.gov (United States)

Biddiss, Elaine; McPherson, Amy; Shea, Geoffrey; McKeever, Patricia

2013-01-01

To design an innovative interactive media display in a pediatric hospital clinic waiting space that addresses the growing demand for accessible, contact-surface-free options for play. In healthcare settings, waiting can be anxiety provoking for children and their accompanying family members. Opportunities for positive distraction have been shown to reduce waiting anxiety, leading to positive health outcomes. An interactive media display, ScreenPlay, was created and evaluated using a participatory design approach and a combination of techniques including quality function deployment and mixed data elicitation methods (questionnaires, focus groups, and observations). The user and organizational design requirements were established and used to review contemporary strategies for positive distraction in healthcare waiting spaces and to conceptualize and test ScreenPlay. Ten staff members, 11 children/youths, and 6 parents participated in the design and evaluation of ScreenPlay. ScreenPlay provided a positive, engaging experience without the use of contact surfaces through which infections can be spread. It was accessible to children, youth, and adults of all motor abilities. All participants strongly agreed that the interactive media display would improve the healthcare waiting experience. ScreenPlay is an interactive display that is the result of a successful model for the design of healthcare waiting spaces that is collaborative, interdisciplinary, and responsive to the needs of its community. Design process, healing environments, hospital, interdisciplinary, pediatric.

What Are We Waiting For Customer Wait Time, Fill Rate, And Marine Corps Equipment Operational Availability

Science.gov (United States)

2016-12-01

directed the use of Customer Wait Time (CWT) as a measure of supply chain performance (Department of Defense [DOD], 2000). CWT is defined as “the total...time elapsed between issuance of a customer order and satisfaction of the order” (United States Marine Corps [USMC], 2014, pp. 2–29). In theory...rate is a widely used metric for setting inventory levels and is also a useful measure of customer satisfaction . In general, high fill-rates can be

Maternity waiting homes: A panacea for maternal/neonatal ...

African Journals Online (AJOL)

women to inadequately equipped delivery settings 4,5. Eritrea has made some ... Maternity waiting homes were introduced in Eritrea in 2007 as a strategy to mitigate .... 24(4):472-8. 5. Chandramohan D, Cutts F, Millard P The effect of stay in.

Stroke Education in an Emergency Department Waiting Room: a Comparison of Methods

Directory of Open Access Journals (Sweden)

Yu-Feng Yvonne Chan1

2015-03-01

Full Text Available Background: Since the emergency department (ED waiting room hosts a large, captive audience of patients and visitors, it may be an ideal location for conduct-ing focused stroke education. The aim of this study was to assess the effective-ness of various stroke education methods.Methods: Patients and visitors of an urban ED waiting room were randomized into one of the following groups: video, brochure, one-to-one teaching, combi-nation of these three methods, or control group. We administered a 13-question multiple-choice test to assess stroke knowledge prior to, immediately after, and at 1 month post-education to patients and visitors in the ED waiting room.Results: Of 4 groups receiving education, all significantly improved their test scores immediately post intervention (test scores 9.4±2.5-10.3±2.0, P<0.01. At 1 month, the combination group retained the most knowledge (9.4±2.4 exceed-ing pre-intervention and control scores (both 6.7±2.6, P<0.01.Conclusion: Among the various stroke education methods delivered in the ED waiting room, the combination method resulted in the highest knowledge reten-tion at 1-month post intervention.

Improving Patients Experience in Peadiatric Emergency Waiting Room.

Science.gov (United States)

Ehrler, Frederic; Siebert, Johan; Wipfli, Rolf; Duret, Cyrille; Gervaix, Alain; Lovis, Christian

2016-01-01

When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear.

The everyday of people waiting for kidney transplantation

Directory of Open Access Journals (Sweden)

Micheli Rezende Ferreira Cruz

2016-01-01

Full Text Available Objective: to understand the everyday of people experiencing the waiting list for kidney transplantation. Methods: this is a qualitative research, based on Heideggerian phenomenology. 14 deponents participated in hemodialysis and registered on the waiting list for kidney transplantation. Phenomenological interview with the research question: How is the experience awaiting the kidney transplant? Color marking technique for analyzing demarcating lines that show similarity, of these, emerged the essential structures that enabled the units of meaning. Results: changing lifestyles, imposing a routine and rigidity of treatment signaling everyday stress and exhaustion of hemodialysis being. Emerging from the modes of gossip, curiosity, and bureaucracy, unfolding-inauthentic and impersonal regarding their care. Conclusion: hemodialysis dependence and awaiting kidney transplantation transfer care for family/professional caregivers. To understand the everyday marked by impositions and restrictions, the reflection about how professional health interaction/being-care becomes important.

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care

Science.gov (United States)

Yadav, Geeta; Goldberg, Hanna R.; Barense, Morgan D.; Bell, Chaim M.

2016-01-01

Background Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. Methods A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Results Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care. PMID:27632206

An examination of gender bias on the eighth-grade MEAP science test as it relates to the Hunter Gatherer Theory of Spatial Sex Differences

Science.gov (United States)

Armstrong-Hall, Judy Gail

The purpose of this study was to apply the Hunter-Gatherer Theory of sex spatial skills to responses to individual questions by eighth grade students on the Science component of the Michigan Educational Assessment Program (MEAP) to determine if sex bias was inherent in the test. The Hunter-Gatherer Theory on Spatial Sex Differences, an original theory, that suggested a spatial dimorphism concept with female spatial skill of pattern recall of unconnected items and male spatial skills requiring mental movement. This is the first attempt to apply the Hunter-Gatherer Theory on Spatial Sex Differences to a standardized test. An overall hypothesis suggested that the Hunter-Gatherer Theory of Spatial Sex Differences could predict that males would perform better on problems involving mental movement and females would do better on problems involving the pattern recall of unconnected items. Responses to questions on the 1994-95 MEAP requiring the use of male spatial skills and female spatial skills were analyzed for 5,155 eighth grade students. A panel composed of five educators and a theory developer determined which test items involved the use of male and female spatial skills. A MANOVA, using a random sample of 20% of the 5,155 students to compare male and female correct scores, was statistically significant, with males having higher scores on male spatial skills items and females having higher scores on female spatial skills items. Pearson product moment correlation analyses produced a positive correlation for both male and female performance on both types of spatial skills. The Hunter-Gatherer Theory of Spatial Sex Differences appears to be able to predict that males could perform better on the problems involving mental movement and females could perform better on problems involving the pattern recall of unconnected items. Recommendations for further research included: examination of male/female spatial skill differences at early elementary and high school levels to

Application of Queueing Theory to the Analysis of Changes in Outpatients' Waiting Times in Hospitals Introducing EMR.

Science.gov (United States)

Cho, Kyoung Won; Kim, Seong Min; Chae, Young Moon; Song, Yong Uk

2017-01-01

This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college.

Science.gov (United States)

Scull, Tracy Marie; Kupersmidt, Janis Beth; Malik, Christina Valerie; Keefe, Elyse Mallory

2018-04-01

To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. 184 community college students (ages 18-19) participated in the study from April-December 2015. Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.

Environmental injustice and air pollution in coal affected communities, Hunter Valley, Australia

Energy Technology Data Exchange (ETDEWEB)

Higginbotham, N.; Freeman, S.; Connor, L.; Albrecht, G. [University of Newcastle, Callaghan, NSW (Australia). School of Medicine & Public Health

2010-03-15

The authors describe environmental injustice from air pollution in the Upper Hunter, Australia, and analyse the inaction of state authorities in addressing residents' health concerns. Obstacles blocking a public-requested health study and air monitoring include: the interdependence of state government and corporations in reaping the economic benefits of coal production; lack of political will, regulatory inertia and procedural injustice; and study design and measurement issues. We analyse mining- and coal-related air pollution in a contested socio-political arena, where residents, civil society and local government groups struggle with corporations and state government over the burden of imposed health risk caused by air pollution.

Reachability analysis to design zero-wait entry guidance

NARCIS (Netherlands)

Gonzalez-Puerta, Alejandro; Mooij, E.; Valles, Celia Yabar

2018-01-01

This paper presents a novel reentry guidance architecture that aims to improve cur- rent mission safety by enabling zero-wait orbital aborts. To do so, an on-board trajectory planner based on Adaptive Multivariate Pseudospectral Interpolation (AMPI) is devel- oped. This planner generates

Tools for Management for Grassland Ecosystem Sustainability: Thinking "Outside the Box"

Science.gov (United States)

Gerald J. Gottfried

2004-01-01

Grassland ecosystem management is dynamic and has adapted to the development of new tools and ideas. Our ancestors were indirectly managing grasslands when they learned to move livestock to take advantage of better water and greener forage. One could argue that even their hunting of grassland wildlife, especially the use of fire to drive animals to waiting hunters, had...

Transformation of a Pediatric Primary Care Waiting Room: Creating a Bridge to Community Resources.

Science.gov (United States)

Henize, Adrienne W; Beck, Andrew F; Klein, Melissa D; Morehous, John; Kahn, Robert S

2018-06-01

Introduction Children and families living in poverty frequently encounter social risks that significantly affect their health and well-being. Physicians' near universal access to at-risk children and their parents presents opportunities to address social risks, but time constraints frequently interfere. We sought to redesign our waiting room to create a clinic-to-community bridge and evaluate the impact of that redesign on family-centered outcomes. Methods We conducted a pre-post study of a waiting room redesign at a large, academic pediatric primary care center. Design experts sought input about an optimal waiting room from families, community partners and medical providers. Family caregivers were surveyed before and after redesign regarding perceived availability of help with social needs and access to community resources, and hospitality and feelings of stress. Pre-post differences were assessed using the Chi square or Wilcoxon rank sum test. Results The key redesign concepts that emerged included linkages to community organizations, a welcoming environment, and positive distractions for children. A total of 313 caregiver surveys were completed (pre-160; post-153). Compared to pre-redesign, caregivers surveyed post-redesign were significantly more likely to perceive the waiting room as a place to obtain help connecting to community resources and find information about clinical and educational resources (both p < 0.05). Families were also significantly more likely to report the waiting room as more welcoming and relaxing, with sufficient privacy and space (all p < 0.05). Discussion Waiting rooms, typically a place of wasted time and space, can be redesigned to enhance families' engagement and connection to community resources.

The Influence of Ambient Scent and Music on Patients' Anxiety in a Waiting Room of a Plastic Surgeon

NARCIS (Netherlands)

Fenko, Anna; Loock, Caroline

2014-01-01

OBJECTIVE: This study investigates the influence of ambient scent and music, and their combination, on patients' anxiety in a waiting room of a plastic surgeon. BACKGROUND: Waiting for an appointment with a plastic surgeon can increase a patient's anxiety. It is important to make the waiting time

Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

DEFF Research Database (Denmark)

Lyhne, N M; Christensen, A; Alanin, M C

2013-01-01

BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

DNW--"did not wait" or "demographic needing work": a study of the profile of patients who did not wait to be seen in an Irish emergency department.

LENUS (Irish Health Repository)

Gilligan, P

2009-11-01

Patients who fail to wait for medical assessment in the emergency department (ED) have been referred to in the international literature as "did not wait" (DNW) or "left without being seen" (LWBS) patients or, indeed, simply as "walkouts". This is taken as a performance indicator internationally. In common with many countries, Ireland has very considerable problems in the delivery of ED care due largely to inadequate resources and the inappropriate use of EDs as holding bays for admitted patients. This is the first study of this size to profile the DNW phenomenon in Ireland.

Period Determination of Asteroid Targets Observed at Hunters Hill Observatory: May 2009 - September 2010

Science.gov (United States)

Higgins, David

2011-01-01

Lightcurves for 27 asteroids were obtained at the Hunters Hill Observatory (HHO) from 2009 May through 2010 September: 308 Polyxo, 326 Tamara, 369 Aeria, 504 Cora, 822 Lalage, 1164 Kobolda, 1619 Ueta, 1625 The NORC, 1685 Toro, 2189 Zaragoza, 2287 Kalmykia, 2639 Planman, 3695 Fiaia, 4786 Tatianina, 5333 Kanaya, (5452) 1937 NN, 6170 Levasseur, 7741 Fedoseev, 14815 Rutberg, 15724 Zille, 16525 Shumarinaiko, (21996) 1993 XP31, (29729) 1999 BY1, (35404) 1997 YV5, (39087) 2000 VN50, (66146) 1998 TU3, and (101769) 1999 FF52.

Measured elemental transfer factors for boreal hunter/gatherer scenarios: fish, game and berries

International Nuclear Information System (INIS)

Sheppard, S.C.; Long, J.M.; Sanipelli, B.

2010-01-01

The environmental assessment of long-term nuclear waste management requires data to estimate food chain transfers for radionuclides in various environmental settings. For key elements such as iodine (I) and chlorine (Cl), there is a paucity of transfer factor data, particularly outside of agricultural food chains. This study dealt with transfers of I, Cl and 28 other elements to foods that would be typical of boreal hunter/gatherer lifestyles, as well as being common foods for modern recreational and subsistence hunters. Food/substrate concentration ratios (CRs) and related transfer factors for eight species of widely distributed fish, whitetail deer (Odocoileus virginianus), Canada geese (Branta canadensis) and wild blueberries (Vaccinium myrtilloides) were measured and compared to the literature. Limited data were obtained for caribou (Rangifer tarandus), elk (Cervus elaphus) and moose (Alces americanus). Freshwater sediment Kd values and CRs for a ubiquitous freshwater macrophyte were also obtained. The CRs for I in fish were 29 L kg -1 in edible muscle (fillets) of large-bodied species and 85 L kg -1 for whole, small-bodied fish. The log CRs for fish and macrophytes were correlated across elements. For several elements, the Kds for sediments in deep water were ∼4-fold higher than for littoral samples. The elemental transfers to wild animals for some elements were notably different than the literature indicates for domestic animals. It is argued that the transfer data obtained using indigenous elements from real environmental settings, as opposed to contaminant elements in experimental or impacted environments, are especially relevant to assessment of long-term impacts.

Measured elemental transfer factors for boreal hunter/gatherer scenarios: fish, game and berries

Energy Technology Data Exchange (ETDEWEB)

Sheppard, S.C., E-mail: sheppards@ecomatters.co [ECOMatters Inc., WB Lewis Business Centre, 24 Aberdeen Avenue, Pinawa, Manitoba R0E 1L0 (Canada); Long, J.M.; Sanipelli, B. [ECOMatters Inc., WB Lewis Business Centre, 24 Aberdeen Avenue, Pinawa, Manitoba R0E 1L0 (Canada)

2010-11-15

The environmental assessment of long-term nuclear waste management requires data to estimate food chain transfers for radionuclides in various environmental settings. For key elements such as iodine (I) and chlorine (Cl), there is a paucity of transfer factor data, particularly outside of agricultural food chains. This study dealt with transfers of I, Cl and 28 other elements to foods that would be typical of boreal hunter/gatherer lifestyles, as well as being common foods for modern recreational and subsistence hunters. Food/substrate concentration ratios (CRs) and related transfer factors for eight species of widely distributed fish, whitetail deer (Odocoileus virginianus), Canada geese (Branta canadensis) and wild blueberries (Vaccinium myrtilloides) were measured and compared to the literature. Limited data were obtained for caribou (Rangifer tarandus), elk (Cervus elaphus) and moose (Alces americanus). Freshwater sediment Kd values and CRs for a ubiquitous freshwater macrophyte were also obtained. The CRs for I in fish were 29 L kg{sup -1} in edible muscle (fillets) of large-bodied species and 85 L kg{sup -1} for whole, small-bodied fish. The log CRs for fish and macrophytes were correlated across elements. For several elements, the Kds for sediments in deep water were {approx}4-fold higher than for littoral samples. The elemental transfers to wild animals for some elements were notably different than the literature indicates for domestic animals. It is argued that the transfer data obtained using indigenous elements from real environmental settings, as opposed to contaminant elements in experimental or impacted environments, are especially relevant to assessment of long-term impacts.

Profile of idursulfase for the treatment of Hunter syndrome

Directory of Open Access Journals (Sweden)

Sestito S

2015-07-01

Full Text Available Simona Sestito, Ferdinando Ceravolo, Michele Grisolia, Elisa Pascale, Licia Pensabene, Daniela Concolino Department of Pediatrics, University Magna Graecia of Catanzaro, Catanzaro, Italy Abstract: Mucopolysaccharidosis type II (MPS II; Hunter syndrome is a rare X-linked lysosomal storage disorder caused by deficiency of the enzyme iduronate-2-sulfatase (IDS. Enzyme replacement therapy (ERT with recombinant human IDS, available since 2005, is currently the most appropriate treatment for this progressive, multisystemic, chronic, and life-threatening disease. Efficacy and safety of therapy with idursulfase have been assessed in several clinical trials, and confirmed in many clinical reports. Long-term follow-up of patients receiving ERT has demonstrated the importance of an early onset of treatment with idursulfase, before irreversible pathological changes occur. Intravenously administered idursulfase is not able to cross the blood–brain barrier, so neurological signs and symptoms cannot benefit from ERT, still remaining a major challenge in the treatment of MPS II. Keywords: MPS II, glycosaminoglycans, enzyme replacement therapy, ERT

Estimating the waiting time of multi-priority emergency patients with downstream blocking.

Science.gov (United States)

Lin, Di; Patrick, Jonathan; Labeau, Fabrice

2014-03-01

To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital.

Self-Stabilization of Wait-Free Shared Memory Objects

NARCIS (Netherlands)

Hoepman, J.H.; Papatriantafilou, Marina; Tsigas, Philippas

2002-01-01

This paper proposes a general definition of self-stabilizing wait-free shared memory objects. The definition ensures that, even in the face of processor failures, every execution after a transient memory failure is linearizable except for an a priori bounded number of actions. Shared registers have

Determinants of variability in waiting times for radiotherapy in the treatment of breast cancer

International Nuclear Information System (INIS)

Bouche, Gauthier; Ingrand, Isabelle; Mathoulin-Pelissier, Simone; Ingrand, Pierre; Breton-Callu, Christel; Migeot, Virginie

2010-01-01

Purpose: To examine psycho-social and geographic determinants of delay in starting radiotherapy in early invasive breast cancer patients. Material and methods: Waiting time was defined as the time elapsed until the beginning of radiotherapy, starting from the date of surgery (in absence of chemotherapy) or from the end of chemotherapy. Results: Eight hundred and ninety six women aged 24-89 took part in the study. Mean waiting times were 52 days (sd = 19) between surgery and radiotherapy and 31 days (sd = 14) between chemotherapy and radiotherapy. Differences between radiotherapy centres (p < 0.0001) accounted for 30% and 12%, respectively, of total variance in waiting times. Using a multivariate mixed analysis that took into account intra-centre correlation, the time between surgery and radiotherapy was shorter for young patients (p = 0.020), those who had sought information about their illness (p = 0.024) and those who had undergone surgery and radiotherapy in the same centre (p = 0.021). On the other hand, no patient characteristic was associated with the time between chemotherapy and radiotherapy. Conclusion: Centre is the major factor that explained longer waiting times in radiotherapy, emphasising the structural hypothesis. It is important to pursue initiatives to improve the organization within radiotherapy centres and then to verify that these initiatives have succeeded in shortening waiting times.

Waiting for transplant: physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care.

