WorldWideScience

Sample records for inadequate spillway capacity

  1. When air really matters: Flow depth relationships for stepped spillways

    Science.gov (United States)

    With changing demographics in the vicinity of aging embankment dams, hazard creep, a change in classification from low to significant or high, can become problematic and limit rehabilitation options. The most common deficiency for embankment dams due to hazard creep is inadequate spillway capacity....

  2. Discussion of "Aeration, flow instabilities, and residual energy on pooled stepped spillways of embankment dams" by Stephen Felder and Hubert Chanson

    Science.gov (United States)

    Stepped spillways applied to embankment dams provide overtopping protection and address a common deficiency in aging dams by providing increased spillway capacity. Pooled-stepped spillways offer a design alternative to the traditional flat-stepped spillways. Researchers from the University of Quee...

  3. Hydraulic Research for Spillway Dam of Jambor Weir at Polotsk Hydroelectric Station

    Directory of Open Access Journals (Sweden)

    G. G. Kruglov

    2012-01-01

    Full Text Available The paper describes hydraulic tests of discharge capacity and pools conjunction in respect of dam spillway of Jambor weir at the Polotsk hydroelectric station. The process of ice passage through the spillway dam has been studied in the paper. The paper contains recommendations on safety depth downstream.

  4. Hydraulic Design of Stepped Spillways Workshop

    Science.gov (United States)

    Stepped chutes and spillways are commonly used for routing discharges during flood events. In addition, stepped chutes are used for overtopping protection of earthen embankments. Stepped spillways provide significant energy dissipation due to its stepped feature; as a result, the stilling basin as...

  5. Effects of tailwater depth on spillway aeration

    African Journals Online (AJOL)

    2011-04-15

    Apr 15, 2011 ... Hydraulic structures such as spillways or weirs with their water-air controlling mechanisms are not only important for their structural properties but also for their effects on downstream ecology. Tailwater depth is an important factor affecting dissolved oxygen transfer and aeration rates of spillways. In this ...

  6. Spillway design implications resulting from changes in rainfall extremes

    International Nuclear Information System (INIS)

    Muzik, I.

    1999-01-01

    A study was conducted in order to determine how serious implications regarding spillway design of small dams would result from changes in flood frequencies and magnitudes, because of changes in rainfall regime in turn brought on by climate change due to carbon dioxide accumulation in the atmosphere. The region selected for study was the central Alberta foothills and adjacent prairie environment. A study watershed, representative of the region, was chosen to assess the present and possible future flood frequency-magnitude relationships. A Monte Carlo simulation method was used in conjunction with rainfall-runoff modelling of the study watershed to generate data for flood frequency analysis of maximum annual flood series corresponding to the present and future climate scenarios. The impact of resulting differences in design floods for small dams on spillway design was investigated using the Prairie Farm Rehabilitation Administration small dam design method. Changes in the mean and standard deviation of rainfall depth of design storms in a region will result in new probability distributions of the maximum annual flood flows. A 25% increase in the mean and standard deviation of design rainfall depth resulted in greater increases of 1:2 and 1:100 flood flows than a 50% increase in the standard deviation alone did. Under scenario 1, the 1:2 flood flows increased more than did the 1:100 flows. Scenario 2 produced opposite results, whereby the 1:100 flows increased more than did the 1:2 flows. It seems that a climate change of the type of scenario 1 would result in a more severe increase in flood flows than scenario 2 would. Retrofitting existing spillways of small dams would in most cases require increasing flow capacities of both operating and auxilliary spillways. 23 refs

  7. Repair, Evaluation, Maintenance, and Rehabilitation Research Program. Geotechnical Aspects of Rock Erosion in Emergency Spillway Channels. Report 4. Geologic and Hydrodynamic Controls on the Mechanics of Knickpoint Migration

    Science.gov (United States)

    1989-12-01

    conducted on the Los Esteros Spillway in Guadalupe County, New Mex-co, to investigate the feasibility of increasing the capacity of the spillway from...sedimentary rock sequences including those interbedded with volcanic and volcano-clastic rocks. These discontinuities include bedding planes, bed contacts

