Im/mobilities and dis/connectivities in medical globalisation: How global is Global Health?

Science.gov (United States)

Dilger, Hansjörg; Mattes, Dominik

2018-03-01

The interdisciplinary, politically contested field of Global Health has often been described as a consequence of, and response to, an intensification of the mobilities of, and connectivities between, people, pathogens, ideas, and infrastructure across national borders and large distances. However, such global mobilities and connectivities are not as omnidirectional and unpatterned as the rhetoric of many Global Health actors suggests. Instead, we argue that they are suffused by a plethora of institutional, national, and global political agendas, and substantially shaped by transnational and postcolonial power relations. Furthermore, the configurations that are typically subsumed under the category of Global Health represent only a minor part of the range of im/mobilities and dis/connectivities that are essential for understanding transformations of epidemiological patterns, health care infrastructures, and the responses to health-related challenges in a globalising world. In order to broaden such a limiting analytical perspective, we propose to expand the analytical focus in studying Global Health phenomena by paying close attention to the myriad ways in which particular im/mobilities and dis/connectivities constitute medicine and well-being in global and transnational settings. Pursuing a conceptual shift from studies of 'Global Health' to studying 'medical globalization' may carve out new analytical ground for such an endeavour.

Finding a sustainable prototype for integrative medicine

Directory of Open Access Journals (Sweden)

Geetha Krishnan Gopalakrishna Pillai

2014-01-01

Full Text Available Mainstreaming traditional systems of medicine and integrating them with the established health delivery mechanisms is an important step in accelerating advancement of health sciences to achieve current global health care goals. This paper proposes the "axial-model" of Integrative Medicine (IM. A replicable model, viable across multiple IM possibilities, which are clinically beneficial, supports evidence-based evolution and is socially acceptable. Axial model may be implemented to integrate two or more systems of medicines, provided they are legally regulated and approved for clinical administration. It proposes three consecutively phased clinical processes, named parallel, complementary and protocol, respectively. The model supports translational medicine by mainstreaming beneficial practices of traditional medicine as a part of its process of execution.

Integrated management system: The integration of ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000

Science.gov (United States)

Muzaimi, Hafizzudin; Chew, Boon Cheong; Hamid, Syaiful Rizal

2017-03-01

The implementation of integrated management system (IMS) for better quality management has become a preference for many organizations. This can be seen as many organizations used the combination of quality ISO 9001, an environment ISO 14001 and occupational health and safety management system OHSAS 18001 as a core for the IMS that largely implemented. Besides, the linked between quality management with risk management system need to be identified as the management system that enhance the effectiveness of IMS. Therefore, the risk management system ISO 31000 also presented as a part of integration. In nowadays competitive environment, the increasing pressure and needs from customer or stakeholders make it compulsory for the organization to propose the new system and standards. This paper presents and discusses about the benefit of integration, the management system components that can be converged and the implementation approach. A series of interview was conducted through in-depth interviews with 8 experts in this field, while data collected were analyzed qualitatively. The results consist of 16 factors of IMS implementation that have been identified and the use of PDCA approach for an effective implementation of IMS. As a conclusion, the paper proposes the integration of four management systems (ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000) and on how the IMS can be used to structure the process of management for quality management towards sustainability practices in the organization.

An Analysis of the Effect of the Implementation of an Integrated Management System (IMS on Work Ergonomics in an O&M Power Plant Company

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Dewi Permata Ifadiana

2016-05-01

Full Text Available Ergonomics has developed significantly for the prevention of related accidents. Its implementation, however, depends on the existing management system within a company. The integrated management system (IMS is frequently implemented in industry, which is an integration of ISO 9001, ISO 14001, and OHSAS 18001. The objectives of this research were to analyze the effects of IMS implementation on work ergonomics and to find the influencing factors. The methods used were the 4x4 method for investigating accidents; interviews; and a questionnaire for workers and managers at an electricity company. The subjects were divided into three levels, namely: top management, middle management, and workers. Logistic regression was used to analyze and estimate the effects of one or more management variables on ergonomics related accidents. The results showed that the implementation of IMS has supported work ergonomics very well based on the average scores, which ranged from 2.99 to 3.38. The logistic regression showed that the most influential IMS on work ergonomics was the Do (D of Deming’s PDCA cycle, whereas the most influential parameter for ergonomics accident prevention was Policy (P and Do (D at the top management level.

"ARZT IM GANZEN SPEKTRUM" ["PHYSICIAN IN THE FULL SPEKTRUM"

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Mitzkat, Anika

2006-11-01

Full Text Available [english] For more than 20 years teaching in the medical program at Witten/Herdecke Private University has followed the goal of introducing students to the reality of patient care by a practical approach. The “adaptive physician personality” describes the educational objective of a physician who is able to orient towards “the full spectrum” of his professional core competencies. In regard to the “adaptive physician personality” four Integrated Curricula (Communication, Science, Ethics, and Health Economy had been developed along with the introduction of a model medical program in 2000. Witten/Herdecke University thereby today addresses the requirements defined by the New Medical Licensure Act of 27.06.2002 and brings forward at the same time a program which prepares the medical student for the multi-dimensional responsibilities in the reality of modern health care. This article describes the Integrated Curricula exemplified by the Communication curriculum. This relatively young area of medical teaching in Germany is still extensively unexplored concerning evidence-based research about its effectiveness and efficiency of teaching. [german] Die Lehre im Studiengang Humanmedizin an der Privaten Universität Witten/Herdecke (UWH verfolgt seit mehr als 20 Jahren das Ziel, Studierende praxisnah an die Realität der Patientenversorgung heranzuführen. Das Ausbildungsziel des Medizinstudiums ist dabei die ”lernfähige Arztpersönlichkeit”, die sich möglichst „im ganzen Spektrum” ärztlicher Kernkompetenzen zu orientieren vermag. Im Hinblick auf das Ziel der „lernfähigen Arztpersönlichkeit“ wurden mit der Einführung des Modellstudiengangs Medizin im Jahr 2000 vier Integrierte Curricula (Kommunikation, Wissenschaft, Ethik und Gesundheitsökonomie aufgebaut. Die Lehre an der Universität Witten/Herdecke geht damit einerseits auf die Anforderungen, die mit Einführung der neuen Approbationsordnung für Ärzte vom 27.06.2002 an

IMS IN SMES - REASONS, ADVANTAGES AND BARRIERS ON IMPLEMENTATION

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Dragan Rajković

2008-09-01

Full Text Available Appearance of a number of management systems with various and sometimes divergent demands, demands for revise of optimal strategy on implementation of these standards in small and medium-sized enterprises (SMEs and the attempt on their integration into integrated management system are suggested even more. Firstly question on choice and reasons for implementation of standards is raised. Management and employees expect benefits on the implementation and they pass and minimize the implementation barriers. Basic concept on integrated management system (IMS into SMEs and analyse on reasons, advantages and barriers at IMS implementation are presented in this paper.

Digitalisierung im Verteilnetz: Evolution oder Revolution anhand konkreter Beispiele

Science.gov (United States)

Krone, Oliver; Bachmann, Maurus

Durch die Integration der neuen erneuerbaren Energien steht das Stromnetz vor großen Herausforderungen. Das Energiesystem als Gesamtes und die Verteilnetze im Speziellen werden smart. Anhand konkreter Beispiele wird aufgezeigt, wie die Digitalisierung im Elektrizitätsnetz voranschreitet. Diese Entwicklung ist eine Evolution, nicht aber eine Revolution.

Integrative Cardiac Health Project

Science.gov (United States)

2014-10-01

primary cardiac arrest. Circulation. 1998;97(2):155Y160. 8. Sesso HD, Lee IM, Gaziano JM, Rexrode KM, Glynn RJ, Buring JE. Maternal and paternal ...to signal transduction, inflammation, and host–pathogen interactions .27 Whole blood RNA isolation systems such as PAXgene accurately capture in vivo...the effect of healthy behaviors on leukocyte function and leukocyte–endothelium interactions that are important for cardiovascular health

Incorporation of integrative medicine education into undergraduate medical education: a longitudinal study

Institute of Scientific and Technical Information of China (English)

Saswati Mahapatra; Anjali Bhagra; Bisrat Fekadu; Zhuo Li; Brent A.Bauer; Dietlind L.Wahner-Roedler

2017-01-01

OBJECTIVE:Integrative medicine (IM) combines complementary medical approaches into conventional medicine and considers the whole person.We implemented a longitudinal IM short-course curriculum into our medical school education.This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding IM among students.METHODS:A mandatory short IM curriculum across all years of medical school was created and taught by IM professionals and physician faculty members with expertise in integrative therapies.Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school.Paired data analysis was done,and only students who completed surveys at both time points were included in final analyses.RESULTS:Of 52 students in each class,17 (33％) in the class of 2015 and 22 (42％) in the class of 2016 completed both surveys.After the IM curriculum,students' knowledge of and comfort with several IM therapies—biofeedback,mindfulness,and the use of St.John's wort—improved significantly.Students' personal health practices also improved,including better sleep,exercise,and stress management for the class of 2015.Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year.CONCLUSION:It is feasible to incorporate IM education into undergraduate medical education,and this is associated with improvement in students' knowledge of IM and personal health practices.

The implementation of the Plan Esperanza and response to the imPACT Review.

Science.gov (United States)

Vidaurre, Tatiana; Santos, Carlos; Gómez, Henry; Sarria, Gustavo; Amorin, Edgar; López, Marga; Regalado, Roxana; Manrique, Javier; Tarco, Duniska; Ayestas, Carlos; Calderón, Mónica; Mas, Luis; Neciosup, Silvia; Salazar, Miriam; Chávez, Juan Carlos; Ubillus, Milward; Limache, Abel; Ubillus, José Carlos; Navarro, Jeannie; Sarwal, Kavita; Sutcliffe, Simon; Gutiérrez-Aguado, Alfonso; Silva, Marianela; Mena, Amalia; Guillén, María Eugenia; Castañeda, Carlos; Abugattas, Julio

2017-10-01

Following the implementation of the National Cancer Prevention and Control Results-based Budget Programme (PpR Cancer-024) in 2011, the Peruvian Government approved the Plan Esperanza-a population-based national cancer control plan-in 2012. Legislation that ensured full government-supported funding for people who were otherwise unable to access or afford care and treatment accompanied the Plan. In 2013, the Ministry of Health requested an integrated mission of the Programme of Action for Cancer Therapy (imPACT) report to strengthen cancer control in Peru. The imPACT Review, which was executed in 2014, assessed Peru's achievements in cancer control, and areas for improvement, including cancer control planning, further development of population-based cancer registration, increased prevention, early diagnosis, treatment and palliative care, and the engagement and participation of civil society in the health-care system. This Series paper gives a brief history of the development of the Plan Esperanza, describes the innovative funding model that supports it, and summarises how funds are disseminated on the basis of disease, geography, and demographics. An overview of the imPACT Review, and the government's response in the context of the Plan Esperanza, is provided. The development and execution of the Plan Esperanza and the execution of and response to the imPACT Review demonstrates the Peruvian Government's commitment to fighting cancer across the country, including in remote and urban areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

INTEGRATED HSEQ MANAGEMENT SYSTEMS: DEVELOPMENTS AND TRENDS

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Osmo Kauppila

2015-06-01

Full Text Available The integration of health and safety, environmental and quality (HSEQ management systems has become a current topic in the 21st century, as the need for systems thinking has grown along with the number of management system standards. This study aims to map current developments and trends in integrated HSEQ management. Three viewpoints are taken: the current state of the main HSEQ management standards, research literature on integrated management systems (IMS, and a case study of an industry-led HSEQ cluster in Northern Finland. The results demonstrate that some of the most prominent current trends are the harmonization of the high level structure of management systems by ISO, the evaluation of IMS, accounting for the supply chain in HSEQ issues, and sustainability and risk management. The results of the study can be used by practitioners to get a view of the current state of HSEQ management systems and their integration, and by researchers to seek out potential directions for HSEQ and IMS related research.

A Management Tool for Improvement (Improving) IMS Stations Performance

International Nuclear Information System (INIS)

Mohammad, D.; Pantin, A.; Quintana, E.

2011-01-01

IMS-Maintenance is a software under development by the personnel of ARN-CTBT office, intended for the technical management of IMS stations under ARN's responsibility. This software integrates the whole control of the equipment in an IMS station, including the management of consumables used in daily or periodic operation. It permits an easy retrieval (access) of the technical features, suppliers, etc. of each item of the equipment, as well as its maintenance history and scheduled task. Although this project is still in a starting phase, a preliminary version of this software is being used in radionuclide station RN01 (Buenos Aires), having already demonstrated its usefulness and potential for the improvement of IMS station management. (authors)

ImTK: an open source multi-center information management toolkit

Science.gov (United States)

Alaoui, Adil; Ingeholm, Mary Lou; Padh, Shilpa; Dorobantu, Mihai; Desai, Mihir; Cleary, Kevin; Mun, Seong K.

2008-03-01

The Information Management Toolkit (ImTK) Consortium is an open source initiative to develop robust, freely available tools related to the information management needs of basic, clinical, and translational research. An open source framework and agile programming methodology can enable distributed software development while an open architecture will encourage interoperability across different environments. The ISIS Center has conceptualized a prototype data sharing network that simulates a multi-center environment based on a federated data access model. This model includes the development of software tools to enable efficient exchange, sharing, management, and analysis of multimedia medical information such as clinical information, images, and bioinformatics data from multiple data sources. The envisioned ImTK data environment will include an open architecture and data model implementation that complies with existing standards such as Digital Imaging and Communications (DICOM), Health Level 7 (HL7), and the technical framework and workflow defined by the Integrating the Healthcare Enterprise (IHE) Information Technology Infrastructure initiative, mainly the Cross Enterprise Document Sharing (XDS) specifications.

IMS Application Developer's Handbook Creating and Deploying Innovative IMS Applications

CERN Document Server

Noldus, Rogier; Mulligan, Catherine; Fikouras, Ioannis; Ryde, Anders; Stille, Mats

2011-01-01

IMS Application Developer Handbook will give a hands-on view of exactly what needs to be done by IMS application developers to write an application and take it "live" on an operator's network. It will offer practical guidance on building innovative applications using the features and capabilities of the IMS network, show how the rapidly changing development environment is impacting on the business models employed in the industry and how existing network solutions can be moved towards IMS. The book will also elaborate on how IMS applies basic VoIP principles and techniques to realise a true mul

Integration und Ausgrenzung im Osten Europas : Beiträge für die 13. Tagung junger Osteuropa-Experten

OpenAIRE

2005-01-01

Inhaltsverzeichnis: I. Integration und Ausgrenzung an der EU-Grenze - Elena Kropatcheva: Perspektiven der Integrationsmodelle Russlands (8-11); Silke Skilters: Estland, Lettland und Litauen zwischen Kooperation und Konkurrenz (12-16); Anne Wetzel: Die Grenze(n) zwischen der Ukraine und der EU: gibt es mehr als "drinnen" und "draußen"? (17-20); Katrin Böttger: Die Europäische Nachbarschaftspolitik und ihre integrierenden und ausgrenzenden Faktoren (21-24); Olaf Melzer: Russland im Europarat: D...

imFASP: An integrated approach combining in-situ filter-aided sample pretreatment with microwave-assisted protein digestion for fast and efficient proteome sample preparation.

Science.gov (United States)

Zhao, Qun; Fang, Fei; Wu, Ci; Wu, Qi; Liang, Yu; Liang, Zhen; Zhang, Lihua; Zhang, Yukui

2016-03-17

An integrated sample preparation method, termed "imFASP", which combined in-situ filter-aided sample pretreatment and microwave-assisted trypsin digestion, was developed for preparation of microgram and even nanogram amounts of complex protein samples with high efficiency in 1 h. For imFASP method, proteins dissolved in 8 M urea were loaded onto a filter device with molecular weight cut off (MWCO) as 10 kDa, followed by in-situ protein preconcentration, denaturation, reduction, alkylation, and microwave-assisted tryptic digestion. Compared with traditional in-solution sample preparation method, imFASP method generated more protein and peptide identifications (IDs) from preparation of 45 μg Escherichia coli protein sample due to the higher efficiency, and the sample preparation throughput was significantly improved by 14 times (1 h vs. 15 h). More importantly, when the starting amounts of E. coli cell lysate decreased to nanogram level (50-500 ng), the protein and peptide identified by imFASP method were improved at least 30% and 44%, compared with traditional in-solution preparation method, suggesting dramatically higher peptide recovery of imFASP method for trace amounts of complex proteome samples. All these results demonstrate that the imFASP method developed here is of high potential for high efficient and high throughput preparation of trace amounts of complex proteome samples. Copyright © 2016 Elsevier B.V. All rights reserved.

Dialogic learning and interactive groups: an IMS LD template integrated in runtime systems

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Mar Pérez-Sanagustín

2008-07-01

Full Text Available Dialogic learning and interactive groups have proved to be a useful educational methodological approach in lifelong learning with adults. The principles of this approach stress the importance of dialogue and equal participation in every stage of the learning process – including the design of the training activities. This paper adopts these principles as the basis for a configurable template that can be integrated in runtime systems. The template is formulated as a meta-UoL which can be interpreted by IMS Learning Design players. This template serves as a guide to flexibly select and edit the activities at runtime (on the fly. The meta-UoL has been used successfully by two significant practitioners so as to create a real-life example, with positive and encouraging results.

Results from an Interval Management (IM) Flight Test and Its Potential Benefit to Air Traffic Management Operations

Science.gov (United States)

Baxley, Brian; Swieringa, Kurt; Berckefeldt, Rick; Boyle, Dan

2017-01-01

NASA's first Air Traffic Management Technology Demonstration (ATD-1) subproject successfully completed a 19-day flight test of an Interval Management (IM) avionics prototype. The prototype was built based on IM standards, integrated into two test aircraft, and then flown in real-world conditions to determine if the goals of improving aircraft efficiency and airport throughput during high-density arrival operations could be met. The ATD-1 concept of operation integrates advanced arrival scheduling, controller decision support tools, and the IM avionics to enable multiple time-based arrival streams into a high-density terminal airspace. IM contributes by calculating airspeeds that enable an aircraft to achieve a spacing interval behind the preceding aircraft. The IM avionics uses its data (route of flight, position, etc.) and Automatic Dependent Surveillance-Broadcast (ADS-B) state data from the Target aircraft to calculate this airspeed. The flight test demonstrated that the IM avionics prototype met the spacing accuracy design goal for three of the four IM operation types tested. The primary issue requiring attention for future IM work is the high rate of IM speed commands and speed reversals. In total, during this flight test, the IM avionics prototype showed significant promise in contributing to the goals of improving aircraft efficiency and airport throughput.

I'm a Map, I'm a Green Tree

Science.gov (United States)

Anderson, Daniel

2010-01-01

I'm talking about the ways we represent ourselves and our world. I've put some thoughts on the topic together here--a gathering that enacts new media creating and takes up conceptual layers like metaphors, models, and composing. The primary sources are videos from the Get a Mac campaign, aka I'm a Mac; I'm a PC ads. Posthuman concepts blending…

An IMS testbed for SIP applications

DEFF Research Database (Denmark)

Caba, Cosmin Marius; Soler, José

2013-01-01

The paper presents the design and implementation of an emulation platform for the IP Multimedia Subsystem. The SIP Servlet API v1.1 has been used to implement the final system. The purpose of the emulation is to offer to IMS service developers an environment where they can integrate development...

Estimating the global public health implications of electricity and coal consumption.

Science.gov (United States)

Gohlke, Julia M; Thomas, Reuben; Woodward, Alistair; Campbell-Lendrum, Diarmid; Prüss-Üstün, Annette; Hales, Simon; Portier, Christopher J

2011-06-01

The growing health risks associated with greenhouse gas emissions highlight the need for new energy policies that emphasize efficiency and low-carbon energy intensity. We assessed the relationships among electricity use, coal consumption, and health outcomes. Using time-series data sets from 41 countries with varying development trajectories between 1965 and 2005, we developed an autoregressive model of life expectancy (LE) and infant mortality (IM) based on electricity consumption, coal consumption, and previous year's LE or IM. Prediction of health impacts from the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) integrated air pollution emissions health impact model for coal-fired power plants was compared with the time-series model results. The time-series model predicted that increased electricity consumption was associated with reduced IM for countries that started with relatively high IM (> 100/1,000 live births) and low LE (electricity consumption regardless of IM and LE in 1965. Increasing coal consumption was associated with increased IM and reduced LE after accounting for electricity consumption. These results are consistent with results based on the GAINS model and previously published estimates of disease burdens attributable to energy-related environmental factors, including indoor and outdoor air pollution and water and sanitation. Increased electricity consumption in countries with IM consumption has significant detrimental health impacts.

Developing an effective IM/IT strategy.

Science.gov (United States)

Kramer, Sarah; Walker, Joanne; Falk, Will

2009-01-01

Healthcare organizations and systems around the world lag far behind banking, manufacturing, travel and other industries in their use of information management/information technology (IM/IT) to deliver high-quality products and services. Across Canada, healthcare organizations, as well as governments, understand that information and information technology are needed to deliver quality care and to sustain our publicly funded health system. However, insufficient funding, few experienced resources, lack of strong leadership and absence of clear business/clinical rationale have restricted innovation and advancement in the use of IM/IT to improve healthcare delivery and patient outcomes.

ImWalkMF: Joint matrix factorization and implicit walk integrative learning for recommendation

KAUST Repository

Zhang, Chuxu

2018-01-15

Data sparsity and cold-start problems are prevalent in recommender systems. To address such problems, both the observable explicit social information (e.g., user-user trust connections) and the inferable implicit correlations (e.g., implicit neighbors computed by similarity measurement) have been introduced to complement user-item ratings data for improving the performances of traditional model-based recommendation algorithms such as matrix factorization. Although effective, (1) the utilization of the explicit user-user social relationships suffers from the weakness of unavailability in real systems such as Netflix or the issue of sparse observable content like 0.03% trust density in Epinions, thus there is no or little explicit social information that can be employed to improve baseline model in real applications; (2) the current similarity measurement approaches focus on inferring implicit correlations between a user (item) and their direct neighbors or top-k similar neighbors based on user-item ratings bipartite network, so that they fail to comprehensively unfold the indirect potential relationships among users and items. To solve these issues regarding both explicit/implicit social recommendation algorithms, we design a joint model of matrix factorization and implicit walk integrative learning, i.e., ImWalkMF, which only uses explicit ratings information yet models both direct rating feedbacks and multiple direct/indirect implicit correlations among users and items from a random walk perspective. We further propose a combined strategy for training two independent components in the proposed model based on sampling. The experimental results on two real-world sparse datasets demonstrate that ImWalkMF outperforms the traditional regularized/probabilistic matrix factorization models as well as other competitive baselines that utilize explicit/implicit social information.

Environmental trace analysis by means of supersensitive GC-IMS

International Nuclear Information System (INIS)

Leonhardt, J.W.

1997-01-01

The effective control of pollutants in ambient air requires their fast in situ identification and concentration determination of chemical compounds in the range of micrograms per m 3 . There are attempts to use conventional analytical techniques as portable GC and GC-MS. These systems are relatively expensive. A new supersensitive ion Mobility Sensor (IMS) was developed and checked by IUT Ltd, which meets the new demands. The use of tritium sources is an advantage in comparison with other IMS being equipped by nickel-63, the application of which is rather critical in respect of the radiation protection. On the other hand an integrated separation column allows to reduce interferences by matrix effects. The technical parameters of the IUT GC- IMS and some of its most important applications are briefly presented

Development of a plug-type IMS-MS instrument and its applications in resolving problems existing in in-situ detection of illicit drugs and explosives by IMS.

Science.gov (United States)

Du, Zhenxia; Sun, Tangqiang; Zhao, Jianan; Wang, Di; Zhang, Zhongxia; Yu, Wenlian

2018-07-01

Ion mobility spectrometry (IMS) which acts as a rapid analysis technique is widely used in the field detection of illicit drugs and explosives. Due to limited separation abilities of the pint-sized IMS challenges and problems still exist regarding high false positive and false negative responses due to the interference of the matrix. In addition, the gas-phase ion chemistry and special phenomena in the IMS spectra, such one substance showing two peaks, were not identified unambiguously. In order to explain or resolve these questions, in this paper, an ion mobility spectrometry was coupled to a mass spectrometry (IMS-MS). A commercial IMS is embedded in a custom-built ion chamber shell was attached to the mass spectrometer. The faraday plate of IMS was fabricated with a hole for the ions to passing through to the mass spectrometer. The ion transmission efficiency of IMS-MS was optimized by optimizing the various parameters, especially the distance between the faraday plate and the cone of mass spectrum. This design keeps the integrity of the two original instruments and the mass spectrometry still works with multimode ionization source (i.e., IMS-MS, ESI-MS, APCI-MS modes). The illicit drugs and explosive samples were analyzed by the IMS-MS with 63 Ni source. The results showed that the IMS-MS is of high sensitivity. The ionization mechanism of the illicit drug and explosive samples with 63 Ni source were systematically studied. In addition, the interferent which interfered the detection of cocaine was identified as dibutyl phthalate (DBP) by this platform. The reason why the acetone solution of amphetamine showed two peaks was explained. Copyright © 2018 Elsevier B.V. All rights reserved.

[Manfred Schneider. Lübeck im 12. und 13. Jahrhundert. Archäologische Befunde zur entstehung einer mittelalterlichen Grossstadt. In : Expansion - integration? Danish-Baltic Contacts 1147-1410] / Dennis Hortmuth

Index Scriptorium Estoniae

Hortmuth, Dennis

2011-01-01

Arvustus:Manfred Schneider. Lübeck im 12. und 13. Jahrhundert. Archäologische Befunde zur entstehung einer mittelalterlichen Grossstadt. In : Expansion - integration? Danish-Baltic Contacts 1147-1410 AD. (Vordingborg, 2009).

How IMS Enables Converged Services for Cable and 3G Technologies: A Survey

Directory of Open Access Journals (Sweden)

Noël Crespi

2008-04-01

Full Text Available The IP multimedia subsystem (IMS is a service control overlay standardized by the 3GPP. The IMS is based on session initiation protocol (SIP to establish, modify, and terminate the sessions. It provides a clean separation between services, signaling, and media with the potential to enable control and management of services over multiple transport technologies. In the scope of fixed-mobile convergence, this paper is dedicated to presenting a review of how cable networks can be integrated into IMS technology to achieve 3G-cable horizontal convergence. Cable networks, as one of the major fixed broadband access technologies with PacketCable architecture, are able to provide broadband internet access and VoIP in addition to cable TV. In this article, we review the evolution in PacketCable architecture to take up IMS. In this way, we consider the standardization and research activities to address this integration. We review some important challenges such as SIP protocol compatibility, defining unique user profile, required enhancement in authentication process, QoS and charging system.

How IMS Enables Converged Services for Cable and 3G Technologies: A Survey

Directory of Open Access Journals (Sweden)

Mani Mehdi

2008-01-01

Full Text Available The IP multimedia subsystem (IMS is a service control overlay standardized by the 3GPP. The IMS is based on session initiation protocol (SIP to establish, modify, and terminate the sessions. It provides a clean separation between services, signaling, and media with the potential to enable control and management of services over multiple transport technologies. In the scope of fixed-mobile convergence, this paper is dedicated to presenting a review of how cable networks can be integrated into IMS technology to achieve 3G-cable horizontal convergence. Cable networks, as one of the major fixed broadband access technologies with PacketCable architecture, are able to provide broadband internet access and VoIP in addition to cable TV. In this article, we review the evolution in PacketCable architecture to take up IMS. In this way, we consider the standardization and research activities to address this integration. We review some important challenges such as SIP protocol compatibility, defining unique user profile, required enhancement in authentication process, QoS and charging system.

Organisationsprobleme im Ökomarketing

OpenAIRE

Dienel, Wolfram

2000-01-01

Organisationsprobleme im Ökomarketing - eine transaktionskostentheoretische Analyse im Absatzkanal konventioneller Lebensmittelhandel Die im Vergleich zum großen Nachfragepotential zögerliche Entwicklung des Ökomarkts in Deutschland ist auf Organisationsprobleme zurückzuführen. Die Organisationsprobleme behindern insbesondere die großskalige Ökomarkterschließung über die konventionellen Supermarktketten, erschweren aber auch die Effizienzsteigerung im kleiner strukturierten alternativen N...

“Como Arrancar una Planta”: Women’s Reflections about Influences of Im/Migration on Their Everyday Lives and Health in Mexico

Directory of Open Access Journals (Sweden)

Eva K. Robertson

2015-04-01

Full Text Available The aim of this study is to analyze women’s reflections about how experiences of im/migration from rural to urban settings in Monterrey, Mexico, influence their everyday life experience and health and that of their families. The participants were eight women from heterogeneous indigenous backgrounds, one woman with a mestizo background, two health professionals, three persons from organizations supporting indigenous groups, and two researchers. I collected data from personal observations, documents, and interviews that I then analyzed with a critical ethnography methodology developed by Carspecken. The women emphasized that food habits were the first to be adapted to circumstances in an urban everyday life constrained by working conditions. Together with their experiences of discrimination and violence, urban living determines the challenges and the priorities of daily life. Urban life affects how they perceive and treat their own and their family’s health and wellbeing. Nevertheless, their sense of belonging and home remains in their communities of origin, and they strive to reach a balance in their lives and preserve a connection to their roots, motherhood, and traditional knowledge. However, the women handle their im/migration experiences in diverse ways depending on their own conditions and the structural forces limiting or allowing them to act in decisive life situations. Im/migration is not just a matter of choice; it is about survival and is influenced by social determinants and “structural vulnerability” that influences and/or limit human agency. These, together with an unsustainable economic situation, make migration the only option, a forced decision within households. Structural forces such as social injustice in welfare policies restrict human rights and rights for health. Social determinants of health can constrain decision making and frame choices concerning health and childbearing in everyday life.

Information management system study results. Volume 1: IMS study results

Science.gov (United States)

1971-01-01

The information management system (IMS) special emphasis task was performed as an adjunct to the modular space station study, with the objective of providing extended depth of analysis and design in selected key areas of the information management system. Specific objectives included: (1) in-depth studies of IMS requirements and design approaches; (2) design and fabricate breadboard hardware for demonstration and verification of design concepts; (3) provide a technological base to identify potential design problems and influence long range planning (4) develop hardware and techniques to permit long duration, low cost, manned space operations; (5) support SR&T areas where techniques or equipment are considered inadequate; and (6) permit an overall understanding of the IMS as an integrated component of the space station.

INTEGRATED MANAGEMENT SYSTEMS IN LOCAL PUBLIC ENTERPRIZE FOR PRODUCTION, DISTRIBUTION AND CLEANING OF WASTED WATER

Directory of Open Access Journals (Sweden)

Slavko Arsovski

2007-06-01

Full Text Available Appearance of large number of management systems, with different and sometimes divergent demands, needs reconsideration of their implementation strategies and their integration in one integrated management system (IMS. So defined IMS would be designed and implemented in different areas. In this paper is presented basic concept of integration of partical management systems in areas of quality (ISO 9001, environmental protection (ISO 14001, occupational health (ISO 18001, food safety (ISO 22000 and accreditation of laboratories (ISO17025/ISO17020. As a pilot organization is choosed local public enterprise for production, supply and drain of water.

INTEGRATED HSEQ MANAGEMENT SYSTEMS: DEVELOPMENTS AND TRENDS

OpenAIRE

Osmo Kauppila; Janne Härkönen; Seppo Väyrynen

2015-01-01

The integration of health and safety, environmental and quality (HSEQ) management systems has become a current topic in the 21st century, as the need for systems thinking has grown along with the number of management system standards. This study aims to map current developments and trends in integrated HSEQ management. Three viewpoints are taken: the current state of the main HSEQ management standards, research literature on integrated management systems (IMS), and a case study of an industry...

Environmental trace analysis by means of supersensitive GC-IMS

Energy Technology Data Exchange (ETDEWEB)

Leonhardt, J.W. [IUTLimited, Berlin, (Germany)

1997-10-01

The effective control of pollutants in ambient air requires their fast in situ identification and concentration determination of chemical compounds in the range of micrograms per m{sup 3}. There are attempts to use conventional analytical techniques as portable GC and GC-MS. These systems are relatively expensive. A new supersensitive ion Mobility Sensor (IMS) was developed and checked by IUT Ltd, which meets the new demands. The use of tritium sources is an advantage in comparison with other IMS being equipped by nickel-63, the application of which is rather critical in respect of the radiation protection. On the other hand an integrated separation column allows to reduce interferences by matrix effects. The technical parameters of the IUT GC- IMS and some of its most important applications are briefly presented 6 refs., 1 tab., 5 figs.

Adaptive e-learning methods and IMS Learning Design. An integrated approach

NARCIS (Netherlands)

Burgos, Daniel; Specht, Marcus

2006-01-01

Please, cite this publication as: Burgos, D., & Specht, M. (2006). Adaptive e-learning methods and IMS Learning Design. In Kinshuk, R. Koper, P. Kommers, P. Kirschner, D. G. Sampson & W. Didderen (Eds.), Proceedings of the 6th IEEE International Conference on Advanced Learning Technologies (pp.

Integrated annotation and analysis of in situ hybridization images using the ImAnno system: application to the ear and sensory organs of the fetal mouse.

Science.gov (United States)

Romand, Raymond; Ripp, Raymond; Poidevin, Laetitia; Boeglin, Marcel; Geffers, Lars; Dollé, Pascal; Poch, Olivier

2015-01-01

An in situ hybridization (ISH) study was performed on 2000 murine genes representing around 10% of the protein-coding genes present in the mouse genome using data generated by the EURExpress consortium. This study was carried out in 25 tissues of late gestation embryos (E14.5), with a special emphasis on the developing ear and on five distinct developing sensory organs, including the cochlea, the vestibular receptors, the sensory retina, the olfactory organ, and the vibrissae follicles. The results obtained from an analysis of more than 11,000 micrographs have been integrated in a newly developed knowledgebase, called ImAnno. In addition to managing the multilevel micrograph annotations performed by human experts, ImAnno provides public access to various integrated databases and tools. Thus, it facilitates the analysis of complex ISH gene expression patterns, as well as functional annotation and interaction of gene sets. It also provides direct links to human pathways and diseases. Hierarchical clustering of expression patterns in the 25 tissues revealed three main branches corresponding to tissues with common functions and/or embryonic origins. To illustrate the integrative power of ImAnno, we explored the expression, function and disease traits of the sensory epithelia of the five presumptive sensory organs. The study identified 623 genes (out of 2000) concomitantly expressed in the five embryonic epithelia, among which many (∼12%) were involved in human disorders. Finally, various multilevel interaction networks were characterized, highlighting differential functional enrichments of directly or indirectly interacting genes. These analyses exemplify an under-represention of "sensory" functions in the sensory gene set suggests that E14.5 is a pivotal stage between the developmental stage and the functional phase that will be fully reached only after birth.

THOR Ion Mass Spectrometer instrument - IMS

Science.gov (United States)

Retinò, Alessandro; Kucharek, Harald; Saito, Yoshifumi; Fraenz, Markus; Verdeil, Christophe; Leblanc, Frederic; Techer, Jean-Denis; Jeandet, Alexis; Macri, John; Gaidos, John; Granoff, Mark; Yokota, Shoichiro; Fontaine, Dominique; Berthomier, Matthieu; Delcourt, Dominique; Kistler, Lynn; Galvin, Antoniette; Kasahara, Satoshi; Kronberg, Elena

2016-04-01

Turbulence Heating ObserveR (THOR) is the first mission ever flown in space dedicated to plasma turbulence. Specifically, THOR will study how turbulent fluctuations at kinetic scales heat and accelerate particles in different turbulent environments within the near-Earth space. To achieve this goal, THOR payload is being designed to measure electromagnetic fields and particle distribution functions with unprecedented resolution and accuracy. Here we present the Ion Mass Spectrometer (IMS) instrument that will measure the full three-dimensional distribution functions of near-Earth main ion species (H+, He+, He++ and O+) at high time resolution (~ 150 ms for H+ , ~ 300 ms for He++) with energy resolution down to ~ 10% in the range 10 eV/q to 30 keV/q and angular resolution ~ 10°. Such high time resolution is achieved by mounting multiple sensors around the spacecraft body, in similar fashion to the MMS/FPI instrument. Each sensor combines a top-hat electrostatic analyzer with deflectors at the entrance together with a time-of-flight section to perform mass selection. IMS electronics includes a fast sweeping high voltage board that is required to make measurements at high cadence. Ion detection includes Micro Channel Plates (MCP) combined with Application-Specific Integrated Circuits (ASICs) for charge amplification, discrimination and time-to-digital conversion (TDC). IMS is being designed to address many of THOR science requirements, in particular ion heating and acceleration by turbulent fluctuations in foreshock, shock and magnetosheath regions. The IMS instrument is being designed and will be built by an international consortium of scientific institutes with main hardware contributions from France, USA, Japan and Germany.

