WorldWideScience

Sample records for inadequate facilities bureaucratic

  1. Lobbying Bureaucrats

    DEFF Research Database (Denmark)

    Bennedsen, Morten; Feldmann, Sven E.

    2004-01-01

    the implementation stage of policy and apply itto different institutional structures of government. The paper addresses the followingquestions: First, how does the decision to delegate change when the bureaucratic agentis subject to external influence? What cost does this influence impose on the legislativeprincipal......? Finally, how susceptible are policy choices to bureaucratic lobbying underdifferent government structures? In answering these questions, the paper seeks to providea comparative theory of lobbying and to explain the different patterns of interestgroup activity across political systems....

  2. CONSEQUENCES OF INADEQUATE ENGAGEMENT OF EXPERTS FOR BUILDING SPORT FACILITIES IN BAR

    Directory of Open Access Journals (Sweden)

    Miodrag Banović

    2010-09-01

    Full Text Available In Bar we still do not have experiance that for investments in sport facilities, sport experts are consulted. Such an approach to this problem put in question racional reasons for an investment? Consequences: Such facilities were not built in accordance with the sport rules and could not be registrated to the Sports Associations for performance of official sport competitions. 1. Hotel „Topolica“, 1980. year (open swimming pool, 2. OŠ „Anto Đedović“, 1983. year (asfaltfloor playground, 3. Sportsko-rekreativni centar Bar, 1986. year (tartan track i asfaltfloor playground, 4. OŠ „Meksiko“, 1987. year ( gim, 5. Sportsko-rekreativni centar Bar, 1987. year (stadium dressing room, 6. Sportsko-rekreativni centar Bar, 2004. year (tartan track i asfaltfloor playground, i cross-country track 7. Rekreativni parak „Oaza“, 2005. godine ( trim track reconstruction and artificial light instalement at „Oaza“, 8. Sportsko-rekreativni centar Bar, 2009. year (football – tennis pitch, Distorical and descriptive methods were used. Subject of inquiery were sport facilities where sport rules were not followed.Vanity of certain persons has been fulfilled, but not the needs of sport population. If there is a wish that sport facilities should be in the function of sport in its full capacity, it is necessary that during construction, reconstruction and adaptation of such facilities expers are to be engaged.

  3. BUREAUCRATIC STRUCTURE AND DECISIONMAKING.

    Science.gov (United States)

    DOWNS, ANTHONY

    ASPECTS OF ORGANIZATION THEORY ARE REVIEWED ANALYTICALLY TO DEVELOP THE IMPLICATIONS OF THREE MAJOR HYPOTHESES DEFINING THE RELATIONSHIP OF BUREAUS AND BUREAUCRATIC OFFICIALS TO THE DECISIONMAKING PROCESS IN A REALISTIC WORLD WHERE INFORMATION IS COSTLY AND UNCERTAINTY IS AN IMPORTANT FACTOR IN MAKING DECISIONS--(1) BUREAUCRATIC OFFICIALS SEEK TO…

  4. From bureaucratic tot post-bureaucratic: the difficulties of transition

    NARCIS (Netherlands)

    Josserand, E.; Teo, S.; Clegg, S.R.

    2006-01-01

    Purpose - Modern bureaucracies are under reconstruction, bureaucracy being no longer "modern"; they are becoming "post" bureaucratic. Defining the post-bureaucratic organization as a hybrid form provides insight into the intrinsic difficulties involved in the refurbishment of large complex

  5. Africa Reform Agenda: Bureaucratic Organisations: A Priority in the ...

    African Journals Online (AJOL)

    In view of the dramatically changing environment within which public administrators work, bureaucracies seem inadequate to meet the new and anticipated challenges facing the public sector. The solution, however, is not abandoning the reform of bureaucratic organisations, but channeling such reform in a way that it ...

  6. Bureaucratic Administration in Modern Society

    Directory of Open Access Journals (Sweden)

    Goga Gina Livioara

    2009-06-01

    Full Text Available In the European states, a responsible administration, from a political point of view,coordinated by law, competent and professional and neutral from a public point of view, has been thebasis for the European state for a long time and a dominant model of this type of administration isrepresented by the Weberian bureaucratic model, which emphasized the value of efficiency, consistency,continuity and predictability. Bureaucracy is indispensable in any state and very important in thedemocratic regimes. Weber asserted that the bureaucratic organisation obtained power in virtue of thedecrease of the economical and social differences. The modern state depends on a bureaucratic basis,but once established, bureaucracy is among the social structures that are most difficult to eliminate. Theemergence and development of the bureaucratic mechanisms has become a monster of the modernsociety, because the bureaucracy works in the opposite direction from democracy.

  7. Gaps between breastfeeding awareness and practices in Vietnamese mothers result from inadequate support in health facilities and social norms.

    Science.gov (United States)

    Tuan, Nguyen T; Nguyen, Phuong H; Hajeebhoy, Nemat; Frongillo, Edward A

    2014-11-01

    -practice gaps requires strengthening breastfeeding support in health facilities and the sociocultural environment to make desired practices normative. © 2014 American Society for Nutrition.

  8. How politicians and bureaucrats network

    DEFF Research Database (Denmark)

    Alexander, Damon; Lewis, Jenny; Considine, Mark

    2011-01-01

    Effective public administration relies on the passage of information through interpersonal communication networks. While we have a vast research literature concerning formal structures and roles in organizations, including public agencies and government institutions, we know far less about the flow...... of information through semiformal, voluntary interactions. In this paper we use a large survey to explore the networking patterns of politicians and bureaucrats and to compare these with the more formal structural attributes of hierarchy and functional specialization. Social network analysis and standard...... quantitative measures are used to examine which actors are most central in advice and strategic information networks and how this varies across governments. The results suggest that the communication networks of politicians and bureaucrats differ substantially, with politicians being surprisingly peripheral...

  9. Bureaucratic Corruption and Mass Media

    OpenAIRE

    Suphachol Suphachalasai

    2005-01-01

    This paper investigates the relationship between a bureaucracy and mass media industry, and its implications to corruption. We develop a bureaucratic model of corruption with mass media. A representative profit maximizing media firm seeks for corruption news to be printed and sold. Channels through which competition in media industry and press freedom affect equilibrium corruption in a bureaucracy are modeled. Different degrees of media freedom and competition affect production and employment...

  10. THE BUREAUCRATIC PHENOMENON: CLASSICAL CONCEPTS

    OpenAIRE

    Дама Ибрагима

    2013-01-01

    Aim of this article - to analyze Hegel and Karl Marx’s classic bureaucracy theories and also Max Weber’s concept of rational bureaucracy and its development in the works of Herbert Simon, Robert Merton, Peter Blau and Michel Crozier. It shows that the above listed researchers only undertook a change of terminology within the same theoretical tradition. The article describes different approaches to the bureaucratic system of administrative schools of the late 1950s and early 1980s. Major concl...

  11. Professional Performance and Bureaucratic Benchmarking Information

    DEFF Research Database (Denmark)

    Schneider, Melanie L.; Mahlendorf, Matthias D.; Schäffer, Utz

    controls because of organizational-professional conflicts. We therefore analyze the association between bureaucratic benchmarking information provision and professional performance and suggest that the association is more positive if prior professional performance was low. We test our hypotheses based...... on archival, publicly disclosed, professional performance data for 191 German orthopedics departments, matched with survey data on bureaucratic benchmarking information given to chief orthopedists by the administration. We find a positive association between bureaucratic benchmarking information provision...

  12. Innovativeness of Employees in Bureaucratic Hotel Organizations

    OpenAIRE

    Metod Suligoj

    2011-01-01

    The purpose of this study is to ascertain the differences in the attitude to innovativeness between bureaucratic and non-bureaucratic hotel organisations. We defined as bureaucratic the organisations establishing standards. For this purpose we first defined basic terminology such as hotel idustry, innovativeness and bureaucracy, general, and of tourism and the hotel industry. We also pointed out that the government is aware of the importance of innovativeness in the hotel industry and tourism...

  13. Professional Performance and Bureaucratic Benchmarking Information

    DEFF Research Database (Denmark)

    Schneider, Melanie L.; Mahlendorf, Matthias D.; Schäffer, Utz

    Prior research documents positive effects of benchmarking information provision on performance and attributes this to social comparisons. However, the effects on professional recipients are unclear. Studies of professional control indicate that professional recipients often resist bureaucratic...... controls because of organizational-professional conflicts. We therefore analyze the association between bureaucratic benchmarking information provision and professional performance and suggest that the association is more positive if prior professional performance was low. We test our hypotheses based...... on archival, publicly disclosed, professional performance data for 191 German orthopedics departments, matched with survey data on bureaucratic benchmarking information given to chief orthopedists by the administration. We find a positive association between bureaucratic benchmarking information provision...

  14. THE BUREAUCRATIC PHENOMENON: CLASSICAL CONCEPTS

    Directory of Open Access Journals (Sweden)

    Дама Ибрагима

    2013-09-01

    Full Text Available Aim of this article - to analyze Hegel and Karl Marx’s classic bureaucracy theories and also Max Weber’s concept of rational bureaucracy and its development in the works of Herbert Simon, Robert Merton, Peter Blau and Michel Crozier. It shows that the above listed researchers only undertook a change of terminology within the same theoretical tradition. The article describes different approaches to the bureaucratic system of administrative schools of the late 1950s and early 1980s. Major conclusions in the article include the following: administering the state apparatus consists in the organization of government on the basis of regulated rights, mandatory procedures that are invoked to ensure balance in the interest of man and society; bad effectiveness of government, infringement of the rights and freedoms of the individual is the result of dysfunction in the state apparatus; the struggle against it can be carried out with the help of administrative, economical and legal methods.DOI: http://dx.doi.org/10.12731/2218-7405-2013-6-45

  15. The Conflict of Professionals in Bureaucratic Organizations

    Science.gov (United States)

    Sorensen, James E.; Sorensen, Thomas L.

    1974-01-01

    A study of 264 certified public accountants in large public accounting firms showed that when professionals work in a professional-bureaucratic organization, conflict and deprivation result with predictable consequences such as job dissatisfaction and job migration. (Author)

  16. Professional Performance and Bureaucratic Benchmarking Information

    DEFF Research Database (Denmark)

    Schneider, Melanie L.; Mahlendorf, Matthias D.; Schäffer, Utz

    Prior research documents positive effects of benchmarking information provision on performance and attributes this to social comparisons. However, the effects on professional recipients are unclear. Studies of professional control indicate that professional recipients often resist bureaucratic...

  17. Professional Performance and Bureaucratic Benchmarking Information

    DEFF Research Database (Denmark)

    Schneider, Melanie L.; Mahlendorf, Matthias D.; Schäffer, Utz

    and professional performance but only if prior professional performance was low. Supplemental analyses support the robustness of our results. Findings indicate conditions under which bureaucratic benchmarking information may affect professional performance and advance research on professional control and social...

  18. Bureaucratic reform, informal sector and welfare

    OpenAIRE

    Chaudhuri, Sarbajit; Mandal, Biswajit

    2012-01-01

    In this paper we formulate a three-sector general equilibrium model where one sector produces a service or good used as an intermediate input in two other sectors. Intermediate input here resembles bureaucratic (in)efficiency/control, red-tapism etc. in light of these concerns we introduce informal sector where wage is determined through competitive mechanism. We show that informal wage must go up if bureaucratic efficiency increases in general or if informal sector becomes less prone to bure...

  19. Inadequate housing in Ghana

    Directory of Open Access Journals (Sweden)

    Franklin Obeng-Odoom

    2011-01-01

    Full Text Available Two themes are evident in housing research in Ghana. One involves the study of how to increase the number of dwellings to correct the overall housing deficit, and the other focuses on how to improve housing for slum dwellers. Between these two extremes, there is relatively little research on why the existing buildings are poorly maintained. This paper is based on a review of existing studies on inadequate housing. It synthesises the evidence on the possible reasons for this neglect, makes a case for better maintenance and analyses possible ways of reversing the problem of inadequate housing.

  20. Street-level Bureaucrats and Regulatory Deterrence

    DEFF Research Database (Denmark)

    Winter, Søren C.; J. May, Peter

    2015-01-01

    This chapter considers the role of street-level bureaucrats in regulatory deterrence. The empirical foci are the degrees and ways with which regulatory inspectors shape regulated entities’ perceptions that noncompliance will be detected. These are examined using data about the enforcement...... the difficulty of assessing the detection risk, regulated entities use various heuristics regarding competence of inspectors, fairness of inspection, and trust in others that affect their perceptions of the likelihood of violations being detected. These results underscore the importance of fair and competent...... inspection for improving compliance. More generally, the chapter demonstrates the roles street-level bureaucrats fulfill on the frontlines of regulatory enforcement....

  1. Of Bureaucrats and Passionate Public Managers

    DEFF Research Database (Denmark)

    Meyer, Renate; Egger-Peitler, Isabell; Höllerer, Markus A.

    2014-01-01

    the assumption that high PSM is associated with the traditional ethos and social identity in the public sector. What we find is that a Weberian legalistic-bureaucratic logic supports neither a high attraction to policy-making nor a high level of compassion. A managerial orientation, on the other hand, entails...

  2. Implementation Regimes and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    Winter, Søren; T. Dinesen, Peter; J. May, Peter

    -government regimes foster greater policy commitment, attention to rules, and adherence among frontline workers than is the case for a local-government implementation regime. These lead to actions of street-level bureaucrats in central-government regimes that are more in line with national policies than those...

  3. Effective emergency management: reconsidering the bureaucratic approach.

    Science.gov (United States)

    Neal, D M; Phillips, B D

    1995-12-01

    The command and control approach is compared with the Emergent Human Resources Model (EHRM) approach to emergency management. Four decades of systematic research shows that a rigid, bureaucratic command and control approach to emergency management generally leads to an ineffective emergency response. Previous studies and our own research suggest that flexible, malleable, loosely coupled, organizational configurations can create a more effective disaster response.

  4. The Humanities Amidst the Bureaucratic Realities.

    Science.gov (United States)

    Terrey, John

    1983-01-01

    Examines the prospects for the humanities within the bureaucratic structure which determines resource allocations. Suggests that higher education be viewed as big business to help clarify ways in which change, policy, and individuals interact within complex settings. Concludes that leadership is needed to sustain the role of the humanities within…

  5. Using Literature to Teach about Bureaucratic Structure.

    Science.gov (United States)

    Carroll, Virginia Schaefer; Gailey, Joan D.

    1992-01-01

    An interdisciplinary business administration course taught at Kent State University (Ohio) uses literature to teach bureaucratic structure, based on the idea that, for business students, studying literature is an opportunity to develop alternative methods of perceiving and managing human resources. The curriculum is described and the reading list…

  6. School Bureaucratization and Alienation from High School

    Science.gov (United States)

    Anderson, Barry D.

    1973-01-01

    The major goals of this study are to identify dimensions of bureaucracy and alienation, to determine the relationship of these dimensions to second-order, or integrating, factors, and to determine the relationships between the integrating factors of bureaucratic structure and alienation. (Author)

  7. A Theory of the Reform of Bureaucratic Institutions

    OpenAIRE

    Susanto Basu; David Li

    2000-01-01

    By bureaucratic institutions or bureaucracy, we mean the rules and regulations that are implemented by government agencies. Burdensome bureaucratic institutions are leading obstacles to economic development and therefore the target of economic reform of many countries in today's world. In this paper, we provide a theoretical framework to analyze the reform of bureaucratic institutions. The analysis shows the key to the reform is to properly incentivize the incumbent generation of bureaucrats,...

  8. Cutting through Red Tape: Strategies for Dealing with Bureaucrats.

    Science.gov (United States)

    Neugebauer, Roger

    1994-01-01

    This article discusses the characteristics of bureaucratic organizations and bureaucrats, focusing on how these attributes affect day-care centers that must deal with bureaucracies. Outlined are several strategies for dealing with the types of bureaucrats that child care directors are likely to encounter. (MDM)

  9. Disability and Bureaucratic Forms of Life

    Directory of Open Access Journals (Sweden)

    Thomas Abrams

    2015-06-01

    Full Text Available This paper employs a hybrid actor-network theory/phenomenological approach to a frequent bother in the lives of disabled persons: bureaucratic forms. I argue that these forms are key sites where disabled personhood emerges, something I examine through the lens of what philosopher Annemarie Mol calls ‘ontological politics’. To be disabled is to be entered into the bureaucratic form of life. These forms translate human existence into a categorize-able, transportable and combinable object, to be administered through ‘centers of calculation’. Combining Heidegger’s fundamental ontology with Latour’s theory of paperwork, I suggest that these forms represent disability in terms of ‘objective presence’, as a mere pre-existing thing, rather than a human way of being. I conclude with suggestions for further phenomenological research that takes embodied difference as its point of departure.

  10. Bureaucratic oppression: its causes and cures

    Directory of Open Access Journals (Sweden)

    Edward L. Rubin

    2017-12-01

    Full Text Available Objective to consider and study the legal procedures aimed at deterring bureaucratic oppression. Methods dialectic approach to cognition of social phenomena enabling to analyze them in historical development and functioning in the context of the totality of objective and subjective factors that determined the choice of the following research methods analysis synthesis comparison systematic formallegal comparativelegal methods. Results the auricle views legal procedures aimed at deterring bureaucratic oppression. The author comes to the conclusion that these legal procedures are one of the multiple mechanisms which allow regulation of interaction between a state and private persons. As the problem extends to an extremely broad range of interactions the paper analyzes and reveals the features of only certain types of potentially oppressing interactions between a state and citizens the treatment of business enterprises by regulatory agencies the treatment of government grantees by funding agencies the treatment of individuals by protective services and the treatment of individuals in government institutions. Scientific novelty Part I of the Article discusses the sources of bureaucratic oppression and identifies four such sources status differences stranger relations institutional pathologies and divergent incentives. Part II explores four solutions to the problem of bureaucratic oppression that have been proposed and in some cases implemented. The first two ndash the judicial solution of due process and the legislative solution of ombudspersons involve actors external to the administrative system. The second two ndash the management theory solution of clientcentered administration and the microeconomic solution of market simulating mechanisms ndash are internal to that system. Because of the limitations of these various solutions Part III proposes an additional solution described as a collaborative monitor. This monitor would be an agency of the

  11. Bureaucratic oppression: its causes and cures

    OpenAIRE

    Edward L. Rubin

    2017-01-01

    Objective to consider and study the legal procedures aimed at deterring bureaucratic oppression. Methods dialectic approach to cognition of social phenomena enabling to analyze them in historical development and functioning in the context of the totality of objective and subjective factors that determined the choice of the following research methods analysis synthesis comparison systematic formallegal comparativelegal methods. Results the auricle views legal procedures aimed at...

  12. The Impact of Aid on Bureaucratic Quality

    DEFF Research Database (Denmark)

    Selaya, Pablo; Thiele, Rainer

    2012-01-01

    We show that the impact of foreign aid on bureaucratic quality in recipient countries varies with the mode of delivery. Specifically, grants are found to impair the functioning of the bureaucracy, whereas loans are not. The negative impact of grants is larger when they are given as budget support...... rather than as assistance for specific projects or for programmes in general. Our results thus suggest that the probability of adverse effects rises with the degree of discretion recipients have over the incoming resources, which is in conflict with donors' recent emphasis on strengthening local...

  13. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    May, Peter J.; Winter, Søren

    2010-01-01

    This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals...

  14. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    J. May, Peter; Winter, Søren

    2009-01-01

    This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals...

  15. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    J. May, Peter; Winter, Søren

    2012-01-01

    This article addresses the influence of politicians, managers, and the dispositions of street level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage......, their professional knowledge, and their policy predispositions. Our main contribution is an unpacking of the political and managerial influences on caseworkers’ policy emphases. We find direct effects and, more notably, indirect effects that operate on the influence of caseworkers’ perceptions of policy goals...

  16. Bureaucratic Minimal Squawk Behavior: Theory and Evidence from Regulatory Agencies

    OpenAIRE

    Clare Leaver

    2009-01-01

    This paper argues that bureaucrats are susceptible to `minimal squawk` behavior. I develop a simple model in which a desire to avoid criticism can prompt, otherwise public-spirited, bureaucrats to behave inefficiently. Decisions are taken to keep interest groups quiet and mistakes out of the public eye. The policy implications of this behavior are at odds with the received view that agencies should be structured to minimise the threat of `capture`. I test between theories of bureaucratic beha...

  17. Bureaucratic Blockages : Water, Civil Servants, and Community in Tanzania

    OpenAIRE

    Bailey, Juli

    2017-01-01

    How do civil servants in district water and sanitation departments address problems of water access in rural communities in Tanzania? What are the bureaucratic procedures they follow? How do the bureaucratic procedures around formulating budgets, managing money, and interacting with communities impede or enhance their ability to manage water projects? This report addresses these and related ...

  18. From Bureaucratic Organizations to Learning Organizations: An Evolutionary Roadmap

    Science.gov (United States)

    Jamali, D.; Khoury, G.; Sahyoun, H.

    2006-01-01

    Purpose: To track changes in management paradigms from the bureaucratic to the post-bureaucratic to the learning organization model, highlighting core differentiating features of each paradigm as well as necessary ingredients for successful evolution. Design/methodology/approach: The article takes the form of a literature review and critical…

  19. Missing Areas in the Bureaucratic Reputation Framework

    Directory of Open Access Journals (Sweden)

    Moshe Maor

    2016-06-01

    Full Text Available Drawing on insights from social networks, social cognition and the study of emotions, this conceptual article offers a set of ideas and a series of predictions on how systematic variation in two sets of relationships may bear on agency behavior. The first is the agency-audience relationship which revolves around how and what multiple audiences think about public agencies, how these thoughts impact upon agency behavior, how information regarding this behavior is transformed within multiple audiences and how it influences audience memory and behavior regarding that agency. The second is the relationship between the reputation of an agency head and the reputation of that agency. The article identifies six broad areas that offer the most promising possibilities for future research on bureaucratic reputation, calling on researchers to incorporate insights from the aforementioned literatures, to dimensionalize these sets of relationships and to assess the generalizability of reputation’s effects.

  20. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    J. May, Peter; Winter, Søren

    This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals......, their professional knowledge, and their policy predispositions. Our main contribution is an unpacking of the political and managerial influences on caseworkers’ policy emphases. We find direct effects and, more notably, indirect effects that operate on the influence of caseworkers’ perceptions of policy goals...

  1. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    May, Peter J.; Winter, Søren

    2012-01-01

    This article addresses the influence of politicians, managers, and the dispositions of street level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with thenational employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals......, their professional knowledge, and their policy predispositions. Our main contribution is an unpacking of the political and managerial influences on caseworkers’ policy emphases. We find direct effects and, more notably, indirect effects that operate on the influence of caseworkers’ perceptions of policy goals...

  2. Initial treatment of severe malaria in children is inadequate – a study ...

    African Journals Online (AJOL)

    -medicated at home. Initial consultations are at primary local health facilities where less effective drugs are prescribed at inadequate dosages. Recommended ACTs were also often prescribed at inadequate dosages. Education in the use of ...

  3. Bureaucratization and medical professionals' values: A cross-national analysis.

    Science.gov (United States)

    Racko, Girts

    2017-05-01

    Understanding the impact of the bureaucratization of governance systems on the occupational values of medical professionals is a fundamental concern of the sociological research of healthcare professions. While previous studies have examined the impact of bureaucratized management, organizations, and healthcare fields on medical professionals' values, there is a lack of cross-national research on the normative impact of the bureaucratized systems of national governance. Using the European Social Survey data for 29 countries, this study examines the impact of the bureaucratization of national governance systems on the occupational values of medical professionals. The findings indicate that medical professionals who are employed in countries with the more bureaucratized systems of national governance are less concerned with openness to change values, that emphasize autonomy and creativity, and self-transcendence values, that emphasize common good. The findings also indicate that the negative effect of the bureaucratization of national governance on the openness to change values is stronger for medical professionals in more bureaucratized organizations with more rationalized administration systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Consequences of Inadequate Physical Activity

    Centers for Disease Control (CDC) Podcasts

    2018-03-27

    Listen as CDC Epidemiologist Susan Carlson, PhD, talks about her research, which estimates the percentage of US deaths attributed to inadequate levels of physical activity.  Created: 3/27/2018 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/27/2018.

  5. Radiologists' responses to inadequate referrals

    International Nuclear Information System (INIS)

    Lysdahl, Kristin Bakke; Hofmann, Bjoern Morten; Espeland, Ansgar

    2010-01-01

    To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

  6. Sociocultural Factors and Bureaucratic Practices in Universities in Ghana

    Directory of Open Access Journals (Sweden)

    SOLOMON KOFI AMOAH

    2014-05-01

    Full Text Available Max Weber, one of the pioneers in bureaucratic organisational studies believes in the ultimate triumph of bureaucracy over the collegial culture of universities. This paper argues that rather than ultimate triumph of bureaucracy over the collegial culture of universities (Weber 1947, the interests of universities would be better served when the bureaucratic culture is designed to accommodate some core socio-cultural expectations of organizational members, without compromising productivity.  The research examined the implications of some selected sociocultural factors for bureaucratic practices in selected universities in Ghana through a mix method approach. The findings show that, the authority structures of the two universities typify the Weberian Ideal type bureaucracy with   hierarchical culture and standardized rules and procedures for carrying out every task. This notwithstanding, the societal culture was found to be influential in shaping the bureaucratic behaviour and conducts of organizations’ members. The paper aims at bringing to the fore the strength of the informal structures in reshaping bureaucratic culture and work behaviour, and the need to consider socio-cultural contexts in designing bureaucratic organizations.

  7. [Inadequate treatment of affective disorders].

    Science.gov (United States)

    Bergsholm, P; Martinsen, E W; Holsten, F; Neckelmann, D; Aarre, T F

    1992-08-30

    Inadequate treatment of mood (affective) disorders is related to the mind/body dualism, desinformation about methods of treatment, the stigma of psychiatry, low funding of psychiatric research, low educational priority, and slow acquisition of new knowledge of psychiatry. The "respectable minority rule" has often been accepted without regard to the international expertise, and the consequences of undertreatment have not been weighed against the benefits of optimal treatment. The risk of chronicity increases with delayed treatment, and inadequately treated affective disorders are a leading cause of suicide. During the past 20 years the increase in suicide mortality in Norway has been the second largest in the world. Severe mood disorders are often misclassified as schizophrenia or other non-affective psychoses. Atypical mood disorders, notably rapid cycling and bipolar mixed states, are often diagnosed as personality, adjustment, conduct, attention deficit, or anxiety disorders, and even mental retardation. Neuroleptic drugs may suppress the most disturbing features of mood disorders, a fact often misinterpreted as supporting the diagnosis of a schizophrenia-like disorder. Treatment with neuroleptics is not sufficient, however, and serious side effects may often occur. The consequences are too often social break-down and post-depression syndrome.

  8. Bureaucratic complexity and impacts of corruption in utilities

    Energy Technology Data Exchange (ETDEWEB)

    Seim, Line Toendel; Soereide, Tina [Chr. Michelsen Institute, P.O.Box 6033 Postterminalen, N-5892 Bergen (Norway)

    2009-06-15

    This paper explores how the relationship between bureaucratic complexity and corruption affects the performance in utilities. We observe considerable variation in the performance of the utilities across countries, even across countries which appear to be relatively similar. Our hypothesis is that corruption plays an important role in explaining this observed difference in performance. In particular, corruption coupled with a complex regulatory structure can have negative effects on performance. The analysis points at the importance of considering the institutional framework and institutional quality when introducing new bureaucratic procedures, as the same set of policy advice will work differently in different countries. We measure bureaucratic complexity by the number of procedures needed for starting a business from the Doing Business Database provided by the World Bank. (author)

  9. Bureaucratic Tax-Seeking: The Danish Waste Tax

    DEFF Research Database (Denmark)

    Christoffersen, Henrik; Svendsen, Gert Tinggaard

    2002-01-01

    model. These suggestions are confirmed by the case of the Danish waste tax with its fixed price approach and perverse incentives compared to that of achieving environmental target levels in a cost-minimising way. Thus, we recommend that bureaucratic institutions should coordinate their tax...... fishermen or hunters (here named "bureaucratic tax-seeking"). Second, the absence of a strong and fully informed troop leader prevents rational coordination of collective action. Taxing citizens or firms is then like harvesting rents from a natural resource and therefore we apply a common-pool resource...

  10. Why Does Bureaucratic Corruption Occur in the EU?

    DEFF Research Database (Denmark)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-01-01

    Why does bureaucratic corruption occur in the EU system? Several examples suggest that bureaucratic corruption exists and that the Commission’s anti-fraud agency, OLAF, is not a fully independent authority. We thus develop a novel interpretation of the principalsupervisor-agent model to cope...... with non-independent anti-fraud units. This model shows that corruption is likely to occur when the expected value to the client from bribing the agent is larger than the expected value to the principal of truth-telling by the supervisor. Overall, this analysis points to the risks of flawed incentives...

  11. Bribe-Taking by Bureaucrats: Personal and Circumstantial Determinants

    OpenAIRE

    Chi, Wei; Wang, Yijiang

    2008-01-01

    We argue that personal (e.g., age, gender and education) and circumstantial (e.g., bureaucratic rank and sector of employment) factors affect the cost and the benefit of bribe-taking by the bureaucrats. The bureaucrat’s bribe-taking decision is modeled. A unique data set is used to test the predictions of the model. The empirical findings include that education reduces, but power (measured by rank and sector of work) increases, the magnitude of bribe-taking. Age affects bribe-taking in a ...

  12. Rights, regulation and bureaucratic impact: The impact of human ...

    African Journals Online (AJOL)

    In contemplating the extent to which rights-based litigation is conducive to positive social change, attention ought to be paid to the bureaucratic impact of court judgments that vindicate rights against the State. As a case study of such impact, this article considers the effects of human rights litigation on the regulation of ...

  13. Street-level bureaucrats help clients, even in difficult circumstances

    NARCIS (Netherlands)

    L.G. Tummers (Lars)

    2015-01-01

    textabstractThis policy brief presents the main findings of the Marie Curie Project “COPING: Policy implementation in stressful times: Analyzing coping strategies of civil servants”. The project combines insights from public administration and psychology to study how street-level bureaucrats (also

  14. Street-level bureaucrats help clients, even in difficult circumstances

    NARCIS (Netherlands)

    Tummers, L.G.

    2015-01-01

    This policy brief presents the main findings of the Marie Curie Project “COPING: Policy implementation in stressful times: Analyzing coping strategies of civil servants”. The project combines insights from public administration and psychology to study how street-level bureaucrats (also termed

  15. What Is Political about Bureaucratic-Collegial Decision-Making?

    Science.gov (United States)

    Childers, Marie E.

    1981-01-01

    A fundamental assumption that bureaucratic, collegial, and political models of administration are independent and distinct is challenged, and process and structure within higher education institutions are differentiated as they describe role and power relationships and lines of authority. Survey results are cited as evidence and implications are…

  16. The Policy Choices of Bureaucrats: an institutional analysis

    NARCIS (Netherlands)

    S. Naseer (Shaheen)

    2018-01-01

    textabstractThis dissertation analyzes the over-arching question of how the institutional and social context of public bureaucracy impact the choices of bureaucrats. These choices are introduced in the form of inertial-preferences and identity-driven preferences in the decision-making of

  17. Managerial use of performance data by bureaucrats and politicians

    DEFF Research Database (Denmark)

    Moynihan, Donald P.; Nielsen, Poul Aaes; Kroll, Alexander

    2017-01-01

    This chapter examines experimental evidence on performance informa- tion use by public officials – including both bureaucrats and politi- cians – charged with managing public services. Unlike topics covered in many of the chapters in this book, the topic is relatively new, and while observational...

  18. The Impact of New Information Technology on Bureaucratic Organizational Culture

    Science.gov (United States)

    Givens, Mark A.

    2011-01-01

    Virtual work environments (VWEs) have been used in the private sector for more than a decade, but the United States Marine Corps (USMC), as a whole, has not yet taken advantage of associated benefits. The USMC construct parallels the bureaucratic organizational culture and uses an antiquated information technology (IT) infrastructure. During an…

  19. Critical Experience Amidst Bureaucratic Structures: Interdisciplinary Dialogue on Educational Futures.

    Science.gov (United States)

    Herman, Robin; Crawford, Jeffrey

    The public schools of today are pictured as rigid bureaucratic structures, unresponsive to dynamic change, and stultifying to individual initiative and growth. A discussion is presented on the future needs of education that will meet expanding demands for greater freedom for the individual in a democracy to make intelligent decisions. Proposals…

  20. Bureaucratic Structure in Schools: A Refinement and Synthesis in Measurement.

    Science.gov (United States)

    Sousa, David A.; Hoy, Wayne K.

    1981-01-01

    Compares two methods of measuring bureaucratic structure, Hall's organizational inventory and the University of Aston (England) approach, and tests them using data from 55 public high schools in New Jersey. Factor analysis reveals four underlying dimensions of school structure, including organizational control, rational specialization, system…

  1. Models of University Governance: Bureaucratic, Collegial, and Political.

    Science.gov (United States)

    Baldridge, J. Victor

    The fundamental argument of this paper is that sociologists and administration theorists have not yet constructed appropriate intellectual models for analyzing academic administration, and that the lack is hindering research. Two of the dominant models of university governance, the bureaucratic and the collegial, are examined and criticized, and a…

  2. africa reform agenda: bureaucratic organisations as priority in the ...

    African Journals Online (AJOL)

    NESG PUBLICATIONS

    acceptance of its normative and realistic order (Beetham, 1996). In any nation, public administration matters. .... birth to bureaucracies and bureaucrats. They first of all aim to establish this large institutional order ... areas (Wallis, 1989; Du Gay, 2000). According to Wallis (1989), there are several government-led activities.

  3. The Dilemma of Bureaucratic Rationalisation: The Role of the World ...

    African Journals Online (AJOL)

    Despite the widely publicised humanitarian condition during the Nigerian Civil War (1967-1970), the World Health Organisation (WHO) was conspicuously absent in the provision of emergency assistance to the war affected areas. This article employs the bureaucratic framework to explain the inaction of the WHO in the ...

  4. Bureaucratic accountability in the education action zones of South ...

    African Journals Online (AJOL)

    The Education Action Zone program me in Gauteng p rovince, South A frica, has been w idely seen as a very successful school improvement initiative, with particular significance as it represents a unique model of top-down, bureaucratic accountability as a vehicle for turning- around dysfunctional secondary schools. In this ...

  5. Pathologies in de-bureaucratic public organizations in Nigeria ...

    African Journals Online (AJOL)

    This growing interest is in most, if not indeed all, less developed countries, including Nigeria. Hence the central concern of this paper is identification and objective but critical analysis of the major bureau-pathologies in de-bureaucratic public organization in Nigeria. The rationale for the identification and critical analysis is to ...

  6. Parkinson's Law quantified: three investigations on bureaucratic inefficiency

    Science.gov (United States)

    Klimek, Peter; Hanel, Rudolf; Thurner, Stefan

    2009-03-01

    We formulate three famous, descriptive essays of Parkinson on bureaucratic inefficiency in a quantifiable and dynamical socio-physical framework. In the first model we show how the use of recent opinion formation models for small groups can be used to understand Parkinson's observation that decision-making bodies such as cabinets or boards become highly inefficient once their size exceeds a critical 'Coefficient of Inefficiency', typically around 20. A second observation of Parkinson—which is sometimes referred to as Parkinson's Law—is that the growth of bureaucratic or administrative bodies usually goes hand in hand with a drastic decrease of its overall efficiency. In our second model we view a bureaucratic body as a system of a flow of workers, who enter, become promoted to various internal levels within the system over time, and leave the system after having served for a certain time. Promotion usually is associated with an increase of subordinates. Within the proposed model it becomes possible to work out the phase diagram under which conditions of bureaucratic growth can be confined. In our last model we assign individual efficiency curves to workers throughout their life in administration, and compute the optimum time to give them the old age pension, in order to ensure a maximum of efficiency within the body—in Parkinson's words we compute the 'Pension Point'.

  7. Bureaucratic Influence in the Formation of State School Policy.

    Science.gov (United States)

    Mazzoni, Tim L.

    1985-01-01

    An analysis of structured interviews conducted in 1973, 1979, and 1984 with state legislators and school lobbyists and 14 case studies that investigated issues in Minnesota state school policymaking reveal that influence relationships do not correspond to the bureaucratic model. Political leaders influence policymaking far more than do…

  8. Bureaucratic Accountability in the Education Action Zones of South Africa

    Science.gov (United States)

    Fleisch, Brahm

    2006-01-01

    The Education Action Zone programme in Gauteng province, South Africa, has been widely seen as a very successful school improvement initiative, with particular significance as it represents a unique model of top-down, bureaucratic accountability as a vehicle for turning- around dysfunctional secondary schools. In this article I evaluate the impact…

  9. Bureaucratic Tax-Seeking: The Danish Waste Tax

    DEFF Research Database (Denmark)

    Christoffersen, Henrik; Svendsen, Gert Tinggaard

    2002-01-01

    model. These suggestions are confirmed by the case of the Danish waste tax with its fixed price approach and perverse incentives compared to that of achieving environmental target levels in a cost-minimising way. Thus, we recommend that bureaucratic institutions should coordinate their tax...

  10. Bureaucratic corruption and anti-corruption strategies in Nigeria: an ...

    African Journals Online (AJOL)

    This paper derives from the contemporary concern facing good governance and the sustainability of democratic government in Nigeria. The phenomenon of corruption i.e. bureaucratic corruption has negative implications on the nation and therefore capable of terminating our nascent democracy, hence, the need to curb or ...

  11. Is the Non-unitary Subject a Plausible and Productive Way to Understand Development Bureaucrats?

    NARCIS (Netherlands)

    Tamas, P.A.; Sato, C.

    2012-01-01

    Development bureaucrats are the human instruments of the policies that mobilise funds, create organisations and underwrite interventions. For their home audiences development organisations need to present bureaucrats who are reliable instruments. In the field these same organisations need staff who

  12. Welfare Reform and the Street Level Bureaucrat in homelessness services

    OpenAIRE

    Alden, SL

    2015-01-01

    Local authority housing option teams (LAHAS’s) are a perennially lean service and the recent austerity agenda and corresponding rise in households at threat of homelessness mean resources are stretched to the limit. This article draws on Michael Lipsky’s street level bureaucrat conceptual framework to seek an understanding of how frontline practitioners interpret and deliver policy directives in a challenging political environment whilst assessing their ability to influence service outcomes. ...

  13. The overprotective parent - Bureaucratic agencies and natural hazard management

    OpenAIRE

    Paul Raschky

    2007-01-01

    Due to the public good character of protective measures against natural disasters events, their allocation is very often in the realm of bureaucratic and expert agencies. Based on the economic theory of bureaucracy the behaviour of a bureau providing the good "protection against natural hazards" is analysed. The existing model is extended by further institutional constraints accounting for societal control mechanisms. The main proposition is that the allocation of protective measures through ...

  14. Bureaucratic Complexity and Impacts of Corruption in Utilities

    OpenAIRE

    Tøndel, Line; Søreide, Tina

    2008-01-01

    This paper explores how the relationship between bureaucratic complexity and corruption affects the performance in utilities. We observe considerable variation in the performance of the utilities across countries, also across countries which appear to be relatively similar in terms of GDP per capita. Our hypothesis is that corruption is an important explanatory factor. In particular, corruption coupled with a complex regulatory structure can have negative effects on performance in this sector...

  15. Public administration: from bureaucratic culture to citizen-oriented culture

    OpenAIRE

    Claver Cortés, Enrique; Llopis Taverner, Juan; Gascó Gascó, José Luis; Molina Manchón, Hipólito; Conca Flor, Francisco José

    1999-01-01

    This paper analyzes how public administration may improve the service it offers to citizens through a suitable organizational culture; for this purpose, it starts by studying the specific features of the culture of public administration. In this respect, it analyzes the existing taxonomies in public administration, the role of culture in these agencies and how a diagnosis of such culture is made. Then, it describes the problems of bureaucratic culture, typical of many public agencies, and bri...

  16. Insulation or patronage: Political institutions and bureaucratic efficiency

    OpenAIRE

    Mueller, Hannes

    2015-01-01

    © by De Gruyter 2015. This article presents a model of political insulation of bureaucracies. Political influence can harm competence because it lowers the incentives of bureaucrats to invest in competence. Politicians then want to adopt institutions that insulate the bureaucracy because this establishes a commitment to reward competence. Political leaders insulate the bureaucracy if public good provision is important compared to rent extraction or when political competition forces the politi...

  17. Parkinson's Law Quantified: Three Investigations on Bureaucratic Inefficiency

    OpenAIRE

    Klimek, Peter; Hanel, Rudolf; Thurner, Stefan

    2008-01-01

    We formulate three famous, descriptive essays of C.N. Parkinson on bureaucratic inefficiency in a quantifiable and dynamical socio-physical framework. In the first model we show how the use of recent opinion formation models for small groups can be used to understand Parkinson's observation that decision making bodies such as cabinets or boards become highly inefficient once their size exceeds a critical 'Coefficient of Inefficiency', typically around 20. A second observation of Parkinson - w...

  18. Bureaucratization and Adaptive Behavior in the Higher Education

    Directory of Open Access Journals (Sweden)

    Vyacheslav V. Volchik

    2016-12-01

    Full Text Available The paper is devoted to researching the economic behavior of individuals in the higher education in the term of increasing bureaucratization. Reasons of bureaucracy and inefficiencies generated by it are considered on the example of the higher education sector. Constant changes in the bureaucratic system requirements need to be adapted in the behavior of actors. The authors highlight approaches to adaptation within the framework of the Austrian school of economics. Austrian approaches to adapt and the adaptive rationality concept in institutional economics are compared. The role of rationality in the process of adaptation is shown in the research. The empirical basis of the study is represented by the transcripts of 50 in-depth interviews conducted in 2015 with students, lecturers and heads of higher education institutions of the Rostov region. The main objective of the interview is the allocation of institutional change in higher education. Bureaucratization was named by respondents as one of the most important changes. The paper systematizes the respondents' answers on the impact of bureaucracy and carries out typology of adapting ways to the formal innovations. Imitating practices as a form of adaptation to the growth of the formal requirements are considered clearly. The authors display the negative impact of this adaptation form to the quality of educational activities and organizational culture.

  19. Socio-phenomenological perspective of the bureaucratic organizational structure

    Directory of Open Access Journals (Sweden)

    Jairo E. Cuenú Cabezas

    2011-12-01

    Full Text Available To accomplish their purposes in carrying out their activities, organizations need a structure. The word structure is used by different disciplines, which - in general terms - conceive it as an order-relation. In organizational theory, the word structure essentially defines the relationships amongst individuals to reach a given end. The organizational structure is a product of the interaction of human beings and it is they, from their experiences, rationalities, and expectations, who determine how the purposes should be accomplished. Different forms exist, in terms of structure, to accomplish organizational purposes; one of the most representative forms is the bureaucratic approach. Bureaucracy is a method to use special abilities. This cannot be denied, but it is also a form, from Alfred Schütz’ phenomenological sociology, of establishing settings of intimacy and anonymity in organizational relations. The objective of this article is to show how the bureaucratic structure generates intimacy or anonymity in the organization. In the first place, the article presents the concept of structure from which the organizational structure is explained, especially the bureaucratic structure. The second part presents Alfred Schütz’ phenomenological sociology, emphasizing on the concept he raised of the world of everyday life and the relations of otherness. With the aforementioned, intimacy and anonymity in the organization is developed or explained. In conclusion, among other aspects, we address the need for the organizational theory or for organizational theorists to approach everyday life in organizations

  20. Ethical decision making within the bureaucratic context: a case study.

    Science.gov (United States)

    Desai, Kathryn

    2003-01-01

    Balancing the polarized notions of quality and quantity of service and care is a challenge for the 21st century health and social service system. The expectation of transparent decision making at both the policy and the practice level of case management has forced practitioners to seek guidance in ethical decision making. Case management, as a system, has potential to lead this new practice approach by incorporating the principles of ethical decision making in planning and coordinating care. A recent case study of ethical decision making within the bureaucratic context offers some insight and learning and may help inform future practice.