Science.gov (United States)

Anthony, Samantha J; Annunziato, Rachel A; Fairey, Elise; Kelly, Vicky L; So, Stephanie; Wray, Jo

2014-08-01

The waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been given to the physical, psychological, or social impact of the waiting period in the literature. In this review, we discuss the physical, nutritional, and psychosocial implications of the waiting period for child and adolescent transplant candidates and the impact on their parents and siblings. We identify areas for future research and provide recommendations for clinical practice to support children, adolescents, and families during the waiting period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Slow Earthquake Hunters: A New Citizen Science Project to Identify and Catalog Slow Slip Events in Geodetic Data

Science.gov (United States)

Bartlow, N. M.

2017-12-01

Slow Earthquake Hunters is a new citizen science project to detect, catalog, and monitor slow slip events. Slow slip events, also called "slow earthquakes", occur when faults slip too slowly to generate significant seismic radiation. They typically take between a few days and over a year to occur, and are most often found on subduction zone plate interfaces. While not dangerous in and of themselves, recent evidence suggests that monitoring slow slip events is important for earthquake hazards, as slow slip events have been known to trigger damaging "regular" earthquakes. Slow slip events, because they do not radiate seismically, are detected with a variety of methods, most commonly continuous geodetic Global Positioning System (GPS) stations. There is now a wealth of GPS data in some regions that experience slow slip events, but a reliable automated method to detect them in GPS data remains elusive. This project aims to recruit human users to view GPS time series data, with some post-processing to highlight slow slip signals, and flag slow slip events for further analysis by the scientific team. Slow Earthquake Hunters will begin with data from the Cascadia subduction zone, where geodetically detectable slow slip events with a duration of at least a few days recur at regular intervals. The project will then expand to other areas with slow slip events or other transient geodetic signals, including other subduction zones, and areas with strike-slip faults. This project has not yet rolled out to the public, and is in a beta testing phase. This presentation will show results from an initial pilot group of student participants at the University of Missouri, and solicit feedback for the future of Slow Earthquake Hunters.

Effects of Wait Time When Communicating with Children Who Have Sensory and Additional Disabilities

Science.gov (United States)

Johnson, Nicole; Parker, Amy T.

2013-01-01

Introduction: This study utilized wait-time procedures to determine if they are effective in helping children with deafblindness or multiple disabilities that include a visual impairment communicate in their home. Methods: A single subject with an alternating treatment design was used for the study. Zero- to one-second wait time was utilized…

Preferences for symmetry in human faces in two cultures: data from the UK and the Hadza, an isolated group of hunter-gatherers.

Science.gov (United States)

Little, Anthony C; Apicella, Coren L; Marlowe, Frank W

2007-12-22

Many studies show agreement within and between cultures for general judgements of facial attractiveness. Few studies, however, have examined the attractiveness of specific traits and few have examined preferences in hunter-gatherers. The current study examined preferences for symmetry in both the UK and the Hadza, a hunter-gatherer society of Tanzania. We found that symmetry was more attractive than asymmetry across both the cultures and was more strongly preferred by the Hadza than in the UK. The different ecological conditions may play a role in generating this difference. Such variation in preference may be adaptive if it reflects adaptation to local conditions. Symmetry is thought to indicate genetic quality, which may be more important among the Hadza with much higher mortality rates from birth onwards. Hadza men who were more often named as good hunters placed a greater value on symmetry in female faces. These results suggest that high quality Hadza men are more discriminating in their choice of faces. Hadza women had increased preferences for symmetry in men's faces when they were pregnant or nursing, perhaps due to their increased discrimination and sensitivity to foods and disease harmful to a foetus or nursing infant. These results imply that symmetry is an evolutionarily relevant trait and that variation in symmetry preference appears strategic both between cultures and within individuals of a single culture.

Improvements to the Hunter Dose tracking system

Energy Technology Data Exchange (ETDEWEB)

Whiteside, T. S. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Aucott, T. J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Brand, A. D. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Diprete, D. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2017-07-01

Since 1965, the Savannah River Site (SRS) has conducted deer hunts which are open to the general public. SRS performs field monitoring for cesium-137 (Cs-137) of each harvested animal to determine whether the animal may be released to the hunter. A new field system for measuring Cs-137 in the harvested animals has been developed. The system incorporates numerous enhancements compared to the original system. The original system was composed of two Ludlum Measurements scalar-driven 2 inch x 2 inch sodium iodide counters, while the new system is based on a single Ametek Ortec Digibase-driven 2 inch x 4 inch x 16 inch sodium iodide gamma spectrometer. The new system includes a series of easy-to-assemble stainless steel encapsulated lead shields. The combination of the larger detector size and lead shielding improved the detection limit of the new system by a factor of approximately three compared to the original system. This lower detection limit allows for a larger number of measurements to be directly compared to the laboratory results, in cases where animal portions have been sampled. The results from developing and using this system are presented as well as recommendations on improvements to the overall field monitoring of the SRS hunts.

Waiting to Drive (A Minute of Health with CDC)

Centers for Disease Control (CDC) Podcasts

Over the past 10 years, the number of fatal motor-vehicle crashes involving teenage drivers has declined by more than 50 percent. This podcast discusses the trend of teens waiting until they are older to drive.

Why wait? : Organizing integrated processes in cancer care

NARCIS (Netherlands)

Leeftink, Anne Greetje

2017-01-01

The access to cancer diagnostics and cancer treatment is not the same for all types of cancer patients. Furthermore, the resources involved in these processes are costly and scarce. Long access and waiting times to diagnostics and treatment can cause increased anxiety of patients. The goal of this

Waiting Time Dynamics in Two-Dimensional Infrared Spectroscopy

NARCIS (Netherlands)

Jansen, Thomas L. C.; Knoester, Jasper

We review recent work on the waiting time dynamics of coherent two-dimensional infrared (2DIR) spectroscopy. This dynamics can reveal chemical and physical processes that take place on the femto- and picosecond time scale, which is faster than the time scale that may be probed by, for example,

The support needs of patients waiting for publicly funded bariatric surgery - implications for health service planners.

Science.gov (United States)

Sharman, M J; Venn, A J; Jose, K A; Williams, D; Hensher, M; Palmer, A J; Wilkinson, S; Ezzy, D

2017-02-01

The objective of this study was to investigate the experience of waiting for publicly funded bariatric surgery in an Australian tertiary healthcare setting. Focus groups and individual interviews involving people waiting for or who had undergone publicly funded bariatric surgery were audio-recorded, transcribed and analysed thematically. A total of 11 women and 6 men engaged in one of six focus groups in 2014, and an additional 10 women and 9 men were interviewed in 2015. Mean age was 53 years (range 23-66); mean waiting time was 6 years (range 0-12), and mean time since surgery was 4 years (range 0-11). Waiting was commonly reported as emotionally challenging (e.g. frustrating, depressing, stressful) and often associated with weight gain (despite weight-loss attempts) and deteriorating physical health (e.g. development of new or worsening obesity-related comorbidity or decline in mobility) or psychological health (e.g. development of or worsening depression). Peer support, health and mental health counselling, integrated care and better communication about waitlist position and management (e.g. patient prioritization) were identified support needs. Even if wait times cannot be reduced, better peer and health professional supports, together with better communication from health departments, may improve the experience or outcomes of waiting and confer quality-of-life gains irrespective of weight loss. © 2016 World Obesity Federation.

Weighing waiting

Directory of Open Access Journals (Sweden)

Samuel M. Duncan

2007-12-01

Full Text Available People have been shown to delay decision making to wait for missing noninstrumental attribute information --- information that would not have altered their decision if known at the outset --- with this delay originally attributed to uncertainty obscuring one's true preference (Bastardi and Shafir, 1998. To test this account, relative to an alternative that delay arises from low confidence in one's preference (Tykocinski and Ruffle, 2003, we manipulated information certainty and the magnitude of a penalty for delay, the latter intended to reduce the influence of easily resolved sources of delay and to magnify any influence of uncertainty. Contrary to expectations, the results were largely inconsistent with the uncertainty account in that, under a low penalty, delay did not depend on information certainty; and, under a high penalty, delay rate was actually much lower when information was uncertain. To explain the latter, we propose that people use a strategy for resolving choice under uncertainty that does not require establishing a confident preference for each value of the missing information. These findings are related to others in which choice difficulty has been found to be a major source of delay.

Mean Waiting Time and Patients' Satisfaction in GOPD, Federal ...

African Journals Online (AJOL)

Mean Waiting Time and Patients' Satisfaction in GOPD, Federal Medical Centre, Owerri. ... Journal Home > Vol 4, No 2 (2013) > ... dis-satisfaction as noted from this study should be addressed by the staff and management of the hospital.

Mass measurement on the rp-process waiting point {sup 72}Kr

Energy Technology Data Exchange (ETDEWEB)

Rodriguez, D. [Gesellschaft fuer Schwerionenforschung mbH, Darmstadt (Germany); Kolhinen, V.S. [Jyvaeskylae Univ. (Finland); Audi, G. [CSNSM-IN2P3-Centre National de la Recherche Scientifique (CNRS), 91 - Orsay (FR)] [and others

2004-06-01

The mass of one of the three major waiting points in the astrophysical rp-process {sup 72}Kr was measured for the first time with the Penning trap mass spectrometer ISOLTRAP. The measurement yielded a relative mass uncertainty of {delta}m/m=1.2 x 10{sup -7} ({delta}m=8 keV). Other Kr isotopes, also needed for astrophysical calculations, were measured with more than one order of magnitude improved accuracy. We use the ISOLTRAP masses of{sup 72-74}Kr to reanalyze the role of the {sup 72}Kr waiting point in the rp-process during X-ray bursts. (orig.)

The importance of patient expectations as a determinant of satisfaction with waiting times for hip and knee replacement surgery.

Science.gov (United States)

Conner-Spady, Barbara L; Sanmartin, Claudia; Johnston, Geoffrey H; McGurran, John J; Kehler, Melissa; Noseworthy, Tom W

2011-08-01

The disconfirmation model hypothesizes that satisfaction is a function of a perceived discrepancy from an initial expectation. Our objectives were: (1) to test the disconfirmation model as it applies to patient satisfaction with waiting time (WT) and (2) to build an explanatory model of the determinants of satisfaction with WT for hip and knee replacement. We mailed 1000 questionnaires to 2 random samples: patients waiting or those who had received a joint replacement within the preceding 3-12 months. We used ordinal logistic regression analysis to build an explanatory model of the determinants of satisfaction. Of the 1330 returned surveys, 1240 contained patient satisfaction data. The sample was 57% female; mean age was 70 years (SD 11). Consistent with the disconfirmation model, when their WTs were longer than expected, both waiting (OR 5.77, 95% CI 3.57-9.32) and post-surgery patients (OR 6.57, 95% CI 4.21-10.26) had greater odds of dissatisfaction, adjusting for the other variables in the model. Compared to those who waited 3 months or less, post-surgery patients who waited 6 to 12 months (OR 2.59, 95% CI 1.27-5.27) and over 12 months (OR 3.30, 95% CI 1.65-6.58) had greater odds of being dissatisfied with their waiting time. Patients who felt they were treated unfairly had greater odds of being dissatisfied (OR 4.74, 95% CI 2.60-8.62). In patients on waiting lists and post-surgery for hip and knee replacement, satisfaction with waiting times is related to fulfillment of expectations about waiting, as well as a perception of fairness. Measures to modify expectations and increase perceived fairness, such as informing patients of a realistic WT and communication during the waiting period, may increase satisfaction with WTs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Renewal processes based on generalized Mittag-Leffler waiting times

Science.gov (United States)

Cahoy, Dexter O.; Polito, Federico

2013-03-01

The fractional Poisson process has recently attracted experts from several fields of study. Its natural generalization of the ordinary Poisson process made the model more appealing for real-world applications. In this paper, we generalized the standard and fractional Poisson processes through the waiting time distribution, and showed their relations to an integral operator with a generalized Mittag-Leffler function in the kernel. The waiting times of the proposed renewal processes have the generalized Mittag-Leffler and stretched-squashed Mittag-Leffler distributions. Note that the generalizations naturally provide greater flexibility in modeling real-life renewal processes. Algorithms to simulate sample paths and to estimate the model parameters are derived. Note also that these procedures are necessary to make these models more usable in practice. State probabilities and other qualitative or quantitative features of the models are also discussed.

Cumulative incidence for wait-list death in relation to length of queue for coronary-artery bypass grafting: a cohort study

Directory of Open Access Journals (Sweden)

Levy Adrian R

2006-08-01

Full Text Available Abstract Background In deciding where to undergo coronary-artery bypass grafting, the length of surgical wait lists is often the only information available to cardiologists and their patients. Our objective was to compare the cumulative incidence for death on the wait list according to the length of wait lists at the time of registration for the operation. Methods The study cohort included 8966 patients who registered to undergo isolated coronary-artery bypass grafting (82.4% men; 71.9% semi-urgent; 22.4% non-urgent. The patients were categorized according to wait-list clearance time at registration: either "1 month or less" or "more than 1 month". Cumulative incidence for wait-list death was compared between the groups, and the significance of difference was tested by means of regression models. Results Urgent patients never registered on a wait list with a clearance time of more than 1 month. Semi-urgent patients registered on shorter wait lists more often than non-urgent patients (79.1% vs. 44.7%. In semi-urgent and non-urgent patients, the observed proportion of wait-list deaths by 52 weeks was lower in category "1 month or less" than in category "more than 1 month" (0.8% [49 deaths] vs. 1.6% [39 deaths], P P Conclusion Long wait lists for coronary-artery bypass grafting are associated with increased probability that a patient dies before surgery. Physicians who advise patients where to undergo cardiac revascularization should consider the risk of pre-surgical death that is associated with the length of a surgical wait list.

IS WAITING THE HARDEST PART? A CRITICAL STUDY OF THE EXPERIENCE OF WOMEN AWAITING BREAST BIOPSY RESULTS.

Science.gov (United States)

Hodgkinson, T; Govender, C; Rayne, S

2017-06-01

Most previous research efforts have focused on the psychological effects of receiving a cancer diagnosis rather than the period of waiting for definitive Results. Early detection of cancer is directly linked to successful treatment regimes, yet these procedures evoke significant anxiety in patients. The long wait for medical test Results in state health institutions, with one of the possible outcomes being a cancer diagnosis, means that the days of waiting can induce emotional distress before the diagnosis has even been given. Eight research collaborators were invited to, in their own voice, shed light on their individual experiences while waiting for their biopsy Results to gain an understanding of the experiences of each collaborator by letting her tell her story and to explore the possibility of shared experience between collaborators. Research collaborators at a local, government hospital kept a journal for the two-week waiting period for their biopsy Results. Shortly before receiving their Results, they took part in a short semi-structured interview to inquire about their waiting. The theoretical framework used for data interpretation is critical theory focusing on the structures within society and healthcare systems that impact on the experience of waiting. The undercurrent of critical commentary about the roles of the gender, economic, political and cultural factors that contribute to the screening experience for women in South Africa helps to shed light on the complex forces at play within the procedures. The Results indicate that for some women waiting provokes significant psychological stress which manifests in multiple psychological processes including the psychological bracing phenomenon, denial, suppression and negation of their emotional experience all perpetuated by the structures of power within the health care system. More understanding of the psychological experience of awaiting a cancer diagnosis is required and there is an important place for

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

Science.gov (United States)

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

2012-09-18

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

Patients’ Attitude towards Travelling For Breast Services versus Waiting Longer For Local Services

LENUS (Irish Health Repository)

Abd Elwahab, S

2018-05-01

Geographical access is a cornerstone of health care provision. However, prolonged waiting for breast clinic appointments in local services results in delayed diagnosis and excessive anxiety for patients. In this study, we present a patient satisfaction survey results of an initiative to offer out-patient clinic appointments for non-urgent patients referred to the breast unit in Letterkenny General Hospital (LGH), Ireland, and exceeded the recommended waiting period of 12 weeks. These patients were offered appointment in University Hospital Galway (UCHG), which is an average travel time of about 3.5-4.5 hours away from LGH. 163 patients out of 336 (48.5%) patients actively waiting more than 12 weeks for appointments in LGH accepted alternative appointments in UCHG. Despite the long travel distance for these patients, 100% of them reported high satisfaction and 97.3% said they would accept further UCHG appointments if a similar situation of prolonged waiting in LGH arises. None of these patients were diagnosed with cancer, and only one had a benign lumpectomy. This study showed that if offered alternative appointments, just under half of the patients would accept. The initiative provides a feasible solution for long waiters, and the survey shows that patients’ satisfaction remains high despite long travel.

Practical Solutions for Reducing Container Ships’ Waiting Times at Ports Using Simulation Model

Institute of Scientific and Technical Information of China (English)

Abdorreza Sheikholeslami; Gholamreza Ilati; Yones Eftekhari Yeganeh

2013-01-01

The main challenge for container ports is the planning required for berthing container ships while docked in port. Growth of containerization is creating problems for ports and container terminals as they reach their capacity limits of various resources which increasingly leads to traffic and port congestion. Good planning and management of container terminal operations reduces waiting time for liner ships. Reducing the waiting time improves the terminal’s productivity and decreases the port difficulties. Two important keys to reducing waiting time with berth allocation are determining suitable access channel depths and increasing the number of berths which in this paper are studied and analyzed as practical solutions. Simulation based analysis is the only way to understand how various resources interact with each other and how they are affected in the berthing time of ships. We used the Enterprise Dynamics software to produce simulation models due to the complexity and nature of the problems. We further present case study for berth allocation simulation of the biggest container terminal in Iran and the optimum access channel depth and the number of berths are obtained from simulation results. The results show a significant reduction in the waiting time for container ships and can be useful for major functions in operations and development of container ship terminals.

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

Directory of Open Access Journals (Sweden)

Hourvash Akbari Haghighinejad

2016-01-01

Full Text Available Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14 was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity. The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the numberwaiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

Change in hearing during 'wait and scan' management of patients with vestibular schwannoma

DEFF Research Database (Denmark)

Stangerup, Sven-Eric; Caye-Thomasen, P.; Tos, M.

2008-01-01

: At the time of diagnosis, 334 patients (53 per cent) had good hearing and speech discrimination of better than 70 per cent; at the end of the 10-year observation period, this latter percentage was 31 per cent. In 17 per cent of the patients, speech discrimination at diagnosis was 100 per cent; of these, 88......Aim: To evaluate hearing changes during 'wait and scan' management of patients with vestibular schwannoma. Subjects: Over a 10-year period, 636 patients have prospectively been allocated to 'wait and scan' management, with annual magnetic resonance scanning and audiological examination. Results...... surgery and of radiation therapy with those of 'wait and scan' management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth Udgivelsesdato: 2008/7...

Determinants of Patient Waiting Time in the General Outpatient ...

African Journals Online (AJOL)

obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both .... Simple random sampling was done for the first two patients to get the starting ... record clerks (12% [9/76]), and jumping of queue by patients.

Waiting for the Leaf; Warten auf den Leaf

Energy Technology Data Exchange (ETDEWEB)

Wilms, Jan

2012-01-15

Nissan will be the first manufacturer to launch an electric vehicle of the VW Golf category in the German market. With a mileage of about 170 km and a roomy passenger compartment, the Leaf promises much comfort. In the US market, it was launched two years ago. Was it worth while waiting for?.

U.S. tells CERN to wait for support

CERN Multimedia

Mervis, J

1995-01-01

The US has put off CERN's request for a $300 million contribution to help build the Large Hadron Collider. Department of Energy officials asserted that such a decision must wait until after the budget is finalized. House Science Committee Chairman Robert Walker also claimed it was too early to make a decision.