Systems Modeling to Implement Integrated System Health Management Capability

Science.gov (United States)

Figueroa, Jorge F.; Walker, Mark; Morris, Jonathan; Smith, Harvey; Schmalzel, John

2007-01-01

ISHM capability includes: detection of anomalies, diagnosis of causes of anomalies, prediction of future anomalies, and user interfaces that enable integrated awareness (past, present, and future) by users. This is achieved by focused management of data, information and knowledge (DIaK) that will likely be distributed across networks. Management of DIaK implies storage, sharing (timely availability), maintaining, evolving, and processing. Processing of DIaK encapsulates strategies, methodologies, algorithms, etc. focused on achieving high ISHM Functional Capability Level (FCL). High FCL means a high degree of success in detecting anomalies, diagnosing causes, predicting future anomalies, and enabling health integrated awareness by the user. A model that enables ISHM capability, and hence, DIaK management, is denominated the ISHM Model of the System (IMS). We describe aspects of the IMS that focus on processing of DIaK. Strategies, methodologies, and algorithms require proper context. We describe an approach to define and use contexts, implementation in an object-oriented software environment (G2), and validation using actual test data from a methane thruster test program at NASA SSC. Context is linked to existence of relationships among elements of a system. For example, the context to use a strategy to detect leak is to identify closed subsystems (e.g. bounded by closed valves and by tanks) that include pressure sensors, and check if the pressure is changing. We call these subsystems Pressurizable Subsystems. If pressure changes are detected, then all members of the closed subsystem become suspect of leakage. In this case, the context is defined by identifying a subsystem that is suitable for applying a strategy. Contexts are defined in many ways. Often, a context is defined by relationships of function (e.g. liquid flow, maintaining pressure, etc.), form (e.g. part of the same component, connected to other components, etc.), or space (e.g. physically close

A reasoned action approach to health promotion.

Science.gov (United States)

Fishbein, Martin

2008-01-01

This article describes the integrative model of behavioral prediction (IM), the latest formulation of a reasoned action approach. The IM attempts to identify a limited set of variables that can account for a considerable proportion of the variance in any given behavior. More specifically, consistent with the original theory of reasoned action, the IM assumes that intentions are the immediate antecedents of behavior, but in addition, the IM recognizes that environmental factors and skills and abilities can moderate the intention-behavior relationship. Similar to the theory of planned behavior, the IM also assumes that intentions are a function of attitudes, perceived normative pressure and self-efficacy, but it views perceived normative pressure as a function of descriptive as well as of injunctive (i.e., subjective) norms. After describing the theory and addressing some of the criticisms directed at a reasoned action approach, the paper illustrates how the theory can be applied to understanding and changing health related behaviors.

Inductive Monitoring System (IMS)

Data.gov (United States)

National Aeronautics and Space Administration — IMS: Inductive Monitoring System The Inductive Monitoring System (IMS) is a tool that uses a data mining technique called clustering to extract models of normal...

A two-stage extraction procedure for insensitive munition (IM) explosive compounds in soils.

Science.gov (United States)

Felt, Deborah; Gurtowski, Luke; Nestler, Catherine C; Johnson, Jared; Larson, Steven

2016-12-01

The Department of Defense (DoD) is developing a new category of insensitive munitions (IMs) that are more resistant to detonation or promulgation from external stimuli than traditional munition formulations. The new explosive constituent compounds are 2,4-dinitroanisole (DNAN), nitroguanidine (NQ), and nitrotriazolone (NTO). The production and use of IM formulations may result in interaction of IM component compounds with soil. The chemical properties of these IM compounds present unique challenges for extraction from environmental matrices such as soil. A two-stage extraction procedure was developed and tested using several soil types amended with known concentrations of IM compounds. This procedure incorporates both an acidified phase and an organic phase to account for the chemical properties of the IM compounds. The method detection limits (MDLs) for all IM compounds in all soil types were regulatory risk-based Regional Screening Level (RSL) criteria for soil proposed by the U.S. Army Public Health Center. At defined environmentally relevant concentrations, the average recovery of each IM compound in each soil type was consistent and greater than 85%. The two-stage extraction method decreased the influence of soil composition on IM compound recovery. UV analysis of NTO established an isosbestic point based on varied pH at a detection wavelength of 341 nm. The two-stage soil extraction method is equally effective for traditional munition compounds, a potentially important point when examining soils exposed to both traditional and insensitive munitions. Copyright © 2016 Elsevier Ltd. All rights reserved.

A database and tool, IM Browser, for exploring and integrating emerging gene and protein interaction data for Drosophila

Directory of Open Access Journals (Sweden)

Parrish Jodi R

2006-04-01

Full Text Available Abstract Background Biological processes are mediated by networks of interacting genes and proteins. Efforts to map and understand these networks are resulting in the proliferation of interaction data derived from both experimental and computational techniques for a number of organisms. The volume of this data combined with the variety of specific forms it can take has created a need for comprehensive databases that include all of the available data sets, and for exploration tools to facilitate data integration and analysis. One powerful paradigm for the navigation and analysis of interaction data is an interaction graph or map that represents proteins or genes as nodes linked by interactions. Several programs have been developed for graphical representation and analysis of interaction data, yet there remains a need for alternative programs that can provide casual users with rapid easy access to many existing and emerging data sets. Description Here we describe a comprehensive database of Drosophila gene and protein interactions collected from a variety of sources, including low and high throughput screens, genetic interactions, and computational predictions. We also present a program for exploring multiple interaction data sets and for combining data from different sources. The program, referred to as the Interaction Map (IM Browser, is a web-based application for searching and visualizing interaction data stored in a relational database system. Use of the application requires no downloads and minimal user configuration or training, thereby enabling rapid initial access to interaction data. IM Browser was designed to readily accommodate and integrate new types of interaction data as it becomes available. Moreover, all information associated with interaction measurements or predictions and the genes or proteins involved are accessible to the user. This allows combined searches and analyses based on either common or technique-specific attributes

Anforderungen an ein System zur Dokumentanalyse im Unternehmenskontext : Integration von Datenbeständen, Aufbau- und Ablauforganisation

OpenAIRE

Baumann, Stephan; Hadj Ali, Majdi Ben; Lichter, Jürgen; Malburg, Michael; Meyer auf'm Hofe, Harald; Wenzel, Claudia

1997-01-01

Workflowmanagementsysteme werden im Bürobereich verstärkt zur effizienten Geschäftsprozeßabwicklung eingesetzt. Das bereits Mitte der 70er Jahre propagierte papierlose Büro bleibt jedoch gegenwärtig immer noch Utopie, da auch durch den allgegenwärtigen Einsatz von Computern im Bürobereich der Durchsatz an Schriftstücken nicht gesenkt wird. Insbesondere die Handhabung von papierintensiven Vorgängen ist in hohem Maße abhängig von einer Identifikation und Aufbereitung der in den Dokumenten e...

Power-efficient method for IM-DD optical transmission of multiple OFDM signals.

Science.gov (United States)

Effenberger, Frank; Liu, Xiang

2015-05-18

We propose a power-efficient method for transmitting multiple frequency-division multiplexed (FDM) orthogonal frequency-division multiplexing (OFDM) signals in intensity-modulation direct-detection (IM-DD) optical systems. This method is based on quadratic soft clipping in combination with odd-only channel mapping. We show, both analytically and experimentally, that the proposed approach is capable of improving the power efficiency by about 3 dB as compared to conventional FDM OFDM signals under practical bias conditions, making it a viable solution in applications such as optical fiber-wireless integrated systems where both IM-DD optical transmission and OFDM signaling are important.

General Purpose Data-Driven Online System Health Monitoring with Applications to Space Operations

Science.gov (United States)

Iverson, David L.; Spirkovska, Lilly; Schwabacher, Mark

2010-01-01

Modern space transportation and ground support system designs are becoming increasingly sophisticated and complex. Determining the health state of these systems using traditional parameter limit checking, or model-based or rule-based methods is becoming more difficult as the number of sensors and component interactions grows. Data-driven monitoring techniques have been developed to address these issues by analyzing system operations data to automatically characterize normal system behavior. System health can be monitored by comparing real-time operating data with these nominal characterizations, providing detection of anomalous data signatures indicative of system faults, failures, or precursors of significant failures. The Inductive Monitoring System (IMS) is a general purpose, data-driven system health monitoring software tool that has been successfully applied to several aerospace applications and is under evaluation for anomaly detection in vehicle and ground equipment for next generation launch systems. After an introduction to IMS application development, we discuss these NASA online monitoring applications, including the integration of IMS with complementary model-based and rule-based methods. Although the examples presented in this paper are from space operations applications, IMS is a general-purpose health-monitoring tool that is also applicable to power generation and transmission system monitoring.

Resilience in IMS

DEFF Research Database (Denmark)

Kamyod, Chayapol; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

2012-01-01

) and supporting always on services. Therefore, not only Quality of Service (QoS) but also resilience is required. In this paper, we attempt to evaluate and analyze end-to-end reliability of the IMS system using a model proposed as a combination of Reliability Block Diagram (RBD) and Markov Reward Models (MRMs......Reliability evaluation of systems has been widely researched for improving system resilience especially in designing processes of a complex system. The convergence of different access networks is possible via IP Multimedia Subsystem (IMS) for development toward Next Generation Networks (NGNs......). The resilience of the IMS architecture is studied by applying 1:1 redundancy at different communication scenarios between end users within and across communication domains. The model analysis provides useful reliability characteristics of the system and can be further applied for system design processes....

Delegation und Kooperation im Gesundheitswesen

OpenAIRE

Rosenau, Henning

2010-01-01

Delegation und Kooperation im Gesundheitswesen. - In: Tıpta işbirliği ve hukuksal sorunlar = Delegation und Kooperation im Gesundheitswesen / ed.: Hakan Hakeri ... - Samsun : Adalet, 2010. - S. 7-18

Innovationsmanagement im Marketing: Anleitung zur Innovations-Sensibilisierung und deren Umsetzung im Rahmen der Neuen Lernkultur

OpenAIRE

Mangisch, Christian; Blatter, Martin

2009-01-01

Der Kurs “Innovationsmanagement im Marketing“ vermittelt den Teilnehmenden Wissen zum Innovationsmanagement, zum innovativen Team und zu innovativen Marketing Trends. Diese Kurse sind online auf dem folgenden Link www.ritzycampus.ch zu finden. Die Teilnehmer müssen für den Online-Kurs keine speziellen Kenntnisse oder Voraussetzungen mitbringen. Diese Online-Kurse im Fach Marketing sind an ein breites Publikum gerichtet. Sie ermöglichen den Studierenden im Eigenstudium die Grundlagen der Theme...

Δim-lacunary statistical convergence of order α

Science.gov (United States)

Altınok, Hıfsı; Et, Mikail; Işık, Mahmut

2018-01-01

The purpose of this work is to introduce the concepts of Δim-lacunary statistical convergence of order α and lacunary strongly (Δim,p )-convergence of order α. We establish some connections between lacunary strongly (Δim,p )-convergence of order α and Δim-lacunary statistical convergence of order α. It is shown that if a sequence is lacunary strongly (Δim,p )-summable of order α then it is Δim-lacunary statistically convergent of order α.

[Kriegsland im Osten Eroberung, Kolonisierung und Militärherrschaft im Ersten Weltkrieg] / Markus Pöhlmann

Index Scriptorium Estoniae

Pöhlmann, Markus

2003-01-01

Rets.: Vejas Gabriel Liulevicius. Kriegsland im Osten Eroberung, Kolonisierung und Militärherrschaft im Ersten Weltkrieg. Aus dem Amerikanischen von Jürgen Bauer, Edith Nerke und Fee Engemann. Hamburg : 2002

Volatility study of [C1C1im][NTf2] and [C2C3im][NTf2] ionic liquids

International Nuclear Information System (INIS)

Rocha, Marisa A.A.; Ribeiro, Filipe M.S.; Schröder, Bernd; Coutinho, João A.P.; Santos, Luís M.N.B.F.

2014-01-01

Highlights: • Vapor pressures of [C 1 C 1 im][NTf 2 ] and [C 2 C 3 im][NTf 2 ] ionic liquids are reported. • [C 1 C 1 im][NTf 2 ] presents higher enthalpy and entropy of vaporization than expected. • The high volatility of [C 2 C 3 im][NTf 2 ] is a result from its asymmetric character. -- Abstract: Vapor pressures of 1,3-dimethylimidazolium bis(trifluoromethylsulfonyl)imide, ([C 1 C 1 im][NTf 2 ]) and 1-ethyl-3-propylimidazolium bis(trifluoromethylsulfonyl)imide, ([C 2 C 3 im][NTf 2 ]) ionic liquids were measured as a function of temperature using a Knudsen effusion apparatus combined with a quartz crystal microbalance. Enthalpies and entropies of vaporization were derived from the fitting of vapor pressure and temperature results to the Clarke and Glew equation. [C 1 C 1 im][NTf 2 ] presents a higher enthalpy and entropy of vaporization than the neighboring members of the series. The enthalpy of vaporization of [C 2 C 3 im][NTf 2 ] lies in between the asymmetric and symmetric ionic liquid series, reflecting a decrease in the electrostatic interactions due to a decrease of the charge accessibility between the ionic pairs when the methyl group is replaced by an ethyl group. The obtained higher volatility of [C 2 C 3 im][NTf 2 ] arises from its asymmetric character, leading to an higher entropic contribution that compensates the enthalpic penalty. The border conditions ([C 1 C 1 im][NTf 2 ], [C 2 C 1 im][NTf 2 ] and [C 2 C 2 im][NTf 2 ]), topology ([C 2 C 3 im][NTf 2 ]) and symmetry/asymmetry of the ILs effect were evaluated and rationalized based on a comparative analysis of the thermodynamic properties, enthalpies and entropies of vaporization

Application of Hadamard transform in IMS

International Nuclear Information System (INIS)

Sha Miaomiao; Liu Weihao; Chen Yong; Jiang Dazhen

2008-01-01

Hadamard transform can improve the SNR by increasing the ion duty cycle in IMS. In this paper, the ion spectral signals were processed by Hadamard transform based on the IMS detector hardware platform. The results showed that Hadamard transform can greatly improve the SNR of the IMS detector in contrast with traditional method. (authors)

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

Science.gov (United States)

Yazdani, Amin; Wells, Richard

2012-01-01

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

Integrated management systems and workflow-based electronic document management: An empirical study

Directory of Open Access Journals (Sweden)

Hang Thu Pho

2014-01-01

Full Text Available Purpose: Many global organizations have aligned their strategy and operation via the ISO-based framework of integrated management system (IMS that allows them to merge quality, environment, health and safety management systems. In such context, having a robust electronic document management system (EDMS is essential, especially at global enterprises where a large amount of documents generated by processes flows through different work cultures. However, there is no "one-size-fits-all" design for EDMS because it depends on organizations' needs, size and resource allocation. This article discusses the interrelation between EDMS and IMS in order to suggest a best practice. Design/methodology/approach: This article methodologically based upon a qualitative, interpretivistic, longitudinal empirical study in a wind turbine factory. Findings and Originality/value: IMS improvement and effectiveness has been overlooking EDMS as a key factor in establishing appropriate technological support of the IMS processes. Rightful application of EDMS can further contribute to organizational learning, precision of documentation and cross-organisational collaboration. Research limitations/implications: Theorising on IMS needs a stronger perspective of the technological limitations and potentials of basing IMS on EDMS. Practical implications: IMS are complex systems involving a large number of administrative functions. EDMS provides a formal representation with automation potentials both heightening and securing document trustworthiness. Social implications: IMS has a tendency to stay with professionals, e.g. line managers and QA/QC/QMS professionals. The EDMS line of discussion suggests a broader inclusion. Originality/value: Researching IMS as a technological implementation is giving a better platform of aligning the IMS with other business processes and is bringing IMS closer to the operational activities within the enterprise.

Security in the internet; Sicherheitsaspekte im Internet

Energy Technology Data Exchange (ETDEWEB)

Seibel, R.M.M.; Kocher, K.; Landsberg, P. [Witten-Herdecke Univ., Witten (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

2000-04-01

Aim of the study: Is it possible to use the Internet as a secure media for transport of telemedicine? Which risks exist for routine use? In this article state of the art methods of security were analysed. Telemedicine in the Internet has severe risks, because patient data and hospital data of a secure Intranet can be manipulated by connecting it to the Web. Conclusions: Establishing of a firewall and the introduction of HPC (Health Professional Card) are minimizing the risk of un-authorized access to the hospital server. HPC allows good safety with digital signature and authentication of host and client of medical data. For secure e-mail PGP (Pretty Good Privacy) is easy to use as a standard protocol. Planning all activities exactly as well as following legal regulations are important requisites for reduction of safety risks in Internet. (orig.) [German] Ziele der Studie und Analyse: Es sollten die Fragen beantwortet werden, ob es moeglich ist, das Internet als sicheres Uebermittlungsmedium fuer Telemedizin zu nutzen und welche Sicherheitsrisiken bestehen. Dazu wurden die gaengigen Sicherheitsmethoden analysiert. Telemedizin im Internet ist mit Sicherheitsrisiken behaftet, die durch die Oeffnung eines Intranets mit der Moeglichkeit zur unberechtigten Manipulation von aussen bedingt sind. Schlussfolgerung: Diese Sicherheitsrisiken koennen durch eine Firewall weitgehend unterbunden werden. Chipkarten wie die Health professional card ermoeglichen eine hohe Sicherheit bei digitaler Signatur und sicherer Authentifikation der Sender und Empfaenger von Daten im Internet. Auch Standards wie Pretty good privacy sind inzwischen fuer sichere e-mails einfach einzusetzen. Wichtige Voraussetzung fuer die Reduktion von Sicherheitsrisiken ist unter Beruecksichtigung der gesetzlichen Vorgaben die exakte Planung aller Aktivitaeten im Internet, bei denen medizinische Patientendaten versandt werden sollen, in einem Team aus Aerzten und Informatikern. (orig.)

Integrated Management System - Scope, Possibilities And Methodology

Science.gov (United States)

Čekanová, Katarína

2015-06-01

Organizations are becoming more aware of the importance of integrated management systems (IMS). Interest in this subject indicates that IMS are seen as "management systems of the future". Based on this, the aim of this articles characterizes the possibility of building IMS through the identification of common elements and specific requirements in accordance with the ISO 9001, ISO 14001 and OHSAS 18001 professional references. Part of the article is the methodology of building IMS in the organization.

E2eUberIM

DEFF Research Database (Denmark)

Wac, Katarzyna; Cummings, Mark; Dey, Jayanta

2016-01-01

, high-quality services, we propose an innovative end-to-end service management framework called e2eUberIM. This framework contains a scalable, flexible, and volatile information model (UberIM) and a real-time, "organic" communication and storage process (e2eUber). It leverages the proprietary interfaces...... of different vendors, enabling the resulting enhanced operations system environment to automatically and in real-time optimize operational overhead while maximizing the user experience, and quickly field new innovative, composed "any-services" (XaaS). We document the e2eUberIM requirements and its design...

Imágenes e identidades

OpenAIRE

Guerrini, Sebastión

2013-01-01

Las identidades se estructuran en un proceso de identificación continua con imágenes. Esto afecta no solo a las identidades de las personas, sino también a las de las instituciones, organizaciones y empresas. En este sentido, el rol de ser del Diseño en Comunicación Visual es intentar afectar a las identidades de los espectadores de sus imágenes. Por esta razón, primero es importante definir qué son las imágenes. Facultad de Bellas Artes

λ (Δim) -statistical convergence of order α

Science.gov (United States)

Colak, Rifat; Et, Mikail; Altin, Yavuz

2017-09-01

In this study, using the generalized difference operator Δim and a sequence λ = (λn) which is a non-decreasing sequence of positive numbers tending to ∞ such that λn+1 ≤ λn+1, λ1 = 1, we introduce the concepts of λ (Δim) -statistical convergence of order α (α ∈ (0, 1]) and strong λ (Δim) -Cesàro summablility of order α (α > 0). We establish some connections between λ (Δim) -statistical convergence of order α and strong λ (Δim) -Cesàro summablility of order α. It is shown that if a sequence is strongly λ (Δim) -Cesàro summable of order α, then it is λ (Δim) -statistically convergent of order β in case 0 < α ≤ β ≤ 1.

Advanced Interval Management (IM) Concepts of Operations

Science.gov (United States)

Barmore, Bryan E.; Ahmad, Nash'at N.; Underwood, Matthew C.

2014-01-01

This document provides a high-level description of several advanced IM operations that NASA is considering for future research and development. It covers two versions of IM-CSPO and IM with Wake Mitigation. These are preliminary descriptions to support an initial benefits analysis

Study of the Continuous Improvement Trend for Health, Safety and Environmental Indicators, after Establishment of Integrated Management System (IMS) in a Pharmaceutical Industry in Iran.

Science.gov (United States)

Mariouryad, Pegah; Golbabaei, Farideh; Nasiri, Parvin; Mohammadfam, Iraj; Marioryad, Hossein

2015-10-01

Nowadays, organizations try to improve their services and consequently adopt management systems and standards which have become key parts in various industries. One of these management systems which have been noticed in the recent years is Integrated Management System that is the combination of quality, health, safety and environment management systems. This study was conducted with the aim of evaluating the improvement trend after establishment of integrated management system for health, safety and environment indicators, in a pharmaceutical industry in Iran. First, during several inspections in different parts of the industry, indicators that should have been noted were listed and then these indicators were organized in 3 domains of health, safety and environment in the form of a questionnaire that followed Likert method of scaling. Also, the weight of each index was resulted from averaging out of 30 managers and the viewpoints of the related experts in the field. Moreover, by checking the documents and evidence of different years (5 contemplation years of this study), the score of each indicator was determined by multiplying the weight and score of the indices and were finally analysed. Over 5 years, scores of health scope indicators, increased from 161.99 to 202.23. Score in the first year after applying the integrated management system establishment was 172.37 in safety part and in the final year increased to 197.57. The changes of environmental scope rates, from the beginning of the program up to the last year increased from 49.24 to 64.27. Integrated management systems help organizations to improve programs to achieve their objectives. Although in this study all trends of health, safety and environmental indicator changes were positive, but at the same time showed to be slow. So, one can suggest that the result of an annual evaluation should be applied in planning future activities for the years ahead.

IMPLEMENTASI HASIL PAP SMEARS PADA PENGEMBANGAN SURVEILANS TERPADU INFEKSI MENULAR SEKSUAL DI JAWA TIMUR (ANALISIS UNTUK MENGEMBANGKAN SURVEILANS-RESPONS IMS

Directory of Open Access Journals (Sweden)

Widjiartini Widjiartini

2012-12-01

Full Text Available Background: The implementation analysis of Pap Smears result to the integrated Surveillance development of sexual infection in order to respond the IMS and HIV/AIDS cases which increased especially among the housewife and its aim to the implementation Pap Smears result. Results: The Analysis result: 1. Based on the Pap Smears analysis result when its managed properly might be benefited the information not merely detected service cancer which is tend to increase but its also detected fungal infection and 5 types of IMS data: Haemavilus Vaginalis (HV, Gonococoes (Cocen, Trichomonas Vaginalis (TV, Herpes and Virus Papiloma Humanus (HPV which is Cocen and TV tend to increase every years. This data might be used for Surveillance Respond of Pap Smears intended to the productive housewife who is representing susceptible age group against sexual infection and HIV/AIDS. 2. The integrated Surveillance activity of HIV and sexual infection along with eight steps of respond Pap Smears, the structure is matching up with Surveillance of WHO respond and the system and mechanism base on decision of Minister of Health number 1116/2003 to instruct the formation of Surveillance technical implementation and the formation Surveillance technical implementation and the formation Surveillance networking among those units. 3. Developing the integrated Surveillance of sexual infection and HIV/AIDS through the uphold unit Pap Smears is required the determination of basis function, the Surveillance uphold unit, the Respond Surveillance uphold and function, formulation of Protap and Instruction, Training, Monitoring and Evaluation Surveillance System, Communication, Procurement of Coordination and Resources. Exceptional the above mentioned it is necessary pay attention as well as Surveillance structure and quality. Suggestion: 1. Improving the Surveillance Respond System by improving the users of culture information and data for making a decision the unit of Pap Smears

The effectiveness of integrative medicine interventions on pain and anxiety in cardiovascular inpatients: a practice-based research evaluation.

Science.gov (United States)

Johnson, Jill R; Crespin, Daniel J; Griffin, Kristen H; Finch, Michael D; Rivard, Rachael L; Baechler, Courtney J; Dusek, Jeffery A

2014-12-13

Pain and anxiety occurring from cardiovascular disease are associated with long-term health risks. Integrative medicine (IM) therapies reduce pain and anxiety in small samples of hospitalized cardiovascular patients within randomized controlled trials; however, practice-based effectiveness research has been limited. The goal of the study is to evaluate the effectiveness of IM interventions (i.e., bodywork, mind-body and energy therapies, and traditional Chinese medicine) on pain and anxiety measures across a cardiovascular population. Retrospective data obtained from medical records identified patients with a cardiovascular ICD-9 code admitted to a large Midwestern hospital between 7/1/2009 and 12/31/2012. Outcomes were changes in patient-reported pain and anxiety, rated before and after IM treatments based on a numeric scale (0-10). Of 57,295 hospital cardiovascular admissions, 6,589 (11.5%) included IM. After receiving IM therapy, patients averaged a 46.5% (p-value value value medicine (p-value value value value based research to investigate the best approach for incorporating these therapies into an acute care setting such that IM therapies are most appropriately provided to patient populations.

Integrating Community Health Workers (CHWs) into Health Care Organizations.

Science.gov (United States)

Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

2017-10-01

Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

Exploring integrative medicine for back and neck pain - a pragmatic randomised clinical pilot trial

Directory of Open Access Journals (Sweden)

Rydén Anna

2009-09-01

Full Text Available Abstract Background A model for integrative medicine (IM adapted to Swedish primary care was previously developed. The aim of this study was to explore the feasibility of a pragmatic randomised clinical trial to investigate the effectiveness of the IM model versus conventional primary care in the management of patients with non-specific back/neck pain. Specific objectives included the exploration of recruitment and retention rates, patient and care characteristics, clinical differences and effect sizes between groups, selected outcome measures and power calculations to inform the basis of a full-scale trial. Methods Eighty patients with back/neck pain of at least two weeks duration were randomised to the two types of care. Outcome measures were standardised health related quality of life (the eight domains of SF-36 complemented by a set of exploratory "IM tailored" outcomes targeting self-rated disability, stress and well-being (0-10 scales; days in pain (0-14; and the use of analgesics and health care over the last two weeks (yes/no. Data on clinical management were derived from medical records. Outcome changes from baseline to follow-up after 16 weeks were used to explore the differences between the groups. Results Seventy-five percent (80/107 of screened patients in general practice were eligible and feasible to enrol into the trial. Eighty-two percent (36/44 of the integrative and 75% (27/36 of the conventional care group completed follow-up after 16 weeks. Most patients had back/neck pain of at least three months duration. Conventional care typically comprised advice and prescription of analgesics, occasionally complemented with sick leave or a written referral to physiotherapy. IM care generally integrated seven treatment sessions from two different types of complementary therapies with conventional care over ten weeks. The study was underpowered to detect any statistically significant differences between the groups. One SF-36 domain

Standardization process aligned to integrated management system: the case of TRANSPETRO's Oil Pipelines and Terminals Unit

Energy Technology Data Exchange (ETDEWEB)

Almeida, Maria Fatima Ludovico de [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio/ITUC), Rio de Janeiro, RJ (Brazil). Instituto Tecnologico; Labrunie, Charles; Araujo, Dario Doria de [TRANSPETRO - PETROBRAS Transporte S.A., Rio de Janeiro, RJ (Brazil). Diretoria de Terminais e Oleodutos

2009-07-01

This paper presents the implementation by PETROBRAS Transporte S.A. - TRANSPETRO of its Oil Pipelines and Terminals Standardization Program (PRONOT) within the scope of the 'Integrated Management System' (IMS). This program, launched in 2006 in the regions where the company operates, aims at standardizing all of its oil pipeline and terminal operations. Its implementation was planned in two phases: the first, already successfully concluded, refers to pipeline operations, industrial maintenance and right-of-way activities management; and the second, initiated in 2009, encompasses cross-sectional activities including health, safety and environment (HSE); training and development of oil pipeline workforce; communication with stake holders; oil pipeline integrity; and engineering project requirements. The documental structures of TRANSPETRO IMS and PRONOT are described and represented graphically to emphasize the intentional alignment of the standardization process carried out by the Oil Pipelines and Terminals Unit to the corporate IMS, based upon national and international literature review and through practical research focusing on the best international practices. (author)

Towards personalized TV for concurrent use; unlocking the potential of IMS-based IPTV

NARCIS (Netherlands)

Brandenburg, R. van; Deventer, M.O. van; Karagiannis, G.; Schenk, M.

2009-01-01

Television (TV) is getting more personal. It went from a passive broadcast medium without any form of personalization or user identification, to subscription TV, interactive TV and now to IPTV, featuring an integrated return channel. IMS-based IPTV is a good example of a personalised IPTV

Towards Personalized TV for Concurrent Use: Unlocking the Potential of IMS-Based IPTV

NARCIS (Netherlands)

van Brandenburg, Ray; van Deventer, M. Oskar; Karagiannis, Georgios; Schenk, Mike

2009-01-01

Television (TV) is getting more personal. It went from a passive broadcast medium without any form of personalization or user identification, to subscription TV, interactive TV and now to IPTV, featuring an integrated return channel. IMS-based IPTV is a good example of a personalised IPTV

Integration of Mental Health into Primary Health Care in a rural ...

African Journals Online (AJOL)

Objective: Mental health has been identified as a major priority in the Ugandan Health Sector Strategic Plan. Efforts are currently underway to integrate mental health services into the Primary Health Care system. In this study, we report aspects of the integration of mental health into primary health care in one rural district in ...

Integrating physical and mental health promotion strategies

OpenAIRE

Palma, Jessica Anne

2010-01-01

While health is defined as ‘a state of complete physical, mental and social well-being’, physical and mental health have traditionally been separated. This paper explores the question: How can physical and mental health promotion strategies be integrated and addressed simultaneously? A literature review on why physical and mental health are separated and why these two areas need to be integrated was conducted. A conceptual framework for how to integrate physical and mental health promotion st...

imDEV: a graphical user interface to R multivariate analysis tools in Microsoft Excel

Science.gov (United States)

Interactive modules for data exploration and visualization (imDEV) is a Microsoft Excel spreadsheet embedded application providing an integrated environment for the analysis of omics data sets with a user-friendly interface. Individual modules were designed to provide toolsets to enable interactive ...

I'm a Guy. How Can I Talk to My Female Doctor about Certain Things?

Science.gov (United States)

... Español I'm a Guy. How Can I Talk to My Female Doctor About Certain Things? KidsHealth / ... site. Note: All information on TeensHealth® is for educational purposes only. For specific medical advice, diagnoses, and ...

Integrating cell phones and mobile technologies into public health practice: a social marketing perspective.

Science.gov (United States)

Lefebvre, Craig

2009-10-01

Mobile communications are being used for many purposes, from instant messaging (IM), mobile or microblogging (Twitter), social networking sites (Facebook, MySpace), e-mail to basic voicemail. A brief background on cell phone and mobile technology use in public health is reviewed. The focus of the article is framing the use of mobile technologies in public health from a social marketer's perspective--using the 4 Ps marketing mix as a guide.

Integrated Management System – Scope, Possibilities And Methodology

Directory of Open Access Journals (Sweden)

Čekanová Katarína

2015-06-01

Full Text Available Organizations are becoming more aware of the importance of integrated management systems (IMS. Interest in this subject indicates that IMS are seen as “management systems of the future”. Based on this, the aim of this articles characterizes the possibility of building IMS through the identification of common elements and specific requirements in accordance with the ISO 9001, ISO 14001 and OHSAS 18001 professional references. Part of the article is the methodology of building IMS in the organization.

Characteristics of cancer patients presenting to an integrative medicine practice-based research network.

Science.gov (United States)

Edman, Joel S; Roberts, Rhonda S; Dusek, Jeffery A; Dolor, Rowena; Wolever, Ruth Q; Abrams, Donald I

2014-09-01

To assess psychosocial characteristics, symptoms and reasons for seeking integrative medicine (IM) care in cancer patients presenting to IM clinical practices. A survey of 3940 patients was conducted at 8 IM sites. Patient reported outcome measures were collected and clinicians provided health status data. This analysis compares 353 participants self-identified as cancer patients with the larger noncancer cohort. Mean age of the cancer cohort was 55.0 years. Participants were predominantly white (85.9%), female (76.4%), and well educated (80.5% completed college). For 15.2% of cancer patients, depression scores were consistent with depressive symptoms, and average scores for perceived stress were higher than normal, but neither were significantly different from noncancer patients. The most prevalent comorbid symptoms were chronic pain (39.8%), fatigue (33.5%), and insomnia (23.3%). In the cancer cohort, perceived stress was significantly associated with depression, fatigue, insomnia, pain, and QOL. Cancer patients who chose an IM clinical practice "seeking healthcare settings that address spirituality as an aspect of care" had significantly higher levels of perceived stress, depression, and pain than those not selecting this reason. Demographic characteristics, depression scores, perceived stress scores, and reasons for seeking integrative cancer care were not significantly different between cancer patients and noncancer patients. Perceived stress may be an important indicator of QOL. The association of perceived stress, depression and pain with seeking spirituality suggests that providing IM interventions, such as effective stress management techniques and pastoral or spiritual counseling, may be helpful to patients living with cancer. © The Author(s) 2014.

Integration: the firm and the health care sector.

Science.gov (United States)

Laugesen, Miriam J; France, George

2014-07-01

Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations.

Synthesis and DNA binding properties of 1-(3-aminopropyl)-imidazole-containing triamide f-Im*PyIm: a novel diamino polyamide designed to target 5'-ACGCGT-3'.

Science.gov (United States)

Satam, Vijay; Babu, Balaji; Porte, Alexander; Savagian, Mia; Lee, Megan; Smeltzer, Thomas; Liu, Yang; Ramos, Joseph; Wilson, W David; Lin, Shicai; Kiakos, Kostantinos; Hartley, John A; Lee, Moses

2012-09-15

A novel diamino/dicationic polyamide f-Im(*)PyIm (5) that contains an orthogonally positioned aminopropyl chain on an imidazole (Im(*)) moiety was designed to target 5'-ACGCGT-3'. The DNA binding properties of the diamino polyamide 5, determined by CD, ΔT(M), DNase I footprinting, SPR, and ITC studies, were compared with those of its monoamino/monocationic counterpart f-ImPyIm (1) and its diamino/dicationic isomer f-ImPy(*)Im (2), which has the aminopropyl group attached to the central pyrrole unit (Py(*)). The results gave evidence for the minor groove binding and selectivity of polyamide 5 for the cognate sequence 5'-ACGCGT-3', and with strong affinity (K(eq)=2.3×10(7) M(-1)). However, the binding affinities varied according to the order: f-ImPy(*)Im (2)>f-ImPyIm (1)≥f-Im(*)PyIm (5) confirming that the second amino group can improve affinity, but its position within the polyamide can affect affinity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Dust abatement in mining and tunnelling - status report; Stand der Technik bei der Staubbekaempfung im Berg- und Tunnelbau

Energy Technology Data Exchange (ETDEWEB)

Mikki, P. [CFT GmbH, Compact-Filtertechnik, Gladbeck (Germany)

2005-02-01

Health and safety have priority in underground mining, especially dust and silicosis prevention in mining and tunnelling. While silicosis is not considered as an occupational disease in the strict sense, it is well known that most silicosis cases occur in these industries. (orig.) [German] Im Untertagebau sind die Probleme des Gesundheitsschutzes von vorrangiger Bedeutung, insbesondere im Bereich der Staub- und Silikosebekaempfung im Berg- und Tunnelbau. Wenn auch bei der Silikose nicht ausschliesslich von einer unter Tagespezifischen Berufskrankheit gesprochen werden kann, so entfaellt doch der ueberwiegende Teil der auftretenden Krankheitsfaelle auf diese Industriezweige. (orig.)

Integrated management systems. Advantages and disadvantages; difficulties and recommendations in the process of implementation

Directory of Open Access Journals (Sweden)

Aneta Wysokińska-Senkus

2011-01-01

Full Text Available Nowadays, organisations are constantly looking for methods to improve their efficiency and to guarantee them a competitive advantage, sustainable profitable growth and ability to survive in a turbulent environment. An increasing popularity of implementation of certified management systems has been noticed. The most often integrated management system are eg. ISO 9001, ISO 14001, ISO 18001. The paper presents the conditions for the implementation of an integrated management system (IMS, the characteristics of the most integrated management systems, the advantages and disadvantages of integration and the difficulties in the implementation of IMS and recommendations regarding the effectiveness of the integration of IMS.

Ion Mobility Spectrometer / Mass Spectrometer (IMS-MS)

Energy Technology Data Exchange (ETDEWEB)

Hunka, Deborah E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Austin, Daniel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2005-10-01

The use of Ion Mobility Spectrometry (IMS)in the Detection of Contraband Sandia researchers use ion mobility spectrometers for trace chemical detection and analysis in a variety of projects and applications. Products developed in recent years based on IMS-technology include explosives detection personnel portals, the Material Area Access (MAA) checkpoint of the future, an explosives detection vehicle portal, hand-held detection systems such as the Hound and Hound II (all 6400), micro-IMS sensors (1700), ordnance detection (2500), and Fourier Transform IMS technology (8700). The emphasis to date has been on explosives detection, but the detection of chemical agents has also been pursued (8100 and 6400).

A New IMS Based Inter-working Solution

Science.gov (United States)

Zhu, Zhongwen; Brunner, Richard

With the evolution of third generation network, more and more multimedia services are developed and deployed. Any new service to be deployed in IMS network is required to inter-work with existing Internet communities or legacy terminal users in order to appreciate the end users, who are the main drivers for the service to succeed. The challenge for Inter-working between IMS (IP Multimedia Subsystem) and non-IMS network is “how to handle recipient’s address”. This is because each network has its own routable address schema. For instance, the address for Google Talk user is xmpp:xyz@google.com, which is un-routable in IMS network. Hereafter a new Inter-working (IW) solution between IMS and non-IMS network is proposed for multimedia services that include Instant Messaging, Chat, and File transfer, etc. It is an end-to-end solution built on IMS infrastructure. The Public Service Identity (PSI) defined in 3GPP standard (3rd Generation Partnership Project) is used to allow terminal clients to allocate this IW service. When sending the SIP (Session Initial Protocol) request out for multimedia services, the terminal includes the recipient’s address in the payload instead of the “Request-URI” header. In the network, the proposed solution provides the mapping rules between different networks in MM-IW (Multimedia IW). The detailed technical description and the corresponding use cases are present. The comparison with other alternatives is made. The benefits of the proposed solution are highlighted.