  1. Bureaucracy Versus Environment: The Environmental Costs of Bureaucratic Governance

    Science.gov (United States)

    Singer, S. Fred

    The 15 contributors to this volume have an important message. They are convinced that both environmental and economic costs of bureaucratic management of natural resources are too high, and unnecessarily so. The main reason is an institutional one: Authority is given to those who do not bear responsibility for the consequences o f their actions.A classic case is the set of specific numerical emission standards for automobiles in the Clean Air Act Amendments of 1970. Congress arrived at these standards without a scientific basis, without technical analysis, and certainly without any consideration of costs and benefits. Only 3 years later did Senator Muskie ask the National Academy of Sciences to conduct a cost-benefit analysis. The NAS results were presented in a fashion that seemed to support the action of Congress; yet, the statutory emissions standards yielded marginal costs well beyond their marginal benefits. They had a major impact on Detroit during the 1970's, and very likely damaged, perhaps irreversibly, the competitive standing of the American automobile industry, a major segment of the U.S. economy. But the economic costs of these actions were never considered, least of all by the responsible bureaucrats. They were completely buffered from any consequences flowing from the exercise of their authority.

  2. Bureaucratic Reform in Irrigation: A Review of Four Case Studies

    Directory of Open Access Journals (Sweden)

    Diana Suhardiman

    2014-10-01

    Full Text Available Poor performance of government-managed irrigation systems persists globally. This paper argues that addressing performance requires not simply more investment or different policy approaches, but reform of the bureaucracies responsible for irrigation management. Based on reform experiences in The Philippines, Mexico, Indonesia, and Uzbekistan, we argue that irrigation (policy reform cannot be treated in isolation from the overall functioning of government bureaucracies and the wider political structure of the states. Understanding of how and why government bureaucracies shape reform processes and outcomes is crucial to increase the actual significance of reforms. To demonstrate this, the paper links reform processes in the irrigation sector with the wider discourse of bureaucratic reform in the political science, public administration, and organisational science literature. Doing so brings to light the need for systematic comparative research on the organisational characteristic of the irrigation bureaucracies, their bureaucratic identities, and how these are shaped by various segments within the bureaucracies to provide the insights needed to improve irrigation systems performance.

  3. The organization of political parties and the politics of bureaucratic reform

    OpenAIRE

    Cruz, Cesi; Keefer, Philip

    2013-01-01

    Bureaucratic reform is a priority of donor organizations, including the World Bank, but is notoriously difficult to implement. In many countries, politicians have little interest in the basic financial and personnel management systems that are essential to political oversight of bureaucratic performance. To explain this, this paper presents a new perspective on the political economy of bur...

  4. The Relationship of Student Teachers' Bureaucratic Orientation to Verbal Classroom Behavior.

    Science.gov (United States)

    Sturm, Dieter W. F.

    1979-01-01

    Determines the relationship of student teachers' commitment to values, attitudes, and behaviors characteristically fostered by bureaucratic organizations and their verbal classroom behavior while teaching. Findings reveal no difference in verbal classroom behavior of student teachers high and low in bureaucratic orientation, and no difference in…

  5. The Relationship between Bureaucratic School Structures and Teacher Self-Efficacy

    Science.gov (United States)

    Kilinç, Ali Çagatay; Kosar, Serkan; Er, Emre; Ögdem, Zeki

    2016-01-01

    The purpose of this study was to examine the relationship between bureaucratic school structures and teachers' self-efficacy. Participants included 252 teachers from 15 primary schools in Ankara, Turkey. Mean, standard deviation, correlation, and regression analyses were conducted. Results indicated that bureaucratic school structures and teacher…

  6. The Bureaucratic Model in University Budgeting: An Alternative Explanation to Power.

    Science.gov (United States)

    Schick, Allen G.; And Others

    1982-01-01

    Examined the relationship between instructional workload and budgeting of personnel positions and how this relationship changes as personnel positions become scarce. Longitudinal data suggest a direct relationship between the bureaucratic model and personnel allocations; tendencies to use the bureaucratic model increase as personnel positions…

  7. Nurse managers and budgeting: professional/bureaucratic conflict?

    Science.gov (United States)

    Abernethy, M A; Stoelwinder, J U

    1988-01-01

    Professional/bureaucratic conflict theory suggests that the extent to which nurse managers use management control systems will depend on whether their goal orientation is to system rather than output or derived goals. This article examines the use of budgeting as a management control strategy, in relation to the goal orientation of nurse managers, in four large teaching hospitals. The goal orientations and use of budgeting by nurse managers is also compared with those of physician managers and other sub-unit managers. The results indicate that nurse managers appear to be developing their goals of professionalization without a diminution of their organizational focus or their orientation towards providing a high standard of patient care.

  8. Interactive policy processes: a challenge for street-level bureaucrats

    DEFF Research Database (Denmark)

    Agger, Annika; Damgaard, Bodil

    2018-01-01

    Street-level bureaucrats (SLB) are, according to the literature, assigned a crucial role providing better policy implementation and generating trust between the system and the citizens. In this article, we argue that Lipsky’s division between public managers and SLB needs an update. Today more...... converting public managers to SLB. The key question raised is thus: What kind of skills and capabilities of SLB are needed in more interactive forms of public policy making? And what are the consequences for how the universities educate these groups?’ Drawing on a study of 32 urban professionals that work...... public managers are expected to work closely and directly with affected stakeholders in order to solve cross-cutting ‘wicked problems’. More interactive and participative collaborative policy processes increasingly require public managers to move from back-office work to front-office work, in effect...

  9. Bureaucratic Tax-Seeking: The Danish Waste Tax

    DEFF Research Database (Denmark)

    Christoffersen, Henrik; Svendsen, Gert Tinggaard

    2000-01-01

    Two main results in traditional tax theory states the following. First, general taxes minimize the welfare loss from changed relative prices. Second, because the total public budget tends to exceed the optimal size, a leader (here named 'troop leader') is needed in the budget process to prevent...... over-taxation. Nevertheless, differentiated taxes initiated by individual ministries generate a still larger proportion of total tax revenue, in particular under cover of taxing externalities such as environmental pollution. We suggest that this situation leads to over-taxation for two reasons. First......, the absence of a strong and fully informed troop leader prevents rational coordination of collective action. Second, budget maximization leads to overwhelming fiscal pressure because bureaucracies are competing about resources just like fishermen or hunters (here named 'bureaucratic tax-seeking'). Taxing...

  10. Italian retail gasoline activities: inadequate distribution network

    International Nuclear Information System (INIS)

    Verde, Stefano

    2005-01-01

    It is common belief that competition in the Italian retail gasoline activities is hindered by oil companies' collusive behaviour. However, when developing a broader analysis of the sector, low efficiency and scarce competition could results as the consequences coming from an inadequate distribution network and from the recognition of international markets and focal point [it

  11. Barriers to Mammography among Inadequately Screened Women

    Science.gov (United States)

    Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

    2015-01-01

    Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

  12. Radiologists' responses to inadequate referrals

    Energy Technology Data Exchange (ETDEWEB)

    Lysdahl, Kristin Bakke [Oslo University College, Faculty of Health Sciences, Oslo (Norway); University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Hofmann, Bjoern Morten [University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Gjoevik University College, Faculty of Health Care and Nursing, Gjoevik (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway)

    2010-05-15

    To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

  13. Financial incentives are inadequate for most companies

    Indian Academy of Sciences (India)

    Financial incentives are inadequate for most companies. market far less lucrative than for other diseases, which results in chronic underinvestment; reduced investment in TB drug R&D,. Pfizer withdrawal from TB R&D; AstraZeneca abandon TB R&D & close site; Novartis pull out; 4/22 Big Pharma producing antibacterials ...

  14. Evidence Report: Risk Factor of Inadequate Nutrition

    Science.gov (United States)

    Smith, Scott M.; Zwart, Sara R.; Heer, Martina

    2015-01-01

    The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

  15. Bureaucrats, Budgets, and the BIA: Segmentary Opposition in a Residential School

    Science.gov (United States)

    Colfer, Carol J. Pierce

    1975-01-01

    The article describes the political system which operates in an American Indian school and discusses the striking analogy between the school's bureaucratic structure and operation and the structure and operation of a segmentary lineage system. (AUTHOR/NQ)

  16. Inovativnost zaposlenih v birokratskih hotelskih organizacijah = Innovativeness of Employees in Bureaucratic Hotel Organizations

    Directory of Open Access Journals (Sweden)

    Metod Šuligoj

    2011-03-01

    Full Text Available The purpose of this study is to ascertain the differences in the attitudeto innovativeness between bureaucratic and non-bureaucratichotel organisations. We defined as bureaucratic the organisations establishingstandards. For this purpose we first defined basic terminologysuch as hotel idustry, innovativeness and bureaucracy, general,and of tourism and the hotel industry. We also pointed out thatthe government is aware of the importance of innovativeness in thehotel industry and tourism, whence a number of measures are introduced.In the empirical part, using statistical methods, such as the descriptiveanalysis and the Bonferroni test, we established that thereare no statistically significant differences between bureaucratic and non-bureaucratic organisations with regard to innovativeness. In thisway, by using a scientific method, we rejected the often misinterpretedopinion on the negative influence of bureaucracy on innovativeness inthe hotel industry.

  17. Electoral Proximity and the Political Involvement of Bureaucrats: A Natural Experiment in Argentina, 1904

    OpenAIRE

    Valentín Figueroa; Universidad Torcuato Di Tella / IIGG

    2016-01-01

    In this paper, I use a slightly modified version of the Becker–Stigler model of corrupt behavior to explain bureaucratic political involvement. Since bureaucrats prefer higher rewards and not to support losing candidates, we expect them to become politically involved near elections – when rewards are expected to be higher, and information more abundant. Taking advantage of a natural experiment, I employ differences-in-means and differences-in-differences techniques to esti-mate the effect of ...

  18. The Relationship Between Bureaucratic School Structure and Teachers' Level of Academic Optimism

    OpenAIRE

    Özdemir, Servet; Kılınç, Ali Çağatay

    2014-01-01

    Scholar have recently exerted a great deal of time and effort on investigating the concept of academic optimism in the content of achieving a higher level of student success. The purpose of this study was to examine the relationships between bureaucratic school structure and teacher academic optimism. This study concentrating on examining the relationships between bureaucratic school structure and teacher sense of academic optimism conducted relational search model and made use of...

  19. Analyzing Red Tape: The Performative vs Informative Roles of Bureaucratic Documents

    OpenAIRE

    Lee, R.M.

    1980-01-01

    The preparation and transfer of documents bureaucratic procedures are generally viewed solely as a means of transferring information within the organization. When taken as the basis for analyzing and improving bureaucratic systems, this view is too narrow. Another, performative aspect of these documents also needs to be considered in the analysis. This paper elaborates on this additional function of organizational documents and points out the need for a broader framework for analyzing bu...

  20. Managers as consultants:The hybridity and tensions of neo-bureaucratic management

    OpenAIRE

    Sturdy, Andrew J; Wright, Christopher; Wylie, Nick

    2016-01-01

    The nature and extent of changes in management remain subject to debate, especially around the notion of post-bureaucracy. Most research concedes that, partly in response to critiques of bureaucracy, some change has occurred, but towards hybrid or neo-bureaucratic practices which retain core elements of bureaucratic organisation. However, both the mechanisms through which these changes have occurred and their outcomes have received less attention. This paper addresses these issues by focusing...

  1. Inovativnost zaposlenih v birokratskih hotelskih organizacijah = Innovativeness of Employees in Bureaucratic Hotel Organizations

    OpenAIRE

    Metod Šuligoj

    2011-01-01

    The purpose of this study is to ascertain the differences in the attitudeto innovativeness between bureaucratic and non-bureaucratichotel organisations. We defined as bureaucratic the organisations establishingstandards. For this purpose we first defined basic terminologysuch as hotel idustry, innovativeness and bureaucracy, general,and of tourism and the hotel industry. We also pointed out thatthe government is aware of the importance of innovativeness in thehotel industry and tourism, whenc...

  2. Bureaucrats Versus the Ballot Box in Foreign Policy Decision Making: An Experimental Analysis of the Bureaucratic Politics Model and the Poliheuristic Theory

    Science.gov (United States)

    Christensen, Eben J.; Redd, Steven B.

    2004-01-01

    The bureaucratic politics model and the poliheuristic theory are used to examine how political advice presented in various contexts influences choice. Organizational advisers who offer endogenous political advice are compared with situations in which the decision maker is offered advice by a separate, or exogenous, political adviser. Results show…

  3. 9 CFR 417.6 - Inadequate HACCP Systems.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Inadequate HACCP Systems. 417.6... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be found to be inadequate if: (a) The HACCP plan in operation does not meet the requirements set forth in...

  4. Inadequate Nutritional Status of Hospitalized Cancer Patients

    Directory of Open Access Journals (Sweden)

    Ali Alkan

    2017-03-01

    Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

  5. Organizing Special Operations Forces: Navigating the Paradoxical Requirements of Institutional-Bureaucratic and operational Environments

    DEFF Research Database (Denmark)

    Dalgaard-Nielsen, Anja

    2017-01-01

    Increased focus on the potential of special operations has lead several countries to establish dedicated special operations organizations. Analysts have warned against bureaucratization, yet little research has explored the effect of organizational formalization or asked how best to organize....... This article draws from research into high-reliability organizations and interviews in Denmark’s Special Operations Command. It contrasts the demands of the command’s institutional-bureaucratic and operational environments and argues that the ability to straddle them is key to success. The high......-reliability organization’s ability to match divergent problems with dissimilar internal organizational behaviors is held out as a model for inspiration....

  6. Inadequate control of world's radioactive sources

    International Nuclear Information System (INIS)

    2002-01-01

    The radioactive materials needed to build a 'dirty bomb' can be found in almost any country in the world, and more than 100 countries may have inadequate control and monitoring programs necessary to prevent or even detect the theft of these materials. The IAEA points out that while radioactive sources number in the millions, only a small percentage have enough strength to cause serious radiological harm. It is these powerful sources that need to be focused on as a priority. In a significant recent development, the IAEA, working in collaboration with the United States Department of Energy (DOE) and the Russian Federation's Ministry for Atomic Energy (MINATOM), have established a tripartite working group on 'Securing and Managing Radioactive Sources'. Through its program to help countries improve their national infrastructures for radiation safety and security, the IAEA has found that more than 100 countries may have no minimum infrastructure in place to properly control radiation sources. However, many IAEA Member States - in Africa, Asia, Latin America, and Europe - are making progress through an IAEA project to strengthen their capabilities to control and regulate radioactive sources. The IAEA is also concerned about the over 50 countries that are not IAEA Member States (there are 134), as they do not benefit from IAEA assistance and are likely to have no regulatory infrastructure. The IAEA has been active in lending its expertise to search out and secure orphaned sources in several countries. More than 70 States have joined with the IAEA to collect and share information on trafficking incidents and other unauthorized movements of radioactive sources and other radioactive materials. The IAEA and its Member States are working hard to raise levels of radiation safety and security, especially focusing on countries known to have urgent needs. The IAEA has taken the leading role in the United Nations system in establishing standards of safety, the most significant of

  7. The association between inadequate prenatal care and future healthcare use among offspring in the Bedouin population.

    Science.gov (United States)

    Estis-Deaton, Asia; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Walfisch, Asnat

    2017-12-01

    To evaluate the impact of inadequate prenatal care on long-term morbidity among the offspring of an ethnic minority population. A retrospective population-based cohort analysis was performed among all Bedouin women with singleton pregnancies who delivered in a tertiary medical center in Israel between January 1, 1991, and January 1, 2014. Morbidity was defined as pediatric hospitalization across six distinct disease categories before 18 years of age. The cumulative morbidity rates were compared for offspring born following pregnancies with either inadequate (prenatal care facility) or adequate prenatal care. Overall, 127 396 neonates were included; 19 173 (15.0%) were born following inadequate prenatal care. Pediatric hospitalizations for all morbidities other than cardiovascular ones were less frequent among the inadequate prenatal care group than the adequate prenatal care group (Pprenatal care group, with the exception of cardiovascular disease. Inadequate prenatal care correlated with reduced pediatric hospitalization rates among offspring, possibly owing to a lack of child healthcare service utilization within the Bedouin population. © 2017 International Federation of Gynecology and Obstetrics.

  8. Romanticizing Bureaucratic Leadership? The Politics of How Elected Officials Attribute Responsibility for Performance

    DEFF Research Database (Denmark)

    Nielsen, Poul A.; Moynihan, Donald P.

    2017-01-01

    A core task for elected officials is to hold bureaucratic leaders responsible, but how do they determine if public managers actually influence outcomes? We propose that partisan and leadership heuristics affect how politicians apply a logic of individualized responsibility, i.e. focus on individu...

  9. Using Bureaucratic and Cultural Linkages to Improve Instruction: The Principal's Contribution.

    Science.gov (United States)

    Firestone, William A.; Wilson, Bruce L.

    1985-01-01

    Principals can influence teachers and instructional behavior by working through linkage mechanisms within the organizational structure of the school. Two types of linkages are identified: bureaucratic and cultural. Principals have access to linkages of both kinds; using linkages effectively, they can generate a common purpose in their schools. (MD)

  10. APPLICABILITY OF THE BUREAUCRATIC MODEL TO THE ORGANIZATIONAL STRUCTURE OF THE SCHOOL.

    Science.gov (United States)

    ANDERSON, JAMES G.

    THE STUDY OBJECTIVES WERE (1) TO EXAMINE THE DEVELOPMENT AND FUNCTIONING OF RULES WITHIN THE SCHOOL, (2) TO DETERMINE WHETHER CERTAIN LATENT BUREAUCRATIC CHARACTERISTICS EXIST IN THE SCHOOL AND THEIR RELATION TO RULES, AND (3) TO DEVELOP LIKERT SCALES, TO MEASURE CERTAIN STRUCTURAL CHARACTERISTICS OF THE SCHOOL AND LATENT CHARACTERISTICS OF…

  11. Multilevel Governance and Organizational Performance: Investigating the Political-Bureaucratic Labyrinth

    Science.gov (United States)

    Meier, Kenneth J.; O'Toole, Laurence J., Jr.; Nicholson-Crotty, Sean

    2004-01-01

    Research on governance has extensively explored the complex interactions of governmental, nongovernmental, and for-profit entities in the execution of public policy. It has consistently failed, however, to model empirically the joint effects of political and bureaucratic actors in governance systems. To address this issue, a theory of multilevel…

  12. Soviet Education Policy 1917-1935: From Ideology to Bureaucratic Control.

    Science.gov (United States)

    Lauglo, Jon

    1988-01-01

    Examining early Soviet educational policy, Lauglo analyzes the initial expression of Marxist humanist values, popular participation, and the value of productive work for general education. Discusses the routinization into a Stalinist pattern of bureaucratically controlled utilitarianism and comments briefly on recent indications of change in…

  13. The Relationship of Bureaucratic Structure to School Climate: An Exploratory Factor Analysis of Construct Validity

    Science.gov (United States)

    Lennon, Patricia A.

    2010-01-01

    This researcher examined the relationship of bureaucratic structure to school climate by means of an exploratory factor analysis of a measure of bureaucracy developed by Hoy and Sweetland (2000) and the four dimensional measure of climate developed by Hoy, Smith, and Sweetland (2002). Since there had been no other empirical studies whose authors…

  14. Techno-Bureaucratic Governance and Public Service Delivery: Indonesia and Nigeria in Perspectives

    Directory of Open Access Journals (Sweden)

    Jacob Olufemi Fatile

    2015-09-01

    Full Text Available Techno-bureaucratic governance is fundamental to contemporary public service. This is because the roles of the bureaucrats and technocrats become more relevant in policy formulation and implementation when the government had to (reinvent its institutions to move from routine administration to that of development planning and management. Utilizing a qualitative approach, the paper notes that techno-bureaucratic ideology values technical expertise itself and its technical experts, efficiency, economic development and effective public service delivery. Adopting comparative perspective, the paper examines techno-bureaucratic governance and public service delivery in Indonesia and Nigeria. The paper takes a cursory look at the similarities and differences between the two countries. The paper notes that the technocracy nurtured by the New Order in Indonesia was cohesive and effective because of its technical expertise and has helped Indonesia to turn oil income into productive investments,whereas in Nigeria the oil income was used for prestigious projects to the detriment of productive investments. The paper therefore recommend among others that developing societies need a new strategy in delivery services in their public service, and this can be achieved through skilled professionals, technocrats and knowledge based actors. It concludes that for public service to deliver effective services, an efficient bureaucracy and technocracy remain invaluable.

  15. Bureaucratic Control or Professional Autonomy? Performance Management in New Zealand Schools.

    Science.gov (United States)

    Fitzgerald, Tanya; Youngs, Howard; Grootenboer, Peter

    2003-01-01

    Investigates New Zealand teachers' perceptions of the bureaucratic and professional approaches to performance management in their schools. In climate of increasing control of teachers' work and professional activities by the state, results indicate that school managers have adopted a professional approach to staff appraisal. (Contains 41…

  16. The bureaucratization of war: moral challenges exemplified by the covert lethal drone

    Directory of Open Access Journals (Sweden)

    Richard Adams

    2013-12-01

    Full Text Available This article interrogates the bureaucratization of war, incarnate in the covert lethal drone. Bureaucracies are criticized typically for their complexity, inefficiency, and inflexibility. This article is concerned with their moral indifference. It explores killing, which is so highly administered, so morally remote, and of such scale, that we acknowledge a covert lethal program. This is a bureaucratized program of assassination in contravention of critical human rights. In this article, this program is seen to compromise the advance of global justice. Moreover, the bureaucratization of lethal force is seen to dissolve democratic ideals from within. The bureaucracy isolates the citizens from lethal force applied in their name. People are killed, in the name of the State, but without conspicuous justification, or judicial review, and without informed public debate. This article gives an account of the risk associated with the bureaucratization of the State's lethal power. Exemplified by the covert drone, this is power with formidable reach. It is power as well, which requires great moral sensitivity. Considering the drone program, this article identifies challenges, which will become more prominent and pressing, as technology advances.

  17. Beyond the Call of Duty? Essays on motivation and self-selection of bureaucrats

    NARCIS (Netherlands)

    M.W.J.M. Buurman (Margaretha)

    2011-01-01

    textabstractThe existence and effects of public service motivation (PSM), or altruism, among bureaucrats, is a well-debated topic among economists and administrative scientists (see e.g. Perry and Hondeghem 2008a, Besley and Ghatak 2005, Francois 2000 and 2007). However, the debate about motivation

  18. Administrative Practices as Institutional Identity: Bureaucratic Impediments to HE "Internationalisation" Policy in Japan

    Science.gov (United States)

    Poole, Gregory S.

    2016-01-01

    This paper explores how bureaucracy impedes the implementation of higher education (HE) policy at Japanese universities. Administrative systems employ Weberian legal-rational bureaucratic practices that are central to the institutional identity of a university. Rather than the means to internationalisation and reform in general, these systems…

  19. Multilevel Governance and Organizational Performance: Investigating the Political-Bureaucratic Labyrinth

    NARCIS (Netherlands)

    Meier, Kenneth J.; O'Toole, Laurence J.; Nicholson-Crotty, Sean

    2003-01-01

    Research on governance has extensively explored the complex interactions of governmental, nongovernmental, and for-profit entities in the execution of public policy. It has consistently failed, however, to model empirically the joint effects of political and bureaucratic actors in governance

  20. The Road Less Traveled: An Alternative to the Bureaucratic Model of Librarianship.

    Science.gov (United States)

    Jaffe, Martin

    1990-01-01

    Suggests that, although the characteristics of librarianship are definitely those of a profession, in practice many libraries actually operate under a nonprofessional or bureaucratic organizational model. The hypothetical experiences of an entry-level librarian are considered, and an alternative vision of a professional model is offered. (EAM)

  1. Local Government Budgeting: The Econometric Comparison of Political and Bureaucratic Models.

    Science.gov (United States)

    Feldstein, Martin; Frisch, Daniel

    An interesting econometric problem is to decide whether any given state in the budget process is an example of the political or the bureaucratic model of budgeting. The current paper presents a method of deciding this question and then uses it to study local governmental spending on education. The method is based on the important difference…

  2. Relationship between Professional Learning Community, Bureaucratic Structure and Organisational Trust in Primary Education Schools

    Science.gov (United States)

    Kalkan, Fatma

    2016-01-01

    This research uses relational survey method to determine the relationship between professional learning community, bureaucratic structure and organisational trust according to the perceptions of teachers who work in primary education schools. Data were collected from 805 teachers who work in primary education schools in the districts (Altindag,…

  3. Bureaucratism as a phenomenon of rational bureaucracy: the reasons of appearance and the ways of overcoming

    Directory of Open Access Journals (Sweden)

    V. D. Bodnarchuk

    2016-03-01

    Full Text Available The essence and contents of the concepts «bureaucracy» and «bureaucratism» in domestic and foreign science are researched. Generalized definitions of these concepts from a position of public administration are proposed. It is proved that the bureaucracy is a necessary condition for the existence of public administration, without that it cannot perform its functions. As for the bureaucratism, it is negative and even destructive phenomenon, that destroys laws and social rules, limits public participation in making public and administrative decisions, slows reforms in the country. The reasons of the bureaucratism’s appearance in the system of public administration are analyzed, namely: the low professional and moral level of civil servants, the excessive politicization of public and administrative apparatus, the insufficient development of civil society institutions, including independent media, and the general low level of public consciousness and activity. It was demonstrated that the objective gap between the Max Weber’s bureaucracy ideal model and real public administration system is always a place for the signs of bureaucratism, such as formalism, individualism, automatism, that reduce the public administration effectiveness. Therefore the de-bureaucratization ways finding should not behave to full eradication of bureaucratism’s phenomenon that is a priori impossible, and to creating the conditions that makes it impossible the bureaucratism’s most threatening for the society forms - careerism, protectionism, bribery. The ways to bureaucratism’s overcoming, in particular through the institutionalization of civil society, the system auditing of public activities and the implementation of market processes in public administration, are suggested. The complex of these measures will contribute to rationalization and de-bureaucratization of public administration activity.

  4. Legal-sounding bureaucratic re-centralisation of community forestry in Nepal

    DEFF Research Database (Denmark)

    Basnyat, Bijendra; Treue, Thorsten; Pokharel, Ridish Kumar

    2018-01-01

    management plans. Meagre government or more generous donor budgets financed the revisions. Forest bureaucrats and/or consultants did the work and benefitted financially. None of the approaches, however, lived up to technical, scientific standards or followed stipulated participatory processes. The revised......Exactly how do forest bureaucracies manoeuvre to regain power and maximise benefits in the bewildering legal, financial, and administrative field of forest decentralisation? Based on a review of thirty management plans, stakeholder consultations, intensive interactions with six forest user groups......, forest officials, and donor project employees in Nepal, we document the mechanisms of legal-sounding re-centralisation. The central tenet is that bureaucratically established procedures, which are not required by law but treated as if they were, are used to impose regular revisions of community forest...

  5. Domesticating Uncertainty - Reflections on electoral and bureaucratic practices in a election office

    DEFF Research Database (Denmark)

    Vadgård, Anne Kathrine Pihl

    of science applied to elections and the election office I explore the office as a center for the extended network of polling stations and election officials. In this, the different methods and technologies used to orchestrate Election Day are highlighted. The argument draws on Latour’s concept of Centres......Election Day is often considered a celebration of democracy in which politicians and voters alike partake in the festivities. They vote, campaign discuss, and engage. Election Day is, however, also the culmination of months and months of preparation behind the scene. In the bureaucratic engine room...... – the election office – every little step towards this celebratory day and the subsequent counting of the ballots are planned meticulously. By following these often mundane and ordinary practices at a Danish election office this paper discusses the bureaucratic infrastructures, in which electoral and democratic...

  6. The End of Abundance: How Water Bureaucrats Created and Destroyed the Southern California Oasis

    Directory of Open Access Journals (Sweden)

    David Zetland

    2009-10-01

    Full Text Available This paper describes how water bureaucrats shaped Southern California’s urban development and put the region on a path of unsustainable growth. This path was popular and successful until the supply shocks of the 1960s, 1970s and 1980s made shortage increasingly likely. The drought of 1987-1991 revealed that the norms and institutions of abundance were ineffective in scarcity. Ever since then, Southern California has teetered on the edge of shortage and economic and social disruption. Despite the risks of business as usual, water bureaucrats, politicians and developers continue to defend a status quo management strategy that serves their interests but not those of citizens. Professional norms, control of the discourse, and insulation from outside pressure slow or inhibit the adoption of management techniques suitable to scarcity. Pressure from increasing population and politically and environmentally destabilised supplies promise to make rupture more likely and more costly.

  7. Effect of Corrupt Behavior of the Forestry Bureaucrats on the Forest Sustainability

    Directory of Open Access Journals (Sweden)

    Sudarsono Soedomo

    2012-11-01

    Full Text Available 800x600 This article show that corrupt bureaucrats do not always result in a negative effect on the forest sustainability. Even under a certain condition, a corrupt behavior may result in a positive effect on the forest sustainability. An inappropriate policy is more important a cause of the forest sustainability than a corrupt behavior. Therefore, fixing this structural mistake needs to be prioritized in combating the forest destruction, for this structural mistake is the real primary cause of the forest destruction in Indonesia. Fixing this structural mistake is much more effective in combating the forest destruction than finding honest bureaucrats. Keywords:     Birokrat, Distortionary, Nondistortionary, Kelestarian, Korup. Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4

  8. Electoral Proximity and the Political Involvement of Bureaucrats: A Natural Experiment in Argentina, 1904

    Directory of Open Access Journals (Sweden)

    Valentín Figueroa

    2016-01-01

    Full Text Available In this paper, I use a slightly modified version of the Becker–Stigler model of corrupt behavior to explain bureaucratic political involvement. Since bureaucrats prefer higher rewards and not to support losing candidates, we expect them to become politically involved near elections – when rewards are expected to be higher, and information more abundant. Taking advantage of a natural experiment, I employ differences-in-means and differences-in-differences techniques to esti-mate the effect of electoral proximity on the political involvement of justices of the peace in the city of Buenos Aires in 1904. I find a large, positive, and highly local effect of electoral proximity on their political involvement, with no appreciable impact in the months before or after elections.

  9. An Essay on the History of the Russian and Soviet Bureaucratic Nomenclature

    OpenAIRE

    Alexander Obolonsky

    2015-01-01

    The topic of the paper is the history of Russian nomenclature bureaucratic system from the beginning of the 19-th century to the contemporary time. As the Soviet period is the main subject of attention, the earlier times are considered rather briefly, with the accent being made on the 19-th century attempts to modernize bureaucracy, particularly on M. Speranskys initiative to introduce an education criterion instead of the domineering then length of service, and also on periodical unsuccessfu...

  10. Bureaucratic Behavior: A Review of the Theory and its Application to Serbian Public Administration

    OpenAIRE

    Jelena Žarković-Rakić

    2007-01-01

    A professional and competent public administration is necessary for successful transition from a socialist, centrally planned economy to a functioning market democracy. The difficulty lies in building an organized and effective civil service sector. This paper gives a brief overview of formal bureaucratic reasoning, beginning with Niskanen’s theory, followed by the principal-agent model. The "Weberian state hypothesis", which provides an alternative view of bureaucracies in less developed cou...

  11. Does Introduction of Bureaucratic Competition Reduce Corruption in Public Service Delivery?

    OpenAIRE

    Banerjee, Panchali; Mukherjee, Vivekananda

    2015-01-01

    The paper theoretically explores the impact of introducing bureaucratic competition on corruption. For this purpose it considers three different measures of corruption such as corruption incidence (CI), relative corruption incidence (CRI) and corruption rents (CR) in two different types of economies namely corruption-tolerant economies and corruption-reliant economies. As it compares both intensive margin (i.e. the magnitude of bribe) and extensive margin (i.e. the number of bribe incident) o...

  12. One size fits all? : decentralization, corruption, and the monitoring of bureaucrats

    OpenAIRE

    Lessmann, Christian; Markwardt, Gunther

    2009-01-01

    The majority of theoretical and empirical studies on the relationship between decentralization and corruption argues that the devolution of power might be a feasible instrument to keep corruption at bay. We argue that this result crucially depends on the possibility to monitor bureaucrat's behavior. The benefits of interjurisdictional competition only occur if there is a supervisory body such as a free press, which is often lacking in less-developed countries. Using crosscountry data, we anal...

  13. Trust in Management under Post-bureaucratic Conditions: The Case of Finnish Civil Servants

    OpenAIRE

    Jaakko Koivumäki; Pasi Pyöriä

    2013-01-01

    The Finnish state administration has recently undergone a wave of reforms towards decentralized decision-making and increased flexibility in organizing work. Traditional bureaucracy, however, has its virtues. Based on a survey and qualitative interview material, the results presented in this paper indicate that many characteristics of bureaucracy, such as well-defined work roles and hierarchical control, facilitate trust among employees. In contrast, the current post-bureaucratic model of org...

  14. Transformational leadership and change readiness and a moderating role of perceived bureaucratic structure: an empirical investigation

    OpenAIRE

    Badri Abbasi

    2017-01-01

    The purpose of this study was to examine the relationship between transformational leadership and change readiness through perceived bureaucratic structure among government employees in Rasht. As a methodology, descriptive method was applied using questionnaire to collect data. The studied population consisted of 600 employees from three state organizations including Municipality, Gilan Tax Department and Gilan Justice Court. According to Morgan table, the sample size was estimated at 234. Th...

  15. 96/5000 Other literature Bureaucratic records and traces of disappearances in Argentina

    OpenAIRE

    Emilio Crenzel

    2014-01-01

    In this article I examine a series of bureaucratic records produced during the military dictatorship by workers in two state agencies, a morgue and a public hospital, located in two different provinces of Argentina, Córdoba and Buenos Aires. In these public documents, these workers left evidence, for several and different reasons, on the existence of practices that integrated phases or moments of the system of forced disappearance of persons, a crime which distinguished the last military dict...

  16. A signaling perspective on bureaucratic encounters: How public officials interpret signals and cues

    OpenAIRE

    Raaphorst, Nadine; Van de Walle, Steven

    2017-01-01

    This article provides scholars studying frontline judgements an analytical framework – the signaling perspective – that could be used to examine how street-level bureaucrats evaluate unobservable citizen-client properties. It proposes to not only look at the kind of signals and cues officials gather, but also at the interpretive frames used to make sense of them. This offers a valuable contribution to the street-level bureaucracy literature, which largely focuses on explaining discretionary d...

  17. Trust in Management under Post-bureaucratic Conditions: The Case of Finnish Civil Servants

    Directory of Open Access Journals (Sweden)

    Jaakko Koivumäki

    2013-12-01

    Full Text Available The Finnish state administration has recently undergone a wave of reforms towards decentralized decision-making and increased flexibility in organizing work. Traditional bureaucracy, however, has its virtues. Based on a survey and qualitative interview material, the results presented in this paper indicate that many characteristics of bureaucracy, such as well-defined work roles and hierarchical control, facilitate trust among employees. In contrast, the current post-bureaucratic model of organizing work may increase insecurity and decrease trust.

  18. Bureaucratic limits of firm size: Empirical analysis using transaction cost economics

    OpenAIRE

    Canbäck, Staffan

    2002-01-01

    This thesis was submitted for the degree of Doctor of Business Administration and awarded by Brunel University on behalf of Henley Management College This thesis tests Oliver Williamson’s proposition that transaction cost economics can explain the limits of firm size. Williamson suggests that diseconomies of scale are manifested through four interrelated factors: atmospheric consequences due to specialisation, bureaucratic insularity, incentive limits of the employment relation and communi...

  19. Bureaucrats as Innovators? Statistical Analysis on Innovative Capacity within the Hungarian Central Civil Service

    OpenAIRE

    Marton GELLÉN

    2016-01-01

    What makes a public administration innovative if it is strongly legalistic and profoundly bureaucratic? Are there innovators in such a setting who would be able to elaborate strategies in accordance with public demands? If yes, who are the innovators and what are they like? Are they among the leaders? The article offers an answer to these questions based on an empirical research conducted in Hungary where public administration is not only legalistic but has a strong culture of topdown dominat...

  20. [Red tape in psychiatry: on bureaucracy, bureaucratism, and our secret fondness for procedures].

    Science.gov (United States)

    Blom, J D; Smink, F R E; Kwidama, E V; Vladár Rivero, V M

    2016-01-01

    A frequent complaint in psychiatry is that the psychiatrist-patient relationship and the quality of care are hampered by bureaucratic processes. To provide an analysis of various types of bureaucracy in psychiatry that can serve as a starting-point for the improvement of care and the performance of qualitative studies. We conducted an exploratory study using PubMed, Google, and various Dutch medical journals. Contemporary psychiatry is characterised by a bureaucratic organization structure. Mental, somatic, and social problems are translated in a standardised manner into medical jargon which gives rise to a DSM diagnosis, a cost-price, and outcome measures. This medical-bureaucratic system has important virtues, provided it is applied efficiently and the patient-psychiatrist relationship remains intact. In the Netherlands, however, this balance has been disturbed. Future research can be facilitated if distinctions are made between various types of bureaucracy (referred to here as Hippocratic, Weberian, and Kafkaesque bureaucracy). In addition, we discuss various national initiatives which aim to counter bureaucracy, including initiatives of the Dutch government. If the patient-psychiatrist relationship is to regain its central role, bureaucracy needs to be countered constantly. The government can facilitate this process, but healthcare providers can also play a key role and meanwhile help to bring about a substantial reduction in the costs of care.

  1. Bureaucratic power in note-writing: authoritative expertise within the state.

    Science.gov (United States)

    Mangset, Marte; Asdal, Kristin

    2018-02-24

    What produces the power of senior civil servants at ministries of finance, positioned at the top of the bureaucratic hierarchy? Max Weber has claimed that a hierarchical organization, meritocratic recruitment and procedural work provide bureaucracies with legitimacy. In particular he insisted on the role of Fachwissen (disciplinary knowledge) obtained through formal education. However, he also argued for the role of Dienstwissen, forms of knowledge and skills stemming from the experience of service in itself. Weber did not elaborate on this concept in detail, and few analysts of governmental expertise have examined this notion. We draw on the practice-turn in sociology, combining the study of governmental expertise with micro-sociological studies of administrative practices. By analysing interviews with 48 senior civil servants at the British, French and Norwegian ministries of finance about their daily practices, this article demonstrates that bureaucratic note-writing and the procedural evaluation of such notes constitute a key form of expertise that yields authority. The study provides an analytical framework for understanding what administrative expertise consists of, how it is integral to procedural work, the forms bureaucratic hierarchies take in practice and how these three dimensions provide authority. © London School of Economics and Political Science 2018.

  2. The Link Between Inadequate Sleep and Obesity in Young Adults.

    Science.gov (United States)

    Vargas, Perla A

    2016-03-01

    The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.

  3. The costs and benefits of 'red tape': anti-bureaucratic structure and gender inequity in a science research organization.

    Science.gov (United States)

    Roth, Wendy D; Sonnert, Gerhard

    2011-06-01

    This paper explicates a central conflict that can affect science research organizations, the conflict between the anti-bureaucratic stance believed to advance science and concerns for gender equity rooted in the universalist ethos of science. We present a case study of a science research organization, using employment and publication records, a survey of 308 employees, and qualitative interviews with 60 employees. We show how anti-bureaucratic organizational structures perpetuate gender inequities for both female scientists and non-scientists.

  4. Analysis of inadequate cervical smears using Shewhart control charts

    Directory of Open Access Journals (Sweden)

    Wall Michael K

    2004-06-01

    Full Text Available Abstract Background Inadequate cervical smears cannot be analysed, can cause distress to women, are a financial burden to the NHS and may lead to further unnecessary procedures being undertaken. Furthermore, the proportion of inadequate smears is known to vary widely amongst providers. This study investigates this variation using Shewhart's theory of variation and control charts, and suggests strategies for addressing this. Methods Cervical cytology data, from six laboratories, serving 100 general practices in a former UK Health Authority area were obtained for the years 2000 and 2001. Control charts of the proportion of inadequate smears were plotted for all general practices, for the six laboratories and for the practices stratified by laboratory. The relationship between proportion of inadequate smears and the proportion of negative, borderline, mild, moderate or severe dyskaryosis as well as the positive predictive value of a smear in each laboratory was also investigated. Results There was wide variation in the proportion of inadequate smears with 23% of practices showing evidence of special cause variation and four of the six laboratories showing evidence of special cause variation. There was no evidence of a clinically important association between high rates of inadequate smears and better detection of dyskaryosis (R2 = 0.082. Conclusions The proportion of inadequate smears is influenced by two distinct sources of variation – general practices and cytology laboratories, which are classified by the control chart methodology as either being consistent with common or special cause variation. This guidance from the control chart methodology appears to be useful in delivering the aim of continual improvement.

  5. Provision and financing of assistive technology devices in Germany: a bureaucratic odyssey? The case of amyotrophic lateral sclerosis and Duchenne muscular dystrophy.

    Science.gov (United States)

    Henschke, Cornelia

    2012-05-01

    The regulations for financing assistive technology devices (ATDs) are complex and fragmented and, thus, might influence adequate provision of these devices to people who need multiple ATDs. This study aims to explore and analyze patients' problems with the provision and financing of ATDs for the following two rare diseases: amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD). A survey was conducted by means of semi-standardized questionnaires addressing the issues of coverage decisions for ATDs and problems with provision of ATDs. Information was retrieved from ALS (n=19) and DMD (n=14) patients. Conducted interviews were transcribed verbatim and analyzed using qualitative content analysis. Respondents experienced difficulties with the provision and financing of ATDs. They underlined problems such as long approval processes and a serious bureaucratic burden, which induced inadequate provision of ATDs. Experiences of ALS and DMD respondents frequently were similar, especially regarding financing decisions and the process of decision making by sickness funds. The results suggest that difficulties in receiving and financing ATDs are common problems among ALS and DMD patients. There is a need for an interdisciplinary approach in the provision of ATDs and their financing, which should be coordinated by case managers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Neutralized Politics by Bureaucratic Power in Turkey from 1923 to 2002

    OpenAIRE

    Erdal Gişi

    2014-01-01

    Although the Republic of Turkey is recognized as a country figured in opposition to the heritage of and in contrast with the Ottoman Empire, it is obvious that this viewpoint does not fully comply with realities. In this regard, it is possible to claim that the attempt of a bureaucratic group to control the whole social and political area, which also revealed itself for centuries in the Ottoman Period and became more evident in its last periods, has passed to the Republic. Center-periphery re...