Financial cost to institutions on patients waiting for gall bladder disease surgery.

Science.gov (United States)

Waqas, Ahmed; Qasmi, Shahzad Ahmed; Kiani, Faran; Raza, Ahmed; Khan, Khizar Ishtiaque; Manzoor, Shazia

2014-01-01

The aim of this study was to determine the financial costs to institution on patients waiting for gall bladder disease surgery and suggest measures to reduce them. This multi-centre prospective descriptive survey was performed on all patients who underwent an elective cholecystectomy by three consultants at secondary care hospitals in Pakistan between Jan 2010 to Jan 2012. Data was collected on demographics, the duration of mean waiting time, specific indications and nature of disease for including the patients in the waiting list, details of emergency re-admissions while awaiting surgery, investigations done, treatment given and expenditures incurred on them during these episodes. A total of 185 patients underwent elective open cholecystectomy. The indications for listing the patients for surgery were biliary colic in 128 patients (69%), acute cholecystitis in 43 patients (23%), obstructive jaundice in 8 patients (4.5%) and acute pancreatitis in 6 patients (3.2%). 146 (78.9%) and 39 (21.1%) of patients were listed as outdoor electives and indoor emergencies respectively. Of the 185 patients, 54 patients (29.2%) were re-admitted. Financial costs in Pakistani rupees per episode of readmission were 23050 per episode in total and total money spent on all readmissions was Rs. 17,05,700/-. Financial costs on health care institutions due to readmissions in patients waiting for gall bladder disease surgery are high. Identifying patients at risk for these readmissions and offering them early laparoscopic cholecystectomy is very important.

Síndrome de Hunter-Hurler

Directory of Open Access Journals (Sweden)

Antonio B. Lefèvre

1954-03-01

Full Text Available Les deux cas de gargoylisme présentés ont appelé l'attention des auteurs et ont mérité leur publication vue la rareté de la maladie en question. Le diagnostic repose en un certain nombre de signes cliniques, lesquels, cependant, n'ont pas besoin d'être au complet pour que l'on puisse affermir le diagnostic du syndrome de Hunter-Hurler. C'est ce qui arrive, d'ailleurs, avec la majorité des maladies de caractère génétique, dans les-quelles il est possible de verifier la transmission de quelques traits seule-ment de Pensemble clinique, insuffisants pour caractériser la maladie sous tous ses aspects, mais suffisants pour permettre un diagnostic très sûr. Cas nº 1: les auteurs font ressortir la face caractéristique de la maladie, la petite taille, les doigts en griffe, les alterations très caractéristiques de forme des vertèbres lombaires et le retard psycho-moteur considérable; comme antécédents familiaux, il a été constaté qu'une cousine-germaine du côté paternel de la malade est morte à 1'âge de 12 ans d'une maladie semblable. Cas nº 2: ici ressortent la face caractéristique, la petite taille, le développement retardé, les altérations des vertèbres lombaires et, à l'examen oculaire, un aspect suggestif de l'opacité cornéenne considérée comme pathognomonique du gargoylisme. Aucun traitement a été tenté dans les deux cas.

Factors impacting hunter access to private lands in southeast Minnesota

Science.gov (United States)

Walberg, Eric; Cornicelli, Louis; Fulton, David C.

2018-01-01

White-tailed deer (Odocoileus virginianus) have important socioeconomic and ecological impacts in the United States. Hunting is considered to be important for the effective management of deer and relies on access to privately owned lands. In 2013, we surveyed nonindustrial private landowners in southeast Minnesota and created two logit models to examine factors that impact landowners’ decision to (a) allow public hunting access and (b) post private property. Parcel characteristics were found to impact landowner decisions to allow hunting access, particularly the size of the property and whether it was posted. Hunting access to small properties was more likely to be restricted to family, friends, and neighbors (83%) compared to medium (74%) or large properties (60%). Hunter concerns (e.g., liability) and knowledge about deer management was significant in both models, suggesting there are opportunities to educate landowners about the importance of allowing public hunting access and available liability protections.

Processing communications events in parallel active messaging interface by awakening thread from wait state

Science.gov (United States)

Archer, Charles J; Blocksome, Michael A; Ratterman, Joseph D; Smith, Brian E

2013-10-22

Processing data communications events in a parallel active messaging interface (`PAMI`) of a parallel computer that includes compute nodes that execute a parallel application, with the PAMI including data communications endpoints, and the endpoints are coupled for data communications through the PAMI and through other data communications resources, including determining by an advance function that there are no actionable data communications events pending for its context, placing by the advance function its thread of execution into a wait state, waiting for a subsequent data communications event for the context; responsive to occurrence of a subsequent data communications event for the context, awakening by the thread from the wait state; and processing by the advance function the subsequent data communications event now pending for the context.

Pavlovian hunters on the margin - archaeozoological analysis of the animal remains discovered at the Pavlov II site (1966-67 excavations)

Czech Academy of Sciences Publication Activity Database

Wilczyński, J.; Wojtal, P.; Svoboda, Jiří

2017-01-01

Roč. 73, 3-4 (2017), s. 322-331 ISSN 2533-4050 Institutional support: RVO:68081758 Keywords : Gravettian * hunters-gatherers * southern Moravia * subsistence strategies Subject RIV: AC - Archeology, Anthropology, Ethnology OBOR OECD: Archaeology http://fi.nm.cz/wp-content/uploads/2017/12/06_Wilczynski_et-al_2017.pdf

Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach

Science.gov (United States)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2017-04-01

Emergency department (ED) is the main unit of a hospital that provides emergency treatment. Operating 24 hours a day with limited number of resources invites more problems to the current chaotic situation in some hospitals in Malaysia. Delays in getting treatments that caused patients to wait for a long period of time are among the frequent complaints against government hospitals. Therefore, the ED management needs a model that can be used to examine and understand resource capacity which can assist the hospital managers to reduce patients waiting time. Simulation model was developed based on 24 hours data collection. The model developed using Arena simulation replicates the actual ED's operations of a public hospital in Selangor, Malaysia. The OptQuest optimization in Arena is used to find the possible combinations of a number of resources that can minimize patients waiting time while increasing the number of patients served. The simulation model was modified for improvement based on results from OptQuest. The improvement model significantly improves ED's efficiency with an average of 32% reduction in average patients waiting times and 25% increase in the total number of patients served.

Quality Improvement Cycles that Reduced Waiting Times at ...

African Journals Online (AJOL)

It was decided to undertake quality improvement (QI) cycles to analyse and improve the situation, using waiting time as a measure of improvement. Methods: A QI team was chosen to conduct two QI cycles. The allocated time for QI cycle 1 was from May to August 2006 and for QI cycle 2 from September to December 2006.

Impact of co-located general practitioner (GP) clinics and patient choice on duration of wait in the emergency department.

Science.gov (United States)

Sharma, Anurag; Inder, Brett

2011-08-01

To empirically model the determinants of duration of wait of emergency (triage category 2) patients in an emergency department (ED) focusing on two questions: (i) What is the effect of enhancing the degree of choice for non-urgent (triage category 5) patients on duration of wait for emergency (category 2) patients in EDs; and (ii) What is the effect of co-located GP clinics on duration of wait for emergency patients in EDs? The answers to these questions will help in understanding the effectiveness of demand management strategies, which are identified as one of the solutions to ED crowding. The duration of wait for each patient (difference between arrival time and time first seen by treating doctor) was modelled as a function of input factors (degree of choice, patient characteristics, weekend admission, metro/regional hospital, concentration of emergency (category 2) patients in hospital service area), throughput factors (availability of doctors and nurses) and output factor (hospital bed capacity). The unit of analysis was a patient episode and the model was estimated using a survival regression technique. The degree of choice for non-urgent (category 5) patients has a non-linear effect: more choice for non-urgent patients is associated with longer waits for emergency patients at lower values and shorter waits at higher values of degree of choice. Thus more choice of EDs for non-urgent patients is related to a longer wait for emergency (category 2) patients in EDs. The waiting time for emergency patients in hospital campuses with co-located GP clinics was 19% lower (1.5 min less) on average than for those waiting in campuses without co-located GP clinics. These findings suggest that diverting non-urgent (category 5) patients to an alternative model of care (co-located GP clinics) is a more effective demand management strategy and will reduce ED crowding.

Effect of self-triage on waiting times at a walk-in sexual health clinic.

Science.gov (United States)

Hitchings, Samantha; Barter, Janet

2009-10-01

Lengthy waiting times can be a major problem in walk-in sexual health clinics. They are stressful for both patients and staff and may lead to clients with significant health issues leaving the department before being seen by a clinician. A self-triage system may help reduce waiting times and duplication of work, improve patient pathways and decrease wasted visits. This paper describes implementation of a self-triage system in two busy sexual and reproductive health clinics. Patients were asked to complete a self-assessment form on registration to determine the reason for attendance. This then enabled patients to be directed to the most appropriate specialist or clinical service. The benefits of this approach were determined by measuring patient waiting times, reduction in unnecessary specialist review together with patient acceptability as tested by a patient satisfaction survey. The ease of comprehension of the triage form was also assessed by an independent readers' panel. A total of 193 patients were recruited over a 4-month period from November 2004 to February 2005. Patients from the November and December clinics were assigned to the 'traditional treatment' arm, with patients at subsequent clinics being assigned to the 'self-triage' system. Waiting times were collected by the receptionist and clinic staff. Ninety six patients followed the traditional route, 97 the new self-triage system. Sixty-nine (35.8%) patients completed the satisfaction survey. The self-triage system significantly reduced waiting time from 40 (22, 60) to 23 (10, 40) minutes [results expressed as median (interquartile range)]. There was a non-significant reduction in the proportion of patients seeing two clinicians from 21% to 13% (p = 0.17). Satisfaction levels were not significantly altered (95% compared to 97% satisfied, p = 0.64). The readers' panel found the triage form both easy to understand and to complete. Self-triage can effectively reduce clinic waiting times and allow better

Hunter color dimensions, sugar content and volatile compounds in pasteurized yellow passion fruit juice (Passiflora edulis var. flavicarpa during storage

Directory of Open Access Journals (Sweden)

Delcio Sandi

2004-06-01

Full Text Available Changes in Hunter L, a and b values, glucose, fructose and sucrose contents, concentration of four volatile compounds (ethyl butirate, ethyl caproate, hexyl butirate and hexyl caproate and furfural, were studied in yellow passion fruit juice (Passiflora edulis var. flavicarpa pasteurized at 75ºC/60s, 80ºC/41s or 85ºC/27s, during storage at room temperature (25±5ºC and refrigeration (5±1ºC for 120 days. While the sucrose content decreased, the glucose and fructose contents increased significantly over storage time. The Hunter L and b values behaved similarly, with a tendency to decrease over time, inversely to Hunter a value. Volatile compound concentrations also decreased over time, inversely to the furfural content. Pasteurization at 85ºC/27s resulted minimum changes in the studied passion fruit characteristics, while that at 75ºC/60s was the most harmful. Storage under refrigeration tended to keep the best quality characteristics of the juice.Foi estudada a variação dos valores "L", "a" e "b" do sistema de Hunter, dos teores de glucose, frutose e sacarose, e da concentração de quatro compostos voláteis (butirato de etila, caproato de etila, butirato de hexila e caproato de hexila e furfural, em suco de maracujá-amarelo (Passiflora edulis var. flavicarpa submetido à pasteurização (75ºC/60 s, 80ºC/41 s e 85ºC/27 s, durante o armazenamento a temperatura ambiente (25±5ºC e refrigerada (5±1ºC por 120 dias. Enquanto os teores de sacarose diminuíram, aqueles de glucose e frutose aumentaram significativamente. Os valores "L" e "b" apresentaram comportamento semelhante, com tendência a diminuir ao longo do tempo, inversamente ao valor "a". As concentrações dos compostos voláteis também diminuíram, exceto para o furfural. A pasteurização a 85ºC/27 s proporcionou as menores alterações nas características estudadas, enquanto aquela à 75ºC/60 s foi a mais prejudicial. O armazenamento sob refrigeração apresentou

Lead shot pellets dispersed by hunters: ingested by ducks

Energy Technology Data Exchange (ETDEWEB)

Danell, K [Univ. of Umea, Sweden; Andersson, A; Marcstrom, V

1977-01-01

Many of the lead pellets shot by waterfowl hunters over shores and waters fall on the feeding grounds of ducks and geese. These pellets, picked up and ingested by the birds, can remain in the gizzard where they are eroded by mechanical and chemical action. In some cases the bird absorbs enough lead to cause lead poisoning. This report describes the incidence of ingested lead shot pellets found in 928 ducks collected in Sweden during hunting season. Pellets were found in both dabbling and diving ducks and were present in birds from six of the eight localities sampled. Usually one or two pellets were found but some ducks contained up to 62 pellets. As the incidence of ingested pellets in the present study is approximately the same as that found in North America, where the annual duck loss due to lead poisoning is estimated to be 2 to 3 percent of the population, it may be assumed that lead poisoning is a mortality factor for Swedish ducks also.

Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

Science.gov (United States)

Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

2008-01-01

BACKGROUND: Monitoring wait times and defining targets for care have been advocated to improve health care delivery related to cancer, heart, diagnostic imaging, joint replacements and sight restoration. There are few data on access to care for digestive diseases, although they pose a greater economic burden than cancer or heart disease in Canada. The present study compared wait times for specialist gastroenterology care with recent, evidence-based, consensus-defined benchmark wait times for a range of digestive diseases. METHODS: Total wait times from primary care referral to investigation were measured for seven digestive disease indications by using the Practice Audit in Gastroenterology program, and were benchmarked against consensus recommendations. RESULTS: Total wait times for 1903 patients who were undergoing investigation exceeded targets for those with probable cancer (median 26 days [25th to 75th percentiles eight to 56 days] versus target of two weeks); probable inflammatory bowel disease (101 days [35 to 209 days] versus two weeks); documented iron deficiency anemia (71 days [19 to 142 days] versus two months); positive fecal occult blood test (73 days [36 to 148 days] versus two months); dyspepsia with alarm symptoms (60 days [23 to 140 days] versus two months); refractory dyspepsia without alarm symptoms (126 days [42 to 225 days] versus two months); and chronic constipation and diarrhea (141 days [68 to 264 days] versus two months). A minority of patients were seen within target times: probable cancer (33% [95% CI 20% to 47%]); probable inflammatory bowel disease (12% [95% CI 1% to 23%]); iron deficiency anemia (46% [95% CI 37% to 55%]); positive occult blood test (41% [95% CI 28% to 54%]); dyspepsia with alarm symptoms (51% [95% CI 41% to 60%]); refractory dyspepsia without alarm symptoms (33% [95% CI 19% to 47%]); and chronic constipation and diarrhea (21% [95% CI 14% to 29%]). DISCUSSION: Total wait times for the seven indications exceeded the

Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

Energy Technology Data Exchange (ETDEWEB)

Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

2016-11-15

We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000

Directory of Open Access Journals (Sweden)

Hayden Robert

2005-03-01

Full Text Available Abstract Background In British Columbia, Canada, all necessary medical services are funded publicly. Concerned with growing wait lists in the mid-1990s, the provincial government started providing extra funding for coronary artery bypass grafting (CABG operations annually. Although aimed at improving access, it is not known whether supplementary funding changed the time that patients spent on wait lists for CABG. We sought to determine whether the period of registration on wait lists had an effect on time to isolated CABG and whether the period effect was similar across priority groups. Methods Using records from a population-based registry, we studied the wait-list time before and after supplementary funding became available. We compared the number of weeks from registration to surgery for equal proportions of patients in synthetic cohorts defined by five registration periods in the 1990s. Results Overall, 9,231 patients spent a total of 137,126 person-weeks on the wait lists. The time to surgery increased by the middle of the decade, and decreased toward the end of the decade. Relative to the 1991–92 registration period, the conditional weekly probabilities of undergoing surgery were 30% lower among patients registered on the wait lists in 1995–96, hazard ratio (HR = 0.70 (0.65–0.76, and 23% lower in 1997–98 patients, HR = 0.77 (0.71–0.83, while there were no differences with 1999–2000 patients, HR = 0.94 (0.88–1.02, after adjusting for priority group at registration, comorbidity, age and sex. We found that the effect of registration period was different across priority groups. Conclusion Our results provide evidence that time to CABG shortened after supplementary funding was provided on an annual basis to tertiary care hospitals within a single publicly funded health system. One plausible explanation is that these hospitals had capacity to increase the number of operations. At the same time, the effect was not uniform across

Mandatory weight loss during the wait for bariatric surgery.

Science.gov (United States)

Glenn, Nicole M; Raine, Kim D; Spence, John C

2015-01-01

Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies. © The Author(s) 2014.

Waiting Time from Diagnosis to Treatment has no Impact on Survival in Patients with Esophageal Cancer

NARCIS (Netherlands)

Visser, E.; Leeftink, Anne Greetje; van Rossum, P.S.N.; Siesling, Sabine; van Hillegersberg, R.; Ruurda, J.P.

2016-01-01

Background Waiting time from diagnosis to treatment has emerged as an important quality indicator in cancer care. This study was designed to determine the impact of waiting time on long-term outcome of patients with esophageal cancer who are treated with neoadjuvant therapy followed by surgery or

Symposium on Molecular Spectroscopy (42nd) Held in Columbus, Ohio on June 15-19, 1987.

Science.gov (United States)

1987-06-19

Department of bomiotry, Indism Univereity, Sloomimtom, Isdiamo, 47405. NT PSRUSA-JAUU, NDICA AMU Department of Cemistry , University of Nerylands Collge Pork...DEPARTMENT OF CEMISTRY , HUNTER, COLLEGE, CUMY, NEW YORK, NEW YORK, 10021. . T DISSILKAMP, ROBERT SCOTT DEPARTMENT OF CHEMISTRY, INDIANA UNIVERSITY...43210. NTWRF L LAUGHLIN, KEN DEPARTM3MT OF CIDEISTRY, UNIVERSITY OF CALIFORNIA, BEREALEY, CALIFORNIA, 94720. TIWRF LEE, DU DEPARMENT OF CEMISTRY , HUNTER

Experience of being a low priority patient during waiting time at an emergency department

Directory of Open Access Journals (Sweden)

Adolfsson A

2012-01-01

Full Text Available Ingrid Dahlen1,2, Lars Westin1, Annsofie Adolfsson11School of Life Sciences, University of Skövde, Skövde, Sweden; 2Emergency Department, Skaraborg Hospital, Skövde, SwedenBackground: Work in the emergency department is characterized by fast and efficient medical efforts to save lives, but can also involve a long waiting time for patients. Patients are given a priority rating upon their arrival in the clinic based on the seriousness of their problem, and nursing care for lower priority patients is given a lower prioritization. Regardless of their medical prioritization, all patients have a right to expect good nursing care while they are waiting. The purpose of this study was to illustrate the experience of the low prioritized patient during their waiting time in the emergency department.Methods: A phenomenological hermeneutic research method was used to analyze an interview transcript. Data collection consisted of narrative interviews. The interviewees were 14 patients who had waited more than three hours for surgical, orthopedic, or other medical care.Results: The findings resulted in four different themes, ie, being dependent on care, being exposed, being vulnerable, and being secure. Lower priority patients are not paid as much attention by nursing staff. Patients reported feeling powerless, insulted, and humiliated when their care was delayed without their understanding what was happening to them. Not understanding results in exposure that violates self-esteem.Conclusion: The goal of the health care provider must be to minimize and prevent suffering, prevent feelings of vulnerability, and to create conditions for optimal patient well being.Keywords: emergency department, patients, waiting times, nursing staff

Two facets of patience in young children: Waiting with and without an explicit reward.