Argumentellipse in der "weichen" Nachricht im Deutschen und im Slowenischen

Directory of Open Access Journals (Sweden)

Uršula Krevs

1998-12-01

Full Text Available Argumentellipsen werden in der sprachlichen Kommunikation ohne weiteres akzeptiert, obwohl sie allenfalls in gewissem Sinne wegen ihrer Elliptizität abweichend wirken. Im folgenden interessiert uns, wie die Argumentellipse als syntaktische Entität in den Text eingebettet wird und welche Funktionen sie ausübt. Unsere Aufmerksamkeit gilt bier der Textsorte "weiche" Nachricht, die als Abweichung des Grundmusters gilt. Um im Sprachenpaar Deutsch-Slowenisch die in dieser Textsorte realisierten Argumentellipsen vergleichen zu können, wurde die Homogenität in der Thematik angestrebt und die Texte aus dem gleichen Kommunikationsbereich gewählt. So wurden die Korpora zwei Zeitschriften, die sich mit der gleichen Sportart beschäftigen, entnommen: der deutschen Zeitschrift "Rotpunkt" und der slowenischen Zeitschrift  "Grif '.

Study in environmental medicine in the areas of Bitterfeld and Hettstedt and a comparison area, 1995 - 1996. Data Book; Umweltmedizinische Untersuchungen im Raum Bitterfeld, im Raum Hettstedt und einem Vergleichsgebiet 1995-1996. Data Book

Energy Technology Data Exchange (ETDEWEB)

Heinrich, J.; Jacob, B.; Hoelscher, B.; Wilde, B.; Wolff, H.; Wjst, M.; Cyrys, J.; Wichmann, H.E. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Epidemiologie

1998-10-01

In the past, the environmental situation in the industrial agglomeration of Bitterfeld/Wolfen was characterized by extremely high pollution of the atmosphere, for instance with fly ash, sulfur dioxide, nitrogen monoxide and chlorinated hydrocarbons, by water pollution and soil pollution. In the Hettstest area, by contrast, heavy-metal pollution from decades of mining activities and emissions from the nonferrous heavy metals industry was most prominent.- The study, which was sponsored by the Federal Environmental Agency, aimed to establish possible health hazards to the public in these two centres of pollution in comparison with the little polluted control territory of Zerbst. These hazards are quantified in terms of the long-term effect of high atmospheric pollution in the Bitterfeld and Hettstedt regions. In addition, changes in health parameters as a function of time are recorded for a six-year period concomitantly to ongoing redevelopment measures. This will permit necessary policy adjustments.- As during the first survey in 1992/93, the health checks were done by physicians and nurses at schools, nursery-schools, Public Health offices and, in part, in special vehicles equipped with pulmonary function test units. All health checks were done according to the same standardized specifications, using the same devices, and by the same investigators.- Information was requested from the children`s parents regarding illnesses and symptoms, especially respiratory tract diseases and allergies, and regarding sociodemographic aspects and characteristics of the children`s domestic environment that might bear on the results. Their pulmonary function was measured in body plethysmographs and their respiratory tract sensitivity was measured prior to and after cold air provocation. Skin prick tests to determine major inhalative and food allergens and blood tests for specific antibodies complemented the information on possible allergic diseases.- Further, hematological parameters

Integrated circuit devices in control systems of coal mining complexes

Energy Technology Data Exchange (ETDEWEB)

1983-01-01

Systems of automatic monitoring and control of coal mining complexes developed in the 1960's used electromagnetic relays, thyristors, and flip-flops on transistors of varying conductivity. The circuits' designers, devoted much attention to ensuring spark safety, lowering power consumption, and raising noise immunity and repairability of functional devices. The fast development of integrated circuitry led to the use of microelectronic components in most devices of mine automation. An analysis of specifications and experimental research into integrated circuits (IMS) shows that the series K 176 IMS components made by CMOS technology best meet mine conditions of operation. The use of IMS devices under mine conditions has demonstrated their high reliability. Further development of integrated circuitry involve using microprocessors and microcomputers. (SC)

IMS Learning Design Frequently Asked Questions

NARCIS (Netherlands)

Tattersall, Colin; Manderveld, Jocelyn; Hummel, Hans; Sloep, Peter; Koper, Rob; De Vries, Fred

2004-01-01

This list of frequently asked questions was composed on the basis of questions asked of the Educational Technology Expertise Centrum. The questions addessed are: Where can I find the IMS Learning Design Specification? What is meant by the phrase “Learning Design”? What is the IMS LD Specification

Resilience of the IMS system

DEFF Research Database (Denmark)

Kamyod, Chayapol; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

2014-01-01

The paper focuses on end-to-end resilience analysis of the IMS based network through the principal resilience parameters by using OPNET. The resilience behaviours of communication across multiple IMS domains are investigated at different communication scenarios and compared with previous state......-of-the-art. Moreover, the resilience effects when adding a redundancy of the S-CSCF unit are examined. The results disclose interesting resilience behaviours for long distance communications....

Integrative health coaching: an organizational case study.

Science.gov (United States)

Wolever, Ruth Q; Caldwell, Karen L; Wakefield, Jessica P; Little, Kerry J; Gresko, Jeanne; Shaw, Andrea; Duda, Linda V; Kosey, Julie M; Gaudet, Tracy

2011-01-01

The aim of this study was to describe integrative health (IH) coaching as developed in three different interventions offered through a major medical center, as a step toward further defining the field of health coaching. An organizational case study was conducted with document analysis and interviews. Interviewees were the first six IH coaches at Duke Integrative Medicine who provided 360 clients with individual and/or group coaching (two to 28 sessions) in a randomized clinical study and two work-site wellness programs. Qualitative analysis using the constant comparative method was conducted. Integrative health coaching is characterized by a process of self-discovery that informs goal setting and builds internal motivation by linking clients' goals to their values and sense of purpose. Time, commitment, and motivation are necessary in the IH coaching process. The underpinnings of IH coaching are distinct from the medical model, and the process is distinct from health education, executive coaching, and psychotherapy. Integrative health coaching fits well with the assumptions of integrative medicine and has a role in supporting behavior change. Copyright © 2011. Published by Elsevier Inc.

System Performance of an Integrated Airborne Spacing Algorithm with Ground Automation

Science.gov (United States)

Swieringa, Kurt A.; Wilson, Sara R.; Baxley, Brian T.

2016-01-01

The National Aeronautics and Space Administration's (NASA's) first Air Traffic Management (ATM) Technology Demonstration (ATD-1) was created to facilitate the transition of mature ATM technologies from the laboratory to operational use. The technologies selected for demonstration are the Traffic Management Advisor with Terminal Metering (TMA-TM), which provides precise time-based scheduling in the Terminal airspace; Controller Managed Spacing (CMS), which provides controllers with decision support tools to enable precise schedule conformance; and Interval Management (IM), which consists of flight deck automation that enables aircraft to achieve or maintain precise spacing behind another aircraft. Recent simulations and IM algorithm development at NASA have focused on trajectory-based IM operations where aircraft equipped with IM avionics are expected to achieve a spacing goal, assigned by air traffic controllers, at the final approach fix. The recently published IM Minimum Operational Performance Standards describe five types of IM operations. This paper discusses the results and conclusions of a human-in-the-loop simulation that investigated three of those IM operations. The results presented in this paper focus on system performance and integration metrics. Overall, the IM operations conducted in this simulation integrated well with ground-based decisions support tools and certain types of IM operational were able to provide improved spacing precision at the final approach fix; however, some issues were identified that should be addressed prior to implementing IM procedures into real-world operations.

Compresión de imágenes médicas

Directory of Open Access Journals (Sweden)

Tatiana Noreña

2013-03-01

Full Text Available La medicina moderna es una actividad cada vez más compleja, basada en la información proveniente de múltiples fuentes: historias clínicas, dictáfonos e imágenes y vídeos provenientes de múltiples dispositivos. Las imágenes médicas constituyen una de las fuentes de mayor importancia, por cuanto ofrecen un apoyo integral del acto médico: el diagnóstico y el seguimiento. Sin embargo, la cantidad de información generada por los dispositivos de adquisición de imágenes sobrepasa rápidamente la disponibilidad de almacenamiento que tienen los servicios de radiología, lo cual genera costos adicionales en equipos de cómputo con mayor capacidad de almacenamiento. Además, la tendencia actual de desarrollo de aplicaciones en la “nube de cómputo”, tiene limitaciones por cuanto, aunque el almacenamiento es virtual y está disponible desde cualquier sitio, la conexión se hace a través de internet. En estos dos casos, el uso óptimo de la información requiere necesariamente de algoritmos de compresión potentes y adaptados a las necesidades de la actividad médica. En este artículo se presenta una revisión de las técnicas de compresión más utilizadas para el almacenamiento de imágenes, así como un análisis crítico de éstas desde el punto de vista de su uso en ambientes clínicos.   doi: http://dx.doi.org/10.7705/biomedica.v33i1.804

Integrated primary health care in Australia

Directory of Open Access Journals (Sweden)

Gawaine Powell Davies

2009-10-01

Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Integrated primary health care in Australia.

Science.gov (United States)

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Outcome mapping for health system integration

Directory of Open Access Journals (Sweden)

Tsasis P

2013-03-01

Full Text Available Peter Tsasis,1 Jenna M Evans,2 David Forrest,3 Richard Keith Jones4 1School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada; 2Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; 3Global Vision Consulting Ltd, Victoria, Canada; 4R Keith Jones and Associates, Victoria, Canada Abstract: Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. Keywords: integrated care, integrated delivery systems, complex adaptive systems, social capital

Intelligent Integrated System Health Management

Science.gov (United States)

Figueroa, Fernando

2012-01-01

Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

Individualisierte Produkte im Fokus der intergrierten Produktentwicklung

OpenAIRE

Baumberger, C.;Gahr, A.

2017-01-01

Individualisierte Produkte stellen neue Herausforderungen an die Produktentwicklung – vornehmlich im Bereich der Produktstrukturplanung, der kundenindividuellen Produktadaption und dem Zielkostenmanagement. Diese Themen werden am Lehrstuhl für Produktentwicklung im Rahmen des Sonderforschungsbereiches 582 behandelt.

Managing P2P services via the IMS

NARCIS (Netherlands)

Liotta, A.; Lin, L.

2007-01-01

The key aim of our work was to illustrate the benefits and means to deploy P2P services via the IMS. Having demonstrated the technical viability of P2P-IMS we have also found a way to add a new management dimension to existing P2P systems. P2P-IMS comes with a natural "data management" mechanism,

Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy.

Science.gov (United States)

Barlow, M Rose; Chu, James A

2014-01-01

Some people with dissociative identity disorder (DID) have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. The goal of this study was to pilot the integration measure (IM) and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

Geschlechterstereotype im Einsatz

Directory of Open Access Journals (Sweden)

Erika Kegyes

2007-11-01

Full Text Available Die umfangreiche Monographie gehört zum Forschungsbereich der kritischen angewandten Linguistik (Critical Applied Linguistics und liegt sowohl theoretisch als auch praktisch im Schnittpunkt der gender- und werbesprachlichen Untersuchungen.

Integrated audit in labour, health and environmental protection in RAG Deutsche Steinkohle AG; Das integrierte Audit im Arbeits-, Gesundheits- und Umweltschutz bei der RAG Deutsche Steinkohle AG

Energy Technology Data Exchange (ETDEWEB)

Jaensch, Christian [Zentralbereich Arbeits-, Gesundheits- und Umweltschutz, RAG Aktiengesellschaft, Herne (Germany)

2009-07-02

On the basis of the experience acquired with the environmental audit at RAG the internal audit was extended by the safety at work and health protection fields. This approach is the logical adaptation to the development of the integrated management system in labour, health and environmental protection (LHE), which is specified in the internal RAG LHE concept. The audit serves essentially for regular and systematic checking of the management process in labour, health and environmental protection. The aims pursued with this integrated audit and also the course of an audit are explained. In addition the special requirements both on an audit in a mining company and also on own auditors are outlined. This internal check has been carried out in all RAG Deutsche Steinkohle companies since 2008. (orig.)

Workplace mental health: developing an integrated intervention approach

Science.gov (United States)

2014-01-01

Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace. PMID:24884425

Integrating health and environmental impact analysis

DEFF Research Database (Denmark)

Reis, S; Morris, G.; Fleming, L. E.

2015-01-01

which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose...... while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding...... the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession...

Muriithi, IM

African Journals Online (AJOL)

Muriithi, IM. Vol 8, No 2 (2014) - Articles Correlation of magnetic resonance imaging findings with arthroscopy in the evaluation of rotator cuff pathology. Abstract PDF · Vol 8, No 2 (2014) - Articles Patterns of knee, hip and hand osteoarthritis in Kenyatta National Hospital Abstract PDF. ISSN: 1994-1072. AJOL African ...

Integration of priority population, health and nutrition interventions into health systems: systematic review

Directory of Open Access Journals (Sweden)

Adeyi Olusoji

2011-10-01

Full Text Available Abstract Background Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Methods Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction and secondary (improved population coverage, access to health services, efficiency, and quality using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Results Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Conclusions Targeted priority population health interventions we identified led to improved health

Integration of priority population, health and nutrition interventions into health systems: systematic review.

Science.gov (United States)

Atun, Rifat; de Jongh, Thyra E; Secci, Federica V; Ohiri, Kelechi; Adeyi, Olusoji; Car, Josip

2011-10-10

Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction) and secondary (improved population coverage, access to health services, efficiency, and quality) using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Targeted priority population health interventions we identified led to improved health outcomes, quality of care, patient satisfaction and access to care

Ion mobility spectrometer / mass spectrometer (IMS-MS).

Energy Technology Data Exchange (ETDEWEB)

Hunka Deborah Elaine; Austin, Daniel E.

2005-07-01

The use of Ion Mobility Spectrometry (IMS) in the Detection of Contraband Sandia researchers use ion mobility spectrometers for trace chemical detection and analysis in a variety of projects and applications. Products developed in recent years based on IMS-technology include explosives detection personnel portals, the Material Area Access (MAA) checkpoint of the future, an explosives detection vehicle portal, hand-held detection systems such as the Hound and Hound II (all 6400), micro-IMS sensors (1700), ordnance detection (2500), and Fourier Transform IMS technology (8700). The emphasis to date has been on explosives detection, but the detection of chemical agents has also been pursued (8100 and 6400). Combining Ion Mobility Spectrometry (IMS) with Mass Spectrometry (MS) is described. The IMS-MS combination overcomes several limitations present in simple IMS systems. Ion mobility alone is insufficient to identify an unknown chemical agent. Collision cross section, upon which mobility is based, is not sufficiently unique or predictable a priori to be able to make a confident peak assignment unless the compounds present are already identified. Molecular mass, on the other hand, is much more readily interpreted and related to compounds. For a given compound, the molecular mass can be determined using a pocket calculator (or in one's head) while a reasonable value of the cross-section might require hours of computation time. Thus a mass spectrum provides chemical specificity and identity not accessible in the mobility spectrum alone. In addition, several advanced mass spectrometric methods, such as tandem MS, have been extensively developed for the purpose of molecular identification. With an appropriate mass spectrometer connected to an ion mobility spectrometer, these advanced identification methods become available, providing greater characterization capability.

Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

Science.gov (United States)

de Leeuw, Evelyne

2017-03-20

Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

Integration of health care organizations: using the power strategies of horizontal and vertical integration in public and private health systems.

Science.gov (United States)

Thaldorf, Carey; Liberman, Aaron

2007-01-01

Integration in health care attempts to provide all elements in a seamless continuum of care. Pressures influencing development of system-wide integration primarily come from unsustainable cost increases in the United States over the later part of the 20th century and the early 21st century. Promoters of health care integration assume that it will lead to increased effectiveness and quality of care while concurrently increasing cost-effectiveness and possibly facilitating cost savings. The primary focus of this literature review is on the Power Strategies of Horizontal and Vertical Integration. The material presented suggests that vertical integration is most effective in markets where the partners involved are larger and dominant in the regions they serve. The research has also found that integrating health care networks had little or no significant effect on improving overall organizational efficiencies or profits. Capital investment in information technologies still is cost prohibitive and outweighs its benefits to integration efficiencies in the private sector; however, there are some indications of improvements in publicly provided health care. Further research is needed to understand the reasons the public sector has had greater success in improving effectiveness and efficiency through integration than the private sector.

Bremssysteme im Personenkraftwagen

Science.gov (United States)

Reif, Konrad

Für die ersten drei Punkte ist die Betriebsbremsanlage ("Fußbremse“) zuständig. Der Fahrer aktiviert sie durch Betätigen des Bremspedals. Die Feststellbremsanlage ("Handbremse“) hält das Fahrzeug im Stillstand.

Towards a model for integrative medicine in Swedish primary care

Directory of Open Access Journals (Sweden)

Falkenberg Torkel

2007-07-01

Full Text Available Abstract Background Collaboration between providers of conventional care and complementary therapies (CTs has gained in popularity but there is a lack of conceptualised models for delivering such care, i.e. integrative medicine (IM. The aim of this paper is to describe some key findings relevant to the development and implementation of a proposed model for IM adapted to Swedish primary care. Methods Investigative procedures involved research group and key informant meetings with multiple stakeholders including general practitioners, CT providers, medical specialists, primary care administrators and county council representatives. Data collection included meeting notes which were fed back within the research group and used as ongoing working documents. Data analysis was made by immersion/crystallisation and research group consensus. Results were categorised within a public health systems framework of structures, processes and outcomes. Results The outcome was an IM model that aimed for a patient-centered, interdisciplinary, non-hierarchical mix of conventional and complementary medical solutions to individual case management of patients with pain in the lower back and/or neck. The IM model case management adhered to standard clinical practice including active partnership between a gate-keeping general practitioner, collaborating with a team of CT providers in a consensus case conference model of care. CTs with an emerging evidence base included Swedish massage therapy, manual therapy/naprapathy, shiatsu, acupuncture and qigong. Conclusion Despite identified barriers such as no formal recognition of CT professions in Sweden, it was possible to develop a model for IM adapted to Swedish primary care. The IM model calls for testing and refinement in a pragmatic randomised controlled trial to explore its clinical effectiveness.

Politische Inhalte im Internet: Angebot und Nachfrage politischer Inhalte im World Wide Web am Beispiel von Volksabstimmungen in der Schweiz

OpenAIRE

Rademacher, Patrick Horst Josef

2010-01-01

Welche Bedeutung kommt dem Internet in der Politikvermittlung zu? Dieser Frage geht Patrick Rademacher nach, indem er untersucht, welche Anbieter politische Inhalte im Internet zur Verfügung stellen, wie sie dabei vorgehen und wie die Struktur der Inhalte beschaffen ist. Darüber hinaus analysiert er, inwiefern die online angebotenen Inhalte auf eine Nachfrage durch die Bürger treffen. Im Untersuchungskontext von Volksabstimmungen in der Schweiz hat der Autor hierfür im Jahr 2008 umfangreiche ...

Integrated Health Management Definitions

Data.gov (United States)

National Aeronautics and Space Administration — The Joint Army Navy NASA Air Force Modeling and Simulation Subcommittee's Integrated Health Management panel was started about 6 years ago to help foster...

Integration of targeted health interventions into health systems: a conceptual framework for analysis.

Science.gov (United States)

Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

2010-03-01

The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and

Development and formative evaluation of an innovative mHealth intervention for improving coverage of community-based maternal, newborn and child health services in rural areas of India

Directory of Open Access Journals (Sweden)

Dhiren Modi

2015-02-01

Full Text Available Background: A new cadre of village-based frontline health workers, called Accredited Social Health Activists (ASHAs, was created in India. However, coverage of selected community-based maternal, newborn and child health (MNCH services remains low. Objective: This article describes the process of development and formative evaluation of a complex mHealth intervention (ImTeCHO to increase the coverage of proven MNCH services in rural India by improving the performance of ASHAs. Design: The Medical Research Council (MRC framework for developing complex interventions was used. Gaps were identified in the usual care provided by ASHAs, based on a literature search, and SEWA Rural's1 three decades of grassroots experience. The components of the intervention (mHealth strategies were designed to overcome the gaps in care. The intervention, in the form of the ImTeCHO mobile phone and web application, along with the delivery model, was developed to incorporate these mHealth strategies. The intervention was piloted through 45 ASHAs among 45 villages in Gujarat (population: 45,000 over 7 months in 2013 to assess the acceptability, feasibility, and usefulness of the intervention and to identify barriers to its delivery. Results: Inadequate supervision and support to ASHAs were noted as a gap in usual care, resulting in low coverage of selected MNCH services and care received by complicated cases. Therefore, the ImTeCHO application was developed to integrate mHealth strategies in the form of job aid to ASHAs to assist with scheduling, behavior change communication, diagnosis, and patient management, along with supervision and support of ASHAs. During the pilot, the intervention and its delivery were found to be largely acceptable, feasible, and useful. A few changes were made to the intervention and its delivery, including 1 a new helpline for ASHAs, 2 further simplification of processes within the ImTeCHO incentive management system and 3 additional web

Gruppenbezogene Menschenfeindlichkeit im Sport in Brandenburg

OpenAIRE

Delto, Hannes; Tzschoppe, Petra

2016-01-01

Mit der Querschnittsstudie "Wir und die Anderen – Gruppenbezogene Menschenfeindlichkeit im organisierten Sport in Brandenburg" wurde das Syndrom Gruppenbezogener Menschenfeindlichkeit im organisierten Sport untersucht. Das Konzept der Gruppenbezogenen Menschenfeindlichkeit – ausgehend von einer Ideologie der Ungleichwertigkeit – wurde von Prof. Wilhelm Heitmeyer (Universität Bielefeld) entwickelt. Die Ergebnisse ermöglichen explizite Aussagen über Ausmaß und Ursachen Gruppenbezogener Menschen...

Verletzungen und Fehlbeanspruchungen im leistungsorientierten Rudersport

OpenAIRE

Bussian, Marc Robert

2004-01-01

Die Stellung der Breitensportart Rudern als gesundheitsfördernde Sportform ist in der Literatur gleichlautend positiv beschrieben. Im leistungsorientierten Rudersport müssen neben den Verletzungen und Fehlbeanspruchungen der eigentlichen Sportart die unabdingbaren Nebentrainingsformen berücksichtigt werden. In den neunziger Jahren vollzog sich ein trainingsmethodischer Wandel, die Einführung eines erschwinglichen Rudersimulators und eine technische Weiterentwicklung im Boots- und Ruderbau. Ei...

Prescription data mining, medical privacy and the First Amendment: the U.S. Supreme Court in Sorrell v. IMS health Inc.

Science.gov (United States)

Boumil, Marcia M; Dunn, Kaitlyn; Ryan, Nancy; Clearwater, Katrina

2012-01-01

In 2011, the United States Supreme Court in Sorrell v. IMS Health Inc. struck down a Vermont law that would restrict the ability of pharmaceutical companies to purchase certain physician-identifiable prescription data without the consent of the prescriber. The law's stated purpose was threefold: to protect the privacy of medical information, to protect the public health and to contain healthcare costs by promoting Vermont's preference in having physicians prescribe more generic drugs. The issue before the Supreme Court was whether the Vermont law represented a legitimate, common sense regulatory program or a bold attempt to suppress commercial speech when the "message" is disfavored by the state. Striking down the law, the Supreme Court applied a heightened level of First Amendment scrutiny to this commercial transaction and held that the Vermont law was not narrowly tailored to protect legitimate privacy interests.

A Reasoned Action Approach to Health Promotion

OpenAIRE

Fishbein, Martin

2008-01-01

This article describes the integrative model of behavioral prediction (IM), the latest formulation of a reasoned action approach. The IM attempts to identify a limited set of variables that can account for a considerable proportion of the variance in any given behavior. More specifically, consistent with the original theory of reasoned action, the IM assumes that intentions are the immediate antecedents of behavior, but in addition, the IM recognizes that environmental factors and skills and ...

Health information exposure from information and communication technologies and its associations with health behaviors: Population-based survey.

Science.gov (United States)

Shen, Chen; Wang, Man Ping; Wan, Alice; Viswanath, Kasisomayajula; Chan, Sophia Siu Chee; Lam, Tai Hing

2018-08-01

Health information and communication technologies (ICTs) are increasingly used but little is known about routine exposure to health information from ICTs and its associations with health behaviors. A territory-wide population-based dual landline and mobile telephone survey was conducted in 2016 in Hong Kong, where smartphone ownership and Internet access are among the most prevalent, easiest and fastest in the world. Health information exposure from traditional sources (television/radio/newspaper/magazine), Internet websites, social media sites and instant messaging (IM); and information on smoking, alcohol consumption and physical activity were recorded. Prevalence was weighted by age, sex and education level of the general population. Multinomial logistic regression was used to assess the association of health information exposure with smoking and alcohol consumption, whilst multivariable linear regression was used to assess the association with frequency of moderate and vigorous physical activity (days/week). Of 3063 respondents, most (71.6%) were often or sometimes exposed to health information from traditional sources, followed by Internet websites (40.9%), social media sites (40.7%), and IM (27.0%). Respondents with lower education and household income were less frequently exposed to health information from Internet websites, social media sites and IM (all P < 0.001). Health information exposure from IM was associated with being never smokers, and more frequent moderate and vigorous physical activity (all P for trend <0.05). Health information exposure from IM was least frequent but associated with healthier behaviors. Further public health education campaigns can consider using IM to deliver information, particularly to disadvantaged groups. Copyright © 2018 Elsevier Inc. All rights reserved.

Pengaruh Intensitas Mengakses Twitter Duta Im3 terhadap Kepuasan Pengalaman Adopsi dan Kepuasan Pengalaman Adopsi terhadap Keputusan Penggunaan Program Im3

OpenAIRE

Ayu Kinasih, Diyan Hafdinovianti; Pradekso, Tandiyo; Setiabudi, Djoko

2014-01-01

Nama : Diyan H Ayu KinasihNIM : D2C009029Judul : Pengaruh Intensitas Mengakses Twitter Duta IM3 terhadapKepuasan Pengalaman Adopsi dan Kepuasan PengalamanAdopsi terhadap Keputusan Penggunaan Program IM3ABSTRAKTwitter sebagai salah satu promotion tools yang digunakan oleh PTIndosat Tbk, diharapkan dapat memperkenalkan program-program serta eventyang dilakukan oleh Indosat. Melalui duta IM3 sebagai brand ambassador, Indosatmencoba meraih pasar anak muda dengan melakukan kegiatan promosi.Tipe pe...

Migrant integration policies and health inequalities in Europe.

Science.gov (United States)

Giannoni, Margherita; Franzini, Luisa; Masiero, Giuliano

2016-06-01

Research on socio-economic determinants of migrant health inequalities has produced a large body of evidence. There is lack of evidence on the influence of structural factors on lives of fragile groups, frequently exposed to health inequalities. The role of poor socio-economic status and country level structural factors, such as migrant integration policies, in explaining migrant health inequalities is unclear. The objective of this paper is to examine the role of migrant socio-economic status and the impact of migrant integration policies on health inequalities during the recent economic crisis in Europe. Using the 2012 wave of Eurostat EU-SILC data for a set of 23 European countries, we estimate multilevel mixed-effects ordered logit models for self-assessed poor health (SAH) and self-reported limiting long-standing illnesses (LLS), and multilevel mixed-effects logit models for self-reported chronic illness (SC). We estimate two-level models with individuals nested within countries, allowing for both individual socio-economic determinants of health and country-level characteristics (healthy life years expectancy, proportion of health care expenditure over the GDP, and problems in migrant integration policies, derived from the Migrant Integration Policy Index (MIPEX). Being a non-European citizen or born outside Europe does not increase the odds of reporting poor health conditions, in accordance with the "healthy migrant effect". However, the country context in terms of problems in migrant integration policies influences negatively all of the three measures of health (self-reported health status, limiting long-standing illnesses, and self-reported chronic illness) in foreign people living in European countries, and partially offsets the "healthy migrant effect". Policies for migrant integration can reduce migrant health disparities.

Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy

Directory of Open Access Journals (Sweden)

Margaret Rose Barlow

2014-01-01

Full Text Available Background: Some people with dissociative identity disorder (DID have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. Objective: The goal of this study was to pilot the integration measure (IM and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Method: Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Results: Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. Conclusions: The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

The Application of Internal Marketing (IM in a Service Organization

Directory of Open Access Journals (Sweden)

R. Sharma

2013-07-01

Findings and Strategic Implications. To complement earlier theoretical proposition on IM, the findings indicate that there are several empirical aspects such as “costs, people and concept” which hinder successful implementation of IM. This study proposes several strategic HR recommendations to reduce the “implementation gap” in IM such as to conduct continuous staff training on IM knowledge on regular time intervals, to reduce excessive work load and pressure and engaging staff members in continuous personal development sessions. In addition, the findings reveal that IM training should be given priority to solve “people-oriented” issues.

Integrated management system best practices in radioecological laboratories

International Nuclear Information System (INIS)

Carvalho, Claudia Aparecida Zerbinatti de

2009-01-01

This paper presents a Master dissertation advancements with the target of studying the best practices, in order to give support to an IMS conceptual model ?Integrated Management System (quality, environment, work safety and health), applied to radioecological laboratories. The planning of the proposed research comprises the following stages: first stage - the bibliographic and documental survey in IMS; a survey and study of the applied standards (QMS NBR ISO 9000 (2005), NBR ISO 9001 (2008), NBR ISO 9004 (2000), EMS 14001(2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)); identification and characterization in radioecological laboratories processes; a methodological study of better practices and benchmarking is carried out. In the second stage of the research, the development of a case study is forecast (qualitative research, with electronic questionnaires and personal interviews, when possible), preceded by a survey and selection of international and national radioecological laboratories to be studied and, in sequence, these laboratories should be contacted and agree to participate in the research; in a third stage, the construction of a matrix of better practices, which incur in the results able to subside an IMS conceptual model proposition for radioecological laboratories; the fourth and last stage of the research comprises the construction of a conceptual proposal of an IMS structure for radioecological laboratories. The first stage of the research results are presented concisely, as well as a preliminary selection of laboratories to be studied. (author)

Integrated management system best practices in radioecological laboratories

Energy Technology Data Exchange (ETDEWEB)

Carvalho, Claudia Aparecida Zerbinatti de [Centro Tecnologico da Marinha em Sao Paulo (CTMSP), SP (Brazil). Dept. da Qualidade], e-mail: clau.zerbina@gmail.com; Zouain, Desiree Moraes [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)], e-mail: dmzouain@ipen.br

2009-07-01

This paper presents a Master dissertation advancements with the target of studying the best practices, in order to give support to an IMS conceptual model ?Integrated Management System (quality, environment, work safety and health), applied to radioecological laboratories. The planning of the proposed research comprises the following stages: first stage - the bibliographic and documental survey in IMS; a survey and study of the applied standards (QMS NBR ISO 9000 (2005), NBR ISO 9001 (2008), NBR ISO 9004 (2000), EMS 14001(2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)); identification and characterization in radioecological laboratories processes; a methodological study of better practices and benchmarking is carried out. In the second stage of the research, the development of a case study is forecast (qualitative research, with electronic questionnaires and personal interviews, when possible), preceded by a survey and selection of international and national radioecological laboratories to be studied and, in sequence, these laboratories should be contacted and agree to participate in the research; in a third stage, the construction of a matrix of better practices, which incur in the results able to subside an IMS conceptual model proposition for radioecological laboratories; the fourth and last stage of the research comprises the construction of a conceptual proposal of an IMS structure for radioecological laboratories. The first stage of the research results are presented concisely, as well as a preliminary selection of laboratories to be studied. (author)

Wozu und wie kooperative Arbeitsformen im studienbegleitenden Deutschunterricht?

Directory of Open Access Journals (Sweden)

Karmelka Barić

2016-04-01

Full Text Available Ausgehend von einer Reflexion über die im Beruf und im Leben notwendigen Kompetenzen in der Kommunikation sowie von der Überzeugung, dass es notwendig ist, diese Kompetenzen schon im Studium durch geeignete Arbeitsverfahren und Themen zu entwickeln, werden Kooperation und Autonomie fördernde Arbeitsformen für den studienbegleitenden Deutsch- und Fremdsprachenunterricht (SDU/SFU vorgestellt. Diese Arbeitsformen sind auf andere Sprachen übertragbar und aus dem Lehrwerk Mit Deutsch studieren arbeiten leben A2/B1 (Lévy-Hillerich, Serena, Barić & Cickovska 2010 und der dazu gehörenden Lernplattform entnommen. Das Lehrwerk selbst ist eine Umsetzung der SDU-Rahmencurricula, die im Laufe von über zwanzig Jahren in zehn Ländern im Rahmen eines 1994 am Goethe-Institut Warschau begonnenen Hochschulprojekts und der daraus entstandenen Forschungstätigkeit entstanden sind. Grundlage des Projekts ist ein ganzheitlicher soziopädagogischer Ansatz, der LernerInnen als Menschen betrachtet, die im Präsenz- oder im virtuellen Unterricht in der Sprache und durch die Sprache fach- und sprachübergreifende Kooperationsfähigkeiten entwickeln, die sich später im Leben in der Gesellschaft auswirken. Nach der Vorstellung des Projekts und seiner wissenschaftlichen Hintergründe im ersten Teil des Beitrags werden im zweiten Teil die sich aus dem Ansatz ergebenden Arbeitsformen untersucht: Dabei werden die sich dazu eignenden Themen, die Lernhilfen für StudentInnen, die den LehrerInnen zufallenden Rollen sowie die Ansprüche an Lehrbücher/Unterrichtsmaterialien und Online-/Blended-Learning-Lernszenarien besprochen. Der abschließende Überblick im dritten Teil über die Schwierigkeiten, die beim kooperativen Lernen im SDU/SFU auftreten können, ist gleichzeitig eine offenbleibende Frage danach, wie LehrerInnen aus- und fortgebildet werden sollten, um sich den Anforderungen einer sich dauernd verändernden Lernlandschaft stellen zu können.   The paper

Die Rule of Law im Völker- und im Europarecht – aktuelle Probleme

Directory of Open Access Journals (Sweden)

Helmut Tichy

2015-04-01

Full Text Available Diese am 5. März 2015 in Graz gehaltene Antrittsvorlesung eines Praxisprofessors, der im Hauptberuf Leiter des Völkerrechtsbüros im österreichischen Außenministerium ist, beschäftigt sich mit dem Begriff der Herrschaft des Rechts in den internationalen Beziehungen (Rule of Law und mit den Möglichkeiten Österreichs, zur Stärkung der Rule of Law und zur Lösung aktueller Probleme beizutragen. Dabei werden insbesondere die Mitwirkung an Kodifikationsbemühungen und an der Verbesserung der Einhaltung des humanitären Völkerrechts, die Umsetzung der Menschenrechte (auch in Österreich und Fragen der internationalen Gerichtsbarkeit angesprochen.

Integrating mental health into primary health care – Uganda's ...

African Journals Online (AJOL)

Adele

demographic and health indicators.1 The data showed a high growth rate in excess of 3% ... an integrated form with all other health care needs including promotive and ... In 1999 the government of Uganda (Ministry of Health) developed a ten .... The usual drug procurement system was strengthened with a special project.

Gruppenbezogene Menschenfeindlichkeit im Sport in Sachsen

OpenAIRE

Delto, Hannes; Tzschoppe, Petra

2015-01-01

Mit der Querschnittsstudie „Wir und die Anderen – Gruppenbezogene Menschenfeindlichkeit im organisierten Sport in Sachsen“ wurde erstmals das Syndrom Gruppenbezogener Menschenfeindlichkeit im organisierten Sport untersucht. Das Konzept der Gruppenbezogenen Menschenfeindlichkeit – ausgehend von einer Ideologie der Ungleichwertigkeit – wurde von Prof. Wilhelm Heitmeyer (Universität Bielefeld) entwickelt. Die Ergebnisse ermöglichen explizite Aussagen über Ausmaß und Ursachen Gruppenbezogener Men...

Usability test of the ImPRO, computer-based procedure system

International Nuclear Information System (INIS)

Jung, Y.; Lee, J.

2006-01-01

ImPRO is a computer based procedure in both flowchart and success logic tree. It is evaluated on the basis of computer based procedure guidelines. It satisfies most requirements such as presentations and functionalities. Besides, SGTR has been performed with ImPRO to evaluate reading comprehension and situation awareness. ImPRO is a software engine which can interpret procedure script language, so that ImPRO is reliable by nature and verified with formal method. One bug, however, had hidden one year after release, but it was fixed. Finally backup paper procedures can be prepared on the same format as VDU in case of ImPRO failure. (authors)

Midlatitude magnetometer chains during the IMS

International Nuclear Information System (INIS)

Mcpherron, R.L.