  7. The theory of bureaucratic caring for nursing practice in the organizational culture.

    Science.gov (United States)

    Ray, M A

    1989-01-01

    Changes in the health care environment have raised many questions related to patient care. How are political, economic, legal, and technological caring decisions made? How is spiritual caring fostered? How can ethical caring be the grounds on which moral decisions are made? What new policies must be designed to enhance the human perspective in corporate policy, and how will these principles and policies guide actions? The impact of the Theory of Bureaucratic Caring on the corporate enterprise will necessitate a system shift from a narrow to a broad focus where management and caring views can exist side by side and realistically represent the transformation of health care organizations to benefit humankind.

  8. Bureaucratic behavior: A review of the theory and its application to Serbian public administration

    Directory of Open Access Journals (Sweden)

    Žarković-Rakić Jelena

    2007-01-01

    Full Text Available A professional and competent public administration is necessary for successful transition from a socialist, centrally planned economy to a functioning market democracy. The difficulty lies in building an organized and effective civil service sector. This paper gives a brief overview of formal bureaucratic reasoning, beginning with Niskanen’s theory, followed by the principal-agent model. The "Weberian state hypothesis", which provides an alternative view of bureaucracies in less developed countries, is subsequently explored. Finally, the currant state of Serbian public administration is described, along with a discussion of challenges to be addressed in the future.

  9. The Bureaucratization of Social Policies. The Management of Rural Food Programs in Argentina

    Directory of Open Access Journals (Sweden)

    Lorena Poblete

    2008-01-01

    Full Text Available Between 1995 and 1999 the reform of the wine production sector caused significant social changes in Mendoza (Argentina. The restructuring of the paternalistic model which had been the core of the old system of productivity made the rural workers to experience a complete lack of references. They went from a well—known and controlled poverty to a system of social instability in which even the basic resources were missing. The State, unable to satisfy the claims made by the rural workers, created a bureaucratic mechanism for the allocation of social aid.

  10. DEVELOPING AN INSTITUTIONAL ANALYSIS FRAMEWORK IN STUDYING BUREAUCRATIC BEHAVIOUR IN GOVERNMENT AGENCIES FROM CENTRAL AND EASTERN EUROPE

    Directory of Open Access Journals (Sweden)

    ANDRADA-MARIA ALBESCU

    2011-04-01

    Full Text Available The aim of this paper is to develop a comprehensive institutional analysis framework in studying bureaucratic behaviour in government agencies. Although the purpose is to outline a general framework for research, the focus will be on taking into account the specifics of the agencification process in states from Central and Eastern Europe. The paper is divided into three sections. In the first section I compare various neoinstitutionalist approaches in terms of analysing the processes and transformations in the institutional environment concerning government agencies as semi-autonomous bodies in state organization. I argue that the approach which has a greater potential in explaining the processes and transformations in the institutional environment in government agencies is rational choice institutionalism. The second section of this paper is focused on presenting several traditional bureaucratic models in studying bureaucratic behaviour, from the traditional approach to public choice ones, in order to determine their possible contribution in analysing officials behaviour in semiautonomous agencies. Using these and the institutional analysis framework sugested in the first section of this paper I will focus on developing a model for studying bureaucratic behaviour in government agencies. The final section of the paper will be focused on the possibility of using the institutional analysis framework for studying bureaucratic behaviour in government agencies in Central and Eastern Europe and the challenges presented.

  11. The impact of inadequate wastewater treatment on the receiving ...

    African Journals Online (AJOL)

    The impact of inadequate wastewater treatment on the receiving water bodies – Case study: Buffalo City and Nkokonbe Municipalities of the Eastern Cape ... into their respective receiving water bodies (Tembisa Dam, the Nahoon and Eastern Beach which are part of the Indian Ocean; the Tyume River and the Kat River).

  12. The impact of inadequate wastewater treatment on the receiving ...

    African Journals Online (AJOL)

    7950 = Water SA (on-line). 687. The impact of inadequate wastewater treatment on the receiving water bodies – Case study: Buffalo City and. Nkokonbe Municipalities of the Eastern Cape Province. MNB Momba1*, AN Osode2 and M Sibewu1.

  13. Inadequate cerebral oxygen delivery and central fatigue during strenuous exercise

    DEFF Research Database (Denmark)

    Nybo, Lars; Rasmussen, Peter

    2007-01-01

    Under resting conditions, the brain is protected against hypoxia because cerebral blood flow increases when the arterial oxygen tension becomes low. However, during strenuous exercise, hyperventilation lowers the arterial carbon dioxide tension and blunts the increase in cerebral blood flow, which...... can lead to an inadequate oxygen delivery to the brain and contribute to the development of fatigue....

  14. Inadequate Information in Laboratory Test Requisition in a Tertiary ...

    African Journals Online (AJOL)

    Aim: Laboratory investigations are important aspect of patient management and inadequate information or errors arising from the process of filling out laboratory Request Forms can impact significantly on the quality of laboratory result and ultimately on patient care. Objectives: This study examined the pattern of deficiencies ...

  15. Inadequate sleep and muscle strength: Implications for resistance training.

    Science.gov (United States)

    Knowles, Olivia E; Drinkwater, Eric J; Urwin, Charles S; Lamon, Séverine; Aisbett, Brad

    2018-02-02

    Inadequate sleep (e.g., an insufficient duration of sleep per night) can reduce physical performance and has been linked to adverse metabolic health outcomes. Resistance exercise is an effective means to maintain and improve physical capacity and metabolic health, however, the outcomes for populations who may perform resistance exercise during periods of inadequate sleep are unknown. The primary aim of this systematic review was to evaluate the effect of sleep deprivation (i.e. no sleep) and sleep restriction (i.e. a reduced sleep duration) on resistance exercise performance. A secondary aim was to explore the effects on hormonal indicators or markers of muscle protein metabolism. A systematic search of five electronic databases was conducted with terms related to three combined concepts: inadequate sleep; resistance exercise; performance and physiological outcomes. Study quality and biases were assessed using the Effective Public Health Practice Project quality assessment tool. Seventeen studies met the inclusion criteria and were rated as 'moderate' or 'weak' for global quality. Sleep deprivation had little effect on muscle strength during resistance exercise. In contrast, consecutive nights of sleep restriction could reduce the force output of multi-joint, but not single-joint movements. Results were conflicting regarding hormonal responses to resistance training. Inadequate sleep impairs maximal muscle strength in compound movements when performed without specific interventions designed to increase motivation. Strategies to assist groups facing inadequate sleep to effectively perform resistance training may include supplementing their motivation by training in groups or ingesting caffeine; or training prior to prolonged periods of wakefulness. Copyright © 2018. Published by Elsevier Ltd.

  16. Bureaucrats as Innovators? Statistical Analysis on Innovative Capacity within the Hungarian Central Civil Service

    Directory of Open Access Journals (Sweden)

    Marton GELLÉN

    2016-12-01

    Full Text Available What makes a public administration innovative if it is strongly legalistic and profoundly bureaucratic? Are there innovators in such a setting who would be able to elaborate strategies in accordance with public demands? If yes, who are the innovators and what are they like? Are they among the leaders? The article offers an answer to these questions based on an empirical research conducted in Hungary where public administration is not only legalistic but has a strong culture of topdown domination. The current study targets the key element of innovativeness namely: managerial and cultural prerequisites of innovation within central public administration. The empirical research was carried out in the Hungarian central civil service. The article also discusses whether such an environment would have an impact on innovations. According to the fi ndings of the article, certain prerequisites of an innovative environment exist in the given strictly hierarchic, traditionally stiff setting; however, traits of innovativeness can be identifi ed in innovators who are genuine bureaucrats at the same time.

  17. Inadequate Empirical Antibiotic Therapy in Hospital Acquired Pneumonia.

    Science.gov (United States)

    Dahal, S; Rijal, B P; Yogi, K N; Sherchand, J B; Parajuli, K; Parajuli, N; Pokhrel, B M

    2015-01-01

    Inadequate empirical antibiotic therapy for HAP is a common phenomena and one of the indicators of the poor stewardship. This study intended to analyze the efficacy of empirical antibiotics in the light of microbiological data in HAP cases. Suspected cases of HAP were followed for clinico-bacterial evidence, antimicrobial resistance and pre and post culture antibiotic use. The study was taken from February,2014 to July 2014 in department of Microbiology and department of Respiratory medicine prospectively. Data was analyzed by Microsoft Office Excel 2007. Out of 758 cases investigated, 77(10 %) cases were HAP, 65(84%) of them were culture positive and 48(74 %) were late in onset. In early onset cases, isolates were Acinetobacter 10(42%), Escherichia coli 5(21%), S.aureus 4(17%), Klebsiella 1(4%) and Pseudomonas 1(4%). From the late onset cases Acinetobacter 15(28%), Klebsiella 17(32%) and Pseudomonas 13(24%) were isolated. All Acinetobacter, 78% Klebsiella and 36% Pseudomonas isolates were multi drug resistant. Empirical therapies were inadequate in 12(70%) of early onset cases and 44(92%) of late onset type. Cephalosporins were used in 7(41%) of early onset infections but found to be adequate only in 2(12%) cases. Polymyxins were avoided empirically but after cultures were used in 9(19%) cases. Empirical antibiotics were vastly inadequate, more frequently so in late onset infections. Use of cephalosporins empirically in early onset infections and avoiding empirical use of polymyxin antibiotics in late onset infections contributed largely to the findings. Inadequate empirical regimen is a real time feedback for a practitioner to update his knowledge on the local microbiological trends.

  18. From a Bureaucratic to a Critical-Sociocultural Model of Policymaking in Colombia

    Directory of Open Access Journals (Sweden)

    Doris Correa

    2013-10-01

    Full Text Available In the context of the National Bilingual Program 2004-2019, currently called “Program for Strengthening the Development of Competencies in a Foreign Language,” the Colombian government has implemented a series of actions to raise the level of English proficiency of teachers and students and insert the country into globalization processes. The purpose of this article, which is the result of a project conducted by the authors in Antioquia (Colombia about the stakeholders’ views of the program, is to show how these actions fit a bureaucratic policymaking model which has been highly questioned by policy experts and to propose a new model which can be used to make deep changes in the program with the participation of all stakeholders.

  19. Professional responses to post bureaucratic hospital reforms and their impact on care provision

    DEFF Research Database (Denmark)

    Johnsen, Helle

    2015-01-01

    Background Post bureaucracy is increasingly shaping how health care professionals work. Within hospital settings, post bureaucracy is frequently connected to loss of professional autonomy and protocol-based care. However, this development also affects relationships between care providers and care...... receivers. Question To explore experiences of post bureaucratic hospital reforms and their impact on care provision. Method Data builds on nine mini group interviews with midwives (n = three), nurses (n = three) and physiotherapists (n = three), in all thirty participants. Data was analysed using existing...... theories of professionalism and post bureaucracy. Findings Two overarching themes were identified: ‘Time, tasks and institutional duties’ which referred to transformations in care practices, increased use of screening procedures, efficiency requirements and matching linear time to the psychosocial needs...

  20. [The conflict of tomatoes and olive oil within a bureaucratic machinery].

    Science.gov (United States)

    Gil García, E

    2000-03-01

    In this short article, the author relates, by means of a case report, a type of conflict which occurs as a result of the paradoxes derived from the current managerial model practiced in the Andalucian public hospitals. The limitations and the incompetence of a bureaucracy, rigid in compliance with its functions, and which is incapable of attending to the demands that belong to the hard core of the organization, place the supposed most important and most immediate objectives of an efficient managerial system in "danger". The basic hypothesis lies in the need to bear in mind, at the time of designing a hospital's organizational system, the "structures of the invisible interests", with their corresponding paradoxes and perversions, of each of the distinct component parts of this system. And how these invisible bureaucratic interests can hinder and pervert managerial and organizational designs which appear to be ideal and optimal in their objectives and principles.

  1. The research imperative and bureaucratic control: the case of clinical research.

    Science.gov (United States)

    Hall, D

    1991-01-01

    This paper examines the development of Research Ethics Committees and explores some of the conflicts of value and role which surround the practice of medical research. The case of medical research on children is discussed as one which raises in an acute form concerns about consent and risk/benefit analysis. The paper draws on a survey of Research Ethics Committees to illustrate their variety of structure and functioning, and to relate current practice to a model of bureaucratic control. Bureaucracy is considered both in its common-sense understanding of officious rule-making and delay, and in its theoretical formulation in terms of specialisation, standardisation, formalization and centralisation of procedures. It is argued that the concept of bureaucracy can aid an understanding of the problems of control over research, as well as providing a model for more informed, consistent and open decision making.

  2. Protecting Traditional Knowledge Related to Biological Resources: Is Scientific Research Going to Become More Bureaucratized?

    Science.gov (United States)

    Reddy, Prashant; Lakshmikumaran, Malathi

    2015-06-22

    For the past several decades, there has been a world debate on the need for protecting traditional knowledge. A global treaty appears to be a distant reality. Of more immediate concern are the steps taken by the global community to protect access to biological resources in the name of protecting traditional knowledge. The Indian experience with implementing the Convention on Biological Diversity has created substantial legal uncertainty in collaborative scientific research between Indians and foreigners apart from bureaucratizing the entire process of scientific research, especially with regard to filing of applications for intellectual property rights. The issue therefore is whether the world needs to better balance the needs of the scientific community with the rights of those who have access to traditional knowledge. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.

  3. Unruly clients : a study of how bureaucrats try and fail to transform gatekeepers, communists and preachers into ideal beneficiaries

    NARCIS (Netherlands)

    Vries, de P.

    1992-01-01

    State-peasant relations in this book are studied by focussing on the strategies which farmers and bureaucrats deploy in a colonisation area of the Atlantic zone of Costa Rica in order to deal with forms of state intervention which include programmes, projects and other instruments of state

  4. Deferasirox pharmacokinetics in patients with adequate versus inadequate response

    Science.gov (United States)

    Chirnomas, Deborah; Smith, Amber Lynn; Braunstein, Jennifer; Finkelstein, Yaron; Pereira, Luis; Bergmann, Anke K.; Grant, Frederick D.; Paley, Carole; Shannon, Michael

    2009-01-01

    Tens of thousands of transfusion-dependent (eg, thalassemia) patients worldwide suffer from chronic iron overload and its potentially fatal complications. The oral iron chelator deferasirox has become commercially available in many countries since 2006. Although this alternative to parenteral deferoxamine has been a major advance for patients with transfusional hemosiderosis, a proportion of patients have suboptimal response to the maximum approved doses (30 mg/kg per day), and do not achieve negative iron balance. We performed a prospective study of oral deferasirox pharmacokinetics (PK), comparing 10 transfused patients with inadequate deferasirox response (rising ferritin trend or rising liver iron on deferasirox doses > 30 mg/kg per day) with control transfusion-dependent patients (n = 5) with adequate response. Subjects were admitted for 4 assessments: deferoxamine infusion and urinary iron measurement to assess readily chelatable iron; quantitative hepatobiliary scintigraphy to assess hepatic uptake and excretion of chelate; a 24-hour deferasirox PK study following a single 35-mg/kg dose of oral deferasirox; and pharmacogenomic analysis. Patients with inadequate response to deferasirox had significantly lower systemic drug exposure compared with control patients (P deferasirox must be determined. This trial has been registered at http://www.clinicaltrials.gov under identifier NCT00749515. PMID:19724055

  5. The Bureaucratic Tradition in Latin American Education: The Legacy of Spanish Colonialism.

    Science.gov (United States)

    Hanson, Mark

    As Latin American nations marshall their rapidly growing human and material resources, they frequently encounter organizational infrastructures which are incapable of supporting the rapid process of modernization. Yet, these inadequate infrastructures persist over time, leaving behind unrecoverable losses. Attempts to understand the problems of…

  6. The influence of bureaucrats on the policy-making process in the former Soviet Union: The case of Chernobyl

    Science.gov (United States)

    Kerner, Lucy Alexandra

    The events that started to unfurl in the former Soviet Union in the beginning of the 1990s and that ended with the disintegration of the USSR caught many sovietologists, and specialists on former communist and socialist regimes by surprise. Major theories and analyses developed and successfully used in such areas as Comparative Politics, International Relations, and Comparative Socialism turned out to be impotent to foresee the approach of the dramatic changes. Noticing the growing significance of and influence on the policy making process of numerous bureaucracies, this study has applied alternative approaches that were developed in such fields as Organizational Theory, Bureaucratic Behavior, and Public Policy. The issue of bureaucratic performance in the former USSR became the central focal point of the study. Methods suggested by specialists in these fields permitted measurement of the performance of different bureaucratic medical institutions during and after the Chernobyl crisis. Utilization of performance measurements helped uncover several important phenomena. One, that performance of the Soviet medical institutions/organizations and bureaucracies that they housed reached an ultimate dysfunctional stage. It became counterproductive to the point that we can brand it pathological. The characteristic feature of pathological performance is that its outcomes (final results) have a totally counterproductive effect on the external environment and on the community which uses its services and/or products. In the case of Chernobyl it was medical services that were either very poorly provided to the victims of the accident or totally withheld from them The result was a manifold increase in different illnesses and deaths among the population affected by the accident. Second, behavior and performance of the medical bureaucracies in comparison with the behavior and performance of other Soviet bureaucracies has shown that it was not unique. This counterproductive behavior

  7. Internet addiction: reappraisal of an increasingly inadequate concept.

    Science.gov (United States)

    Starcevic, Vladan; Aboujaoude, Elias

    2017-02-01

    This article re-examines the popular concept of Internet addiction, discusses the key problems associated with it, and proposes possible alternatives. The concept of Internet addiction is inadequate for several reasons. Addiction may be a correct designation only for the minority of individuals who meet the general criteria for addiction, and it needs to be better demarcated from various patterns of excessive or abnormal use. Addiction to the Internet as a medium does not exist, although the Internet as a medium may play an important role in making some behaviors addictive. The Internet can no longer be separated from other potentially overused media, such as text messaging and gaming platforms. Internet addiction is conceptually too heterogeneous because it pertains to a variety of very different behaviors. Internet addiction should be replaced by terms that refer to the specific behaviors (eg, gaming, gambling, or sexual activity), regardless of whether these are performed online or offline.

  8. Inadequate doses of hemodialysis. Predisposing factors, causes and prevention

    Directory of Open Access Journals (Sweden)

    Pehuén Fernández

    2017-04-01

    Full Text Available Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V greater than 40 l (72 kg body weight approximately are 11 times more likely (OR = 11.6; CI 95% = 3.2 to 51.7, p < 0.0001 to receive an inadequate dose of hemodialysis, than those with a smaller V. This situation is more frequent in men (OR = 3.5; 95% CI 1.01-15.8; p = 0.0292. V greater than 40 l was the only independent predictor of sub-dialysis in the multivariate analysis (OR = 10.3; 95% CI 2.8-37; p < 0.0004. The main cause of suboptimal dialysis was receiving a lower blood flow (Qb than the prescribed (336.4 ± 45.8 ml/min vs. 402.3 ± 28.8 ml/min respectively, p < 0.0001 (n = 18. Other causes were identified: shorter duration of the session (n = 2, vascular access recirculation (n = 1, and error in the samples (n = 1. In conclusion, the only independent predisposing factor found in this study for sub-optimal dialysis is V greater than 40 l. The main cause was receiving a slower Qb than prescribed. From these findings, an algorithm for the management of these patients was developed

  9. Evidence Report: Risk of Inadequate Human-Computer Interaction

    Science.gov (United States)

    Holden, Kritina; Ezer, Neta; Vos, Gordon

    2013-01-01

    Human-computer interaction (HCI) encompasses all the methods by which humans and computer-based systems communicate, share information, and accomplish tasks. When HCI is poorly designed, crews have difficulty entering, navigating, accessing, and understanding information. HCI has rarely been studied in an operational spaceflight context, and detailed performance data that would support evaluation of HCI have not been collected; thus, we draw much of our evidence from post-spaceflight crew comments, and from other safety-critical domains like ground-based power plants, and aviation. Additionally, there is a concern that any potential or real issues to date may have been masked by the fact that crews have near constant access to ground controllers, who monitor for errors, correct mistakes, and provide additional information needed to complete tasks. We do not know what types of HCI issues might arise without this "safety net". Exploration missions will test this concern, as crews may be operating autonomously due to communication delays and blackouts. Crew survival will be heavily dependent on available electronic information for just-in-time training, procedure execution, and vehicle or system maintenance; hence, the criticality of the Risk of Inadequate HCI. Future work must focus on identifying the most important contributing risk factors, evaluating their contribution to the overall risk, and developing appropriate mitigations. The Risk of Inadequate HCI includes eight core contributing factors based on the Human Factors Analysis and Classification System (HFACS): (1) Requirements, policies, and design processes, (2) Information resources and support, (3) Allocation of attention, (4) Cognitive overload, (5) Environmentally induced perceptual changes, (6) Misperception and misinterpretation of displayed information, (7) Spatial disorientation, and (8) Displays and controls.

  10. Influenza preparedness and the bureaucratic reflex: anticipating and generating the 2009 H1N1 event.

    Science.gov (United States)

    Barker, Kezia

    2012-07-01

    This paper draws together work on the event to problematise the generative implications of anticipatory governance in the management of emerging infectious disease. Through concerns for preparedness, the need to anticipate outbreaks of disease has taken on a new urgency. With the identification of the H1N1 virus circulating amongst human populations in 2009, public health measures and security practices at regional, national and international levels were rapidly put into play. However, as the ensuing event demonstrated, the social, political and economic disruptions of emerging infectious diseases can be matched by those of anticipatory actions. I argue that the event-making potential of surveillance practices and the pre-determined arrangements of influenza preparedness planning, when triggered by the H1N1 virus, caused an event acceleration through the hyper-sensitised global health security architecture. In the UK, this led to a bureaucratic reflex, a security response event that overtook the present actualities of the disease. This raises questions about the production of forms of insecurity by the security apparatus itself. Copyright © 2012. Published by Elsevier Ltd.

  11. 96/5000 Other literature Bureaucratic records and traces of disappearances in Argentina

    Directory of Open Access Journals (Sweden)

    Emilio Crenzel

    2014-08-01

    Full Text Available In this article I examine a series of bureaucratic records produced during the military dictatorship by workers in two state agencies, a morgue and a public hospital, located in two different provinces of Argentina, Córdoba and Buenos Aires. In these public documents, these workers left evidence, for several and different reasons, on the existence of practices that integrated phases or moments of the system of forced disappearance of persons, a crime which distinguished the last military dictatorship (1976-1983 of their predecessors. The analysis of these administrative records is an exploratory approach that aims to contribute to the understanding of the logic / s operation of state bureaucracies during the last military dictatorship, try to establish and understand the variety of relationships that a portion of its members established with the practice of forced disappearance of persons and other repressive practices unwrapped during this period and try to document the variety of ideas and emotions that, contemporary to the facts, were put into play in relation to the perpetrators of these crimes and their victims.

  12. Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

    Science.gov (United States)

    Swanson, Jeffrey; Weissert, William G

    2017-08-01

    Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

  13. Manager’s decision-making in organizations –empirical analysis of bureaucratic vs. learning approach

    Directory of Open Access Journals (Sweden)

    Jana Frenová

    2010-06-01

    Full Text Available The paper is focused on the study of manager’s decision-making with respect to the basic model of learning organization, presented by P. Senge as a system model of management. On one hand, the empirical research was conducted in connection with key dimensions of organizational learning such as: 1. system thinking, 2. personal mastery, 3. mental models, 4. team learning, 5. building shared vision and 6. dynamics causes. On the other hand, the research was connected with the analysis of the bureaucratic logic of decision-making process, characterized by non-functional stability, inflexibility, individualism, power, authority and hierarchy, centralization, vagueness, fragmentariness. The objective of the research was to analyse to what extent manager’s decision–making is based on bureaucratic tools or organizational learning in either complex problem-solving or non-problemsolving decision-making. (MANOVA, method of the repeated measure, intersubject factor – situation: 1. non problematic, 2. problematic. The conclusion of analysis is that there are significant differences in character of solving of problem situation and non-problem situation decision-making: the bureaucratic attributes of decision-making are more intensive in problematic situations while learning approach is more actual in non-problematic situations. The results of our analysis have shown that managers who apply the learning organization attributes in their decision-making. are more successful in problem-solving.

  14. Newcastle disease virus outbreaks: vaccine mismatch or inadequate application?

    Science.gov (United States)

    Dortmans, Jos C F M; Peeters, Ben P H; Koch, Guus

    2012-11-09

    Newcastle disease (ND) is one of the most important diseases of poultry, and may cause devastating losses in the poultry industry worldwide. Its causative agent is Newcastle disease virus (NDV), also known as avian paramyxovirus type 1. Many countries maintain a stringent vaccination policy against ND, but there are indications that ND outbreaks can still occur despite intensive vaccination. It has been argued that this may be due to antigenic divergence between the vaccine strains and circulating field strains. Here we present the complete genome sequence of a highly virulent genotype VII virus (NL/93) obtained from vaccinated poultry during an outbreak of ND in the Netherlands in 1992-1993. Using this strain, we investigated whether the identified genetic evolution of NDV is accompanied by antigenic evolution. In this study we show that a live vaccine that is antigenically adapted to match the genotype VII NL/93 outbreak strain does not provide increased protection compared to a classic genotype II live vaccine. When challenged with the NL/93 strain, chickens vaccinated with a classic vaccine were completely protected against clinical disease and mortality and virus shedding was significantly reduced, even with a supposedly suboptimal vaccine dose. These results suggest that it is not antigenic variation but rather poor flock immunity due to inadequate vaccination practices that may be responsible for outbreaks and spreading of virulent NDV field strains. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Bureaucratic logic in new social movement clothing: the limits of health promotion research.

    Science.gov (United States)

    Stevenson, H M; Burke, M

    1992-01-01

    This paper discusses theoretical, methodological and political problems in the field of health promotion research. It argues that these problems result from a partial and contradictory appropriation of the discourse of new social movements. Politically, the health promotion movement is largely confined within the state, rather than the expression of a social movement against the state. The direction of health promotion research and policy is, therefore, caught in the bureaucratic logic of "trapped administrators", and results in contradictory emphases on problems like the development of "health promotion indicators", which show little result in informing a broader but coherent conceptualization of health, let alone in effecting change in health policy and outcomes. Such political problems reflect parallel confusions about theory and methodology. Theoretically, the field relies heavily on a critique of bio-medical science, but fails to move beyond a rhetorical outline of an alternative to systematic arguments about what promotes health. In this regard, the literature on health promotion remains unaware of important conceptual developments in the social sciences, relies on imprecise specifications of major constructs like community empowerment, and has no conception of the state. Methodologically, the literature is influenced by contradictory epistemological tendencies which reflect a positivist inspiration (as in the search for indicators) and an anti-positivist emphasis on agency and social change through the collective action and the discursive reconstitution of social identity, value and meaning. In regard to these questions, this paper is critical of observers who suggest that the way ahead is to embrace post-modern research strategies.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Bureaucratic discretion and alternative teacher certification: understanding program variation in Missouri.

    Directory of Open Access Journals (Sweden)

    Ethan B. Heinen

    2007-06-01

    Full Text Available Alternative teacher certification literature has contributed significantly to our understanding of this approach to teacher preparation. However, this literature has more often than not treated alternative teacher certification programs (ATCPs as a black box, thus ignoring program heterogeneity. The present study examines how and why five ATCPs in Missouri have evolved in different ways. To understand this variation and its potential significance for researchers and practitioners, we use political science literature on bureaucratic discretion to understand programs' varied responses within the same state policy context. Using a multiple case study design, we present two key findings. First, external factors such as the state's regulatory approach, programs' relationships with school districts, and programs' relationship with external partners shape program coordinators' perceptions of their discretionary authority. Second, within an environment of limited regulation, programs responded to these external factors in ways that shaped programs in dramatically different ways. These approaches ranged from formal partnerships with large urban school districts and philanthropic funders to alternative certification programs that were at least partially blended with existing undergraduate and post baccalaureate teacher preparation programs. In our discussion, we explore how state attempts to widen the discretionary space between the rules may have allowed external interests (e.g., school districts, and external funders to backfill that space in ways that limit the potential for programs to provide high quality preparation experiences. This study explores these consequences and trade offs in order to inform policy makers and practitioners who are concerned with fostering innovative and creative ways to prepare high quality teachers.

  17. Metabolic regulation during sport events: factual interpretations and inadequate allegations

    Directory of Open Access Journals (Sweden)

    Jacques Remy Poortmans

    2013-09-01

    Full Text Available Different fuels are available to generate ATP for muscle activities during sport events. Glycogen from striated muscles and liver stores may be converted to lactic acid or almost completely oxidized to carbon dioxide (CO2, triacylglycerol within the muscle itself and fatty acids from adipose tissue could be converted to CO2 in acting muscles, some free amino acids can be released within the muscle itself and from intestinal stores to sustain the amount of ATP generation indispensable for muscle contraction. All single biochemical reactions, but one, need one or several enzymes to activate the conversion of a substrate into a product. The energy transformation in biochemical reactions is led by application of so-called free energy. Reversible and non-reversible reactions within a metabolic pathway are dependent on specific enzymes near or far from equilibrium. Allosteric enzymes are regulatory enzymes that provide the direction in the pathway. A regulatory enzyme is either activated or inhibited by small regulators (ligands. A reversible substrate cycle between A and B is catalyzed by two enzymes with different fluxes. The need of ATP production for muscle contraction is under the leadership of regulatory enzymes and available substrate stores. The improvement of adapted metabolic reactions under sport training depends on the appropriate increase of regulatory enzymes within the glycolytic and oxidative pathways. The amount of some specific enzymes is increased by training in order to improve the maximum activity of the metabolic pathway. Unfortunately, several publications do not precisely implicate the appropriate enzyme(s to explain or reject the adaptation induced by the training schedule. A few examples will illustrate the factual interpretation and the inadequate allegation.

  18. The association of xerostomia and inadequate intake in older adults.

    Science.gov (United States)

    Rhodus, N L; Brown, J

    1990-12-01

    Recent studies indicate that nearly one in five older adults has xerostomia (dry mouth). Salivary gland dysfunction and/or inadequate saliva increases the difficulty of these older adults in obtaining proper nutrition. Problems in lubricating, masticating, tolerating, tasting, and swallowing food contribute notably to the complex physiological and psychological manifestations of aging. To our knowledge, the literature has not demonstrated an association between xerostomia and malnutrition in the elderly. We randomly selected 67 older adults from institutionalized and free-living geriatric populations. Nutritional intake analysis was performed on both groups of study subjects, who were found to have xerostomia by use of sialometry, and on control subjects matched for age, sex, and physical status. Intake of total energy, protein, dietary fiber, total fat, saturated fat, cholesterol, sodium, potassium, vitamin A, vitamin C, thiamin, riboflavin, vitamin B-6, calcium, iron, and zinc was compared with the 1989 Recommended Dietary Allowances. Subjects' intakes were also compared with that of a control group. Medical systemic information and number and types of medications were compared among the groups. Statistical analysis of the data indicated significant (p less than .001) inadequacies in the nutritional intake patterns of institutionalized and free-living older adults with xerostomia. Subjects with xerostomia (more than 75% of the free-living and institutionalized seniors) had significant deficiencies of fiber, potassium, vitamin B-6, iron, calcium, and zinc. Taste and food perception were significantly reduced in the elders with xerostomia. Our study indicates the potential contribution of xerostomia to the high prevalence of geriatric malnutrition in the United States.

  19. Inadequate pain relief among patients with primary knee osteoarthritis.

    Science.gov (United States)

    Laires, Pedro A; Laíns, Jorge; Miranda, Luís C; Cernadas, Rui; Rajagopalan, Srini; Taylor, Stephanie D; Silva, José C

    Despite the widespread treatments for osteoarthritis (OA), data on treatment patterns, adequacy of pain relief, and quality of life are limited. The prospective multinational Survey of Osteoarthritis Real World Therapies (SORT) was designed to investigate these aspects. To analyze the characteristics and the patient reported outcomes of the Portuguese dataset of SORT at the start of observation. Patients ≥50 years with primary knee OA who were receiving oral or topical analgesics were eligible. Patients were enrolled from seven healthcare centers in Portugal between January and December 2011. Pain and function were evaluated using the Brief Pain Inventory (BPI) and WOMAC. Quality of life was assessed using the 12-Item Short Form Health Survey (SF-12). Inadequate pain relief (IPR) was defined as a score >4/10 on item 5 of the BPI. Overall, 197 patients were analyzed. The median age was 67.0 years and 78.2% were female. Mean duration of knee OA was 6.2 years. IPR was reported by 51.3% of patients. Female gender (adjusted odds ratio - OR 2.15 [95%CI 1.1, 4.5]), diabetes (OR 3.1 [95%CI 1.3, 7.7]) and depression (OR 2.24 [95%CI 1.2, 4.3]) were associated with higher risk of IPR. Patients with IPR reported worst outcomes in all dimensions of WOMAC (p<0.001) and in all eight domains and summary components of SF-12 (p<0.001). Our findings indicate that improvements are needed in the management of pain in knee OA in order to achieve better outcomes in terms of pain relief, function and quality of life. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  20. [Planned non-hospital births in industrialized countries: bureaucratic dream vs. professional responsibility].

    Science.gov (United States)

    Arabin, B; Chervenak, F A; McCullough, L B

    2013-02-01

    This article addresses in how far planned non-hospital births should be an alternative to planned hospital births. Advocates of planned non-hospital deliveries have emphasised patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and have doubts that the information available for the pregnant women and the public is in accord with professional responsibility. We understand that the increasing rates of interventions and operative deliveries in hospital births demand an answer, but we doubt that planned home birth is the appropriate professional solution. Complications during non-hospital births inevitably demand a transport of mother and child to a perinatal centre. The time delay by itself is an unnecessary risk for both and this cannot be abolished by bureaucratic quality criteria as introduced for non-hospital births in Germany. Evidence-based studies have shown that modern knowledge of the course of delivery including ultrasound as well as intensive care during the delivery all reduce the rate of operative deliveries. Unfortunately, this is not well-known and only rarely considered during any delivery. All these facts, however, are the best arguments to find a cooperative model within perinatal centres to combine the art of midwifery with modern science, reduction of pain and perinatal care of the pregnant women before, during and after birth. We therefore call on obstetricians, midwifes and health-care providers as well as health politicians to carefully analyse the studies from Western countries showing increasing risks if the model of intention-to-treat is considered and accoordingly not to support planned non-hospital births nor to include these models into prospective trials. Alternatively, we recommend the introduction of a home-like climate within hospitals and perinatal centres, to avoid unnecessary invasive measures and to really care for the pregnant mother

  1. Rights, Regulation and Bureaucratic Impact: The Impact of Human Rights Litigation on the Regulation of Informal Trade in Johannesburg

    Directory of Open Access Journals (Sweden)

    Marius Pieterse

    2017-01-01

    Full Text Available In contemplating the extent to which rights-based litigation is conducive to positive social change, attention ought to be paid to the bureaucratic impact of court judgments that vindicate rights against the State. As a case study of such impact, this article considers the effects of human rights litigation on the regulation of informal trade in the City of Johannesburg, where a 2013 attempt by local government to clamp down on informal trade in the central business district (CBD led to high-profile court action. After describing and problematising the City's general approach to managing informal trade, the article focuses on "Operation Clean Sweep", which aimed to rid much of the CBD of informal traders and became the focal point of rights-based resistance. It then briefly describes the constitutional and jurisprudential framework within which the legal challenge to "Operation Clean Sweep" was to be decided, before critically discussing the judgment of the Constitutional Court in South African Informal Traders Forum v City of Johannesburg 2014 4 SA 371 (CC, which effectively halted "Operation Clean Sweep" by interdicting the City from removing traders from their places of business. The article then proceeds to consider the aftermath of the judgment, and assesses its impact on the City's informal trade policy and urban management practices, as well as on the broader regulatory and political environment around street trade in South African cities. The article shows that the bureaucratic impact of the judgment has, at best, been mixed, and that the judgment has not been entirely successful in disrupting the legal and bureaucratic mindsets, frameworks and processes that simultaneously create, exacerbate and unsuccessfully attempt to address the "unmanageability" of street trade in Johannesburg.

  2. Street-level Bureaucrats Coping with Conflicts in Area-based Initiatives in Copenhagen and Malmö

    DEFF Research Database (Denmark)

    Agger, Annika; Poulsen, Birgitte

    2017-01-01

    Partnering with citizens and civil society in order to find better solutions has become a growing strategy in many urban regeneration projects in Western Europe countries. Street-level bureaucrats (SLBs) are increasingly recruited to manage what can be labelled ‘participatory planning processes...... performances’ in a policy field characterised as having a high level of conflictual views of the use of common spaces, the article is able to shed light on contextual factors that can influence the performance of an SLB and thus inspire future work with ABIs and the practice field of public administration....

  3. The status of school sanitation facilities in some selected primary ...

    African Journals Online (AJOL)

    admin

    The access to drinking water facilities. (water taps) and hand washing facilities were very much limited to the extent not conforming to the standard. The presence of school-based water, sanitation, and hygiene committee and clubs was unheard. Conclusion: The inadequate sanitation facility in schools poses a health risk ...

  4. Applying Bureaucratic Caring Theory and the Chronic Care Model to Improve Staff and Patient Self-Efficacy.

    Science.gov (United States)

    Potter, Marcia A; Wilson, Candy

    Patient activation and engagement can be powerful enablers for health outcomes that are just as important as staff engagement and satisfaction. The authors applied the Bureaucratic Caring Theory and the Chronic Care Model to a process improvement project designed to link activation, engagement, satisfaction, and health outcomes. Twenty-two adults with diabetes and 7 staff members caring for them participated in a 12-week process improvement project that incorporated a time-based element of longitudinal care with skill-based competencies to provide collaborative, team-based care to patients with type 2 diabetes. Patients completed satisfaction surveys at the end of their clinical encounters. Staff members completed satisfaction surveys pre- and postimplementation. The authors analyzed hemoglobin A1C levels pre- and postimplementation. As engagement and activation increased for both staff and patients, hemoglobin A1C levels decreased. The clinical implication is that the use of Bureaucratic Caring Theory may foster caring while broad application of the Chronic Care Model may improve self-efficacy, create healthier populations, and reduce health care costs.

  5. Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution.

    Science.gov (United States)

    Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael Wv

    2011-12-01

    The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients.

  6. Off to the Courts? Or the Agency? Public Attitudes on Bureaucratic and Legal Approaches to Policy Enforcement

    Directory of Open Access Journals (Sweden)

    Quinn Mulroy

    2018-04-01

    Full Text Available A key curiosity in the operation of the American regulatory state lies with its hybrid structure, defined by centralized, bureaucratic approaches but also more decentralized actions such as lawsuits brought by private citizens in the courts. While current research on these two pathways focuses at the elite level—exploring how and why political actors and institutions opt for legal or administrative strategies for implementing different public policies—there is little research that examines public attitudes toward how policy is enforced in the U.S. Given that the public is a key partner in this process, this paper integrates public attitudes into the discussion, tapping into conceptions of “big government,” privatization, and the tort reform movement. Using original data from a series of vignette-based experiments included in the 2014 Cooperative Congressional Election Survey, we examine public preferences about how policy is regulated—by private citizens in the courts or by government officials in agencies—across a broad number of policy areas. We offer one of the first studies that adjudicates the boundaries of public attitudes on litigation and bureaucratic regulation in the U.S., offering implications for how elites might approach the design of policy implementation for different issue areas.

  7. Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution

    Science.gov (United States)

    Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael WV

    2011-01-01

    Objective The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Discussion Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. Conclusion It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients. PMID:22693481

  8. Doctors as street-level bureaucrats in a rural hospital in South Africa.

    Science.gov (United States)

    Gaede, Bernhard M

    2016-01-01

    or to contribute to the inefficiencies of healthcare delivery. While appearing to be in conflict, the merging of the roles of the health professional and the bureaucrat is required to be able to function effectively within the healthcare system. Being a doctor and being a civil servant are synergistic in daily work, and as a result it is difficult to neatly differentiate professional and civil servant roles in decision-making. It is in the discretion of both roles that considerable flexibility within the roles is possible. Such freedom to act is critical for being able to find local solutions and thereby improve healthcare services. The findings resonate strongly with studies from other parts of the world and offer a window into making sense of the local decision making of doctors. Street-level bureaucracy remains an important lens to view the work of healthcare professionals in the public sector. In the tension between the top-down policy-making and the bottom-up pressure, street-level bureaucracy acts as an important terrain for improving the implementation of services and therefore advocacy and health system improvement.

  9. Inadequate humidification of respiratory gases during mechanical ventilation of the newborn.

    Science.gov (United States)

    Tarnow-Mordi, W O; Sutton, P; Wilkinson, A R

    1986-01-01

    Proximal airway humidity was measured during mechanical ventilation in 14 infants using an electronic hygrometer. Values below recommended minimum humidity of adult inspired gas were recorded on 251 of 396 occasions. Inadequate humidification, largely due to inadequate proximal airway temperature, is commoner than recognised in infants receiving mechanical ventilation. PMID:3740912

  10. Inadequate humidification of respiratory gases during mechanical ventilation of the newborn.

    OpenAIRE

    Tarnow-Mordi, W O; Sutton, P; Wilkinson, A R

    1986-01-01

    Proximal airway humidity was measured during mechanical ventilation in 14 infants using an electronic hygrometer. Values below recommended minimum humidity of adult inspired gas were recorded on 251 of 396 occasions. Inadequate humidification, largely due to inadequate proximal airway temperature, is commoner than recognised in infants receiving mechanical ventilation.

  11. The challenge of inadequate achievement in mathematics: Focus on a meta-approach

    Directory of Open Access Journals (Sweden)

    Kobus Maree

    2009-09-01

    Full Text Available As is the case elsewhere in the world, all stakeholders in South Africa are deeply concerned about the level and scope of underachievement in mathematics, not only at Grade 12 level, but, indeed, at University, University of Technology and Further Education and Training levels. These concerns assume a deeper dimension in light of the fact that inadequate achievement in mathematics inevitably will have a ripple effect on the academic situation in any country: inadequate achievement in mathematics precludes learners from applying for admission to sought-after fi elds of study, which, in turn, prevents numerous learners from realising their true potential and, eventually, from being happy and successful in careers that they might otherwise have been able to execute successfully. It goes without saying that inadequate achievement in mathematics will impact negatively on the overall economic situation in any country (even more so in a developing country such as South Africa. Truth being, achievement in mathematics amounts to equipping oneself with survival skills. In this article, the spotlight shifts from a narrow and outdated focus on problems that are associated with inadequate achievement in mathematics to possible solutions for this disconcerting situation and the implied challenge it raises. The focus is thus on three levels that collectively underpin and impact on achievement in mathematics, viz. the macro level, the meso level and the micro level. The macro level refers mainly to the input by the national government (and, by default, the National Department of Education. In the fi rst instance, it is the responsibility of the state to provide adequate schooling facilities for all learners, irrespective of where they fi nd themselves. Furthermore, it is the duty of the state to ensure that every learner has access to basic facilities, including food, water, sanitation and housing. The state (via the National Department of Education is also

  12. Increasing capacity for innovation in bureaucratic primary care organizations: a whole system participatory action research project.