Science.gov (United States)

Barragan-Jason, Gladys; Atance, Cristina; Kopp, Leia; Hopfensitz, Astrid

2018-07-01

Patience, or the ability to tolerate delay, is typically studied using delay of gratification (DoG) tasks. However, among other factors (e.g., type of reward), the use of a reward to test patience is affected by an individual's motivation to obtain the reward (e.g., degree of preference for the small vs. large reward). In addition, DoG tasks do not assess the extent to which an individual can wait in the absence of an explicit reward-or what we term "patience as a virtue." Accordingly, the current study used a new measure of patience-the "pure waiting paradigm"-in which 3- to 5-year-old children waited 3 min with nothing to do and with no explicit reward. We then examined the relation between performance on this task (as assessed by children's spontaneous patient behaviors) and performance on two DoG tasks (candy and video rewards). Significant correlations were found between DoG performance and patient behaviors in the pure waiting paradigm, especially when controlling for motivation. These results and methodology show for the first time a direct link between patience as a virtue and DoG performance and also provide new insights about the study of patience in children. Copyright © 2018 Elsevier Inc. All rights reserved.

Blood pressure self-measurement in the obstetric waiting room

DEFF Research Database (Denmark)

Wagner, Stefan; Kamper, Christina H.; Toftegaard, Thomas Skjødeberg

2013-01-01

a reliable blood pressure reading. Results: We found that the patients did not adhere to given instructions when performing blood pressure self-measurement in the waiting room. None of the 81 patients adhered to all six inves- tigated recommendations, while around a quarter adhered to five out of six...

Waiting in the queue on Hotelling’s Main Street

NARCIS (Netherlands)

Peters, H.J.M.; Schröder, M.J.W.; Vermeulen, A.J.

2015-01-01

We consider a variant of Hotelling’s location model that was proposed by Kohlberg (1983): when choosing a firm, consumers take travel time and also (expected) waiting time, which again depends on the number of consumers choosing that firm, into consideration. If we assume that firms are symmetric,

Theseus Waits on Lakebed for First Flight

Science.gov (United States)

1996-01-01

The Theseus prototype remotely-piloted aircraft (RPA) waits on the lakebed before its first test flight from NASA's Dryden Flight Research Center, Edwards, California, on May 24, 1996. The Theseus aircraft, built and operated by Aurora Flight Sciences Corporation, Manassas, Virginia, was a unique aircraft flown at NASA's Dryden Flight Research Center, Edwards, California, under a cooperative agreement between NASA and Aurora. Dryden hosted the Theseus program, providing hangar space and range safety for flight testing. Aurora Flight Sciences was responsible for the actual flight testing, vehicle flight safety, and operation of the aircraft. The Theseus remotely piloted aircraft flew its maiden flight on May 24, 1996, at Dryden. During its sixth flight on November 12, 1996, Theseus experienced an in-flight structural failure that resulted in the loss of the aircraft. As of the beginning of the year 2000, Aurora had not rebuilt the aircraft. Theseus was built for NASA under an innovative, $4.9 million fixed-price contract by Aurora Flight Sciences Corporation and its partners, West Virginia University, Morgantown, West Virginia, and Fairmont State College, Fairmont, West Virginia. The twin-engine, unpiloted vehicle had a 140-foot wingspan, and was constructed largely of composite materials. Powered by two 80-horsepower, turbocharged piston engines that drove twin 9-foot-diameter propellers, Theseus was designed to fly autonomously at high altitudes, with takeoff and landing under the active control of a ground-based pilot in a ground control station 'cockpit.' With the potential ability to carry 700 pounds of science instruments to altitudes above 60,000 feet for durations of greater than 24 hours, Theseus was intended to support research in areas such as stratospheric ozone depletion and the atmospheric effects of future high-speed civil transport aircraft engines. Instruments carried aboard Theseus also would be able to validate satellite-based global environmental

Randomized controlled trial of computerized alcohol intervention for college students: role of class level.

Science.gov (United States)

Strohman, Ashleigh Sweet; Braje, Sopagna Eap; Alhassoon, Omar M; Shuttleworth, Sylvie; Van Slyke, Jenna; Gandy, Sharareh

2016-01-01

Because of their ability to reach a much wider audience than face-to-face counseling or psychoeducation, computer-delivered interventions for risky or potentially problematic use have been increasing on college campuses. However, there are very few studies that examine who benefits most from such interventions. The purpose of this study was to determine if participation in Alcohol-Wise, a computerized intervention, is associated with changes in alcohol drinking behavior and its consequences, perceptions of college drinking norms, and expectancies. It was hypothesized that class level (i.e. freshman/sophomore versus junior/senior) would moderate the effectiveness of Alcohol-Wise. College students (n = 58) were randomly assigned to one of two conditions: (i) the computer-delivered intervention or (ii) wait-list control. Measures were completed at baseline and approximately 30-days later. At follow-up, freshman and sophomore students in the intervention group showed significant reduction in peak number of standard drinks and blood alcohol concentration, but the effect was not observed for juniors and seniors. The intervention group reported more accurate estimates of drinking norms at follow-up relative to controls. There were no significant changes over time in alcohol expectancies in either group. This study provides support for the potential usefulness of Alcohol-Wise intervention at reducing short-term drinking among underclassmen but not upperclassmen in a 4-year college setting. These findings suggest that computerized interventions may be more effective when provided early, but not later, in a student's college career.

Public reporting on quality, waiting times and patient experience in 11 high-income countries

OpenAIRE

Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew

2016-01-01

: This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospi...

The use of the waiting list in a fair selection of patients for nursing home care

NARCIS (Netherlands)

Meiland, F. J.; Danse, J. A.; Hoos, A. M.; Wendte, J. F.; Gunning-Schepers, L. J.

1996-01-01

When health care resources are scarce, waiting lists may be used as a distribution measure in order to enhance the fair allocation of resources through selection of patients. In this study, the structure and use of a waiting list for a fair selection of patients for nursing home admission was

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study.

Science.gov (United States)

Sun, Jing; Lin, Qian; Zhao, Pengyu; Zhang, Qiongyao; Xu, Kai; Chen, Huiying; Hu, Cecile Jia; Stuntz, Mark; Li, Hong; Liu, Yuanli

2017-08-22

It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients' satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. The monthly average length of waiting time decreased 3.49 min (P = 0.003) for consultations and 8.70 min (P = 0.02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = -0.71, P = 0.004). The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study

Directory of Open Access Journals (Sweden)

Jing Sun

2017-08-01

Full Text Available Abstract Background It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. Methods We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. Results The monthly average length of waiting time decreased 3.49 min (P = 0.003 for consultations and 8.70 min (P = 0.02 for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003. There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = −0.71, P = 0.004. Conclusions The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives

Middle and Late Holocene hunter-gatherers in East Central Europe: changing paradigms of the ‘non-Neolithic’ way of life

Directory of Open Access Journals (Sweden)

Marek Nowak

2007-12-01

Full Text Available According to traditional views, the main reason for ‘demesolithisation’ in East Central Europe was the spread of the Neolithic oecumene, particularly from c. 4000 BC. Simultaneously, the disintegrated Late Mesolithic world gradually underwent typological unification, and finally reached the stage that is sometimes described as pre-Neolithic. However, we definitely have to bear in mind that as a matter of fact we deal only with the ‘history’ of archaeological artefacts that are treated as typical attributes of hunter-gatherers. The analyses of chronological, technological, settlement, economic, and social data referring to foragers of East Central Europe demonstrate that the quantitative decrease and changes of their archaeological attributes in the fifth, fourth, and third millennia were not connected with a profound reorientation of their spatial and ideological existence. It was rather a continuation of previous patterns, even though territories settled by farming societies were steadily growing in size. The final disappearance of Central European hunter-gatherers – but only in a strictly typological dimension – took place in the Late Neolithic and Early Bronze Age.

Waiting to Drive (A Minute of Health with CDC)

Centers for Disease Control (CDC) Podcasts

2015-04-09

Over the past 10 years, the number of fatal motor-vehicle crashes involving teenage drivers has declined by more than 50 percent. This podcast discusses the trend of teens waiting until they are older to drive.  Created: 4/9/2015 by MMWR.   Date Released: 4/9/2015.

Stress, psychological distress, and coping in patients on the waiting list for lung transplantation : an exploratory study

NARCIS (Netherlands)

Vermeulen, KM; Bosma, OH; van der Bij, W; Koeter, GH; TenVergert, EM

Little information is available in literature on quality of life, stress and coping during the period patients are waiting for lung transplantation. This study explored potential stressful events that patients experience during the waiting period assessed the level of anxiety and depression and

Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey.

Science.gov (United States)

Xie, Zhenzhen; Or, Calvin

2017-01-01

The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.

Wait time management strategies for total joint replacement surgery: sustainability and unintended consequences.

Science.gov (United States)

Pomey, Marie-Pascale; Clavel, Nathalie; Amar, Claudia; Sabogale-Olarte, Juan Carlos; Sanmartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2017-09-07

In Canada, long waiting times for core specialized services have consistently been identified as a key barrier to access. Governments and organizations have responded with strategies for better access management, notably for total joint replacement (TJR) of the hip and knee. While wait time management strategies (WTMS) are promising, the factors which influence their sustainable implementation at the organizational level are understudied. Consequently, this study examined organizational and systemic factors that made it possible to sustain waiting times for TJR within federally established limits and for at least 18 months or more. The research design is a multiple case study of WTMS implementation. Five cases were selected across five Canadian provinces. Three success levels were pre-defined: 1) the WTMS maintained compliance with requirements for more than 18 months; 2) the WTMS met requirements for 18 months but could not sustain the level thereafter; 3) the WTMS never met requirements. For each case, we collected documents and interviewed key informants. We analyzed systemic and organizational factors, with particular attention to governance and leadership, culture, resources, methods, and tools. We found that successful organizations had specific characteristics: 1) management of the whole care continuum, 2) strong clinical leadership; 3) dedicated committees to coordinate and sustain strategy; 4) a culture based on trust and innovation. All strategies led to relatively similar unintended consequences. The main negative consequence was an initial increase in waiting times for TJR and the main positive consequence was operational enhancement of other areas of specialization based on the TJR model. This study highlights important differences in factors which help to achieve and sustain waiting times. To be sustainable, a WTMS needs to generate greater synergies between contextual-level strategy (provincial or regional) and organizational objectives and

Lung cancer care trajectory at a Canadian centre: an evaluation of how wait times affect clinical outcomes.

Science.gov (United States)

Kasymjanova, G; Small, D; Cohen, V; Jagoe, R T; Batist, G; Sateren, W; Ernst, P; Pepe, C; Sakr, L; Agulnik, J

2017-10-01

Lung cancer continues to be one of the most common cancers in Canada, with approximately 28,400 new cases diagnosed each year. Although timely care can contribute substantially to quality of life for patients, it remains unclear whether it also improves patient outcomes. In this work, we used a set of quality indicators that aim to describe the quality of care in lung cancer patients. We assessed adherence with existing guidelines for timeliness of lung cancer care and concordance with existing standards of treatment, and we examined the association between timeliness of care and lung cancer survival. Patients with lung cancer diagnosed between 2010 and 2015 were identified from the Pulmonary Division Lung Cancer Registry at our centre. We demonstrated that the interdisciplinary pulmonary oncology service successfully treated most of its patients within the recommended wait times. However, there is still work to be done to decrease variation in wait time. Our results demonstrate a significant association between wait time and survival, supporting the need for clinicians to optimize the patient care trajectory. It would be helpful for Canadian clinicians treating patients with lung cancer to have wait time guidelines for all treatment modalities, together with standard definitions for all time intervals. Any reductions in wait times should be balanced against the need for thorough investigation before initiating treatment. We believe that our unique model of care leads to an acceleration of diagnostic steps. Avoiding any delay associated with referral to a medical oncologist for treatment could be an acceptable strategy with respect to reducing wait time.

THE INFLUENCE OF WAITING TIME SATISFACTION ON CUSTOMER LOYALTY TOWARDS MULTI-STAGE SERVICES IN A FULL-SERVICE RESTAURANT: EVIDENCE FROM INDIA

Directory of Open Access Journals (Sweden)

A. Mittal

2016-06-01

Full Text Available Research shows waiting time in services is an important source of service evaluation by the customer. In fact, time is one component of the total 'cost' that the customer bears and cost is a core component of the perceived cost-benefit equation that the customer uses to evaluate her or his sustained patronage of a particular service. In most services, customers consider waiting as a waste of time. However, from the customer perspective, in the case of a full-service restaurant, waiting is expected and sometimes desirable also. Prior research, mainly in the west, suggests that when customers think that a wait for service is too long, they become less satisfied with overall service quality. Based on a research setting in a full-scale restaurant in India, this paper seeks answers to two research questions: First, what are the determinants of overall waiting-time satisfaction and second, what is the influence of waiting-time satisfaction on customer loyalty.

No-Wait Job Shop Scheduling, a Constraint Propagation Approach

NARCIS (Netherlands)

Lennartz, P.M.

2006-01-01

Multi-machine scheduling problems have earned themselves a reputation of intractability. In this thesis we try to solve a special kind of these problems, the so-called no-wait job shop problems. In an instance of this problem-class we are given a number of operations that are to be executed on a

Waiting for total knee replacement surgery: factors associated with pain, stiffness, function and quality of life

Directory of Open Access Journals (Sweden)

Dionne Clermont E

2009-05-01

Full Text Available Abstract Background Recent evidences show that education and rehabilitation while waiting for knee replacement have positive effects on the patients' health status. Identification of factors associated with worse pain, function and health-related quality of life (HRQoL while waiting for surgery could help develop pre-surgery rehabilitation interventions that target specifically these factors and prioritize patients that may benefit the most from them. The objectives of this study were to measure pain, stiffness, function and HRQoL in patients at enrolment on waiting lists for knee replacement and to identify demographic, clinical, socioeconomic and psychosocial characteristics associated with these outcomes. Methods This study is part of a broader study measuring the effects of pre-surgery wait in patients scheduled for knee replacement. From 02/2006 to 09/2007, 197 patients newly scheduled for total knee replacement were recruited from the waiting lists of three university hospitals in Quebec City, Canada. Pain, stiffness and function were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC and HRQoL was measured with the SF-36 Health Survey. Stepwise multiple regression analysis was used to assess the strength of the associations between the independent variables and the WOMAC and SF-36 scores. Results The scores of all eight HRQoL physical and mental domains of the SF-36 were significantly lower than aged matched Canadian normative data (p Conclusion Patients waiting for knee replacement have poor function and HRQoL. Characteristics that were found to be associated with these outcomes could help develop pre-surgery rehabilitation program and prioritize patients that may benefit the most from them. Such programs could include interventions to reduce psychological distress, therapeutic exercises targeting both knees and weight loss management.

Guided online or face-to-face cognitive behavioral treatment for insomnia: A randomized wait-list controlled trial

NARCIS (Netherlands)

Lancee, J.; van Straten, A.; Morina, N.; Kaldo, V.; Kamphuis, J.H.

2016-01-01

Study Objectives: To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition. Methods: A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were

Waiting-time approximations in multi-queue systems with cyclic service

NARCIS (Netherlands)

Boxma, O.J.; Meister, B.W.

1987-01-01

This study is devoted to mean waiting-time approximations in a single-server multi-queue model with cyclic service and zero switching times of the server between consecutive queues. Two different service disciplines are considered: exhaustive service and (ordinary cyclic) nonexhaustive service. For

Silicone infusion tubing instead of Hunter rods for two-stage zone 2 flexor tendon reconstruction in a resource-limited surgical environment.

Science.gov (United States)

Kibadi, K; Moutet, F

2017-10-01

The authors describe their experience using silicone infusion tubing in place of Hunter rods for two-stage zone 2 flexor tendon reconstruction in a resource-limited surgical environment. This case report features a 47-year-old, right-handed man who had no active PIP and DIP joint flexion in four fingers of the right hand 5 months after an injury. During the first repair stage, the A2 and A4 pulleys were reconstructed using an extensor retinaculum graft. An infusion tube was inserted instead of Hunter rods. During the second stage, formation of a digital neo-canal around the infusion tubing was observed. The infusion tubing was removed and replaced with a palmaris longus tendon graft according to the conventional technique. Physiotherapy and rehabilitation followed surgery. At 6 months, very significant progress had been made with complete recovery of PIP and DIP flexion in the four fingers. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Experience of being a low priority patient during waiting time at an emergency department.

Science.gov (United States)

Dahlen, Ingrid; Westin, Lars; Adolfsson, Annsofie

2012-01-01

Work in the emergency department is characterized by fast and efficient medical efforts to save lives, but can also involve a long waiting time for patients. Patients are given a priority rating upon their arrival in the clinic based on the seriousness of their problem, and nursing care for lower priority patients is given a lower prioritization. Regardless of their medical prioritization, all patients have a right to expect good nursing care while they are waiting. The purpose of this study was to illustrate the experience of the low prioritized patient during their waiting time in the emergency department. A phenomenological hermeneutic research method was used to analyze an interview transcript. Data collection consisted of narrative interviews. The interviewees were 14 patients who had waited more than three hours for surgical, orthopedic, or other medical care. The findings resulted in four different themes, ie, being dependent on care, being exposed, being vulnerable, and being secure. Lower priority patients are not paid as much attention by nursing staff. Patients reported feeling powerless, insulted, and humiliated when their care was delayed without their understanding what was happening to them. Not understanding results in exposure that violates self-esteem. The goal of the health care provider must be to minimize and prevent suffering, prevent feelings of vulnerability, and to create conditions for optimal patient well being.

Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management.

Science.gov (United States)

Arnesen, Kjell E; Erikssen, Jan; Stavem, Knut

2002-12-01

In a system with implicit queue management, to examine gender and socioeconomic status as determinants of waiting time for inpatient surgery, after adjusting for other potential predictors. A cohort of 452 subjects was examined in outpatient clinics of a general hospital and referred to inpatient surgery. They were followed until scheduled hospital admission (n=396) or until the requested procedure no longer was relevant (n=56). We compared waiting time between groups from referral date until hospital admission, using Kaplan-Meier estimates of waiting times and log rank test. A Cox proportional hazards model was used for assessing the risk ratio (RR) of hospital admission for scheduled surgery. Gender and socioeconomic status could not explain variations in waiting time. However, patients with suspected/verified neoplastic disease or a risk of serious deterioration without treatment had markedly shorter waiting times than the reference groups, with adjusted RR (95% confidence intervals (95%CI)) of time to receiving in-patient surgery of 2.3 (1.7-3.0) and 2.0 (1.3-3.0), respectively. Being on sick leave was associated with shorter waiting time, adjusted RR of 1.7 (1.2-2.5). Referrals from within the hospital or other hospitals had also shorter waiting times than referrals from primary health care physicians, adjusted RR=1.4 (1.1-1.8). There was no evidence of bias against women or people in lower socioeconomic classes in this implicit queue management system. However, patients' access to inpatient surgery was associated with malignancy, prognosis, sick leave status, physician experience, referral pattern and the major diagnosis category.