  8. Ice Harbor Spillway Dissolved Gas Field Studies: Before and After Spillway Deflectors

    Science.gov (United States)

    2016-07-01

    environmental challenges. ERDC develops innovative solutions in civil and military engineering, geospatial sciences, water resources, and environmental...Dissolved oxygen Hydraulic structures Spillways Stilling basins Water--Air entrainment Tailwater ecology Ice Harbor Dam

  9. Modelling Flow over Stepped Spillway with Varying Chute Geometry ...

    African Journals Online (AJOL)

    This study has modeled some characteristics of the flows over stepped spillway with varying chute geometry through a laboratory investigation. Using six physically built stepped spillway models, with each having six horizontal plain steps at 4cm constant height, 30 cm width and respective chute slope angles at 310, 320, ...

  10. Hydrodynamic modelling of flow over a spillway using a two ...

    Indian Academy of Sciences (India)

    Abstract. Spillway flow, a classical problem of hydraulics, is generally a gravity- driven free surface flow. Spillway flows are essentially rapidly varying flows near the crest with pronounced curvature of the streamlines in the vertical direction. Two processes simultaneously occur in the flow over the crest, that is, formation and.

  11. Hydrodynamic modelling of flow over a spillway using a two ...

    Indian Academy of Sciences (India)

    economic analysis and safety of the dam. Normally, a narrow spillway with .... Navier–Stokes equations. The comprehensive study of the flow over spillway requires a 3-dimensional model based on the .... Remaining boundary conditions such as open boundaries at the upstream and downstream end, free surface and solid ...

  12. modelling flow over stepped spillway with varying chute geometry

    African Journals Online (AJOL)

    2012-07-02

    Jul 2, 2012 ... A basic dimensional analysis of the flow over the chute of the stepped spillway, assuming that the dom- inant feature is the momentum exchange between the free stream and the cavity flow within the steps of the spillway [2,3,4], is as presented in equation (1): f1(Ho,Hn,Um,hw,Li,Ls,Ks, tg(θ),µw,ρw,g)=0. (1).

  13. Computational Fluid Dynamics Modeling of Flow over Stepped Spillway

    Directory of Open Access Journals (Sweden)

    Raad Hoobi Irzooki

    2017-12-01

    Full Text Available In present paper, the computational fluid dynamics (CFD - program Flow-3D was used toanalyze and study the characteristics of flow energy dissipation over stepped spillways. Threedifferent spillway heights ( (15, 20 and 25cm were used. For each one of these models, threenumbers of steps (N (5, 10 and 25 and three spillway slopes (S (0.5, 1 and 1.25 were used.Eight different discharges ranging (600-8500cm³/s were passed over each one of these models,therefore the total runs of this study are 216. The energy dissipation over these models and thepressure distribution on the horizontal and vertical step faces over some models were studied. Forverification purpose of the (CFD program, the experimental work was conducted on four models ofstepped spillway and five different discharges were passed over each model. The magnitude ofdissipated energy on models was compared with results of numerical program under sameconditions. The comparison showed good agreement between them with standard percentage errorranging between (-2.01 - 11.13%. Thus, the program Flow-3D is a reasonable numerical programwhich can be used in this study.Results showed that the energy dissipation increases with increased spillway height anddecreased number of steps and spillway slope. Also, the energy dissipation decreases withincreasing the flow rate. An empirical equation for measuring the energy dissipation was derivedusing the dimensional analysis. The coefficient of determination of this equation ( equals 0.766.

  14. Safety of gravity dams and spillways against floods

    International Nuclear Information System (INIS)

    Lariviere, R.; Leger, P.; Tinawi, R.; Roussel, M.