    Science.gov (United States)

    Thomas, Paul; McDonnell, Juliet; McCulloch, Janette; While, Alison; Bosanquet, Nick; Ferlie, Ewan

    2005-01-01

    We wanted to identify what organizational features support innovation in Primary Care Groups (PCGs). Our study used a whole system participatory action research model. Four research teams provided complementary insights. Four case study PCGs were analyzed. Two had an intervention to help local facilitators reflect on their work. Data included 70 key informant interviews, observations of clinical governance interventions and committee meetings, analysis of written materials, surveys and telephone interviews of London Primary Care Organizations, interviews with 20 nurses, and interviews with 6 finance directors. A broad range of stakeholders reviewed data at annual conferences and formed conclusions about trustworthy principles. Sequential research phases were refocused in the light of these conclusions and in response to the changing political context. Five features were associated with increased organizational capacity for innovation: (1) clear structures and a vision for corporate and clinical governance; (2) multiple opportunities for people to reflect and learn at all levels of the organization, and connections between these "learning spaces"; (3) both clinicians and managers in leadership roles that encourage participation; (4) the right timing for an initiative and its adaptation to the local context; and (5) external facilitation that provides opportunities for people to make sense of their experiences. Low morale was commonly attributed to 3 features: (1) overwhelming pace of reform, (2) inadequate staff experience and supportive infrastructure, and (3) financial deficits. These features together may support innovation in other primary care bureaucracies. The research methodology enabled people from different backgrounds to make sense of diverse research insights.

  13. Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia

    Science.gov (United States)

    2013-01-01

    qualifying facilities serve this large population which is below the UN’s minimum recommendation. The utilization of the existing facilities for delivery was also low, which is clearly inadequate to reduce maternal deaths to the MDG target. PMID:24180672

  14. Facilities & Leadership

    Data.gov (United States)

    Department of Veterans Affairs — The facilities web service provides VA facility information. The VA facilities locator is a feature that is available across the enterprise, on any webpage, for the...

  15. Biochemistry Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Biochemistry Facility provides expert services and consultation in biochemical enzyme assays and protein purification. The facility currently features 1) Liquid...

  16. The inadequate liability and compensation regime for damage caused by nuclear activities

    International Nuclear Information System (INIS)

    Dyke, Jon M. Van

    2010-09-01

    The specific obligation to provide restitution and compensation when nuclear activities cause injuries has been recognized repeatedly and is now certainly part of customary international law. But problems remain regarding how to measure damages, how to implement the duty to repair the injuries, and what specific obligations exist to protect neighboring states from transboundary pollution. Although some treaties exist governing liability for harm resulting from nuclear accidents, they are not adequate to protect victims and have not been widely ratified. The failure to require nuclear operators to prepare for damage that may result from accidents constitutes a subsidy to the nuclear industry and makes it difficult to compare the real costs of nuclear energy with the costs of other energy sources. This survey of settled norms and unresolved issues demonstrates that further work is needed to develop a comprehensive and authoritative regime to govern harm from nuclear activities. Although it is clear that both the operators of nuclear facilities and the states that have jurisdiction over them would be responsible to provide restitution and compensation for such harm under a strict liability regime, the types of injuries that must be compensated and the range of damages that must be covered remain subjects of controversy. Although the underlying customary international law principles (the no-harm principle and the polluter-pays principle) are clear, the actual treaties that have been drafted are inadequate and they have not been widely ratified. Victims of damage from nuclear activities would have difficulty finding a neutral tribunal in which to bring their claims and would face procedural obstacles including caps on liabilities and inappropriately short statutes of limitations as well as difficulties regarding proof of damages. The failure to develop a proper regime that would ensure full restitution and compensation for harm resulting from nuclear facilities

  17. The significance of inadequate transcranial Doppler studies in children with sickle cell disease.

    Directory of Open Access Journals (Sweden)

    Simon Greenwood

    Full Text Available Sickle cell disease (SCD is a common cause of cerebrovascular disease in childhood. Primary stroke prevention is effective using transcranial Doppler (TCD scans to measure intracranial blood velocities, and regular blood transfusions or hydroxycarbamide when these are abnormal. Inadequate TCD scans occur when it is not possible to measure velocities in all the main arteries. We have investigated the prevalence and significance of this in a retrospective audit of 3915 TCD scans in 1191 children, performed between 2008 and 2015. 79% scans were normal, 6.4% conditional, 2.8% abnormal and 12% inadequate. 21.6% of 1191 patients had an inadequate scan at least once. The median age of first inadequate scan was 3.3 years (0.7-19.4, with a U-shaped frequency distribution with age: 28% aged 2-3 years, 3.5% age 10 years, 25% age 16 years. In young children reduced compliance was the main reason for inadequate TCDs, whereas in older children it was due to a poor temporal ultrasound window. The prevalence of inadequate TCD was 8% in the main Vascular Laboratory at King's College Hospital and significantly higher at 16% in the outreach clinics (P<0.0001, probably due to the use of a portable ultrasound machine. Inadequate TCD scans were not associated with underlying cerebrovascular disease.

  18. The politics and anti-politics of the global fund experiment: understanding partnership and bureaucratic expansion in Uganda.

    Science.gov (United States)

    Taylor, E Michelle; Harper, Ian

    2014-01-01

    After a decade of operations, the Global Fund is an institutional form in flux. Forced to cancel its eleventh round of funding due to a shortfall in donor pledges, the Fund is currently in firefighting mode, overhauling its leadership, governance structures, and operations. Drawing on a case study of Uganda, we look at how the original Global Fund vision to be a simple financial instrument has played out at the country level. Even prior to the cancellation of round 11, the proliferation of partners required to sustain the Global Fund to Fight AIDS, Tuberculosis and Malaria experiment led to increasing bureaucratization and an undermining of the Fund's own intentions to award life-saving grants according to need. Understanding these effects through the ethnographic material presented here may be one way of reflecting on the Fund's structure and practices as it struggles to reinvent itself in the face of criticism that it has impeded resource distribution.

  19. Predictors of Inadequate Inpatient Colonoscopy Preparation and Its Association with Hospital Length of Stay and Costs.

    Science.gov (United States)

    Yadlapati, Rena; Johnston, Elyse R; Gregory, Dyanna L; Ciolino, Jody D; Cooper, Andrew; Keswani, Rajesh N

    2015-11-01

    Adequate bowel preparation is essential to safe and effective inpatient colonoscopy. Predictors of poor inpatient colonoscopy preparation and the economic impacts of inadequate inpatient preparations are not defined. The aims of this study were to (1) determine risk factors for inadequate inpatient bowel preparations, and (2) examine the association between inadequate inpatient bowel preparation and hospital length of stay (LOS) and costs. We performed a retrospective cohort study of adult patients undergoing inpatient colonoscopy preparation over 12 months (1/1/2013-12/31/2013). Of 524 identified patients, 22.3% had an inadequate preparation. A multiple logistic regression model identified the following potential predictors of inadequate bowel preparation: lower income (OR 1.11; 95% CI 1.04, 1.22), opiate or tricyclic antidepressant (TCA) use (OR 1.55; 0.98, 2.46), and afternoon colonoscopy (OR 1.66; 1.07, 2.59); as well as American Society of Anesthesiologists (ASA) class ≥3 (OR 1.15; 1.05, 1.25) and symptoms of nausea/vomiting (OR 1.14; 1.04, 1.25) when a fair preparation was considered inadequate. Inadequate bowel preparation was associated with significantly increased hospital LOS (model relative mean estimate 1.25; 95% CI 1.03, 1.51) and hospital costs (estimate 1.31; 1.03, 1.67) when compared to adequate preparations. The rate of inadequate inpatient bowel preparations is high and associated with a significant increase in hospital LOS and costs. We identified five potential predictors of inadequate inpatient preparation: lower socioeconomic class, opiate/TCA use, afternoon colonoscopies, ASA class ≥3, and pre-preparation nausea/vomiting; these data should guide future initiatives to improve the quality of inpatient bowel preparations.

  20. Bureaucratic Itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems.

    Science.gov (United States)

    Abadia, Cesar Ernesto; Oviedo, Diana G

    2009-03-01

    Steady increases in the number of Colombians insured by the health care system contrasts with the hundreds of thousands of legal actions interposed to warrant citizen's right to health. This study aims to analyze the relationships among patients' experiences of denials by the system, the country's legal mechanisms, and the functioning of insurance companies and service providing institutions. We conducted a mixed-methods case study in Bogotá and present a quantitative description of 458 cases, along with semi-structured interviews and an in-depth illness history. We found that Colombians' denials of care most commonly include appointments, laboratory tests or treatments. Either insurance companies or service providing institutions use the system's legal structure to justify the different kinds of denials. To warrant their right to health care, citizens are forced to interpose legal mechanisms, which are largely ruled in favor, but delays result in a progressive and cumulative pattern of harmful consequences, as follows: prolongation of suffering, medical complications of health status, permanent harmful consequences, permanent disability, and death. We diagram the path that Colombians need to follow to have their health care claims attended by the system in a matrix called Bureaucratic Itineraries. Bureaucratic Itineraries is a theoretical and methodological construct that links the personal experience of illness with the system's structure and could be an important tool for understanding, evaluating and comparing different systems' performances. In this case, it allowed us to conclude that managed care in Colombia has created complex bureaucracies that delay and limit care through cost-containment mechanisms, which has resulted in harmful consequences for people's lives.

  1. Behaviorally inadequate

    DEFF Research Database (Denmark)

    Kasperbauer, Tyler Joshua

    2014-01-01

    According to situationism in psychology, behavior is primarily influenced by external situational factors rather than internal traits or motivations such as virtues. Environmental ethicists wish to promote pro-environmental behaviors capable of providing adequate protection for the environment......, but situationist critiques suggest that character traits, and environmental virtues, are not as behaviorally robust as is typically supposed. Their views present a dilemma. Because ethicists cannot rely on virtues to produce pro-environmental behaviors, the only real way of salvaging environmental virtue theory...... positive results. However, because endorsing behaviorally ineffective virtues, for whatever reason, entails that environmental ethicists are abandoning the goal of helping and protecting the environment, environmental ethicists should consider looking elsewhere than virtues and focus instead on the role...

  2. Fabrication Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Fabrication Facilities are a direct result of years of testing support. Through years of experience, the three fabrication facilities (Fort Hood, Fort Lewis, and...

  3. Waste Facilities

    Data.gov (United States)

    Vermont Center for Geographic Information — This dataset was developed from the Vermont DEC's list of certified solid waste facilities. It includes facility name, contact information, and the materials...

  4. Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

    2016-01-01

    To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  5. Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

    Science.gov (United States)

    Weiner, Saul J; Laporte, Margaret; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

    2004-04-01

    Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

  6. Cautious Citizenship: The Deterring Effect of Immigration Issue Salience on Health Care Use and Bureaucratic Interactions among Latino US Citizens.

    Science.gov (United States)

    Pedraza, Franciso I; Nichols, Vanessa Cruz; LeBrón, Alana M W

    2017-10-01

    Research shows that health care use among Latino immigrants is adversely affected by restrictive immigration policy. A core concern is that immigrants shy away from sharing personal information in response to policies that expand bureaucratic monitoring of citizenship status across service-providing organizations. This investigation addresses the concern that immigration politics also negatively influences health care utilization among Latino US citizens. One implication is that health insurance expansions may not reduce health care inequities among Latinos due to concern about exposure to immigration law enforcement authorities. Using data from the 2015 Latino National Health and Immigration Survey, we examine the extent to which the politics of immigration deters individuals from going to health care providers and service-providing institutions. Results indicate that Latino US citizens are less likely to make an appointment to see a health care provider when the issue of immigration is mentioned. Additionally, Latino US citizens who know someone who has been deported are more inclined to perceive that information shared with health care providers is not secure. We discuss how cautious citizenship, or risk-avoidance behaviors toward public institutions in order to avoid scrutiny of citizenship status, informs debates about reducing health care inequities. Copyright © 2017 by Duke University Press.

  7. Democracy leadership (study approach of bureaucrats leadership at sub bagian tata usaha badan perencanaan pembangunan daerah, East Java province)

    Science.gov (United States)

    Lestari, Y.; Rosdiana, W.; Noviyanti

    2018-01-01

    The main key to organizational success depends on the success of a leadership. Each organization’s progress will require the ability of a leader to transformed the organization. The emergence of the democratic-leadership is one of the most humane style of leadership. Democratic leadership positioned people as the most important factor in the leadership exercised by the orientation and emphasis on relationships with members of the organization. This study raised that the democratic-leadership in government agencies to study the leadership approach of bureaucrats at Sub Bagian Tata Usaha Badan Perencanaan Pembangunan Daerah East Java Province. The data collection techniques used descriptive research with qualitative approach, then the techniques were interviews, observation and documentation. While, the research data analysis used interactive analysis model approach of Miles and Huberman, which includes: (1) data reduction; (2) the presentation of the data; and (3) conclusion. Based on Nawawi theory’s [1], this study showed that (1) Leaders are very obedient to the rules/procedures work, (2) Leaders look more autocratic, (3) leaders make familiarity with subordinates, (4) leaders develop kinship situation and teamwork, (5) the leaders seem monotonous work and do not like a modification, (6) Leaders seem slow in decision making, and (7) leaders are accustomed to low-risk jobs with less survival trends.

  8. When and How do Bureaucratic Conflicts Matter in Trade Policy? Evidence from the US Trade Policymaking Process during the Clinton Administration (1993–2001

    Directory of Open Access Journals (Sweden)

    Rodrigo Fagundes Cézar

    Full Text Available Abstract The study of the role played by bureaucracies contributed substantively to the analysis of the domestic determinants of foreign policy outcomes, particularly by softening the premise of the state as a unitary-rational actor. However, the potential of focusing on bureaucracies to analyse US trade policy outcomes has been severely underestimated by the most recent IPE scholarship, which tends to focus on the Congress and interest groups, and to consider the Executive a unitary actor. Based on elements of the bureaucratic politics model, this article uses evidence from the US trade policy during Clinton’s administration (1993–2001 in order to present arguments regarding how and when bureaucratic conflicts matter the most, and highlight the relevance of these conflicts in the trade decision-making process.

  9. Skull-base Osteomyelitis: a Dreaded Complication after Trivial Fall and Inadequate Management

    Directory of Open Access Journals (Sweden)

    Kundan Mittal

    2015-10-01

    Full Text Available Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

  10. Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

    Science.gov (United States)

    Higgins, P; Murray, M L; Williams, E M

    1994-03-01

    This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.

  11. Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma

    DEFF Research Database (Denmark)

    Oliver, Amanda J.; Covar, Ronina A.; Goldfrad, Caroline H.

    2016-01-01

    Objective To evaluate the dose-response, efficacy, and safety of fluticasone furoate (FF; 25 µg, 50 µg, and 100 µg), administered once daily in the evening during a 12-week treatment period to children with inadequately controlled asthma. Study design This was a Phase IIb, multicenter, stratified...

  12. Wearable Devices for Classification of Inadequate Posture at Work Using Neural Networks.

    Science.gov (United States)

    Barkallah, Eya; Freulard, Johan; Otis, Martin J-D; Ngomo, Suzy; Ayena, Johannes C; Desrosiers, Christian

    2017-09-01

    Inadequate postures adopted by an operator at work are among the most important risk factors in Work-related Musculoskeletal Disorders (WMSDs). Although several studies have focused on inadequate posture, there is limited information on its identification in a work context. The aim of this study is to automatically differentiate between adequate and inadequate postures using two wearable devices (helmet and instrumented insole) with an inertial measurement unit (IMU) and force sensors. From the force sensors located inside the insole, the center of pressure (COP) is computed since it is considered an important parameter in the analysis of posture. In a first step, a set of 60 features is computed with a direct approach, and later reduced to eight via a hybrid feature selection. A neural network is then employed to classify the current posture of a worker, yielding a recognition rate of 90%. In a second step, an innovative graphic approach is proposed to extract three additional features for the classification. This approach represents the main contribution of this study. Combining both approaches improves the recognition rate to 95%. Our results suggest that neural network could be applied successfully for the classification of adequate and inadequate posture.

  13. The Inadequacy of Academic Environment Contributes to Inadequate Teaching and Learning Phenomena

    Science.gov (United States)

    Quasim, Shahla; Arif, Muhammad Shahbaz

    2014-01-01

    This study aims at the inadequacy of academic environment as an indicator contributing to the inadequate teaching and learning situation in Pakistan. The main focus is to look into the low proficiency of students in the subject of English at secondary school level. A comprehensive questionnaire was designed from the literature concerned and The…

  14. 25 CFR 170.811 - What happens if lack of funds results in inadequate maintenance?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What happens if lack of funds results in inadequate maintenance? 170.811 Section 170.811 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.811 What happens if lack of funds...

  15. Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

    Science.gov (United States)

    Silva, Cristiane M; Silva, Silvia A da; Antunes, Margarida M de C; Silva, Gisélia Alves Pontes da; Sarinho, Emanuel Sávio Cavalcanti; Brandt, Katia G

    To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29ng/mL; p=0.041) and higher deficiency frequency (20.3% vs.8.2; p=0.049) than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p=0.002). Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p=0.972). Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  16. Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?

    Directory of Open Access Journals (Sweden)

    Suzan Gunduz

    2016-01-01

    Conclusion: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better.

  17. Inadequate Evidence for Multiple Intelligences, Mozart Effect, and Emotional Intelligence Theories

    Science.gov (United States)

    Waterhouse, Lynn

    2006-01-01

    I (Waterhouse, 2006) argued that, because multiple intelligences, the Mozart effect, and emotional intelligence theories have inadequate empirical support and are not consistent with cognitive neuroscience findings, these theories should not be applied in education. Proponents countered that their theories had sufficient empirical support, were…

  18. The theory-practice gap: impact of professional-bureaucratic work conflict on newly-qualified nurses.

    Science.gov (United States)

    Maben, Jill; Latter, Sue; Clark, Jill Macleod

    2006-08-01

    resources and reduce the professional-bureaucratic work conflict are discussed.

  19. Facilities Programming.

    Science.gov (United States)

    Bullis, Robert V.

    1992-01-01

    A procedure for physical facilities management written 17 years ago is still worth following today. Each of the steps outlined for planning, organizing, directing, controlling, and evaluating must be accomplished if school facilities are to be properly planned and constructed. However, lessons have been learned about energy consumption and proper…

  20. Donepezil: A cause of inadequate muscle relaxation and delayed neuromuscular recovery

    Directory of Open Access Journals (Sweden)

    Alka Bhardwaj

    2011-01-01

    Full Text Available A 74-year-old female with diabetes mellitus type II and Alzheimer′s disease, taking donepezil for 4 months was operated for right modified radical mastectomy under general anesthesia. During the procedure a higher dose of non-depolarizing muscle relaxant was required than those recommended for her age yet the muscle relaxation was inadequate intra-operatively. Residual neuromuscular blockade persisted postoperatively, due to the cumulative effect of large doses of non-depolarizing muscle relaxant, needing post-operative ventilatory assistance. After ruling out other causes of resistance to non-depolarizing muscle relaxants, we concluded that acetylcholinesterase inhibitor donepezil was primarily responsible for inadequate muscle relaxation and delayed post-operative neuromuscular recovery.

  1. Role of Sex and the Environment in Moderating Weight Gain Due to Inadequate Sleep.

    Science.gov (United States)

    Coborn, Jamie E; Houser, Monica M; Perez-Leighton, Claudio E; Teske, Jennifer A

    2017-12-01

    The growing prevalence of obesity, inadequate sleep and sleep disorders together with the negative impact of lack of sleep on overall health highlights the need for therapies targeted towards weight gain due to sleep loss. Sex disparities in obesity and sleep disorders are present; yet, the role of sex is inadequately addressed and thus it is unclear whether sensitivity to sleep disruption differs between men and women. Like sex, environmental factors contribute to the development of obesity and poor sleep. The obesogenic environment is characterized by easy access to palatable foods and a low demand for energy expenditure in daily activities. These and other environmental factors are discussed, as they drive altered sleep or their interaction with food choice and intake can promote obesity. We discuss data that suggest differences in sleep patterns and responses to sleep disruption influence sex disparities in weight gain, and that enviromental disturbances alter sleep and interact with features of the obesogenic environment that together promote obesity.

  2. OCCUPATIONAL ACCIDENTS AS INDICATORS OF INADEQUATE WORK CONDITIONS AND WORK ENVIRONMENT

    OpenAIRE

    Petar Babović

    2009-01-01

    Occupational accidents due to inadequate working conditions and work environment present a major problem in highly industrialised countries, as well as in developing ones. Occupational accidents are a regular and accompanying phenomenon in all human activities and one of the main health related and economic problems in modern societies.The aim of this study is the analysis of the connections of unfavourable working conditions and working environment on occupational accidents. Occurrence of oc...

  3. Global trends in dietary micronutrient supplies and estimated prevalence of inadequate intakes.

    Directory of Open Access Journals (Sweden)

    Ty Beal

    Full Text Available Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million, micronutrient deficiencies (2 billion, and overweight or obesity (2.1 billion. We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.

  4. Global trends in dietary micronutrient supplies and estimated prevalence of inadequate intakes.

    Science.gov (United States)

    Beal, Ty; Massiot, Eric; Arsenault, Joanne E; Smith, Matthew R; Hijmans, Robert J

    2017-01-01

    Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million), micronutrient deficiencies (2 billion), and overweight or obesity (2.1 billion). We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.

  5. Cognitive Dissonance, Confirmatory Bias and Inadequate Information Processing: Evidence from Experimental Auctions

    OpenAIRE

    Cao, Ying; Just, David R.; Wansink, Brian

    2014-01-01

    Using psychological terms such as cognitive dissonance and confirmation bias, this study reveals how individual consumers inadequately process (food safety) information, pay limited attention to signals, and make purchase decisions that are bias towards their initial choices. While it is expected that reading extra information about potential risk associated with the food decreases consumers' willingness to pay (WTP), the magnitude of the impact varies across individuals. In general, consumer...

  6. Growth inhibition in rats fed inadequate and incomplete proteins: repercussion on mandibular biomechanics

    OpenAIRE

    Bozzini, Clarisa; Champin, Graciela Monica; Bozzini, Carlos Eduardo Jose; Alippi, Rosa Maria

    2015-01-01

    This study describes the effects of feeding growing rats with a diet containing inadequate and incomplete proteins on both the morphological and the biomechanical properties of the mandible. Female rats aged 30 d were fed freely with one of two diets, control (CD, 301 Cal/100g) and experimental (ED, 359 Cal/100g). CD was a standard laboratory diet, while ED was a synthetic diet containing cornflower supplemented with vitamins and minerals. Both diets had the same physical characteristics. Con...

  7. Inadequate management of pregnancy-associated listeriosis: lessons from four case reports.

    Science.gov (United States)

    Charlier, C; Goffinet, F; Azria, E; Leclercq, A; Lecuit, M

    2014-03-01

    Listeria monocytogenes infection during pregnancy can lead to dramatic fetal or neonatal outcomes. No clinical trial has evaluated treatment options, and retrospective studies of cases are therefore important to define optimal regimens. We report four cases of materno-neonatal listeriosis illustrating inadequate antimicrobial therapy management and discuss recommended treatment options. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  8. Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers.

    Science.gov (United States)

    Fuentes-López, Eduardo; Fuente, Adrian; Contreras, Karem V

    2017-12-18

    The aim of this study is to determine possible associations between vocal hygiene habits and self-reported vocal symptoms in telemarketers. A cross-sectional study that included 79 operators from call centres in Chile was carried out. Their vocal hygiene habits and self-reported symptoms were investigated using a validated and reliable questionnaire created for the purposes of this study. Forty-five percent of telemarketers reported having one or more vocal symptoms. Among them, 16.46% reported that their voices tense up when talking and 10.13% needed to clear their throat to make their voices clearer. Five percent mentioned that they always talk without taking a break and 40.51% reported using their voices in noisy environments. The number of working hours per day and inadequate vocal hygiene habits were associated with the presence of self-reported symptoms. Additionally, an interaction between the use of the voice in noisy environments and not taking breaks during the day was observed. Finally, the frequency of inadequate vocal hygiene habits was associated with the number of symptoms reported. Using the voice in noisy environments and talking without taking breaks were both associated with the presence of specific vocal symptoms. This study provides some evidence about the interaction between these two inadequate vocal hygiene habits that potentiates vocal symptoms.

  9. Managing inadequate responses to frontline treatment of chronic myeloid leukemia: a case-based review.

    Science.gov (United States)

    Bixby, Dale L

    2013-05-01

    The tyrosine kinase inhibitors (TKIs) imatinib, nilotinib, and dasatinib are the standard of care for treating patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML). Compared with interferon-based treatment, the previous standard of care, imatinib is associated with significantly higher cytogenetic response rates and prolonged overall survival. Nilotinib and dasatinib, both newer and more potent TKIs, significantly improve cytogenetic and molecular response rates compared with imatinib. Despite significant advances in CML treatment enabled by the TKIs, a fraction of patients who receive frontline treatment with a TKI demonstrate inadequate response. The reasons for this vary, but in many cases, inadequate response can be attributed to non-adherence to the treatment regimen, intolerance to the drug, intrinsic or acquired resistance to the drug, or a combination of reasons. More often than not, strategies to improve response necessitate a change in treatment plan, either a dose adjustment or a switch to an alternate drug, particularly in the case of drug intolerance or drug resistance. Improved physician-patient communication and patient education are effective strategies to address issues relating to adherence and intolerance. Because inadequate response to TKI treatment correlates with poor long-term outcomes, it is imperative that patients who experience intolerance or who fail to achieve appropriate responses are carefully evaluated so that appropriate treatment modifications can be made to maximize the likelihood of positive long-term outcome. Copyright © 2012. Published by Elsevier Ltd.

  10. Predictors of inadequate initial echocardiography in suspected Kawasaki disease: Criteria for sedation.

    Science.gov (United States)

    Lorenzoni, Raymond P; Choi, Jaeun; Choueiter, Nadine F; Munjal, Iona M; Katyal, Chhavi; Stern, Kenan W D

    2018-03-09

    Kawasaki disease is the primary cause of acquired pediatric heart disease in developed nations. Timely diagnosis of Kawasaki disease incorporates transthoracic echocardiography for visualization of the coronary arteries. Sedation improves this visualization, but not without risks and resource utilization. To identify potential sedation criteria for suspected Kawasaki disease, we analyzed factors associated with diagnostically inadequate initial transthoracic echocardiography performed without sedation. This retrospective review of patients Kawasaki disease from 2009 to 2015 occurred at a medium-sized urban children's hospital. The primary outcome was diagnostically inadequate transthoracic echocardiography without sedation due to poor visualization of the coronary arteries, determined by review of clinical records. The associations of the primary outcome with demographics, Kawasaki disease type, laboratory data, fever, and antipyretic or intravenous immunoglobulin treatment prior to transthoracic echocardiography were analyzed. In total, 112 patients (44% female, median age 2.1 years, median BSA 0.54 m 2 ) underwent initial transthoracic echocardiography for suspected Kawasaki disease, and 99 were not sedated. Transthoracic echocardiography was diagnostically inadequate in 19 out of these 99 patients (19.2%) and was associated with age ≤ 2.0 years, weight ≤ 10.0 kg, and antipyretic use ≤ 6 hours before transthoracic echocardiography (all P Kawasaki disease. These factors should be considered when deciding which patients to sedate for initial Kawasaki disease transthoracic echocardiography. © 2018 Wiley Periodicals, Inc.

  11. Factors associated with inadequate work ability among women in the clothing industry.

    Science.gov (United States)

    Augusto, Viviane Gontijo; Sampaio, Rosana Ferreira; Ferreira, Fabiane Ribeiro; Kirkwood, Renata Noce; César, Cibele Comini

    2015-01-01

    Work ability depends on a balance between individual resources and work demands. This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

  12. Mammography Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mammography Facility Database is updated periodically based on information received from the four FDA-approved accreditation bodies: the American College of...

  13. Health Facilities

    Science.gov (United States)

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. When you ...

  14. Canyon Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — B Plant, T Plant, U Plant, PUREX, and REDOX (see their links) are the five facilities at Hanford where the original objective was plutonium removal from the uranium...

  15. Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients.

    Directory of Open Access Journals (Sweden)

    Anna H Van't Hoog

    Full Text Available The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB, that a quarter of the prevalent cases had not yet sought care, and a low case detection rate.We aimed to identify factors associated with inadequate case finding among adults with PTB in this population by comparing characteristics of 194 PTB patients diagnosed in a health facility after self-report, i.e., through passive case detection, with 88 patients identified through active case detection during the prevalence survey. We examined associations between method of case detection and patient characteristics, including HIV-status, socio-demographic variables and disease severity in univariable and multivariable logistic regression analyses.HIV-infection was associated with faster passive case detection in univariable analysis (crude OR 3.5, 95% confidence interval (CI 2.0-5.9, but in multivariable logistic regression this was largely explained by the presence of cough, illness and clinically diagnosed smear-negative TB (adjusted OR (aOR HIV 1.8, 95% CI 0.85-3.7. Among the HIV-uninfected passive case detection was less successful in older patients aOR 0.76, 95%CI 0.60-0.97 per 10 years increase, and women (aOR 0.27, 95%CI 0.10-0.73. Reported current or past alcohol use reduced passive case detection in both groups (0.42, 95% CI 0.23-0.79. Among smear-positive patients median durations of cough were 4.0 and 6.9 months in HIV-infected and uninfected patients, respectively.HIV-uninfected patients with infectious TB who were older, female, relatively less ill, or had a cough of a shorter duration were less likely found through passive case detection. In addition to intensified case finding in HIV-infected persons, increasing the suspicion of TB among HIV-uninfected women and the elderly are needed to improve TB case

  16. [Electrical field exposure and human health. Risk assessment and problems relative to bureaucratic procedures and to the role of instituitional organizations in control and prevention].

    Science.gov (United States)

    Grappasonni, I; Petrelli, F; Pellegrini, M G; Nacciarriti, L; Bernardini, C; Cocchioni, M

    2000-01-01

    After closely analyzing the phenomenon regarding the immense increase and diffusion of equipment which generates low- and high-frequency electromagnetic fields, the AA emphasize both the methodological and interpretive difficulties of assessing the effects produced on public health. They maintain the need to exercise caution in determining the tolerable limits of exposure, and in particular long-term ones. Finally, after analyzing the bureaucratic procedure which led to the formulation of Decree No. 381 of 1998, they express the hope that the various Regions will set themselves high-quality objectives when promulgating the necessary legislation, so as to minimize the risk factor.

  17. Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

    Science.gov (United States)

    Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

    2013-09-01

    To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

  18. Risk factors for and consequences of inadequate surgical margins in oral squamous cell carcinoma

    DEFF Research Database (Denmark)

    Lawaetz, Mads; Homøe, Preben

    2014-01-01

    OBJECTIVE: The purpose of this study was to examine which factors are associated with inadequate surgical margins and to assess the postoperative consequences. STUDY DESIGN: A retrospective cohort of 110 patients with oral squamous cell carcinoma treated with surgery during a 2-year period...... was examined. Clinical, histopathologic, and operative variables were related to the surgical margin status. Furthermore postoperative treatment data were compared with margin status. RESULTS: Univariate statistically significant associations were found between the tumor site in the floor of mouth, more...

  19. The role of abutment-attachment selection in resolving inadequate interarch distance: a clinical report.

    Science.gov (United States)

    Alsiyabi, Abdullah S; Felton, David A; Cooper, Lyndon F

    2005-09-01

    A critical factor that needs to be evaluated during the diagnosis and treatment planning phase for patients seeking an implant-tissue-supported overdenture or metal-resin implant fixed denture is the presence of adequate interarch distance. The amount of interarch distance is critical to the selection of appropriate implant abutments and attachments for both implant-tissue-supported overdentures and metal-resin implant fixed complete dentures. This clinical report describes a patient with complications related to the failure to diagnose inadequate interarch distance, and the methods used to resolve the patient's chief complaint. A guide for abutment-attachment selection using one commercially available implant system is given.

  20. Impact of Facilities on Academic Performance of Students with Special Needs in Mainstreamed Public Schools in Southwestern Nigeria

    Science.gov (United States)

    Fareo, Dorcas Oluremi; Ojo, Olakunbi Olubukola

    2013-01-01

    Facilities have a great impact on academic performances of students, and inadequate facilities translate to poor performance. The study examined the availability and convenience of the facilities that were provided to students with special educational needs in mainstreamed schools. It ascertained the qualifications of teachers teaching in…

  1. Inadequate knowledge of neonatal danger signs among recently delivered women in southwestern rural Uganda: a community survey.

    Directory of Open Access Journals (Sweden)

    Jacob Sandberg

    Full Text Available BACKGROUND: Early detection of neonatal illness is an important step towards improving newborn survival. Every year an estimated 3.07 million children die during their first month of life and about one-third of these deaths occur during the first 24 hours. Ninety-eight percent of all neonatal deaths occur in low- and middle-income countries like Uganda. Inadequate progress has been made globally to reduce the amount of neonatal deaths that would be required to meet Millennium Development Goal 4. Poor knowledge of newborn danger signs delays care seeking. The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda. METHODS: Results from a community survey of 765 recently delivered women were analyzed using univariate and multivariate logistic regressions. Six key danger signs were identified, and spontaneous responses were categorized, tabulated, and analyzed. RESULTS: Knowledge of at least one key danger sign was significantly associated with being birth prepared (adjusted OR 1.7, 95% CI 1.2-2.3. Birth preparedness consisted of saving money, identifying transportation, identifying a skilled birth attendant and buying a delivery kit or materials. Overall, respondents had a poor knowledge of key newborn danger signs: 58.2% could identify one and 14.8% could identify two. We found no association between women attending the recommended number of antenatal care visits and their knowledge of danger signs (adjusted OR 1.0, 95% CI 0.8-1.4, or between women using a skilled birth attendant at delivery and their knowledge of danger signs (adjusted OR 1.2, 95% CI 0.9-1.7. CONCLUSIONS: Our findings indicate the need to enhance education of mothers in antenatal care as well as those discharged from health facilities after delivery. Further promotion of birth preparedness is encouraged as part of the continuum of maternal care.

  2. Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance

    Directory of Open Access Journals (Sweden)

    Ivanović Branislava

    2008-01-01

    Full Text Available Background. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical mitral prosthesis due to inadequately treated resistance to peroral anticoagulant therapy. Resistance to oral anticoagulant medications was proven by an increased dosage of warfarin up to 20 mg and, after that, acenokumarol to 15 mg over ten days which did not lead to an increase in the international normalized ratio (INR value over 1.2. On the basis of information that she did not take food rich in vitamin K or medications which could reduce effects of oral anticoagulants, and that she did not have additional illnesses and conditions that could cause an inadequate response to anticoagulant therapy, it was circumstantially concluded that this was a hereditary form of resistance. Because of the existing mechanical prosthetics on the mitral position, low molecular heparin has been introduced into the therapy. The patient reduced it on her own initiative, leading to nonocclusive valvular thrombosis. Conclusion. When associated complications like absolute arrhithmia does not exist, the finding of resistance to oral anticoagulant agents is an indication for the replacement of a mechanical prosthetic with a biological one which has been done in this patients.

  3. Approach to the patients with inadequate response to colchicine in familial Mediterranean fever.

    Science.gov (United States)

    Gül, Ahmet

    2016-04-01

    Familial Mediterranean fever (FMF) is the most common form of monogenic autoinflammatory conditions, and response to colchicine has been considered as one of its distinctive features among other hereditary periodic fever disorders. Prophylactic colchicine has been shown to be effective in the prevention of inflammatory attacks and development of amyloidosis. However, the highest tolerable doses of colchicine may not be adequate enough to manage these goals in approximately 5% of FMF patients. Inadequate response to colchicine in fully compliant FMF patients may be associated with genetic and/or environmental factors affecting disease severity and colchicine bioavailability. Clarification of the molecular pathogenic mechanisms of FMF has revealed that interleukin-1 beta (IL-1β) cytokine is the most likely target to attack, and several case reports and case series have already documented the efficacy and safety of available anti-IL-1 agents, such as anakinra, rilonacept, and canakinumab in those patients inadequately responding to colchicine. Characterization and early identification of those FMF patients with uncontrolled inflammatory activity have become more important after the availability of new treatment options for the prevention of disease-associated complications and permanent damages. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Inadequate Sleep and Exercise Associated with Burnout and Depression Among Medical Students.

    Science.gov (United States)

    Wolf, Megan R; Rosenstock, Jason B

    2017-04-01

    The authors studied whether low levels of exercise or inadequate sleep correlated with higher levels of burnout and depression in medical students. Medical students of all years at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, were invited to participate in an anonymous online survey in Fall 2012 and Winter 2013. Validated measures were used to assess exercise, sleep, burnout, and depression. Response rates were 28.7 % at the beginning of the school year and 22.6 % at the middle of the school year. Burnout rates overall were 22.4 % at the beginning of the year and 19.2 % in the middle of the year. Eight percent of students screened positive for depression at the beginning of the year and 9.3 % in the middle of the year. Decreased exercise frequency was significantly correlated with lower professional efficacy. Pathological sleepiness was significantly associated with a higher prevalence of burnout. Inadequate sleep correlated with significantly lower professional efficacy and higher exhaustion scores. Burnout was associated with a positive depression screen. Positive depression screening, pathological sleepiness, and sleeping less than 7 h a night were independent predictors of burnout. Sleep habits, exercise, and a positive depression screen were associated with burnout risk within the medical student population.

  5. Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

    Science.gov (United States)

    Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

    2009-04-01

    Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

  6. Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria.

    Science.gov (United States)

    Abubakar, Ismaila Rimi

    2017-01-01

    Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings.

  7. University multi-user facility survey-2010.

    Science.gov (United States)

    Riley, Melissa B

    2011-12-01

    Multi-user facilities serve as a resource for many universities. In 2010, a survey was conducted investigating possible changes and successful characteristics of multi-user facilities, as well as identifying problems in facilities. Over 300 surveys were e-mailed to persons identified from university websites as being involved with multi-user facilities. Complete responses were received from 36 facilities with an average of 20 years of operation. Facilities were associated with specific departments (22%), colleges (22%), and university research centers (8.3%) or were not affiliated with any department or college within the university (47%). The five most important factors to succeed as a multi-user facility were: 1) maintaining an experienced, professional staff in an open atmosphere; 2) university-level support providing partial funding; 3) broad client base; 4) instrument training programs; and 5) an effective leader and engaged strategic advisory group. The most significant problems were: 1) inadequate university financial support and commitment; 2) problems recovering full service costs from university subsidies and user fees; 3) availability of funds to repair and upgrade equipment; 4) inability to retain highly qualified staff; and 5) unqualified users dirtying/damaging equipment. Further information related to these issues and to fee structure was solicited. Overall, there appeared to be a decline in university support for facilities and more emphasis on securing income by serving clients outside of the institution and by obtaining grants from entities outside of the university.

  8. Defining localities of inadequate treatment for childhood asthma: A GIS approach

    Directory of Open Access Journals (Sweden)

    Pliskin Joseph S

    2006-01-01

    Full Text Available Abstract Background The use of Geographic Information Systems (GIS has great potential for the management of chronic disease and the analysis of clinical and administrative health care data. Asthma is a chronic disease associated with substantial morbidity, mortality, and health care use. Epidemiologic data from all over the world show an increasing prevalence of asthma morbidity and mortality despite the availability of effective treatment. These facts led to the emergence of strategies developed to improve the quality of asthma care. The objective To develop an efficient tool for quality assurance and chronic disease management using a Geographic Information System (GIS. Geographic location The southern region of Israel. January 1998 – October 2000. Databases Administrative claims data of the largest HMO in Israel: drug dispensing registry, demographic data, Emergency Room visits, and hospitalization data bases. Methods We created a list of six markers for inadequate pharmaceutical treatment of childhood asthma from the Israeli clinical guidelines. We used this list to search the drug dispensing registry to identify asthmatic children who received inadequate treatment and to assess their health care utilization and bad outcomes: emergency room visits and hospitalizations. Using GIS we created thematic maps on which we located the clinics with a high percentage of children for whom the treatment provided was not in adherence with the clinical guidelines. Results 81% of the children were found to have at least one marker for inadequate treatment; 17.5% were found to have more than one marker. Children with markers were found to have statistically significant higher rates of Emergency Room visits, hospitalizations and longer length of stay in hospital compared with children without markers. The maps show in a robust way which clinics provided treatment not in accord with the clinical guidelines. Those clinics have high rates of Emergency Room

  9. Psychological distress is associated with inadequate dietary intake in Vietnamese marriage immigrant women in Korea.

    Science.gov (United States)

    Hwang, Ji-Yun; Lee, Sang Eun; Kim, Sun Hye; Chung, Hye Won; Kim, Wha Young

    2010-05-01

    Previous studies have reported that the nutritional status of Vietnamese female marriage immigrants in Korea is inadequate. And the mediation of acculturation stress can contribute to problems in their eating practices and dietary intakes. This study examines an association between psychological distress and inadequate dietary intake in Vietnamese female marriage immigrants living in Korea. A cross-sectional study analyzed baseline data (n=570) from the Cohort of Intermarried Women in Korea. Daily nutrient intakes were compared according to the quartiles of distress scores assessed by the Psychological Well-Being Index-Short Form. One-way analysis of variance and chi(2) tests were used to compare eating practices and nutrient intake across quartiles of psychological distress. Subjects in the highest stress scores were more likely to skip breakfast and to change their dietary habits after living in Korea than those in groups with low stress scores. Analyses of the subjects' Mini Dietary Assessments revealed that those with the highest stress scores were less likely to consume milk or dairy products, eat regular meals, or have balanced diets than those with the lowest stress scores. Nutrient intakes were found to be inadequate in the subjects, and those with the highest stress scores showed lower consumptions of energy, carbohydrate, protein, fat, calcium, zinc, thiamin, riboflavin, and folate compared to those with the lowest scores. The prevalence of underweight (body mass index [calculated as kg/m(2)] <18.5) increased from the lowest to highest quartiles of psychological distress scores. Psychological distress in Vietnamese female marriage immigrants living in Korea was negatively associated with dietary intake. These findings can assist dietetics practitioners working with minority immigrants because such information is important in designing appropriate strategies for dietary counseling. A follow-up study should address the underlying mechanisms of the observed

  10. Avoidable waste of research related to inadequate methods in clinical trials.

    Science.gov (United States)

    Yordanov, Youri; Dechartres, Agnes; Porcher, Raphaël; Boutron, Isabelle; Altman, Douglas G; Ravaud, Philippe

    2015-03-24

    To assess the waste of research related to inadequate methods in trials included in Cochrane reviews and to examine to what extent this waste could be avoided. A secondary objective was to perform a simulation study to re-estimate this avoidable waste if all trials were adequately reported. Methodological review and simulation study. Trials included in the meta-analysis of the primary outcome of Cochrane reviews published between April 2012 and March 2013. We collected the risk of bias assessment made by the review authors for each trial. For a random sample of 200 trials with at least one domain at high risk of bias, we re-assessed risk of bias and identified all related methodological problems. For each problem, possible adjustments were proposed that were then validated by an expert panel also evaluating their feasibility (easy or not) and cost. Avoidable waste was defined as trials with at least one domain at high risk of bias for which easy adjustments with no or minor cost could change all domains to low risk. In the simulation study, after extrapolating our re-assessment of risk of bias to all trials, we considered each domain rated as unclear risk of bias as missing data and used multiple imputations to determine whether they were at high or low risk. Of 1286 trials from 205 meta-analyses, 556 (43%) had at least one domain at high risk of bias. Among the sample of 200 of these trials, 142 were confirmed as high risk; in these, we identified 25 types of methodological problem. Adjustments were possible in 136 trials (96%). Easy adjustments with no or minor cost could be applied in 71 trials (50%), resulting in 17 trials (12%) changing to low risk for all domains. So the avoidable waste represented 12% (95% CI 7% to 18%) of trials with at least one domain at high risk. After correcting for incomplete reporting, avoidable waste due to inadequate methods was estimated at 42% (95% CI 36% to 49%). An important burden of wasted research is related to inadequate

  11. Support facilities

    International Nuclear Information System (INIS)

    Williamson, F.S.; Blomquist, J.A.; Fox, C.A.