No-Wait Flexible Flow Shop Scheduling with Due Windows

Directory of Open Access Journals (Sweden)

Rong-Hwa Huang

2015-01-01

Full Text Available To improve capacity and reduce processing time, the flow shop with multiprocessors (FSMP system is commonly used in glass, steel, and semiconductor production. No-wait FSMP is a modern production system that responds to periods when zero work is required in process production. The production process must be continuous and uninterrupted. Setup time must also be considered. Just-in-time (JIT production is very popular in industry, and timely delivery is important to customer satisfaction. Therefore, it is essential to consider the time window constraint, which is also very complex. This study focuses on a no-wait FSMP problem with time window constraint. An improved ant colony optimization (ACO, known as ant colony optimization with flexible update (ACOFU, is developed to solve the problem. The results demonstrate that ACOFU is more effective and robust than ACO when applied to small-scale problems. ACOFU has superior solution capacity and robustness when applied to large-scale problems. Therefore, this study concludes that the proposed algorithm ACOFU performs excellently when applied to the scheduling problem discussed in this study.

Waiting Time Increases Risk of Attrition in Gambling Disorder Treatment

DEFF Research Database (Denmark)

Linnet, Jakob; Pedersen, Anders Sune

2014-01-01

Attrition is a well known problem in psychotherapeutic treatment. Patients with addiction have high attrition rates, and it is therefore important to identify factors that can improve completion rates in addiction. Here, we investigated the influence of waiting time as a predictor of treatment...

Relative entropy and waiting time for continuous-time Markov processes

NARCIS (Netherlands)

Chazottes, J.R.; Giardinà, C.; Redig, F.H.J.

2006-01-01

For discrete-time stochastic processes, there is a close connection between return (resp. waiting) times and entropy (resp. relative entropy). Such a connection cannot be straightforwardly extended to the continuous-time setting. Contrarily to the discrete-time case one needs a reference measure on

Vibrant Energy Aware Spray and Wait Routing in Delay Tolerant Network

Directory of Open Access Journals (Sweden)

Viren G. Patel

2013-01-01

Full Text Available Delay tolerant networks (DTN are wireless networks where disconnections arise often due to the mobility of nodes, failures of energy, the low density of nodes, or when the network extends over long distances. In these situations, traditional routing protocols that have been developed for mobile ad hoc networks prove to be unsuccessful to the scope of transmitting messages between nodes. The Spray and Wait routing may achieve low routing and energy efficiency due to the blindness in the spray phase. To deal with this situation, we propose an opportunistic routing with enclosed message copies, called the Vibrant Energy aware Spray and Wait (VESW, which utilizes the information about vibrancy of node and remaining energy to allocate the number of copies between the corresponding pair nodes in the spray phase.

Waiting for a kidney transplant: the experience of patients with end-stage renal disease in South Korea.

Science.gov (United States)

Chong, Hye Jin; Kim, Hyun Kyung; Kim, Sung Reul; Lee, Sik

2016-04-01

To explore the experiences of Korean patients with end-stage renal disease awaiting kidney transplantation. The need for kidney transplantation has increased worldwide, while the number of kidney donors has not increased commensurately. This mismatch is a serious issue in South Korea. Prolonged waits for transplantation may cause physical and psychosocial issues and lead to poor outcomes. Nevertheless, the experience of waiting for kidney transplantation in South Korea has never been explored in depth. A qualitative descriptive design was used. The participants were eight patients diagnosed with end-stage renal disease on the waiting list for kidney transplantation in South Korea. Data were collected through individual in-depth interviews. All conversations during interviews were recorded and transcribed verbatim. Transcribed data were analysed using conventional content analysis. The experience of waiting for kidney transplantation consisted of six categories: (1) the light at the end of the tunnel, (2) being on call without any promise, (3) a tough tug of war between excitement and frustration, (4) doubts in the complexity, (5) A companion on the hard journey and (6) getting ready for D-day. Kidney transplantation candidates experience psychosocial difficulties and concerns while waiting for long periods of time without any assurance of resolution. Systematic education and psychosocial support from health care professionals and family members help patients get through what they describe as a difficult journey. Comprehensive management programs for kidney transplantation candidates are needed. Health care professionals need to recognise the psychosocial concerns of patients awaiting kidney transplantation. Clinicians should provide patients with information and support throughout the waiting period. © 2016 John Wiley & Sons Ltd.

The unethical focus on access: a study of medical ethics and the waiting-time guarantee.

Science.gov (United States)

Karlberg, H I; Brinkmo, B-M

2009-03-01

All civilized societies favour ethical principles of equity. In healthcare, these principles generally focus on needs for medical care. Methods for establishing priorities among such needs are instrumental in this process. In this study, we analysed whether rules on access to healthcare, waiting-time guarantees, conflict with ethical principles of distributive justice. We interviewed directors, managers and other decision-makers of various healthcare providers of hospitals, primary care organizations and purchasing offices. We also conducted focus group interviews with professionals from a number of distinct medical areas. Our informants and their co-workers were reasonably familiar with the ethical platforms for priority-setting established by the Swedish parliament, giving the sickest patients complete priority. However, to satisfy the waiting-time guarantees, the informants often had to make priority decisions contrary to the ethical principles by favouring access before needs to keep waiting times within certain limits. The common opinion was that the waiting-time guarantee leads to crowding-out effects, overruling the ethical principles based on needs. For more than a decade, the interpretation in Sweden of the equitable principle based on medical needs has been distorted through political decisions, leading to healthcare providers giving priority to access rather than needs for care.

Workshop: Waiting for the top quark

International Nuclear Information System (INIS)

Anon.

1991-01-01

The world of elementary particle physics is eagerly waiting for the top quark, probably the final element of the 'periodic table' of elementary particle constituents. This table consists of two families of weakly interacting particles (leptons) - one series carrying electric charge; the other being electrically neutral - together with a family of quarks carrying electric charge 2/3 (up, charm, top) and a family of charge -1/3 quarks (down, strange, beauty). It was then not surprising that the 1990 Theory Workshop at the DESY Laboratory in Hamburg in October, devoted this time to 'top physics', attracted some 200 physicists, substantially more than previous workshops in the series

Learning to wait: A laboratory investigation

Science.gov (United States)

Oprea, R.; Friedman, D.; Anderson, S.T.

2009-01-01

Human subjects decide when to sink a fixed cost C to seize an irreversible investment opportunity whose value V is governed by Brownian motion. The optimal policy is to invest when V first crosses a threshold V* = (1 + w*) C, where the wait option premium w* depends on drift, volatility, and expiration hazard parameters. Subjects in the Low w* treatment on average invest at values quite close to optimum. Subjects in the two Medium and the High w* treatments invested at values below optimum, but with the predicted ordering, and values approached the optimum by the last block of 20 periods. ?? 2009 The Review of Economic Studies Limited.

Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project.

Science.gov (United States)

Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K

2017-10-01

Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives. © 2017 John Wiley & Sons Ltd.

Psychosocial and Patient Education Needs of Prostate Cancers Selecting Watchful Waiting

National Research Council Canada - National Science Library

Knight, Sara J; Latini, David M

2006-01-01

... of this approach to disease management. We propose to gather data from prostate cancer patients selecting watchful waiting in lieu of an active treatment for their cancer in order to understand the psychosocial and symptom management...

How to share concurrent asynchronous wait-free variables: Preliminary version

NARCIS (Netherlands)

M. Li (Ming); P.M.B. Vitányi (Paul)

1989-01-01

textabstractWe use a structured top-down approach to develop algorithms for atomic variables shared by concurrent asynchronous wait-free processes, starting from the problem specification. By this design we obtain a better understanding of what the algorithms do, why they do it, and that they

Waiting Time Policies in the Health Care Sector. What Works?

DEFF Research Database (Denmark)

Christiansen, Terkel; Bech, Mickael

2013-01-01

times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

Science.gov (United States)

Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

2011-10-01

This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

Assessing the impact of a waiting time survey on reducing waiting times in urban primary care clinics in Cape Town, South Africa

Directory of Open Access Journals (Sweden)

Johann Daniels

2017-09-01

Full Text Available A waiting time survey (WTS conducted in several clinics in Cape Town, South Africa provided recommendations on how to shorten waiting times (WT. A follow-up study was conducted to assess whether WT had reduced. Using a stratified sample of 22 clinics, a before and after study design assessed changes in WT. The WT was measured and perceptions of clinic managers were elicited, about the previous survey’s recommendations. The overall median WT decreased by 21 minutes (95%CI: 11.77- 30.23, a 28% decrease from the previous WTS. Although no specific factor was associated with decreases in WT, implementation of recommendations to reduce WT was 2.67 times (95%CI: 1.33-5.40 more likely amongst those who received written recommendations and 2.3 times (95%CI: 1.28- 4.19 more likely amongst managers with 5 or more years’ experience. The decrease in WT found demonstrates the utility of a WTS in busy urban clinics in developing country contexts. Experienced facility managers who timeously receive customised reports of their clinic’s performance are more likely to implement changes that positively impact on reducing WT.

Patient deaths blamed on long waits at the Phoenix VA

Directory of Open Access Journals (Sweden)

Robbins RA

2014-04-01

Full Text Available No abstract available. Article truncated at 150 words. This morning the lead article in the Arizona Republic was a report blaming as many as 40 deaths at the Phoenix VA on long waits (1. Yesterday, Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, held a hearing titled “A Continued Assessment of Delays in VA Medical Care and Preventable Veteran Deaths.” “It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care,” Miller announced to a stunned audience. The committee has spent months investigating patient-care scandals and allegations at VA facilities in Pittsburgh, Atlanta, Miami and other cities. said that dozens of VA hospital patients in Phoenix may have died while awaiting medical care. He went on to say that staff investigators have evidence that the Phoenix VA Health Care System keeps two sets of records to conceal prolonged waits that patients must endure for ...

Statistical Validation of Calibrated Wind Data Collected From NOAA's Hurricane Hunter Aircraft

Science.gov (United States)

Graham, K.; Sears, I. T.; Holmes, M.; Henning, R. G.; Damiano, A. B.; Parrish, J. R.; Flaherty, P. T.

2015-12-01

Obtaining accurate in situ meteorological measurements from the NOAA G-IV Hurricane Hunter Aircraft currently requires annual wind calibration flights. This project attempts to demonstrate whether an alternate method to wind calibration flights can be implemented using data collected from many previous hurricane, winter storm, and surveying flights. Wind derivations require using airplane attack and slip angles, airplane pitch, pressure differentials, dynamic pressures, ground speeds, true air speeds, and several other variables measured by instruments on the aircraft. Through the use of linear regression models, future wind measurements may be fit to past statistical models. This method of wind calibration could replace the need for annual wind calibration flights, decreasing NOAA expenses and providing more accurate data. This would help to ensure all data users have reliable data and ultimately contribute to NOAA's goal of building of a Weather Ready Nation.

Rabbit hunter uveitis: case report of tularemia uveitis.

Science.gov (United States)

Terrada, Céline; Azza, Said; Bodaghi, Bahram; Le Hoang, Phuc; Drancourt, Michel

2016-09-01

Literature reports on ophthalmological manifestations related to tularemia, a zoonose caused by the bacterium Francisella tularensis, largely refer to Parinaud's oculoglandular syndrome, which consists of the association of conjunctivitis with preauricular lymphadenitis. In this paper, we report a case of intraocular inflammation during tularemia infection. A 52-year-old Caucasian man was diagnosed with unilateral uveitis. The uveitis was posterior, with a 2+ vitritis and a large yellowish lesion involving the macula with an overlying sub-retinal detachment, extending inferiorly, and subretinal hemorrhages. Fluorescein angiography showed a late hyperfluorescence with focal vascular leakage. Ultrasound biomicroscopy confirmed the presence of a 3.8 mm parietal granuloma with a few calcifications in the left eye. While extensive work-up eliminated any other infectious and non-infectious etiology, tularemia was diagnosed by advanced serology consisting of two-dimensional Western-immunoblotting. The patient, a hunter, recalled having killed rabbits in the days before the symptoms appeared. Uveitis was rapidly controlled following treatment with doxycycline, yet three years after initiation of the treatment, the patient still complained of loss of vision in the left eye with a central scotoma. Posterior uveitis may be an infrequent manifestation of tularemia infection, and therefore this infection should be considered in the differential diagnosis of intraocular inflammation in areas where F. tularensis is endemic.

Poisson-process generalization for the trading waiting-time distribution in a double-auction mechanism

Science.gov (United States)

Cincotti, Silvano; Ponta, Linda; Raberto, Marco; Scalas, Enrico

2005-05-01

In this paper, empirical analyses and computational experiments are presented on high-frequency data for a double-auction (book) market. Main objective of the paper is to generalize the order waiting time process in order to properly model such empirical evidences. The empirical study is performed on the best bid and best ask data of 7 U.S. financial markets, for 30-stock time series. In particular, statistical properties of trading waiting times have been analyzed and quality of fits is evaluated by suitable statistical tests, i.e., comparing empirical distributions with theoretical models. Starting from the statistical studies on real data, attention has been focused on the reproducibility of such results in an artificial market. The computational experiments have been performed within the Genoa Artificial Stock Market. In the market model, heterogeneous agents trade one risky asset in exchange for cash. Agents have zero intelligence and issue random limit or market orders depending on their budget constraints. The price is cleared by means of a limit order book. The order generation is modelled with a renewal process. Based on empirical trading estimation, the distribution of waiting times between two consecutive orders is modelled by a mixture of exponential processes. Results show that the empirical waiting-time distribution can be considered as a generalization of a Poisson process. Moreover, the renewal process can approximate real data and implementation on the artificial stocks market can reproduce the trading activity in a realistic way.

The tyranny of distance: maternity waiting homes and access to birthing facilities in rural Timor-Leste.

Science.gov (United States)

Wild, Kayli; Barclay, Lesley; Kelly, Paul; Martins, Nelson

2012-02-01

To examine the impact of maternity waiting homes on the use of facility-based birthing services for women in two remote districts of Timor-Leste. A before-and-after study design was used to compare the number of facility-based births in women who lived at different distances (0-5, 6-25, 26-50 and > 50 km) from the health centre before and after implementation of maternity waiting homes. Routine data were collected from health centre records at the end of 2007; they included 249 births in Same, Manufahi district, and 1986 births in Lospalos, Lautem district. Population data were used to estimate the percentage of women in each distance category who were accessing facility-based care. Most facility-based births in Same (80%) and Lospalos (62%) were among women who lived within 5 km of the health centre. There was no significant increase in the number of facility-based births among women in more remote areas following implementation of the maternity waiting homes. The percentage of births in the population that occurred in a health facility was low for both Manufahi district (9%) and Lautem district (17%), and use decreased markedly as distance between a woman's residence and the health facilities increased. The maternity waiting homes in Timor-Leste did not improve access to facility-based delivery for women in remote areas. The methods for distance analysis presented in this paper provide a framework that could be used by other countries seeking to evaluate maternity waiting homes.

The Sit-and-Wait Hypothesis in Bacterial Pathogens: A Theoretical Study of Durability and Virulence

Directory of Open Access Journals (Sweden)

Liang Wang

2017-11-01

Full Text Available The intriguing sit-and-wait hypothesis predicts that bacterial durability in the external environment is positively correlated with their virulence. Since its first proposal in 1987, the hypothesis has been spurring debates in terms of its validity in the field of bacterial virulence. As a special case of the vector-borne transmission versus virulence tradeoff, where vector is now replaced by environmental longevity, there are only sporadic studies over the last three decades showing that environmental durability is possibly linked with virulence. However, no systematic study of these works is currently available and epidemiological analysis has not been updated for the sit-and-wait hypothesis since the publication of Walther and Ewald’s (2004 review. In this article, we put experimental evidence, epidemiological data and theoretical analysis together to support the sit-and-wait hypothesis. According to the epidemiological data in terms of gain and loss of virulence (+/- and durability (+/- phenotypes, we classify bacteria into four groups, which are: sit-and-wait pathogens (++, vector-borne pathogens (+-, obligate-intracellular bacteria (--, and free-living bacteria (-+. After that, we dive into the abundant bacterial proteomic data with the assistance of bioinformatics techniques in order to investigate the two factors at molecular level thanks to the fast development of high-throughput sequencing technology. Sequences of durability-related genes sourced from Gene Ontology and UniProt databases and virulence factors collected from Virulence Factor Database are used to search 20 corresponding bacterial proteomes in batch mode for homologous sequences via the HMMER software package. Statistical analysis only identified a modest, and not statistically significant correlation between mortality and survival time for eight non-vector-borne bacteria with sit-and-wait potentials. Meanwhile, through between-group comparisons, bacteria with higher

Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times.

Science.gov (United States)

Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Sanmartin, Claudia; Decoster, Carolyn; Clavel, Nathalie; Warren, Elaine; Drew, Madeleine; Noseworthy, Tom

2013-06-06

Long waits for core specialized services have consistently been identified as a key barrier to access. Governments and organizations at all levels have responded with strategies for better wait list management. While these initiatives are promising, insufficient attention has been paid to factors influencing the implementation and sustainability of wait time management strategies (WTMS) implemented at the organizational level. A systematic review was conducted using the main electronic databases, such as CINAHL, MEDLINE, and Cochrane Database of Systematic Reviews, to identify articles published between 1990 and 2011 on WTMS for scheduled care implemented at the organizational level or higher and on frameworks for analyzing factors influencing their success. Data was extracted on governance, culture, resources, and tools. We organized a workshop with Canadian healthcare policy-makers and managers to compare our initial findings with their experience. Our systematic review included 47 articles: 36 related to implementation and 11 to sustainability. From these, we identified a variety of WTMS initiated at the organizational level or higher, and within these, certain factors that were specific to either implementation or sustainability and others common to both. The main common factors influencing success at the contextual level were stakeholder engagement and strong funding, and at the organizational level, physician involvement, human resources capacity, and information management systems. Specific factors for successful implementation at the contextual level were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. For sustainability, we found no new factors. The workshop participants identified the same major factors as found in the articles and added others, such as information sharing between physicians and managers. Factors related to implementation were studied

EVALUTION OF THE SINGLE INTERCITY FREIGHT TRANSPORTATION WAITING TIME

Directory of Open Access Journals (Sweden)

N. Ponomariova

2015-07-01

Full Text Available The example of vechicle operation on the pendulum intercity route during single freightages processing is considered. Two approaches to the definition of the single freightage waiting time by the carrier are proposed. These approaches allow to take into account the probability of the single freightage obtaining by the carrier during the different load level of the transport enterprise capacity.