    1997-01-01

    The structural safety of concrete gravity dams and spillways during major floods was discussed, concentrating on failure mechanisms, the methodology for hydrological safety evaluation for existing dams, the notion of imminent failure flood, the resistance to overtopping and the effects of floating debris. In particular, the incidence of overtopping on structural stability of typical gravity dams was investigated using a variety of assumptions concerning the peak and residual shear strength parameters of construction joints according to CDSA guidelines. Some considerations regarding rehabilitation techniques to increase the hydrological safety of gravity dams and spillways, such as functional safety analysis of electro-mechanical equipment of gated spillways in case of major floods, emergency planning, and the availability of qualified personnel to ensure the safety of the installation, were also discussed. 19 refs., 8 figs

  15. 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.

  16. INCREASING JET LENGTH AT LOW DISCHARGE FOR THE SKI-JUMP SPILLWAY OF KEBAN DAM

    OpenAIRE

    MERDİN, Selami; ERTAŞ, Basri

    2010-01-01

    ABSTRACT The most important disadvantage of the ski-jump spillways is the scouring at the downstream of the spillway where the flow hits the ground. For this reason, it is important that the flow is thrown from the end of the spillway to a safe distance. In this study, a spillway model was designed to provide a safe distance at low discharges. In order to examine the efficiency of the new model, firstly, a basic ski-jump spillway model with 220  toe angle was constructed. On this mod...

  17. Synthesis of Sensor Fish Data for Assessment of Fish Passage Conditions at Turbines, Spillways, and Bypass Facilities – Phase 1: The Dalles Dam Spillway Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Zhiqun; Serkowski, John A.; Fu, Tao; Carlson, Thomas J.; Richmond, Marshall C.

    2007-12-31

    This report summarizes the characterization of spillway passage conditions at The Dalles Dam in 2006 and the effort to complete a comprehensive database for data sets from The Dalles Dam spillway Sensor Fish and balloon-tagged live fish experiments. Through The Dalles Dam spillway case study, Pacific Northwest National Laboratory (PNNL) researchers evaluated the database as an efficient means for accessing and retrieving system-wide data for the U.S Army Corps of Engineers (USACE).

  18. Extreme flood abatement in large dams with gate-controlled spillways

    Science.gov (United States)

    Sordo-Ward, Alvaro; Garrote, Luis; Bejarano, M. Dolores; Castillo, Luis G.

    2013-08-01

    In this study the flood abatement effect at dams with gated spillways under a wide range of extreme floods is analysed (100 < return period <10,000 years). A group of integrated models (rainfall generator, hydrological model and dam operation model) interacting within a Monte Carlo simulation framework is used for producing numerous hydrologic events at 21 sites across mainland Spain, and the hydrologic response applied to 81 configurations of dams and reservoirs. Common behavioural patterns are identified and dimensionless coefficients classified, based on the hydrologic variables and the dam and reservoir characteristics. The relationships between these coefficients are analysed, with a significant degree of correlation both among the cases and the varying magnitude of floods being obtained. Finally, models that enable evaluation of the abatement capacity of a dam with a gated spillway in the event of a flood with Tr between 500 and 10,000 years are offered. In addition, they allow the frequency curve of such a maximum flow to be obtained, something which could serve of use not only during the design phase but also in the evaluation of the hydrologic safety of dams.

  19. Internal erosion under spillway rested on an embankment dam

    Directory of Open Access Journals (Sweden)

    Mohammad Sedghi-Asl

    2015-12-01

    Full Text Available In this paper we investigate the mechanism of internal erosion caused in the right abutment of the Shahghasem dam’s spillway. Shahghasem dam is an earthen dam located in Yasouj, in southwest of Iran. A significant hole and pipe have been observed in the corner of the right abutment from upstream view. The foundation is Marlstone, which has low cohesion and susceptible for internal erosion and piping in some conditions. Going through details of the design maps has shown that Lane’s criteria for selecting safe dimensions of the seepage control measures have not been considered properly. A series of the supportive walls are designed to attach to the right part of the spillway in order to increase the length of seepage. The pipe route of the erosion should also be grouted with high quality concrete.

  20. Free flow spillways on loam dams; Deversoirs a ecoulement libre sur des digues en terre

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    The free flow spillways technique was developed abroad and has been used and developed in France by two research offices and foremen. Dams of this type can have heights of 8 to 20 m and both dams and spillways must fit with special technical characteristics which are described (drainage, joints, reinforcements, wall surface, embankment etc..). The experience of French foremen with this type of dams and spillways is reported. (J.S.)