    1977-01-01

    Computer support is centered on the Remote Access Data Station (RADS), which is equipped with a 1000 lpm printer, 1000 cpm reader, and a 300 cps paper tape reader with 500-foot spools. The RADS is located in a data preparation room with four 029 key punches (two of which interpret), a storage vault for archival magnetic tapes, card files, and a 30 cps interactive terminal principally used for job inquiry and routing. An adjacent room provides work space for users, with a documentation library and a consultant's office, plus file storage for programs and their documentations. The facility has approximately 2,600 square feet of working laboratory space, and includes two fully equipped photographic darkrooms, sectioning and autoradiographic facilities, six microscope cubicles, and five transmission electron microscopes and one Cambridge scanning electron microscope equipped with an x-ray energy dispersive analytical system. Ancillary specimen preparative equipment includes vacuum evaporators, freeze-drying and freeze-etching equipment, ultramicrotomes, and assorted photographic and light microscopic equipment. The extensive physical plant of the animal facilities includes provisions for holding all species of laboratory animals under controlled conditions of temperature, humidity, and lighting. More than forty rooms are available for studies of the smaller species. These have a potential capacity of more than 75,000 mice, or smaller numbers of larger species and those requiring special housing arrangements. There are also six dog kennels to accommodate approximately 750 dogs housed in runs that consist of heated indoor compartments and outdoor exercise areas

  12. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies

    NARCIS (Netherlands)

    Bonnes, J.L.; Westra, S.W.; Bouwels, L.H.; Boer, M.J. de; Brouwer, M.A.; Smeets, J.L.R.M.

    2016-01-01

    INTRODUCTION: In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial

  13. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  14. 2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

    Science.gov (United States)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

  15. Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

    Directory of Open Access Journals (Sweden)

    Carina Maciel Silva-Boghossian

    2014-05-01

    Full Text Available The present study investigated the effect of non-surgical periodontal treatment (SRP on the composition of the subgingival microbiota of chronic periodontitis (CP in individuals with type 2 diabetes (DM2 with inadequate metabolic control and in systemically healthy (SH individuals. Forty individuals (20 DM2 and 20 SH with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01. Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001. At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01. Those in the DM2 group showed significantly higher prevalence and/or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001. However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001 over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months’ evaluation compared with those in the DM2 group with inadequate metabolic control.

  16. Predictors of an inadequate defibrillation safety margin at ICD implantation: insights from the National Cardiovascular Data Registry.

    Science.gov (United States)

    Hsu, Jonathan C; Marcus, Gregory M; Al-Khatib, Sana M; Wang, Yongfei; Curtis, Jeptha P; Sood, Nitesh; Parker, Matthew W; Kluger, Jeffrey; Lampert, Rachel; Russo, Andrea M

    2014-07-22

    Defibrillation testing is often performed to establish effective arrhythmia termination, but predictors and consequences of an inadequate defibrillation safety margin (DSM) remain largely unknown. The aims of this study were to develop a simple risk score predictive of an inadequate DSM at implantable cardioverter-defibrillator (ICD) implantation and to examine the association of an inadequate DSM with adverse events. A total of 132,477 ICD Registry implantations between 2010 and 2012 were analyzed. Using logistic regression models, factors most predictive of an inadequate DSM (defined as the lowest successful energy tested 3 days (odds ratio: 1.24; 95% confidence interval: 1.19 to 1.30; p < 0.0001), and in-hospital mortality (odds ratio: 1.96; 95% confidence interval: 1.63 to 2.36; p < 0.0001). A simple risk score identified ICD recipients at risk for an inadequate DSM. An inadequate DSM was associated with an increased risk for in-hospital adverse events. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Violations of Law in the Bureaucrats Community and Their Perception by the Ukrainian and Russian People in the Late XVIII – First Half of XIX Centuries

    Directory of Open Access Journals (Sweden)

    Sergey I. Degtyarev

    2014-06-01

    Full Text Available Studies the problem of service violations and abuses, which were extremely common in the bureaucratic environment of the Russian Empire in the late XVIII – early XIX centuries. The author attempts to answer the question of how these negative phenomena were perceived various population groups in different regions of the empire? It was concluded, that range of offenses, which were committed officials, was extremely broad. In doing so they affected the interests of society regardless of ethnic, social or professional affiliation of its members. This contributed to occurrence of a negative image of officials at all levels of society and in all regions of the empire. Inability and unwillingness of the government fight the offense in the environment of bureaucracy during many decades has led to the creation a negative image of the official. It was display in numerous literary works and poetry of Ukrainian and Russian authors, the memoirs of contemporaries, official documents.

  18. Emission Facilities - Erosion & Sediment Control Facilities

    Data.gov (United States)

    NSGIC Education | GIS Inventory — An Erosion and Sediment Control Facility is a DEP primary facility type related to the Water Pollution Control program. The following sub-facility types related to...

  19. Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

    Science.gov (United States)

    Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

    2016-01-01

    NASA is preparing for long duration manned missions beyond low-Earth orbit that will be challenged in several ways, including long-term exposure to the space environment, impacts to crew physiological and psychological health, limited resources, and no resupply. The food system is one of the most significant daily factors that can be altered to improve human health, and performance during space exploration. Therefore, the paramount importance of determining the methods, technologies, and requirements to provide a safe, nutritious, and acceptable food system that promotes crew health and performance cannot be underestimated. The processed and prepackaged food system is the main source of nutrition to the crew, therefore significant losses in nutrition, either through degradation of nutrients during processing and storage or inadequate food intake due to low acceptability, variety, or usability, may significantly compromise the crew's health and performance. Shelf life studies indicate that key nutrients and quality factors in many space foods degrade to concerning levels within three years, suggesting that food system will not meet the nutrition and acceptability requirements of a long duration mission beyond low-Earth orbit. Likewise, mass and volume evaluations indicate that the current food system is a significant resource burden. Alternative provisioning strategies, such as inclusion of bioregenerative foods, are challenged with resource requirements, and food safety and scarcity concerns. Ensuring provisioning of an adequate food system relies not only upon determining technologies, and requirements for nutrition, quality, and safety, but upon establishing a food system that will support nutritional adequacy, even with individual crew preference and self-selection. In short, the space food system is challenged to maintain safety, nutrition, and acceptability for all phases of an exploration mission within resource constraints. This document presents the

  20. Air Quality Facilities

    Data.gov (United States)

    Iowa State University GIS Support and Research FacilityFacilities with operating permits for Title V of the Federal Clean Air Act, as well as facilities required to submit an air emissions inventory, and other facilities...

  1. Racial and Social Class Differences in How Parents Respond to Inadequate Achievement: Consequences for Children's Future Achievement.

    Science.gov (United States)

    Robinson, Keith; Harris, Angel L

    2013-12-01

    Despite numerous studies on parental involvement in children's academic schooling, there is a dearth of knowledge on how parents respond specifically to inadequate academic performance. This study examines whether 1) racial differences exist in parenting philosophy for addressing inadequate achievement, 2) social class has implications for parenting philosophy, and 3) parents' philosophies are consequential for children's academic achievement. Using data from the Child Development Supplement (N=1041) to the Panel Study of Income Dynamics, we sort parents into two categories-those whose parenting repertoires for addressing poor achievement include punitive responses and those whose repertoires do not. We then determine whether racial differences exist between these categories and how various responses within the aforementioned categories are related to students' academic achievement. The findings show that white and black parents have markedly different philosophies on how to respond to inadequate performance, and these differences appear to impact children's achievement in dramatically different ways. Educators and policy makers should pay particular attention to how parents respond to inadequate achievement as imploring parents of inadequately performing students to be more involved without providing them with some guidance might exacerbate the problem.

  2. Public health safety and environment in inadequate hospital and healthcare settings: a review.

    Science.gov (United States)

    Baguma, D

    2017-03-01

    Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Effects of inadequate maternal dietary protein:carbohydrate ratios during pregnancy on offspring immunity in pigs

    Directory of Open Access Journals (Sweden)

    Tuchscherer Margret

    2012-11-01

    Full Text Available Abstract Background Inadequate nutrition in utero may retard foetal growth and alter physiological development of offspring. This study investigated the effects of low and high protein diets fed to primiparous German Landrace sows throughout pregnancy on the immune function of their offspring at different ages. Sows were fed diets with adequate (AP, 12.1%; n = 13, low (LP, 6.5%; n = 15, or high (HP, 30%; n = 14 protein content, made isoenergetic by varying carbohydrate levels. Cortisol, total protein and immunoglobulin (IgG, IgM, IgA concentrations were measured in the blood of sows over the course of pregnancy. Cortisol, total protein, immunoglobulins, lymphocyte proliferation, immune cell counts, and cytokines were assessed in the blood of offspring at baseline and under challenging conditions (weaning; lipopolysaccharide (LPS administration. Results In sows, the LP diet increased cortisol (P P P P + cell percentage and the CD4+/CD8+ ratio increased after weaning (P P = 0.09 and HP (P P  Conclusions Our results indicate that both low and high protein:carbohydrate ratios in the diet of pregnant sows can induce short-term as well as long-lasting effects on immune competence in piglets that may have serious consequences for host defence against bacterial pathogens.

  4. Dutch healthcare professionals inadequately perceived if three- and four-year-old preschool children were overweight.

    Science.gov (United States)

    Bocca, Gianni; Corpeleijn, Eva; Broens, Jasper; Stolk, Ronald P; Sauer, Pieter J

    2016-10-01

    We studied whether healthcare professionals adequately perceived if preschool children were overweight and whether this was influenced by their own body mass index (BMI). We sent 716 Dutch healthcare professionals questionnaires containing seven pictures and seven sketches of three- and four-year-old children showing body weights from underweight to morbidly obese. The professionals rated the pictures on a five-point scale from too heavy to too light and chose the sketch that they felt best depicted the child's body shape. They also reported their own height and weight and their BMI was calculated. Of the 716 questionnaires, 346 (48.3%) were returned with complete information and analysed. Healthcare professionals mostly chose sketches that showed children as being lighter than they really were. Depending on their own BMI group, the overweight child was perceived as having a normal weight by 74-79% of the healthcare professionals. The obese children were rated correctly by 44-52% of the professionals, but 14-15% said their weight was normal. The morbidly obese child was adequately assessed by 93-98% of the professionals. Healthcare professionals inadequately perceived whether three- and four-year-old children were overweight and this may have hindered early interventions, leading to overweight children becoming overweight adolescents. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support.

    Science.gov (United States)

    Freisthler, Bridget; Johnson-Motoyama, Michelle; Kepple, Nancy J

    2014-08-01

    Supervisory neglect, or the failure of a caregiver to appropriately supervise a child, is one of the predominant types of neglectful behaviors, with alcohol use being considered a key antecedent to inadequate supervision of children. The current study builds on previous work by examining the role of parental drinking and alcohol outlet densities while controlling for caregiver and child characteristics. Data were obtained from 3,023 participants via a telephone survey from 50 cities throughout California. The telephone survey included items on neglectful parenting practices, drinking behaviors, and socio-demographic characteristics. Densities of alcohol outlets were measured for each of the 202 zip codes in the study. Multilevel Bernoulli models were used to analyze the relationship between four supervisory neglect parenting practices and individual-level and zip code-level variables. In our study, heavy drinking was only significantly related to one of our four outcome variables (leaving a child where he or she may not be safe). The density of on premise alcohol outlets was positively related to leaving a child home alone when an adult should be present. This study demonstrates that discrete relationships exist between alcohol related variables, social support, and specific supervisory neglect subtypes at the ecological and individual levels.

  6. Increasing Trends in Orthopedic Fellowships Are Not due to Inadequate Residency Training

    Directory of Open Access Journals (Sweden)

    K. A. Almansoori

    2015-01-01

    Full Text Available Orthopedic residents have one of the highest fellowship participation rates among medical specialities and there are growing concerns that inadequate residency training may be contributing to this trend. Therefore, a mixed-exploratory research survey was distributed to all 148 graduating Canadian orthopedic residents to investigate their perceptions and attitudes for pursuing fellowships. A response rate of 33% (n=49 was obtained with the majority of residents undertaking one (27% or two (60% fellowships. Surgical-skill development was reported as the most common motivating factor, followed by employment and marketability; malpractice protection and financial reasons were the least relevant. The overwhelming majority of residents (94%, n=46 felt adequately prepared by their residency training for independent general practice, and 84% (n=41 of respondents did not feel that current fellowship trends were due to poor residency training. Three common themes were expressed in their comments: the growing perceived expectation by healthcare professionals and employers to be fellowship-certified, the integration of fellowship training into the surgical education hierarchy, and the failure of residency training curriculums to accommodate for this trend. In conclusion, Canadian orthopedic residents are confident of their residency training and are increasingly pursuing fellowships to primarily develop their surgical skills and expertise.

  7. Fossil fuel subsidy removal and inadequate public power supply: Implications for businesses

    International Nuclear Information System (INIS)

    Bazilian, Morgan; Onyeji, Ijeoma

    2012-01-01

    We briefly consider the impact of fossil fuel subsidy removal policies in the context of inadequate power supply, with a focus on the implications for businesses. In doing so, we utilize the case of the early 2012 fuel subsidy removal in Nigeria. The rationale for such subsidy-removal policies is typically informed by analysis showing that they lead to an economically inefficient allocation of resources and market distortions, while often failing to meet intended objectives. However, often the realities of infrastructural and institutional deficiencies are not appropriately factored into the decision-making process. Businesses in many developing countries, already impaired by the high cost of power supply deficiencies, become even less competitive on an unsubsidized basis. We find that justifications for removal often do not adequately reflect the specific environments of developing country economies, resulting in poor recommendations – or ineffective policy. - Highlights: ► We consider the impact of fuel subsidy removal in the context of energy poverty. ► Calls for subsidy removal often do not reflect the developing country realities. ► Businesses impaired by power supply deficiencies, become even less competitive.

  8. Death Associated with Inadequate Reassessment of Venous Thromboembolism Prophylaxis at and after Hospital Discharge.

    Science.gov (United States)

    2015-01-01

    Venous thromboembolism (VTE) prophylaxis, also known as thromboprophylaxis, reduces the risk of deep vein thrombosis, pulmonary embolism, and associated complications, including death, in high-risk patients. VTE prophylaxis is recommended for acutely ill, hospitalized medical patients at risk of thrombosis. Anticoagulants, the pharmacologic agents of choice to prevent VTE, are considered high-alert medications. By definition, therefore, anticoagulants bear a hightened risk of causing significant patient harm when they are used in error. As part of ongoing collaboration with a provincial death investigation service, ISMP Canada received a report of a fatal incident that involved continuation of VTE prophylaxis with enoxaparin for a patient discharge to a long-term care (LTC) facility from an acute care setting. The findings and recommendations from this case are charged to highlight the need to build routine reassessment of VTE prophylaxis into the process for discharging patients from the acute care setting and upon transfer to another facility or to primary care. The incident described in this bulletin highlights the importance of continually reassessing the need for VTE prophylaxis, especially at transitions of care, such as discharge from an acute care setting. Evidence and guidelines confirm the benefits of VTE prophylaxis in certain patients during a hospital stay for an acute illness, but the balance of benefits and risks may become unfavourable once the patient is discharged. Clear documentation from the acute care facility can assist the receiving facility and health-care providers, as well as family caregivers, when determining whether thromboprophylaxis is still warranted. Until clear guidance to continue thromboprophylaxis after acute care is available, health-care organizations and practitioners across the spectrum of care are urged to share and consider the strategies presented in this bulletin to ensure the safe use of VTE prophylaxis and improved

  9. High Prevalence of Inadequate Calcium and Iron Intakes by Mexican Population Groups as Assessed by 24-Hour Recalls.

    Science.gov (United States)

    Sánchez-Pimienta, Tania G; López-Olmedo, Nancy; Rodríguez-Ramírez, Sonia; García-Guerra, Armando; Rivera, Juan A; Carriquiry, Alicia L; Villalpando, Salvador

    2016-09-01

    A National Health and Nutrition Survey (ENSANUT) conducted in Mexico in 1999 identified a high prevalence of inadequate mineral intakes in the population by using 24-h recall questionnaires. However, the 1999 survey did not adjust for within-person variance. The 2012 ENSANUT implemented a more up-to-date 24-h recall methodology to estimate usual intake distributions and prevalence of inadequate intakes. We examined the distribution of usual intakes and prevalences of inadequate intakes of calcium, iron, magnesium, and zinc in the Mexican population in groups defined according to sex, rural or urban area, geographic region of residence, and socioeconomic status (SES). We used dietary intake data obtained through the 24-h recall automated multiple-pass method for 10,886 subjects as part of ENSANUT 2012. A second measurement on a nonconsecutive day was obtained for 9% of the sample. Distributions of usual intakes of the 4 minerals were obtained by using the Iowa State University method, and the prevalence of inadequacy was estimated by using the Institute of Medicine's Estimated Average Requirement cutoff. Calcium inadequacy was 25.6% in children aged 1-4 y and 54.5-88.1% in subjects >5 y old. More than 45% of subjects >5 y old had an inadequate intake of iron. Less than 5% of children aged 12 y had inadequate intakes of magnesium, whereas zinc inadequacy ranged from <10% in children aged <12 y to 21.6% in men aged ≥20 y. Few differences were found between rural and urban areas, regions, and tertiles of SES. Intakes of calcium, iron, magnesium, and zinc are inadequate in the Mexican population, especially among adolescents and adults. These results suggest a public health concern that must be addressed. © 2016 American Society for Nutrition.

  10. Estimating the global prevalence of inadequate zinc intake from national food balance sheets: effects of methodological assumptions.

    Directory of Open Access Journals (Sweden)

    K Ryan Wessells

    Full Text Available The prevalence of inadequate zinc intake in a population can be estimated by comparing the zinc content of the food supply with the population's theoretical requirement for zinc. However, assumptions regarding the nutrient composition of foods, zinc requirements, and zinc absorption may affect prevalence estimates. These analyses were conducted to: (1 evaluate the effect of varying methodological assumptions on country-specific estimates of the prevalence of dietary zinc inadequacy and (2 generate a model considered to provide the best estimates.National food balance data were obtained from the Food and Agriculture Organization of the United Nations. Zinc and phytate contents of these foods were estimated from three nutrient composition databases. Zinc absorption was predicted using a mathematical model (Miller equation. Theoretical mean daily per capita physiological and dietary requirements for zinc were calculated using recommendations from the Food and Nutrition Board of the Institute of Medicine and the International Zinc Nutrition Consultative Group. The estimated global prevalence of inadequate zinc intake varied between 12-66%, depending on which methodological assumptions were applied. However, country-specific rank order of the estimated prevalence of inadequate intake was conserved across all models (r = 0.57-0.99, P<0.01. A "best-estimate" model, comprised of zinc and phytate data from a composite nutrient database and IZiNCG physiological requirements for absorbed zinc, estimated the global prevalence of inadequate zinc intake to be 17.3%.Given the multiple sources of uncertainty in this method, caution must be taken in the interpretation of the estimated prevalence figures. However, the results of all models indicate that inadequate zinc intake may be fairly common globally. Inferences regarding the relative likelihood of zinc deficiency as a public health problem in different countries can be drawn based on the country

  11. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies.

    Science.gov (United States)

    Bonnes, Judith L; Westra, Sjoerd W; Bouwels, Leon H R; DE Boer, Menko Jan; Brouwer, Marc A; Smeets, Joep L R M

    2016-05-01

    In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial substrate between ischemic and nonischemic heart disease (IHD/non-IHD) and the accompanying differences in clinical characteristics, we studied inadequate DSMs and their predictors in relation to the underlying etiology. Cohort of routine defibrillation tests (n = 785) after first implantable cardioverter defibrillator (ICD)-implantations at the Radboud UMC (2005-2014). A defibrillation threshold >25 J was regarded as an inadequate DSM. In total, 4.3% of patients had an inadequate DSM; in IHD 2.5% versus 7.3% in non-IHD (P = 0.002). We identified a group of non-IHD patients at high risk (13-42% inadequate DSM); the remainder of the cohort (>70%) had a risk of only 2% (C-statistic entire cohort 0.74; C-statistic non-IHD 0.82). This was based upon two identified interaction terms: (1) non-IHD and age (aOR 0.94 [95% CI 0.91-0.97]); (2) non-IHD and the indexed left ventricular (LV) internal diastolic diameter (aOR 3.50 [95% CI 2.10-5.82]). The present study on risk stratification for an inadequate DSM not only confirms the importance of making a distinction between IHD and non-IHD, but also shows that risk factors in an entire cohort (LV dilatation, age) may only apply to a subgroup (non-IHD). Appreciation of this concept could favorably affect current risk stratification. If confirmed, our approach may be used to optimize individualized testing decisions in an upcoming era of non-routine testing. © 2016 Wiley Periodicals, Inc.

  12. Nuclear facilities

    International Nuclear Information System (INIS)

    Anon.

    2002-01-01

    During September and October 2001, 15 events were recorded on the first grade and 1 on the second grade of the INES scale. The second grade event is in fact a re-classification of an incident that occurred on the second april 2001 at Dampierre power plant. This event happened during core refueling, a shift in the operation sequence led to the wrong positioning of 113 assemblies. A preliminary study of this event shows that this wrong positioning could have led, in other circumstances, to the ignition of nuclear reactions. Even in that case, the analysis made by EDF shows that the consequences on the staff would have been limited. Nevertheless a further study has shown that the existing measuring instruments could not have detected the power increase announcing the beginning of the chain reaction. The investigation has shown that there were deficiencies in the control of the successive operations involved in refueling. EDF has proposed a series of corrective measures to be implemented in all nuclear power plants. The other 15 events are described in the article. During this period 121 inspections have been made in nuclear facilities. (A.C.)

  13. Income-related inequalities in inadequate dentition over time in Australia, Brazil and USA adults.

    Science.gov (United States)

    Peres, Marco A; Luzzi, Liana; Peres, Karen G; Sabbah, Wael; Antunes, Jose L; Do, Loc G

    2015-06-01

    To assess changes over time of the absolute and relative household income-related inequalities in inadequate dentition (ID) among Australians, Brazilians and USA adults. This study used nationwide oral health survey data from Australia (n = 1200 in 1999; n = 2729 in 2005), Brazil (n = 13 431 in 2003; n = 9779 in 2010) and USA (n = 2542 in 1999; n = 1596 in 2005). Absolute income inequalities were calculated using Absolute Concentration Index (ACI) and Slope Index of Inequality (SII), while relative inequalities were calculated using Relative Concentration Index (RCI) and Relative Index of Inequality (RII). Prevalence of ID in the studied period dropped from 8.7% to 3.1% in Australia; from 42.1% to 22.4% in Brazil; and remained stable in USA, nearly 8.0%. Absolute income inequalities were highest in Brazil, followed by the USA and Australia; relative inequalities were lower in Brazil than in Australia and the USA. ID was higher among Brazilian females (2010) and for the poorest group in all countries and periods. A remarkable reduction in absolute inequalities were found in Australia [Slope Index of Inequality (SII) and AIC 60%] and in Brazil (SII 25%; ACI 33%) while relative inequalities increased both in Australia (RCI and RII 40%) and in Brazil (RCI 24%; RII 38%). No changes in absolute and relative income inequalities were found in the USA. There were still persistent absolute and relative income inequalities in ID in all examined countries. There has been a reduction in absolute income inequalities in ID but an increase in relative income inequalities. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Inadequate dietary intake of children and adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus.

    Science.gov (United States)

    Caetano, Michelle C; Ortiz, Thaís T; Terreri, Maria Teresa S R L A; Sarni, Roseli O S; Silva, Simone G L; Souza, Fabíola I S; Hilário, Maria Odete E

    2009-01-01

    To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients' clinical and anthropometric characteristics and to the drugs used in their treatment. By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis. Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5% had active disease, and among the JSLE patients, 68.2% showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5% of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2%. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3%, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4%, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2% of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients.

  15. Proposed biodiversity conservation areas: gap analysis and spatial prioritization on the inadequately studied Qinghai Plateau, China

    Directory of Open Access Journals (Sweden)

    Renqiang Li

    2018-01-01

    Full Text Available Global biodiversity priorities are primarily addressed through the establishment or expansion of conservation areas (CAs. Spatial prioritization of these CAs can help minimize biodiversity loss by accounting for the uneven distribution of biodiversity and conservation considerations (e.g., accessibility, cost, and biodiversity threats. Furthermore, optimized spatial priorities can help facilitate the judicious use of limited conservation resources by identifying cost effective CA designs. Here, we demonstrate how key species and ecosystems can be incorporated into systematic conservation planning to propose the expansion and addition of new CAs in the biodiversity-unique and data-poor region of Qinghai Plateau, China. We combined species distribution models with a systematic conservation planning tool, MARXAN to identify CAs for biodiversity on Qinghai Plateau. A set of 57 optimal CAs (273,872 km2, 39.3 % of this Province were required to achieve the defined conservation targets in Qinghai Province. We also identified 29 new CAs (139,216 km2, 20% of Qinghai Province outside the existing nature reserve (NRs that are necessary to fully achieve the proposed conservation targets. The conservation importance of these 29 new CAs was also indicated, with 10 labeled as high priority, 11 as medium priority, and 8 as low priority. High priority areas were more abundant in the eastern and southeastern parts of this region. Our results suggest that many species remain inadequately protected within the Qinghai Plateau, with conservation gaps in eastern and northwestern regions. The proposed more representative and effective CAs can provide useful information for adjusting the existing NRs and developing the first National Park in China.

  16. Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin

    Directory of Open Access Journals (Sweden)

    Jong Ho Kim

    2016-04-01

    Full Text Available BackgroundWe compared the efficacies of vildagliptin (50 mg twice daily relative to pioglitazone (15 mg once daily as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c levels in Korean patients with type 2 diabetes.MethodsThe present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin.ResultsThe mean changes in HbA1c levels from baseline were –0.94% in the vildagliptin group and –0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG levels were –60.2 mg/dL in the vildagliptin group and –38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040. There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL, and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was –0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002.ConclusionAs an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

  17. Inadequately marketing our brand: Medical student awareness of acute care surgery.

    Science.gov (United States)

    Montgomery, Stephanie C; Privette, Alicia R; Ferguson, Pamela L; Mirdamadi, Meena; Fakhry, Samir M

    2015-11-01

    Despite focused national efforts to promote acute care surgery (ACS), little is known about medical student awareness of ACS as a career choice. The impending shortage of general surgeons emphasizes the need to increase interest in this comprehensive surgical specialty. The goal of this study was to determine whether students would be more likely to consider choosing ACS if they were aware of the specialty and its benefits. A survey was distributed electronically to medical students at our institution, a Level I trauma center with an active ACS service. The survey asked questions regarding specialty choice and factors that were used in making that decision. Also included were questions regarding their familiarity and affinity for ACS. The survey was returned by 518 students. Each medical school year was proportionately represented. Twenty-one percent of the students reported surgery as their career choice; however, women were half as likely to choose surgery as men. When asked to define ACS, 23% of all students gave the correct response. Only 8.9% of the students in the preclinical years correctly defined ACS. Even in the clinical years, 54% were unaware of ACS as a specialty. Students reported that the top factors that influenced their choice were controllable lifestyle, predictable schedule, and a positive medical school role model. When asked to identify what would make ACS appealing, a 50-hour work week was deemed most influential. When given the definition of ACS with approximate pay and on-call hours, 41.5% of the students and 75% of those interested in surgery would be likely to choose ACS as a career. This study highlights that awareness of ACS as a specialty is lacking. This may reflect inadequate marketing of our "brand" both locally and nationally. Focused efforts at familiarizing students with ACS and increased role modeling may increase interest in ACS.

  18. Anemia in ST-Elevation Myocardial Infarction Patients with Markers of Inadequate Bone Marrow Response.

    Science.gov (United States)

    Arbel, Yaron; Milwidsky, Assi; Finkelstein, Ariel; Halkin, Amir; Revivo, Miri; Berliner, Shlomo; Ellis, Martin; Herz, Itzhak; Keren, Gad; Banai, Shmuel

    2015-08-01

    Anemia confers an adverse prognosis in patients with ST-elevation myocardial infarction (STEMI). Several mechanisms have been implicated in the etiology of anemia in this setting, including inflammation, blood loss, and the presence of comorbidities such as renal failure. To evaluate the adequacy of bone marrow response as potentially reflected by elevation in blood and reticulocyte counts. Consecutive men with STEMI who underwent primary percutaneous intervention within 6 hours of symptom onset and who presented to our catheterization laboratory during a 36 month period were included in the study. The cohort was divided into quartiles according to hemoglobin concentration, and differences in clinical and laboratory characteristics between the groups were evaluated. A total of 258 men with STEMI were recruited, 22% of whom suffered from anemia according to the World Health Organization classification (hemoglobin < 13 g/dl). Men in the lowest quartile of hemoglobin concentration presented with significantly lower white blood cell and platelet counts (9.6 ± 2.9 vs. 12.6 ± 3.6 x 103/μl, P < 0.001) and (231 ± 79 vs. 263 ± 8 x 103/μl, P < 0.01), respectively, despite higher inflammatory biomarkers (C-reactive protein and fibrinogen) compared with patients in the upper hemoglobin concentration quartile. Reticulocyte production index was not significantly higher in anemic patients, with a value of 1.8, 1.4, 1.5 and 1.6 in the ascending hemoglobin quartiles, respectively (P = 0.292). Anemic men with STEMI have relatively lower leukocyte and platelet counts as well as a reduced reticulocyte count despite higher inflammatory biomarkers. These findings might suggest inadequate bone marrow response.

  19. Cancers in Australia in 2010 attributable to inadequate consumption of fruit, non-starchy vegetables and dietary fibre

    Science.gov (United States)

    Nagle, Christina M; Wilson, Louise F; Hughes, Maria Celia B; Ibiebele, Torukiri I; Miura, Kyoko; Bain, Christopher J; Whiteman, David C; Webb, Penelope M

    2015-01-01

    Objectives To estimate the number and proportion of cancers occurring in Australia in 2010 attributable to consumption deficits in fruit, non-starchy vegetables and dietary fibre. Methods We estimated the population attributable fraction (PAF) for cancers causally associated with inadequate intake of fruit and non-starchy vegetables (oral cavity, pharynx, oesophageal squamous cell carcinoma, stomach, larynx); inadequate intake of fruit (lung); and insufficient intake of fibre (colorectum). We used standard formulae incorporating prevalence of exposure (1995 National Nutrition Survey) and relative risks from independent studies. Results Overall, 1,555 (1.4% of all) and 311 (0.3% of all) cancers were attributable to inadequate intakes of fruit and non-starchy vegetables, respectively. A further 2,609 colorectal cancers (18% of colorectal) were attributable to insufficient fibre intake. If Australians increased their fibre intake by eating the recommended daily intakes of fruit and vegetables, an estimated 1,293 (8.8%) colorectal cancers could be prevented. Conclusions One in six colorectal cancer cases was attributable to inadequate intake of dietary fibre and about 1,800 cancers at other sites were attributable to insufficient fruit and non-starchy vegetable consumption. Implications Increasing the proportion of Australians who consume the recommended intake of fruit, vegetables and fibre could prevent up to 4% of all cancers. PMID:26437726

  20. 20 CFR 411.321 - Under what conditions will SSA terminate an agreement with an EN due to inadequate performance?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Under what conditions will SSA terminate an agreement with an EN due to inadequate performance? 411.321 Section 411.321 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Networks § 411.321 Under...

  1. Safety and efficacy of twice-daily exenatide in Taiwanese patients with inadequately controlled type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Chieh-Hsiang Lu

    2013-03-01

    Conclusion: This subgroup analysis of Taiwanese patients was consistent with the overall study results, which showed that exenatide BID is superior to placebo for improving glycemic control in Asian patients with type 2 diabetes who experienced inadequate glycemic control when using oral antidiabetic therapy.

  2. Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves' disease

    NARCIS (Netherlands)

    Kempers, Marlies J. E.; van Trotsenburg, A. S. Paul; van Rijn, Rick R.; Smets, Anne M. J. B.; Smit, Bert J.; de Vijlder, Jan J. M.; Vulsma, Thomas

    2007-01-01

    Context: Central congenital hypothyroidism (CH-C) in neonates born to mothers with inadequately treated Graves' disease usually needs T-4 supplementation. The thyroid and its regulatory system have not yet been extensively studied after T-4 withdrawal, until we observed disintegrated thyroid glands

  3. Dialysis Hypotension : A Role for Inadequate Increase in Arginine Vasopressin Levels? A Systematic Literature Review and Meta-Analysis

    NARCIS (Netherlands)

    Ettema, Esmee M.; Zittema, Debbie; Kuipers, Johanna; Gansevoort, Ron T.; Vart, Priya; de Jong, Paul E.; Westerhuis, Ralf; Franssen, Casper F. M.

    2014-01-01

    Background: Intradialytic hypotension is a common complication of hemodialysis (HD). Some studies have suggested that inadequate arginine vasopressin (AVP) increase could play a role in the pathogenesis of intradialytic hypotension. However, AVP levels during HD and its relation to hypotension has

  4. Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients

    NARCIS (Netherlands)

    van't Hoog, Anna H.; Marston, Barbara J.; Ayisi, John G.; Agaya, Janet A.; Muhenje, Odylia; Odeny, Lazarus O.; Hongo, John; Laserson, Kayla F.; Borgdorff, Martien W.

    2013-01-01

    The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB), that a quarter of the prevalent cases had not yet sought care, and a

  5. Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands.

    NARCIS (Netherlands)

    Boerleider, A.W.; Manniën, J.; Wiegers, T.A.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background: In many industrialized western countries non-western women constitute a substantial part of the prenatal care client population. In The Netherlands, these women have also been shown to be more likely to make inadequate use of prenatal care. Explanatory factors for this include, among

  6. Confidence versus Performance as an Indicator of the Presence of Alternative Conceptions and Inadequate Problem-Solving Skills in Mechanics

    Science.gov (United States)

    Potgieter, Marietjie; Malatje, Esther; Gaigher, Estelle; Venter, Elsie

    2010-01-01

    This study investigated the use of performance-confidence relationships to signal the presence of alternative conceptions and inadequate problem-solving skills in mechanics. A group of 33 students entering physics at a South African university participated in the project. The test instrument consisted of 20 items derived from existing standardised…

  7. Inadequate dietary calcium and vitamin D intakes in renal-transplant recipients in Ireland.

    LENUS (Irish Health Repository)

    Lynch, Irene T

    2012-02-03

    vitamin D intakes in adult renal-transplant patients are in many cases inadequate.

  8. Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: Risk factors and impact on outcomes

    Directory of Open Access Journals (Sweden)

    Piskin Nihal

    2012-10-01

    Full Text Available Abstract Background Initial antimicrobial therapy (AB is an important determinant of clinical outcome in patients with severe infections as pneumonia, however well-conducted studies regarding prognostic impact of inadequate initial AB in patients who are not undergoing mechanical ventilation (MV are lacking. In this study we aimed to identify the risk factors for inadequate initial AB and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP and hospital acquired pneumonia (HAP. Methods We retrospectively studied the accuracy of initial AB in patients with pneumonia in a university hospital in Turkey. A total of 218 patients with HAP and 130 patients with VAP were included. For each patient clinical, radiological and microbiological data were collected. Stepwise multivariate logistic regression analysis was used for risk factor analysis. Survival analysis was performed by using Kaplan-Meier method with Log-rank test. Results Sixty six percent of patients in VAP group and 41.3% of patients in HAP group received inadequate initial AB. Multiple logistic regression analysis revealed that the risk factors for inadequate initial AB in HAP patients were; late-onset HAP (OR = 2.35 (95% CI, 1.05-5.22; p = 0.037 and APACHE II score at onset of HAP (OR = 1.06 (95% CI, 1.01-1.12; p = 0.018. In VAP patients; antibiotic usage in the previous three months (OR = 3.16 (95% CI, 1.27-7.81; p = 0.013 and admission to a surgical unit (OR = 2.9 (95% CI, 1.17-7.19; p = 0.022 were found to be independent risk factors for inadequate initial AB. No statistically significant difference in crude hospital mortality and 28-day mortality was observed between the treatment groups in both VAP and HAP. However we showed a significant increase in length of hospital stay, duration of mechanical ventilation and a prolonged clinical resolution in the inadequate AB group in both VAP and HAP. Conclusion Our data

  9. Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: risk factors and impact on outcomes.

    Science.gov (United States)

    Piskin, Nihal; Aydemir, Hande; Oztoprak, Nefise; Akduman, Deniz; Comert, Fusun; Kokturk, Furuzan; Celebi, Guven

    2012-10-24

    Initial antimicrobial therapy (AB) is an important determinant of clinical outcome in patients with severe infections as pneumonia, however well-conducted studies regarding prognostic impact of inadequate initial AB in patients who are not undergoing mechanical ventilation (MV) are lacking. In this study we aimed to identify the risk factors for inadequate initial AB and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP) and hospital acquired pneumonia (HAP). We retrospectively studied the accuracy of initial AB in patients with pneumonia in a university hospital in Turkey. A total of 218 patients with HAP and 130 patients with VAP were included. For each patient clinical, radiological and microbiological data were collected. Stepwise multivariate logistic regression analysis was used for risk factor analysis. Survival analysis was performed by using Kaplan-Meier method with Log-rank test. Sixty six percent of patients in VAP group and 41.3% of patients in HAP group received inadequate initial AB. Multiple logistic regression analysis revealed that the risk factors for inadequate initial AB in HAP patients were; late-onset HAP (OR = 2.35 (95% CI, 1.05-5.22; p = 0.037) and APACHE II score at onset of HAP (OR = 1.06 (95% CI, 1.01-1.12); p = 0.018). In VAP patients; antibiotic usage in the previous three months (OR = 3.16 (95% CI, 1.27-7.81); p = 0.013) and admission to a surgical unit (OR = 2.9 (95% CI, 1.17-7.19); p = 0.022) were found to be independent risk factors for inadequate initial AB. No statistically significant difference in crude hospital mortality and 28-day mortality was observed between the treatment groups in both VAP and HAP. However we showed a significant increase in length of hospital stay, duration of mechanical ventilation and a prolonged clinical resolution in the inadequate AB group in both VAP and HAP. Our data suggests that the risk factors for inadequate initial AB

  10. Irradiation Facilities at CERN

    CERN Document Server

    Gkotse, Blerina; Carbonez, Pierre; Danzeca, Salvatore; Fabich, Adrian; Garcia, Alia, Ruben; Glaser, Maurice; Gorine, Georgi; Jaekel, Martin, Richard; Mateu,Suau, Isidre; Pezzullo, Giuseppe; Pozzi, Fabio; Ravotti, Federico; Silari, Marco; Tali, Maris

    2017-01-01

    CERN provides unique irradiation facilities for applications in many scientific fields. This paper summarizes the facilities currently operating for proton, gamma, mixed-field and electron irradiations, including their main usage, characteristics and information about their operation. The new CERN irradiation facilities database is also presented. This includes not only CERN facilities but also irradiation facilities available worldwide.

  11. Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

    Science.gov (United States)

    LaGasse, Linda L.; Wouldes, Trecia A.; Arria, Amelia M.; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Neal, Charles R.; Huestis, Marilyn A.; DellaGrotta, Sheri; Lester, Barry M.

    2013-01-01

    This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socio-economic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care. PMID:22588827

  12. Basic Research Firing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Basic Research Firing Facility is an indoor ballistic test facility that has recently transitioned from a customer-based facility to a dedicated basic research...

  13. Jupiter Laser Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Jupiter Laser Facility is an institutional user facility in the Physical and Life Sciences Directorate at LLNL. The facility is designed to provide a high degree...

  14. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  15. Aperture area measurement facility

    Data.gov (United States)

    Federal Laboratory Consortium — NIST has established an absolute aperture area measurement facility for circular and near-circular apertures use in radiometric instruments. The facility consists of...

  16. Licensed Healthcare Facilities

    Data.gov (United States)

    California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  17. High Throughput Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Argonne?s high throughput facility provides highly automated and parallel approaches to material and materials chemistry development. The facility allows scientists...

  18. Facility Registry Service (FRS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Facility Registry Service (FRS) provides an integrated source of comprehensive (air, water, and waste) environmental information about facilities across EPA,...

  19. Management of Decommissioning on a Multi-Facility Site

    International Nuclear Information System (INIS)

    Laraia, Michele; McIntyre, Peter; Visagie, Abrie

    2008-01-01

    The management of the decommissioning of multi-facility sites may be inadequate or inappropriate if based on approaches and strategies developed for sites consisting of only a single facility. The varied nature of activities undertaken, their interfaces and their interdependencies are likely to complicate the management of decommissioning. These issues can be exacerbated where some facilities are entering the decommissioning phase while others are still operational or even new facilities are being built. Multi-facility sites are not uncommon worldwide but perhaps insufficient attention has been paid to optimizing the overall site decommissioning in the context of the entire life cycle of facilities. Decommissioning management arrangements need to be established taking a view across the whole site. A site-wide decommissioning management system is required. This should include a project evaluation and approval process and specific arrangements to manage identified interfaces and interdependencies. A group should be created to manage decommissioning across the site, ensuring adequate and consistent practices in accordance with the management system. Decommissioning management should be aimed at the entire life cycle of facilities. In the case of multi facility sites, the process becomes more complex and decommissioning management arrangements need to be established with a view to the whole site. A site decommissioning management system, a group that is responsible for decommissioning on site, a site project evaluation and approval process and specific arrangements to manage the identified interfaces are key areas of a site decommissioning management structure that need to be addressed to ensure adequate and consistent decommissioning practices. A decommissioning strategy based on single facilities in a sequential manner is deemed inadequate

  20. Guide to research facilities

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-01

    This Guide provides information on facilities at US Department of Energy (DOE) and other government laboratories that focus on research and development of energy efficiency and renewable energy technologies. These laboratories have opened these facilities to outside users within the scientific community to encourage cooperation between the laboratories and the private sector. The Guide features two types of facilities: designated user facilities and other research facilities. Designated user facilities are one-of-a-kind DOE facilities that are staffed by personnel with unparalleled expertise and that contain sophisticated equipment. Other research facilities are facilities at DOE and other government laboratories that provide sophisticated equipment, testing areas, or processes that may not be available at private facilities. Each facility listing includes the name and phone number of someone you can call for more information.