Change of tumor target volume during waiting time for intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Chen Bo; Yi Junlin; Gao Li; Xu Guozhen; Huang Xiaodong; Zhang Zhong; Luo Jingwei; Li Suyan

2007-01-01

Objective: To determine the influence of change in tumor target volume of nasopharyngeal carcinoma (NPC) while waiting for intensity modulated radiation therapy (IMRT). Methods: From March 2005 to December 2005, 31 patients with nasopharyngeal carcinoma received IMRT as the initial treatment at the Cancer Hospital of Chinese Academic of Medical Sciences. The original simulation CT scan was acquired before IMRT planning. A second CT scan was acquired before the start of radiotherapy. Wait- ing time was defined as the duration between CT simulation and start of radiotherapy. CT-CT fusion was used to minimize the error of delineation between the first tumor target volume (GTV) and the second tumor target volume (sGTV). Tumor target volume was calculated by treatment planning system. T test was carried out to analyse the difference between GTV and sGTV. Pearson correlation and multivariate linear regression was used to analyse the influence factor of the change betweent GTV and sGTV. Results: Median waiting time was 18 days (range, 9-27 days). There were significant differences between GTV and sGTV of both primary tumor (P=0.009) and metastatic lymphoma (P=0.005 ). Both Pearson correlation and multivariate linear regression showed that the change of primary tumor target volume had significant correlation with the first tumor target volume but had no significant correlation with the waiting time, sex, age, T stage and N stage (1992 Chinese Fuzhou Staging Classification). Conclusions: Within the range of the waiting time ob- served in our study, large volume primary tumor would have had a significant increase in volume, but whether the therapeutic effect would be influenced or not would need to be proved by study of large number of cases. Patients with large volume tumor should be considered to reduce the influence of waiting time by enlarging gross target volume and clinical targe volume and by neoadjuveant chemotherapy. For avoiding the unnecessary high-dose to normal

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

OpenAIRE

Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

2016-01-01

Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emerg...

[Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

Science.gov (United States)

Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

2015-12-01

Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Continuous time random walk model with asymptotical probability density of waiting times via inverse Mittag-Leffler function

Science.gov (United States)

Liang, Yingjie; Chen, Wen

2018-04-01

The mean squared displacement (MSD) of the traditional ultraslow diffusion is a logarithmic function of time. Recently, the continuous time random walk model is employed to characterize this ultraslow diffusion dynamics by connecting the heavy-tailed logarithmic function and its variation as the asymptotical waiting time density. In this study we investigate the limiting waiting time density of a general ultraslow diffusion model via the inverse Mittag-Leffler function, whose special case includes the traditional logarithmic ultraslow diffusion model. The MSD of the general ultraslow diffusion model is analytically derived as an inverse Mittag-Leffler function, and is observed to increase even more slowly than that of the logarithmic function model. The occurrence of very long waiting time in the case of the inverse Mittag-Leffler function has the largest probability compared with the power law model and the logarithmic function model. The Monte Carlo simulations of one dimensional sample path of a single particle are also performed. The results show that the inverse Mittag-Leffler waiting time density is effective in depicting the general ultraslow random motion.

Hospital competition, GP fundholders and waiting times in the UK internal market: the case of elective surgery.

Science.gov (United States)

Xavier, Ana

2003-03-01

In this paper I model the demand for and supply of elective surgery using a modified Hotelling framework in which time, money, and distance are determinants of the demand for hospital care. Hospitals compete with each other in terms of the waiting time and consequently treat a certain number of patients. The basic model of hospital competition is then extended to incorporate the general practitioner (GP) fundholding scheme whereby the GPs are allocated a budget with which to buy care for their patients. Waiting time increases when production of care becomes more expensive, when the benefit obtained from treatment increases, when the unit cost of distance decreases, and when the importance given to time as a performance indicator decreases. The higher the money price the lower the waiting time. Finally, the money price paid by the GP fundholders is greater than that paid by the Health Authorities and greater than the hospitals marginal cost of production. As a consequence, fundholding patients pay a zero time price while non-fundholding patients experiment a positive waiting time.

Asymptotic inference for waiting times and patiences in queues with abandonment

DEFF Research Database (Denmark)

Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

2009-01-01

Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about waiting time and patience distributions in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

Networks of Food Sharing Reveal the Functional Significance of Multilevel Sociality in Two Hunter-Gatherer Groups.

Science.gov (United States)

Dyble, Mark; Thompson, James; Smith, Daniel; Salali, Gul Deniz; Chaudhary, Nikhil; Page, Abigail E; Vinicuis, Lucio; Mace, Ruth; Migliano, Andrea Bamberg

2016-08-08

Like many other mammalian and primate societies [1-4], humans are said to live in multilevel social groups, with individuals situated in a series of hierarchically structured sub-groups [5, 6]. Although this multilevel social organization has been described among contemporary hunter-gatherers [5], questions remain as to the benefits that individuals derive from living in such groups. Here, we show that food sharing among two populations of contemporary hunter-gatherers-the Palanan Agta (Philippines) and Mbendjele BaYaka (Republic of Congo)-reveals similar multilevel social structures, with individuals situated in households, within sharing clusters of 3-4 households, within the wider residential camps, which vary in size. We suggest that these groupings serve to facilitate inter-sexual provisioning, kin provisioning, and risk reduction reciprocity, three levels of cooperation argued to be fundamental in human societies [7, 8]. Humans have a suite of derived life history characteristics including a long childhood and short inter-birth intervals that make offspring energetically demanding [9] and have moved to a dietary niche that often involves the exploitation of difficult to acquire foods with highly variable return rates [10-12]. This means that human foragers face both day-to-day and more long-term energetic deficits that conspire to make humans energetically interdependent. We suggest that a multilevel social organization allows individuals access to both the food sharing partners required to buffer themselves against energetic shortfalls and the cooperative partners required for skill-based tasks such as cooperative foraging. Copyright © 2016 Elsevier Ltd. All rights reserved.

Potential impact of enhanced practice efficiency on endoscopy waiting times.

LENUS (Irish Health Repository)

Harewood, G C

2009-06-01

With the growing demand on endoscopy services, optimising practice efficiency has assumed increasing importance. Prior research has identified practice changes, which increase the efficiency in endoscopy. In this study, the potential impact of these practice changes on the current and projected future endoscopy waiting times at our institution was assessed.

High-dose chemoradiotherapy and watchful waiting for distal rectal cancer

DEFF Research Database (Denmark)

Appelt, Ane L; Pløen, John; Harling, Henrik

2015-01-01

-dose radiotherapy with concomitant chemotherapy followed by observation (watchful waiting) was successful for non-surgical management of low rectal cancer. METHODS: Patients with primary, resectable, T2 or T3, N0-N1 adenocarcinoma in the lower 6 cm of the rectum were given chemoradiotherapy (60 Gy in 30 fractions...

ADAPTATION OF JOHNSON SEQUENCING ALGORITHM FOR JOB SCHEDULING TO MINIMISE THE AVERAGE WAITING TIME IN CLOUD COMPUTING ENVIRONMENT

Directory of Open Access Journals (Sweden)

SOUVIK PAL

2016-09-01

Full Text Available Cloud computing is an emerging paradigm of Internet-centric business computing where Cloud Service Providers (CSPs are providing services to the customer according to their needs. The key perception behind cloud computing is on-demand sharing of resources available in the resource pool provided by CSP, which implies new emerging business model. The resources are provisioned when jobs arrive. The job scheduling and minimization of waiting time are the challenging issue in cloud computing. When a large number of jobs are requested, they have to wait for getting allocated to the servers which in turn may increase the queue length and also waiting time. This paper includes system design for implementation which is concerned with Johnson Scheduling Algorithm that provides the optimal sequence. With that sequence, service times can be obtained. The waiting time and queue length can be reduced using queuing model with multi-server and finite capacity which improves the job scheduling model.

Asymptotic inference for waiting times and patiences in queues with abandonment

DEFF Research Database (Denmark)

Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about the waiting time and patience distribution in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

WAITING TIME DISTRIBUTION OF SOLAR ENERGETIC PARTICLE EVENTS MODELED WITH A NON-STATIONARY POISSON PROCESS

International Nuclear Information System (INIS)

Li, C.; Su, W.; Fang, C.; Zhong, S. J.; Wang, L.

2014-01-01

We present a study of the waiting time distributions (WTDs) of solar energetic particle (SEP) events observed with the spacecraft WIND and GOES. The WTDs of both solar electron events (SEEs) and solar proton events (SPEs) display a power-law tail of ∼Δt –γ . The SEEs display a broken power-law WTD. The power-law index is γ 1 = 0.99 for the short waiting times (<70 hr) and γ 2 = 1.92 for large waiting times (>100 hr). The break of the WTD of SEEs is probably due to the modulation of the corotating interaction regions. The power-law index, γ ∼ 1.82, is derived for the WTD of the SPEs which is consistent with the WTD of type II radio bursts, indicating a close relationship between the shock wave and the production of energetic protons. The WTDs of SEP events can be modeled with a non-stationary Poisson process, which was proposed to understand the waiting time statistics of solar flares. We generalize the method and find that, if the SEP event rate λ = 1/Δt varies as the time distribution of event rate f(λ) = Aλ –α exp (– βλ), the time-dependent Poisson distribution can produce a power-law tail WTD of ∼Δt α –3 , where 0 ≤ α < 2

Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

Science.gov (United States)

Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

2014-01-01

Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

Did warfare among ancestral hunter-gatherers affect the evolution of human social behaviors?

Science.gov (United States)

Bowles, Samuel

2009-06-05

Since Darwin, intergroup hostilities have figured prominently in explanations of the evolution of human social behavior. Yet whether ancestral humans were largely "peaceful" or "warlike" remains controversial. I ask a more precise question: If more cooperative groups were more likely to prevail in conflicts with other groups, was the level of intergroup violence sufficient to influence the evolution of human social behavior? Using a model of the evolutionary impact of between-group competition and a new data set that combines archaeological evidence on causes of death during the Late Pleistocene and early Holocene with ethnographic and historical reports on hunter-gatherer populations, I find that the estimated level of mortality in intergroup conflicts would have had substantial effects, allowing the proliferation of group-beneficial behaviors that were quite costly to the individual altruist.

Passenger arrival and waiting time distributions dependent on train service frequency and station characteristics: A smart card data analysis

DEFF Research Database (Denmark)

Ingvardson, Jesper Bláfoss; Nielsen, Otto Anker; Raveau, Sebastián

2018-01-01

Waiting time at public transport stops is perceived by passengers to be more onerous than in-vehicle time, hence it strongly influences the attractiveness and use of public transport. Transport models traditionally assume that average waiting times are half the service headway by assuming random...... Copenhagen Area covering metro, suburban, and regional rail stations thereby giving a range of service headways from 2 to 60 min. It was shown that the proposed mixture distribution is superior to other distributions proposed in the literature. This can improve waiting time estimations in public transport...

Prospective evaluation through questionnaires of the emotional status of cancer patients in the waiting rooms of a department of oncology

OpenAIRE

Roberta Resega; Sheila Piva; Annalisa Bramati; Christian Lurati; Nicla La Verde; Marco Riva; Marina Chiara Garassino; Anna Moretti; Claudio Mencacci; Valter Torri; Gabriella Farina; Maria Chiara Dazzani

2016-01-01

Objective: The aim of this study is to better identify the prevailing emotions and feelings of cancer patients during their stay in waiting rooms in a department of oncology. Methods: In July 2014, patients in the waiting rooms of our Department of Oncology were asked to fill out dedicated questionnaires. Patients had to choose sentences that best described their feelings, thoughts and experiences; this part was differentiated according to the waiting rooms (Consultation Rooms versus Day H...

Portrait of a Geothermal Spring, Hunter's Hot Springs, Oregon.

Science.gov (United States)

Castenholz, Richard W

2015-01-27

Although alkaline Hunter's Hot Springs in southeastern Oregon has been studied extensively for over 40 years, most of these studies and the subsequent publications were before the advent of molecular methods. However, there are many field observations and laboratory experiments that reveal the major aspects of the phototrophic species composition within various physical and chemical gradients of these springs. Relatively constant temperature boundaries demark the upper boundary of the unicellular cyanobacterium, Synechococcus at 73-74 °C (the world-wide upper limit for photosynthesis), and 68-70 °C the upper limit for Chloroflexus. The upper limit for the cover of the filamentous cyanobacterium, Geitlerinema (Oscillatoria) is at 54-55 °C, and the in situ lower limit at 47-48 °C for all three of these phototrophs due to the upper temperature limit for the grazing ostracod, Thermopsis. The in situ upper limit for the cyanobacteria Pleurocapsa and Calothrix is at ~47-48 °C, which are more grazer-resistant and grazer dependent. All of these demarcations are easily visible in the field. In addition, there is a biosulfide production in some sections of the springs that have a large impact on the microbiology. Most of the temperature and chemical limits have been explained by field and laboratory experiments.

Parental experience of enzyme replacement therapy for Hunter syndrome.

Science.gov (United States)

Buraczewska, M; O'Leary, D; Walsh, O; Monavari, A; Crushell, E

2013-04-01

We aimed to establish the profile of Irish patients with Hunter Syndrome (Mucopolysaccharidosis type II, MPS II) receiving weekly intravenous Enzyme Replacement Therapy (ERT) with recombinant iduronate-2-sulfatase and to assess the social impact and parental opinion of ERT through the use of a parental questionnaire. Nine patients aged 3.5- 14 years have received a mean of 2 (range 0.5-3.5) years of ERT. Treatment was associated with clinical improvements from baseline in hepatosplenomegaly in 6/7 (85%) respiratory manifestations in 4/6 (67%) and a mean reduction in urinary glycosaminoglycan excretion of 62%. Changes noted by parents included increased energy 3/9 (33%) and softening of skin, hair and facial features 8/9 (89%). Parents report that seven hours weekly were spent on hospitalizations for ERT. Parental employment was adversely affected in 8 (89%) families. One day of school/preschool (20%) was lost every week for 8 (89%) children. All parents believed the benefits of ERT out-weigh the difficulties involved. All families would welcome the introduction of home based therapy. In conclusion the social and educational burden of hospital-based ERT on these children and their families is significant. The introduction of home-based therapy is likely to improve overall quality of life for MPSII patients and their families.

Hip and knee arthroplasty waiting list – how accurate and fair?

African Journals Online (AJOL)

access by hospital managers and provincial planners. ... interaction of administration and clinical staff. ... Resource-intensive procedures require the use of patient waiting lists in an attempt to increase fairness ... These deficiencies have prompted the introduction of a scoring-based prioritisation system incorporating clinical,.

Emergency Department Waiting Times (EDWaT): A Patient Flow Management and Quality of Care Rating mHealth Application.

Science.gov (United States)

Househ, Mowafa; Yunus, Faisel

2014-01-01

Saudi hospital emergency departments (ED) have suffered from long waiting times, which have led to a delay in emergency patient care. The increase in the population of Saudi Arabia is likely to further stretch the healthcare services due to overcrowding leading to decreased healthcare quality, long patient waits, patient dissatisfaction, ambulance diversions, decreased physician productivity, and increased frustration among medical staff. This will ultimately put patients at risk for poor health outcomes. Time is of the essence in emergencies and to get to an ED that has the shortest waiting time can mean life or death for a patient, especially in cases of stroke and myocardial infarction. In this paper, we present our work on the development of a mHealth Application - EDWaT - that will: provide patient flow information to the emergency medical services staff, help in quick routing of patients to the nearest hospital, and provide an opportunity for patients to review and rate the quality of care received at an ED, which will then be forwarded to ED services administrators. The quality ratings will help patients to choose between two EDs with the same waiting time and distance from their location. We anticipate that the use of EDWaT will help improve ED wait times and the quality of care provision in Saudi hospitals EDs.

A modelling framework for mitigating customers' waiting time at a vehicle inspection centre

Science.gov (United States)

Ahmad, Norazura; Abidin, Norhaslinda Zainal; Ilyas, Khibtiyah; Abduljabbar, Waleed Khalid

2017-11-01

In Malaysia, an agency that is entrusted by the Government to perform mandatory vehicle inspection for public, commercial and private vehicles, receive many customers daily. Often complaints of problems received from the customers are associated with waiting time that leads to lost of business and dissatisfied customers. To address this issue, we propose a framework for modelling a vehicle inspection system using an integration of simulation and optimization approaches. The strengths of simulation and optimization are reviewed briefly that is hoped to reveal the synergy between the established methods in determining an appropriate customer's waiting time for inspection at a vehicle inspection centre. Relevant concepts and preliminary results are also presented and discussed in this paper.

Deficient neural activity subserving decision-making during reward waiting time in intertemporal choice in adult attention-deficit hyperactivity disorder.

Science.gov (United States)

Todokoro, Ayako; Tanaka, Saori C; Kawakubo, Yuki; Yahata, Noriaki; Ishii-Takahashi, Ayaka; Nishimura, Yukika; Kano, Yukiko; Ohtake, Fumio; Kasai, Kiyoto

2018-04-24

Impulsivity, which significantly affects social adaptation, is an important target behavioral characteristic in interventions for attention-deficit hyperactivity disorder (ADHD). Typically, people are willing to wait longer to acquire greater rewards. Impulsivity in ADHD may be associated with brain dysfunction in decision-making involving waiting behavior under such situations. We tested the hypothesis that brain circuitry during a period of waiting (i.e., prior to the acquisition of reward) is altered in adults with ADHD. The participants included 14 medication-free adults with ADHD and 16 healthy controls matched for age, sex, IQ, and handedness. The behavioral task had participants choose between a delayed, larger monetary reward and an immediate, smaller monetary reward, where the reward waiting time actually occurred during functional magnetic resonance imaging measurement. We tested for group differences in the contrast values of blood-oxygen-level dependent signals associated with the length of waiting time, calculated using the parametric modulation method. While the two groups did not differ in the time discounting rate, the delay-sensitive contrast values were significantly lower in the caudate and visual cortex in individuals with ADHD. The higher impulsivity scores were significantly associated with lower delay-sensitive contrast values in the caudate and visual cortex. These results suggest that deficient neural activity affects decision-making involving reward waiting time during intertemporal choice tasks, and provide an explanation for the basis of impulsivity in adult ADHD. © 2018 The Author. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology.

A study on the impact of prioritising emergency department arrivals on the patient waiting time.

Science.gov (United States)

Van Bockstal, Ellen; Maenhout, Broos

2018-05-03

In the past decade, the crowding of the emergency department has gained considerable attention of researchers as the number of medical service providers is typically insufficient to fulfil the demand for emergency care. In this paper, we solve the stochastic emergency department workforce planning problem and consider the planning of nurses and physicians simultaneously for a real-life case study in Belgium. We study the patient arrival pattern of the emergency department in depth and consider different patient acuity classes by disaggregating the arrival pattern. We determine the personnel staffing requirements and the design of the shifts based on the patient arrival rates per acuity class such that the resource staffing cost and the weighted patient waiting time are minimised. In order to solve this multi-objective optimisation problem, we construct a Pareto set of optimal solutions via the -constraints method. For a particular staffing composition, the proposed model minimises the patient waiting time subject to upper bounds on the staffing size using the Sample Average Approximation Method. In our computational experiments, we discern the impact of prioritising the emergency department arrivals. Triaging results in lower patient waiting times for higher priority acuity classes and to a higher waiting time for the lowest priority class, which does not require immediate care. Moreover, we perform a sensitivity analysis to verify the impact of the arrival and service pattern characteristics, the prioritisation weights between different acuity classes and the incorporated shift flexibility in the model.

Quality of Life in Rectal Cancer Patients After Chemoradiation: Watch-and-Wait Policy Versus Standard Resection - A Matched-Controlled Study.