  1. Kinetic Energy Dissipation on Labyrinth Configuration Stepped Spillway

    Directory of Open Access Journals (Sweden)

    Jaafar S. Maatooq

    2017-12-01

    Full Text Available In present work a labyrinth (zigzag, in shape has been used to configure the steps of stepped spillway by using the physical model. This configuration does not introduce previously by investigators or in construction techniques of dams or cascades. It would be expected to improve the flow over chute. A magnifying the width path of each step to become, LT, instead of, W, will induce the interlocking between the mainstream and that spread laterally due to labyrinth path. This phenomenon leads to reduce the jet velocities near the surfaces, thus minimizing the ability of cavitation and with increasing a circulation regions the ability of air entrainment be maximized. The results were encouraging, (e.g., the reverse performance has recorded for spillway slope. From the evaluation of outcome, the average recorded of percentage profits of kinetic energy dissipation with a labyrinth shape compared with the results of traditional shape were ranged between (13- 44%. Different predictive formulas have been proposed based on iteration analysis, can be recommended for evaluation and design.

  2. Agri-spillways as soil erosion protection tools in conventional sloping vineyards (Montes de Málaga, Spain)

    Science.gov (United States)

    Rodrigo-Comino, Jesús

    2017-04-01

    Rainfall causes soil erosion on Mediterranean sloping vineyards (>25˚ of slope inclination), however, little is known about information related to cheap, effective and suitable soil erosion protection measures. In the vineyards of the Montes de Málaga (southern Spain), a concrete land management practice against soil erosion is actually conducted by building tilled rills to down-slope direction to canalize water and sediments. We decided to call them agri-spillways. In this study, by carrying out runoff experiments, we assessed two agri-spillways (from 10 m to 15 m length) under extreme conditions. A motor driven pump mobilizes a constant water inflow about of 1.33 L s-1during between 12 and 15 minutes (≈1000 litres). Finally, we observed: i) a high capacity of these agri-spillways to canalize a large volume of water and sediments; and, ii) higher speed of water flow (from 0.16 m s-1to 0.28 m s-1) and sediment concentration (SC) rates with ratios up to 1538.6 g l-1). By comparing among them, the speed of water flow and the SC were much higher in one of tested rills, which was 5 meters length less and 7 degrees more of inclination. So, we concluded that these agri-spillways, after correctly planning and long term maintenance from contribution area to down-slope direction, can be function as a potential tool for designing suitable and cheap plans to protect the soil in Mediterranean sloping vineyards. Acknowledgements Firstly, we acknowledge the farmer's syndicate UPA (Unión de Pequeños Agricultores) and the wine-grower Pepe Gámez (Almáchar) for providing access to the study area. Secondly, we thank the students of the Bachelor course and Master from Trier University for their hard efforts in the field and laboratory works in the Almáchar campaign. Thirdly, we acknowledge the geomorphology and soil laboratory technicians María Pedraza and Rubén Rojas of GSoilLab (Málaga University) for the soil analysis. Finally, we also thank the Ministerio de Educaci

  3. Seismic Analysis of the 2017 Oroville Dam Spillway Erosion Crisis

    Science.gov (United States)

    Goodling, P.; Lekic, V.; Prestegaard, K. L.