  1. Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Teixeira, Maria Cristina Triguero Veloz; Marino, Regina Luisa de Freitas; Carreiro, Luiz Renato Rodrigues

    2015-01-01

    Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6-16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6-18 (CBCL/6-18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.

  2. Evaluation of the improvement suggestion system in a nuclear facility

    Energy Technology Data Exchange (ETDEWEB)

    Carnaval, Joao Paulo Rodrigues; Moraes, Geice Almeida, E-mail: joaocarnaval@inb.gov.br, E-mail: geice@inb.gov.br [Industrias Nucleares do Brasil S.A (INB), Resende, RJ (Brazil)

    2017-11-01

    This work evaluated methods for processing improvement suggestions of a nuclear factory, with the intention to verify those which best fits to the company purposes. Two methods for processing improvement suggestions were applied in the studied organization. The first one was guided to the processing suggestions by specific independent sectors of the company and the second one was conducted to the processing of suggestions by a multidisciplinary team. It has been concluded that a multidisciplinary team focused on research and development would be the best option to the implementation of improvement suggestions and technological innovation on this facility, instead of multi sector processing which revealed to be excessive bureaucratic before the expected goals. This study can be used by nuclear facilities to optimize an existing system of improvements analysis or even guide them for the implantation of a new one. It is more significant for the companies certified on ISO and OHSAS standards for the quality management, environmental and safety and occupational health systems which requires that the continuous improvement must exist and to be demonstrated. But it is also relevant for nuclear plants aiming to implement an Integrated Management System certified on ISO Standards. (author)

  3. Evaluation of the improvement suggestion system in a nuclear facility

    International Nuclear Information System (INIS)

    Carnaval, Joao Paulo Rodrigues; Moraes, Geice Almeida

    2017-01-01

    This work evaluated methods for processing improvement suggestions of a nuclear factory, with the intention to verify those which best fits to the company purposes. Two methods for processing improvement suggestions were applied in the studied organization. The first one was guided to the processing suggestions by specific independent sectors of the company and the second one was conducted to the processing of suggestions by a multidisciplinary team. It has been concluded that a multidisciplinary team focused on research and development would be the best option to the implementation of improvement suggestions and technological innovation on this facility, instead of multi sector processing which revealed to be excessive bureaucratic before the expected goals. This study can be used by nuclear facilities to optimize an existing system of improvements analysis or even guide them for the implantation of a new one. It is more significant for the companies certified on ISO and OHSAS standards for the quality management, environmental and safety and occupational health systems which requires that the continuous improvement must exist and to be demonstrated. But it is also relevant for nuclear plants aiming to implement an Integrated Management System certified on ISO Standards. (author)

  4. Brazilians' experiences with iron fortification: evidence of effectiveness for reducing inadequate iron intakes with fortified flour policy.

    Science.gov (United States)

    Vieira, Diva Aliete Dos Santos; Steluti, Josiane; Verly, Eliseu; Marchioni, Dirce Maria; Fisberg, Regina Mara

    2017-02-01

    To assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the mandatory fortification of flour with Fe. Two cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design. São Paulo, Brazil. Adolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661). The Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19-50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors. The mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.

  5. An implant-supported removable partial denture on milled bars to compromise the inadequate treatment plan: a clinical report

    OpenAIRE

    Kim, Jee-Hwan; Lee, Jae-Hoon

    2010-01-01

    Presurgical prosthetic treatment planning is critical for the success of the implant prosthesis. Inadequate treatment plan, due to insufficient discussion between prosthodontist, and surgeon, may result in poor prognosis. A 26-year-old male patient was referred for prosthodontic treatment after implant was placed in the area of teeth #17, 16, 22, 25 and 27, without adequate discussion nor the treatment planning between oral surgeon and prosthodontist. It was found that the patient had two hop...

  6. Environmental Assessment for Demolition and Construction of Military Personnel Support Facilities Kirtland Air Force Base, New Mexico

    Science.gov (United States)

    2010-07-01

    researchers propose that these small groups hunted much smaller game, and gathered and scavenged foods comprised a significant portion of their diet ...facility are tied up simply tending separate inadequate facilities. For example, there are two old gyms with three worn-out basketball courts while...the need is one top-notch gym with two basketball courts; there are antiquated undersize men’s and women’s dressing room-locker-shower facilities at two

  7. Prevalence and risk factors of inadequate cervical dilation following laminaria insertion in second-trimester abortion--case control study.

    Science.gov (United States)

    Ben-Ami, Ido; Stern, Sharon; Vaknin, Zvi; Smorgick, Noam; Schneider, David; Halperin, Reuvit

    2015-04-01

    The objective was to explore the prevalence of and risk factors for inadequate cervical dilation following insertion of a single set of laminaria in women scheduled for dilation & evacuation (D&E) at 14-24 weeks' gestation. We retrospectively reviewed all cases of women who underwent pregnancy termination by D&E at 14-24 weeks' gestation between January 2003 and December 2013. All cases in which the surgical procedure was cancelled due to failure to achieve adequate cervical dilation after a single set of laminaria inadequate cervical dilation were included. The control group was women who underwent D&E following adequate cervical dilation after a single set of laminaria, and were matched according to gestational week in a ratio of 1:3. The overall dilation failure rate was 3.2%, with 4.0% among the induced-abortion patients and 1.5% among the patients with fetal demise (p=.002). Patients who had inadequate cervical dilation had lower rates of gravidity (p=.002) and previous spontaneous vaginal delivery (plaminaria insertion, namely, previous cesarean section (p=.002) and previous cervical procedure (plaminaria. Women who are scheduled for D&E, and in whom one of these risk factors exists, might benefit from additional interventions to achieve better cervical preparation. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Inadequate vertical bone dimension managed by bone-added osteotome sinus floor elevation (BAOSFE): a literature review and case report.

    Science.gov (United States)

    Kolhatkar, Shilpa; Cabanilla, Leyvee; Bhola, Monish

    2009-05-01

    The purpose of this report is to provide a brief literature review of the bone-added osteotome sinus floor elevation (BAOSFE) procedure and to present a case utilizing this technique. Implant placement in the posterior maxillary region is often compromised due to anatomic limitations. In clinical situations where there is inadequate vertical bone dimension, the BAOSFE technique can be employed to increase bone height and allow placement of implants with an appropriate length dimension. A case of a 60-year-old female with inadequate vertical bone dimension in the area of an extracted #13 is presented. The BAOSFE technique was performed which facilitated the placement of a 3.75 X 13 mm implant. Anatomic limitations such as inadequate vertical bone dimension in the posterior maxillary region may result in placement of shorter implants. Sinus floor elevation (SFE) procedures using a crestal approach such as the BAOSFE, in certain selected cases, can effectively and predictably increase bone height. The BAOSFE technique is an excellent procedure that can overcome limitations associated with the posterior maxillary region.

  9. Inadequate housing among families under investigation for child abuse and neglect: prevalence from a national probability sample.

    Science.gov (United States)

    Fowler, Patrick J; Henry, David B; Schoeny, Michael; Landsverk, John; Chavira, Dina; Taylor, Jeremy J

    2013-09-01

    This study aimed to estimate the prevalence of inadequate housing that threaten out-of-home placement among families under investigation by child welfare. Data came from the National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal survey of child welfare-involved families. Child protective services caseworkers as well as caregivers provided information on families whose child remained in the home after initial investigation (N = 3,867). Multilevel latent class analyses tested the presence of inadequately housed subgroups using 4 housing problem indicators at baseline. Logistic regressions assessed convergent and predictive validity. A two class latent solution best fit the data. Findings indicated that inadequate housing contributed to risk for out-of-home placement in approximately 16 % of intact families under investigation by child protective services. These families were 4 times more likely to need housing services 12 months later. Federal legislation emphasizes integration of social services as necessary to end homelessness. This study demonstrates overlap across public agencies. Enhanced coordination of child welfare and housing services facilitates interventions to prevent and mitigate homelessness.

  10. Plum Brook facilities

    Science.gov (United States)

    Kozar, Robert

    1993-01-01

    The topics are presented in viewgraph form and include the following: the Spacecraft Propulsion Research Research Facility (B-2); the Hydrogen Heat Transfer Facility (HHTF); the Rocket Dynamics and Control Facility (B-3); the Cryogenic Propellant Tank Site (K-Site); and the Space Power Facility (SPF).

  11. Emergency Department Visits for Homelessness or Inadequate Housing in New York City before and after Hurricane Sandy.

    Science.gov (United States)

    Doran, Kelly M; McCormack, Ryan P; Johns, Eileen L; Carr, Brendan G; Smith, Silas W; Goldfrank, Lewis R; Lee, David C

    2016-04-01

    Hurricane Sandy struck New York City on October 29, 2012, causing not only a large amount of physical damage, but also straining people's health and disrupting health care services throughout the city. In prior research, we determined that emergency department (ED) visits from the most vulnerable hurricane evacuation flood zones in New York City increased after Hurricane Sandy for several medical diagnoses, but also for the diagnosis of homelessness. In the current study, we aimed to further explore this increase in ED visits for homelessness after Hurricane Sandy's landfall. We performed an observational before-and-after study using an all-payer claims database of ED visits in New York City to compare the demographic characteristics, insurance status, geographic distribution, and health conditions of ED patients with a primary or secondary ICD-9 diagnosis of homelessness or inadequate housing in the first week after Hurricane Sandy's landfall versus the baseline weekly average in 2012 prior to Hurricane Sandy. We found statistically significant increases in ED visits for diagnosis codes of homelessness or inadequate housing in the week after Hurricane Sandy's landfall. Those accessing the ED for homelessness or inadequate housing were more often elderly and insured by Medicare after versus before the hurricane. Secondary diagnoses among those with a primary ED diagnosis of homelessness or inadequate housing also differed after versus before Hurricane Sandy. These observed differences in the demographic, insurance, and co-existing diagnosis profiles of those with an ED diagnosis of homelessness or inadequate housing before and after Hurricane Sandy suggest that a new population cohort-potentially including those who had lost their homes as a result of storm damage-was accessing the ED for homelessness or other housing issues after the hurricane. Emergency departments may serve important public health and disaster response roles after a hurricane, particularly for

  12. Bureaucratic Structure and Bureaucratic Performance in Less Developed Countries

    OpenAIRE

    Rauch, James E; Evans, Peter B.

    1999-01-01

    Recent cross-country empirical analysis has found that privately produced ratings of the performance of the central government bureaucracy in areas such as corruption and red tape are significant predictors of economic performance. We argue that several relatively simple, easily identifiable structural features constitute the key ingredients of effective state bureaucracies and should help to predict these ratings: competitive salaries, internal promotion and career stability, and meritocrati...

  13. Are Future Bureaucrats More Prosocial?

    DEFF Research Database (Denmark)

    Tepe, Markus; Vanhuysse, Pieter

    2017-01-01

    , fairness, strategic fairness, and cooperation towards public goods, and a post-experimental survey on subjects’ PSM. Higher levels of PSM are not associated with studying public administration but are positively associated with altruism, and negatively with strategic fairness. The experimental data reveals...... robust subject pool effects. Even after controlling for PSM, public administration students both behave more altruistically and display less merely strategic fairness than business students. And they behave more cooperatively than students of both business and law. These behavioral findings about future...

  14. Political Influence and Bureaucratic Autonomy

    NARCIS (Netherlands)

    Yesilkagit, A.K.; Thiel, S. van

    The establishment of autonomous public bodies during the past two decades has created a highly fragmented public sector. Using a dataset with more than 200 Dutch public sector organisations, this article examines three related sets of questions: to what extent a relationship exists between formal

  15. Political influence and bureaucratic autonomy

    NARCIS (Netherlands)

    K. Yesilkagit (Kutsal); S. van Thiel (Sandra)

    2008-01-01

    textabstractThe establishment of autonomous public bodies during the past two decades has created a highly fragmented public sector. Using a dataset with more than 200 Dutch public sector organisations, this article examines three related sets of questions: to what extent a relationship exists

  16. Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation: a prospective cohort study.

    Science.gov (United States)

    Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

    2015-04-21

    Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.

  17. Inadequate prescription of chronic consumption of proton pump inhibitors in a hospital in Mexico: Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jaime Alberto Sánchez-Cuén

    2013-03-01

    Full Text Available Introduction: PPIs have been an enormous therapeutic advance in acid-related diseases. However, it has been detected an abuse in its consumption. The aim of this study was to determine the frequency of inadequate prescription of chronic use of PPIs in outpatients in a speciality hospital. Material and methods: we performed a cross-sectional descriptive study review. The study population were patients, chronic users of proton pump inhibitors (PPIs, attending outpatient consult in a hospital of government workers. We defined as chronic user of PPIs that patient that takes medication daily for over a year and inappropriate prescription, that one that has not been approved by the clinical guidelines. A simple random sampling was utilized. The following parameters were investigated: diagnosis and prescription of PPIs, time of use, at which level of care PPIs were prescribed (primary care or specialist, self-medication, with or without endoscopy. For the statistical analysis, we used Student's t-test and Chi-square, 95% confidence intervals and significance 0.05 %. Results: we reviewed 153 patients, 40 (26.1 % men and 113 (73.9 % women, mean age 58 ± 11.4 years. The prescription of chronic treatment with PPIs was adequate in 64.7 % of patients and inadequate in 35.3 %. The most common appropriate prescription (31.3 % of chronic use of PPIs was due to gastroesophageal reflux disease. The most common inadequate prescription was absence of diagnosis (22.2 %, polypharmacy without nonsteroidal antiinflammatory drugs (16.6 % and chronic gastritis (16.6 %. History of endoscopy were not statistically significant. Conclusions: the frequency of inappropriate prescriptions of chronic use of PPIs was high, around 35.3 %, similar to those reported in hospitals in developed countries.

  18. Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

    Science.gov (United States)

    Shi, Zumin; Zhen, Shiqi; Wittert, Gary A.; Yuan, Baojun; Zuo, Hui; Taylor, Anne W.

    2014-01-01

    Objectives Riboflavin (vitamin B2) has been shown in animal studies to affect the absorption and metabolism of iron. Cross-sectional population studies show a relationship between riboflavin intake and anemia but prospective population studies are limited. The aim of the study was to determine the relationship between riboflavin intake and the risk of anemia in a Chinese cohort. Method The study used data from 1253 Chinese men and women who participated in two waves of the Jiangsu Nutrition Study (JIN), five years apart, in 2002 and 2007. Riboflavin intake and hemoglobin (Hb) were quantitatively assessed together with dietary patterns, lifestyle, socio-demographic and health-related factors. Results At baseline, 97.2% of participants had inadequate riboflavin intake (below the estimate average requirement). Riboflavin intake was positively associated with anemia at baseline, but low riboflavin intake was associated with an increased risk of anemia at follow-up among those anemic at baseline. In the multivariate model, adjusting for demographic and lifestyle factors and dietary patterns, the relative risk and 95% confidence interval for anemia at follow-up, across quartiles of riboflavin intake were: 1, 0.82(0.54–1.23), 0.56(0.34–0.93), 0.52(0.28–0.98) (p for trend 0.021). There was a significant interaction between riboflavin and iron intake; when riboflavin intake was low, a high iron intake was associated with a lower probability of anemia at follow-up. This association disappeared when riboflavin intake was high. Conclusion Inadequate riboflavin intake is common and increases the risk of anemia in Chinese adults. Given the interaction with iron intake correcting inadequate riboflavin intake may be a priority in the prevention of anemia, and population based measurement and intervention trials are required. PMID:24533156

  19. Inadequate functional health literacy in Spanish as a barrier to cervical cancer screening among immigrant Latinas in New York City.

    Science.gov (United States)

    Garbers, Samantha; Chiasson, Mary Ann

    2004-10-01

    The objective of this study was to examine the association between inadequate functional health literacy in Spanish among low-income Latinas aged 40 and older and cervical cancer screening knowledge and behavior. Spanish-speaking Latinas aged 40-78 of various nationalities (n = 205) participated in a study that included a survey on cervical cancer knowledge and behavior administered in Spanish and the Spanish version of the Test of Functional Health Literacy in Adults. Compared to those with adequate and marginal health literacy, women with inadequate functional health literacy in Spanish were significantly less likely to have ever had a Papanicolaou (Pap) test (odds ratio, 0.12; 95% confidence interval [CI], 0.04-0.37) or in the last three years (odds ratio, 0.35; 95% CI, 0.18-0.68) and were significantly more likely to have had their last Pap test at a local public hospital (odds ratio, 2.43; 95% CI, 1.18-4.97). Even when controlling for other factors, women with inadequate health literacy were 16.7 times less likely (adjusted odds ratio, 0.06; 95% CI, 0.01-0.55) to have ever had a Pap test. Almost half of the population we studied will have difficulty interpreting written medical materials, even in Spanish. When developing efforts to reach women who have not been screened, programs and service providers need to be aware that the women most in need of information about screening may be more likely to be unable to read any written materials provided to them, regardless of the language or level of simplicity of the materials. Programs and strategies need to be implemented to increase screening prevalence and to minimize the identified gaps in regular screening for Latinas who have low health literacy.

  20. Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes.

    Science.gov (United States)

    Melin, Eva O; Thunander, Maria; Svensson, Ralph; Landin-Olsson, Mona; Thulesius, Hans O

    2013-06-01

    The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric, and lifestyle variables in a population-based cohort of type 1 diabetes patients. Cross-sectional study. In this study, 292 patients with type 1 diabetes, aged 1859 years, participated. psychological data were assessed by self-report instruments: Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records, and data from the Swedish National Diabetes Registry were collected. Self-reported depression (adjusted odds ratio (AOR) 4.8), obesity (AOR 4.3), and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c>8.6%). Gender-stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women and smoking in men (AOR 4.2) were associated with HbA1c>8.6%. Alexithymia, antidepressant medication, and physical inactivity were associated with HbA1c>8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity, and absence of abdominal obesity were associated with self-reported depression. Depression was the only psychological factor independently associated with HbA1c>8.6%. The association was of comparable importance as obesity and smoking, well-known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c>8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and lifestyle factors in order to achieve the goals for HbA1c.

  1. Circulating sclerostin and estradiol levels are associated with inadequate response to bisphosphonates in postmenopausal women with osteoporosis.

    Science.gov (United States)

    Morales-Santana, Sonia; Díez-Pérez, Adolfo; Olmos, José M; Nogués, Xavier; Sosa, Manuel; Díaz-Curiel, Manuel; Pérez-Castrillón, José L; Pérez-Cano, Ramón; Torrijos, Antonio; Jodar, Esteban; Rio, Luis Del; Caeiro-Rey, José R; Reyes-García, Rebeca; García-Fontana, Beatriz; González-Macías, Jesús; Muñoz-Torres, Manuel

    2015-12-01

    The biological mechanisms associated with an inadequate response to treatment with bisphosphonates are not well known. This study investigates the association between circulating levels of sclerostin and estradiol with an inadequate clinical outcome to bisphosphonate therapy in women with postmenopausal osteoporosis. This case-control study is based on 120 Spanish women with postmenopausal osteoporosis being treated with oral bisphosphonates. Patients were classified as adequate responders (ARs, n=66, mean age 68.2±8 years) without incident fractures during 5 years of treatment, or inadequate responders (IRs, n=54, mean age 67±9 years), with incident fractures between 1 and 5 years of treatment. Bone mineral density (DXA), structural analysis of the proximal femur and structural/fractal analysis of the distal radius were assessed. Sclerostin concentrations were measured by ELISA and 17β-estradiol levels by radioimmunoassay based on ultrasensitive methods. In the ARs group, sclerostin serum levels were significantly lower (p=0.02) and estradiol concentrations significantly higher (p=0.023) than in the IRs group. A logistic regression analysis was performed, including as independent variables in the original model femoral fracture load, 25 hydroxyvitamin D, previus history of fragility fracture, sclerostin and estradiol. Only previous history of fragility fracture (OR 14.04, 95% CI 2.38-82.79, p=0.004) and sclerostin levels (OR 1.11, 95% CI 1.02-1.20, p=0.011), both adjusted by estradiol levels remained associated with IRs. Also, sclerostin concentrations were associated with the index of resistance to compression (IRC) in the fractal analysis of the distal radius, a parameter on bone microstructure. Sclerostin and estradiol levels are associated with the response to bisphosphonate therapy in women with postmenopausal osteoporosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Ouellette Thermal Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Thermal Test Facility is a joint Army/Navy state-of-the-art facility (8,100 ft2) that was designed to:Evaluate and characterize the effect of flame and thermal...

  3. Lesotho - Health Facility Survey

    Data.gov (United States)

    Millennium Challenge Corporation — The main objective of the 2011 Health Facility Survey (HFS) was to establish a baseline for informing the Health Project performance indicators on health facilities,...

  4. Integrated Disposal Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Located near the center of the 586-square-mile Hanford Site is the Integrated Disposal Facility, also known as the IDF.This facility is a landfill similar in concept...

  5. Neighbourhood facilities for sustainability

    CSIR Research Space (South Africa)

    Gibberd, Jeremy T

    2013-01-01

    Full Text Available . In this paper these are referred to as ‘Neighbourhood Facilities for Sustainability’. Neighbourhood Facilities for Sustainability (NFS) are initiatives undertaken by individuals and communities to build local sustainable systems which not only improve...

  6. Materiel Evaluation Facility

    Data.gov (United States)

    Federal Laboratory Consortium — CRREL's Materiel Evaluation Facility (MEF) is a large cold-room facility that can be set up at temperatures ranging from −20°F to 120°F with a temperature change...

  7. Dialysis Facility Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

  8. Explosive Components Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The 98,000 square foot Explosive Components Facility (ECF) is a state-of-the-art facility that provides a full-range of chemical, material, and performance analysis...

  9. Wastewater Treatment Facilities

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Individual permits for municipal, industrial, and semi-public wastewater treatment facilities in Iowa for the National Pollutant Discharge Elimination System (NPDES)...

  10. Energetics Conditioning Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Energetics Conditioning Facility is used for long term and short term aging studies of energetic materials. The facility has 10 conditioning chambers of which 2...

  11. Environmental Toxicology Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Fully-equipped facilities for environmental toxicology researchThe Environmental Toxicology Research Facility (ETRF) located in Vicksburg, MS provides over 8,200 ft...

  12. Projectile Demilitarization Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Projectile Wash Out Facility is US Army Ammunition Peculiar Equipment (APE 1300). It is a pilot scale wash out facility that uses high pressure water and steam...

  13. Armament Technology Facility (ATF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Armament Technology Facility is a 52,000 square foot, secure and environmentally-safe, integrated small arms and cannon caliber design and evaluation facility....

  14. Cold Vacuum Drying Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Located near the K-Basins (see K-Basins link) in Hanford's 100 Area is a facility called the Cold Vacuum Drying Facility (CVDF).Between 2000 and 2004, workers at the...

  15. Rocketball Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This test facility offers the capability to emulate and measure guided missile radar cross-section without requiring flight tests of tactical missiles. This facility...

  16. CLEAR test facility

    CERN Multimedia

    Ordan, Julien Marius

    2017-01-01

    A new user facility for accelerator R&D, the CERN Linear Electron Accelerator for Research (CLEAR), started operation in August 2017. CLEAR evolved from the former CLIC Test Facility 3 (CTF3) used by the Compact Linear Collider (CLIC). The new facility is able to host and test a broad range of ideas in the accelerator field.

  17. Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample.

    Science.gov (United States)

    Brantsæter, Anne Lise; Knutsen, Helle Katrine; Johansen, Nina Cathrine; Nyheim, Kristine Aastad; Erlund, Iris; Meltzer, Helle Margrete; Henjum, Sigrun

    2018-02-17

    Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC) and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children ( n = 47), adolescents ( n = 46), adults ( n = 71), the elderly ( n = 23), pregnant women ( n = 45), ovo-lacto vegetarians ( n = 25), and vegans ( n = 19). In all participants combined, the median (95% CI) UIC was 101 (90, 110) µg/L, median (25th, 75th percentile) calculated iodine intake was 112 (77, 175) µg/day and median (25th, 75th percentile) estimated usual iodine intake was 101 (75, 150) µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82%) and vegans the lowest (14%) probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

  18. Schoolchildren have similar predicted prevalences of inadequate intakes as toddlers in village populations in Egypt, Kenya, and Mexico.

    Science.gov (United States)

    Murphy, S P; Calloway, D H; Beaton, G H

    1995-09-01

    To examine the probability of inadequacy of schoolchild nutrient intakes; to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets and to examine the relative adequacy of the diets of sibling pairs. Food consumption data were measured 2 days per month across approximately one year. Mean nutrient intakes were calculated and compared to international standards using a probability approach. Villages in Egypt, Kenya, and Mexico. 285 school-age children (7-9 years of age) and 255 toddlers (18-30 months of age) including 94 sibling pairs. Within a country, there was a striking similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B12, which was more likely to be inadequate among schoolchildren. Nutrients of concern for both ages in one or more countries included iron, zinc, calcium, riboflavin, and vitamins B12, D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%. Nutrient adequacy tends to be a household characteristic for these two ages of children. Nutritional interventions that target the household have a high probability of benefitting multiple age groups of children.

  19. Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample

    Directory of Open Access Journals (Sweden)

    Anne Lise Brantsæter

    2018-02-01

    Full Text Available Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children (n = 47, adolescents (n = 46, adults (n = 71, the elderly (n = 23, pregnant women (n = 45, ovo-lacto vegetarians (n = 25, and vegans (n = 19. In all participants combined, the median (95% CI UIC was 101 (90, 110 µg/L, median (25th, 75th percentile calculated iodine intake was 112 (77, 175 µg/day and median (25th, 75th percentile estimated usual iodine intake was 101 (75, 150 µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82% and vegans the lowest (14% probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

  20. Pregabalin for the treatment of patients with generalized anxiety disorder with inadequate treatment response to antidepressants and severe depressive symptoms.

    Science.gov (United States)

    Olivares, José M; Álvarez, Enrique; Carrasco, José L; Pérez Páramo, María; López-Gómez, Vanessa

    2015-09-01

    To evaluate the effectiveness of pregabalin in patients with resistant generalized anxiety disorder (GAD) and severe depressive symptoms, we carried out a post-hoc analysis of a multicenter, prospective, and observational 6-month study. We included patients who were at least 18 years old, fulfilled the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for GAD, showed inadequate responses to previous courses of antidepressant treatment, had Montgomery-Asberg Rating Scale scores of at least 35, had not received pregabalin previously, and were prescribed pregabalin upon entry into this study. We included 1815 patients fulfilling the DSM-IV criteria for GAD, and 133 (7.3%) fulfilled the selection criteria for these analyses. Ninety-seven percent of the patients received pregabalin (mean dose: 222 mg/day) in combination with other psychotropics. The Hamilton Anxiety Scale total score was reduced by a mean of 20.3 points (95% confidence interval, 22.1-18.4) (57.2% reduction) at month 6. Pregabalin also ameliorated comorbid depressive symptoms, with a reduction in the mean score of the Montgomery-Asberg Rating Scale of 22.3 points (95% confidence interval, 24.2-20.4) (56.6% reduction). Our results suggest that pregabalin, as part of a combination regimen with antidepressants and/or benzodiazepines, might be effective for the treatment of patients with GAD who have shown inadequate response to previous antidepressants and have severe depressive symptoms.

  1. Inadequate evaluation and management of threats in Australia's Marine Parks, including the Great Barrier Reef, misdirect Marine conservation.

    Science.gov (United States)

    Kearney, Bob; Farebrother, Graham

    2014-01-01

    The magnificence of the Great Barrier Reef and its worthiness of extraordinary efforts to protect it from whatever threats may arise are unquestioned. Yet almost four decades after the establishment of the Great Barrier Reef Marine Park, Australia's most expensive and intensely researched Marine Protected Area, the health of the Reef is reported to be declining alarmingly. The management of the suite of threats to the health of the reef has clearly been inadequate, even though there have been several notable successes. It is argued that the failure to prioritise correctly all major threats to the reef, coupled with the exaggeration of the benefits of calling the park a protected area and zoning subsets of areas as 'no-take', has distracted attention from adequately addressing the real causes of impact. Australia's marine conservation efforts have been dominated by commitment to a National Representative System of Marine Protected Areas. In so doing, Australia has displaced the internationally accepted primary priority for pursuing effective protection of marine environments with inadequately critical adherence to the principle of having more and bigger marine parks. The continuing decline in the health of the Great Barrier Reef and other Australian coastal areas confirms the limitations of current area management for combating threats to marine ecosystems. There is great need for more critical evaluation of how marine environments can be protected effectively and managed efficiently.

  2. State legislatures and energy policy in the Northeast: energy facility siting and legislative action

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-06-01

    At the Federal level, a vast array of bureaucratic and legislative institutions are presently immersed in various explorations of energy policy and its national ramifications. Almost each of the 50 states has Energy offices. One element of the institutional/political equation, however, often is missed in studies of energy policy: the state legislature. This institution may well be vitally important to formulation of broad policies, and certainly is critical to successful implementation of certain aspects of those policies--especially when new enabling legislation, new tax incentives, or new regulatory powers are required. The study covers three main aspects of energy-policy formulation and action by state legislatures: legislative structure; enactment of energy-facility-siting laws; and passage (or defeat) of significant energy legislation of a more general nature. Emphasis is placed on energy-facility-siting statutes and approaches for two reasons. First, energy facilities have a great impact on land use, environmental quality, and economic growth. Second, siting of these facilities raises inherent conflicts in the attempt to achieve balance between potentially contradictory objectives. The states of New Jersey and Maryland were examined in considerable depth as examples in this study. (MCW)

  3. Good ergonomic practices in a terminal facility

    Energy Technology Data Exchange (ETDEWEB)

    Anjos, Luciana Mattos dos; Curty, Adriana Favacho [CHEMTECH, Rio de Janeiro, RJ (Brazil); Franca, Guilherme Foerster do Monte; Jardino, Alessandro Neto [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    Ergonomics is the technological design of the interplay between men, machines and environment in order to make labor activities more pleasant, profitable and functional. This article analyses the importance of ergonomic issues in process terminal plants and facilities, since the conceptual design stage until the detail engineering design. The ergonomic solutions are compared with practices that are current in engineering design plants nowadays. It will be shown how an inadequate ergonomic design often leads to accessibility problems and non-effectiveness during plant operation and dangers in emergency situations. The way perform an ergonomic design is to integrate the various disciplines that are involved in all stages of the design plant. The earlier the ergonomic design is implemented the better are the results in cost reduction, since later design modifications are more time-consuming and expensive. (author)

  4. Facility transition instruction

    International Nuclear Information System (INIS)

    Morton, M.R.

    1997-01-01

    The Bechtel Hanford, Inc. facility transition instruction was initiated in response to the need for a common, streamlined process for facility transitions and to capture the knowledge and experience that has accumulated over the last few years. The instruction serves as an educational resource and defines the process for transitioning facilities to long-term surveillance and maintenance (S and M). Generally, these facilities do not have identified operations missions and must be transitioned from operational status to a safe and stable configuration for long-term S and M. The instruction can be applied to a wide range of facilities--from process canyon complexes like the Plutonium Uranium Extraction Facility or B Plant, to stand-alone, lower hazard facilities like the 242B/BL facility. The facility transition process is implemented (under the direction of the US Department of Energy, Richland Operations Office [RL] Assistant Manager-Environmental) by Bechtel Hanford, Inc. management, with input and interaction with the appropriate RL division and Hanford site contractors as noted in the instruction. The application of the steps identified herein and the early participation of all organizations involved are expected to provide a cost-effective, safe, and smooth transition from operational status to deactivation and S and M for a wide range of Hanford Site facilities

  5. Facilities inventory protection for nuclear facilities

    International Nuclear Information System (INIS)

    Schmitt, F.J.

    1989-01-01

    The fact that shut-down applications have been filed for nuclear power plants, suggests to have a scrutinizing look at the scopes of assessment and decision available to administrations and courts for the protection of facilities inventories relative to legal and constitutional requirements. The paper outlines the legal bases which need to be observed if purposeful calculation is to be ensured. Based on the different actual conditions and legal consequences, the author distinguishes between 1) the legal situation of facilities licenced already and 2) the legal situation of facilities under planning during the licencing stage. As indicated by the contents and restrictions of the pertinent provisions of the Atomic Energy Act and by the corresponding compensatory regulation, the object of the protection of facilities inventor in the legal position of the facility owner within the purview of the Atomic Energy Act, and the licensing proper. Art. 17 of the Atomic Energy Act indicates the legislators intent that, once issued, the licence will be the pivotal point for regulations aiming at protection and intervention. (orig./HSCH) [de

  6. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study

    DEFF Research Database (Denmark)

    Lund, S.S.; Tarnow, L.; Astrup, A.S.

    2008-01-01

    BACKGROUND: Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM) have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment...... with metformin versus placebo in patients with T1DM and persistent poor glycaemic control. METHODOLOGY/PRINCIPAL FINDINGS: One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c) (HbA(1c)) > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment....... Thereafter, patients were randomized (baseline) to treatment with either metformin (1 g twice daily) or placebo for 12 months (double-masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c) after one year of treatment...

  7. A survey of breakfast-skipping and inadequate breakfast-eating among young schoolchildren in Nova Scotia.

    Science.gov (United States)

    McIntyre, L

    1993-01-01

    The prevalence of breakfast-skipping and inadequate breakfast-eating among schoolchildren in Nova Scotia was determined by surveying 2,500 children in Grades 1 to 3 in 25 randomly selected schools. Breakfast-skipping was measured on two occasions using a validated survey instrument administered by videotaped child entertainers. 4.8% of children came to school without eating or drinking anything on the morning of testing. Breakfast omission was significantly related to grade with 6.1% of Grade 1 children skipping breakfast compared with 3.2% in Grade 3. Boys were significantly more likely to skip breakfast than girls but the absolute differences were small. 86% of children consumed a breakfast including two food groups; 56% three food groups. Adequacy of consumption was poorer in lower grades but did not vary by other sociodemographic variables. Breakfast omission in Nova Scotia children attending Grades 1, 2 or 3 does not warrant a provincial public health response.

  8. Facilities projects performance measurement system

    International Nuclear Information System (INIS)

    Erben, J.F.

    1979-01-01

    The two DOE-owned facilities at Hanford, the Fuels and Materials Examination Facility (FMEF), and the Fusion Materials Irradiation Test Facility (FMIT), are described. The performance measurement systems used at these two facilities are next described

  9. The Effect of Inadequate Initial Empiric Antimicrobial Treatment on Mortality in Critically Ill Patients with Bloodstream Infections: A Multi-Centre Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Rachel D Savage

    Full Text Available Hospital mortality rates are elevated in critically ill patients with bloodstream infections. Given that mortality may be even higher if appropriate treatment is delayed, we sought to determine the effect of inadequate initial empiric treatment on mortality in these patients. A retrospective cohort study was conducted across 13 intensive care units in Canada. We defined inadequate initial empiric treatment as not receiving at least one dose of an antimicrobial to which the causative pathogen(s was susceptible within one day of initial blood culture. We evaluated the association between inadequate initial treatment and hospital mortality using a random effects multivariable logistic regression model. Among 1,190 patients (1,097 had bacteremia and 93 had candidemia, 476 (40% died and 266 (22% received inadequate initial treatment. Candidemic patients more often had inadequate initial empiric therapy (64.5% versus 18.8%, as well as longer delays to final culture results (4 vs 3 days and appropriate therapy (2 vs 0 days. After adjustment, there was no detectable association between inadequate initial treatment and mortality among bacteremic patients (Odds Ratio (OR: 1.02, 95% Confidence Interval (CI 0.70-1.48; however, candidemic patients receiving inadequate treatment had nearly three times the odds of death (OR: 2.89, 95% CI: 1.05-7.99. Inadequate initial empiric antimicrobial treatment was not associated with increased mortality in bacteremic patients, but was an important risk factor in the subgroup of candidemic patients. Further research is warranted to improve early diagnostic and risk prediction methods in candidemic patients.

  10. Distinguishing the impacts of inadequate prey and vessel traffic on an endangered killer whale (Orcinus orca population.

    Directory of Open Access Journals (Sweden)

    Katherine L Ayres

    Full Text Available Managing endangered species often involves evaluating the relative impacts of multiple anthropogenic and ecological pressures. This challenge is particularly formidable for cetaceans, which spend the majority of their time underwater. Noninvasive physiological approaches can be especially informative in this regard. We used a combination of fecal thyroid (T3 and glucocorticoid (GC hormone measures to assess two threats influencing the endangered southern resident killer whales (SRKW; Orcinus orca that frequent the inland waters of British Columbia, Canada and Washington, U.S.A. Glucocorticoids increase in response to nutritional and psychological stress, whereas thyroid hormone declines in response to nutritional stress but is unaffected by psychological stress. The inadequate prey hypothesis argues that the killer whales have become prey limited due to reductions of their dominant prey, Chinook salmon (Oncorhynchus tshawytscha. The vessel impact hypothesis argues that high numbers of vessels in close proximity to the whales cause disturbance via psychological stress and/or impaired foraging ability. The GC and T3 measures supported the inadequate prey hypothesis. In particular, GC concentrations were negatively correlated with short-term changes in prey availability. Whereas, T3 concentrations varied by date and year in a manner that corresponded with more long-term prey availability. Physiological correlations with prey overshadowed any impacts of vessels since GCs were lowest during the peak in vessel abundance, which also coincided with the peak in salmon availability. Our results suggest that identification and recovery of strategic salmon populations in the SRKW diet are important to effectively promote SRKW recovery.

  11. Capillary Blood Ketone Levels as an Indicator of Inadequate Breast Milk Intake in the Early Neonatal Period.

    Science.gov (United States)

    Futatani, Takeshi; Shimao, Ayako; Ina, Shihomi; Higashiyama, Hiroyuki; Fujita, Shuhei; Ueno, Kazuyuki; Igarashi, Noboru; Hatasaki, Kiyoshi

    2017-12-01

    To determine the utility of capillary blood ketone levels as an indicator of inadequate intake of breast milk in the early postnatal period. Levels of capillary blood beta-hydroxybutyrate (βOHB), the main ketone body in the blood, were measured with a bedside ketone meter in 585 full-term neonates aged 48-95 hours who were breastfed exclusively. Relationships between weight-loss percentage, blood sodium, glucose, pH, partial pressure of carbon dioxide, base-deficit levels, and βOHB levels were investigated. The diagnostic accuracy of βOHB for predicting excessive weight loss (weight loss ≥10% of birth weight) and hypernatremic dehydration (blood sodium level ≥150 mEq/L) was determined. βOHB levels were correlated positively with weight-loss percentage and blood sodium levels and were correlated negatively with blood glucose levels. The diagnostic accuracy of βOHB was 0.846 (optimal cut off, 1.55 mmol/L; sensitivity, 80.9%, specificity, 74.0%) for predicting excessive weight loss and 0.868 (optimal cut off, 1.85 mmol/L; sensitivity, 94.3%; specificity, 69.9%) for predicting hypernatremic dehydration according to the area under the receiver operating characteristic curve. Multiple logistic analysis revealed that βOHB and weight loss percentage were the only independent predictors of hypernatremic dehydration. Increases in βOHB levels also were associated with worsening metabolic acidosis and hypocapnia. High βOHB levels were associated with inadequate intake of breast milk in the early postnatal period. The use of bedside capillary blood ketone levels may be clinically useful as an indicator of dehydration, energy depletion, and acid-base imbalance in breastfeeding infants in the early postnatal period. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Synchrotron radiation facilities

    CERN Multimedia

    1972-01-01

    Particularly in the past few years, interest in using the synchrotron radiation emanating from high energy, circular electron machines has grown considerably. In our February issue we included an article on the synchrotron radiation facility at Frascati. This month we are spreading the net wider — saying something about the properties of the radiation, listing the centres where synchrotron radiation facilities exist, adding a brief description of three of them and mentioning areas of physics in which the facilities are used.

  13. Facility effluent monitoring plan determinations for the 400 Area facilities

    International Nuclear Information System (INIS)

    Nickels, J.M.

    1991-09-01

    This Facility Effluent Monitoring Plan determination resulted from an evaluation conducted for the Westinghouse Hanford Company 400 Area facilities on the Hanford Site. The Facility Effluent Monitoring Plan determinations have been prepared in accordance with A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans. Two major Westinghouse Hanford Company facilities in the 400 Area were evaluated: the Fast Flux Test Facility and the Fuels Manufacturing and examination Facility. The determinations were prepared by Westinghouse Hanford Company. Of these two facilities, only the Fast Flux Test Facility will require a Facility Effluent Monitoring Plan. 7 refs., 5 figs., 4 tabs

  14. Proximal Probes Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  15. Manufacturing Demonstration Facility (MDF)

    Data.gov (United States)

    Federal Laboratory Consortium — The U.S. Department of Energy Manufacturing Demonstration Facility (MDF) at Oak Ridge National Laboratory (ORNL) provides a collaborative, shared infrastructure to...

  16. High Combustion Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — At NETL's High-Pressure Combustion Research Facility in Morgantown, WV, researchers can investigate new high-pressure, high-temperature hydrogen turbine combustion...

  17. Universal Drive Train Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This vehicle drive train research facility is capable of evaluating helicopter and ground vehicle power transmission technologies in a system level environment. The...

  18. Facility Environmental Management System

    Data.gov (United States)

    Federal Laboratory Consortium — This is the Web site of the Federal Highway Administration's (FHWA's) Turner-Fairbank Highway Research Center (TFHRC) facility Environmental Management System (EMS)....

  19. Engine Test Facility (ETF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Air Force Arnold Engineering Development Center's Engine Test Facility (ETF) test cells are used for development and evaluation testing of propulsion systems for...

  20. Catalytic Fuel Conversion Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility enables unique catalysis research related to power and energy applications using military jet fuels and alternative fuels. It is equipped with research...

  1. GPS Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Global Positioning System (GPS) Test Facility Instrumentation Suite (GPSIS) provides great flexibility in testing receivers by providing operational control of...

  2. Mobile Solar Tracker Facility

    Data.gov (United States)

    Federal Laboratory Consortium — NIST's mobile solar tracking facility is used to characterize the electrical performance of photovoltaic panels. It incorporates meteorological instruments, a solar...

  3. Transonic Experimental Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Transonic Experimental Research Facility evaluates aerodynamics and fluid dynamics of projectiles, smart munitions systems, and sub-munitions dispensing systems;...

  4. Imagery Data Base Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Imagery Data Base Facility supports AFRL and other government organizations by providing imagery interpretation and analysis to users for data selection, imagery...

  5. Geospatial Data Analysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Geospatial application development, location-based services, spatial modeling, and spatial analysis are examples of the many research applications that this facility...

  6. Textiles Performance Testing Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Textiles Performance Testing Facilities has the capabilities to perform all physical wet and dry performance testing, and visual and instrumental color analysis...

  7. Composite Structures Manufacturing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Composite Structures Manufacturing Facility specializes in the design, analysis, fabrication and testing of advanced composite structures and materials for both...

  8. Neutron Therapy Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Neutron Therapy Facility provides a moderate intensity, broad energy spectrum neutron beam that can be used for short term irradiations for radiobiology (cells)...

  9. Pavement Testing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Comprehensive Environmental and Structural AnalysesThe ERDC Pavement Testing Facility, located on the ERDC Vicksburg campus, was originally constructed to provide an...