Science.gov (United States)

Hupkens, Britt J P; Martens, Milou H; Stoot, Jan H; Berbee, Maaike; Melenhorst, Jarno; Beets-Tan, Regina G; Beets, Geerard L; Breukink, Stéphanie O

2017-10-01

Fifteen to twenty percent of patients with locally advanced rectal cancer have a clinical complete response after chemoradiation therapy. These patients can be offered nonoperative organ-preserving treatment, the so-called watch-and-wait policy. The main goal of this watch-and-wait policy is an anticipated improved quality of life and functional outcome in comparison with a total mesorectal excision, while maintaining a good oncological outcome. The aim of this study was to compare the quality of life of watch-and-wait patients with a matched-controlled group of patients who underwent chemoradiation and surgery (total mesorectal excision group). This was a matched controlled study. This study was conducted at multiple centers. The study population consisted of 2 groups: 41 patients after a watch-and-wait policy and 41 matched patients after chemoradiation and surgery. Patients were matched on sex, age, tumor stage, and tumor height. All patients were disease free at the moment of recruitment after a minimal follow-up of 2 years. Quality of life was measured by validated questionnaires covering general quality of life (Short Form 36, European Organization for Research and Treatment of Cancer QLQ-C30), disease-specific total mesorectal excision (European Organization for Research and Treatment of Cancer QLQ-CR38), defecation problems (Vaizey and low anterior resection syndrome scores), sexual problems (International Index of Erectile Function and Female Sexual Function Index), and urinary dysfunction (International Prostate Symptom Score). The watch-and-wait group showed better physical and cognitive function, better physical and emotional roles, and better global health status compared with the total mesorectal excision group. The watch-and-wait patients showed fewer problems with defecation and sexual and urinary tract function. This study only focused on watch-and-wait patients who achieved a sustained complete response for 2 years. In addition, this is a study

Increases in heart rate and serum cortisol concentrations in healthy dogs are positively correlated with an indoor waiting-room environment.

Science.gov (United States)

Perego, Roberta; Proverbio, Daniela; Spada, Eva

2014-03-01

Few studies have investigated the effect of veterinary clinical procedures on the welfare of dogs, with specific emphasis on the veterinary practice environment. Clinicopathologic variables have also not been assessed in these potentially stressful situations. Similar to human clinical studies, the veterinary clinical waiting room could present a significant stress factor for dogs. The present study was designed to investigate the effect of waiting-room environment on serum cortisol and glucose alterations as well as heart rate in privately owned healthy dogs. The clinical trial included 24 healthy dogs that were divided into 2 groups: the clinical waiting-room group (A) and the control group (B) that waited outside in a garden. During the entire experiment, 18 dogs (9 dogs per group) were monitored with a human heart rate monitor fastened around the chest. After 20 minutes of waiting, blood samples were collected from all of the dogs (24 dogs) to determine serum cortisol concentration. Serum cortisol concentration and mean, maximum, and minimum heart rate were significantly higher in group A compared with group B, but there was no statistical difference in serum glucose concentrations between the 2 study groups. Results of this study suggest that the waiting room is a potentially stressful situation for dogs in clinical veterinary practice, when compared with a garden, based on the assessment of adrenal cortex function and heart rate evaluation. © 2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

Una valigia caduta in mare: Jaume Serra Hunter e la "Scuola di Barcellona"

Directory of Open Access Journals (Sweden)

Nazzareno Fioraso

2014-12-01

Full Text Available Nella storiografia filosofica spagnola non esiste, probabilmente, una definizione ambigua e problematica come quella che riguarda la cosiddetta "Scuola di Barcellona". La tesi principale di questo articolo è che tale scuola non giunse mai a nascere, ma ne esistette soltanto una forma embrionale che non poté maturare perché, in conseguenza della situazione politica venutasi a creare con la guerra civile (1936-1939, i suoi componenti si dispersero nell'esilio. Ciò nonostante, è possibile riconoscere alcuni tratti comuni, seppur labili e (forse non sostanziali, nella diaspora degli intellettuali catalani che rendono possibile definirla, con le dovute cautele, "Scuola di Barcellona". Tali caratteristiche comuni si possono far risalire a colui che, in un certo senso, fu il fondatore della scuola, essendo il principale maestro delle nuove leve filosofiche della Catalogna all'inizio del XX secolo: Jaume Serra Hunter.

Results of the radiological survey at West Hunter Avenue Firehall, Maywood, New Jersey (MJ027)

International Nuclear Information System (INIS)

Foley, R.D.; Floyd, L.M.

1990-03-01

Maywood Chemical Works (MCW) of Maywood, New Jersey, generated process wastes and residues associated with the production and refining of thorium and thorium compounds from monazite ores from 1916 to 1956. At the request of the US Department of Energy (DOE), a group from Oak Ridge National Laboratory conducts investigative radiological surveys of properties in the vicinity of MCW to determine whether a property is contaminated with radioactive residues, principally 232 Th, derived from the MCW site. The survey typically includes direct measurement of gamma radiation levels and soil sampling for radionuclide analyses. The survey of this site, West Hunter Avenue Firehall, Maywood, New Jersey (MJ027), was conducted during 1987. 4 refs., 3 tabs

Predicting hunter behavior of indigenous communities in the Ecuadorian Amazon: insights from a household production model

Directory of Open Access Journals (Sweden)

Enrique de la Montaña

2015-12-01

Full Text Available Many indigenous communities living in the Amazon rely on hunting and fishing to meet the majority of their protein needs. Despite the importance of these practices, few studies from the region have analyzed the socioeconomic drivers of hunting and fishing at the household level. We propose a household production model to assess the effect of key economic parameters on hunting and fishing in small indigenous communities located in the Ecuadorian Amazon, whose principal source of protein is derived from hunting and fishing. The model was validated using empirical data from two communities that reflect different levels of market integration and forest conservation. Demand and supply functions were generated from household data gathered over 19 months. Elasticities were derived to determine the sensitivity of the decision to engage in hunting to exogenous parameters such as off-farm wages, hunting costs, bushmeat price, penalties for the illegal sale of bushmeat, and biological characteristics of the game species. After calibrating the model, we simulated changes in the key economic parameters. The parameter that most directly affected hunting activity in both communities was off-farm wages. Simulating a 10% wage increase resulted in a 16-20% reduction in harvested biomass, while a 50% increase diminished harvested biomass by > 50%. Model simulations revealed that bushmeat price and penalties for illegal trade also had important effects on hunter behavior in terms of amount of bushmeat sold, but not in terms of total harvest. As a tool for understanding hunters' economic decision-making, the model provides a basis for developing strategies that promote sustainable hunting and wildlife conservation while protecting indigenous livelihoods.

Origin of HTLV-1 in hunters of nonhuman primates in Central Africa.

Science.gov (United States)

Kazanji, Mirdad; Mouinga-Ondémé, Augustin; Lekana-Douki-Etenna, Sonia; Caron, Mélanie; Makuwa, Maria; Mahieux, Renaud; Gessain, Antoine

2015-02-01

Of 78 Gabonese individuals who had received bites from nonhuman primates (NHPs) while hunting, 7 were infected with human T lymphotropic virus (HTLV-1). Five had been bitten by gorillas and were infected with subtype B strains; however, a 12-year-old girl who was severely bitten by a Cercopithecus nictitans was infected with a subtype D strain that was closely related to the simian T lymphotropic virus (STLV-1) that infects this monkey species. Her mother was infected with a subtype B strain. These data confirm that hunters in Africa can be infected by HTLV-1 that is closely related to the strains circulating among local NHP game. Our findings strongly suggest that a severe bite represent a risk factor for STLV-1 acquisition. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A Study to Determine Patient Waiting Time at the Outpatient Pharmacy at Wilford Hall USAF Medical Center

Science.gov (United States)

1988-06-01

at Wilford Hall USAF Medical Center significantly reduced the patient wait time at the main outpatient pharmacy. Satellite pharmacies have been ).’l...PRESENTING TO WINDOW 1, 19 MAR 88. 47 C:. A’.’E-:A: -ESCRIRTIONS PER PATIENT ...........48 H. WILFORD HALL MEDICAL CENTER OUTPATIENT QUESTIONNAIRE...that wait times at tne outpatient pharmacy were excessive. It was this concern that motivated the Medical Center Administrator to request that patient

A prospective study on the impact of waiting times for radiotherapy ...

African Journals Online (AJOL)

Background: Radiotherapy plays a vital role in the management of cervical cancer. However, because of high patient load and limited resources, waiting lists are unacceptably long. This is a highly curable malignancy that often occurs in economically active, relatively young women. The impact of treatment delays on society ...

Mobile Technology Waiting for the 3G Rush

Institute of Scientific and Technical Information of China (English)

HAYET SELLAMI

2006-01-01

@@ China is potentially the biggest third generation (3G) mobile market in the world, and everyone is eager to grab a piece of the pie. Foreign carriers are still not allowed to apply for licences since China's decision regarding licensing and adoption of 3G mobile services is still pending, but the waiting list is long. Both Chinese officials and industry executives have stated that they want 3G in place in time for the August 2008 Olympic Games held in Beijing. This tight deadline leaves no room for failure.

Patients\\' response to waiting time in an out-patient pharmacy in ...

African Journals Online (AJOL)

Purpose: To identify the dispensing procedure at a pharmacy, investigate the possible operational problems that may lead to excessive patient waiting times as prescriptions are filled and to examine patient disposition to perceived delays at the pharmacy. Methods: The study was carried out in a 574-bed university teaching ...

Maternity waiting homes and institutional birth in Nicaragua: policy options and strategic implications.

Science.gov (United States)

García Prado, Ariadna; Cortez, Rafael

2012-01-01

With the aim of promoting institutional births and reducing the high maternal and child mortality rates in rural and poor zones, the government of Nicaragua is supporting the creation of maternity waiting homes. This study analyzes that strategy and examines the factors associated with the use of maternity waiting homes and institutional birth. To that end, we apply a quantitative approach, by means of an econometric analysis of the data extracted from surveys conducted in 2006 on a sample of women and parteras or traditional birth attendants, as well as a qualitative approach based on interviews with key informants. Results indicate that although the operation of the maternity waiting homes is usually satisfactory, there is still room for improvement along the following lines: (i) disseminating information about the homes to both women and men, as the latter frequently decide the course of women's healthcare, and to parteras, who can play an important role in referring women; (ii) strengthening the postpartum care; (iii) ensuring financial sustainability by obtaining regular financial support from the government to complement contributions from the community; and (iv) strengthening the local management and involvement of the regional government. These measures might be useful for health policy makers in Nicaragua and in other developing countries that are considering this strategy. Copyright © 2011 John Wiley & Sons, Ltd.

The influence of waiting time satisfaction on customer loyalty towards multi-stage services in a full-service restaurant: evidence from India

OpenAIRE

MITTAL A.

2016-01-01

Research shows waiting time in services is an important source of service evaluation by the customer. In fact, time is one component of the total 'cost' that the customer bears and cost is a core component of the perceived cost-benefit equation that the customer uses to evaluate her or his sustained patronage of a particular service. In most services, customers consider waiting as a waste of time. However, from the customer perspective, in the case of a full-service restaurant, waiting is exp...

Reduction of admit wait times: the effect of a leadership-based program.

Science.gov (United States)

Patel, Pankaj B; Combs, Mary A; Vinson, David R

2014-03-01

Prolonged admit wait times in the emergency department (ED) for patients who require hospitalization lead to increased boarding time in the ED, a significant cause of ED congestion. This is associated with decreased quality of care, higher morbidity and mortality, decreased patient satisfaction, increased costs for care, ambulance diversion, higher numbers of patients who leave without being seen (LWBS), and delayed care with longer lengths of stay (LOS) for other ED patients. The objective was to assess the effect of a leadership-based program to expedite hospital admissions from the ED. This before-and-after observational study was undertaken from 2006 through 2011 at one community hospital ED. A team of ED and hospital leaders implemented a program to reduce admit wait times, using a computerized hospital-wide tracking system to monitor inpatient and ED bed status. The team collaboratively and consistently moved ED patients to their inpatient beds within an established goal of 60 minutes after an admission decision was reached. Top leadership actively intervened in real time by contacting staff whenever delays occurred to expedite immediate solutions to achieve the 60-minute goal. The primary outcome measures were the percentage of ED patients who were admitted to inpatient beds within 60 minutes from the time the beds were requested and ED boarding time. LOS, patient satisfaction, LWBS rate, and ambulance diversion hours were also measured. After ED census, hospital admission rates, and ED bed capacity were controlled for using a multivariable linear regression analysis, the admit wait time reduction program contributed to an increase in patients being admitted to the hospital within 60 minutes by 16 percentage points (95% confidence intervals [CI] = 10 to 22 points; p leadership-based program to reduce admit wait times and boarding times was associated with a significant increase in the percentage of patients admitted to the hospital within 60 minutes and a

Pooled Open Blocks Shorten Wait Times for Nonelective Surgical Cases.

Science.gov (United States)

Zenteno, Ana C; Carnes, Tim; Levi, Retsef; Daily, Bethany J; Price, Devon; Moss, Susan C; Dunn, Peter F

2015-07-01

Assess the impact of the implementation of a data-driven scheduling strategy that aimed to improve the access to care of nonelective surgical patients at Massachusetts General Hospital (MGH). Between July 2009 and June 2010, MGH experienced increasing throughput challenges in its perioperative environment: approximately 30% of the nonelective patients were waiting more than the prescribed amount of time to get to surgery, hampering access to care and aggravating the lack of inpatient beds. This work describes the design and implementation of an "open block" strategy: operating room (OR) blocks were reserved for nonelective patients during regular working hours (prime time) and their management centralized. Discrete event simulation showed that 5 rooms would decrease the percentage of delayed patients from 30% to 2%, assuming that OR availability was the only reason for preoperative delay. Implementation began in January 2012. We compare metrics for June through December of 2012 against the same months of 2011. The average preoperative wait time of all nonelective surgical patients decreased by 25.5% (P reason for delay. Rigorous metrics were developed to evaluate its performance. Strong managerial leadership was crucial to enact the new practices and turn them into organizational change.

Straight to flexible sigmoidoscopy: rationalization of 2-week wait referrals in suspected colorectal cancer.

Science.gov (United States)

Couch, D G; Murphy, J H; Boyle, K M; Hemingway, D M

2015-11-01

The 2-week wait pathway was designed to decrease the time from presentation to primary care of patients with 'red flag' symptoms of suspected cancer for review by a specialist for the diagnosis or exclusion of cancer. In our tertiary referral centre we have found that 968 colonoscopies per year are required to satisfy the demand for the 2-week wait, leading to limited colonoscopy availability for other services. We sought to determine the yield of colorectal cancer found at colonoscopy referred via the 2-week wait and referenced to the original red flag symptoms. This was in order to select the most efficacious alternative primary investigation based upon presenting symptoms. Electronic records were retrospectively analysed. All patients who went through the 2-week wait for suspicion of colorectal cancer in 2013 and were found to have colorectal cancer on colonoscopy were included. Patients not undergoing colonoscopy as the first investigation were excluded. The splenic flexure was deemed to be within the range of a flexible sigmoidoscope. In all, 2950 referrals were made. 968 colonoscopies were performed as the primary investigation of which 35 were found to have colorectal cancer. No patients referred with rectal bleeding and another symptom had a tumour more proximal to the range of flexible sigmoidoscopy. 80% of tumours proximal to the splenic flexure were suitable for CT diagnosis alone. Our data support the use of flexible sigmoidoscopy alone as an initial investigation for patients presenting with rectal bleeding with or without additional colorectal symptoms. Patients with anaemia (without bleeding) or change in bowel habit (without bleeding) may be investigated with CT colonography alone; colonoscopy may then be used selectively prior to surgery. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

An exploration of the basis for patient complaints about the oldness of magazines in practice waiting rooms: cohort study.

Science.gov (United States)

Arroll, Bruce; Alrutz, Stowe; Moyes, Simon

2014-12-11

To explore the basis for patient complaints about the oldness of most magazines in practice waiting rooms. Cohort study. Waiting room of a general practice in Auckland, New Zealand. 87 magazines stacked into three mixed piles and placed in the waiting room: this included non-gossipy magazines (Time magazine, the Economist, Australian Women's Weekly, National Geographic, BBC History) and gossipy ones (not identified for fear of litigation). Gossipy was defined as having five or more photographs of celebrities on the front cover and most gossipy as having up to 10 such images. The magazines were marked with a unique number on the back cover, placed in three piles in the waiting room, and monitored twice weekly. Disappearance of magazines less than 2 months old versus magazines 3-12 months old, the overall rate of loss of magazines, and the rate of loss of gossipy versus non-gossipy magazines. 47 of the 82 magazines with a visible date on the front cover were aged less than 2 months. 28 of these 47 (60%) magazines and 10 of the 35 (29%) older magazines disappeared (P=0.002). After 31 days, 41 of the 87 (47%, 95% confidence interval 37% to 58%) magazines had disappeared. None of the 19 non-gossipy magazines (the Economist and Time magazine) had disappeared compared with 26 of the 27 (96%) gossipy magazines (Pmagazines and none of the non-gossipy magazines [corrected] had disappeared by 31 days. The study was terminated at this point. General practice waiting rooms contain mainly old magazines. This phenomenon relates to the disappearance of the magazines rather than to the supply of old ones. Gossipy magazines were more likely to disappear than non-gossipy ones. On the grounds of cost we advise practices to supply old copies of non-gossipy magazines. A waiting room science curriculum is urgently needed. © Arroll et al 2014.

Modeling the impact of integrating HIV and outpatient health services on patient waiting times in an urban health clinic in Zambia.

Directory of Open Access Journals (Sweden)

Sarang Deo

Full Text Available Rapid scale up of HIV treatment programs in sub-Saharan Africa has refueled the long-standing health policy debate regarding the merits and drawbacks of vertical and integrated system. Recent pilots of integrating outpatient and HIV services have shown an improvement in some patient outcomes but deterioration in waiting times, which can lead to worse health outcomes in the long run.A pilot intervention involving integration of outpatient and HIV services in an urban primary care facility in Lusaka, Zambia was studied. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. A discrete event simulation model was constructed to facilitate a fair comparison of waiting times before and after integration. The simulation model was also used to develop alternative configurations of integration and to estimate the resulting waiting times.Comparison of raw data showed that waiting times increased by 32% and 36% after integration for OPD and ART patients respectively (p<0.01. Using simulation modeling, we found that a large portion of this increase could be explained by changes in operational conditions before and after integration such as reduced staff availability (p<0.01 and longer breaks between consecutive patients (p<0.05. Controlling for these differences, integration of services, per se, would have resulted in a significant decrease in waiting times for OPD and a moderate decrease for HIV services.Integrating health services has the potential of reducing waiting times due to more efficient use of resources. However, one needs to ensure that other operational factors such as staff availability are not adversely affected due to integration.

Nutrition, modernity and the archaeological record: coastal resources and nutrition among Middle Stone Age hunter-gatherers on the Western Cape coast of South Africa.