1982-01-01

The International Magnetospheric Study (IMS) is an international program to study global problems of magnetospheric dynamics. A key element of the U.S. participation in this program was the establishment of a ground magnetometer network. This network included a number of arrays at high and low latitudes. This report describes three chains established at midlatitudes, including the IMS Midlatitude Chain, the AFGL Magnetometer Network, and the Bell Lab Conjugate Array. Descriptions of the type of equipment, station locations, types of data display, and availability of data for each chain are presented in this report. A major problem of the data analysis phase of the IMS will be reducing selected subsets of these data to a common format. Currently, there are no plans to do this in a systematic manner

Implantate im Mittelohrbereich - Teil 2 (Ergänzungen 2007)

Science.gov (United States)

Stieve, M.; Lenarz, Thomas

In Deutschland leben ca. 12 Millionen Menschen, die an einer ein- oder beidseitigen Schwerhörigkeit leiden. Diese kann angeboren oder im Laufe des Lebens erworben sein. Klinisch und therapeutisch wichtig ist die Unterscheidung hinsichtlich des Schädigungsortes im Bereich des Mittelohres, d. h. eine Schalleitungsschwerhörigkeit, oder im Bereich des Innenohres, d. h. eine Schallempfindungsschwerhörigkeit, wobei hier der Schädigungsort auch am Hörnerven oder in den zentralen Hörabschnitten liegen kann. Therapeutisch lassen sich sowohl Schwerhörigkeiten im Bereich des Mittelohres als auch im Innenohr und sogar im Hirnstammbereich (Hirnstammimplantat) behandeln. 1,9 Millionen Schwerhörige haben eine Erkrankung im Mittelohrbereich, d. h. der Schall kann nur ungenügend auf das Innenohr übertragen werden. Die Ursache besteht meist in einer chronischen Mittelohrentzündung, die zu einer Zerstörung des Trommelfells und der Gehörknöchelchenkette geführt haben. Therapeutisch und damit als Prinzip der operativen Hörverbesserung steht primär der Verschluß des Trommelfells oder eine Rekonstruktion der Gehörknöchelchen. Mittelohroperationen werden mikrochirurgisch unter dem Operationsmikroskop durchgeführt, wobei zunächst durch eine sanierende Operation der Entzündungsprozeß entfernt wird und nach einer Ausheilungszeit die Gehörknöchelchenkette durch künstliche Prothesen rekonstruiert werden kann.

Workshop: health workforce governance and integration.

NARCIS (Netherlands)

Batenburg, R.

2014-01-01

Background: Health workforce governance is increasingly recognized as a burning policy issue and focused on workforce shortages. Yet the most pressing problem is to solve maldistributions through governance and integration. Poor management of health 242 European Journal of Public Health, Vol. 24,

Integrated Care Programme—Department of Health, UK

OpenAIRE

Dewji, Mo; Passmore, Julie; Wardell, John

2010-01-01

Introduction Integration is seen as a key building block within the strategic plan for improving the health and well-being of the population of England. The Integrated Care Pilot programme is a three-year academically assessed research programme sponsored by the Department of Health, England, which aims to explore and gather evidence to support different approaches to integration. Aims With 16 pilot sites across England the objectives of the programme are based upon a Government commitment to...

[Integrated health care organizations: guideline for analysis].

Science.gov (United States)

Vázquez Navarrete, M Luisa; Vargas Lorenzo, Ingrid; Farré Calpe, Joan; Terraza Núñez, Rebeca

2005-01-01

There has been a tendency recently to abandon competition and to introduce policies that promote collaboration between health providers as a means of improving the efficiency of the system and the continuity of care. A number of countries, most notably the United States, have experienced the integration of health care providers to cover the continuum of care of a defined population. Catalonia has witnessed the steady emergence of increasing numbers of integrated health organisations (IHO) but, unlike the United States, studies on health providers' integration are scarce. As part of a research project currently underway, a guide was developed to study Catalan IHOs, based on a classical literature review and the development of a theoretical framework. The guide proposes analysing the IHO's performance in relation to their final objectives of improving the efficiency and continuity of health care by an analysis of the integration type (based on key characteristics); external elements (existence of other suppliers, type of services' payment mechanisms); and internal elements (model of government, organization and management) that influence integration. Evaluation of the IHO's performance focuses on global strategies and results on coordination of care and efficiency. Two types of coordination are evaluated: information coordination and coordination of care management. Evaluation of the efficiency of the IHO refers to technical and allocative efficiency. This guide may have to be modified for use in the Catalan context.

Integrated Ecological River Health Assessments, Based on Water Chemistry, Physical Habitat Quality and Biological Integrity

Directory of Open Access Journals (Sweden)

Ji Yoon Kim

2015-11-01

Full Text Available This study evaluated integrative river ecosystem health using stressor-based models of physical habitat health, chemical water health, and biological health of fish and identified multiple-stressor indicators influencing the ecosystem health. Integrated health responses (IHRs, based on star-plot approach, were calculated from qualitative habitat evaluation index (QHEI, nutrient pollution index (NPI, and index of biological integrity (IBI in four different longitudinal regions (Groups I–IV. For the calculations of IHRs values, multi-metric QHEI, NPI, and IBI models were developed and their criteria for the diagnosis of the health were determined. The longitudinal patterns of the river were analyzed by a self-organizing map (SOM model and the key major stressors in the river were identified by principal component analysis (PCA. Our model scores of integrated health responses (IHRs suggested that mid-stream and downstream regions were impaired, and the key stressors were closely associated with nutrient enrichment (N and P and organic matter pollutions from domestic wastewater disposal plants and urban sewage. This modeling approach of IHRs may be used as an effective tool for evaluations of integrative ecological river health..

Minería de imágenes

OpenAIRE

Fernández, Jacqueline; Miranda, Natalia Carolina; Guerrero, Roberto A.; Piccoli, María Fabiana

2006-01-01

Durante los últimos años, la proliferación de los medios digitales ha creado la necesidad del desarrollo de herramientas para la eficiente representación, acceso y recuperación de información visual. La minería de imágenes se ha convertido en una importante rama de investigación a causa del potencial que posee en descubrir patrones característicos a partir de un importante conjunto de imágenes. No obstante, la minería de imágenes es más que una simple extensión de la minería de datos al domin...

Integrated management system best practices in radioecological laboratories

International Nuclear Information System (INIS)

Carvalho, Claudia Aparecida Zerbinatti de

2010-01-01

The research aims to study the best practices to support a conceptual proposal for IMS - Integrated Management System (quality, environment, safety and health) applicable to Radioecology laboratories. The research design is organized into the following steps: in a first step, it was developed the bibliographic and documentary research in IMS, survey and study of standards (QMS ISO 9000 (2005), ISO 9001 (2008), ISO 9004 (2000), EMS ISO 14001 (2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)), identification and characterization of processes in Radioecology Laboratories and study of best practices methodology and benchmarking; in the second stage of the research it was developed a case study (qualitative research, with questionnaires via e-mail and interviews, when possible), preceded by a survey and selection of international and national radioecology laboratories and then these laboratories were contacted and some of them agreed to participate in this research; in the third stage of the research it was built the framework of best practices that showed results that could support the conceptual proposal for the IMS Radioecology Laboratory; the fourth and final stage of research consisted in the construction of the proposed conceptual framework of SGI for Radioecology Laboratory, being then achieved the initial objective of the research. (author)

Die Pluralbildung im Deutschen - ein Versuch im Rahmen der Optimalitätstheorie

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Wegener, Heide

1999-01-01

Full Text Available Die Pluralbildung im Deutschen ist nicht chaotisch, aber komplex. Unabhängig davon, ob man für die Pluralbildung Regeln, Schemata oder die Wortstruktur als Erklärungsmodell benutzt, bleibt die Tatsache einer beachtlichen Zahl miteinander konkurrierender Formen zu erklären. Dies gilt schon deshalb, weil die Variation unter den Pluralformen wohl mit dazu beiträgt, dass trotz der Arbeiten von Mugdan 1977 und Köpcke 1987, 1993, der klaren Darstellung des Pluralsystems in vielen Grammatiken, z.B. Eisenberg 1986, 1989, 1998 noch immer bisweilen die Meinung besteht, die Pluralbildung im Deutschen sei arbiträr.Es soll gezeigt werden, dass das Pluralsystem des Deutschen nach Beschränkungen aufgebaut ist, die morphologischer und silbenphonologischer Natur sind und sich im Rahmen der Optimalitätstheorie (OT beschreiben lassen. Die OT nimmt an, dass Wortformen universalen Beschränkungen (Constraints unterliegen, und dass diese prinzipiell verletzbar sind. Ich werde zunächst die für die Pluralbildung relevanten Beschränkungen definieren, dann an heimischen Pluralformen und -varianten ihr Zusammenwirken zeigen und schließlich den Assimilationsprozess von Fremdwörtern mit Hilfe dieser Beschränkungen und der Beschränkungshierarchien zu erklären versuchen. Daran werden schließlich Überlegungen zu Verarbeitung und Lernbarkeit der Pluralformen geknüpft.

Recommended integrative medicine competencies for family medicine residents.

Science.gov (United States)

Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

2013-01-01

The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

Using scenarios for dissemination - Experiences from the IMS GLOBEMEN project

DEFF Research Database (Denmark)

Ollus, Martin; Hartel, Ingo; Tølle, Martin

2002-01-01

due to the complexities of the interdisciplinary field addressed. As an instrument for communication to the non-specialist public the IMS GLOBEMEN project produces a web-based scenario as part of its dissemination activities. It is aimed at giving a practical overview of specific challenges...... in the field and contributions from the project. Based upon a generic Virtual Enterprise Reference Architecture (called VERA) the partners in the project have developed a set of protypes to be implemeted in their own business processes. The results will be illutrated in one integrated scenario....

Medienerziehung im Vorschulbereich - Zum Projekt Mediengarten der Wiener Medienpädagogik

Directory of Open Access Journals (Sweden)

Gudrun Kern

2010-09-01

Full Text Available Im Zuge des Projekts Mediengarten der Wiener Medienpädagogik wurde in Kooperation mit angehenden KindergartenpädagogInnen eine Medienerziehung im Sinne einer Auseinandersetzung über Medien im Vorschulbereich anhand konkreter Angebote in Kindergärten konzipiert. Im folgenden Artikel werden die Schwerpunktsetzungen dieses Konzepts vorgestellt und durch praktische Beispiele verdeutlicht.

Cyberbullying und Empathie : affektive, kognitive und medienbasierte Empathie im Kontext von Cyberbullying im Kindes- und Jugendalter

OpenAIRE

Pfetsch, Jan; Müller, Christin R.; Ittel, Angela

2014-01-01

"Bei medial vermittelter Kommunikation sinkt sowohl die Hemmschwelle für aggressive Verhaltensweisen wie Cyberbullying als auch die Wahrscheinlichkeit empathischer Reaktionen. Im Fokus der vorliegenden Studie mit 979 Schülerinnen und Schülern der 4.-8. Klassen (M=12.01, SD=1.68 Jahre, 55% weiblich) stand die Frage, ob Cyberbullies geringere Ausprägungen für affektive, kognitive und medienbasierte Empathie aufweisen als Unbeteiligte. Empathie wurde im Selbst- und Peerbericht erhoben. Hypothese...

A decade of integration and collaboration: the development of integrated health care in Sweden 2000-2010

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Bengt Ahgren

2011-03-01

Full Text Available Introduction: The recent history of integrated health care in Sweden is explored in this article, focusing on the first decade of the 2000s. In addition, there are some reflections about successes and setbacks in this development and challenges for the next decade.     Description of policy and practice: The first efforts to integrate health care in Sweden appeared in the beginning of the 1990s. The focus was on integration of intra-organisational processes, aiming at a more cost-effective health care provision. Partly as a reaction to the increasing economism at that time, there was also a growing interest in quality improvement. Out of this work emerged the "chains of care", integrating all health care providers involved in the care of specific patient groups. During the 2000s, many county councils have also introduced inter-organisational systems of "local health care". There has also been increasing collaboration between health professionals and other professional groups in different health and welfare services.  Discussion and conclusion: Local health care meant that the chains of care and other forms of integration and collaboration became embedded in a more integrative context. At the same time, however, policy makers have promoted free patient choice in primary health care and also mergers of hospitals and clinical departments. These policies tend to fragment the provision of health care and have an adverse effect on the development of integrated care. As a counterbalance, more efforts should be put into evaluation of integrated health care, in order to replace political convictions with evidence concerning the benefits of such health care provision.

DOH to integrate reproductive health in health care delivery.

Science.gov (United States)

According to a Department of Health (DOH) official speaking at the recent Reproductive Health Advocacy Forum in Zamboanga City, the concept of reproductive health (RH) is now on the way to being fully integrated into the Philippines' primary health care system. The DOH is also developing integrated information, education, and communication material for an intensified advocacy campaign on RH among target groups in communities. The forum was held to enhance the knowledge and practice of RH among health, population and development program managers, field workers, and local government units. In this new RH framework, family planning becomes just one of many concerns of the RH package of services which includes maternal and child health, sexuality education, the prevention and treatment of abortion complications, prevention of violence against women, and the treatment of reproductive tract infections. Of concern, however, the Asian economic crisis has led the Philippine government to reduce funding, jeopardizing the public sector delivery of basic services, including reproductive health care. The crisis has also forced other governments in the region to reassess their priorities and redirect their available resources into projects which are practical and sustainable.

A revisionist view of the integrated academic health center.

Science.gov (United States)

Rodin, Judith

2004-02-01

Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.

Knowledge integration, teamwork and performance in health care.

Science.gov (United States)

Körner, Mirjam; Lippenberger, Corinna; Becker, Sonja; Reichler, Lars; Müller, Christian; Zimmermann, Linda; Rundel, Manfred; Baumeister, Harald

2016-01-01

Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect. The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics. The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork. PRACTICAL/IMPLICATIONS: In practice, the results of the study provide a valuable starting point for team development interventions. This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance.

Instrumentale Spielformeln und Vokale Verzierungen im 16.Jahrhundert

Directory of Open Access Journals (Sweden)

Göllner, Theodor

2001-12-01

Full Text Available In the music of the 16th century, stereotype four-note formulas are found in the instrumental as well as in the vocal idiom. Although frequently identical in appearance, their functions are very different. While indispensable in the instrumental idiom, particularly in keyboard music, where they represent the very essence of instruction in 15th-century organ treatises and fundamenta, they appear in vocal music only as additions to finished compositions or existing practices. What amounts to an absolute necessity in one case is merely an ornamental supplement in the other. In vocal music it is treated as a matter of performance carried out by a qualified soloist and limited to the musical centers of Italy. The present article raises the question as to how the genuinely instrumental and widely spread keyboard practice made its impact on the vocal ornaments of the singer, whose primary concern is the musical communication of language.

[de] Die in der Musik des 16. Jahrhunderts im Instrumentalen wie im Vokalen vorkommenden, meist viertönigen, stereotypen Formeln sind zwar in beiden Bereichen weitgehend identisch, doch von höchst unterschiedlicher Funktion. Während sie im Instrumentalen, besonders in der Tastenmusik, unverzichtbar sind und schon im 15. Jahrhundert den Kern der Orgeltraktate und Fundamenta bilden, treten sie im Vokalen zu einer fertigen Komposition oder bestehenden Praxis hinzu. Was im einen Fall eine unbedingte Notwendigkeit ist, wird im anderen zu einem nachträglichen Ornament, das sich oft erst bei der Aufftührung einstellt, den qualifizierten Solosänger voraussetzt und auf die musikalischen Zentren Italiens konzentriert war. Der Artikel versucht zu klären, wie sich das genuin instrumentale, allgemein verbreitete Tastenspiel auf die spezielle Verzierungskunst des Sängers auswirkt, dessen primäre Aufgabe es ist, Sprache musikalisch zu vermitteln.

A tool to guide the process of integrating health system responses to public health problems

Directory of Open Access Journals (Sweden)

Tilahun Nigatu Haregu

2015-06-01

Full Text Available An integrated model of health system responses to public health problems is considered to be the most preferable approach. Accordingly, there are several models that stipulate what an integrated architecture should look like. However, tools that can guide the overall process of integration are lacking. This tool is designed to guide the entire process of integration of health system responses to major public health problems. It is developed by taking into account the contexts of health systems of developing countries and the emergence of double-burden of chronic diseases in these settings. Chronic diseases – HIV/AIDS and NCDs – represented the evidence base for the development of the model. System level horizontal integration of health system responses were considered in the development of this tool.

Mental health care for irregular migrants in Europe: Barriers and how they are overcome

Directory of Open Access Journals (Sweden)

Straßmayr Christa

2012-05-01

Full Text Available Abstract Background Irregular migrants (IMs are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1 to identify barriers to mental health care for IMs, and (2 to explore ways by which these barriers are overcome in practice. Methods Data from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis. Results Experts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation. Conclusions Even in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.

IMS applications analysis

Energy Technology Data Exchange (ETDEWEB)

RODACY,PHILIP J.; REBER,STEPHEN D.; SIMONSON,ROBERT J.; HANCE,BRADLEY G.

2000-03-01

This report examines the market potential of a miniature, hand-held Ion Mobility Spectrometer. Military and civilian markets are discussed, as well as applications in a variety of diverse fields. The strengths and weaknesses of competing technologies are discussed. An extensive Ion Mobility Spectrometry (IMS) bibliography is included. The conclusions drawn from this study are: (1) There are a number of competing technologies that are capable of detecting explosives, drugs, biological, or chemical agents. The IMS system currently represents the best available compromise regarding sensitivity, specificity, and portability. (2) The military market is not as large as the commercial market, but the military services are more likely to invest R and D funds in the system. (3) Military applications should be addressed before commercial applications are addressed. (4) There is potentially a large commercial market for rugged, hand-held Ion Mobility Spectrometer systems. Commercial users typically do not invest R and D funds in this type of equipment rather, they wait for off-the-shelf availability.

Radiological information management system (RadIMS)

International Nuclear Information System (INIS)

Oesterling, R.G.; Marko, S.A.; Tschaeche, A.N.

1991-01-01

Westinghouse Idaho Nuclear Company, Inc. (WINCO) is developing and implementing an information management system, known as RadIMS, to track and record personnel exposure to ionizing radiation. RadIMS has been designed to fulfill all the requirements of US Department of Energy (USDOE) Order 5480.11, ''Radiation Protection for Occupational Workers.'' This Order requires the contractor to maintain detailed radiation exposure records on all individuals who work at the facility. These records must be retrievable for the entire working life of the individual and be available to other USDOE contractors on request. To meet these general needs, RadIMS provides for retrieval of detailed, comprehensive individual exposure histories as well as the usual online interactions to accomplish day-today radiation protection operations. These two extremes of functionality require different approaches in the WINCO computing environment. The exposure histories include database text, paper, microfilm, and electronic bitmaps

Radiological information management system (RadIMS)

Energy Technology Data Exchange (ETDEWEB)

Oesterling, R.G.; Marko, S.A.; Tschaeche, A.N.

1991-08-19

Westinghouse Idaho Nuclear Company, Inc. (WINCO) is developing and implementing an information management system, known as RadIMS, to track and record personnel exposure to ionizing radiation. RadIMS has been designed to fulfill all the requirements of US Department of Energy (USDOE) Order 5480.11, Radiation Protection for Occupational Workers.'' This Order requires the contractor to maintain detailed radiation exposure records on all individuals who work at the facility. These records must be retrievable for the entire working life of the individual and be available to other USDOE contractors on request. To meet these general needs, RadIMS provides for retrieval of detailed, comprehensive individual exposure histories as well as the usual online interactions to accomplish day-today radiation protection operations. These two extremes of functionality require different approaches in the WINCO computing environment. The exposure histories include database text, paper, microfilm, and electronic bitmaps.

Radiological information management system (RadIMS)

Energy Technology Data Exchange (ETDEWEB)

Oesterling, R.G.; Marko, S.A.; Tschaeche, A.N.

1991-08-19

Westinghouse Idaho Nuclear Company, Inc. (WINCO) is developing and implementing an information management system, known as RadIMS, to track and record personnel exposure to ionizing radiation. RadIMS has been designed to fulfill all the requirements of US Department of Energy (USDOE) Order 5480.11, ``Radiation Protection for Occupational Workers.`` This Order requires the contractor to maintain detailed radiation exposure records on all individuals who work at the facility. These records must be retrievable for the entire working life of the individual and be available to other USDOE contractors on request. To meet these general needs, RadIMS provides for retrieval of detailed, comprehensive individual exposure histories as well as the usual online interactions to accomplish day-today radiation protection operations. These two extremes of functionality require different approaches in the WINCO computing environment. The exposure histories include database text, paper, microfilm, and electronic bitmaps.

Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

Science.gov (United States)

Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

2015-01-28

To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

Integration of community health workers into health systems in developing countries: Opportunities and challenges

Directory of Open Access Journals (Sweden)

Collins Otieno Asweto

2016-02-01

Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

The future of the IMS Learning Design specification: a critical look

NARCIS (Netherlands)

Sloep, Peter

2009-01-01

P. B. Sloep (2009). The future of the IMS Learning Design specification: a critical look. Presentation at the IMS Learning Design seminar 'The future of IMS Learning Design'. December, 10, 2009, Wollongong, Australia: University of Wollongong.

Oswer integrated health and safety standard operating practices. Directive

International Nuclear Information System (INIS)

1993-02-01

The directive implements the OSWER (Office of Solid Waste and Emergency Response) Integrated Health and Safety Standards Operating Practices in conjunction with the OSHA (Occupational Safety and Health Act) Worker Protection Standards, replacing the OSWER Integrated Health and Safety Policy

Opportunities for and constraints to integration of health services in Poland

Directory of Open Access Journals (Sweden)

Alicja Sobczak

2002-06-01

Full Text Available At the beginning of the article the typologies, expected outcomes and forces aiming at health care integration are discussed. Integration is recognised as a multidimensional concept. The suggested typologies of integration are based on structural configurations, co-ordination mechanisms (including clinical co-ordination, and driving forces. A review of the Polish experience in integration/disintegration of health care systems is the main part of the article. Creation of integrated health care management units (ZOZs in the beginning of the 1970s serves as an example of structural vertical integration missing co-ordination mechanisms. ZOZs as huge, costly and inflexible organisations became subjects of public criticism and discredited the idea of health care integration. At the end of the 1980s and in the decade of the 1990s, management of public health care was decentralised, the majority of ZOZs dismantled, and many health care public providers got the status of independent entities. The private sector developed rapidly. Sickness funds, which in 1999 replaced the previous state system, introduced “quasi-market” conditions where health providers have to compete for contracts. Some providers developed strategies of vertical and horizontal integration to get a competitive advantage. Consolidation of private ambulatory clinics, the idea of “integrated care” as a “contracting package”, development of primary health care and ambulatory specialist clinics in hospitals are the examples of such strategies. The new health policy declared in 2002 has recognised integration as a priority. It stresses the development of payment mechanisms and information base (Register of Health Services – RUM that promote integration. The Ministry of Health is involved directly in integrated emergency system designing. It seems that after years of disintegration and deregulation the need for effective integration has become obvious.

Im Wind / Mari Vallisoo ; tõlk. Gisbert Jänicke

Index Scriptorium Estoniae

Vallisoo, Mari, 1950-2013

2003-01-01

Sisu: Im Wind = Tuulega ; Zwei Frauen = Kaks naist ; In Gedanken an Aleksander Levin = aleksander Levinile mõteldes ; Jetzt im Dunkel = Nüüd pimedas ; Fragen = Küsimused ; Der Zwillingsbruder = Kaksikvend

Integrated occupational health care at sea

DEFF Research Database (Denmark)

Jensen, Olaf Chresten

2011-01-01

exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing......Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...

77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2012-07-18

... Promotion, and Integrative and Public Health AGENCY: Office of the Assistant Secretary for Health, Office of... Promotion, and Integrative and Public Health. FOR FURTHER INFORMATION CONTACT: Corinne Graffunder... Integrative and Public Health (the ``Advisory Group'') within the Department of Health and Human Services. To...

Transplantate und Implantate im Mittelohrbereich - Teil 1 (Stand 2002)

Science.gov (United States)

Kempf, Hans-Georg; Lenarz, Thomas; Eckert, Karl-Ludwig

In Deutschland leben ungefähr 12 Millionen Menschen, die an einer ein- oder beidseitigen Schwerhörigkeit leiden. Diese kann angeboren oder im Laufe des Lebens erworben sein. Klinisch und therapeutisch wichtig ist die Unterscheidung, ob die Ursache der Schwerhörigkeit im Bereich des Mittelohres, d. h. der Schallübertragung, oder im Bereich des Innenohres, der Hörnerven und der zentralen Hörbahnabschnitte, d. h. der Schallempfindung, liegt. 2,5 Millionen Schwerhörige haben dabei das Problem der Schallübertragung, d.h. die Störung liegt im Mittelohrbereich, und hier kann man in der Regel mit operativen, mikrochirurgisch durchgeführten Massnahmen helfen [1, 2]. Im Vordergrund steht als Ursache hier die chronische Mittelohrentzündung, die sich als Perforation des Trommelfells, als Defekt oder Unterbrechung der Gehörknöchelchen oder auch als Cholesteatom, einer sogenannte Knocheneiterung äussern kann [3]. Therapeutisch und damit als Prinzip der operativen Hörverbesserung steht primär der Verschluss des Trommelfells oder eine Rekonstruktion der Gehörknöchelchen an.

IHE (Integrating the Healthcare Enterprise): A new approach for the improvement of digital communication in healthcare; IHE (Integrating the Healthcare Enterprise): Ein neuer Ansatz zur Verbesserung der digitalen Kommunikation im Gesundheitswesen

Energy Technology Data Exchange (ETDEWEB)

Wein, B.B. [Universitaetsklinikum Aachen (Germany). Klinik fuer Radiologische Diagnostik

2003-02-01

Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information. (orig.) [German] Parallel zur Einfuehrung der DRG (Diagnosis Related Groups) zur Krankenhausfinanzierung findet eine deutliche Reduktion von Finanzmitteln im Gesundheitssystem statt. Bei der Anpassung der Arbeitsprozesse an die neuen Bedingungen wird dem Einsatz informationsverarbeitender Systeme eine zunehmende Bedeutung zuteil. Allerdings bestehen in der heutigen Alltagswirklichkeit erhebliche Schwierigkeiten, Informationen zwischen unterschiedlichen Systemen sicher und ohne grossen Aufwand auszutauschen. Die Sicherstellung einer hohen Interoperabilitaet bietet IHE (Integrating the Healthcare Enterprise). Die in einer konzertierten Aktion zwischen Anwendern und Industrie ins Leben gerufene Bewegung bietet darueber hinaus eine Zukunftssicherung bei Beschaffungsmassnahmen von Informationssystemen sowie eine allgemeine Verbesserung der Patientenversorgung. IHE ist kein Standard

Coherent ambient infrasound recorded by the global IMS network

Science.gov (United States)

Matoza, R. S.; Landes, M.; Le Pichon, A.; Ceranna, L.; Brown, D.

2011-12-01

The International Monitoring System (IMS) includes a global network of infrasound arrays, which is designed to detect atmospheric nuclear explosions anywhere on the planet. The infrasound network also has potential application in detection of natural hazards such as large volcanic explosions and severe weather. Ambient noise recorded by the network includes incoherent wind noise and coherent infrasound. We present a statistical analysis of coherent infrasound recorded by the IMS network. We have applied broadband (0.01 to 5 Hz) array processing systematically to the multi-year IMS historical dataset (2005-present) using an implementation of the Progressive Multi-Channel Correlation (PMCC) algorithm in log-frequency space. We show that IMS arrays consistently record coherent ambient infrasound across the broad frequency range from 0.01 to 5 Hz when wind-noise levels permit. Multi-year averaging of PMCC detection bulletins emphasizes continuous signals such as oceanic microbaroms, as well as persistent transient signals such as repetitive volcanic, surf, or anthropogenic activity (e.g., mining or industrial activity). While many of these continuous or repetitive signals are of interest in their own right, they may dominate IMS array detection bulletins and obscure or complicate detection of specific signals of interest. The new PMCC detection bulletins have numerous further applications, including in volcano and microbarom studies, and in IMS data quality assessment.

Gruppenbezogene Menschenfeindlichkeit im Sport in Sachsen-Anhalt

OpenAIRE

Delto, Hannes; Tzschoppe, Petra

2016-01-01

Mit der Querschnittsstudie „Wir und die Anderen – Gruppenbezogene Menschenfeindlichkeit im organisierten Sport in Sachsen-Anhalt“ wurde das Syndrom Gruppenbezogener Menschenfeindlichkeit im organisierten Sport untersucht. Das Konzept der Gruppenbezogenen Menschenfeindlichkeit – ausgehend von einer Ideologie der Ungleichwertigkeit – wurde von Prof. Wilhelm Heitmeyer (Universität Bielefeld) entwickelt. Die Ergebnisse ermöglichen explizite Aussagen über Ausmaß und Ursachen Gruppenbezogener Mensc...

Freie Lerninhalte im Internet mit Studierenden recherchieren, kommentieren und kompilieren. Zur Gestaltung der online-Selbstlernangebote im hr-Funkkolleg Philosophie

Directory of Open Access Journals (Sweden)

Jakob Krebs

2017-03-01

Full Text Available Wie lassen sich online frei verfügbare Bildungsinhalte mit Studierenden so zusammenstellen, dass sie als thematisch sortierte Selbstlernmaterialien unkompliziert gefunden werden können – sei es von anderen Studierenden, interessierten Laien oder auch von Lehrkräften in Bildungsinstitutionen? Der vorliegende Werkstattbericht rekonstruiert ein Lernszenario, in dem Studierende vorhandene Materialien im Internet recherchierten, kommentierten und kompilierten, um ein Online-Zusatzangebot zu den Radiosendungen im hr-Funkkolleg Philosophie 2014/15 zu erstellen. Die Rahmenbedingungen dieser ungewöhnlichen universitären Kooperation mit dem Rundfunk werden im ersten Abschnitt vorgestellt. Der zweite Abschnitt skizziert das didaktische Design zusammen mit dem Projektstrukturplan eines produktorientierten kollaborativen Lernsettings mit Wiki-Einsatz. Im dritten Abschnitt werden der Lernerfolg bei den Studierenden sowie einige Herausforderungen benannt, die u. a. in der Abschlussevaluierung zur Sprache kamen. Der vierte Abschnitt macht die Projekterfahrungen für reguläre Lehr- und Lern-Szenarien fruchtbar, in denen nicht nur Studierende mit didaktischen Interessen durch die gemeinsame Gestaltung von Internetangeboten fachlich und methodisch profitieren können. Mit dem Bericht wird somit u. a. veranschaulicht, wie sich Ansätze von Blended, Peer-Assisted und Service Learning produktiv kombinieren lassen.

Integrated Management System in construction company-effective tool of quality, environment and safety level improving

OpenAIRE

Gašparík, Jozef

2009-01-01

Contribution Presents the struCture of integrated M anageMent systeM ( iMs) according to international standards ISO 9001:2008, ISO 14001:2004 and STN OHSAS 18001:2009, which consists of 3 management systems focused to quality, environment and safety of building processes. The purpose of paper is to describe basic steps concerning the development of IMS. Paper analises basic processes of IMS like company vision, IMS planning, implementing, monitoring, revive and improving. The paper presents ...

Promoting Mental Health Equity: The Role of Integrated Care.

Science.gov (United States)

Satcher, David; Rachel, Sharon A

2017-12-01

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.

Is vertical integration adding value to health systems?

Science.gov (United States)

Weil, T P

2000-04-01

Vertical integration is a concept used by health systems when attempting to achieve economies of scale, greater coordination of services, and improved market penetration. This article focuses on the actual outcomes of utilizing vertical integration in the health field and then compares these findings with those reported in other industries. This analysis concludes that this organizational model does not work particularly well in the health industry, as illustrated by health alliances' poor fiscal performance when they acquire physician practices or when they start their own HMO plans.

Integrating intersectionality and biomedicine in health disparities research.

Science.gov (United States)

Kelly, Ursula A

2009-01-01

Persisting health disparities have lead to calls for an increase in health research to address them. Biomedical scientists call for research that stratifies individual indicators associated with health disparities, for example, ethnicity. Feminist social scientists recommend feminist intersectionality research. Intersectionality is the multiplicative effect of inequalities experienced by nondominant marginalized groups, for example, ethnic minorities, women, and the poor. The elimination of health disparities necessitates integration of both paradigms in health research. This study provides a practical application of the integration of biomedical and feminist intersectionality paradigms in nursing research, using a psychiatric intervention study with battered Latino women as an example.

Thermische Verletzungen im Kindesalter: Eine retrospektive Kohortenstudie von 212 Fällen

OpenAIRE

Sperling, Patrik Leonhart

2012-01-01

Anhand einer retrospektiven Datenanalyse sollen Verteilungsmuster von Verbrennungen und Verbrühungen bezogen auf Alter und Geschlecht untersucht werden. Erfasst wurden 212 Patienten im Alter von 0 bis 16 Jahren betrachtet, die im Zeitraum vom 01.01.2004 bis zum 31.12.2009 auf Grund einer thermischen Verletzung stationär im Universitätsklinikum Würzburg der Julius-Maximilians-Universität Würzburg behandelt wurden. Den größten Anteil thermischer Verletzungen im Kindesalter stellen Verbrühungen ...

Sequence-specific DNA alkylation by tandem Py-Im polyamide conjugates.

Science.gov (United States)

Taylor, Rhys Dylan; Kawamoto, Yusuke; Hashiya, Kaori; Bando, Toshikazu; Sugiyama, Hiroshi

2014-09-01

Tandem N-methylpyrrole-N-methylimidazole (Py-Im) polyamides with good sequence-specific DNA-alkylating activities have been designed and synthesized. Three alkylating tandem Py-Im polyamides with different linkers, which each contained the same moiety for the recognition of a 10 bp DNA sequence, were evaluated for their reactivity and selectivity by DNA alkylation, using high-resolution denaturing gel electrophoresis. All three conjugates displayed high reactivities for the target sequence. In particular, polyamide 1, which contained a β-alanine linker, displayed the most-selective sequence-specific alkylation towards the target 10 bp DNA sequence. The tandem Py-Im polyamide conjugates displayed greater sequence-specific DNA alkylation than conventional hairpin Py-Im polyamide conjugates (4 and 5). For further research, the design of tandem Py-Im polyamide conjugates could play an important role in targeting specific gene sequences. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Health literacy and public health: A systematic review and integration of definitions and models

LENUS (Irish Health Repository)

Sorensen, Kristine

2012-01-25

Abstract Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

Information Management System (Ims) For Gender Mainstreaming In ...

African Journals Online (AJOL)

Information Management System (IMS) is an essential tool in supporting the provision of information needed for planning and decision making in any organization. Proper IMS facilitates the smooth flow of information both vertical and horizontal. This paper presents the findings of a survey on information needs of the Gender ...

The model of Western integrative medicine: the role of Chinese medicine.

Science.gov (United States)

Dobos, Gustav; Tao, Iven

2011-01-01

The basic concept of integrative medicine (IM) is that by combining mainstream (biomedicine) with complementary and alternative medicine (CAM), synergistic therapeutic effects can be attained. When the methods of mind/body medicine (MBM) are added to this combination, as in Western countries, a new concept emerges that drastically changes the approach toward illness.It is interesting to note that the joining of traditional Chinese medicine and Western medicine in the early days of the Peoples' Republic of China preceded the Western model of IM by almost 50 years. Several elements that make up the key components of IM as practiced today in the West were already present in the Chinese version of IM, and Chinese medicine has played and continues to play an important role in advancing IM. However, one of the major differences between the Chinese and the Western models of IM today, besides MBM and some other treatment options, is that Western integrative medicine (WIM) strictly requires its CAM methods to be supported by scientific evidence.The therapeutic methods of IM and their applications are many and varied. However, they are most frequently employed to treat chronic medical conditions, e.g., bronchial asthma, rheumatic disease, chronic inflammatory bowel disorder and chronic pain. Other fields in which IM may be applied are internal medicine (inflammatory bowel diseases and cardiovascular diseases), musculoskeletal disorders, oncology (chemotherapy-induced side effects), obstetrics and gynecology (dysmenorrhea, endometriosis, infertility and menopausal complaints), pediatrics, geriatrics, neurology (migraine and chronic headache), and psychiatry (anxiety and depression).The concept of WIM is discussed here in detail by reviewing its scope and implications for the practice of medicine and focusing on the role of Chinese medicine in WIM.

The integrated management for renal replacement therapy in Portugal.

Science.gov (United States)

Coelho, Anabela P; Sá, Helena O; Diniz, José A; Dussault, Gilles

2014-01-01

Portugal was the first European country to introduce an integrated management of end-stage renal disease (IM ESRD). This new program integrates various dialysis services and products, which are reimbursed at a fixed rate/patient/week called "comprehensive price payment." This initiative restructured the delivery of dialysis services, the monitoring of outcomes, and the funding of renal replacement therapy. This article described the implementation of a new model of comprehensive provision of hemodialysis (HD) services and aimed to assess its impact on dialysis care. Quality assessments and reports of patient satisfaction, produced by the Ministry of Health since 2008, as well as national registries and reports, provided the data for this review. Indicators of HD services in all continental facilities show positive results that have successively improved along the period of 2009-2011, in spite of an average annual growth of 3% of the population under HD treatment. Mortality rates for HD patients were 12.7%, 12%, and 11%, respectively in 2009, 2010, and 2011; annual hospitalization rates were 4.9%, 3.8%, and 4.4% for the same years; key performance indicators showed averages above the reference values such as hemoglobin, serum phosphorus, eKt/V, water quality, number of days of hospitalization per patient per year, and number of weekly dialysis sessions. The financing analysis of IM ESRD demonstrates a sustained control of global costs, without compromising quality. The IM ERSD program is an innovative and quality-driven approach that benefits both dialysis patients and providers, contributing toward the rationalization of service provision and the efficient use of resources. © 2013 International Society for Hemodialysis.

Systems and methods for integrating ion mobility and ion trap mass spectrometers

Science.gov (United States)

Ibrahim, Yehia M.; Garimella, Sandilya; Prost, Spencer A.

2018-04-10

Described herein are examples of systems and methods for integrating IMS and MS systems. In certain examples, systems and methods for decoding double multiplexed data are described. The systems and methods can also perform multiple refining procedures in order to minimize the demultiplexing artifacts. The systems and methods can be used, for example, for the analysis of proteomic and petroleum samples, where the integration of IMS and high mass resolution are used for accurate assignment of molecular formulae.