  10. Materials Characterization Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Materials Characterization Facility enables detailed measurements of the properties of ceramics, polymers, glasses, and composites. It features instrumentation...

  11. Geodynamics Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This GSL facility has evolved over the last three decades to support survivability and protective structures research. Experimental devices include three gas-driven...

  12. Magnetics Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Magnetics Research Facility houses three Helmholtz coils that generate magnetic fields in three perpendicular directions to balance the earth's magnetic field....

  13. Target Assembly Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Target Assembly Facility integrates new armor concepts into actual armored vehicles. Featuring the capability ofmachining and cutting radioactive materials, it...

  14. DUPIC facility engineering

    Energy Technology Data Exchange (ETDEWEB)

    Park, J. J.; Lee, H. H.; Kim, K. H. and others

    2000-03-01

    The objectives of this study are (1) the refurbishment for PIEF(Post Irradiation Examination Facility) and M6 hot-cell in IMEF(Irradiated Material Examination Facility), (2) the establishment of the compatible facility for DUPIC fuel fabrication experiments which is licensed by government organization, and (3) the establishment of the transportation system and transportation cask for nuclear material between facilities. The report for this project describes following contents, such as objectives, necessities, scope, contents, results of current step, R and D plan in future and etc.

  15. Medical cyclotron facilities

    International Nuclear Information System (INIS)

    1984-09-01

    This report examines the separate proposals from the Austin Hospital and the Australian Atomic Energy Commission for a medical cyclotron facility. The proponents have argued that a cyclotron facility would benefit Australia in areas of patient care, availability and export of radioisotopes, and medical research. Positron emission tomography (PET) and neutron beam therapy are also examined

  16. Sustainable Facilities Management

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Elle, Morten; Hoffmann, Birgitte

    2004-01-01

    The Danish public housing sector has more than 20 years of experience with sustainable facilities management based on user involvement. The paper outlines this development in a historical perspective and gives an analysis of different approaches to sustainable facilities management. The focus...

  17. Samarbejdsformer og Facilities Management

    DEFF Research Database (Denmark)

    Storgaard, Kresten

    Resultater fra en surveyundersøgelse om fordele og ulemper ved forskellige samarbejdsformer indenfor Facilities Management fremlægges.......Resultater fra en surveyundersøgelse om fordele og ulemper ved forskellige samarbejdsformer indenfor Facilities Management fremlægges....

  18. Outline of NUCEF facility

    International Nuclear Information System (INIS)

    Takeshita, Isao

    1996-01-01

    NUCEF is a multipurpose research facility in the field of safety and advanced technology of nuclear fuel cycle back-end. Various experiment facilities and its supporting installations, in which nuclear fuel materials, radio isotopes and TRU elements can be handled, are arranged in more than one hundred rooms of two experiment buildings. Its construction was completed in middle of 1994 and hot experiments have been started since then. NUCEF is located on the site (30,000 m 2 ) of southeastern part in the Tokai Research Establishment of JAERI facing to the Pacific Ocean. The base of Experiment Buildings A and B was directly founded on the rock existing at 10-15 m below ground level taking the aseismatic design into consideration. Each building is almost same sized and composed of one basement and three floors of which area is 17,500 m 2 in total. In the basement, there are exhaust facilities of ventilation system, treatment system of solution fuel and radioactive waste solution and storage tanks of them. Major experiment facilities are located on the first or the second floors in each building. An air-inlet facility of ventilation system for each building is equipped on the third floor. Most of experiment facilities for criticality safety research including two critical facilities: Static Experiment Critical Facility (STACY) and Transient Experiment Critical Facility (TRACY) are installed in Experiment Building A. Experiment equipments for research on advanced fuel reprocessing process and on TRU waste management, which are named BECKY (Back End Fuel Cycle Key Elements Research Facility), are installed in laboratories and a-g cells in Experiment Building B. (J.P.N.)

  19. Pre-bisection of a single skin biopsy does not produce technically inadequate specimens for direct immunofluorescence: a review of 3450 specimens.

    Science.gov (United States)

    Loh, Ern; Armstrong, April W; Fung, Maxwell A

    2014-11-01

    Evaluation of a potential immunobullous disorder typically requires two pieces of tissue obtained by skin biopsy: one placed in formalin for conventional microscopy and a second placed in a different transport medium suitable for direct immunofluorescence (DIF) testing. Clinical practice in this area is not standardized, with dermatologists either obtaining two biopsies or dividing (pre-bisecting) a single biopsy. Some DIF specimens are technically inadequate for interpretation of subepidermal imunobullous disorders because the basement membrane zone is not intact, but it is unknown whether pre-bisecting the tissue increases the risk of compromising the specimen. To investigate whether technically inadequate DIF specimens are associated with pre-bisection. DIF specimens were consecutively sampled from a single referral center and identified as whole (non-bisected) biopsy specimens or pre-bisected biopsy specimens. The proportion of inadequate specimens was calculated for both groups. A total of 3450 specimens were included. The percentage of inadequate specimens was 5.072% (153/3016) for whole (non-bisected) specimens and 5.299% for pre-bisected specimens. This difference was not significant (chi square, p = 0.84). The study was sufficiently powered to detect a relative risk of 1.685. Pre-bisection of a single skin biopsy does not significantly increase the risk of a technically inadequate specimen for direct immunofluorescence testing. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Inadequate calcium intake is highly prevalent in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010.

    Science.gov (United States)

    Im, Jong Geun; Kim, Shin Hye; Lee, Gyeong-Yoon; Joung, Hyojee; Park, Mi-Jung

    2014-11-01

    The present study aimed to assess the adequacy of Ca intake and major food sources of Ca in Korean children and adolescents. A cross-sectional study. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2007-2010. We analysed the daily Ca intake, major food sources of Ca and the prevalence of inadequate Ca intake in the study population. Ca intake was categorized as inadequate when the participant's daily Ca intake was less than the Estimated Average Requirement. Subject The study population consisted of 7233 children and adolescents (3973 boys, 3260 girls; aged 1-18 years). Mean Ca intake was 510·2 mg/d in boys and 431·7 mg/d in girls. Overall, 75·0 % of adolescents (boys 71·6 %, girls 79·1 %) had inadequate Ca intake. The prevalence of inadequate Ca intake increased significantly from toddlers (45-55 %) to adolescents (78-86 %) in both genders. The highest ranked food sources for Ca were dairy products (35·0 %), followed by vegetables (17·3 %), grains (11·3 %) and seafood (9·9 %). Ca intake from dairy products decreased significantly from 57 % in toddlers to 30 % in adolescents, while Ca intakes from other foods increased with age. Inadequate Ca intake is highly prevalent and increased with age in Korean children and adolescents. It should be emphasized to encourage children and adolescents to eat more Ca-rich products to meet their Ca needs.

  1. Excessive homework, inadequate sleep, physical inactivity and screen viewing time are major contributors to high paediatric obesity.

    Science.gov (United States)

    Ren, Hong; Zhou, Zhixiong; Liu, Wenxi Kevin; Wang, Xiujiang; Yin, Zenong

    2017-01-01

    This study examined the relationships between energy balance-related behaviours (EBRBs) outside school hours and obesity in Chinese primary school students. We also explored the influence of gender on those relationships. The study sample was a cross-sectional cohort of 5032 Chinese children who were enrolled in grades 1-6 in primary schools in five Chinese cities and whose mean ages ranged from seven years and three months to 11.9 years. The children's parents completed a survey on their child's height, weight and EBRBs outside school hours. The response rate was 97%, and the reported rates of overweight and obesity were 13.6% and 13.8%, respectively. The obesity rates were higher in boys and lower grade children. Most EBRBs varied between boys and girls and with increased grade levels. The amount of time spent on academic-related activities, screen viewing, outdoor activities and sleep was mostly associated with obesity on weekdays and varied by gender. Rate of obesity was alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic-related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children. ©2016 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  2. Inadequate Models of Adolescent Substance Use Prevention: Looking for Options to Promote Pro-Social Change and Engagement.

    Science.gov (United States)

    Ostaszewski, Krzysztof

    2015-01-01

    In the adolescent substance use prevention two competing models can be found: negative and positive. The negative model is entirely focused on risks and problems that young people should avoid. The positive model goes beyond that problem-oriented perspective and calls for positive youth growth and development. Both models of prevention seems to be inadequate to address effectively the challenging problem of adolescent substance use associated consequences. Both models are in fact flawed, but in different ways. Old, negative model neglects the power of individual strengths and ecological developmental assets, while new, positive model is often instrumentally used by politicians and other stakeholders for completely different goals than an informed, science-based prevention. As a result many substance use prevention programs implemented at schools and in communities are neither theoretically nor empirically informed. In order to address these flaws, the model of balanced prevention was outlined. It posits that triple well informed efforts are needed to achieve both specific substance use prevention goals and youth personal/social development. These efforts include protection building, risks reducing and individual assets development support. The proposed model is an ongoing work in progress. It can be considered as an encouragement for international dialogue to build a balanced conceptual foundation for adolescent substance use prevention.

  3. A new positive pressure ventilation delivery system: its impact on lung ventilation studies that are technically inadequate or non diagnostic

    International Nuclear Information System (INIS)

    Bui, C.; Leiper, C.; Lee, K.; Saunders, C.; Dixson, H.; Elison, B.; Bennett, G.; Gibian, T.; Rutland, J.; Tse, V.; Elzein, H.; Babicheva, R.

    2000-01-01

    Full text: The objective of this study was to evaluate the efficacy and safety of an improved Positive Pressure Ventilation Delivery System (PVDS) in the investigation of Pulmonary Embolism (PE). The major component of PVDS is a commercially available, self-inflating 1.6L Hudson Resuscitator Bag, filled with either oxygen or air (if the patient has CO 2 retention), which is squeezed by the operator to push Technegas from the Technegas Generator Chamber to the patient via the Patient Administration Set synchronously with patient inspiration. 27 spontaneously breathing in-patients (12 males, 15 females, age range 64-89, 21 with chronic airflow limitation), whose conventional lung ventilation images were technically inadequate or non diagnostic, were re-scanned using PVDS within four days after the conventional ventilation study. Randomised blinded visual interpretation of conventional ventilation/perfusion scan vs. PVDS-assisted ventilation/perfusion scan was performed by consensus reading with two experienced observers. In conclusion PVDS was safe and well tolerated. PVDS improved the image quality of the lung ventilation scans in this cohort of patients. This technique has the potential to improve the accuracy of lung scanning in patients with severe lung disease. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  4. Initial dose of vancomycin based on body weight and creatinine clearance to minimize inadequate trough levels in Japanese adults.

    Science.gov (United States)

    Maki, N; Ohkuchi, A; Tashiro, Y; Kim, M R; Le, M; Sakamoto, T; Matsubara, S; Hakamata, Y

    2012-10-01

    Our aims were to elucidate the factors that affected vancomycin (VCM) serum trough levels and to find the optimal initial dose based on creatinine clearance (CrCl) and body weight (BW) to minimize inadequate trough levels in a retrospective observational study among Japanese adults. One hundred and six inpatients, in whom VCM trough levels were measured after completing the third dosing, were consecutively recruited into our study in a tertiary hospital. We considered the frequency of initial VCM total daily dose, CrCl, and BW were independent risk factors of VCM trough levels. In patients with CrCl ≥30 and level of ≥20 mcg/mL, regardless of BW. In patients with CrCl ≥50 mL/min, 2 g/day yielded low frequencies of a trough level of initial total daily dose may be 1 g/day in patients with CrCl ≥30 and <50 mL/min regardless of BW and 2 g/day in patients weighing <55 kg with CrCl ≥50 mL/min among Japanese adults.

  5. IDegLira Versus Alternative Intensification Strategies in Patients with Type 2 Diabetes Inadequately Controlled on Basal Insulin Therapy

    DEFF Research Database (Denmark)

    Freemantle, Nick; Mamdani, Muhammad; Vilsbøll, Tina

    2015-01-01

    glycated hemoglobin (HbA1c) and other outcomes. METHODS: A pooled analysis of five completed Novo Nordisk randomized clinical trials in patients with type 2 diabetes inadequately controlled on basal insulin was used to compare indirectly IDegLira (N = 199) with: addition of liraglutide to basal insulin (N...... = 225) [glucagon-like peptide-1 receptor agonist (GLP-1RA) add-on strategy]; basal-bolus (BB) insulin [insulin glargine (IGlar) + insulin aspart] (N = 56); or up-titration of IGlar (N = 329). A supplementary analysis was performed with the BB arm including patients who received IGlar or IDeg as basal...... of study, differences between IDegLira and BB or up-titrated IGlar, respectively, were as follows: reduction in HbA1c -0.30%, 95% confidence interval (-0.58; -0.01) and -0.65% (-0.83; -0.47); change in body weight -6.89 kg (-7.92; -5.86) and -4.04 kg (-4.69; -3.40) all in favor of IDegLira. Confirmed...

  6. Negative energy balance secondary to inadequate dietary intake of patients on the waiting list for liver transplantation.

    Science.gov (United States)

    Ferreira, Lívia Garcia; Ferreira Martins, Aline Isabel; Cunha, Carolina Elisa; Anastácio, Lucilene Rezende; Lima, Agnaldo Soares; Correia, Maria Isabel Toulson Davisson

    2013-10-01

    The aim of this study was to evaluate the energy balance (EB) of patients on the waiting list for liver transplantation, using total energy expenditure (TEE) assessment and total caloric intake (TCI). We analyzed nutrient adequacy and factors associated with it. EB was obtained by subtracting the TCI (obtained by 3-d food record) from TEE, which was measured as resting energy expenditure and physical activity factor calculation. Socioeconomic and clinical data also were evaluated. Univariate and multiple linear regressions were used (P 0.05). Women, less-educated patients, those with ascites, and those who were malnourished presented with lower TCI (P Liver Disease scores were associated with EB (P fiber (94.5%) inadequacies also were high. The percentage of adequate intake was less than 10% for vitamins B5 and D, calcium, folic acid, and potassium, and higher percentages of adequate intake (>80%) were found for iron and vitamins B1 and B12. Moreover, 54.8% and 16.4% of the patients had excessive sodium and cholesterol intakes, respectively. Negative EB was highly prevalent among patients on the waiting list for liver transplantation, and was associated with the severity of liver disease. Negative EB was primarily affected by low food intake. The food intake data were characterized by low overall energy and protein intake and inadequate composition of the patient's diet plan, which tended to be characterized by specific nutrient deficiencies and excesses. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. What causes treatment failure - the patient, primary care, secondary care or inadequate interaction in the health services?

    Directory of Open Access Journals (Sweden)

    Lange Ove

    2011-05-01

    Full Text Available Abstract Background Optimal treatment gives complete relief of symptoms of many disorders. But even if such treatment is available, some patients have persisting complaints. One disorder, from which the patients should achieve complete relief of symptoms with medical or surgical treatment, is gastroesophageal reflux disease (GERD. Despite the fact that such treatment is cheap, safe and easily available; some patients have persistent complaints after contact with the health services. This study evaluates the causes of treatment failure. Methods Twelve patients with GERD and persistent complaints had a semi-structured interview which focused on the patients' evaluation of treatment failure. The interviews were taped, transcribed and evaluated by 18 physicians, (six general practitioners, six gastroenterologists and six gastrointestinal surgeons who completed a questionnaire for each patient. The questionnaires were scored, and the relative responsibility for the failure was attributed to the patient, primary care, secondary care and interaction in the health services. Results Failing interaction in the health services was the most important cause of treatment failure, followed by failure in primary care, secondary care and the patient himself; the relative responsibilities were 35%, 28%, 27% and 10% respectively. There was satisfactory agreement about the causes between doctors with different specialities, but significant inter-individual differences between the doctors. The causes of the failures differed between the patients. Conclusions Treatment failure is a complex problem. Inadequate interaction in the health services seems to be important. Improved communication between parts of the health services and with the patients are areas of improvement.

  8. DUPIC facility engineering

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. S.; Choi, J. W.; Go, W. I.; Kim, H. D.; Song, K. C.; Jeong, I. H.; Park, H. S.; Im, C. S.; Lee, H. M.; Moon, K. H.; Hong, K. P.; Lee, K. S.; Suh, K. S.; Kim, E. K.; Min, D. K.; Lee, J. C.; Chun, Y. B.; Paik, S. Y.; Lee, E. P.; Yoo, G. S.; Kim, Y. S.; Park, J. C.

    1997-09-01

    In the early stage of the project, a comprehensive survey was conducted to identify the feasibility of using available facilities and of interface between those facilities. It was found out that the shielded cell M6 interface between those facilities. It was found out that the shielded cell M6 of IMEF could be used for the main process experiments of DUPIC fuel fabrication in regard to space adequacy, material flow, equipment layout, etc. Based on such examination, a suitable adapter system for material transfer around the M6 cell was engineered. Regarding the PIEF facility, where spent PWR fuel assemblies are stored in an annex pool, disassembly devices in the pool are retrofitted and spent fuel rod cutting and shipping system to the IMEF are designed and built. For acquisition of casks for radioactive material transport between the facilities, some adaptive refurbishment was applied to the available cask (Padirac) based on extensive analysis on safety requirements. A mockup test facility was newly acquired for remote test of DUPIC fuel fabrication process equipment prior to installation in the M6 cell of the IMEF facility. (author). 157 refs., 57 tabs., 65 figs.

  9. Bürokrasi-Demokrasi İlişkisi ve Bürokratların Seçilmişlerce Kontrolü Sorunu(Relation Between Bureaucracy and Democracy and The Problem of Bureaucratic Control by The Elected

    Directory of Open Access Journals (Sweden)

    Fatih DEMİR

    2011-01-01

    Full Text Available In this paper the discussions made on political/democratic control of bureaucracy in international literature, as well as the theories proposed and models developed. The paper aims at focusing on the theoretical aspects of the issue avoiding the patterns of supervising administration such as parliamentary investigations or ombudsman which are envisaged in administrative or constitutional law. The manner with which democratic control of bureaucracy will be ensured is a long-discussed phenomenon; principal-agent theory, representative bureaucracy approach, administrative procedures and politicization of bureaucracy can be recommended as solutions to this problem. Each of these methods carry the risk of divergence from ideal bureaucratic type, but this is an acceptable price if public sovereignty is to be reflected on administration.

  10. The Birmingham Irradiation Facility

    OpenAIRE

    French, R.S; Hodgson, P; Marin-Reyes, H

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. ca...

  11. The Birmingham Irradiation Facility

    OpenAIRE

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. c...

  12. Sustainable Facilities Management

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Elle, Morten; Hoffmann, Birgitte

    2004-01-01

    The Danish public housing sector has more than 20 years of experience with sustainable facilities management based on user involvement. The paper outlines this development in a historical perspective and gives an analysis of different approaches to sustainable facilities management. The focus...... is on the housing departments and strateies for the management of the use of resources. The research methods used are case studies based on interviews in addition to literature studies. The paper explores lessons to be learned about sustainable facilities management in general, and points to a need for new...

  13. Wind Energy Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Laurie, Carol

    2017-02-01

    This book takes readers inside the places where daily discoveries shape the next generation of wind power systems. Energy Department laboratory facilities span the United States and offer wind research capabilities to meet industry needs. The facilities described in this book make it possible for industry players to increase reliability, improve efficiency, and reduce the cost of wind energy -- one discovery at a time. Whether you require blade testing or resource characterization, grid integration or high-performance computing, Department of Energy laboratory facilities offer a variety of capabilities to meet your wind research needs.

  14. Challenges in the management of decommission waste of nuclear facilities in Ghana

    International Nuclear Information System (INIS)

    Glover, E.T.; Fletcher, J.J.

    2002-01-01

    It is inevitable that every nuclear facility must one day be safely decommissioned. When considering decommissioning, large amounts of radioactive and non-radioactive waste have to be taken into account. Disposal of such materials can have large economic impact on the overall decommissioning cost. In developing countries like Ghana, the perception of environmental protection through waste management, is often not very high as compared to many other pressing needs. Therefore limited resources are allocated for environmental problems. Ghana operates a tank-in- pool type research reactor, 30kW output for research in neutron activation analysis, radioisotope preparation, education and training, a radiotherapy unit that utilizes a 185TBq Co-60 radioactive sources for the treatment of cancer and a gamma irradiation facility which utilizes 1.85PBq Co-60 radioactive source for the irradiation of various materials. All these facilities are operating without designed decommissioning in mind, an inadequate waste management infrastructure as well as a lack of a repository to handling the resulting waste. It is today's beneficials of the nuclear facility that has to deal with the legacies of the future decommissioning activities. The paper outlines some of the challenges and issues to be expected in the management of waste from future decommissioning of nuclear facilities in Ghana with the absence of a waste management infrastructure and inadequate financial resources. The paper puts forth a concept to perform meaningful and significant plans whilst the facilities are still operating. (author)

  15. Hanford Site waste tank farm facilities design reconstitution program plan

    International Nuclear Information System (INIS)

    Vollert, F.R.

    1994-01-01

    Throughout the commercial nuclear industry the lack of design reconstitution programs prior to the mid 1980's has resulted in inadequate documentation to support operating facilities configuration changes or safety evaluations. As a result, many utilities have completed or have ongoing design reconstitution programs and have discovered that without sufficient pre-planning their program can be potentially very expensive and may result in end-products inconsistent with the facility needs or expectations. A design reconstitution program plan is developed here for the Hanford waste tank farms facility as a consequence of the DOE Standard on operational configuration management. This design reconstitution plan provides for the recovery or regeneration of design requirements and basis, the compilation of Design Information Summaries, and a methodology to disposition items open for regeneration that were discovered during the development of Design Information Summaries. Implementation of this plan will culminate in an end-product of about 30 Design Information Summary documents. These documents will be developed to identify tank farms facility design requirements and design bases and thereby capture the technical baselines of the facility. This plan identifies the methodology necessary to systematically recover documents that are sources of design input information, and to evaluate and disposition open items or regeneration items discovered during the development of the Design Information Summaries or during the verification and validation processes. These development activities will be governed and implemented by three procedures and a guide that are to be developed as an outgrowth of this plan

  16. The Birmingham Irradiation Facility

    International Nuclear Information System (INIS)

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm 2 ) silicon sensors

  17. The Birmingham Irradiation Facility

    Energy Technology Data Exchange (ETDEWEB)

    Dervan, P. [The University of Liverpool, Department of Physics (United Kingdom); French, R.; Hodgson, P. [The University of Sheffield, Department of Physics and Astronomy (United Kingdom); Marin-Reyes, H., E-mail: h.marin-reyes@sheffield.ac.uk [The University of Sheffield, Department of Physics and Astronomy (United Kingdom); Wilson, J. [The University of Birmingham, School of Physics and Astronomy (United Kingdom)

    2013-12-01

    At the end of 2012 the proton irradiation facility at the CERN PS will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm{sup 2}) silicon sensors.

  18. The Birmingham Irradiation Facility

    Science.gov (United States)

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-12-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm2) silicon sensors.

  19. The Birmingham Irradiation Facility

    CERN Document Server

    Dervan, P; Hodgson, P; Marin-Reyes, H; Wilson, J

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1 x 1 cm^2 ) silicon sensors.

  20. Urban Test Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — RTTC has access to various facilities for use in urban testing applications,including an agreement with the Hazardous Devices School (HDS): a restrictedaccess Urban...

  1. Robotics Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This 60 feet x 100 feet structure on the grounds of the Fort Indiantown Gap Pennsylvania National Guard (PNG) Base is a mixed-use facility comprising office space,...

  2. Indoor Ground Ejection Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This climate controlled facility is used to evaluate air stores and equipment to determine ejection velocities, store pitch rates, and arming wire and device system...

  3. Hypersonic Tunnel Facility (HTF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Hypersonic Tunnel Facility (HTF) is a blow-down, non-vitiated (clean air) free-jet wind tunnel capable of testing large-scale, propulsion systems at Mach 5, 6,...

  4. Ballistic Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Ballistic Test Facility is comprised of two outdoor and one indoor test ranges, which are all instrumented for data acquisition and analysis. Full-size aircraft...

  5. Powder Metallurgy Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The facility is uniquely equipped as the only laboratory within DA to conduct PM processing of refractory metals and alloys as well as the processing of a wide range...

  6. VT Telecommunication Facilities

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The UtilityTelecom_TELEFAC data layer contains points which are intended to represent the location of telecommunications facilities (towers and/or...

  7. GPS Satellite Simulation Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The GPS satellite simulation facility consists of a GPS satellite simulator controlled by either a Silicon Graphics Origin 2000 or PC depending upon unit under test...

  8. Coastal Harbors Modeling Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Coastal Harbors Modeling Facility is used to aid in the planning of harbor development and in the design and layout of breakwaters, absorbers, etc.. The goal is...

  9. Skilled Nursing Facility PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4432(a) of the Balanced Budget Act (BBA) of 1997 modified how payment is made for Medicare skilled nursing facility (SNF) services. Effective with cost...

  10. Laser Guidance Analysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility, which provides for real time, closed loop evaluation of semi-active laser guidance hardware, has and continues to be instrumental in the development...

  11. Plutonium metal burning facility

    International Nuclear Information System (INIS)

    Hausburg, D.E.; Leebl, R.G.

    1977-01-01

    A glove-box facility was designed to convert plutonium skull metal or unburned oxide to an oxide acceptable for plutonium recovery and purification. A discussion of the operation, safety aspects, and electrical schematics are included

  12. Environmental Test Facility (ETF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Environmental Test Facility (ETF) provides non-isolated shock testing for stand-alone equipment and full size cabinets under MIL-S-901D specifications. The ETF...

  13. Climatic Environmental Test Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — RTTC has an extensive suite of facilities for supporting MIL-STD-810 testing, toinclude: Temperature/Altitude, Rapid Decompression, Low/High Temperature,Temperature...

  14. Corrosion Testing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Corrosion Testing Facility is part of the Army Corrosion Office (ACO). It is a fully functional atmospheric exposure site, called the Corrosion Instrumented Test...

  15. Electra Laser Facility

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: The Electra Laser Facility is used to develop the science and technology needed to develop a reliable, efficient, high-energy, repetitively pulsed krypton...

  16. Combustion Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — For more than 30 years The Combustion Research Facility (CRF) has served as a national and international leader in combustion science and technology. The need for a...

  17. Liquid Effluent Retention Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Liquid Effluent Retention Facility (LERF) is located in the central part of the Hanford Site. LERF is permitted by the State of Washington and has three liquid...

  18. Nuclear facilities siting

    International Nuclear Information System (INIS)

    Kruger, P.

    1979-01-01

    A review of the status of requirements for the selection of sites for the facilities comprising the nuclear fuel cycle for electric power production. The report includes a summary of the legal and regulatory constraints that have resulted in complex and lengthy process for licensing of nuclear facilities. The nuclear fuel cycle, including the post-reactor operations of spent fuel reprocessing and waste disposal, is reviewed. Site evaluation factors for each major activity in the fuel cycle include geology, hydrology, demography, geography, meteorology, ecology, and institutional and social aspects. An analysis of current methods available for site evaluation are described. The report concludes with analysis of current issues affecting the ability of the nation's industry to license suitable sites for the many types of facility needed in the nuclear fuel cycle. The report should be of interest to civil engineers concerned with the resolution of technical problems of facility site selection. 36 refs

  19. Concrete Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This is a 20,000-sq ft laboratory that supports research on all aspects of concrete and materials technology. The staff of this facility offer wide-ranging expertise...

  20. Joint Computing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Raised Floor Computer Space for High Performance ComputingThe ERDC Information Technology Laboratory (ITL) provides a robust system of IT facilities to develop and...

  1. Wind Tunnel Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This ARDEC facility consists of subsonic, transonic, and supersonic wind tunnels to acquire aerodynamic data. Full-scale and sub-scale models of munitions are fitted...

  2. Field Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Field Research Facility (FRF) located in Duck, N.C. was established in 1977 to support the U.S. Army Corps of Engineers' coastal engineering mission. The FRF is...

  3. Coastal Inlet Model Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Coastal Inlet Model Facility, as part of the Coastal Inlets Research Program (CIRP), is an idealized inlet dedicated to the study of coastal inlets and equipped...

  4. Airborne & Field Sensors Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — RTTC facilities include an 800' x 60' paved UAV operational area, clearapproach/departure zone, concrete pads furnished with 208VAC, 3 phase,200 amp power, 20,000 sq...

  5. Frost Effects Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Full-scale study in controlled conditionsThe Frost Effects Research Facility (FERF) is the largest refrigerated warehouse in the United States that can be used for a...

  6. Geophysical Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Geophysical Research Facility (GRF) is a 60 ft long × 22 ft wide × 7 ft deep concrete basin at CRREL for fresh or saltwater investigations and can be temperature...

  7. Aviation Flight Support Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility consists of a 75' x 200' hanger with two adjacent helicopter pads located at Felker Army Airfield on Fort Eustis. A staff of Government and contractor...

  8. Space Power Facility (SPF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Space Power Facility (SPF) houses the world's largest space environment simulation chamber, measuring 100 ft. in diameter by 122 ft. high. In this chamber, large...

  9. Mark 1 Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Mark I Test Facility is a state-of-the-art space environment simulation test chamber for full-scale space systems testing. A $1.5M dollar upgrade in fiscal year...

  10. Advanced Microscopy Facility

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides a facility for high-resolution studies of complex biomolecular systems. The goal is an understanding of how to engineer biomolecules for various...

  11. Treated Effluent Disposal Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Treated non-hazardous and non-radioactive liquid wastes are collected and then disposed of through the systems at the Treated Effluent Disposal Facility (TEDF). More...

  12. Advanced Microanalysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Microanalysis Facility fully integrates capabilities for chemical and structural analysis of electronic materials and devices for the U.S. Army and DoD....

  13. Structural Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Provides a wide variety of testing equipment, fixtures and facilities to perform both unique aviation component testing as well as common types of materials testing...

  14. Waste Water Facilities

    Data.gov (United States)

    Vermont Center for Geographic Information — This dataset contains the locations of municipal and industrial direct discharge wastewater treatment facilities throughout the state of Vermont. Spatial data is not...

  15. Decommissioning nuclear facilities

    International Nuclear Information System (INIS)

    Harmon, K.M.; Jenkins, C.E.; Waite, D.A.; Brooksbank, R.E.; Lunis, B.C.; Nemec, J.F.

    1976-01-01

    This paper describes the currently accepted alternatives for decommissioning retired light water reactor fuel cycle facilities and the current state of decommissioning technology. Three alternatives are recognized: Protective Storage; Entombment; and Dismantling. Application of these alternatives to the following types of facilities is briefly described: light water reactors; fuel reprocessing plants, and mixed oxide fuel fabrication plants. Brief descriptions are given of decommissioning operations and results at a number of sites, and recent studies of the future decommissioning of prototype fuel cycle facilities are reviewed. An overview is provided of the types of operations performed and tools used in common decontamination and decommissioning techniques and needs for improved technology are suggested. Planning for decommissioning a nuclear facility is dependent upon the maximum permitted levels of residual radioactive contamination. Proposed guides and recently developed methodology for development of site release criteria are reviewed. 21 fig, 32 references

  16. Decontamination of nuclear facilities

    International Nuclear Information System (INIS)

    1982-01-01

    Thirty-seven papers were presented at this conference in five sessions. Topics covered include regulation, control and consequences of decontamination; decontamination of components and facilities; chemical and non-chemical methods of decontamination; and TMI decontamination experience

  17. Pittsburgh City Facilities

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Pittsburgh City FacilitiesIncludes: City Administrative Buildings, Police Stations, Fire Stations, EMS Stations, DPW Sites, Senior Centers, Recreation Centers, Pool...

  18. Water Tunnel Facility

    Data.gov (United States)

    Federal Laboratory Consortium — NETL’s High-Pressure Water Tunnel Facility in Pittsburgh, PA, re-creates the conditions found 3,000 meters beneath the ocean’s surface, allowing scientists to study...

  19. Air Data Calibration Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility is for low altitude subsonic altimeter system calibrations of air vehicles. Mission is a direct support of the AFFTC mission. Postflight data merge is...

  20. Hanford Facility contingency plan

    International Nuclear Information System (INIS)

    Sutton, L.N.; Miskho, A.G.; Brunke, R.C.

    1993-10-01

    The Hanford Facility Contingency Plan, together with each TSD unit-specific contingency plan, meets the WAC 173-303 requirements for a contingency plan. This plan includes descriptions of responses to a nonradiological hazardous materials spill or release at Hanford Facility locations not covered by TSD unit-specific contingency plans or building emergency plans. This plan includes descriptions of responses for spills or releases as a result of transportation activities, movement of materials, packaging, and storage of hazardous materials

  1. Auditing radiation sterilization facilities

    Science.gov (United States)

    Beck, Jeffrey A.

    The diversity of radiation sterilization systems available today places renewed emphasis on the need for thorough Quality Assurance audits of these facilities. Evaluating compliance with Good Manufacturing Practices is an obvious requirement, but an effective audit must also evaluate installation and performance qualification programs (validation_, and process control and monitoring procedures in detail. The present paper describes general standards that radiation sterilization operations should meet in each of these key areas, and provides basic guidance for conducting QA audits of these facilities.

  2. National Solar Thermal Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The National Solar Thermal Test Facility (NSTTF) is the only test facility in the United States of its type. This unique facility provides experimental engineering...

  3. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features ... facility. Who Needs to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may ...

  4. Combination of empagliflozin and linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin.

    Science.gov (United States)

    DeFronzo, Ralph A; Lewin, Andrew; Patel, Sanjay; Liu, Dacheng; Kaste, Renee; Woerle, Hans J; Broedl, Uli C

    2015-03-01

    To evaluate the efficacy and safety of combinations of empagliflozin/linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin. Subjects were randomized to a combination of empagliflozin 25 mg/linagliptin 5 mg (n = 137), empagliflozin 10 mg/linagliptin 5 mg (n = 136), empagliflozin 25 mg (n = 141), empagliflozin 10 mg (n = 140), or linagliptin 5 mg (n = 132) as add-on to metformin for 52 weeks. The primary end point was change from baseline in HbA1c at week 24. At week 24, reductions in HbA1c (mean baseline 7.90-8.02% [62.8-64.1 mmol/mol]) with empagliflozin/linagliptin were superior to those with empagliflozin or linagliptin alone as add-on to metformin; adjusted mean (SE) changes from baseline were -1.19% (0.06) (-13.1 mmol/mol [0.7]) with empagliflozin 25 mg/linagliptin 5 mg, -1.08% (0.06) (-11.8 mmol/mol [0.7]) with empagliflozin 10 mg/linagliptin 5 mg, -0.62% (0.06) (-6.8 mmol/mol [0.7]) with empagliflozin 25 mg, -0.66% (0.06) (-7.2 mmol/mol [0.7]) with empagliflozin 10 mg, and -0.70% (0.06) (-7.6 mmol/mol [0.7]) with linagliptin 5 mg (P empagliflozin/linagliptin as second-line therapy for 52 weeks significantly reduced HbA1c compared with the individual components and were well tolerated. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  5. Lifestyle constraints, not inadequate nutrition education, cause gap between breakfast ideals and realities among Japanese in Tokyo.

    Science.gov (United States)

    Melby, Melissa K; Takeda, Wakako

    2014-01-01

    Japanese public health nutrition often promotes 'traditional' cuisine. In-depth interviews with 107 Japanese adults were conducted in Tokyo from 2009 to 2011, using free-listing methods to examine dietary ideals and realities to assess the extent to which realities reflect inadequate nutrition education or lifestyle constraints. Ideal-reality gaps were widest for breakfast. Most people reported Japanese ideals: rice and miso soup were prototypical foods. However, breakfast realities were predominantly western (bread-based). While those aged 40-59 were more likely to hold Japanese ideals (P=0.063), they were less likely to achieve them (P=0.007). All those reporting western ideals achieved them on weekdays, while only 64% of those with Japanese ideals achieved them (PJapanese ideals were positively correlated with proportion of cooking-related housework, and negatively correlated with living standard and income. Ideal menu content was in line with current Japanese nutrition advice, suggesting that more nutrition education may not change dietary ideals or behavior. Participant-reported reasons for ideal-reality discordance demonstrate that work-life balance issues, especially lack of time and family structure/life rhythm, are the largest obstacles to the attainment of dietary ideals. People reporting 'no time' as a primary reason for ideal-reality gaps were less likely to achieve their Japanese ideals (odds ratio=0.212). Time realities of people's lives may undermine educational efforts promoting Japanese breakfasts. When dietary reality/behavior departs from guidelines, it is often assumed that people lack knowledge. If ideals are in line with dietary guidelines, then lack of knowledge is not the likely cause and nutrition education is not the optimal solution. By asking people about the reasons for gaps between their ideals and realities, we can identify barriers and design more effective policies and programs to achieve dietary ideals. Copyright © 2013 Elsevier

  6. An analysis of US fertility centre educational materials suggests that informed consent for preimplantation genetic diagnosis may be inadequate.

    Science.gov (United States)

    LaBonte, Michelle Lynne

    2012-08-01

    The use of preimplantation genetic diagnosis (PGD) has expanded both in number and scope over the past 2 decades. Initially carried out to avoid the birth of children with severe genetic disease, PGD is now used for a variety of medical and non-medical purposes. While some human studies have concluded that PGD is safe, animal studies and a recent human study suggest that the embryo biopsy procedure may result in neurological problems for the offspring. Given that the long-term safety of PGD has not been clearly established in humans, this study sought to determine how PGD safety is presented to prospective patients by means of a detailed website analysis. The websites of 262 US fertility centres performing PGD were analysed and comments about safety and risk were catalogued. Results of the analysis demonstrated that 78.2% of centre websites did not mention safety or risk of PGD at all. Of the 21.8% of centres that did contain safety or risk information about PGD, 28.1% included statements highlighting the potential risks, 38.6% presented information touting the procedure as safe and 33.3% included statements highlighting potential risks and the overall safety of the procedure. Thus, 86.6% of PGD-performing centres state that PGD is safe and/or fail to disclose any risks on their websites despite the fact that the impact of the procedure on the long-term health of offspring is unproven. This lack of disclosure suggests that informed consent is inadequate; this study examines numerous factors that are likely to inhibit comprehensive discussions of safety.

  7. Complementary foods consumed by 6-12-month-old rural infants in South Africa are inadequate in micronutrients.

    Science.gov (United States)

    Faber, Mieke

    2005-06-01

    To determine the nutrient composition of complementary foods consumed by 6-12-month-old South African infants. Nutrient intake was determined for infants who were recruited to participate in a randomised controlled trial using a single 24-hour dietary recall. Infants aged 6-12 months (n=475) residing in The Valley of a Thousand Hills, a rural area in KwaZulu-Natal, South Africa. Energy and protein intakes from complementary foods were adequate. Infants who consumed infant products (commercially available fortified infant cereals/ready-to-eat canned baby foods/formula milk powder) had significantly higher intakes of calcium, iron, zinc, vitamin A, thiamine, riboflavin, niacin, vitamin B6, vitamin B12 and vitamin C than infants who did not consume any infant products. For infants who consumed infant cereals (n=142), these cereals provided 51% of total iron intake. Infant cereals provided more than 25% of total intake for magnesium, thiamine, niacin and vitamin B12. For infants consuming ready-to-eat canned baby foods (n=77), these products contributed less than 15% of total intake for all the micronutrients. The nutrient density of the complementary diet was less than half the desired density for calcium, iron and zinc. Animal products were consumed by 17% of infants, 26% consumed dairy products and 18% consumed vitamin-A-rich fruit and vegetables during the 24-hour recall period. The nutrient composition of complementary foods among rural South African infants was inadequate, especially for iron, zinc and calcium. Strategies should be developed to improve the nutritional quality of their diets.

  8. A randomized trial of the efficacy and safety of quilizumab in adults with inadequately controlled allergic asthma.

    Science.gov (United States)

    Harris, Jeffrey M; Maciuca, Romeo; Bradley, Mary S; Cabanski, Christopher R; Scheerens, Heleen; Lim, Jeremy; Cai, Fang; Kishnani, Mona; Liao, X Charlene; Samineni, Divya; Zhu, Rui; Cochran, Colette; Soong, Weily; Diaz, Joseph D; Perin, Patrick; Tsukayama, Miguel; Dimov, Dimo; Agache, Ioana; Kelsen, Steven G

    2016-03-18

    Quilizumab, a humanized IgG1 monoclonal antibody, targets the M1-prime segment of membrane-expressed IgE, leading to depletion of IgE-switched and memory B cells. In patients with mild asthma, quilizumab reduced serum IgE and attenuated the early and late asthmatic reaction following whole lung allergen challenge. This study evaluated the efficacy and safety of quilizumab in adults with allergic asthma, inadequately controlled despite high-dose inhaled corticosteroids (ICS) and a second controller. Five hundred seventy-eight patients were randomized to monthly or quarterly dosing regimens of subcutaneous quilizumab or placebo for 36 weeks, with a 48-week safety follow-up. Quilizumab was evaluated for effects on the rate of asthma exacerbations, lung function, patient symptoms, serum IgE, and pharmacokinetics. Exploratory analyses were conducted on biomarker subgroups (periostin, blood eosinophils, serum IgE, and exhaled nitric oxide). Quilizumab was well tolerated and reduced serum total and allergen-specific IgE by 30-40 %, but had no impact on asthma exacerbations, lung function, or patient-reported symptom measures. At Week 36, the 300 mg monthly quilizumab group showed a 19.6 % reduction (p = 0.38) in the asthma exacerbation rate relative to placebo, but this was neither statistically nor clinically significant. Biomarker subgroups did not reveal meaningful efficacy benefits following quilizumab treatment. Quilizumab had an acceptable safety profile and reduced serum IgE. However, targeting the IgE pathway via depletion of IgE-switched and memory B cells was not sufficient for a clinically meaningful benefit for adults with allergic asthma uncontrolled by standard therapy. ClinicalTrials.gov NCT01582503.

  9. The CUTLASS database facilities

    International Nuclear Information System (INIS)

    Jervis, P.; Rutter, P.

    1988-09-01

    The enhancement of the CUTLASS database management system to provide improved facilities for data handling is seen as a prerequisite to its effective use for future power station data processing and control applications. This particularly applies to the larger projects such as AGR data processing system refurbishments, and the data processing systems required for the new Coal Fired Reference Design stations. In anticipation of the need for improved data handling facilities in CUTLASS, the CEGB established a User Sub-Group in the early 1980's to define the database facilities required by users. Following the endorsement of the resulting specification and a detailed design study, the database facilities have been implemented as an integral part of the CUTLASS system. This paper provides an introduction to the range of CUTLASS Database facilities, and emphasises the role of Database as the central facility around which future Kit 1 and (particularly) Kit 6 CUTLASS based data processing and control systems will be designed and implemented. (author)

  10. Mound facility physical characterization

    Energy Technology Data Exchange (ETDEWEB)

    Tonne, W.R.; Alexander, B.M.; Cage, M.R.; Hase, E.H.; Schmidt, M.J.; Schneider, J.E.; Slusher, W.; Todd, J.E.