Science.gov (United States)

Kyriacou, Katharine; Parkington, John E; Marais, Adrian D; Braun, David R

2014-12-01

In this paper, we assess the nutritional value of some marine and terrestrial food resources available to Middle Stone Age hunter-gatherers in the Western Cape of South Africa with respect to an important macronutrient (protein) and an essential micronutrient (iron) and introduce a framework for assessing the relative utility of marine and terrestrial resources. Whilst the ability to extract nutrients from the environment has always been a lynchpin in archaeologists' reconstructions of human evolution, a recent paradigm shift has recognized the role of marine resources in encephalization. Nutritional research indicates that marine ecosystems are the best source for long chain polyunsaturated fatty acids essential for proper brain development, and excavations at securely dated archaeological sites in South Africa provide firm evidence for the exploitation of marine resources by Middle Stone Age hunter-gatherers from at least Marine Isotope Stage 5 (130 ka), and possibly even earlier. Because marine molluscs are abundant, predictably located and easily harvested, they would have been readily available to all members of the community, in contrast to terrestrial resources. The improving archaeological record gives important clues to resource choice, but many more nutritional observations are needed to determine the extent to which marine resources could have met the nutrient requirements of prehistoric people. Our observations indicate that marine and terrestrial fauna are both excellent sources of protein, and that marine molluscs have higher iron concentrations than we expected for invertebrate fauna. We calculate the number of individual food items from a selection of marine and terrestrial species needed to provide the protein and iron requirements of a hypothetical group of hunter-gatherers, identify contrasts in peoples' requirements for and access to nutrients and resources, and discuss the implications for prehistoric subsistence strategies and human evolution

Improvement in Obstructive Sleep Apnea Diagnosis and Management Wait Times: A Retrospective Analysis of a Home Management Pathway for Obstructive Sleep Apnea

Directory of Open Access Journals (Sweden)

Samuel Alan Stewart

2015-01-01

Full Text Available Obstructive sleep apnea is a common condition within the Canadian population. The current gold standard for diagnosis and management of patients is in-laboratory (in-lab polysomnography; however, the limited availability of testing options for patients has led to long wait times and increased disease burden within the population. The Sleep Research Laboratory in Saskatoon (Saskatchewan implemented a home management program to run in parallel with the in-lab system several years ago in an effort to increase their capacity and reduce wait times. The present study was a retrospective analysis of all patients referred to the program between 2009 and 2012. The home management system has improved wait times by diagnosing and managing up to one-half of the referred patient population, reducing the wait for in-lab treatment from a median of 152 days in 2009 to 92 days in 2012 (P<0.0001. Moving forward, home management can provide a viable alternative to in-lab testing for patients who meet strict entry criteria, reducing the in-lab workload and, ultimately, reducing wait times.

Hospital Capacity, Waiting Times and Sick Leave Duration - an Empirical Analysis of a Norwegian Health Policy Reform

OpenAIRE

Aakvik, Arild; Holmås, Tor Helge; Kjerstad, Egil

2012-01-01

A health policy reform aiming to reduce hospital waiting times and sickness absences, the Faster Return to Work (FRW) scheme, is evaluated by creating treatment and control groups to facilitate causal interpretations of the empirical results. We use a unique dataset on individuals where we match hospital data with social security data and socio-economic characteristics. The main idea behind the reform is that long waiting times for hospital treatment lead to unnecessarily long periods of sick...

Impact of 'Ideal Clinic' implementation on patient waiting time in primary healthcare clinics in KwaZulu-Natal Province, South Africa: A before-and-after evaluation.

Science.gov (United States)

Egbujie, B A; Grimwood, A; Mothibi-Wabafor, E C; Fatti, G; Tshabalala, A M E T; Allie, S; Vilakazi, G; Oyebanji, O

2018-03-28

Long waiting times are a major source of dissatisfaction for patients attending public healthcare facilities in South Africa (SA). The National Department of Health has identified this as one of six priority areas for improvement. Health system-strengthening (HSS) interventions to improve patient waiting time are being implemented in public health facilities across SA as part of the 'Ideal Clinic' model. The effect of these interventions on patient waiting time needs to be assessed and evidence generated for system improvement. To determine the effect of Ideal Clinic HSS intervention on patient waiting time in public health facilities in Amajuba District, KwaZulu-Natal Province, SA. We implemented 12 months of HSS activity, including facility reorganisation and patient appointment scheduling. The major outcome of interest was the total time spent by patients in a facility during a visit. This was calculated as the median time spent, obtained through a 'before-and-after' intervention survey. Univariate and multivariate factors associated with waiting time were determined. A total of 1 763 patients from nine clinics were surveyed before and after the intervention (n=860 at baseline and n=903 at follow-up). The median overall waiting time after the intervention was 122 minutes (interquartile range (IQR) 81 - 204), compared with 116 minutes (IQR 66 - 168) before (p<0.05). Individual facility results after the intervention were mixed. Two facilities recorded statistically significant reductions in patient waiting time, while three recorded significant increases (p<0.05). Patient load per nurse, type of service received and time of arrival in facilities were all independently associated with waiting time. Patients' arrival patterns, which were determined by appointment scheduling, played a significant role in the results obtained. Implementation of the Ideal Clinic model in the selected facilities led to changes in patient waiting time. Observed changes were

Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data.

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Widdifield, Jessica; Bernatsky, Sasha; Thorne, J Carter; Bombardier, Claire; Jaakkimainen, R Liisa; Wing, Laura; Paterson, J Michael; Ivers, Noah; Butt, Debra; Lyddiatt, Anne; Hofstetter, Catherine; Ahluwalia, Vandana; Tu, Karen

2016-01-01

The Wait Time Alliance recently established wait time benchmarks for rheumatology consultations in Canada. Our aim was to quantify wait times to primary and rheumatology care for patients with rheumatic diseases. We identified patients from primary care practices in the Electronic Medical Record Administrative data Linked Database who had referrals to Ontario rheumatologists over the period 2000-2013. To assess the full care pathway, we identified dates of symptom onset, presentation in primary care and referral from electronic medical records. Dates of rheumatologist consultations were obtained by linking with physician service claims. We determined the duration of each phase of the care pathway (symptom onset to primary care encounter, primary care encounter to referral, and referral to rheumatologist consultation) and compared them with established benchmarks. Among 2430 referrals from 168 family physicians, 2015 patients (82.9%) were seen by 146 rheumatologists within 1 year of referral. Of the 2430 referrals, 2417 (99.5%) occurred between 2005 and 2013. The main reasons for referral were osteoarthritis (32.4%) and systemic inflammatory rheumatic diseases (30.6%). Wait times varied by diagnosis and geographic region. Overall, the median wait time from referral to rheumatologist consultation was 74 (interquartile range 27-101) days; it was 66 (interquartile range 18-84) days for systemic inflammatory rheumatic diseases. Wait time benchmarks were not achieved, even for the most urgent types of referral. For systemic inflammatory rheumatic diseases, most of the delays occurred before referral. Rheumatology wait times exceeded established benchmarks. Targeted efforts are needed to promote more timely access to both primary and rheumatology care. Routine linkage of electronic medical records with administrative data may help fill important gaps in knowledge about waits to primary and specialty care.

Analysis of PFAAs in American alligators part 2: Potential dietary exposure of South Carolina hunters from recreationally harvested alligator meat.

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Tipton, Jessica J; Guillette, Louis J; Lovelace, Susan; Parrott, Benjamin B; Rainwater, Thomas R; Reiner, Jessica L

2017-11-01

Exposure to perfluorinated alkyl acids (PFAAs) has been linked to many harmful health effects including reproductive disorders, developmental delays, and altered liver and kidney function. Most human exposure to environmental contaminants, including PFAAs, occurs through consumption of contaminated food or drinking water. This study uses PFAA data from meat samples collected from recreationally harvested American alligators (Alligator mississippiensis) in South Carolina to assess potential dietary exposure of hunters and their families to PFAAs. Consumption patterns were investigated using intercept surveys of 23 hunters at a wild game meat processor. An exposure scenario using the average consumption frequency, portion size, and median perfluorooctane sulfonic acid (PFOS) concentration in alligator meat from all hunt units found the daily dietary exposure to be 2.11ng/kg body weight per day for an adult human. Dietary PFOS exposure scenarios based on location of harvest suggested the highest daily exposure occurs with alligator meat from the Middle Coastal hunt unit in South Carolina. Although no samples were found to exceed the recommended threshold for no consumption of PFOS found in Minnesota state guidelines, exposure to a mixture of PFAAs found in alligator meat and site-specific exposures based on harvest location should be considered in determining an appropriate guideline for vulnerable populations potentially exposed to PFAAs through consumption of wild alligator meat. Copyright © 2017. Published by Elsevier B.V.

Traffic pollutants measured inside vehicles waiting in line at a major US-Mexico Port of Entry.

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Quintana, Penelope J E; Khalighi, Mehdi; Castillo Quiñones, Javier Emmanuel; Patel, Zalak; Guerrero Garcia, Jesus; Martinez Vergara, Paulina; Bryden, Megan; Mantz, Antoinette

2018-05-01

At US-Mexico border Ports of Entry, vehicles idle for long times waiting to cross northbound into the US. Long wait times at the border have mainly been studied as an economic issue, however, exposures to emissions from idling vehicles can also present an exposure risk. Here we present the first data on in-vehicle exposures to driver and passengers crossing the US-Mexico border at the San Ysidro, California Port of Entry (SYPOE). Participants were recruited who regularly commuted across the border in either direction and told to drive a scripted route between two border universities, one in the US and one in Mexico. Instruments were placed in participants' cars prior to commute to monitor-1-minute average levels of the traffic pollutants ultrafine particles (UFP), black carbon (BC) and carbon monoxide (CO) in the breathing zone of drivers and passengers. Location was determined by a GPS monitor. Results reported here are for 68 northbound participant trips. The highest median levels of in-vehicle UFP were recorded during the wait to cross at the SYPOE (median 29,692particles/cm 3 ) significantly higher than the portion of the commute in the US (median 20,508particles/cm 3 ) though not that portion in Mexico (median 22, 191particles/cm 3 ). In-vehicle BC levels at the border were significantly lower than in other parts of the commute. Our results indicate that waiting in line at the SYPOE contributes a median 62.5% (range 15.5%-86.0%) of a cross-border commuter's exposure to UFP and a median 44.5% (range (10.6-79.7%) of exposure to BC inside the vehicle while traveling in the northbound direction. Reducing border wait time can significantly reduce in-vehicle exposures to toxic air pollutants such as UFP and BC, and these preventable exposures can be considered an environmental justice issue. Copyright © 2017 Elsevier B.V. All rights reserved.

Establishment of native and exotic grasses on mine overburden and topsoil in the Hunter Valley, New South Wales

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Huxtable, C.H.A.; Koen, T.B.; Waterhouse, D. [DNR, Dangar, NSW (Australia)

2005-07-01

Current recommendations for rehabilitation of open-cut coal mines in the Hunter Valley involve the sowing of exotic pasture species to reinstate mined land to Class IV and V under the Rural Land Capability System. Despite the importance of native grasses in the pre-mined landscape, they are currently not widely included in mine rehabilitation. To address this issue a project was conducted between 1994 and 2000 to research the use of native grasses for rehabilitation of open-cut coal mines in the Hunter Valley. This paper reports on 2 mine site experiments that aimed to assess establishment and persistence of a broad range of native and exotic grass species from an autumn sowing in both topsoil and raw spoil over a period of 61 months. The most promising natives in terms of early establishment, persistence and spread over time, included six C-3 accessions (five Austrodanthonia spp. and Austrostipa bigeniculata) and one C-4 accession (Cynodon dactylon). Persistence of these accessions was better in raw spoil than topsoil, despite initial low numbers, due to a lack of weed competition and their ability to spread by self-seeding. In topsoil, and in the absence of any biomass reduction, native species were mostly out-competed by vigorous exotic perennial grasses which were sown in these experiments and from seed influx from adjacent rehabilitation areas or from the soil seed bank. The effects of climatic conditions and differences in soil physical, chemical and seed bank characteristics at the 2 mine sites are also discussed.

"Founder crops" v. wild plants: Assessing the plant-based diet of the last hunter-gatherers in southwest Asia

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Arranz-Otaegui, Amaia; González Carretero, Lara; Roe, Joe; Richter, Tobias

2018-04-01

The Natufian culture (c. 14.6-11.5 ka cal. BP) represents the last hunter-gatherer society that inhabited southwest Asia before the development of plant food production. It has long been suggested that Natufians based their economy on the exploitation of the wild ancestors of the Neolithic "founder crops", and that these hunter-gatherers were therefore on the "threshold to agriculture". In this work we review the available data on Natufian plant exploitation and we report new archaeobotanical evidence from Shubayqa 1, a Natufian site located in northeastern Jordan (14.6-11.5 ka cal. BP). Shubayqa 1 has produced an exceptionally large plant assemblage, including direct evidence for the continuous exploitation of club-rush tubers (often regarded as "missing foods") and other wild plants, which were probably used as food, fuel and building materials. Taking together this data we evaluate the composition of archaeobotanical assemblages (plant macroremains) from the Natufian to the Early Pre-Pottery Neolithic B (EPPNB). Natufian assemblages comprise large proportions of non-founder plant species (>90% on average), amongst which sedges, small-seeded grasses and legumes, and fruits and nuts predominate. During the Pre-Pottery Neolithic, in particular the EPPNB, the presence of "founder crops" increases dramatically and constitute up to c. 42% of the archaeobotanical assemblages on average. Our results suggest that plant exploitation strategies during the Natufian were very different from those attested during subsequent Neolithic periods. We argue that historically driven interpretations of the archaeological record have over-emphasized the role of the wild ancestors of domesticated crops previous to the emergence of agriculture.

Do women spend longer on wait lists for coronary bypass surgery? Analysis of a population-based registry in British Columbia, Canada

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Kuramoto Lisa

2007-08-01

Full Text Available Abstract Background Studies have shown patients who are delayed for surgical cardiac revascularization are faced with increased risks of symptom deterioration and death. This could explain the observation that operative mortality among persons undergoing coronary artery bypass surgery (CABG is higher among women than men. However, in jurisdictions that employ priority wait lists to manage access to elective cardiac surgery, there is little information on whether women wait longer than men for CABG. It is therefore difficult to ascertain whether higher operative mortality among women is due to biological differences or to delayed access to elective CABG. Methods Using records from a population-based registry, we compared the wait-list time between women and men in British Columbia (BC between 1990 and 2000. We compared the number of weeks from registration to surgery for equal proportions of women and men, after adjusting for priority, comorbidity and age. Results In BC in the 1990s, 9,167 patients aged 40 years and over were registered on wait lists for CABG and spent a total of 136,071 person-weeks waiting. At the time of registration for CABG, women were more likely to have a comorbid condition than men. We found little evidence to suggest that women waited longer than men for CABG after registration, after adjusting for comorbidity and age, either overall or within three priority groups. Conclusion Our findings support the hypothesis that higher operative mortality during elective CABG operations observed among women is not due to longer delays for the procedure.

Waiting-time distributions of magnetic discontinuities: Clustering or Poisson process?

International Nuclear Information System (INIS)

Greco, A.; Matthaeus, W. H.; Servidio, S.; Dmitruk, P.

2009-01-01

Using solar wind data from the Advanced Composition Explorer spacecraft, with the support of Hall magnetohydrodynamic simulations, the waiting-time distributions of magnetic discontinuities have been analyzed. A possible phenomenon of clusterization of these discontinuities is studied in detail. We perform a local Poisson's analysis in order to establish if these intermittent events are randomly distributed or not. Possible implications about the nature of solar wind discontinuities are discussed.

Ceramics among Eurasian hunter-gatherers: 32 000 years of ceramic technology use and the perception of containment

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Mihael Budja

2016-12-01

Full Text Available We present two parallel and 32 000 years long trajectories of episodic ceramic technology use in Eurasian pre-Neolithic hunter-gatherer societies. In eastern, Asian trajectory the pottery was produced from the beginning. Ceramic figurines mark the western, European trajectory. The western predates the eastern for about eleven millennia. While ceramic cones and figurines first appeared in Central Europe at c. 31 000 cal BC the earliest vessels in eastern Asia was dated at c. 20 000 cal BC. We discuss women’s agency, perception of containment, ‘cross-craft interactions’, and evolution of private property that that may influenced the inventions of ceramic (pyrotechnology.

The evaluation of a formalized queue management system for coronary angiography waiting lists.

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Alter, D A; Newman, Alice M; Cohen, Eric A; Sykora, Kathy; Tu, Jack V

2005-11-01

Lengthy waiting lists for coronary angiography have been described in many health care systems worldwide. The extent to which formal queue management systems may improve the prioritization and survival of patients in the angiography queue is unknown. To prospectively evaluate the performance of a formal queue management system for patients awaiting coronary angiography in Ontario. The coronary angiography urgency scale, a formal queue management system developed in 1993 using a modified Delphi panel, allocates recommended maximum waiting times (RMWTs) in accordance with clinical necessity. By using a provincial clinical registry, 35,617 consecutive patients referred into the coronary angiography queue between April 1, 2001, and March 31, 2002, were prospectively tracked. Cox proportional hazards models were used to examined mortality risk across urgency after adjusting for additional clinical and comorbid factors. Good agreement was determined in urgency ratings between scores from the coronary angiography urgency scale and implicit physician judgement, which was obtained independently at the time of the index referral (weighted kappa = 0.49). The overall mortality in the queue was 0.3% (0.47%, 0.26% and 0.13% for urgent, semiurgent and elective patients, respectively). Urgency, as specified by the coronary angiography urgency scale, was the strongest predictor of death in the queue (Pqueue management system may decrease mortality in the coronary angiography queue. The authors recommend its implementation in health care systems where patients experience excessive waiting time delays for coronary angiography.

Waiting list paradox: Danish cancer patients diagnosed fast have higher mortality after diagnosis

DEFF Research Database (Denmark)

Tørring, Marie Louise; Frydenberg, Morten; Hansen, Rikke Pilegaard

on hospital discharge diagnoses for the 2004-2005 period, extracted from population-based healthcare databases in the former County of Aarhus, Denmark, and subsequently validated in the National Danish Cancer Registry. All patients with a first-time diagnosis of colon, rectal, lung, skin, breast, or prostate...... with longer diagnostic interval until the reference point of 30 days. For colon, rectal, skin, and breast cancer mortality seemed to increase with diagnostic interval longer than 30 days. The waiting list paradox is manifest in Denmark. We speculate that medical professionals organise the diagnostic pathway......Studies often show that cancer patients diagnosed more rapidly have higher mortality rates than patients with longer waits in the primary and secondary health care sector. Our aim was to examine whether this paradox is manifest in the Danish health care system. The study was based on data...

Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India

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Yogesh Tiwari

2014-01-01

Full Text Available Background: Emergency Department (ED of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients. Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD. Materials and Methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc. of the emergency. Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be "9.00-12.00 h" in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients "under observation" (29.6%; "waiting for routine diagnostic tests" (16.4% and "waiting for discharge" (14.6%. Around 71% patients were waiting due to reasons within emergency complex. Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

CONDICIÓN FÍSICA Y HÁBITOS DE PRÁCTICA FÍSICO-DEPORTIVA DE LOS CAZADORES EXTREMEÑOS [Physical condition and habits of practice exercise of hunters extremeños

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José Martín Gamonales Puerto

2016-12-01

Present study analyses the physical condition and the physical-sportive exercise in a random sample of hunters (n=144 in the Extremadura (Spain. Hunting is recognized as a sportive modality by the Board of the CDS (Spanish High Sports Council. In order to know the physical condition levels in hunters group, were used a selection of Eurofit and AFISAL-INEFC tests for adult. Final results show the relation which exist between physical condition and sociodemographic differences, as well as the influence that hunting can have in a healthy lifestyle. Attending to the results, there are differences in the physical condition according to the age of the individuals. Moreover, it shows a relation between the sociodemographic characteristics of the sample and the additional physical-sportive exercises of the different modalities of hunting.

Healthcare Use for Pain in Women Waiting for Gynaecological Surgery

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Sarah Walker

2016-01-01

Full Text Available Background. Pain while waiting for surgery may increase healthcare utilization (HCU preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n=360 reported a total of 2026 healthcare visits, with 21% (n=126 reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10 pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30 and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists. Conclusions. There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system.

Waiting for the right time: how and why young Thai women manage to avoid heterosexual intercourse.