Calibración de imágenes de radares meteorológicos

Directory of Open Access Journals (Sweden)

Virgilio Santander Socorras Quintero

2014-04-01

Full Text Available En este documento se ilustran las técnicas de fusión de imágenes para complementar y calibrar la información meteorológica presente en imágenes de radares terrestres con el uso de imágenes satelitales meteorológicas. Para realizar la calibración de las imágenes de radares terrestres se implementó un método de fusión de imágenes basado en la herramienta matemática transformada wavelet discreta. Ya que existe una familia de wavelets, es necesario determinar cuál wavelet ofrece el mejor resultado; para esto se determina la correlación existente entre los resultados de fusión de diferentes wavelets y las imágenes uti-lizadas en cada fusión. Se define una metodología para selección de umbral global de segmentación y una metodología para realizar la calibración de las imágenes de radares terrestres. Siguiendo la metodología de calibración de imágenes, se generan algunos resultados y se muestran sus ventajas.

Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

Science.gov (United States)

Bhatia, Rajiv; Wernham, Aaron

2008-08-01

The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care

Directory of Open Access Journals (Sweden)

Raymond Brian

2008-10-01

Full Text Available Abstract Background Integrated personal health records (PHRs offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable. Discussion While there is a spectrum of dominant PHR models, (standalone, tethered, integrated, the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders. Summary Integrated PHRs

Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals.

Science.gov (United States)

Coll-Black, Sarah; Bhushan, Anjana; Fritsch, Kathleen

2007-12-01

Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.

QUANTITATIVE СHARACTERISTICS OF COMPLEMENTARY INTEGRATED HEALTH CARE SYSTEM AND INTEGRATED MEDICATION MANAGEMENT INFORMATION SYSTEM

Directory of Open Access Journals (Sweden)

L. Yu. Babintseva

2015-05-01

i mportant elements of state regulation of the pharmaceutical sector health. For the first time creation of two information systems: integrated medication management infor mation system and integrated health care system in an integrated medical infor mation area, operating based on th e principle of complementarity was justified. Global and technological coefficients of these systems’ functioning were introduced.

Choosing the Right Free IM Providers and Clients for Your Library

Science.gov (United States)

Izenstark, Amanda K.

2009-01-01

With virtual library services increasing, public services librarians may find themselves with questions such as: What instant messaging services (IM) are available? Which IM service would best suit my patrons' needs? Which IM service best suits my library's technology profile? This column describes the features and functionality of major instant…

World-wide developments in motor vehicle inspection/maintenance (I/M) programs

Energy Technology Data Exchange (ETDEWEB)

Klausmeier, R. [Consulting Inc., Austin, TX (United States); Kishan, S. [Radian Corporation, Austin, TX (United States)

1995-12-31

Motor vehicles contribute much to urban air pollution. As a result, most governments have enacted emission standards that significantly lower pollutant emission levels from new motor vehicles. For example, vehicles built in the United States emit 95 % fewer pollutants than uncontrolled vehicles when they are new. However, studies indicate that proper maintenance is needed to obtain the full benefit of vehicle emission controls. Furthermore, there is evidence that a significant percentage of the vehicle fleet is not properly maintained. This has led to the creation of motor vehicle Inspection/Maintenance (I/M) Programs. I/M programs inspect vehicles for indications that they are emitting excessive quantities of pollutants. Vehicles that fail the inspection must be repaired in order to comply with program requirements. The first I/M programs were implemented in the United States in the early 1970s. With substantial urging from the federal government, most of the U.S. states with severe air pollution problems have implemented I/M programs. Recently, with the passage of the U.S. Clean Air Act Amendments of 1990, many states have been required to significantly upgrade the performance and coverage of their I/M programs. I/M programs also have been implemented in Europe and recently in Asia. This presentation reviews developments in I/M programs for light-duty gasoline powered vehicles. Developments in I/M programs for diesel powered vehicles are briefly described. (author)

World-wide developments in motor vehicle inspection/maintenance (I/M) programs

Energy Technology Data Exchange (ETDEWEB)

Klausmeier, R [Consulting Inc., Austin, TX (United States); Kishan, S [Radian Corporation, Austin, TX (United States)

1996-12-31

Motor vehicles contribute much to urban air pollution. As a result, most governments have enacted emission standards that significantly lower pollutant emission levels from new motor vehicles. For example, vehicles built in the United States emit 95 % fewer pollutants than uncontrolled vehicles when they are new. However, studies indicate that proper maintenance is needed to obtain the full benefit of vehicle emission controls. Furthermore, there is evidence that a significant percentage of the vehicle fleet is not properly maintained. This has led to the creation of motor vehicle Inspection/Maintenance (I/M) Programs. I/M programs inspect vehicles for indications that they are emitting excessive quantities of pollutants. Vehicles that fail the inspection must be repaired in order to comply with program requirements. The first I/M programs were implemented in the United States in the early 1970s. With substantial urging from the federal government, most of the U.S. states with severe air pollution problems have implemented I/M programs. Recently, with the passage of the U.S. Clean Air Act Amendments of 1990, many states have been required to significantly upgrade the performance and coverage of their I/M programs. I/M programs also have been implemented in Europe and recently in Asia. This presentation reviews developments in I/M programs for light-duty gasoline powered vehicles. Developments in I/M programs for diesel powered vehicles are briefly described. (author)

A Methodology for Virtual Enterprise Management – Results from IMS 95001/Esprit 26509 Globeman21 project

DEFF Research Database (Denmark)

Tølle, Martin; Vesterager, Johan; Pedersen, Jens Dahl

2000-01-01

This paper presents results of the recently concluded IMS Globeman21 (Global Manufacturing in the 21st Century, IMS 95001/ESPRIT 26509) project. The results is the Virtual Enterprise Concept, a Virtual Enterprise Framework based upon GERAM (ISO/DIS 15704) and a Methodology for Virtual Enterprise...... management and engineering which is related to the Virtual Enterprise Framework (VEF). Applying the VEF as a basis structure for the Methodology provides a systematic approach for preparation and engineering of virtual enterprises. The Virtual Enterprise Framework opens up the prospect of combining...... experiences in the area of virtual enterprise into an integrated whole enabling researchers or practitioners to focus on subsets of the challenge related to the realisation of the virtual enterprise potentials. In this paper the identification, concept and requirements phases of the methodology are briefly...

Evaluation of services of the integrative health clinic in Hong Kong.

Science.gov (United States)

Chung, Joanne W Y; Chung, Louisa M Y; Kwok, Nedra W L; Wong, Thomas K S

2008-10-01

(i) To provide a profile of the clients who have used the Integrative Health Clinic's services, (ii) to determine the clients' extent of satisfaction with the services received and (iii) to assess whether integrative therapies can/should be recommended to other clinics. Based on the integration of various health paradigms and the use of health promotion strategies, our Integrative Health Clinic in Hong Kong provides a range of different therapies for integrated symptom management. The integrative therapies are derived from conventional, complementary and alternative medicine. Design. Postal survey, followed by routine data analysis. Hong Kong Chinese clients attending a residential community health clinic were surveyed about health status and satisfaction towards the services received. A total of 489 clients (30.8% were male and 69.2% female) were registered with the clinic during the study period. The mean age (SD) was 47.8 (15.4) years. The customer satisfaction survey found that traditional Chinese medicine consultation was the most frequently used modality of the Integrative Health Clinic, followed by pain management. Out of the 489 clients, those who attended the Integrative Health Clinic only once in the study period for an annual health assessment and those who died during the period were excluded from the survey, giving a total of 276 eligible clients. Out of the 276 clients, 52.5% (128) responded to the survey that asked them to evaluate their satisfaction with the services received at the clinic and the performance of the clinic's practitioners who interacted with them. For practitioner performance, the percentage of respondents who gave a rating of satisfaction was found to range between 86.3-64.3%, while the percentage of respondents who gave a rating of dissatisfaction ranged from 13.7-35.7%. Overall, the survey found that most aspects of the Integrative Health Clinic's services were rated as satisfactory. The overwhelming satisfaction of clients with

Integrative Mental Health (IMH): paradigm, research, and clinical practice.

Science.gov (United States)

Lake, James; Helgason, Chanel; Sarris, Jerome

2012-01-01

This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

From parallel practice to integrative health care: a conceptual framework

Directory of Open Access Journals (Sweden)

O'Hara Dennis

2004-07-01

Full Text Available Abstract Background "Integrative health care" has become a common term to describe teams of health care providers working together to provide patient care. However this term has not been well-defined and likely means many different things to different people. The purpose of this paper is to develop a conceptual framework for describing, comparing and evaluating different forms of team-oriented health care practices that have evolved in Western health care systems. Discussion Seven different models of team-oriented health care practice are illustrated in this paper: parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary and integrative. Each of these models occupies a position along the proposed continuum from the non-integrative to fully integrative approach they take to patient care. The framework is developed around four key components of integrative health care practice: philosophy/values; structure, process and outcomes. Summary This framework can be used by patients and health care practitioners to determine what styles of practice meet their needs and by policy makers, healthcare managers and researchers to document the evolution of team practices over time. This framework may also facilitate exploration of the relationship between different practice models and health outcomes.

Respuestas faciales ante imágenes de advertencia de tabaco

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M. A. Muñoz

Full Text Available Resumen En 2003, la Comisión Europea propuso una serie de advertencias visuales para ser incluidas en los embalajes de tabaco, con el objetivo de motivar a los fumadores a dejar de fumar y promover actitudes negativas hacia el tabaco. El objetivo de este estudio fue evaluar el impacto de las advertencias sanitarias mediante autoinformes y medidas psicofisiológicas. Cincuenta sujetos sanos (19-23 años visionaron un conjunto de treinta y seis imágenes de diferente contenido emocional y veinticuatro del banco de imágenes preventivas propuestas por la Comisión Europea. Se registró la actividad eléctrica de los músculos cigomático mayor y corrugador mientras los sujetos visionaban estas imágenes. A continuación, los participantes evaluaban las imágenes en las dimensiones de agradabilidad y activación. Los resultados muestran una mayor actividad eléctrica del musculo corrugador ante la presentación de imágenes desagradables comparadas con advertencias desagradables incluidas en los paquetes de tabaco. Estos resultados sugieren que la campaña preventiva podría beneficiarse de imágenes preventivas más impactantes, promoviendo así la activación del sistema motivacional evitativo/defensivo.

Ethical Issues in Integrated Health Care: Implications for Social Workers.

Science.gov (United States)

Reamer, Frederic G

2018-05-01

Integrated health care has come of age. What began modestly in the 1930s has evolved into a mature model of health care that is quickly becoming the standard of care. Social workers are now employed in a wide range of comprehensive integrated health care organizations. Some of these settings were designed as integrated health care delivery systems from their beginning. Others evolved over time, some incorporating behavioral health into existing primary care centers and others incorporating primary care into existing behavioral health agencies. In all of these contexts, social workers are encountering complex, sometimes unprecedented, ethical challenges. This article identifies and discusses ethical issues facing social workers in integrated health care settings, especially related to informed consent, privacy, confidentiality, boundaries, dual relationships, and conflicts of interest. The author includes practical resources that social workers can use to develop state-of-the-art ethics policies and protocols.

Sandia National Laboratories: Integrated Military Systems

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Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios ; Culture Work-Life Balance Special Programs Integrated Military Systems (IMS) Capabilities Facilities

Managing the physics of the economics of integrated health care.

Science.gov (United States)

Zismer, Daniel K; Werner, Mark J

2012-01-01

The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

Intacting Integrity in coping with health issues

DEFF Research Database (Denmark)

Jepsen, Stine Leegaard; Bastrup Jørgensen, Lene; Fridlund, Bengt

2017-01-01

The aim of this study was to develop a formal substantive theory (FST) on the multidimensional behavioral process of coping with health issues. Intacting integrity while coping with health issues emerged as the core category of this FST. People facing health issues strive to safeguard and keep...

Developing health science students into integrated health professionals: a practical tool for learning

Directory of Open Access Journals (Sweden)

Duncan Madeleine

2007-11-01

Full Text Available Abstract Background An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments 12. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape Town, South Africa aim to lay the foundation for becoming an integrated health professional 3. In these courses a diagram depicting the domains of the integrated health professional is used to focus the content of small group experiential exercises towards an appreciation of professionalism. The diagram serves as an organising framework for conceptualising an emerging professional identity and for directing learning towards the domains of 'self as professional' 45. Objective This paper describes how a diagrammatic representation of the core elements of an integrated health professional is used as a template for framing course content and for organising student learning. Based on the assumption that all health care professionals should be knowledgeable, empathic and reflective, the diagram provides students and educators with a visual tool for investigating the subjective and objective dimensions of professionalism. The use of the diagram as an integrating point of reference for individual and small group learning is described and substantiated with relevant literature. Conclusion The authors have applied the diagram with positive impact for the past six years with students and educators reporting that "it just makes sense". The article includes plans for formal evaluation. Evaluation to date is based on preliminary, informal feedback on the value of the diagram as a tool for capturing the domains of professionalism at an early stage in the undergraduate education of health professional students.

Integration of a mobile-integrated therapy with electronic health records: lessons learned.

Science.gov (United States)

Peeples, Malinda M; Iyer, Anand K; Cohen, Joshua L

2013-05-01

Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient-provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center. In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework. Findings from the diverse stakeholder group of a MIT-EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed. Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases. © 2013 Diabetes Technology Society.

Does cultural integration explain a mental health advantage for adolescents?

Science.gov (United States)

Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

2012-06-01

A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a 'total difficulties score' and by classification as a 'probable clinical case'. A total of 6643 pupils in first and second years of secondary school (ages 11-13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005-06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Cultural integration was associated with better mental health, independent of the mental health advantage found among specific ethnic groups: Black Caribbean and

Does cultural integration explain a mental health advantage for adolescents?

Science.gov (United States)

Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

2012-01-01

Background A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. Methods A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a ‘total difficulties score’ and by classification as a ‘probable clinical case’. Results A total of 6643 pupils in first and second years of secondary school (ages 11–13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005–06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Conclusions Cultural integration was associated with better mental health, independent of the mental health advantage

Jung und Alt im Dialog

Directory of Open Access Journals (Sweden)

Caroline Baetge

2012-04-01

Full Text Available Rezension zu: Kupser, Thomas, und Ida Pöttinger, Hrsg. 2011. Mediale Brücken: Generationen im Dialog durch aktive Medienarbeit. Gesellschaft - Altern - Medien 3. München: kopaed.

Health Systems Integration of Sexual and Reproductive Health and HIV Services in Sub-Saharan Africa: A Scoping Study

Science.gov (United States)

Kendall, Tamil; Langer, Ana; Bärnighausen, Till

2014-01-01

Objective: Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. Methods: We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. Results: The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Conclusions: Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery. PMID:25436826

The medical home and integrated behavioral health: advancing the policy agenda.

Science.gov (United States)

Ader, Jeremy; Stille, Christopher J; Keller, David; Miller, Benjamin F; Barr, Michael S; Perrin, James M

2015-05-01

There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patient-centered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration. Copyright © 2015 by the American Academy of Pediatrics.

Real-time resource availability signalling in IMS-based networks

NARCIS (Netherlands)

Ozcelebi, T.; Radovanovic, I.; Lukkien, J.J.

2007-01-01

The emerging converged IP multimedia subsystem (IMS) allows the use of unlicensed, nondedicated and nondeterministic computer access networks for delivering IP multimedia services. To provide end-to-end quality-of-service (QoS) over such networks combined with the IMS core network, for resource

Medida Interpessoal de Psicopatia (IM-P: estudo preliminar no contexto brasileiro Interpersonal Measure of Psychopathy (IM-P: preliminary study in the Brazilian context

Directory of Open Access Journals (Sweden)

Tárcia Rita Davoglio

2011-01-01

Full Text Available INTRODUÇÃO: A observação direta do comportamento interpessoal é um recurso importante na descrição e diagnóstico da personalidade psicopática. A Medida Interpessoal de Psicopatia (Interpersonal Measure of Psychopathy, IM-P é um instrumento psicométrico composto por 21 itens, desenvolvido para ser utilizado em associação com outras escalas de avaliação da psicopatia. Foca-se, especificamente, nos comportamentos interpessoais e aspectos não verbais evidentes na interação do entrevistador com indivíduos que apresentam características psicopáticas. OBJETIVO: Descrever resultados preliminares sobre a investigação de aspectos interpessoais da psicopatia mediante a utilização da IM-P, incluindo as etapas de tradução/adaptação e avaliação de confiabilidade interavaliadores da IM-P, em uma amostra de adolescentes brasileiros. MÉTODO: Trata-se de estudo transversal, descritivo e correlacional realizado com 20 adolescentes masculinos cumprindo medida socioeducativa com privação de liberdade na Região Metropolitana de Porto Alegre (RS. Após os procedimentos de tradução da escala, treinamento dos pesquisadores e teste piloto por meio de uma entrevista semiestruturada, a IM-P foi pontuada por três juízes independentes. RESULTADOS: Os resultados estatísticos, obtidos através do coeficiente de concordância de Kendall, revelaram grau de concordância interavaliadores elevado e satisfatório para os escores totais da IM-P (W = 0,84; p INTRODUCTION: The direct observation of interpersonal behaviors is an important resource in the description and diagnosis of the psychopathic personality. The Interpersonal Measure of Psychopathy (IM-P is a psychometric instrument comprised of 21 items, designed to be applied in association with other instruments that also evaluate psychopaths. It focuses specifically on interpersonal and non-verbal behaviors that become evident during the interaction between the interviewer and individuals

Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

Science.gov (United States)

von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

2015-02-01

To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

Health care for irregular migrants: pragmatism across Europe: a qualitative study

NARCIS (Netherlands)

Dauvrin, M.; Lorant, V.; Sandhu, S.; Devillé, W.; Dia, H.; Dias, S.; Gaddini, A.; Ioannidis, E.; Jensen, N.K.; Kluge, U.; Mertaniemi, R.; Puigpinós i Riera, R.; Sárváry, A.; Straßmayr, C.; Stankunas, M.; Soares, J.J.F.; Welbel, M.; Priebe, S.

2012-01-01

Background Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in

Risk assessment of integrated electronic health records.

Science.gov (United States)

Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

2010-01-01

The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

Address Translation Problems in IMS Based Next Generation Networks

Directory of Open Access Journals (Sweden)

Balazs Godor

2006-01-01

Full Text Available The development of packed based multimedia networks reached a turning point when the ITU-T and the ETSIhave incorporated the IMS to the NGN. With the fast development of mobile communication more and more services andcontent are available. In contrast with fix network telephony both the services and the devices are personalized in the “mobileworld”. Services, known from the Internet - like e-mail, chat, browsing, presence, etc. – are already available via mobiledevices as well. The IMS originally wanted to exploit both the benefits of mobile networks and the fancy services of theInternet. But today it is already more than that. IMS is the core of the next generation telecommunication networks and abasis for fix-mobile convergent services. The fact however that IMS was originally a “mobile” standard, where IPv6 was notoddity generated some problems for the fix networks, where IPv4 is used. In this article I give an overview of these problemsand mention some solutions as well.

Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

Science.gov (United States)

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

2016-01-01

Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

Gesundheit und Pflege im Alter

OpenAIRE

Pfaff, Martin

1989-01-01

Gesundheit und Pflege im Alter : d. Gesundheitsreformgesetz (GRG) ; Möglichkeiten, Grenzen u. weitere Vorschläge / Martin Pfaff ; Klaus Deimer. - In: Expertengespräch "Pflege in der Familie". - Augsburg, 1989. - Getr. Zählung

IM (Integrity Management) software must show flexibility to local codes

Energy Technology Data Exchange (ETDEWEB)

Brors, Markus [ROSEN Technology and Research Center GmbH (Germany); Diggory, Ian [Macaw Engineering Ltd., Northumberland (United Kingdom)

2009-07-01

There are many internationally recognized codes and standards, such as API 1160 and ASME B31.8S, which help pipeline operators to manage and maintain the integrity of their pipeline networks. However, operators in many countries still use local codes that often reflect the history of pipeline developments in their region and are based on direct experience and research on their pipelines. As pipeline companies come under increasing regulatory and financial pressures to maintain the integrity of their networks, it is important that operators using regional codes are able to benchmark their integrity management schemes against these international standards. Any comprehensive Pipeline Integrity Management System (PIMS) software package should therefore not only incorporate industry standards for pipeline integrity assessment but also be capable of implementing regional codes for comparison purposes. This paper describes the challenges and benefits of incorporating one such set of regional pipeline standards into ROSEN Asset Integrity Management Software (ROAIMS). (author)

Integrated Monitoring AWAReness Environment (IM-AWARE), Phase II

Data.gov (United States)

National Aeronautics and Space Administration — American GNC Corporation (AGNC) and Louisiana Tech University (LaTECH) are proposing a significant breakthrough technology, the Integrated Monitoring AWAReness...

Integrated System Health Management Development Toolkit

Science.gov (United States)

Figueroa, Jorge; Smith, Harvey; Morris, Jon

2009-01-01

This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

Indicators and measurement tools for health system integration : a knowledge synthesis protocol

OpenAIRE

Oelke, Nelly Donszelmann; Suter, Esther; Lima, Maria Alice Dias da Silva; Vliet-Brown, Cheryl Van

2015-01-01

Background: Health system integration is a key component of health system reform with the goal of improving outcomes for patients, providers, and the health system. Although health systems continue to strive for better integration, current delivery of health services continues to be fragmented. A key gap in the literature is the lack of information on what successful integration looks like and how to measure achievement towards an integrated system. This multi-site study protocol builds on a ...

[European health systems and the integration problem of modern societies].

Science.gov (United States)

Lüschen, G

2000-04-01

With reference to the national health systems in Germany and the UK we must acknowledge that it was in particular Bismarck's Reform, originally directed toward a solidarity among the socially weak, which entailed in its development a marked redistribution via progressive health fees and standardized health services. In view of Alfred Marshall's original expectations this has resulted in a specific integration of the socially weak and with some difference for nationally tax-financed and social security financed health systems to a genuine contribution towards integration of modern society. An open research question is whether as a consequence of solidarity and integration through health systems there is a decline of social inequality for health. Equally open is the question as to the socio-structural and economic consequences the expansion of modern health systems has.

Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

Science.gov (United States)

Herbert, Valerie M; Connors, Helen

2016-08-01

Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

Aggregation und Management von Metadaten im Kontext von Europeana

Directory of Open Access Journals (Sweden)

Gerda Koch

2017-09-01

Full Text Available Mit dem In-Beziehung-Setzen und Verlinken von Daten im Internet wird der Weg zur Umsetzung des semantischen Webs geebnet. Erst die semantische Verbindung von heterogenen Datenbeständen ermöglicht übergreifende Suchvorgänge und späteres „Machine Learning“. Im Artikel werden die Aktivitäten der Europäischen Digitalen Bibliothek im Bereich des Metadatenmanagements und der semantischen Verlinkung von Daten skizziert. Dabei wird einerseits ein kurzer Überblick zu aktuellen Forschungsschwerpunkten und Umsetzungsstrategien gegeben, und darüber hinaus werden einzelne Projekte und maßgeschneiderte Serviceangebote für naturhistorische Daten, regionale Kultureinrichtungen und Audiosammlungen beschrieben.

The integrated project: a promising promotional strategy for primary health care.

Science.gov (United States)

Daniel, C; Mora, B

1985-10-01

The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain

Health policy and integrated mental health care in the SADC region: strategic clarification using the Rainbow Model.

Science.gov (United States)

van Rensburg, André Janse; Fourie, Pieter

2016-01-01

Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care. The purpose of this study was to explore the nature and strategic forms of integrated mental health care in selected SADC countries, specifically how integrated care is outlined in state-driven policies. Health policies from five SADC countries were analysed using the Rainbow Model as framework. Electronic copies of policy documents were transferred into NVivo 10, which aided in the framework analysis on the different types of integrated mental health care promoted in the countries assessed. Several Rainbow Model components were emphasised. Clinical integration strategies (coordination of person-focused care) such as centrality of client needs, case management and continuity were central considerations, while others such as patient education and client satisfaction were largely lacking. Professional integration (inter-professional partnerships) was mentioned in terms of agreements on interdisciplinary collaboration and performance management, while organisational integration (inter-organisational relationships) emerged under the guise of inter-organisational governance, population needs and interest management. Among others, available resources, population management and stakeholder management fed into system integration strategies (horizontally and vertically integrated systems), while functional integration strategies (financial, management and information system functions) included human resource

Innovative Perspectives of Integrated Chinese Medicine on H. pylori.

Science.gov (United States)

Ye, Hui; Shi, Zong-Ming; Chen, Yao; Yu, Jing; Zhang, Xue-Zhi

2018-06-08

Helicobacter pylori (H. pylori) treatment requires the development of more effective therapies, mainly owing to the challenges posed by the bacterial resistance to antibiotics. In China, critically high infection and antibiotic resistance rates have limited the application of classic H. pylori eradication therapies. Consequently, researchers are attempting to find new solutions by drawing from traditional medicine. This article reviews basic scientific and clinical progress in the use of integrated Chinese and Western medicine (IM) to treat H. pylori; describes the conflicting results between in vivo and in vitro studies in this regard; discusses the observed clinical effects of IM, with emphasis on traditional patent medicines; and proposes a role for IM in both the diagnosis and treatment of H. pylori, including the use of tongue manifestation as an early diagnostic method and capitalizing on IM's direct and indirect methods for enhancing antibiotic effect.

Sexting im Schulumfeld

Directory of Open Access Journals (Sweden)

Barbara Buchegger

2015-03-01

Full Text Available Wir wollten es einfach wissen. Wie steht es nun mit diesem "Sexting" – also der Übermittlung von Nacktaufnahmen, die Jugendliche untereinander teilen? Stimmt unser Eindruck aus den Workshops in Schulen, dass es bereits ein "übliches Verhalten" der Jugendlichen geworden ist? Saferinternet.at hat im November/Dezember 2014 eine Studie durch das Institut für Jugendkulturforschung rund um das Thema "Sexting" in Auftrag gegeben.

Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

Science.gov (United States)

Pronk, Nicolaas P.

2014-01-01

Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

Medienpädagogische Aufgabenfelder hinsichtlich der Visualität im digitalen Zeitalter. Desiderate im Umgang mit visuellen Medienkulturen

Directory of Open Access Journals (Sweden)

Petra Missomelius

2017-04-01

Full Text Available Die bildungskulturell leitende Funktion des Buches diffundiert im digitalen Zeitalter mobiler und transversaler Systeme von Netzwerkmedien. Zudem sind soziokulturelle Lebenswelten wie Bildungsinstitutionen, Familie und Peers durch Heterogenität gekennzeichnet. Indem auch diese Teil des Geflechts medienkultureller Architekturen werden, geraten ehemals gültige Unterscheidungsparameter wie explizites und implizites, formelles und informelles Wissen ins Wanken. Grenzziehungen und konkurrierende Auffassungen gegenüber diesen, vormals als der Bildung entgegengesetzt wahrgenommenen, Bereichen erweisen sich nunmehr als problematisch. So spielt Visualität im Kontext multimodal zusammengesetzter Bildungsmaterialien eine zunehmende Rolle und wird als Möglichkeit des Umgangs mit Komplexität eingesetzt. Wenngleich somit die Zurückhaltung gegenüber (Bewegt-Bildmedien in der pädagogischen Praxis schwindet, so haben sich mit der Digitalisierung medienkulturell bedeutsame Felder eröffnet, welche erziehungswissenschaftlicher Beachtung bedürfen. Eine sich der Komplexität digitaler Medienkulturen stellende Medienpädagogik bringt mit sich, dass auch Funktion und Gebrauch visueller Medien im Kontext von Bildungsprozessen reflektiert stattfinden. Medienpädagogisch informiertes Agieren in visuellen Medienkulturen ist darüber hinaus heute gerade deshalb essentiell, da es sich bei digital generierter Visualität um eine neue Qualität im Unterschied zu traditionellen Bildmedien handelt, welche der Logik der Repräsentation entsprachen. Der Beitrag thematisiert Desiderate, die sich hinsichtlich des Visuellen datenbasierter Medien für die Medienpädagogik ergeben, und geht dabei auf kommunikative Bildlichkeit, auf paradigmatische mediale Formen und auf datengestützte Wissensgenerierung ein.

Ground Operations Autonomous Control and Integrated Health Management

Science.gov (United States)

Daniels, James

2014-01-01

The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

Integrated environment, safety, and health management system description

International Nuclear Information System (INIS)

Zoghbi, J. G.

2000-01-01

The Integrated Environment, Safety, and Health Management System Description that is presented in this document describes the approach and management systems used to address integrated safety management within the Richland Environmental Restoration Project

IMS Intra- and Inter Domain End-to-End Resilience Analysis

DEFF Research Database (Denmark)

Kamyod, Chayapol; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

2013-01-01

This paper evaluated resilience of the reference IMS based network topology in operation through the keys reliability parameters via OPNET. The reliability behaviors of communication within similar and across registered home IMS domains were simulated and compared. Besides, the reliability effects...

Project management plan : Dallas Integrated Corridor Management (ICM) demonstration project.

Science.gov (United States)

2010-12-01

The Dallas Integrated Corridor Management System Demonstration Project is a multi-agency, de-centralized operation which will utilize a set of regional systems to integrate the operations of the corridor. The purpose of the Dallas ICM System is to im...

EFEKTIVITAS MEDIA PEMBELAJARAN IM3 DITINJAU DARI MOTIVASI BELAJAR

Directory of Open Access Journals (Sweden)

J. Handhika

2012-10-01

Full Text Available Penelitian ini bertujuan untuk mengetahui perbedaan penggunaan media pembelajaran IM3 berbasis flash dan media MS. Power Point terhadap prestasi belajar IPA-Fisika. Hasil penelitian  menunjukkan bahwa siswa yang diajar menggunakan media IM3 berbasis flash memberikan rata-rata prestasi lebih baik dibandingkan dengan siswa yang diajar menggunakan power point. Siswa dengan motivasi belajar tinggi menghasilkan rata-rata prestasi lebih baik daripada siswa dengan motivasi belajar rendah, serta terdapat interaksi motivasi belajar dengan media pembelajaran terhadap prestasi belajar IPA-Fisika.   This study aims to determine differences in the use of flash-based IM3 learning media and MS media. Power Point to IPA-Physics learning achievement. Results showed that students who were taught using flash-based media IM3 gives an average performance better than students who were taught using the power point. Students with high motivation to learn the average yield better performance than students with low learning motivation, and there is interaction with the medium of learning motivation toward science learning achievement-Physics.

Ausländische Direktinvestitionen und Technologietransfer im angolanischen Energiesektor

Directory of Open Access Journals (Sweden)

2016-04-01

Full Text Available Dem Zusammenhang von ausländischen Direktinvestionen (Foreign Direct Investment, FDI und Technologietransfer wird sowohl in der Forschung als auch in der politischen Analyse große Bedeutung zugeschrieben. Zahlreiche Veröffentlichungen belegen, dass FDI den Transfer von und/oder den Zugang zu Technologien erleichtert. Allerdings gibt es zu wenige empirische Studien, die diesen Zusammenhang in Bezug auf die Wirtschaft afrikanischer Staaten untersuchen. Der Autor will diese Lücke zu einem kleinen Teil schließen, indem er die Bedeutung des Technologietransfers durch den Zufluss von FDI im Energiesektor Angolas ermittelt. Seine Analyse basiert auf qualitativer Forschung in Angola im Jahr 2014. Er zeigt auf, dass sich die Erzeugung von Energie(trägern und die Verteilungsinfrastruktur - maschinelle Ausrüstung und Qualifizierung - durch den Zufluss von FDI erheblich entwickeln konnte. Allerdings gebe es keinen Beleg dafür, dass dieser Zufluss die endogenen wissenschaftlichen und technologischen Forschungspotenziale im angolanischen Energiesektor gefördert hat. Der Autor empfiehlt politische Maßnahmen zur Förderung dieser Fähigkeiten, insbesondere im Bereich der Produktion.

In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

Directory of Open Access Journals (Sweden)

Andreas Michalsen

2013-01-01

Full Text Available Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM. We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014 and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

Integrated Approaches to Occupational Health and Safety: A Systematic Review.

Science.gov (United States)

Cooklin, A; Joss, N; Husser, E; Oldenburg, B

2017-09-01

The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

Sustainable design, construction and living in the information age; Nachhaltiges Planen, Bauen und Wohnen im Informationszeitalter

Energy Technology Data Exchange (ETDEWEB)

Bretthauser, G.; Dietze, S.; Haefele, K.H.; Isele, J.; Jaekel, J.

2001-06-01

prefabricated wall elements, of components for building design tools, for the information exchange between computer-aided design and computer-aided manufacturing, for the integration of home automation systems in the product model, of user interfaces and user adaptation of SmartHomes. Finally, possibilities of linking-up with R and D projects from other institutes in the Forschungszentrum Karlsruhe and potential external partners for cooperation are mentioned. (orig.) [German] Die vorliegende Studie widmet sich der Thematik des nachhaltigen Planens, Bauens und Wohnens im Informationszeitalter. Der Fokus liegt dabei, entsprechend der Aufgabengebiete und Kompetenzfelder des IAI, auf dem Beitrag der Informations- und Automatisierungstechnik. Die Studie basiert auf umfangreichen Recherchen, den Erfahrungen der Autoren und ersten Vorversuchen. Ihr Anliegen ist es, nach der Analyse des Entwicklungsstandes und der Entwicklungstrends Schlussfolgerungen fuer eigene F and E-Vorhaben zu ziehen. Die allgemeinen Rahmenbedingungen fuer zukuenftiges ''Bauen und Wohnen'' werden insbesondere unter dem Gesichtspunkt der Nachhaltigkeit praesentiert. Wichtige Fragestellungen innerhalb der sozialen, wirtschaftlichen und oekologischen Dimension eines nachhaltigen ''Bauens und Wohnens'' werden im Rahmen dieser Studie allerdings nur angerissen. Die Analyse des Entwicklungsstands und der Entwicklungstendenzen konzentriert sich auf drei Bereiche, den Einsatz der Informationstechnologie insbesondere in der Planungs- und Entwurfsphase, der automatisierten Fertigung und der Hausautomatisierung. Generell kann festgestellt werden, dass der verstaerkte Einsatz der Informations- und Automatisierungstechnik im Bereich ''Bauen und Wohnen'' ein grosses Innovationspotenzial birgt. Wichtige Tendenzen sind im Bereich Planung die Entwicklung von Standards fuer Produktdatenmodelle und die Nutzung von digitalen Gebaeudemodellen in allen Lebenszyklusphasen. Im

Project INTEGRATE - a common methodological approach to understand integrated health care in Europe

Directory of Open Access Journals (Sweden)

Lucinda Cash-Gibson

2014-12-01

Full Text Available Background: The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions occur at the different levels of care and often without a clear link between the interventions (new and/or existing and their impact on outcomes (in terms of patients health, both patient and professional satisfaction and cost-effectiveness. Still, integrated care is seen as a core strategy in the sustainability of health and care provision in most societies in Europe and beyond. More specifically, at present, there is neither clear evidence on transferable factors of integrated care success nor a method for determining how to establish these specific success factors. The drawback of case methodology in this case, however, is that the in-depth results or lessons generated are usually highly context-specific and thus brings the challenge of transferability of findings to other settings, as different health care systems and different indications are often not comparable. Project INTEGRATE, a European Commission-funded project, has been designed to overcome these problems; it looks into four chronic conditions in different European settings, under a common methodology framework (taking a mixed-methods approach to try to overcome the issue of context specificity and limited transferability. The common methodological framework described in this paper seeks to bring together the different case study findings in a way that key lessons may be derived and transferred between countries, contexts and patient-groups, where integrated care is delivered in order to provide insight into generalisability and build on existing evidence in this field.Methodology: To compare the different integrated care experiences, a mixed-methods approach has

78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2013-11-21

... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information...

78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2013-08-12

... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information...

A future task for health-promotion research: Integration of health promotion and sustainable development.

Science.gov (United States)

Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper; Kjærgård, Bente; Andersen, Heidi Myglegård; From, Ditte-Marie; Land, Birgit; Pedersen, Kirsten Bransholm

2018-02-01

Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health-promotion research regarding integration of sustainable development principles. Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified. These are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development, as well as the politics and implementation of policy goals in both areas. Three focal points are proposed as important challenges to address in future research: (a) the duality of health promotion and sustainability and how it can be handled in order to enhance mutually supportive processes between them; (b) the social dimension of sustainability and how it can be strengthened in the development of strategies for health promotion and sustainable development; and (c) exploring and identifying policy approaches and strategies for integrating health promotion and sustainable development.