    1993-12-01

    The purpose of this report is to provide a baseline physical characterization of Mound`s facilities as of September 1993. The baseline characterizations are to be used in the development of long-term future use strategy development for the Mound site. This document describes the current missions and alternative future use scenarios for each building. Current mission descriptions cover facility capabilities, physical resources required to support operations, current safety envelope and current status of facilities. Future use scenarios identify potential alternative future uses, facility modifications required for likely use, facility modifications of other uses, changes to safety envelope for the likely use, cleanup criteria for each future use scenario, and disposition of surplus equipment. This Introductory Chapter includes an Executive Summary that contains narrative on the Functional Unit Material Condition, Current Facility Status, Listing of Buildings, Space Plans, Summary of Maintenance Program and Repair Backlog, Environmental Restoration, and Decontamination and Decommissioning Programs. Under Section B, Site Description, is a brief listing of the Site PS Development, as well as Current Utility Sources. Section C contains Site Assumptions. A Maintenance Program Overview, as well as Current Deficiencies, is contained within the Maintenance Program Chapter.

  11. Assessment Of Market Facilities And Locational Effects On Adjoining Neighborhoods In Nigerian Urban Centers Empirical Evidence From Akure Nigeria

    Directory of Open Access Journals (Sweden)

    Adeyinka S. A.

    2015-08-01

    Full Text Available There is the need for people to buy and sell and transact their businesses in a way that life can go on normally. This study examined the markets facilities level and locational effects on adjoining neighbourhoods in Akure Township. Both primary and secondary data types were employed in the study primary data were collected through the administration of questionnaire on traders and patronsbuyers in the markets and residents of adjoining neighbourhoods and personal observation. Secondary data were collected from government publications. Data collected were analysed using descriptive statistical methods which included frequency counts and Likerts scale to analyse the satisfaction of traders and patrons on the facilities in the markets and severity of locational effects on residents of adjoining neighbourhoods. Findings from the study showed that facilities such as parking spaces fire extinguishers circulation spaces within the markets trading spaces safe area for children perimeter fencing and loading and off-loading bay were inadequately provided. While on-street display of goods traffic congestion air pollution on-street parking due to inadequate parking spaces were the severely perceived locational effects. The study concluded that facilities in the markets were inadequate and that markets constitute nuisances to the adjoining areas. It hereby recommends that markets in the study area be provided with the required level of facilities to prevent future urban problems.

  12. Distributed Energy Resources Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — NREL's Distributed Energy Resources Test Facility (DERTF) is a working laboratory for interconnection and systems integration testing. This state-of-the-art facility...

  13. Comparison of the geometric accuracy of radiotherapy facilities by various manufacturers, performed within the programme of quality audits

    International Nuclear Information System (INIS)

    Pridal, I.; Klaclova, T.; Gremlica, D.; Zackova, H.; Snobr, J.

    1998-01-01

    The evaluation of geometric parameters of radiotherapy facilities is discussed, these parameters being of importance for focusing the target volume and for achieving the required standard of treatment. During quality audits at radiotherapy systems various shortcomings were found as regards the accuracy of irradiation. A part of the shortcomings was due to inadequate setting of the facility parameters; another, however, was related to the mechanical design of the treatment units. The latter problems cannot be easily eliminated and have to be taken into account when using the respective facilities

  14. Non-western women in maternity care in the Netherlands: Exploring 'inadequate' use of prenatal care and the experiences of care professionals

    NARCIS (Netherlands)

    Boerleider, A.W.

    2015-01-01

    Non-western women in the Netherlands are more likely to make inadequate use of prenatal care than native Dutch women. Furthermore, non-western women are diverse in origin which implies diversity in their needs and expectations for maternity care. This thesis examines the factors and reasons

  15. Efficacy and safety of tregalizumab in patients with rheumatoid arthritis and an inadequate response to methotrexate: results of a phase IIb, randomised, placebo-controlled trial

    NARCIS (Netherlands)

    van Vollenhoven, Ronald F.; Keystone, Edward Clark; Strand, Vibeke; Pacheco-Tena, Cesar; Vencovský, Jiří; Behrens, Frank; Racewicz, Arthur; Zipp, Daniela; Rharbaoui, Faiza; Wolter, Ralf; Knierim, Luise; Schmeidl, Rainer; Zhou, Xuefei; Aigner, Silke; Dälken, Benjamin; Wartenberg-Demand, Andrea; Aelion, Jacob; Arreola, Jorge Aguilar; Arias, Maria Araujo; Back, Johan; Baranauskaite, Asta; Bennett, Ralph; Bookman, Arthur; Brzezicki, Jan; Butrimiene, Irena; Churchill, Melvin; Djacenko, Svetlana; Dokoupilova, Eva; Drescher, Edit; Dudek, Anna; Edwards, William; Eliseeva, Larisa; Ershova, Olga; Fortin, Isabelle; Galatikova, Dagmar; de la Torre, Ignacio Garcia; Garmish, Olena; Gasanov, Yuriy; Gnylorybov, Andriy; Goldberg, Marc; Golovchenko, Oleksandr; Gordeev, Ivan; Hiepe, Falk; Sil, Gabriela Huerta; Husarova, Viola; Iaremenko, Oleg; Jeka, Slawomir; Kamburova, Daniela; Kavanaugh, Arthur; Keszthelyi, Peter; Keystone, Edward; Knyazeva, Larisa; Krechikova, Diana; Kuzmanova, Stefka; Lapcikova, Angelika; Levinson, Dennis; Lopez Garcia, Jesus Alberto; Lymar, Iurii; Marinova, Natalia; Moiseev, Sergey; Musilova, Lucie; Nagy, Magdolna; Najam, Sabeen; Nedovic, Jovan; Nemeth, Eleonora; Novosad, Libor; Ochoa-Ortega, Luis; Oparanov, Boycho; Tena, Cesar Pacheco; Penev, Dimitar; Pesant, Yves; Podrazilova, Lucie; Pulka, Grazyna; Racewicz, Artur; Raskina, Tatiana; Rekalov, Dmytro; Reshetko, Olga; Riega Torres, Janett Carmen; Rubbert-Roth, Andrea; Rychlewska-Hanczewska, Anna; Savina, Ludmila; Schulze-Koops, Hendrik; Bukilica, Mirjana Sefik; Shevchuk, Sergii; Simoncsics, Eszter; Simova, Lubomira; Sitek-Ziolkowska, Karina; Skublova, Andrea; Sliwowska, Beata; Smakotina, Svetlana; Spieler, Wolfgang; Stanislavchuk, Mykola; Stefanovic, Dusan; Stejfova, Zuzana; Stoilov, Rumen; Strapkova, Maria; Stryuk, Raisa; Sulyok, Gabriella; Sylwestrzak, Anna; Szombati, Istvan; Theander, Jan; Tomkova, Sona; Trapp, Robert; Tseluyko, Vira; Tälli, Jaak; Vencovsky, Jiri; Vitek, Petr; Vladeva, Stoyanka; Vo, Jacqueline; Vujasinovic-Stupar, Nada; Wassenberg, Siegfried; Wollenhaupt, Juergen; Zielinska, Agnieszka

    2018-01-01

    To evaluate the efficacy, biological activity and safety of tregalizumab in patients with active rheumatoid arthritis (RA) and an inadequate response to methotrexate (MTX). 321 patients were randomised (1:1:1:1) to placebo or tregalizumab 25, 100 or 200 mg once-weekly subcutaneously in addition to

  16. Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation: response

    Directory of Open Access Journals (Sweden)

    Raman Rajiv

    2010-03-01

    Full Text Available Abstract A response to Jorge Esteves, Carolina Maurente da Rosa, Caroline Kaercher Kramer, Luiz Eduardo Osowski, Stéfano Milano and Luís Henrique Canani: Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation. Diabetology & Metabolic syndrome 2009, 1:13.

  17. Prevalence and determinants of inadequate use of folic acid supplementation in Japanese pregnant women: the Japan Environment and Children's Study (JECS).

    Science.gov (United States)

    Obara, Taku; Nishigori, Hidekazu; Nishigori, Toshie; Metoki, Hirohito; Ishikuro, Mami; Tatsuta, Nozomi; Mizuno, Satoshi; Sakurai, Kasumi; Nishijima, Ichiko; Murai, Yuriko; Fujiwara, Ikuma; Arima, Takahiro; Nakai, Kunihiko; Mano, Nariyasu; Yaegashi, Nobuo; Kuriyama, Shinichi

    2017-03-01

    The aim of the study was to clarify the prevalence and determinants of inadequate use of folic acid supplementation in pregnant Japanese women. This study was part of the Japan Environment and Children's Study, a nationwide and government-funded birth cohort study. We collected information on the use of folic acid supplementation before and during pregnancy and characteristics of participants using self-administered questionnaire. Among 9849 women who completed the data collection for this study, the prevalence of inadequate users was 92.6% of the total population and varied from 84.5% to 96.2% among regions. On the basis of multivariate logistic regression analysis, younger age, not married, lower family income, multipara, natural conception and no history of spontaneous abortion were found to be determinants for inadequate users of folic acid supplementation. Most Japanese pregnant women show inadequate folic acid supplementation use. Japanese women of child-bearing age need to be specifically informed about the need for periconceptional intake of folic acid to prevent neural tube defects.

  18. Comprehensive facilities plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    The Ernest Orlando Lawrence Berkeley National Laboratory`s Comprehensive Facilities Plan (CFP) document provides analysis and policy guidance for the effective use and orderly future development of land and capital assets at the Berkeley Lab site. The CFP directly supports Berkeley Lab`s role as a multiprogram national laboratory operated by the University of California (UC) for the Department of Energy (DOE). The CFP is revised annually on Berkeley Lab`s Facilities Planning Website. Major revisions are consistent with DOE policy and review guidance. Facilities planing is motivated by the need to develop facilities for DOE programmatic needs; to maintain, replace and rehabilitate existing obsolete facilities; to identify sites for anticipated programmatic growth; and to establish a planning framework in recognition of site amenities and the surrounding community. The CFP presents a concise expression of the policy for the future physical development of the Laboratory, based upon anticipated operational needs of research programs and the environmental setting. It is a product of the ongoing planning processes and is a dynamic information source.

  19. Power Systems Development Facility

    International Nuclear Information System (INIS)

    1993-06-01

    The objective of the PSDF would be to provide a modular facility which would support the development of advanced, pilot-scale, coal-based power systems and hot gas clean-up components. These pilot-scale components would be designed to be large enough so that the results can be related and projected to commercial systems. The facility would use a modular approach to enhance the flexibility and capability for testing; consequently, overall capital and operating costs when compared with stand-alone facilities would be reduced by sharing resources common to different modules. The facility would identify and resolve technical barrier, as well as-provide a structure for long-term testing and performance assessment. It is also intended that the facility would evaluate the operational and performance characteristics of the advanced power systems with both bituminous and subbituminous coals. Five technology-based experimental modules are proposed for the PSDF: (1) an advanced gasifier module, (2) a fuel cell test module, (3) a PFBC module, (4) a combustion gas turbine module, and (5) a module comprised of five hot gas cleanup particulate control devices. The final module, the PCD, would capture coal-derived ash and particles from both the PFBC and advanced gasifier gas streams to provide for overall particulate emission control, as well as to protect the combustion turbine and the fuel cell

  20. European Synchrotron Radiation Facility

    International Nuclear Information System (INIS)

    Buras, B.

    1985-01-01

    How a European Synchrotron Radiation Facility has developed into a detailed proposal recently accepted as the basis for construction of the facility at Grenoble is discussed. In November 1977, the General Assembly of the European Science Foundation (ESF) approved the report of the ESF working party on synchrotron radiation entitled Synchrotron Radiation - a Perspective View for Europe. This report contained as one of its principal recommendations that work should commence on a feasibility study for a European synchrotron radiation laboratory having a dedicated hard X-ray storage ring and appropriate advanced instrumentation. In order to prepare a feasibility study the European Science Foundation set up the Ad-hoc Committee on Synchrotron Radiation, which in turn formed two working groups: one for the machine and another for instrumentation. This feasibility study was completed in 1979 with the publication of the Blue Book describing in detail the so called 1979 European Synchrotron Radiation Facility. The heart of the facility was a 5 GeV electron storage ring and it was assumed that mainly the radiation from bending magnets will be used. The facility is described

  1. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study.

    Directory of Open Access Journals (Sweden)

    Søren Søgaard Lund

    Full Text Available Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment with metformin versus placebo in patients with T1DM and persistent poor glycaemic control.One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c (HbA(1c > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment. Thereafter, patients were randomized (baseline to treatment with either metformin (1 g twice daily or placebo for 12 months (double-masked. Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c after one year of treatment. At enrolment, mean (standard deviation HbA(1c was 9.48% (0.99 for the metformin group (n = 49 and 9.60% (0.86 for the placebo group (n = 51. Mean (95% confidence interval baseline-adjusted differences after 12 months with metformin (n = 48 versus placebo (n = 50 were: HbA(1c, 0.13% (-0.19; 0.44, p = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9, p<0.001; body weight, -1.74 kg (-3.32; -0.17, p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated.In patients with poorly controlled T1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects of metformin therapy in patients with T1DM are warranted.ClinicalTrials.gov NCT00118937.

  2. Changes in Ultrasonographic Vascularity Upon Initiation of Adalimumab Combination Therapy in Rheumatoid Arthritis Patients With an Inadequate Response to Methotrexate.

    Science.gov (United States)

    Kaeley, Gurjit S; Nishio, Midori J; Goyal, Janak R; MacCarter, Daryl K; Wells, Alvin F; Chen, Su; Kupper, Hartmut; Kalabic, Jasmina

    2016-11-01

    To assess joint disease activity by ultrasound (US) in patients with rheumatoid arthritis (RA) initiating treatment with adalimumab (ADA) plus methotrexate (MTX). Data for this post hoc analysis originated from the MUSICA trial (ClinicalTrials.gov identifier: NCT01185288), which evaluated the efficacy of initiating ADA (40 mg every other week) plus 7.5 or 20 mg/week MTX in 309 patients with RA with an inadequate response to MTX. Synovial vascularization over 24 weeks was assessed bilaterally at metacarpophalangeal joint 2 (MCP2), MCP3, MCP5, metatarsophalangeal joint 5, and the wrists by power Doppler US (PDUS). A semiquantitative 4-grade scale was used. Disease activity was assessed using the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) and Simplified Disease Activity Index (SDAI). The correlation between continuous variables was assessed using Pearson's correlation coefficient. After 24 weeks of treatment with ADA plus MTX, rapid improvements in the mean synovial vascularity score were observed; the greatest improvements were in MCP2 (-0.5), MCP3 (-0.4), and the wrist (-0.4). At week 24, patients with the lowest DAS28-CRP ( 0.9). Synovial vascularity scores correlated poorly with DAS28, swollen joint count in 66 joints (SJC66), SJC28, tender joint count in 68 joints (TJC68), TJC28, Clinical Disease Activity Index (CDAI), SDAI, physician's global assessment, patient's global assessment of pain, and disease duration (ρ < 0.2). Thirty-two (70%) of 46 patients with a DAS28-CRP of <2.6, and 11 (58%) of 19 patients with an SDAI indicating remission had at least 1 joint with a synovial vascularity score of ≥1. PDUS detects changes in synovial vascularity in RA patients treated with ADA plus MTX, and residual synovial vascularity in patients in whom clinical disease control has been achieved. © 2016 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

  3. Facility effluent monitoring plan determinations for the 100 Area facilities

    International Nuclear Information System (INIS)

    Brendel, D.E.

    1991-11-01

    The determination for Facility Effluent Monitoring Plans arose from evaluations conducted for the Westinghouse Hanford Company 100 Area facilities on the Hanford Site. The Facility Effluent Monitoring Plant determinations have been prepared in accordance with A Guide for Preparing Hanford Site Facility Effluent Monitoring Plan, WHC-EP-0438 (WHC 1991). Ten Westinghouse Hanford Company facilities in the 100 Areas were evaluated: N Reactor, KE/KW Reactors, 1706 KE Laboratory, and the Surplus Reactors (B, C, D, DR, F, and H). The N Reactor, KE/KW Reactors, and 1706 KE Laboratory Facility Effluent Monitoring Plan determinations were prepared by Columbia Energy and Environmental Services of Richland, Washington. The determination for the Surplus Reactors was prepared by Westinghouse Hanford Company. Of the 10 facilities evaluated, two will require a Facility Effluent Monitoring Plan: N Reactor and the active spent fuel storage facilities and their contiguous support facilities at 100 KE and 100 KW

  4. An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Machado-Alba

    2014-02-01

    Full Text Available Introduction: The prescription and costs of antiulcer medications for in-hospital use have increased during recent years with reported inadequate use and underused. Aim: To determine the patterns of prescription-indication and also perform an economic analysis of the overcost caused by the non-justified use of antiulcer medications in a third level hospital in Colombia. Materials and methods: Cross-sectional study of prescription-indication of antiulcer medications for patients hospitalized in "Hospital Universitario San Jorge" of Pereira during July of 2012. Adequate or inadequate prescription of the first antiulcer medication prescribed was determined as well as for others prescribed during the hospital stay, supported by clinical practice guidelines from the Zaragoza I sector workgroup, clinical guidelines from the Australian Health Department, and finally the American College of Gastroenterology Criteria for stress ulcer prophylaxis. Daily defined dose per bed/day was used, as well as the cost for 100 beds/day and the cost of each bed/drug. A multivariate analysis was carried out using SPSS 21.0. Results: 778 patients were analyzed, 435 men (55.9% and 343 women, mean age 56.6 ± 20.1 years. The number of patients without justification for the prescription of the first antiulcer medication was 377 (48.5%, and during the whole in-hospital time it was 336 (43.2%. Ranitidine was the most used medication, in 438 patients (56.3%. The cost/month for poorly justified antiulcer medications was € 3,335.6. The annual estimated cost for inadequate prescriptions of antiulcer medications was € 16,770.0 per 100 beds. Conclusion: A lower inadequate prescription rate of antiulcer medications was identified compared with other studies; however it was still high and is troubling because of the major costs that these inadequate prescriptions generates for the institution.

  5. Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries.

    Science.gov (United States)

    Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

    2014-08-01

    To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. In 2012, 502,000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280,000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297,000 deaths. In total, 842,000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361,000 deaths could be prevented, representing 5.5% of deaths in that age group. This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. © 2014 The Authors. Tropical Medicine and International Health published by John Wiley & Sons Ltd.

  6. The ORION Facility

    International Nuclear Information System (INIS)

    Noble, Robert

    2003-01-01

    ORION will be a user-oriented research facility for understanding the physics and developing the technology for future high-energy particle accelerators, as well as for research in related fields. The facility has as its centerpiece the Next Linear Collider Test Accelerator (NLCTA) at the Stanford Linear Accelerator Center (SLAC). The NLCTA will be modified with the addition of a new, high-brightness photoinjector, its drive laser, an S-band rf power system, a user laser room, a low-energy experimental hall supplied with electron beams up to 60 MeV in energy, and a high-energy hall supplied with beams up to 350 MeV. The facility design and parameters are described here along with highlights from the 2nd ORION Workshop held in February 2003

  7. UVSOR facility at IMS

    Energy Technology Data Exchange (ETDEWEB)

    Koyano, I.; Achiba, Y.; Inokuchi, H.; Ishiguro, E.; Kato, R.; Kimura, K.; Seki, K.; Shobatake, K.; Tabayashi, K.; Takagi, Y. (Institute for Molecular Science, Okazaki, Aichi (Japan))

    1982-04-01

    The construction of a synchrotron radiation facility, dedicated to VUV studies in molecular science and its related fields, has started this year at the Institute for Molecular Science, Okazaki, Japan. The facility consists of a 600 MeV storage ring, a 600 MeV injector synchrotron with a 15 MeV linac, experimental stations, and several experimental support facilities in a 2700 m/sup 2/ building. The storage ring has a circumference of 53.2 m, consisting of eight bending magnet sections, for short straight sections, and four long straight sections. The radius of the bending magnet is 2.2 m, making the use of radiation down to 10 A feasible at 600 MeV electron energy (lambdasub(c) = 56.9 A). The proposed researches include spectroscopy, photoelectron spectroscopy, photochemistry, and reaction dynamics of active species. Optical and other instruments for these studies have been designed and some have been constructed.

  8. Mirror Fusion Test Facility

    International Nuclear Information System (INIS)

    Dixon, F.P.

    1977-01-01

    On October 1, 1977 work began at LLL on the Mirror Fusion Test Facility (MFTF), an advanced experimental fusion device. Scheduled for operation in late 1981, MFTF is designed as an intermediate step between present mirror machines, such as 2XIIB, and an experimental fusion reactor. This design incorporates improved technology and a better theoretical understanding of how neutral beam injection, plasma guns, and gas injection into the plasma region compensate for cooling and particle losses. With the new facility, we expect to achieve a confinement factor (n tau) of 10 12 particles . sm/cm 3 --a tenfold increase over 2XIIB n tau values--and to increase plasma temperature to over 500 million K. The following article describes this new facility and reports on progress in some of the R and D projects that are providing the technological base for its construction

  9. FACILITIES MANAGEMENT AT CERN

    CERN Document Server

    2002-01-01

    Recently we have been confronted with difficulties concerning services which are part of a new contract for facilities management. Please see below for some information about this contract. Following competitive tendering and the Finance Committee decision, the contract was awarded to the Swiss firm 'Facilities Management Network (FMN)'. The owners of FMN are two companies 'M+W Zander' and 'Avireal', both very experienced in this field of facilities management. The contract entered into force on 1st July 2002. CERN has grouped together around 20 different activities into this one contract, which was previously covered by separate contracts. The new contract includes the management and execution of many activities, in particular: Guards and access control; cleaning; operation and maintenance of heating plants, cooling and ventilation equipment for buildings not related to the tunnel or the LHC; plumbing; sanitation; lifts; green areas and roads; waste disposal; and includes a centralised helpdesk for these act...

  10. UHV facility at pelletron

    International Nuclear Information System (INIS)

    Gupta, S.K.; Hattangadi, V.A.

    1993-01-01

    One of the important requirements of a heavy ion accelerator is the maintenance of a clean, ultrahigh vacuum (UHV) environment in the accelerating tubes as well as in the beamlines. This becomes necessary in order to minimise transmission losses of the ion beam due to charge exchange or scattering during collisions with the residual gas atoms. In view of these considerations, as an essential ancillary facility, a UHV laboratory with all required facilities has been set up for the pelletron accelerator and the work done in this laboratory is described. First the pelletron accelerator vacuum system is described in brief. The UHV laboratory facilities are described. Our operational experience with the accelerator vacuum system is discussed. The development of accelerator components carried out by the UHV laboratory is also discussed. (author)

  11. Water, sanitation and hygiene in health care facilities: Challenges and priorities

    Directory of Open Access Journals (Sweden)

    Jovanović Dragana

    2017-01-01

    Full Text Available The microbial agents that cause infectious diseases are highly prevalent in health care facilities. Adequate water supply, sanitation and hygiene are the key elements for the provision of basic health services. The consequences of poor sanitary and hygienic conditions and inadequate water supply are numerous in health care facilities. The importance of improving water supply, sanitation and hygiene in health care facilities has been recognized as an international priority and set in the 2030 Agenda for Sustainable Development, particularly through goal 3.8 and 6. The establishment and maintenance of safe water supply and adequate sanitary and hygienic conditions has multiple benefits for health care facilities. It is necessary to introduce and implement risk assessment and risk management approach as effective way of continuously ensuring and maintaining the safety of drinking water quality in health care facilities as recommended by the World Health Organization, in order to reduce the risks associated with inadequate water supply and protect health of patients and staff. Realization of activities on the improvement requires a multidisciplinary approach and good inter-sectoral cooperation at all levels local, national and global.

  12. Robotics for nuclear facilities

    International Nuclear Information System (INIS)

    Abe, Akira; Nakayama, Ryoichi; Kubo, Katsumi

    1988-01-01

    It is highly desirable that automatic or remotely controlled machines perform inspection and maintenance tasks in nuclear facilities. Toshiba has been working to develop multi-functional robots, with one typical example being a master-slave manipulator for use in reprocessing facilities. At the same time, the company is also working on the development of multi-purpose intelligent robots. One such device, an automatic inspection robot, to be deployed along a monorail, performs inspection by means of image processing technology, while and advanced intelligent maintenance robot is equipped with a special wheel-locomotion mechanism and manipulator and is designed to perform maintenance tasks. (author)

  13. Bevalac Radiotherapy Facility

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, J.R.; Howard, J.; Criswell, T.

    1979-03-01

    Patient Treatment Room at the Bevalac is now in full operation. In the design of this facility, emphasis has been placed on creating an atmosphere appropriate to a clinical facility; the usual features of an irradiation cave have been hidden behind carpets, curtains and paint. Patient positioning is done with a Philips Ram-style couch, with additional fixtures to accommodate a patient in the seated or standing, as well as the supine, position. Dosimetry apparatus, collimators, ion chambers and the beam flattening system used to produce the highly uniform 20 cm diameter therapy field are described.

  14. Bevalac Radiotherapy Facility

    International Nuclear Information System (INIS)

    Alonso, J.R.; Howard, J.; Criswell, T.

    1979-03-01

    Patient Treatment Room at the Bevalac is now in full operation. In the design of this facility, emphasis has been placed on creating an atmosphere appropriate to a clinical facility; the usual features of an irradiation cave have been hidden behind carpets, curtains and paint. Patient positioning is done with a Philips Ram-style couch, with additional fixtures to accommodate a patient in the seated or standing, as well as the supine, position. Dosimetry apparatus, collimators, ion chambers and the beam flattening system used to produce the highly uniform 20 cm diameter therapy field are described

  15. Line facilities outline

    International Nuclear Information System (INIS)

    1998-08-01

    This book deals with line facilities. The contents of this book are outline line of wire telecommunication ; development of line, classification of section of line and theory of transmission of line, cable line ; structure of line, line of cable in town, line out of town, domestic cable and other lines, Optical communication ; line of optical cable, transmission method, measurement of optical communication and cable of the sea bottom, Equipment of telecommunication line ; telecommunication line facilities and telecommunication of public works, construction of cable line and maintenance and Regulation of line equipment ; regulation on technique, construction and maintenance.

  16. Next generation storage facility

    International Nuclear Information System (INIS)

    Schlesser, J.A.

    1994-01-01

    With diminishing requirements for plutonium, a substantial quantity of this material requires special handling and ultimately, long-term storage. To meet this objective, we at Los Alamos, have been involved in the design of a storage facility with the goal of providing storage capabilities for this and other nuclear materials. This paper presents preliminary basic design data, not for the structure and physical plant, but for the container and arrays which might be configured within the facility, with strong emphasis on criticality safety features

  17. TMX, a new facility

    International Nuclear Information System (INIS)

    Thomas, S.R. Jr.

    1977-01-01

    As a mirror fusion facility, the Tandem Mirror Experiment (TMX) at the Lawrence Livermore Laboratory (LLL) is both new and different. It utilizes over 23,000 ft 2 of work area in three buildings and consumes over 14 kWh of energy with each shot. As a systems design, the facility is broken into discreet functional regions. Among them are a mechanical vacuum pumping system, a liquid-nitrogen system, neutral-beam and magnet power supplies, tiered structures to support these supplies, a neutron-shielded vacuum vessel, a control area, and a diagnostics area. Constraints of space, time, and cost have all affected the design

  18. Dismantling of nuclear facilities

    International Nuclear Information System (INIS)

    Tallec, M.; Kus, J.P.

    2009-01-01

    Nuclear facilities have a long estimable lifetime but necessarily limited in time. At the end of their operation period, basic nuclear installations are the object of cleansing operations and transformations that will lead to their definitive decommissioning and then to their dismantling. Because each facility is somewhere unique, cleansing and dismantling require specific techniques. The dismantlement consists in the disassembly and disposing off of big equipments, in the elimination of radioactivity in all rooms of the facility, in the demolition of buildings and eventually in the reconversion of all or part of the facility. This article describes these different steps: 1 - dismantling strategy: main de-construction guidelines, expected final state; 2 - industries and sites: cleansing and dismantling at the CEA, EDF's sites under de-construction; 3 - de-construction: main steps, definitive shutdown, preparation of dismantling, electromechanical dismantling, cleansing/decommissioning, demolition, dismantling taken into account at the design stage, management of polluted soils; 4 - waste management: dismantlement wastes, national policy of radioactive waste management, management of dismantlement wastes; 5 - mastery of risks: risk analysis, conformability of risk management with reference documents, main risks encountered at de-construction works; 6 - regulatory procedures; 7 - international overview; 8 - conclusion. (J.S.)

  19. Facilities of Environmental Distinction

    Science.gov (United States)

    Pascopella, Angela

    2011-01-01

    Three of nine school buildings that have won the latest Educational Facility Design Awards from the American Institute of Architects (AIA) Committee on Architecture for Education stand out from the crowd of other school buildings because they are sustainable and are connected to the nature that surrounds them. They are: (1) Thurston Elementary…

  20. National geothermal test facility

    Energy Technology Data Exchange (ETDEWEB)

    1976-03-01

    A brief description of the East Mesa test site is given. The test facility is supplied by brines from three of the existing production wells, each brine having distinctive physical characteristics. Some of the experimental programs involving heat exchangers and power cycles are briefly discussed. These include binary fluid cycles, two-phase expansion cycles, and combination cycles. (MOW)

  1. PFP Wastewater Sampling Facility

    International Nuclear Information System (INIS)

    Hirzel, D.R.

    1995-01-01

    This test report documents the results obtained while conducting operational testing of the sampling equipment in the 225-WC building, the PFP Wastewater Sampling Facility. The Wastewater Sampling Facility houses equipment to sample and monitor the PFP's liquid effluents before discharging the stream to the 200 Area Treated Effluent Disposal Facility (TEDF). The majority of the streams are not radioactive and discharges from the PFP Heating, Ventilation, and Air Conditioning (HVAC). The streams that might be contaminated are processed through the Low Level Waste Treatment Facility (LLWTF) before discharging to TEDF. The sampling equipment consists of two flow-proportional composite samplers, an ultrasonic flowmeter, pH and conductivity monitors, chart recorder, and associated relays and current isolators to interconnect the equipment to allow proper operation. Data signals from the monitors are received in the 234-5Z Shift Office which contains a chart recorder and alarm annunciator panel. The data signals are also duplicated and sent to the TEDF control room through the Local Control Unit (LCU). Performing the OTP has verified the operability of the PFP wastewater sampling system. This Operability Test Report documents the acceptance of the sampling system for use

  2. Toroid magnet test facility

    CERN Multimedia

    2002-01-01

    Because of its exceptional size, it was not feasible to assemble and test the Barrel Toroid - made of eight coils - as an integrated toroid on the surface, prior to its final installation underground in LHC interaction point 1. It was therefore decided to test these eight coils individually in a dedicated test facility.

  3. Mineral facilities of Europe

    Science.gov (United States)

    Almanzar, Francisco; Baker, Michael S.; Elias, Nurudeen; Guzman, Eric

    2010-01-01

    This map displays over 1,700 records of mineral facilities within the countries of Europe and western Eurasia. Each record represents one commodity and one facility type at a single geographic location. Facility types include mines, oil and gas fields, and plants, such as refineries, smelters, and mills. Common commodities of interest include aluminum, cement, coal, copper, gold, iron and steel, lead, nickel, petroleum, salt, silver, and zinc. Records include attributes, such as commodity, country, location, company name, facility type and capacity (if applicable), and latitude and longitude geographical coordinates (in both degrees-minutes-seconds and decimal degrees). The data shown on this map and in table 1 were compiled from multiple sources, including (1) the most recently available data from the U.S. Geological Survey (USGS) Minerals Yearbook (Europe and Central Eurasia volume), (2) mineral statistics and information from the USGS Minerals Information Web site (http://minerals.usgs.gov/minerals/pubs/country/europe.html), and (3) data collected by the USGS minerals information country specialists from sources, such as statistical publications of individual countries, annual reports and press releases of operating companies, and trade journals. Data reflect the most recently published table of industry structure for each country at the time of this publication. Additional information is available from the country specialists listed in table 2.

  4. CERN IRRADIATION FACILITIES.

    Science.gov (United States)

    Pozzi, Fabio; Garcia Alia, Ruben; Brugger, Markus; Carbonez, Pierre; Danzeca, Salvatore; Gkotse, Blerina; Richard Jaekel, Martin; Ravotti, Federico; Silari, Marco; Tali, Maris

    2017-09-28

    CERN provides unique irradiation facilities for applications in dosimetry, metrology, intercomparison of radiation protection devices, benchmark of Monte Carlo codes and radiation damage studies to electronics. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Life after facilities management.

    Science.gov (United States)

    Singer, C J

    1990-06-01

    Healthcare organizations stand to benefit greatly from facilities management. Nevertheless, there is a glaring lack of interest among organizations to consider this option. Healthcare consultant Charles Singer explores the potential advantages of bringing in a second party to handle part or all of a group's data processing operations.

  6. Science and Technology Facilities

    Science.gov (United States)

    Moonen, Jean-Marie; Buono, Nicolas; Handfield, Suzanne

    2004-01-01

    These four articles relate to science and technology infrastructure for secondary and tertiary institutions. The first article presents a view on approaches to teaching science in school and illustrates ideal science facilities for secondary education. The second piece reports on work underway to improve the Science Complex at the "Universite…

  7. Improved Emission Spectrographic Facility

    International Nuclear Information System (INIS)

    Goergen, C.R.; Lethco, A.J.; Hosken, G.B.; Geckeler, D.R.

    1980-10-01

    The Savannah River Plant's original Emission Spectrographic Laboratory for radioactive samples had been in operation for 25 years. Due to the deteriorated condition and the fire hazard posed by the wooden glove box trains, a project to update the facility was funded. The new laboratory improved efficiency of operation and incorporated numerous safety and contamination control features

  8. Test facilities for VINCI®

    Science.gov (United States)

    Greuel, Dirk; Schäfer, Klaus; Schlechtriem, Stefan

    2013-09-01

    With the replacement of the current upper-stage ESC-A of the Ariane 5 launcher by an enhanced cryogenic upper-stage, ESA's Ariane 5 Midterm Evolution (A5-ME) program aims to raise the launcher's payload capacity in geostationary transfer orbit from 10 to 12 tons, an increase of 20 %. Increasing the in-orbit delivery capability of the A5-ME launcher requires a versatile, high-performance, evolved cryogenic upper-stage engine suitable for delivering multiple payloads to all kinds of orbits, ranging from low earth orbit to geostationary transfer orbit with increased perigee. In order to meet these requirements the re-ignitable liquid oxygen/liquid hydrogen expander cycle engine VINCI® currently under development is designated to power the future upper stage, featuring a design performance of 180 kN of thrust and 464 s of specific impulse. Since 2010 development tests for the VINCI® engine have been conducted at the test benches P3.2 and P4.1 at DLR test site in Lampoldshausen under the ESA A5-ME program. For the VINCI® combustion chamber development the P3.2 test facility is used, which is the only European thrust chamber test facility. Originally erected for the development of the thrust chamber of the Vulcain engine, in 2003 the test facility was modified that today it is able to simulate vacuum conditions for the ignition and startup of the VINCI® combustion chamber. To maintain the test operations under vacuum conditions over an entire mission life of the VINCI® engine, including re-ignition following long and short coasting phases, between 2000 and 2005 the test facility P4.1 was completely rebuilt into a new high-altitude simulation facility. During the past two P4.1 test campaigns in 2010 and 2011 a series of important milestones were reached in the development of the VINCI® engine. In preparation for future activities within the frame of ESA's A5-ME program DLR has already started the engineering of a stage test facility for the prospective upper stage

  9. A saúde pública em tempos de burocratização: o caso do médico Noel Nutels Public health in times of bureaucratization: the case of the physician Noel Nutels

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Assunção Paiva

    2003-12-01

    Full Text Available Este artigo discute a trajetória do médico sanitarista Noel Nutels como um estudo de caso. Meu argumento central é que a história da saúde pública, a partir dos anos 1930, sobretudo durante o longo período getulista, é marcada por um processo de burocratização, cujo principal resultado é uma crescente dificuldade na implementação das políticas públicas durante o período. Esta dificuldade indica um gradual conflito nas relações entre aqueles diretamente responsáveis pela elaboração e implementação das políticas públicas e a crescente burocracia estatal. O período histórico que se constitui a partir de 1930 assinala uma ampla divergência entre os padrões de comportamento dos 'homens de ciência' e dos 'homens de estado'. Se o período anterior à revolução tem como marca uma certa sintonia entre esses dois segmentos sociais, a burocratização altera rápida e gradualmente o antigo equilíbrio, conquistado ainda no final do século XIX, e promove um deslocamento do papel de destaque que até então desfrutavam os agentes e autoridades da saúde pública no interior dos aparelhos do Estado.This case study of the trajectory of sanitarian Noel Nutels argues that starting in the 1930s and particularly during the long Vargas period, the history of Brazilian public health became characterized by a process of bureaucratization. Although the chief consequence was an increase in problems in implementing public policies, these difficulties do not appear to have prompted any immediate ideological demobilization within the sanitation movement, as occurred under the Old Republic, having instead engendered conflicts between those directly responsible for designing and implementing public policies, on the one hand, and the growing State bureaucracy, on the other. The historical period initiated in 1930 thus marked a broad divergence between the conduct of 'men of science' and 'men of State'. If the period preceding the revolution

  10. Research in artificial intelligence for nuclear facilities

    International Nuclear Information System (INIS)

    Uhrig, R.E.

    1990-01-01

    The application of artificial intelligence, in the form of expert systems and neural networks, to the control room activities in a nuclear power plant has the potential to reduce operator error and increase plant safety, reliability, and efficiency. Furthermore, artificial intelligence can increase efficiency and effectiveness in a large number of nonoperating activities (testing, routine maintenance, outage planning, equipment diagnostics, and fuel management) and in research facility experiments. Recent work at the University of Tennessee has demonstrated the feasibility of using neural networks to identify six different transients introduced into the simulation of a steam generator of a nuclear power plant. This work is now being extended to utilize data from a nuclear power plant training simulator. In one configuration, the inputs to the neural network are a subset of the quantities that are typical of those available from the safety parameter display system. The outputs of the network represent the various states of the plant (e.g., normal operation, coolant leakage, inadequate core flow, excessive peak fuel temperature, etc.). Training of the neural network is performed by introducing various faults or conditions to be diagnosed into the simulator. The goal of this work is to demonstrate a neural network diagnostic system that could provide advice to the operators in accordance with the emergency operating procedures

  11. Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia.

    Science.gov (United States)

    Abebe, Zeweter; Haki, Gulelat Desse; Baye, Kaleab

    2018-01-01

    Home fortification of complementary foods (CFs) with multiple micronutrient powders (MNPs) is being scaled up in various countries, but little is known about the prevailing complementary feeding practices and the type and nutrient gaps to be filled with MNPs. The present study evaluated the complementary feeding practices of young children and simulated the risk of inadequate and excessive intakes associated with home fortification with MNPs. We have assessed the sociodemographic status, anthropometry, and complementary feeding practices of young children (N = 122) in Mecha district, rural Ethiopia. Using a 2-day, quantitative 24-hr recall, usual intakes of energy, protein, iron, zinc, and calcium were estimated. The risks of inadequate and excessive iron and zinc intakes with or without home fortification scenarios were assessed. The simulations considered intakes from CFs assuming average breast milk contributions and additional nutrients provided by the MNPs. Stunting was highly prevalent (50%) and was associated with a lower dietary diversity (P = .009) and nutrient intakes from the CFs. Median energy, zinc, and calcium intakes were below the estimated needs from CFs; protein needs were met. Median dietary iron intake appeared adequate, but 76%, 95% CI [68%, 84%], of children had inadequate intake (assuming low bioavailability), whereas another 8%, 95% CI: [3%, 13%], had excessive intakes. Simulation of daily and alternative day's fortification with MNP decreased the prevalence of inadequate iron and zinc intake but significantly increased the risk of excessive intakes that remained unacceptably high for iron (>2.5%). Untargeted MNP interventions may lead to excessive intakes, even in settings where poor complementary feeding practices are prevalent. © 2017 John Wiley & Sons Ltd.

  12. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: A multi-center study.

    Science.gov (United States)

    Stanford, Fatima Cody; Alfaris, Nasreen; Gomez, Gricelda; Ricks, Elizabeth T; Shukla, Alpana P; Corey, Kathleen E; Pratt, Janey S; Pomp, Alfons; Rubino, Francesco; Aronne, Louis J

    2017-03-01

    Patients who undergo bariatric surgery often have inadequate weight loss or weight regain. We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Two academic medical centers. We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014. From this cohort, we identified patients who were placed on weight loss pharmacotherapy postoperatively for inadequate weight loss or weight regain. We extracted key demographic data, medical history, and examined weight loss in response to surgery and after the initiation of weight loss pharmacotherapy. A total of 319 patients (RYGB = 258; sleeve gastrectomy = 61) met inclusion criteria for analysis. More than half (54%; n = 172) of all study patients lost≥5% (7.2 to 195.2 lbs) of their total weight with medications after surgery. There were several high responders with 30.3% of patients (n = 96) and 15% (n = 49) losing≥10% (16.7 to 195.2 lbs) and≥15% (25 to 195.2 lbs) of their total weight, respectively, Topiramate was the only medication that demonstrated a statistically significant response for weight loss with patients being twice as likely to lose at least 10% of their weight when placed on this medication (odds ratio = 1.9; P = .018). Regardless of the postoperative body mass index, patients who underwent RYGB were significantly more likely to lose≥5% of their total weight with the aid of weight loss medications. Weight loss pharmacotherapy serves as a useful adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  13. Establishing and maintaining a facility representative program at DOE facilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The purpose of this standard is to help ensure that DOE Facility Representatives are selected based on consistently high standards and from the best qualified candidates, that they receive the necessary training, and that their duties are well understood and documented. The standard defines the duties, responsibilities, and qualifications for Facility Representatives, based on facility hazard classification; risks to workers, the public, and the environment; and the operational activity level. Guidance provided includes: (1) an approach for determining the required facility coverage; (2) the duties, responsibilities, and authorities of a Facility Representative; (3) training and qualifications expected of a Facility Representative; and (4) elements necessary for successful Facility Representative Programs at DOE Field Offices. This guidance was written primarily to address nuclear facilities. 12 refs., 2 tabs.

  14. EPA Facility Registry Service (FRS): AIRS_AFS Sub Facilities

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Air Facility System (AFS) contains compliance and permit data for stationary sources regulated by EPA, state and local air pollution agencies. The sub facility...

  15. EPA Facility Registry Service (FRS): Facility Interests Dataset

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in...

  16. EPA Facility Registry Service (FRS): Facility Interests Dataset Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are...

  17. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in...

  18. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are...

  19. Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

    Science.gov (United States)

    Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

    2017-03-01

    This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the

  20. Separations canyon decontamination facilities

    International Nuclear Information System (INIS)

    Hershey, J.H.

    1975-01-01

    Highly radioactive process equipment is decontaminated at the Savannah River Plant in specially equipped areas of the separations canyon building so that direct mechanical repairs or alterations can be made. Using these facilities it is possible to decontaminate and repair equipment such as 10- x 11-ft storage tanks, 8- x 8-ft batch evaporator pots and columns, 40-in. Bird centrifuges, canyon pumps and agitators, and various canyon piping systems or ''jumpers.'' For example, centrifuge or evaporator pots can be decontaminated and rebuilt for about 60 percent of the 1974 replacement cost. The combined facilities can decontaminate and repair 6 to 10 pieces of major equipment per year. Decontamination time varies with type of equipment and radioactivity levels encountered