Integrating mental health in primary healthcare in low-income countries

DEFF Research Database (Denmark)

Sørensen, Carina Winkler; Bæk, Ole; Kallestrup, Per

2017-01-01

. AIMS: This paper seeks to explore the rationale behind the WHO recommendations for improving mental health services in LICs. At the core of these recommendations is an integration of mental health services into existing primary healthcare. This article presents available research supporting...... from LICs that investigate mental health interventions is scarce. The evidence that does exist favours integration into primary healthcare. There is evidence that collaborative- and stepped-care interventions can provide viable treatment options for patients. CONCLUSION: Integration of mental health...... services into primary healthcare seems like a viable solution to ensure that treatment becomes more available, even though the evidence is limited. Locally conducted research is needed to guide the development of sustainable evidence-based mental health treatment, involving relevant healthcare providers...

ifo Konjunkturprognose 2015/2016: Deutsche Wirtschaft im Aufschwung

OpenAIRE

Wollmershäuser, Timo; Nierhaus, Wolfgang; Berg, Tim Oliver; Breuer, Christian; Garnitz, Johanna; Grimme, Christian; Henzel, Steffen; Hristov, Atanas; Hristov, Nikolay; Meister, Wolfgang; Schröter, Felix; Steiner, Andreas; Wieland, Elisabeth; Wohlrabe, Klaus; Wolf, Anna

2015-01-01

Die deutsche Wirtschaft befindet sich derzeit in einem kräftigen Aufschwung. Das reale Bruttoinlandsprodukt wird in diesem Jahr voraussichtlich um 1,9% expandieren und im kommenden Jahr um 1,8%. Der private Konsum bleibt die Stütze des Aufschwungs, da die Einkommensperspektiven der privaten Haushalte aufgrund der sich weiter verbessernden Arbeitsmarktlage gut sind. Allerdings entfallen allmählich die Kaufkraftgewinne durch den Ölpreisrückgang, so dass sich die Konsumdynamik im Prognosezeitrau...

ODE/IM correspondence and the Argyres-Douglas theory

Science.gov (United States)

Ito, Katsushi; Shu, Hongfei

2017-08-01

We study the quantum spectral curve of the Argyres-Douglas theories in the Nekrasov-Sahashvili limit of the Omega-background. Using the ODE/IM correspondence we investigate the quantum integrable model corresponding to the quantum spectral curve. We show that the models for the A 2 N -type theories are non-unitary coset models ( A 1)1 × ( A 1) L /( A 1) L+1 at the fractional level L=2/2N+1-2 , which appear in the study of the 4d/2d correspondence of N = 2 superconformal field theories. Based on the WKB analysis, we clarify the relation between the Y-functions and the quantum periods and study the exact Bohr-Sommerfeld quantization condition for the quantum periods. We also discuss the quantum spectral curves for the D and E type theories.

Integrative Medicine Patients Have High Stress, Pain, and Psychological Symptoms.

Science.gov (United States)

Wolever, Ruth Q; Goel, Nikita S; Roberts, Rhonda S; Caldwell, Karen; Kligler, Benjamin; Dusek, Jeffery A; Perlman, Adam; Dolor, Rowena; Abrams, Donald I

2015-01-01

Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, and depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous medical conditions, IM for psychological symptoms has been slower to gain recognition in the medical community. This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Research Network (PBRN). IM patients reported higher levels of perceived stress, pain, and depressive symptoms, and lower levels of quality of life compared with national norms. Per provider reports, 60% of patients had at least one of the following: stress (9.3%), fatigue (10.2%), anxiety (7.7%), depression (7.2%), and/or sleep disorders (4.8%). Pain, having both physiological and psychological components, was also included and is the most common condition treated at IM clinics. Those with high stress, psychological conditions, and pain were most frequently treated with acupuncture, IM physician consultation, exercise, chiropractic services, diet/nutrition counseling, and massage. With baseline information on clinical presentation and service utilization, future PBRN studies can examine promising interventions delivered at the clinic to treat stress and psychological conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

An integrated framework for health and ecological risk assessment

International Nuclear Information System (INIS)

Suter, Glenn W.; Vermeire, Theo; Munns, Wayne R.; Sekizawa, Jun

2005-01-01

The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species

76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2011-11-02

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2011-05-06

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2013-06-26

... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. [[Page 38346...

76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2011-09-19

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

Science.gov (United States)

2012-03-15

... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

Measuring cognitive change with ImPACT: the aggregate baseline approach.

Science.gov (United States)

Bruce, Jared M; Echemendia, Ruben J; Meeuwisse, Willem; Hutchison, Michael G; Aubry, Mark; Comper, Paul

2017-11-01

The Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) is commonly used to assess baseline and post-injury cognition among athletes in North America. Despite this, several studies have questioned the reliability of ImPACT when given at intervals employed in clinical practice. Poor test-retest reliability reduces test sensitivity to cognitive decline, increasing the likelihood that concussed athletes will be returned to play prematurely. We recently showed that the reliability of ImPACT can be increased when using a new composite structure and the aggregate of two baselines to predict subsequent performance. The purpose of the present study was to confirm our previous findings and determine whether the addition of a third baseline would further increase the test-retest reliability of ImPACT. Data from 97 English speaking professional hockey players who had received at least 4 ImPACT baseline evaluations were extracted from a National Hockey League Concussion Program database. Linear regression was used to determine whether each of the first three testing sessions accounted for unique variance in the fourth testing session. Results confirmed that the aggregate baseline approach improves the psychometric properties of ImPACT, with most indices demonstrating adequate or better test-retest reliability for clinical use. The aggregate baseline approach provides a modest clinical benefit when recent baselines are available - and a more substantial benefit when compared to approaches that obtain baseline measures only once during the course of a multi-year playing career. Pending confirmation in diverse samples, neuropsychologists are encouraged to use the aggregate baseline approach to best quantify cognitive change following sports concussion.

ImSET: Impact of Sector Energy Technologies

Energy Technology Data Exchange (ETDEWEB)

Roop, Joseph M.; Scott, Michael J.; Schultz, Robert W.

2005-07-19

This version of the Impact of Sector Energy Technologies (ImSET) model represents the ''next generation'' of the previously developed Visual Basic model (ImBUILD 2.0) that was developed in 2003 to estimate the macroeconomic impacts of energy-efficient technology in buildings. More specifically, a special-purpose version of the 1997 benchmark national Input-Output (I-O) model was designed specifically to estimate the national employment and income effects of the deployment of Office of Energy Efficiency and Renewable Energy (EERE) -developed energy-saving technologies. In comparison with the previous versions of the model, this version allows for more complete and automated analysis of the essential features of energy efficiency investments in buildings, industry, transportation, and the electric power sectors. This version also incorporates improvements in the treatment of operations and maintenance costs, and improves the treatment of financing of investment options. ImSET is also easier to use than extant macroeconomic simulation models and incorporates information developed by each of the EERE offices as part of the requirements of the Government Performance and Results Act.

Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings

Science.gov (United States)

Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie

2014-01-01

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845

Solvation of UCl{sub 6}{sup 2-} anionic complex by MeBu{sub 3}N{sup +}, BuMe{sub 2}Im{sup +} and BuMeIm{sup +} cations

Energy Technology Data Exchange (ETDEWEB)

Bosse, Emilie; Den Auwer, Christophe; Berthon, Claude; Guilbaud, Philippe; Moisy, Philippe [CEA Marcoule, DRCP/SCPS, BP 17171, 30207 Bagnols sur Ceze Cedex (France); Grigoriev, Mikhail S. [A.N. Frumkin Institute of Physical Chemistry and Electrochemistry, RAS, Leninskii Prosp. 31, 119991 Moscow (Russian Federation); Nikitenko, Serguei [CNAB, UMR 5084, CNRS - Universite de Bordeaux 1, BP 120 Le Haut Vigneau, 33175 Gradignan Cedex (France); Le Naour, Claire; Cannes, Celine [IPN, UMR 8608, CNRS, Universite Paris-Sud, 91406 Orsay (France)

2008-07-01

The complexes [MeBu{sub 3}N]{sub 2}[UCl{sub 6}] and [BuMe{sub 2}Im]{sub 2}[UCl{sub 6}] were characterized in the solid state and in solution of [MeBu{sub 3}N][Tf{sub 2}N], [BuMe{sub 2}Im][Tf{sub 2}N] and [BuMeIm][Tf{sub 2}N] room temperature ionic liquids using single-crystal XRD, EXAFS, electrochemistry, UV-visible absorption spectroscopy and NMR. In the solid and in solution, the existence of hydrogen bonding between the anionic UCl{sub 6}{sup 2-} complex and the ionic liquid cations were revealed by these techniques. The MeBu{sub 3}N{sup +} cation interacts with UCl{sub 6}{sup 2-} via the protons on the alpha carbon atoms of nitrogen. The protons of the imidazolium ring account for the interaction between the BuMe{sub 2}Im+ cation and the UCl{sub 6}{sup 2-} anion. For the BuMeIm{sup +} cation the major interaction was confirmed between the most acidic proton on C(2) and UCl{sub 6}{sup 2-}. The experimental results also show that the intensity of the interaction between the UCl{sub 6}{sup 2-} anion and the cation varies with the ionic liquid cation in the following order: MeBu{sub 3}N{sup +} {approx} BuMe{sub 2}Im{sup +} << BuMeIm{sup +}. (authors)

Handover Based IMS Registration Scheme for Next Generation Mobile Networks

Directory of Open Access Journals (Sweden)

Shireen Tahira

2017-01-01

Full Text Available Next generation mobile networks aim to provide faster speed and more capacity along with energy efficiency to support video streaming and massive data sharing in social and communication networks. In these networks, user equipment has to register with IP Multimedia Subsystem (IMS which promises quality of service to the mobile users that frequently move across different access networks. After each handover caused due to mobility, IMS provides IPSec Security Association establishment and authentication phases. The main issue is that unnecessary reregistration after every handover results in latency and communication overhead. To tackle these issues, this paper presents a lightweight Fast IMS Mobility (FIM registration scheme that avoids unnecessary conventional registration phases such as security associations, authentication, and authorization. FIM maintains a flag to avoid deregistration and sends a subsequent message to provide necessary parameters to IMS servers after mobility. It also handles the change of IP address for user equipment and transferring the security associations from old to new servers. We have validated the performance of FIM by developing a testbed consisting of IMS servers and user equipment. The experimental results demonstrate the performance supremacy of FIM. It reduces media disruption time, number of messages, and packet loss up to 67%, 100%, and 61%, respectively, as compared to preliminaries.

INTEGRATION OF MANAGEMENT SYSTEM QMS/EMS/OHSAS/FMS/LMS IN WATER SUPPLY ORGANIZATION

Directory of Open Access Journals (Sweden)

Slavko Arsovski

2007-12-01

Full Text Available Level of difficulties arises when goes up number of integrated management systems (IMS. In this paper are given model and empirical research which provide the details of an integrated management system with five component subsystems in area of water supply. Presented model addresses the issues of scope and carracterisctics based on process approach and is tested in water supply organization in Kragujevac, Serbia. Testing in the proposed model is accomplish through realization project of design and implementation of IMS in regional water supply organization in Kragujevac.

77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

Science.gov (United States)

2012-06-05

... Integrative and Public Health; Notice of Meeting AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The web meeting will be open to the public. The agenda...

Regelungen im Verkehr mit Lebensmitteln und Bedarfsgegenständen in Deutschland

Science.gov (United States)

Thomas, Gundula; Freund, Astrid; Gründig, Friedrich

Im Zuge der Globalisierung von Produktion und Handel ändert sich auch der Charakter der Vorschriften im Lebensmittelrecht. Zunehmend treten internationale Rechtsbestimmungen, Abkommen, Standards und andere Normen an die Stelle nationaler Regelungen.

Progress in the development of integrated mental health care in Scotland

Directory of Open Access Journals (Sweden)

Kevin Woods

2002-06-01

Full Text Available The development of integrated care through the promotion of ‘partnership working’ is a key policy objective of the Scottish Executive, the administration responsible for health services in Scotland. This paper considers the extent to which this goal is being achieved in mental health services, particularly those for people with severe and enduring mental illness. Distinguishing between the horizontal and vertical integration of services, exploratory research was conducted to assess progress towards this objective by examining how far a range of functional activities in Primary Care Trusts (PCTs and their constituent Local Health Care Co-operatives (LHCCs were themselves becoming increasingly integrated. All PCTs in Scotland were surveyed by postal questionnaire, and followed up by detailed telephone interviews. Six LHCC areas were selected for detailed case study analysis. A Reference Group was used to discuss and review emerging themes from the fieldwork. The report suggests that faster progress is being made in the horizontal integration of services between health and social care organisations than is the case for vertical integration between primary health care and specialist mental health care services; and that there are significant gaps in the extent to which functional activities within Trusts are changing to support the development of integrated care. A number of models are briefly considered, including the idea of ‘intermediate care’ that might speed the process of integration.

Manifestations of integrated public health policy in Dutch municipalities.

Science.gov (United States)

Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

2016-06-01

Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A future task for Health Promotion research: Integration of Health Promotion and sustainable development

DEFF Research Database (Denmark)

Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper

2018-01-01

Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health promotion research regarding integration of sustainable development principles....... Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired...... and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified: these are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development...

Robust stator resistance identification of an IM drive using model reference adaptive system

International Nuclear Information System (INIS)

Madadi Kojabadi, Hossein; Abarzadeh, Mostafa; Aghaei Farouji, Said

2013-01-01

Highlights: ► We estimate the stator resistance and rotor speed of the IM. ► We proposed a new quantity to estimate the speed and stator resistance of IM. ► The proposed algorithm is robust to rotor resistance variations. ► We estimate the IM speed and stator resistance simultaneously to avoid speed error. - Abstract: Model reference adaptive system (MRAS) based robust stator resistance estimator for sensorless induction motor (IM) drive is proposed. The MRAS is formed with a semi-active power quantity. The proposed identification method can be achieved with on-line tuning of the stator resistance with robustness against rotor resistance variations. Stable and efficient estimation of IM speed at low region will be guaranteed by simultaneous identification of IM speed and stator resistance. The stability of proposed stator resistance estimator is checked through Popov’s hyperstability theorem. Simulation and experimental results are given to highlight the feasibility, the simplicity, and the robustness of the proposed method.

Thermal Degradation Study of IM7/DMBZ-15 High Temperature Composite by TGA/FTIR

National Research Council Canada - National Science Library

Nadler, Melvin

2003-01-01

(U) High temperature graphite composites such as IM7/8552 epoxy, IM7/5250 BMI, and IM7/DMBZ-15 polyimide show blistering and/or "catastrophic" delamination when rapidly heated to temperatures above...

[Variation im heutigen Deutsch...] / Laura Tidrike

Index Scriptorium Estoniae

Tidrike, Laura

2008-01-01

Arvustus: Variation im heutigen Deutsch : Perspektiven für den Sprachunterricht / hrsg. v. Eva Neuland. Frankfurt am Main : Lang, 2006. (Sprache - Kommunikation - Kultur. Soziolinguistische Beiträge ; Vol. 4)

Global R&D through the Intelligent Manufacturing Systems (IMS) program

Science.gov (United States)

Huray, Paul G.

1997-01-01

The industry-led, international intelligent manufacturing systems (IMS) program provides a special vehicle for joint research and development between government, industry and academia in the United States, Canada, Japan, Australia, and Europe. Since its beginning in 1989, the IMS program has progressed through a feasibility phase which demonstrated that international legal barriers, trade issues, and intellectual property problems could be overcome. The program is constructed to provide higher quality design, customized products, shorter delivery cycles and lower costs. Interactions between partner companies have led to new business opportunities for mutual profit and some claim to have learned strategic information about their international competitors. The IMS program is growing through the participation of hundreds of corporate and university partners who share responsibilities in specific projects and jointly reap benefits for their manufacturing products and processes. The logic for choosing or not choosing the IMS mechanisms will be discussed and R and D projects will be identified.

Estudios por imágenes en reumatismo

Directory of Open Access Journals (Sweden)

Muñoz Ch. Sara, Dra.

2012-07-01

Los grandes avances tecnológicos de la última década han mejorado la calidad y cantidad de información que las distintas técnicas aportan, especialmente la RM; esto hace vislumbrar un cambio significativo en el diagnóstico por imágenes, ya que en el futuro no solo estará basado en los cambios morfológicos en órganos y tejidos; las imágenes obtenidas aportarán información bioquímica, molecular y fisiológica de los procesos patológicos facilitando su diagnóstico aun más precoz.

[European integration and health policies: repercussions of the internal European Market on access to health services].

Science.gov (United States)

Guimarães, Luisa; Giovanella, Lígia

2006-09-01

This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

Using IMS VDEX in Agrega

Directory of Open Access Journals (Sweden)

Jose Manuel Canabal

2009-03-01

Full Text Available An essential element in a learning object repository is the meta-information associated with the resources housed by the repository, as this is what enables the objects to be retrieved. In many cases, the meta-information which is described consists of the classification of a resource in relation to a taxonomy or thesaurus. Agrega is a network of learning object repositories in which an LOM profile, called LOM-ES, has been used to label the objects. Part of the meta-information described corresponds to the classification of the object with respect to a group of taxonomies and a thesaurus, which have had to be described using the ims vdex standard to enable them to be managed from the federation nodes. This article describes the way in which ims vdex has been used in order to create this description and how these metadata instances are managed.

Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

Directory of Open Access Journals (Sweden)

Nuria Toro Polanco

2015-06-01

Full Text Available Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii overall impact of integration through several indicators based on the Triple Aim Framework.Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

Directory of Open Access Journals (Sweden)

Nuria Toro Polanco

2015-06-01

Full Text Available Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions. Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii overall impact of integration through several indicators based on the Triple Aim Framework. Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure. Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

Integrated Systems Health Management for Intelligent Systems

Science.gov (United States)

Figueroa, Fernando; Melcher, Kevin

2011-01-01

The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

Integrating mental health and social development in theory and practice.

Science.gov (United States)

Plagerson, Sophie

2015-03-01

In many low and middle income countries, attention to mental illness remains compartmentalized and consigned as a matter for specialist policy. Despite great advances in global mental health, mental health policy and practice dovetail only to a limited degree with social development efforts. They often lag behind broader approaches to health and development. This gap ignores the small but growing evidence that social development unavoidably impacts the mental health of those affected, and that this influence can be both positive and negative. This article examines the theoretical and practical challenges that need to be overcome for a more effective integration of social development and mental health policy. From a theoretical perspective, this article demonstrates compatibility between social development and mental health paradigms. In particular, the capability approach is shown to provide a strong framework for integrating mental health and development. Yet, capability-oriented critiques on 'happiness' have recently been applied to mental health with potentially detrimental outcomes. With regard to policy and practice, horizontal and vertical integration strategies are suggested. Horizontal strategies require stronger devolution of mental health care to the primary care level, more unified messages regarding mental health care provision and the gradual expansion of mental health packages of care. Vertical integration refers to the alignment of mental health with related policy domains (particularly the social, economic and political domains). Evidence from mental health research reinforces aspects of social development theory in a way that can have tangible implications on practice. First, it encourages a focus on avoiding exclusion of those affected by or at risk of mental illness. Secondly, it underscores the importance of the process of implementation as an integral component of successful policies. Finally, by retaining a focus on the individual, it seeks to

A RuleML Study on Integrating Geographical and Health Information

DEFF Research Database (Denmark)

Gao, Sheng; Mioc, Darka; Boley, Harold

2008-01-01

To facilitate health surveillance, flexible ways to represent, integrate, and deduce health information become increasingly important. In this paper, an ontology is used to support the semantic definition of spatial, temporal and thematic factors of health information. The ontology is realized...... as an interchangeable RuleML knowledge base, consisting of facts and rules. Rules are also used for integrating geographical and health information. The implemented eHealthGeo system uses the OO jDREW reasoning engine to deduce implicit information such as spatial relationships. The system combines this with spatial...

Indicators and measurement tools for health system integration: a knowledge synthesis protocol.

Science.gov (United States)

Oelke, Nelly D; Suter, Esther; da Silva Lima, Maria Alice Dias; Van Vliet-Brown, Cheryl

2015-07-29

Health system integration is a key component of health system reform with the goal of improving outcomes for patients, providers, and the health system. Although health systems continue to strive for better integration, current delivery of health services continues to be fragmented. A key gap in the literature is the lack of information on what successful integration looks like and how to measure achievement towards an integrated system. This multi-site study protocol builds on a prior knowledge synthesis completed by two of the primary investigators which identified 10 key principles that collectively support health system integration. The aim is to answer two research questions: What are appropriate indicators for each of the 10 key integration principles developed in our previous knowledge synthesis and what measurement tools are used to measure these indicators? To enhance generalizability of the findings, a partnership between Canada and Brazil was created as health system integration is a priority in both countries and they share similar contexts. This knowledge synthesis will follow an iterative scoping review process with emerging information from knowledge-user engagement leading to the refinement of research questions and study selection. This paper describes the methods for each phase of the study. Research questions were developed with stakeholder input. Indicator identification and prioritization will utilize a modified Delphi method and patient/user focus groups. Based on priority indicators, a search of the literature will be completed and studies screened for inclusion. Quality appraisal of relevant studies will be completed prior to data extraction. Results will be used to develop recommendations and key messages to be presented through integrated and end-of-grant knowledge translation strategies with researchers and knowledge-users from the three jurisdictions. This project will directly benefit policy and decision-makers by providing an easy

EAI 2005 - Proceedings of the 2nd GI-Workshop on Enterprise Application Integration

NARCIS (Netherlands)

Lenz, R.; Hasenkamp, U.; Hasselbring, W.; Reichert, M.U.

Die heutige Flut von Informationsquellen im betrieblichen Umfeld bestimmt die immer weiter zunehmende Notwendigkeit der Integration von Anwendungssystemen und Datenbanken innerhalb der betrieblichen Datenverarbeitung und über Unternehmensgrenzen hinweg. Enterprise Application Integration (EAI)

İletişim Çalışmalarında Yeni Bir Mecra: Finansal İletişim

Directory of Open Access Journals (Sweden)

Gökhan Gökgöz

2013-09-01

Full Text Available 1970’li yıllar toplumsal ve politik tarih açısından önemli bir uğrağı temsil eder. Bu yılların başında yaşanan kriz, ekonominin işleyiş süreçlerini, devletin yapısını ve toplumsal alanın tasavvur edilme biçimini büyük ölçüde değiştirmiştir. Bu dönemde, finansal sermaye, kapitalizm içerisinde bir hegemonik lider olarak ön plana çıkmış; devlet, bir yandan üretimin çekirdeğinden uzak bir yerde konumlandırılırken diğer yandan paranın dolaşım kanallarının rehabilitasyonu işine odaklanmış; insana ilişkin değerler, kültürel mefhumlar ve toplumsal pratikler ise birer değişken olarak ekonomi-politikanın merkezine taşınmıştır. Kültür ile ekonomi arasındaki geleneksel ilişki bozulmuş; bir ekonomi-politikanın başarısı, toplumsal aktörlere temas etme kabiliyeti ile paralel hale gelmiştir. Finansallaşma sürecinde bu temas, iletişim politikaları vasıtasıyla sağlanır; ekonomi-politika ve bundan sorumlu merkezi kurumlarla toplumsal alan arasındaki bağ, iletişim stratejileri üzerinden kurulur; ekonomik alan ile kültürel alan arasındaki boşluk, iletişim kanalları içerisinden taşınan enformasyon marifetiyle doldurulur; insana ilişkin öngörülemezlikler, iletişim süreçleri vasıtasıyla öngörülebilir kılınır. Bu çalışmada, iletişim çalışmaları içerisinde yeni bir mecra olarak çağrılan “finansal iletişim”in farklı temas noktalarına işaret edilecek ve her bir uğrağın finansal iletişim alanına bağlandığı nokta, modeller üzerinden gösterilecektir. 

Ein Ausblick auf Supply-Chain-Management im Jahr 2016

DEFF Research Database (Denmark)

Wieland, Andreas

2016-01-01

Wie sieht Supply-Chain-Management im Jahr 2016 aus? Was erwartet uns? Vieles deutet darauf hin, dass SCM in Zukunft sogar noch mehr auf den Kunden gerichtet sein könnte als bisher.......Wie sieht Supply-Chain-Management im Jahr 2016 aus? Was erwartet uns? Vieles deutet darauf hin, dass SCM in Zukunft sogar noch mehr auf den Kunden gerichtet sein könnte als bisher....

Integration of clinical research documentation in electronic health records.

Science.gov (United States)

Broach, Debra

2015-04-01

Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

Organisation of work safety in the mining industry; Sicherheitsorganisation im Bergbau

Energy Technology Data Exchange (ETDEWEB)

Didier, V. [Bergbau-Berufsgenossenschaft, Bochum (Germany). Referat Unfallverhuetung

1999-10-07

The paper summarizes the main findings of a scientific study. Accident figures for the German mining industry indicate that, in comparison with other industries, there is still plenty of scope for increased prevention. However, the rapid development of safety technology alone is still yielding diminishing returns. The main route to increased safety in the mining industry is by way of improved safety management. Various methods are available for analyzing the efficiency of work-safety structures and procedures. Models for the classification of safety-relevant tasks are based on the legally appropriate and organisationally expedient allocation of responsibilities between management and safety experts. An important management tool in this respect is the hazard analysis procedure laid down in the European Union's Health and Safety at Work Act. Practical studies are used to illustrate that safety results can be improved through reorganisation without increasing prime costs. (orig.) [German] Der Beitrag fasst die wesentlichen Ergebnisse einer wissenschaftlichen Studie zusammen: Die Unfallentwicklung im deutschen Bergbau zeigt im Vergleich zu anderen Industriezweigen noch deutliche Reserven fuer die Praevention. Die Fortentwicklung der Sicherheitstechnik fuer sich allein liefert aber nur noch abnehmende Grenzertraege. Eine Strategie technischer und organisatorischer Einzeldirektiven reicht ebenfalls nicht aus. Der Weg zu besseren Sicherheitsresultaten im Bergbau fuehrt vor allem ueber optimierte Ablaeufe des Sicherheitsmanagements. Mit verschiedenen Methoden lassen sich Aufbau- und Ablauforganisation der Arbeitssicherheit auf ihre Effizienz untersuchen. Aus der juristisch implizierten und organisatorisch zweckmaessigen Aufgabenteilung zwischen Fuehrungskraeften und Sicherheitsexperten ergeben sich Zurodnungsmuster fuer sicherheitsrelevante Aufgaben. Ein wichtiges Fuehrungsinstrument sind Gefaehrdungsanalysen nach dem Arbeitsschutzrecht der Europaeischen Union. Anhand

Report on converging insert moulding with µ-IM

DEFF Research Database (Denmark)

Islam, Aminul

moulding with µ-IM  Task 5.2.1 and COTECH demonstrator: guide line for 5PRC production based on the concept of Task 5.2.1 Information and results provided by this deliverable will be directly used for one of the COTECH demonstrators production which will call for convergent insert moulding with µ......Task 5.2.1 deals with the technical feasibility of converging the state-of-the-art µ IM process with insert moulding to offer a wide range of multi-material µ components. The main objective of this deliverable is to summarize state-of-the-art information and to make the guideline needed...... for the convergence. In particular the following aspects are summed up in the deliverable:  Need for converging insert moulding with µ-IM  Objectives and expected outcome from task 5.2.1  State-of-the-art micro insert moulding and different scenario of micro insert moulding  Challenges ahead of converging insert...

Principles and core functions of integrated child health information systems.

Science.gov (United States)

Hinman, Alan R; Atkinson, Delton; Diehn, Tonya Norvell; Eichwald, John; Heberer, Jennifer; Hoyle, Therese; King, Pam; Kossack, Robert E; Williams, Donna C; Zimmerman, Amy

2004-11-01

Infants undergo a series of preventive and therapeutic health interventions and activities. Typically, each activity includes collection and submission of data to a dedicated information system. Subsequently, health care providers, families, and health programs must query each information system to determine the child's status in a given area. Efforts are underway to integrate information in these separate information systems. This requires specifying the core functions that integrated information systems must perform.

Investigation of Integrated Vehicle Health Management Approaches

Science.gov (United States)

Paris, Deidre

2005-01-01

This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

Digital Medien im Naturwissenschaftlichen Unterricht

CERN Document Server

Meßinger-Koppelt, Jenny

2014-01-01

„Morgens, 8 Uhr: Kurz vor der Schultür werden noch die neuesten Posts auf Facebook geliked, ein Selfie in die Whats-App-Gruppe hochgeladen oder auf YouTube noch ein #LOL-Video gestreamed. Dann klingelt es und die Digital Natives greifen wieder zu Stift, Papier und werden frontal mit Fakten gefüttert“ (A. Spang). Für Schüler sind Internet, Smartphone und Tablet-PC heute selbstverständlicher Teil ihrer Lernwelt. Und auch die Alltags- und Berufswelt ist ohne Informationstechnologien nicht mehr vorstellbar. Doch was bedeutet das für den Schulunterricht, insbesondere für die techniknahen Naturwissenschaften? Wie gelingt im Schulalltag die Balance zwischen Kreidezeit und interaktivem Whiteboard nach mittlerweile 30 Jahren Erfahrung mit Schulcomputern? Der vorliegende Sammelband präsentiert zahlreiche Praxisbeispiele aus dem Schulalltag zum sinnvollen Einsatz digitaler Medien im Biologie-, Chemie- und Physik-Unterricht sowie den aktuellen Stand der fachdidaktischen Forschung. Zu Wort kommen Hochschullehr...

Co-Leadership - A Management Solution for Integrated Health and Social Care.

Science.gov (United States)

Klinga, Charlotte; Hansson, Johan; Hasson, Henna; Sachs, Magna Andreen

2016-05-23

Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers - each manager representing one of the two principal organizations in integrated health and social care services - was explored. To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.

Civil war, social integration and mental health in Croatia.

Science.gov (United States)

Kunovich, R M; Hodson, R

1999-12-01

Research has shown that social relationships are generally beneficial for mental health (Thoits 1995). However, few scholars have examined this association after the occurrence of a significant shock to the social system as a whole. The purpose of this article is to examine the relationship between social integration and war-related distress in Croatia immediately following the recent civil war. Does social integration decrease war-related distress? Does social integration buffer the effect of traumatic events on war-related distress? We analyze these questions using nationally representative survey data collected in Croatia in 1996. Results suggest that social integration has both positive and negative direct effects on distress. Being a member of informal organizations, such as sports clubs, and participating in social activities are beneficial for mental health. On the other hand, being a member of some formal organizations, such as church organizations and unions, is detrimental to mental health. There is little support for the idea that social integration buffers the effect of traumatic events on distress. Only one of thirty-six possible interactions is significant and supports the buffer hypothesis. Frequent participation in social activities buffers the effect of experiencing violence on war-related distress. Also, some forms of social integration appear to aggravate the effect of traumatic events on war-related distress. In sum, social integration does affect war-related distress after a system shock, but in complex and sometimes unexpected ways.

Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.

Science.gov (United States)

Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M

2016-05-01

The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.

Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

Directory of Open Access Journals (Sweden)

Grace Haeson Park

2014-03-01

Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

Administrative Challenges to the Integration of Oral Health With Primary Care

Science.gov (United States)

Maxey, Hannah L.; Randolph, Courtney; Gano, Laura; Kochhar, Komal

2017-01-01

Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce. PMID:27218701

Integrating GDM management in public health: Pakistan perspective.

Science.gov (United States)

Riaz, Musarrat; Basit, Abdul

2016-09-01

Pakistan is a developing country with diverse social, economic and cultural dimensions along with limited resources. Non communicable diseases (NCDS) including diabetes are highly prevalent compromising the already challenged health care system. Gestational diabetes mellitus (GDM) with its associated maternal and foetal complications is increasing with rapidly changing lifestyle pattern. Since Pakistan has limited resources and other health issues compete strongly with gestational diabetes initiatives, the most feasible strategy will be the horizontal integration. This will work with the existing primary health care system integrating NCD control programmes with Maternal and Child health (MCH) programmes. Utilizing the existing health care system is the only implementable cost effective strategy. Antenatal screening and treatment of GDM alone is not sufficient but Post-partum screening (PPS) of women with GDM is an important strategy for prevention of diabetes as the conversion rates of GDM to type 2 diabetes are high. Furthermore, instead of perceiving GDM as a temporary reversible clinical entity, it should be considered as a trans-generational prevention of diabetes that needs to be addressed as a public health issue in order to improve maternal and foetal health.

Cross-sectional environmental study comparing two highly polluted areas in Germany (Bitterfeld and Hettstedt) with a control region; Umweltmedizinische Untersuchungen im Raum Bitterfeld, im Raum Hettstedt und einem Vergleichsgebiet 1992-2000. Bd. 1: Textband. Bd. 2: Publikationen. Bd. 3: Untersuchungsdokumente und Frageboegen. Abschlussbericht

Energy Technology Data Exchange (ETDEWEB)

Heinrich, J.; Frye, C.; Hoelscher, B.; Meyer, I.; Pitz, M.; Cyrys, J.; Schneller, H.; Wjst, M.; Wichmann, H.E.

2001-10-01

The aim of the environmental epidemiologic study was to determine possible negative effects on the health of children in the very polluted areas of Bitterfeld and Hettstedt in comparison to the less polluted areas of Anhalt-Zerbst (Eastern Germany). The time changes of the health parameters were recorded along with the running redevelopments during the time period of 6 years. The study design consisted of three repeated regional cross sectional studies in 1992/93, 1995/96 and 1998/99. In all, there was information of 7.611 questionnaires to be analysed (participation rate: 89%, 75% and 75%). Children living in the most polluted area of Hettstedt had a noticeable higher risk for non allergic respiratory diseases and symptoms compared to children living in the control area of Anhalt-Zerbst. During the time of the examinations in 1992 till 1999 a clear statistically significant decrease in the prevalences of these restrictions of health could be shown. Children without indoor pollutants in their homes profited most by the improvement of ambient air quality. The better lung function (FVC, FEV{sub 1}) between 1992 and 1999 underlines the improvement of the respiratory health. Children living in both polluted ares have allergies more often (physician's diagnosis, symptoms, allergy specific antibodies). The incidence of asthma, the bronchial hyperreactivity and atopic exzema increased, the prevalence of rhinitis and allergic sensitization did not increase. The body burden with lead and cadmium was higher in children living in polluted areas, but it decreased during the period of observation. In 1997, however, the lead concentration in blood increased a little, parallel to the higher lead concentration in settled dust in Hettstedt at that time. (orig.) [German] Ziel der umweltepidemiologischen Studie war es, moegliche gesundheitliche Beeitraechtigungen von Kindern in den Belastungsgebieten Bitterfeld und Hettstedt i. Vgl. zu dem wenig belasteten Gebiet Anhalt

Cross-sectional environmental study comparing two highly polluted areas in Germany (Bitterfeld and Hettstedt) with a control region; Umweltmedizinische Untersuchungen im Raum Bitterfeld, im Raum Hettstedt und einem Vergleichsgebiet 1992-2000. Bd. 1: Textband. Bd. 2: Publikationen. Bd. 3: Untersuchungsdokumente und Frageboegen. Abschlussbericht

Energy Technology Data Exchange (ETDEWEB)

Heinrich, J; Frye, C; Hoelscher, B; Meyer, I; Pitz, M; Cyrys, J; Schneller, H; Wjst, M; Wichmann, H E

2001-10-01

The aim of the environmental epidemiologic study was to determine possible negative effects on the health of children in the very polluted areas of Bitterfeld and Hettstedt in comparison to the less polluted areas of Anhalt-Zerbst (Eastern Germany). The time changes of the health parameters were recorded along with the running redevelopments during the time period of 6 years. The study design consisted of three repeated regional cross sectional studies in 1992/93, 1995/96 and 1998/99. In all, there was information of 7.611 questionnaires to be analysed (participation rate: 89%, 75% and 75%). Children living in the most polluted area of Hettstedt had a noticeable higher risk for non allergic respiratory diseases and symptoms compared to children living in the control area of Anhalt-Zerbst. During the time of the examinations in 1992 till 1999 a clear statistically significant decrease in the prevalences of these restrictions of health could be shown. Children without indoor pollutants in their homes profited most by the improvement of ambient air quality. The better lung function (FVC, FEV{sub 1}) between 1992 and 1999 underlines the improvement of the respiratory health. Children living in both polluted ares have allergies more often (physician's diagnosis, symptoms, allergy specific antibodies). The incidence of asthma, the bronchial hyperreactivity and atopic exzema increased, the prevalence of rhinitis and allergic sensitization did not increase. The body burden with lead and cadmium was higher in children living in polluted areas, but it decreased during the period of observation. In 1997, however, the lead concentration in blood increased a little, parallel to the higher lead concentration in settled dust in Hettstedt at that time. (orig.) [German] Ziel der umweltepidemiologischen Studie war es, moegliche gesundheitliche Beeitraechtigungen von Kindern in den Belastungsgebieten Bitterfeld und Hettstedt i. Vgl. zu dem wenig belasteten Gebiet Anhalt-Zerbst zu

Lagrangian Stochastic Dispersion Model IMS Model Suite and its Validation against Experimental Data

International Nuclear Information System (INIS)

Bartok, J.

2010-01-01

The dissertation presents IMS Lagrangian Dispersion Model, which is a 'new generation' Slovak dispersion model of long-range transport, developed by MicroStep-MIS. It solves trajectory equation for a vast number of Lagrangian 'particles' and stochastic equation that simulates the effects of turbulence. Model contains simulation of radioactive decay (full decay chains of more than 300 nuclides), and dry and wet deposition. Model was integrated into IMS Model Suite, a system in which several models and modules can run and cooperate, e.g. LAM model WRF preparing fine resolution meteorological data for dispersion. The main theme of the work is validation of dispersion model against large scale international campaigns CAPTEX and ETEX, which are two of the largest tracer experiments. Validation addressed treatment of missing data, data interpolation into comparable temporal and spatial representation. The best model results were observed for ETEX I, standard results for CAPTEXes and worst results for ETEX II, known in modelling community for its meteorological conditions that can be hardly resolved by models. The IMS Lagrangian Dispersion Model was identified as capable long range dispersion model for slowly- or nonreacting chemicals and radioactive matter. Influence of input data on simulation quality is discussed within the work. Additional modules were prepared according to praxis requirement: a) Recalculation of concentrations of radioactive pollutant into effective doses form inhalation, immersion in the plume and deposition. b) Dispersion of mineral dust was added and tested in desert locality, where wind and soil moisture were firstly analysed and forecast by WRF. The result was qualitatively verified in case study against satellite observations. (author)

Studying integrated health care systems with a structurationist approach

Science.gov (United States)

Demers, Louis; Arseneault, Stéphane; Couturier, Yves

2010-01-01

Introduction To implement an integrated health care system is not an easy task and to ensure its sustainability is yet more difficult. Aim Discuss how a structurationist approach can shed light on the stakes of these processes and guide the managers of such endeavours. Theory and method Structuration theory [1] has been used by numerous authors to cast new light on complex organizational phenomena. One of the central tenets of this theory is that social systems, such as integrated health care systems, are recurrent social practices across time-space and are characterized by structural properties which simultaneously constrain and enable the constitutive social actors who reproduce and transform the system through their practices. We will illustrate our theoretical standpoint with empirical material gathered during the study of an integrated health care system for the frail elderly in Quebec, Canada. This system has been implemented in 1997 and is still working well in 2010. Results and conclusion To implement an integrated health care system that is both effective and sustainable, its managers must shrewdly allow for the existing system and progressively introduce changes in the way managers and practitioners at work in the system view their role and act on a daily basis.

Detection of microbial volatile organic compounds (MVOC) by means of ion mobility spectroscopy (IMS); Detektion leicht fluechtiger organischer Verbindungen mikrobiellen Ursprungs (MVOC) mittels Ionenmobilitaetsspektrometrie (IMS)

Energy Technology Data Exchange (ETDEWEB)

Tiebe, Carlo

2010-07-01

Traces of microbial volatile organic compounds (MVOCs) can indicate the growth of moulds in the indoor air. The application of ion mobility spectrometry (IMS) is a very promising method for the detection of these MVOCs due to its high sensitivity. A mobile IMS device was tested to use this analytical-chemical method for in situ indoor air diagnostics. The first part of this work describes the test gas generation of 14 MVOCs in the laboratory. The test gases were produced by preparation of permeation procedures. Due to the MVOCs test gases IMS parameters like reduced mobility (K{sub 0}), relative drift time (t{sub rd}), the concentration dependency of MVOCs signals were determined and the limit of detection (LOD) was calculated. The LODs are in the range of 2 to 192 {mu}g m{sup -3} (1 to 51 ppb{sub V}). In the second part of this manuscript seven different mould species were cultivated on nutrient media and their MVOCs emissions were explored. It was found out, that the MVOCs emissions of moulds have a dependency of species and of their cultivation time. These results are confirmed by principal component analysis (PCA). The identification of these MVOCs was performed by test-related GC-MS analysis and approved these results. The MVOCs emissions were explored in the cultivation of mould mixtures on three different building materials. The IMS-results were interpreted chemo metrically by PCA. It was possible to find different emission patterns of cultivated moulds on building materials without an identification of the MVOCs inside the emission chamber. In 27 field trials of different indoor environments (rooms) the IMS was tested to detect MVOCs. In 59 % of the cases a positive correlation is determined between visible mould-infested rooms and the detected MVOCs by IMS. (orig.)

[Photoionization ion mobility spectrometry (UV-IMS) for the isomeric volatile organic compounds].

Science.gov (United States)

Li, Hu; Niu, Wen-qi; Wang, Hong-mei; Huang, Chao-qun; Jiang, Hai-he; Chu, Yan-nan

2012-01-01

The construction and performance study is reported for a newly developed ultraviolet photoionization ion mobility spectrometry (UV-IMS). In the present paper, an UV-IMS technique was firstly developed to detect eleven isomeric volatile organic compounds including the differences in the structure of carbon chain, the style of function group and the position of function group. Their reduced mobility values were determined and increased in this order: linears alcohols homemade UV-IMS was around ppb-ppm.

[Einheit und Vielfalt in der Rechtsgeschichte im Ostseeraum] / Marelle Leppik

Index Scriptorium Estoniae

Leppik, Marelle

2013-01-01

Arvustus: Einheit und Vielfalt in der Rechtsgeschichte im Ostseeraum. Unity and plurality in the legal history of the Baltic Sea area Sechster Rechtshistorikertag im Ostseeraum, 3.-5. Juni 2010 Tartu (Estland) / Riga (Lettland9. Hrsg. von Marju Luts-Sootak, Sanita Osipova und Frank L. Schäfer. (Rechtshistorische Reihe, Bd. 428.) Land. Frankfurt am Main u. a. 2012

Frauen im Netz weltweit – ausgegrenzt und mittendrin

Directory of Open Access Journals (Sweden)

Sigrid Peuker

2003-03-01

Full Text Available Mit dem Global Center for Women’s Studies and Politics (GLOW ist das Feministische Institut der Heinrich-Böll-Stiftung 1998 online gegangen. Mit diesem Schritt wurden Fragen nach den Möglichkeiten und Grenzen sowie nach den Gestaltungsräumen virtueller Kommunikation für Frauen zentral. Mit feminist_spaces. Frauen im Netz. Diskurse – Communities – Visionen, legt die Heinrich-Böll-Stiftung zusammen mit dem Feministischen Institut Antworten aus internationaler Perspektive vor. Das Buch geht auf die gleichnamige zweitätige Konferenz in Berlin im November 2001 zurück.

Partnered research in healthcare delivery redesign for high-need, high-cost patients: development and feasibility of an Intensive Management Patient-Aligned Care Team (ImPACT).

Science.gov (United States)

Zulman, Donna M; Ezeji-Okoye, Stephen C; Shaw, Jonathan G; Hummel, Debra L; Holloway, Katie S; Smither, Sasha F; Breland, Jessica Y; Chardos, John F; Kirsh, Susan; Kahn, James S; Asch, Steven M

2014-12-01

We employed a partnered research healthcare delivery redesign process to improve care for high-need, high-cost (HNHC) patients within the Veterans Affairs (VA) healthcare system. Health services researchers partnered with VA national and Palo Alto facility leadership and clinicians to: 1) analyze characteristics and utilization patterns of HNHC patients, 2) synthesize evidence about intensive management programs for HNHC patients, 3) conduct needs-assessment interviews with HNHC patients (n = 17) across medical, access, social, and mental health domains, 4) survey providers (n = 8) about care challenges for HNHC patients, and 5) design, implement, and evaluate a pilot Intensive Management Patient-Aligned Care Team (ImPACT) for a random sample of 150 patients. HNHC patients accounted for over half (52 %) of VA facility patient costs. Most (94 %) had three or more chronic conditions, and 60 % had a mental health diagnosis. Formative data analyses and qualitative assessments revealed a need for intensive case management, care coordination, transitions navigation, and social support and services. The ImPACT multidisciplinary team developed care processes to meet these needs, including direct access to team members (including after-hours), chronic disease management protocols, case management, and rapid interventions in response to health changes or acute service use. Two-thirds of invited patients (n = 101) enrolled in ImPACT, 87 % of whom remained actively engaged at 9 months. ImPACT is now serving as a model for a national VA intensive management demonstration project. Partnered research that incorporated population data analysis, evidence synthesis, and stakeholder needs assessments led to the successful redesign and implementation of services for HNHC patients. The rigorous design process and evaluation facilitated dissemination of the intervention within the VA healthcare system. Employing partnered research to redesign care for high-need, high

Barriers and facilitators to the integration of mental health services into primary health care: a systematic review protocol.

Science.gov (United States)

Wakida, Edith K; Akena, Dickens; Okello, Elialilia S; Kinengyere, Alison; Kamoga, Ronald; Mindra, Arnold; Obua, Celestino; Talib, Zohray M

2017-08-25

Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works. This review will use the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework approach to identify experiences of mental health integration into PHC; the findings will be reported using the "Best fit" framework synthesis. PubMed, EMBASE, PsycINFO, and Cochrane Central Register of Controlled trials (CENTRAL) will be searched including other sources like the WHO website and OpenGrey database. Assessment of bias and quality will be done at study level using two separate tools to check for the quality of evidence presented. Data synthesis will take on two synergistic approaches (qualitative and quantitative studies). Synthesizing evidence from countries across the globe will provide useful insights into the experiences of integrating mental health services into PHC and how the barriers and challenges have been handled. The findings will be useful to a wide array of stakeholders involved in the implementation of the mental health integration into PHC. The SPIDER framework has been chosen for this review because of its suitable application to qualitative and mixed methods research and will be used as a guide when selecting articles for inclusion. Data extracted will be synthesized using the "Best fit" framework because it has been used before and proved its suitability in producing new conceptual models for explaining decision-making and possible behaviors. Synthesizing evidence from countries across the globe

'Trust and teamwork matter': community health workers' experiences in integrated service delivery in India.

Science.gov (United States)

Mishra, Arima

2014-01-01

A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011-2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive 'teamwork' and 'building trust with the community' (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology - which the health workers espouse - is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration.

[Differences and similarities in approach of integrated strategy for dengue prevention and control between Colombia and Peru].

Science.gov (United States)

Castro-Orozco, Raimundo; Alvis-Guzmán, Nelson; Gómez-Arias, Rubén

2015-10-01

We analyzed and compared two Integrated Management Strategies for Dengue Prevention and Control (IMS-dengue Colombia and IMS-dengue Peru), through a narrative review of available literature, in order to identify common and dissimilar patterns in two Andean countries with epidemiological differences in the context of dengue disease. We were able to identify differences related to: formal assessment of problem, formation of groups of actors, and quantitative information provided by performance indicators. These limitations identified in IMS-dengue Colombia 2006-2010 were overcome in a new version of the strategy (IMS-dengue Colombia 2012-2021). We were able to document an epidemiological impact of implementation of IMS-dengue Colombia 2006-2010. Additionally, a gradual increase was observed in incidence rates of dengue cases that could be related to the strengthening of surveillance system of IMS- dengue Peru.

Integrated medication management in mHealth applications.

Science.gov (United States)

Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

2014-01-01

Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service.

Integrating health and environmental impact analysis.

Science.gov (United States)

Reis, S; Morris, G; Fleming, L E; Beck, S; Taylor, T; White, M; Depledge, M H; Steinle, S; Sabel, C E; Cowie, H; Hurley, F; Dick, J McP; Smith, R I; Austen, M

2015-10-01

Scientific investigations have progressively refined our understanding of the influence of the environment on human health, and the many adverse impacts that human activities exert on the environment, from the local to the planetary level. Nonetheless, throughout the modern public health era, health has been pursued as though our lives and lifestyles are disconnected from ecosystems and their component organisms. The inadequacy of the societal and public health response to obesity, health inequities, and especially global environmental and climate change now calls for an ecological approach which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose a new conceptual model, the ecosystems-enriched Drivers, Pressures, State, Exposure, Effects, Actions or 'eDPSEEA' model, to address this shortcoming. The model recognizes convergence between the concept of ecosystems services which provides a human health and well-being slant to the value of ecosystems while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession. It will require outreach to political and other stakeholders including a currently largely disengaged general public. The need for an effective and robust science-policy interface has

Integrating the Principles of Socioecology and Critical Pedagogy for Health Promotion Health Literacy Interventions.

Science.gov (United States)

Dawkins-Moultin, Lenna; McDonald, Andrea; McKyer, Lisako

2016-01-01

While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level.

Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach.

Science.gov (United States)

Fragidis, Leonidas L; Chatzoglou, Prodromos D; Aggelidis, Vassilios P

2016-11-14

The integration of heterogeneous electronic health records systems by building an interoperable nationwide electronic health record system provides undisputable benefits in health care, like superior health information quality, medical errors prevention and cost saving. This paper proposes a semi-distributed system architecture approach for an integrated national electronic health record system incorporating the advantages of the two dominant approaches, the centralized architecture and the distributed architecture. The high level design of the main elements for the proposed architecture is provided along with diagrams of execution and operation and data synchronization architecture for the proposed solution. The proposed approach effectively handles issues related to redundancy, consistency, security, privacy, availability, load balancing, maintainability, complexity and interoperability of citizen's health data. The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the characteristics of the Greek national healthcare system along with the national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.

Integrative Health and Healing as the New Health Care Paradigm for the Military.

Science.gov (United States)

Petri, Richard P

2015-10-01

Background: The field of integrative health and healing (IH 2 ) is emerging out of the dark recesses of "voodoo" stereotypes and into the light as a new and much needed health care paradigm. It is a philosophy of health and healing that seeks to place patients as the preeminent players in health management, disease prevention, and injury recovery. There is an emphasis of patient responsibility, which includes a holistic approach that merges allopathic with complementary medicine. Objective: The aim of this article is to explore the historical origins of integrative medicine and investigate the future role of the IH 2 paradigm. Methods: This article reviews current available data and information regarding complementary and alternative medicine utilized in civilian and military populations as the basis for a new paradigm for a system of care-a system that empowers patients. Conclusions: The current U.S. health care system is reactive and disease-based, with a focus on reductionism. This system is not serving us well. IH 2 is a new model of cost-effective patient-centered health care.

An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

Science.gov (United States)

Dwinnells, Ronald; Misik, Lauren

2017-10-01

Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

Implementation of integrated management system

International Nuclear Information System (INIS)

Gaspar Junior, Joao Carlos A.; Fonseca, Victor Zidan da

2007-01-01

In present day exist quality assurance system, environment, occupational health and safety such as ISO9001, ISO14001 and OHSAS18001 and others standards will can create. These standards can be implemented and certified they guarantee one record system, quality assurance, documents control, operational control, responsibility definition, training, preparing and serve to emergency, monitoring, internal audit, corrective action, continual improvement, prevent of pollution, write procedure, reduce costs, impact assessment, risk assessment , standard, decree, legal requirements of municipal, state, federal and local scope. These procedure and systems when isolate applied cause many management systems and bureaucracy. Integration Management System reduce to bureaucracy, excess of documents, documents storage and conflict documents and easy to others standards implementation in future. The Integrated Management System (IMS) will be implemented in 2007. INB created a management group for implementation, this group decides planing, works, policy and advertisement. Legal requirements were surveyed, internal audits, pre-audits and audits were realized. INB is partially in accordance with ISO14001, OSHAS18001 standards. But very soon, it will be totally in accordance with this norms. Many studies and works were contracted to deal with legal requirements. This work have intention of show implementation process of ISO14001, OHSAS18001 and Integrated Management System on INB. (author)

Integrated Multilayer Insulation

Science.gov (United States)

Dye, Scott

2009-01-01

Integrated multilayer insulation (IMLI) is being developed as an improved alternative to conventional multilayer insulation (MLI), which is more than 50 years old. A typical conventional MLI blanket comprises between 10 and 120 metallized polymer films separated by polyester nets. MLI is the best thermal- insulation material for use in a vacuum, and is the insulation material of choice for spacecraft and cryogenic systems. However, conventional MLI has several disadvantages: It is difficult or impossible to maintain the desired value of gap distance between the film layers (and consequently, it is difficult or impossible to ensure consistent performance), and fabrication and installation are labor-intensive and difficult. The development of IMLI is intended to overcome these disadvantages to some extent and to offer some additional advantages over conventional MLI. The main difference between IMLI and conventional MLI lies in the method of maintaining the gaps between the film layers. In IMLI, the film layers are separated by what its developers call a micro-molded discrete matrix, which can be loosely characterized as consisting of arrays of highly engineered, small, lightweight, polymer (typically, thermoplastic) frames attached to, and placed between, the film layers. The term "micro-molded" refers to both the smallness of the frames and the fact that they are fabricated in a process that forms precise small features, described below, that are essential to attainment of the desired properties. The term "discrete" refers to the nature of the matrix as consisting of separate frames, in contradistinction to a unitary frame spanning entire volume of an insulation blanket.

Associations between United States Medical Licensing Examination (USMLE) and Internal Medicine In-Training Examination (IM-ITE) scores.

Science.gov (United States)

McDonald, Furman S; Zeger, Scott L; Kolars, Joseph C

2008-07-01

Little is known about the associations of previous standardized examination scores with scores on subsequent standardized examinations used to assess medical knowledge in internal medicine residencies. To examine associations of previous standardized test scores on subsequent standardized test scores. Retrospective cohort study. One hundred ninety-five internal medicine residents. Bivariate associations of United States Medical Licensing Examination (USMLE) Steps and Internal Medicine In-Training Examination (IM-ITE) scores were determined. Random effects analysis adjusting for repeated administrations of the IM-ITE and other variables known or hypothesized to affect IM-ITE score allowed for discrimination of associations of individual USMLE Step scores on IM-ITE scores. In bivariate associations, USMLE scores explained 17% to 27% of the variance in IME-ITE scores, and previous IM-ITE scores explained 66% of the variance in subsequent IM-ITE scores. Regression coefficients (95% CI) for adjusted associations of each USMLE Step with IM-ITE scores were USMLE-1 0.19 (0.12, 0.27), USMLE-2 0.23 (0.17, 0.30), and USMLE-3 0.19 (0.09, 0.29). No single USMLE Step is more strongly associated with IM-ITE scores than the others. Because previous IM-ITE scores are strongly associated with subsequent IM-ITE scores, appropriate modeling, such as random effects methods, should be used to account for previous IM-ITE administrations in studies for which IM-ITE score is an outcome.

Special integrals of Gradshteyn and Ryzhik the proofs

CERN Document Server

Moll, Victor H

2014-01-01

A Guide to the Evaluation of IntegralsSpecial Integrals of Gradshetyn and Ryzhik: The Proofs provides self-contained proofs of a variety of entries in the frequently used table of integrals by I.S. Gradshteyn and I.M. Ryzhik. The book gives the most elementary arguments possible and uses Mathematica® to verify the formulas. Readers discover the beauty, patterns, and unexpected connections behind the formulas.Volume I collects 15 papers from Revista Scientia covering logarithmic integrals, the gamma function, trigonometric integrals, the beta function, the digamma function, the incomplete beta

Wir und die Anderen: Gruppenbezogene Menschenfeindlichkeit im Sport in Sachsen

OpenAIRE

Delto, Hannes; Tzschoppe, Petra

2015-01-01

Mit der Querschnittsstudie "Wir und die Anderen – Gruppenbezogene Menschenfeindlichkeit im organisierten Sport in Sachsen" wurde erstmals das Syndrom Gruppenbezogener Menschenfeindlichkeit im organisierten Sport untersucht. Das Konzept der Gruppenbezogenen Menschenfeindlichkeit – ausgehend von einer Ideologie der Ungleichwertigkeit – wurde von Prof. Wilhelm Heitmeyer (Universität Bielefeld) entwickelt. Die Ergebnisse ermöglichen explizite Aussagen über Ausmaß und Ursachen Gruppenbezogener Men...

Grand Prix Eurovision: Eine Fankultur im Medienzeitalter

Directory of Open Access Journals (Sweden)

Heinz Moser

2017-06-01

Full Text Available Der Grand Prix Eurovision ist seit Jahrzehnten eine der bekanntesten Unterhaltungssendungen im europäischen Raum. Dennoch erregte es Verwunderung, wenn der Schreibende Bekannten darüber berichtete, daß dies ein Forschungsgegenstand sei. Wurde von Interviews mit Grand Prix-Fans erzählt, so fielen schnell Aussagen wie: „Wie kann man sich nur für so etwas Abseitiges und Triviales wie den Grand Prix interessieren“. Dennoch bin ich der Meinung, daß Fankulturen für die entstehende Mediengesellschaft ein nicht unwichtiges Forschungsthema darstellen. Zwar geht es nicht um eine medienpädagogische Fragestellung im engeren Sinne; die Fans des Grand Prix Eurovision sind dem Jugendalter längst entwachsen. Dennoch handelt es sich bei Fangemeinschaften um Phänomene, die im Rahmen von Jugend- und Kinderkulturen von besonderer Relevanz sind. So meint Winter (1997, daß jugendliche Fanwelten eine bedeutende Rolle als Kristallisationspunkte kultureller Differenzierung spielen: ,Die Zugehörigkeit zu einer Fan weit ist Teil der jugendlichen Lebensbewältigung in der Postmoderne, denn in der Gemeinschaft der Fans können Jugendliche emotionale Allianzen eingehen, außeralltäglichen Beschäftigungen nachgehen, expressive Identitätsmuster gemeinschaftlich realisieren und sich mit ihrer Lebenssituation als Heranwachsende auseinandersetzen“ (Winter 1997, S. 51f..

Preparing Social Work Students for Integrated Health Care: Results from a National Study

Science.gov (United States)

Held, Mary Lehman; Mallory, Kim Crane; Cummings, Sherry

2017-01-01

Integrated health care serves a vital role in addressing interrelated physical and behavioral health conditions, but social work graduates often lack sufficient training to work on integrated teams. We surveyed 94 deans of master's of social work programs to assess the current and planned integrated health care curricula and the aptitude of…

Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

Directory of Open Access Journals (Sweden)

Christos Lionis

2009-07-01

Full Text Available Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose: This paper explores the extent to which integrated primary health care (PHC is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development.

Integrating health promotion and disease prevention interventions with vaccination in Honduras.

Science.gov (United States)

Molina-Aguilera, Ida Berenice; Mendoza-Rodríguez, Lourdes Otilia; Palma-Ríos, María Aparicia; Danovaro-Holliday, M Carolina

2012-03-01

We sought to review and describe health interventions integrated with immunization delivery, both routine and during national vaccination weeks, in Honduras between 1991 and 2009. We compiled and examined all annual evaluation reports from the national Expanded Program on Immunization and reports from the national vaccination weeks (NVWs) between 1988 and 2009. We held discussions with the persons responsible for immunization and other programs in the Health Secretary of Honduras for the same time period. Since 1991, several health promotion and disease prevention interventions have been integrated with immunization delivery, including vitamin A supplementation (since 1994), folic acid supplementation (2003), early detection of retinoblastoma (since 2003), breastfeeding promotion (2007-2008), and disease control activities during public health emergencies, such as cholera control (1991-1992) and dengue control activities (since 1991, when a dengue emergency coincides with the NVW). Success factors included sufficient funds and supplies to ensure sustainability and joint planning, delivery, and monitoring. Several health interventions have been integrated with vaccination delivery in Honduras for nearly 20 years. The immunization program in Honduras has sufficient structure, organization, acceptance, coverage, and experience to achieve successful integration with health interventions if carefully planned and suitably implemented.

The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

OpenAIRE

Heusser, Peter; Eberhard, Sabine; Berger, Bettina; Weinzirl, Johannes; Orlow, Pascale

2014-01-01

Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland...

Integrative Medicine and Mood, Emotions and Mental Health.

Science.gov (United States)

Shah, Anuj K; Becicka, Roman; Talen, Mary R; Edberg, Deborah; Namboodiri, Sreela

2017-06-01

An integrative approach to individuals with mood, emotional or mental health concerns involves a comprehensive model of care that is person-centered. Integrative medicine builds on a patient's personal meaning and goals (spiritual aspects) and includes herbal therapies, nutritional support, movement and physical manipulative therapies, mindfulness, relaxation strategies, and psychotherapies. Published by Elsevier Inc.

'Are we there yet?' - operationalizing the concept of Integrated Public Health Policies.

Science.gov (United States)

Hendriks, Anna-Marie; Habraken, Jolanda; Jansen, Maria W J; Gubbels, Jessica S; De Vries, Nanne K; van Oers, Hans; Michie, Susan; Atkins, L; Kremers, Stef P J

2014-02-01

Although 'integrated' public health policies are assumed to be the ideal way to optimize public health, it remains hard to determine how far removed we are from this ideal, since clear operational criteria and defining characteristics are lacking. A literature review identified gaps in previous operationalizations of integrated public health policies. We searched for an approach that could fill these gaps. We propose the following defining characteristics of an integrated policy: (1) the combination of policies includes an appropriate mix of interventions that optimizes the functioning of the behavioral system, thus ensuring that motivation, capability and opportunity interact in such a way that they promote the preferred (health-promoting) behavior of the target population, and (2) the policies are implemented by the relevant policy sectors from different policy domains. Our criteria should offer added value since they describe pathways in the process towards formulating integrated policy. The aim of introducing our operationalization is to assist policy makers and researchers in identifying truly integrated cases. The Behavior Change Wheel proved to be a useful framework to develop operational criteria to assess the current state of integrated public health policies in practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

Science.gov (United States)

Monroe, C Douglas; Chin, Karen Y

2013-05-01

The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

Down-conversion IM-DD RF photonic link utilizing MQW MZ modulator.

Science.gov (United States)

Xu, Longtao; Jin, Shilei; Li, Yifei

2016-04-18

We present the first down-conversion intensity modulated-direct detection (IM-DD) RF photonic link that achieves frequency down-conversion using the nonlinear optical phase modulation inside a Mach-Zehnder (MZ) modulator. The nonlinear phase modulation is very sensitive and it can enable high RF-to-IF conversion efficiency. Furthermore, the link linearity is enhanced by canceling the nonlinear distortions from the nonlinear phase modulation and the MZ interferometer. Proof-of-concept measurement was performed. The down-conversion IM-DD link demonstrated 28dB improvement in distortion levels over that of a conventional IM-DD link using a LiNbO3 MZ modulator.

Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

Science.gov (United States)

Mayhew, Susannah H; Ploubidis, George B; Sloggett, Andy; Church, Kathryn; Obure, Carol D; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E; Watts, Charlotte; Vassall, Anna

2016-01-01

The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration". These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

Directory of Open Access Journals (Sweden)

Susannah H Mayhew

Full Text Available The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs.Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure and a Functional Integration Index (integrated delivery of services to clients. The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration".These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

Value-based choice: An integrative, neuroscience-informed model of health goals.

Science.gov (United States)

Berkman, Elliot T

2018-01-01

Traditional models of health behaviour focus on the roles of cognitive, personality and social-cognitive constructs (e.g. executive function, grit, self-efficacy), and give less attention to the process by which these constructs interact in the moment that a health-relevant choice is made. Health psychology needs a process-focused account of how various factors are integrated to produce the decisions that determine health behaviour. I present an integrative value-based choice model of health behaviour, which characterises the mechanism by which a variety of factors come together to determine behaviour. This model imports knowledge from research on behavioural economics and neuroscience about how choices are made to the study of health behaviour, and uses that knowledge to generate novel predictions about how to change health behaviour. I describe anomalies in value-based choice that can be exploited for health promotion, and review neuroimaging evidence about the involvement of midline dopamine structures in tracking and integrating value-related information during choice. I highlight how this knowledge can bring insights to health psychology using illustrative case of healthy eating. Value-based choice is a viable model for health behaviour and opens new avenues for mechanism-focused intervention.

Innovative Techniken und Algorithmen im Bereich Computational-Finance und Risikomanagement

OpenAIRE

Liang, Qian

2012-01-01

Diese Dissertation besteht aus zwei aktuellen Themen im Bereich Finanzmathematik, die voneinander unabhängig sind. Beim ersten Thema, "Flexible Algorithmen zur Bewertung komplexer Optionen mit mehreren Eigenschaften mittels der funktionalen Programmiersprache Haskell", handelt es sich um ein interdisziplinäres Projekt, in dem eine wissenschaftliche Brücke zwischen der Optionsbewertung und der funktionalen Programmierung geschlagen wurde. Im diesem Projekt wurde eine funktionale Biblio...

Financial incentives for disease management programmes and integrated care in German social health insurance.

Science.gov (United States)

Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen

2006-10-01

As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.

Integrating structural health and condition monitoring

DEFF Research Database (Denmark)

May, Allan; Thöns, Sebastian; McMillan, David

2015-01-01

window’ allowing for the possible detection of faults up to 6 months in advance. The SHM system model uses a reduction in the probability of failure factor to account for lower modelling uncertainties. A case study is produced that shows a reduction in operating costs and also a reduction in risk......There is a large financial incentive to minimise operations and maintenance (O&M) costs for offshore wind power by optimising the maintenance plan. The integration of condition monitoring (CM) and structural health monitoring (SHM) may help realise this. There is limited work on the integration...

Die Raumdarstellung im erzählenden Werk um 1900

OpenAIRE

Lu, Xiaoli

2011-01-01

In der Literatur existiert eine eigene Welt, die mit Raum und Zeit verbunden ist. Im 19. Jahrhundert gewinnen beide, Raum und Zeit, an Bedeutung als bewusst eingesetzte Gestaltungselemente. Es bilden sich zwei Grundrichtungen heraus, eine mit dem Erzählgeschehen verknüpfte Semantisierung in der Klassik und in der Romantik und eine betonte Fixierung des Geschehens in der realen Welt durch genaue Zeit- und Ortsangaben im Realismus. Die Semantisierung von Raum und Zeit führt zu einer Bedeutungss...

[Das Bild und die Wahrnehmung der Stadt und der städtischen Gesellschaft im Hanseraum im Mittelalter und in der frühen Neuzeit] / Juhan Kreem

Index Scriptorium Estoniae

Kreem, Juhan

2009-01-01

Arvustus: Das Bild und die Wahrnehmung der Stadt und der städtischen Gesellschaft im Hanseraum im Mittelalter und in der frühen Neuzeit. hrsg. v. Roman Czaja. Torun, 2004. Torunis 2002. aastal toimunud konverentsi materjalid. Projekti "Pilt ja linn" raames ilmunud publikatsioonide loendit saab näha aadressil http://www.historiaurbium.org/english/attivita_images_en.html.

Integrated approach for managing health risks at work--the role of occupational health nurses.

Science.gov (United States)

Marinescu, Luiza G

2007-02-01

Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

Integration of research and practice to improve public health and healthcare delivery through a collaborative 'Health Integration Team' model - a qualitative investigation.

Science.gov (United States)

Redwood, Sabi; Brangan, Emer; Leach, Verity; Horwood, Jeremy; Donovan, Jenny L

2016-06-22

Economic considerations and the requirement to ensure the quality, safety and integration of research with health and social care provision have given rise to local developments of collaborative organisational forms and strategies to span the translational gaps. One such model - the Health Integration Team (HIT) model in Bristol in the United Kingdom (UK) - brings together National Health Service (NHS) organisations, universities, local authorities, patients and the public to facilitate the systematic application of evidence to promote integration across healthcare pathways. This study aimed to (1) provide empirical evidence documenting the evolution of the model; (2) to identify the social and organisational processes and theory of change underlying healthcare knowledge and practice; and (3) elucidate the key aspects of the HIT model for future development and translation to other localities. Contemporaneous documents were analysed, using procedures associated with Framework Analysis to produce summarised data for descriptive accounts. In-depth interviews were undertaken with key informants and analysed thematically. Comparative methods were applied to further analyse the two data sets. One hundred forty documents were analysed and 10 interviews conducted with individuals in leadership positions in the universities, NHS commissioning and provider organisations involved in the design and implementation of the HIT model. Data coalesced around four overarching themes: 'Whole system' engagement, requiring the active recruitment of all those who have a stake in the area of practice being considered, and 'collaboration' to enable coproduction were identified as 'process' themes. System-level integration and innovation were identified as potential 'outcomes' with far-reaching impacts on population health and service delivery. The HIT model emerged as a particular response to the perceived need for integration of research and practice to improve public health and

Knowledge integration in One Health policy formulation, implementation and evaluation.

Science.gov (United States)

Hitziger, Martin; Esposito, Roberto; Canali, Massimo; Aragrande, Maurizio; Häsler, Barbara; Rüegg, Simon R

2018-03-01

The One Health concept covers the interrelationship between human, animal and environmental health and requires multistakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global framework for health governance. Knowledge integration approaches, at all stages of policy development, could help to address these shortcomings. The identification of key objectives, the resolving of trade-offs and the creation of a common vision and a common direction can be supported by multicriteria analyses. Evidence-based decision-making and transformation of observations into narratives detailing how situations emerge and might unfold in the future can be achieved by systems thinking. Finally, transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop novel networks for collective action. To strengthen One Health governance, we propose that knowledge integration becomes a key feature of all stages in the development of related policies. We suggest several ways in which such integration could be promoted.

Perspectives on Employment Integration, Mental Illness and Disability, and Workplace Health

Directory of Open Access Journals (Sweden)

Nene Ernest Khalema

2014-01-01

Full Text Available This paper reviews the literature on the interplay between employment integration and retention of individuals diagnosed with mental health and related disability (MHRD. Specifically, the paper addresses the importance of an integrative approach, utilizing a social epidemiological approach to assess various factors that are related to the employment integration of individuals diagnosed with severe mental illness. Our approach to the review incorporates a research methodology that is multilayered, mixed, and contextual. The review examines the literature that aims to unpack employers’ understanding of mental illness and their attitudes, beliefs, and practices about employing workers with mental illness. Additionally we offer a conceptual framework entrenched within the social determinants of the mental health (SDOMH literature as a way to contextualize the review conclusions. This approach contributes to a holistic understanding of workplace mental health conceptually and methodologically particularly as practitioners and policy makers alike are grappling with better ways to integrate employees who are diagnosed with mental health and disabilities into to the workplace.

The Mastery Matrix for Integration Praxis: The development of a rubric for integration practice in addressing weight-related public health problems.

Science.gov (United States)

Berge, Jerica M; Adamek, Margaret; Caspi, Caitlin; Grannon, Katherine Y; Loth, Katie A; Trofholz, Amanda; Nanney, Marilyn S

2018-06-01

In response to the limitations of siloed weight-related intervention approaches, scholars have called for greater integration that is intentional, strategic, and thoughtful between researchers, health care clinicians, community members, and policy makers as a way to more effectively address weight and weight-related (e.g., obesity, diabetes, cardiovascular disease, cancer) public health problems. The Mastery Matrix for Integration Praxis was developed by the Healthy Eating and Activity across the Lifespan (HEAL) team in 2017 to advance the science and praxis of integration across the domains of research, clinical practice, community, and policy to address weight-related public health problems. Integrator functions were identified and developmental stages were created to generate a rubric for measuring mastery of integration. Creating a means to systematically define and evaluate integration praxis and expertise will allow for more individuals and teams to master integration in order to work towards promoting a culture of health. Copyright © 2018 Elsevier Inc. All rights reserved.

Quantitative measurement of precipitation using radar in comparison with ground-level measurements, taking orographic influences into account; Quantitative Niederschlagsmessung mit Radar im Vergleich mit Bodenmessungen in orographisch gegliedertem Gelaende

Energy Technology Data Exchange (ETDEWEB)

Gysi, H. [Radar-Info, Karlsruhe (Germany)

1998-01-01

The methods of correction applied to the determination of the spatial distribution of precipitation on the basis of the volumes established by the Karlsruhe C-band precipitation radar distinctly enhance the quality of statements regarding precipitation intensities and their time integration both in summer and winter. (orig./KW) [Deutsch] Die fuer die Bestimmung der raeumlichen Niederschlagsverteilung aus Volumendaten des Karlsruher C-Band Niederschlagradars angewandten Korrekturverfahren verbessern sowohl im Sommer als auch im Winter deutlich die Qualitaet und quantitative Aussagekraft der dargestellten Niederschlagsintensitaeten und deren zeitlichen Integrationen. (orig./KW)

IMS Mitigation Target Areas - 2010 [ds673

Data.gov (United States)

California Natural Resource Agency — Mitigation Target Areas (MTA) were developed by the California Department of Fish and Game for the Interim Mitigation Strategy (IMS). The MTAs are an identification...

An Integrated Response of Trichodesmium erythraeum IMS101 Growth and Photo-Physiology to Iron, CO2, and Light Intensity.

Science.gov (United States)

Boatman, Tobias G; Oxborough, Kevin; Gledhill, Martha; Lawson, Tracy; Geider, Richard J

2018-01-01

We have assessed how varying CO 2 (180, 380, and 720 μatm) and growth light intensity (40 and 400 μmol photons m -2 s -1 ) affected Trichodesmium erythraeum IMS101 growth and photophysiology over free iron (Fe') concentrations between 20 and 9,600 pM. We found significant iron dependencies of growth rate and the initial slope and maximal relative PSII electron transport rates (rP m ). Under iron-limiting concentrations, high-light increased growth rates and rP m ; possibly indicating a lower allocation of resources to iron-containing photosynthetic proteins. Higher CO 2 increased growth rates across all iron concentrations, enabled growth to occur at lower Fe' concentrations, increased rP m and lowered the iron half saturation constants for growth (K m ). We attribute these CO 2 responses to the operation of the CCM and the ATP spent/saved for CO 2 uptake and transport at low and high CO 2 , respectively. It seems reasonable to conclude that T. erythraeum IMS101 can exhibit a high degree of phenotypic plasticity in response to CO 2 , light intensity and iron-limitation. These results are important given predictions of increased dissolved CO 2 and water column stratification (i.e., higher light exposures) over the coming decades.

An Integrated Response of Trichodesmium erythraeum IMS101 Growth and Photo-Physiology to Iron, CO2, and Light Intensity

Directory of Open Access Journals (Sweden)

Tobias G. Boatman

2018-04-01

Full Text Available We have assessed how varying CO2 (180, 380, and 720 μatm and growth light intensity (40 and 400 μmol photons m−2 s−1 affected Trichodesmium erythraeum IMS101 growth and photophysiology over free iron (Fe′ concentrations between 20 and 9,600 pM. We found significant iron dependencies of growth rate and the initial slope and maximal relative PSII electron transport rates (rPm. Under iron-limiting concentrations, high-light increased growth rates and rPm; possibly indicating a lower allocation of resources to iron-containing photosynthetic proteins. Higher CO2 increased growth rates across all iron concentrations, enabled growth to occur at lower Fe′ concentrations, increased rPm and lowered the iron half saturation constants for growth (Km. We attribute these CO2 responses to the operation of the CCM and the ATP spent/saved for CO2 uptake and transport at low and high CO2, respectively. It seems reasonable to conclude that T. erythraeum IMS101 can exhibit a high degree of phenotypic plasticity in response to CO2, light intensity and iron-limitation. These results are important given predictions of increased dissolved CO2 and water column stratification (i.e., higher light exposures over the coming decades.

Health information technology: integration of clinical workflow into meaningful use of electronic health records.

Science.gov (United States)

Bowens, Felicia M; Frye, Patricia A; Jones, Warren A

2010-10-01

This article examines the role that clinical workflow plays in successful implementation and meaningful use of electronic health record (EHR) technology in ambulatory care. The benefits and barriers of implementing EHRs in ambulatory care settings are discussed. The researchers conclude that widespread adoption and meaningful use of EHR technology rely on the successful integration of health information technology (HIT) into clinical workflow. Without successful integration of HIT into clinical workflow, clinicians in today's ambulatory care settings will continue to resist adoption and implementation of EHR technology.

Working toward financial sustainability of integrated behavioral health services in a public health care system.

Science.gov (United States)

Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

2012-06-01

The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

Employee health services integration: meeting the challenge. Successful program.

Science.gov (United States)

Lang, Y C

1998-02-01

1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.

Integral Health Care As A Guiding Axis Of Medical Training: Case Studies

Directory of Open Access Journals (Sweden)

Alcides Viana de Lima Neto

2017-04-01

Full Text Available Objective: The aim is to report the experiences during the practical experiences in the territory assigned to a basic health unit provided by the module of Integral Health Care I. Methods: Case studies resulting from a process of critical reflections about practical experiences by medical students in a basic health unit from August to December 2015. Results: Through the module of Integral Health Care I, students were allowed to recognize the assigned area of a family health team, as well as to develop the territorialization process and to classify the demographic, epidemiological, socioeconomic and environmental profile in that place; in addition to perform other activities as a singular therapeutic project and intervention project. Conclusion: The activities developed motivated the students to be able to apply the concepts of family and community medicine in primary health care, in addition to bringing them closer to the reality of this work process. Descriptors: Integral Health Care; Family Health Strategy; Physician-Patient Relationship; Basic Health Unit.

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

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H. Hildebrandt

2010-06-01

Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg.Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

Directory of Open Access Journals (Sweden)

H. Hildebrandt

2010-06-01

Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot 'Gesundes Kinzigtal'. Description of integrated care case: Located in Southwest Germany, 'Gesundes Kinzigtal' is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg. Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

Hinderniserkennung und -verfolgung mit einer PMD-kamera im automobil

Science.gov (United States)

Schamm, Thomas; Vacek, Stefan; Natroshvilli, Koba; Marius Zöllner, J.; Dillmann, Rüdiger

Die Detektion von Hindernissen vor dem Automobil ist eine Hauptanforderung an moderne Fahrerassistenzsysteme (FAS). In dieser Arbeit wird ein System vorgestellt, das mit Hilfe einer PMDKamera (Photomischdetektor) Hindernisse auf der Fahrspur erkennt und deren relevante Parameter bestimmt. Durch die PMD-Kamera werden zunächst 3D-Tiefenbilder der Fahrzeugumwelt generiert. Nach einem initialen Filterprozess werden im Tiefenbild mit Hilfe eines Bereichswachstumsverfahrens Hindernisse gesucht. Zur Stabilisierung des Verfahrens und zur Parameterberechnung wird ein Kaiman Filter eingesetzt. Das Ergebnis ist eine Liste aller Hindernisse im Fahrbereich des Automobils.

Association between Social Integration and Health among Internal Migrants in ZhongShan, China.

Directory of Open Access Journals (Sweden)

Yanwei Lin

Full Text Available Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3-6.2 years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these

Telematics and smart cards in integrated health information system.

Science.gov (United States)

Sicurello, F; Nicolosi, A

1997-01-01

Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals, pharmacies, etc. The record linkage can provide the connection and integration of various records, thanks to the use of telematic technology (either urban or geographical local networks, such as the Internet) and electronic data cards. Particular emphasis should be placed on the introduction of smart cards, such as portable health cards, which will contain a standardized data set and will be sufficient to access different databases found in various health services. The inter-operability of the social-health records (including multimedia types) and the smart cards (which are one of the most important prerequisites for the homogenization and wide diffusion of these cards at an European level) should be strongly taken into consideration. In this framework a project is going to be developed aiming towards the integration of various data bases distributed territorially, from the reading of the software and the updating of the smart cards to the complete management of the patients' evaluation records, to the quality of the services offered and to the health planning. The applications developed will support epidemiological investigation software and data analysis. The inter-connection of all the databases of the various structures involved will take place through a coordination center, the most important system of which we will call "record linkage" or "integrated database". Smart cards will be distributed to a sample group of possible users and the necessary smart card management tools will be installed in all the structures involved. All the final users (the patients) in the whole

Evaluation of health care delivery integration: the case of the Russian Federation.

Science.gov (United States)

Sheiman, Igor; Shevski, Vladimir

2014-04-01

Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination and continuity of care. It then presents a summary of service integration problems in Russia and the results of a large survey of physicians concerning the attributes of integration. It is argued that characteristics of the national service delivery model don't ensure integration. The Semashko model is not an equivalent to the integrated model. Big organizational forms of service provision, like polyclinics and integrated hospital-polyclinics, don't have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration/fragmentation, regulation of integration activities, enhancing the role of PHC providers, economic incentives. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Christian Westerhoff. Zwangsarbeit im Ersten Weltkrieg. Deutsche Arbeitskräftepolitik im besetzten Polen und Litauen 1914-1918, Tilman Plath.Zwischen Schonung und Menschenjagden. Die Arbeitseinsatzpolitik in den baltischen Generalbezirken des Reich

Index Scriptorium Estoniae

Hiio, Toomas, 1965-

2014-01-01

Arvustus: Westerhoff, Christian. Zwangsarbeit im Ersten Weltkrieg. Deutsche Arbeitskräftepolitik im besetzten Polen und Litauen 1914-1918 (Studien zur historischen Migrationsforschung, 25). Verlag Ferdinand Schöningh. Padeborn 2011

Architektur für ein System zur Dokumentanalyse im Unternehmenskontext - Integration von Datenbeständen, Aufbau- und Ablauforganisation

OpenAIRE

Baumann, Stephan; Lichter, Jürgen; Malburg, Michael; Maus, Heiko; Meyer auf´m Hofe, Harald; Wenzel, Claudia

1998-01-01

Workflowmanagementsysteme werden im Bürobereich verstärkt zur effizienten Geschäftsprozeßabwicklung eingesetzt. Das bereits Mitte der 70er Jahre propagierte papierlose Büro bleibt jedoch gegenwärtig immer noch Utopie. Dieser Widerspruch liegt darin begründet, daß die Handhabung von papierintensiven Vorgängen in hohem Maße abhängig ist von einer Identifkation und Aufbereitung der in den Dokumenten enthaltenen Informationen. Allerdings müssen solche Daten z.B. bei eingehender Post immer noch v...

Integrated management system best practices in radioecological laboratories; Sistema de gestao integrado: melhores praticas para laboratorios radioecologicos

Energy Technology Data Exchange (ETDEWEB)

Carvalho, Claudia Aparecida Zerbinatti de

2010-07-01

The research aims to study the best practices to support a conceptual proposal for IMS - Integrated Management System (quality, environment, safety and health) applicable to Radioecology laboratories. The research design is organized into the following steps: in a first step, it was developed the bibliographic and documentary research in IMS, survey and study of standards (QMS ISO 9000 (2005), ISO 9001 (2008), ISO 9004 (2000), EMS ISO 14001 (2004) and OHSMS OHSAS 18001 (2007) and OHSAS 18002 (2008)), identification and characterization of processes in Radioecology Laboratories and study of best practices methodology and benchmarking; in the second stage of the research it was developed a case study (qualitative research, with questionnaires via e-mail and interviews, when possible), preceded by a survey and selection of international and national radioecology laboratories and then these laboratories were contacted and some of them agreed to participate in this research; in the third stage of the research it was built the framework of best practices that showed results that could support the conceptual proposal for the IMS Radioecology Laboratory; the fourth and final stage of research consisted in the construction of the proposed conceptual framework of SGI for Radioecology Laboratory, being then achieved the initial objective of the research. (author)

Integrating mental health services: the Finnish experience

Directory of Open Access Journals (Sweden)

Ville Lehtinen

2001-06-01

Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in

Shangri-La and the integration of mental health care in Australia

Directory of Open Access Journals (Sweden)

Sebastian Rosenberg

2017-07-01

Full Text Available We wanted the best, but it turned out like always. (Viktor Chernomyrdin1 According to literary legend, Shangri-La is an idyllic and harmonious place. Mental health is aspiring to its own Shangri-La in the shape of better integrated care. But do current reforms make integrated practice more or less likely? And what can be done to increase the chances of success? The aim of this article is to review the current state of mental health reforms in Australia now under way across Primary Health Networks, the National Disability Insurance Scheme, psychosocial support services and elsewhere. What are these changes and what are the implications for the future of integrated mental health care? Is Shangri-La just over the horizon, or have we embarked instead on a fool’s errand?

Shangri-La and the integration of mental health care in Australia.

Science.gov (United States)

Rosenberg, Sebastian

2017-07-26

We wanted the best, but it turned out like always. Victor Chernomydrin) 1 According to literary legend, Shangri-La is an idyllic and harmonious place. Mental health is aspiring to its own Shangri-La in the shape of better integrated care. But do current reforms make integrated practice more or less likely? And what can be done to increase the chances of success? The aim of this article is to review the current state of mental health reforms in Australia now under way across Primary Health Networks, the National Disability Insurance Scheme, psychosocial support services and elsewhere. What are these changes and what are the implications for the future of integrated mental health care? Is Shangri-La just over the horizon, or have we embarked instead on a fool's errand?

Polonium-210 and lead-210 in the Southern Polar Ocean: Naturally occurring tracers of biological and hydrographical processes in the surface waters of the Antarctic Circumpolar Current and the Weddell Sea; Polonium-210 und Blei-210 im Suedpolarmeer: Natuerliche Tracer fuer biologische und hydrographische Prozesse im Oberflaechenwasser des Antarktischen Zirkumpolarstroms und des Weddellmeeres

Energy Technology Data Exchange (ETDEWEB)

Friedrich, J.

1997-11-01

In this thesis the distribution of {sup 210}Po and {sup 210}Pb in the upper 600 m of the Antarctic Circumpolar Current and the Weddell Sea was investigated along north-south transects in austral spring and autumn. {sup 210}Po and {sup 210}Pb can serve as sensitive tracers for the special hydrographic conditions of the Antarctic Circumpolar Current and the Weddell Sea as well as for biological processes during phytoplankton blooms. The {sup 210}Po/{sup 210}Pb disequilibrium was used as a tracer for particle export. This tracer integrates export on a timescale of 276 days because of the 138 day half-life of {sup 210}Po and complements the {sup 234}Th/{sup 238}U disequilibrium as another tracer for plankton production and export on a shorter timescale of several weeks. (orig.) [Deutsch] In der vorliegenden Arbeit wurde die Verteilung von Blei-210 und seinem Enkelnuklid Polonium-210 im Antarktischen Zirkumpolarstrom und im Weddellmeer bis 600 m Tiefe in mehreren meridionalen Transekten im australen Fruehjahr und Herbst waehrend der `Polarstern`-Expeditionen ANT-X/6 und ANT-XI/4 untersucht. Die Verteilung von {sup 210}Pb und {sup 210}Po wird von mehreren Faktoren beeinflusst, sowohl durch die Advektion von Wassermassen im Antarktischen Zirkumpolarstrom und im Weddellmeer als auch von biologischen Prozessen z.B. innerhalb einer Planktonbluete. Bevor die Verteilungsmuster von {sup 210}Pb und {sup 210}Po jedoch als Tracer fuer einen Prozess genutzt werden koennen, muss der Effekt der einzelnen Faktoren auf die Verteilung betrachtet werden. (orig.)

Administrative Challenges to the Integration of Oral Health With Primary Care: A SWOT Analysis of Health Care Executives at Federally Qualified Health Centers.

Science.gov (United States)

Norwood, Connor W; Maxey, Hannah L; Randolph, Courtney; Gano, Laura; Kochhar, Komal

Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.

Toward an Intelligent Ion Mobility Spectrometer (IMS)

International Nuclear Information System (INIS)

McJunkin, Timothy R.; Scott, Jill R.; Miller, Carla J.

2003-01-01

The ultimate goal is to design and build a very smart ion mobility spectrometer (IMS) that can operate autonomously. To accomplish this, software capable of interpreting spectra so that it can be used in control loops for data interpretation as well as adjusting instrument parameters is being developed. Fuzzy logic and fuzzy numbers are used in this IMS spectra classification scheme. Fuzzy logic provides a straight forward method for developing a classification/detection system, whenever rules for classifying the spectra can be described linguistically. Instead of using 'max' and 'min' values, the product of the truth values is used to determine class membership. Using the product allows rule-bases that utilize the AND function to allow each condition to discount truth value in determining membership, while rule-bases with an OR function are allowed to accumulate membership. Fuzzy numbers allow encapsulation of the uncertainties due to ion mobility peak widths as well as measured instrumental parameters, such as pressure and temperature. Associating a peak with a value of uncertainty, in addition to making adjustments to the mobility calculation based on variations in measured parameters, enables unexpected shifts to be more reliably detected and accounted for; thereby, reducing the opportunity for 'false negative' results. The measure of uncertainty is anticipated to serve the additional purpose of diagnosing the operational conditions of the IMS instrument.

Smart Card Based Integrated Electronic Health Record System For Clinical Practice

OpenAIRE

N. Anju Latha; B. Rama Murthy; U. Sunitha

2012-01-01

Smart cards are used in information technologies as portable integrated devices with data storage and data processing capabilities. As in other fields, smart card use in health systems became popular due to their increased capacity and performance. Smart cards are used as a Electronic Health Record (EHR) Their efficient use with easy and fast data access facilities leads to implementation particularly widespread in hospitals. In this paper, a smart card based Integrated Electronic health Reco...

Improved detection of Mycobacterium bovis infection in bovine lymph node tissue using immunomagnetic separation (IMS-based methods.

Directory of Open Access Journals (Sweden)

Linda D Stewart

Full Text Available Immunomagnetic separation (IMS can selectively isolate and concentrate Mycobacterium bovis cells from lymph node tissue to facilitate subsequent detection by PCR (IMS-PCR or culture (IMS-MGIT. This study describes application of these novel IMS-based methods to test for M. bovis in a survey of 280 bovine lymph nodes (206 visibly lesioned (VL, 74 non-visibly lesioned (NVL collected at slaughter as part of the Northern Ireland bovine TB eradication programme. Their performance was evaluated relative to culture. Overall, 174 (62.1% lymph node samples tested positive by culture, 162 (57.8% by IMS-PCR (targeting IS6110, and 191 (68.2% by IMS-MGIT culture. Twelve (6.9% of the 174 culture positive lymph node samples were not detected by either of the IMS-based methods. However, an additional 79 M. bovis positive lymph node samples (27 (13.1% VL and 52 (70.3% NVL were detected by the IMS-based methods and not by culture. When low numbers of viable M. bovis are present in lymph nodes (e.g. in NVLs of skin test reactor cattle decontamination prior to culture may adversely affect viability, leading to false negative culture results. In contrast, IMS specifically captures whole M. bovis cells (live, dead or potentially dormant which are not subject to any deleterious treatment before detection by PCR or MGIT culture. During this study only 2.7% of NVL lymph nodes tested culture positive, whereas 70.3% of the same samples tested M. bovis positive by the IMS-based tests. Results clearly demonstrate that not only are the IMS-based methods more rapid but they have greater detection sensitivity than the culture approach currently used for the detection of M. bovis infection in cattle. Adoption of the IMS-based methods for lymph node testing would have the potential to improve M. bovis detection in clinical samples.

Die emotionale Dimension während der Sprechproduktion im Fremdsprachenlernprozess

Directory of Open Access Journals (Sweden)

Bahar İŞİGÜZEL

2017-12-01

Full Text Available Die Gefühle bzw. Emotionen der Lernenden beim Fremdsprachenlehr- und Lernprozess spielen eine wichtige Rolle. Mit der Verknüpfung der Emotion und Kognition beim Lernprozess, haben die positiven Gefühle eine große Bedeutung für den Lernerfolg. Als eine produktive Fertigkeit hat das Sprechen eine wesentlich intensive Beziehung mit den Emotionen, weil es in der realen Zeit fließend laufen muss. Der Lernende soll bei der Sprechproduktion spontan die richtigen Wörter auf die richtige Art und Weise anwenden und sie auch noch verständlich aussprechen. Leider erreicht die Sprechfertigkeit meistens eine niedrigere Niveaustufe als die anderen drei (Schreiben, Lesen und Hören Fertigkeiten im Fremdsprachenunterrichtprozess. Diese qualitative Untersuchung konzentriert sich auf die Daten (Tonaufnahme, die anhand eines Interviews während einer Sprechproduktionsübung im universitären Fremdsprachenunterricht gesammelt wurden. Um die emotionale Dimension der Lernenden während der Sprechproduktion zu identifizieren, wurden im Einzelinterview die Frage „Wie fühlst du dich während du eine Fremdsprache (Englisch sprichst?“ gestellt. Die Teilnehmer dieser Untersuchung waren 29 Studenten, die im WS 2016 - 2017 an Universität Nevşehir Hacı Bektaş Veli (Türkei immatrikuliert waren. Die Auswertung des Interviews folgte mit einer Transkription und einer Interpretation der Tonaufnahmen. Die Meinungen zu der emotionalen Dimension während der Sprechproduktion der Studenten wurden kategorisiert. Die Resultate dieser qualitativen Untersuchung zeigen, dass die emotionale Dimension der Lernenden im universitären Kontext sich in drei Kategorien (positiv, negativ und frühere Ausbildung verteilen.

The Health Care Strengthening Act: The next level of integrated care in Germany.

Science.gov (United States)

Milstein, Ricarda; Blankart, Carl Rudolf

2016-05-01

The lack of integration of health-care sectors and specialist groups is widely accepted as a necessity to effectively address the most urgent challenges in modern health care systems. Germany follows a more decentralized approach that allows for many degrees of freedom. With its latest bill, the German government has introduced several measures to explicitly foster the integration of health-care services. This article presents the historic development of integrated care services and offers insights into the construction of integrated care programs in the German health-care system. The measures of integrated care within the Health Care Strengthening Act are presented and discussed in detail from the perspective of the provider, the payer, and the political arena. In addition, the effects of the new act are assessed using scenario technique based on an analysis of the effects of previously implemented health policy reforms. Germany now has a flourishing integrated care scene with many integrated care programs being able to contain costs and improve quality. Although it will be still a long journey for Germany to reach the coordination of care standards set by leading countries such as the United Kingdom, New Zealand or Switzerland, international health policy makers may deliberately and selectively adopt elements of the German approach such as the extensive freedom of contract, the strong patient-focus by allowing for very need-driven and regional solutions, or the substantial start-up funding allowing for more unproven and progressive endeavors to further improve their own health systems. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

From Foucault to Freire through Facebook: Toward an Integrated Theory of mHealth

Science.gov (United States)

Bull, Sheana; Ezeanochie, Nnamdi

2016-01-01

Objective: To document the integration of social science theory in literature on mHealth (mobile health) and consider opportunities for integration of classic theory, health communication theory, and social networking to generate a relevant theory for mHealth program design. Method: A secondary review of research syntheses and meta-analyses…

Organizing integrated health-care services to meet older people's needs.

Science.gov (United States)

Araujo de Carvalho, Islene; Epping-Jordan, JoAnne; Pot, Anne Margriet; Kelley, Edward; Toro, Nuria; Thiyagarajan, Jotheeswaran A; Beard, John R

2017-11-01

In most countries, a fundamental shift in the focus of clinical care for older people is needed. Instead of trying to manage numerous diseases and symptoms in a disjointed fashion, the emphasis should be on interventions that optimize older people's physical and mental capacities over their life course and that enable them to do the things they value. This, in turn, requires a change in the way services are organized: there should be more integration within the health system and between health and social services. Existing organizational structures do not have to merge; rather, a wide array of service providers must work together in a more coordinated fashion. The evidence suggests that integrated health and social care for older people contributes to better health outcomes at a cost equivalent to usual care, thereby giving a better return on investment than more familiar ways of working. Moreover, older people can participate in, and contribute to, society for longer. Integration at the level of clinical care is especially important: older people should undergo comprehensive assessments with the goal of optimizing functional ability and care plans should be shared among all providers. At the health system level, integrated care requires: (i) supportive policy, plans and regulatory frameworks; (ii) workforce development; (iii) investment in information and communication technologies; and (iv) the use of pooled budgets, bundled payments and contractual incentives. However, action can be taken at all levels of health care from front-line providers through to senior leaders - everyone has a role to play.

Biomechanisch-kinemetrische Bewegungsanalyse und Ansätze zur Bewegungssteuerung für ein Training im Wellenreiten

OpenAIRE

Matschkur, Tina

2008-01-01

Neben der biomechanisch-kinemetrischen Bewegungsanalyse einzelner ausgewählter Techniken im Wellenreiten beschäftigt sich diese Dissertation auch ansatzweise im Rahmen einer elektromyographischen Fallstudie mit der muskulären Koordination bei der Bewegungsausführung im Surfen, um daraus Schlussfolgerungen für das Training im Wellenreiten treffen zu können. Ein geschichtlicher und wissenschaftlicher Überblick über das Wellenreiten leitet das Thema ein und macht somit auf die besondere Ausgangs...

Eisengehalt von Fleisch - Ermittlung des Eisengehalts im Fleisch verschiedener Tierarten

OpenAIRE

Westphal, Karsten; Klose, Ralf; Golze, Manfred

2009-01-01

Der Bericht beinhaltet Ergebnisse von Fleischuntersuchungen auf den Eisengehalt. Untersucht wurden 308 Schweinefleischproben und etwa 300 Fleischproben der Tierarten Rind, Bison, Auerochse, Büffel, Schaf, Ziege, Kaninchen, Wildschwein, Rehwild, Rotwild und Fasan. Die sächsischen Ergebnisse bestätigen Untersuchungen anderer Bundesländer und belegen den starken Rückgang des Eisengehaltes im Schweinefleisch. Er lag im Mittel bei 4,1 mg/kg Frischmasse (FM). Vor 30 Jahren lag der Eisengehalt...

Quad-Polarization Transmission for High-Capacity IM/DD Links

DEFF Research Database (Denmark)

Estaran Tolosa, Jose Manuel; Castaneda, Mario A. Usuga; Porto da Silva, Edson

2014-01-01

We report the first experimental demonstration of IM/DD links usi ng four states of polarization. Fiber - Induced polarization rotation is compensated with a simple tracking algorithm operating on the Stokes space. The principle is prove n at 128 Gb/s over 2 - km SSMF......We report the first experimental demonstration of IM/DD links usi ng four states of polarization. Fiber - Induced polarization rotation is compensated with a simple tracking algorithm operating on the Stokes space. The principle is prove n at 128 Gb/s over 2 - km SSMF...

Vertical integration and organizational networks in health care.

Science.gov (United States)

Robinson, J C; Casalino, L P

1996-01-01

This paper documents the growing linkages between primary care-centered medical groups and specialists and between physicians and hospitals under managed care. We evaluate the two alternative forms of organizational coordination: "vertical integration," based on unified ownership, and "virtual integration," based on contractual networks. Excess capacity and the need for investment capital are major short-term determinants of these vertical versus virtual integration decisions in health care. In the longer term, the principal determinants are economies of scale, risk-bearing ability, transaction costs, and the capacity for innovation in methods of managing care.

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

Science.gov (United States)

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

2016-12-01

School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

Changes in Quality of Health Care Delivery after Vertical Integration.

Science.gov (United States)

Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

2015-08-01

To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data were assembled by the health plan's informatics team. Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care-sensitive admissions increased when the acquisition caused disruption in admitting patterns. Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. © Health Research and Educational Trust.

An Approach to Integrating Health Disparities within Undergraduate Biomedical Engineering Education.

Science.gov (United States)

Vazquez, Maribel; Marte, Otto; Barba, Joseph; Hubbard, Karen

2017-11-01

Health disparities are preventable differences in the incidence, prevalence and burden of disease among communities targeted by gender, geographic location, ethnicity and/or socio-economic status. While biomedical research has identified partial origin(s) of divergent burden and impact of disease, the innovation needed to eradicate health disparities in the United States requires unique engagement from biomedical engineers. Increasing awareness of the prevalence and consequences of health disparities is particularly attractive to today's undergraduates, who have undauntedly challenged paradigms believed to foster inequality. Here, the Department of Biomedical Engineering at The City College of New York (CCNY) has leveraged its historical mission of access-and-excellence to integrate the study of health disparities into undergraduate BME curricula. This article describes our novel approach in a multiyear study that: (i) Integrated health disparities modules at all levels of the required undergraduate BME curriculum; (ii) Developed opportunities to include impacts of health disparities into undergraduate BME research projects and mentored High School summer STEM training; and (iii) Established health disparities-based challenges as BME capstone design and/or independent entrepreneurship projects. Results illustrate the rising awareness of health disparities among the youngest BMEs-to-be, as well as abundant undergraduate desire to integrate health disparities within BME education and training.

‘Trust and teamwork matter’: Community health workers' experiences in integrated service delivery in India

Science.gov (United States)

Mishra, Arima

2014-01-01

A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. PMID:25025872

A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services.

Science.gov (United States)

Reynolds, Heidi W; Sutherland, Elizabeth G

2013-05-06

Because of the current emphasis and enthusiasm focused on integration of health systems, there is a risk of piling resources into integrated strategies without the necessary systems in place to monitor their progress adequately or to measure impact, and to learn from these efforts. The rush to intervene without adequate monitoring and evaluation will continue to result in a weak evidence base for decision making and resource allocation. Program planning and implementation are inextricability linked to monitoring and evaluation. Country level guidance is needed to identify country-specific integrated strategies, thereby increasing country ownership. This paper focuses on integrated health services but takes into account how health services are influenced by the health system, managed by programs, and made up of interventions. We apply the principles in existing comprehensive monitoring and evaluation (M&E) frameworks in order to outline a systematic approach to the M&E of integration for the country level. The approach is grounded by first defining the country-specific health challenges that integration is intended to affect. Priority points of contact for care can directly influence health, and essential packages of integration for all major client presentations need to be defined. Logic models are necessary to outline the plausible causal pathways and define the inputs, roles and responsibilities, indicators, and data sources across the health system. Finally, we recommend improvements to the health information system and in data use to ensure that data are available to inform decisions, because changes in the M&E function to make it more integrated will also facilitate integration in the service delivery, planning, and governance components. This approach described in the paper is the ideal, but its application at the country level can help reveal gaps and guide decisions related to what health services to prioritize for integration, help plan for how to

Improving Acceptance, Integration and Health among LGBT Service Members

Science.gov (United States)

2017-10-01

these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy

Co-Leadership – A Management Solution for Integrated Health and Social Care

Directory of Open Access Journals (Sweden)

Charlotte Klinga

2016-05-01

Full Text Available Introduction: Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers – each manager representing one of the two principal organizations in integrated health and social care services – was explored. Aim: To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Method: Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Results: Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care.  Conclusion and discussion: Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.

Mixed, Nonsplit, Extended Stability, Stiff Integration of Reaction Diffusion Equations

KAUST Repository

Alzahrani, Hasnaa H.

2016-01-01

A tailored integration scheme is developed to treat stiff reaction-diffusion prob- lems. The construction adapts a stiff solver, namely VODE, to treat reaction im- plicitly together with explicit treatment of diffusion. The second-order Runge

Integrating environment health and safety management at Petro-Canada

International Nuclear Information System (INIS)

Raymond, G.

1993-01-01

Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

Process-integrated slag treatment; Prozessintegrierte Schlackebehandlung

Energy Technology Data Exchange (ETDEWEB)

Koralewska, R.; Faulstich, M. [Technische Univ., Garching (Germany). Lehrstuhl fuer Wasserguete- und Abfallwirtschaft

1998-09-01

The present study compares two methods of washing waste incineration slag, one with water only, and one which uses additives during wet deslagging. The presented aggregate offers ideal conditions for process-integrated slag treatment. The paper gives a schematic description of the integrated slag washing process. The washing liquid serves to wash out the readily soluble constituents and remove the fines, while the additives are for immobilising heavy metals in the slag material. The study is based on laboratory and semi-technical trials on the wet chemical treatment of grate slag with addition of carbon dioxide and phosphoric acid. [Deutsch] Die dargestellten Untersuchungen beziehen sich auf den Vergleich zwischen einer Waesche der Muellverbrennungsschlacke mit Wasser und unter Zugabe von Additiven im Nassentschlacker. In diesem Aggregat bieten sich optimale Voraussetzungen fuer eine prozessintegrierte Schlackebehandlung. Die Durchfuehrung der integrierten Schlackewaesche wird schematisch gezeigt. Durch die Waschfluessigkeit sollen die leichtloeslichen Bestandteile ausgewaschen und die Feinanteile ausgetragen sowie durch die Additive zusaetzlich die Schwermetalle im Schlackematerial immobilisiert werden. Dazu erfolgten Labor- und halbtechnische Versuche zur nasschemischen Behandlung der Rostschlacken unter Zugabe von Kohlendioxid und Phosphorsaeure. (orig./SR)

Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

Science.gov (United States)

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-09-22

Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

Community-Based Rehabilitation in Bangladesh, Health Components Need to be Integrated with Primary Health Care

Directory of Open Access Journals (Sweden)

Md Shahidur Rahman

2018-01-01

Full Text Available Community-based rehabilitation (CBR is defined as a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities. The role of CBR is to work closely with the health sector to ensure that the needs of people with disabilities and their family members are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices. CBR also needs to work with individuals and their families to facilitate their access to health services and to work with other sectors to ensure that all aspects of health are addressed. Health components of CBR as per WHO guidelines are grossly neglected in Bangladesh. Some government and non-government organizations are working independently, but health components are inadequately addressed. We observed that primary health care, if integrated with medical rehabilitation of disabled, will better address the need and help bring disabled into mainstream of development. Health care providers at grass root level need to be trained in CBR activities which can be arranged centrally with health ministry, social welfare ministry and rehabilitation specialists. In this review we have tried to reveal the health components of CBR in global and Bangladesh context and importance of integrating health components of CBR with primary health care.

Green electricity in abundance. A photovoltaic roof lends a ranch in the style of the 50s a contemporary note; Gruenstrom im Ueberfluss. Ein Photovoltaikdach verleiht einer Ranch im Stil der 50er-Jahre einen zeitgenoessischen Akzent

Energy Technology Data Exchange (ETDEWEB)

Hirsch, Matthew; Krause, Matthias B.

2013-03-15

Landlady Kate Kennedy wanted to build her property in a conservation area three hours' drive south of San Francisco in a ranch-style house. Architect Jonathan Feldman added energy-efficient elements and a roof-integrated photovoltaic system to the project. Kennedy now produces more electricity than it can consume. [German] Hausherrin Kate Kennedy wollte ihr Anwesen in einem Naturschutzgebiet drei Autostunden suedlich von San Francisco unbedingt im Stil eines Ranch-Hauses bauen. Architekt Jonathan Feldman fuegte dem Projekt energieeffiziente Elemente und eine dachintegrierte Photovoltaikanlage hinzu. Nun produziert Kennedy mehr Solarstrom, als sie verbrauchen kann.

Female teams im eSport: Re-Konstruktion der Kategorie Geschlecht

OpenAIRE

Streubel, Anett

2010-01-01

"Das Ziel dieses Papers ist es, die Herausbildung von "female Teams" im eSport zu untersuchen. Das Hauptaugenmerk liegt hierbei auf Rekonstruktionsmechanismen der Kategorie Geschlecht, welche durch Sprache und Diskurse gebildet, erlernt und fortgeführt werden. Der Anteil der Spielerinnen, die das Computerspielen als Sport betreiben, wächst stetig an - deshalb soll in dieser Studie der Profibereich des eSport näher betrachtet werden. In einem Tätigkeitsfeld, in dem nicht der Körper im Mittelpu...

Integrated management system

International Nuclear Information System (INIS)

Florescu, N.

2003-01-01

A management system is developed in order to reflect the needs of the business and to ensure that the objectives of the organization will be achieved. The process model and each individual process within the system then needs to identify the drives or requirements from external customers and stakeholders, regulations, and standards such as ISO and 50-C-Q. The processes are then developed to address these drivers. Developing the process in this way makes it fully integrated and capable of incorporating any new requirements. The International Standard (ISO 9000:2000) promotes the adoption of a process approach when developing, implementing and improving the effectiveness of a quality management system to enhance customer satisfaction by meeting customer requirements. The IAEA Code recognizes that the entire work is a process which can be planned, assessed and improved. For an organization to function effectively, numerous linked activities have to be identified and managed. By definition a process is an activity that using resources and taking into account all the constraints imposed executes the necessary operations which transform the inputs in outcomes. Running a system of processes within an organization, identification of the interaction between the processes and their management can be referred to as a 'process approach'. The advantage of such an approach is the ensuring of the ongoing control over the linkage between the individual processes composing the system as well as over their combination and interaction. Developing a management system implies: identification of the process which delivers Critical Success Factor (CSFs) of the business; identifying the support processes enabling the CSFs to be accomplished; identifying the processes that deliver the business fundamentals. An integrated management system should include all activities not only those related to Quality, Health and Safety. When developing an IMS it is necessary to identify all of the drivers

Zur mediopassiven 2. Und 3. Person dualis im indogermanischen

Directory of Open Access Journals (Sweden)

Bojan Čop

1972-12-01

Full Text Available Bekanntlich gibt es in einigen seltenen idg. Sprachen (im Arischen, Griechischen, Tocharischen auch Personal - suffixe für die 2. u n d 3. P. Du. des Mediopassivs. Von diesen sind die griechischen Ausgänge – 2. und 3. Du primär, 2. Du. sekundär, Du. sekundär sicher junge Neubildungen, s. z. B. Brugmann, Grdr.2 II 3 II, 657, § 602; Schwyzer, Gr. Gr. I 670, 672. Ein voll ausgebildetes System solcher Endungen besitzt das Arische; im Tocharischen kommt nur eine einzige Form mit solcher Endung vor, die die 2. P. Du. Med. lmperativi darstellt. Unter solchen Umständen scheint es schwierig, aus diesem Material wahrscheinliche Schlüsse für da_s Urindogermanische zu machen. Und doch ist gerade die tocharische Form, die uns eine ausserordentlich grosse Hilfe leistet, wenn man sie richtig zu beurteilen vermag. Die tocharische Endung, verbunden mit den arischen, wird unter Einschluss der allgemeinen Tendenzen und Regelungen im System der indogermanischen Personalsuffixe ohne Schwierigkeit die urindogermanische Urform erscheinen lassen.

[Glanz und Elend - Mythos und Wirklichkeit der Herrenhäuser im Baltikum] / Karsten Brüggemann

Index Scriptorium Estoniae

Brüggemann, Karsten, 1965-

2014-01-01

Arvustus: Glanz und Elend - Mythos und Wirklichkeit der Herrenhäuser im Baltikum. Hrsg. von Ilse von zur Mühlen im Auftrag der Carl-Schirren-Gesellschaft e.V. und des Ostpreußischen Landesmuseums Lüneburg. Kunstverlag Josef Fink. Lindenberg im Allgäu 2012

Season of infectious mononucleosis and risk of multiple sclerosis at different latitudes; the EnvIMS Study.

Science.gov (United States)

Lossius, Andreas; Riise, Trond; Pugliatti, Maura; Bjørnevik, Kjetil; Casetta, Ilaria; Drulovic, Jelena; Granieri, Enrico; Kampman, Margitta T; Landtblom, Anne-Marie; Lauer, Klaus; Magalhaes, Sandra; Myhr, Kjell-Morten; Pekmezovic, Tatjana; Wesnes, Kristin; Wolfson, Christina; Holmøy, Trygve

2014-05-01

Seasonal fluctuations in solar radiation and vitamin D levels could modulate the immune response against Epstein-Barr virus (EBV) infection and influence the subsequent risk of multiple sclerosis (MS). Altogether 1660 MS patients and 3050 controls from Norway and Italy participating in the multinational case-control study of Environmental Factors In Multiple Sclerosis (EnvIMS) reported season of past infectious mononucleosis (IM). IM was generally reported more frequently in Norway (p=0.002), but was associated with MS to a similar degree in Norway (odds ratio (OR) 2.12, 95% confidence interval (CI) 1.64-2.73) and Italy (OR 1.72, 95% CI 1.17-2.52). For all participants, there was a higher reported frequency of IM during spring compared to fall (p<0.0005). Stratified by season of IM, the ORs for MS were 1.58 in spring (95% CI 1.08-2.31), 2.26 in summer (95% CI 1.46-3.51), 2.86 in fall (95% CI 1.69-4.85) and 2.30 in winter (95% CI 1.45-3.66). IM is associated with MS independently of season, and the association is not stronger for IM during spring, when vitamin D levels reach nadir. The distribution of IM may point towards a correlation with solar radiation or other factors with a similar latitudinal and seasonal variation.

Instrument Development of Integrative Health and Wellness Assessment™.

Science.gov (United States)

McElligott, Deborah; Eckardt, Sarah; Montgomery Dossey, Barbara; Luck, Susan; Eckardt, Patricia

2017-12-01

The nurse coach role was developed to address the needs of our nation and the world for health and wellbeing. The Theory of Integrative Nurse Coaching provides a foundation for coaching interventions supporting health promotion, and a framework for the development of the Integrative Health and Wellness Assessment (IHWA) short form. This 36-question Likert-type scale self-reporting tool assists participants in assessing healthy behaviors through a self-reflection process, provides information for the coaching relationship, and may be an outcome measurement. This article describes the history of the IHWA tool and the development and pilot testing of the IHWA short form using guidelines provided by DeVellis. Results of the Kaiser-Meyer-Olkin test yielded a value of .520, and the Bartlett's test of sphericity was significant. Cronbach's alpha overall scale internal consistency was .88 ( n = 36). Pilot study results indicate that the scale could be improved through additional revision, and an ongoing study is in progress.