    2017-12-01

    The outflow channel of the northern California (USA) Oroville Dam suffered catastrophic erosion damage in February and March, 2017. High discharges released through the spillway (up to 3,000 m3/s) caused rapid spillway erosion, forming a deep chasm. A repeat LiDAR survey obtained from the California Department of Water Resources indicates that the chasm eroded to a depth of 48 meters. A three-component broadband seismometer (STS-1) operated by the Berkeley Digital Seismological Network recorded microseismic energy produced by the flowing water, providing a natural laboratory to test methods for seismically monitoring sudden catastrophic floods and erosion. In this study, we evaluate the three-component waveforms recorded during five constant-discharge periods - before, during, and after the spillway crisis - each of which had a different channel geometry. We apply frequency-dependent polarization analysis (FDPA; following Park, 1987), which characterizes particle motion at each frequency. The method is based on principal component analysis on a spectral covariance matrix in one-hour windows and it produces the horizontal azimuth, vertical tilt, horizontal phase, and vertical phase of the dominant particle motion. The results indicate a greater vertical component (perhaps roughness-induced) of power at a broad range of frequencies at a given discharge after the formation of the chasm. As the outflow crater developed, the back-azimuth of the primary source of seismic energy changed from the nearby Thermalito Diversion Pool (188 degrees) to the center of the outflow channel (170 degrees). To further analyze FDPA results, we apply the 2D spectral-element solver package SPECFEM2D (Tromp et al. 2008), and find that local topography should be considered when interpreting the surface waveforms predicted by FDPA results. This research suggests that monitoring changing channel geometry and erosion in large-scale flood events may be enhanced by seismic FDPA analysis. The

  4. Stability Analysis of a Run-of-River Diversion Hydropower Plant with Surge Tank and Spillway in the Head Pond

    Science.gov (United States)

    Sarasúa, José Ignacio; Elías, Paz; Wilhelmi, José Román; Sánchez, José Ángel

    2014-01-01

    Run-of-river hydropower plants usually lack significant storage capacity; therefore, the more adequate control strategy would consist of keeping a constant water level at the intake pond in order to harness the maximum amount of energy from the river flow or to reduce the surface flooded in the head pond. In this paper, a standard PI control system of a run-of-river diversion hydropower plant with surge tank and a spillway in the head pond that evacuates part of the river flow plant is studied. A stability analysis based on the Routh-Hurwitz criterion is carried out and a practical criterion for tuning the gains of the PI controller is proposed. Conclusions about the head pond and surge tank areas are drawn from the stability analysis. Finally, this criterion is applied to a real hydropower plant in design state; the importance of considering the spillway dimensions and turbine characteristic curves for adequate tuning of the controller gains is highlighted. PMID:25405237

  5. Stability Analysis of a Run-of-River Diversion Hydropower Plant with Surge Tank and Spillway in the Head Pond

    Directory of Open Access Journals (Sweden)

    José Ignacio Sarasúa

    2014-01-01

    Full Text Available Run-of-river hydropower plants usually lack significant storage capacity; therefore, the more adequate control strategy would consist of keeping a constant water level at the intake pond in order to harness the maximum amount of energy from the river flow or to reduce the surface flooded in the head pond. In this paper, a standard PI control system of a run-of-river diversion hydropower plant with surge tank and a spillway in the head pond that evacuates part of the river flow plant is studied. A stability analysis based on the Routh-Hurwitz criterion is carried out and a practical criterion for tuning the gains of the PI controller is proposed. Conclusions about the head pond and surge tank areas are drawn from the stability analysis. Finally, this criterion is applied to a real hydropower plant in design state; the importance of considering the spillway dimensions and turbine characteristic curves for adequate tuning of the controller gains is highlighted.

  6. Design of Deflectors for Little Goose Spillway, Snake River, Oregon: A Physical Model Study

    Science.gov (United States)

    2017-06-01

    ER D C/ CH L TR -1 7- 10 Dissolved Gas Abatement Studies Design of Deflectors for Little Goose Spillway, Snake River, Oregon A...Studies ERDC/CHL TR-17-10 June 2017 Design of Deflectors for Little Goose Spillway, Snake River, Oregon A Physical Model Study Steven C. Wilhelms... Snake Rivers causes the absorption of atmospheric gases (chiefly nitrogen and oxygen) to supersaturated levels that often exceed the acceptable

  7. New approach for evaluating risk and ranking spillways based on operational safety

    Energy Technology Data Exchange (ETDEWEB)

    Briand, M.H.; Huard, M.O.; Hanno, H. [RSW Inc., Montreal, PQ (Canada); Manescu, D.; Morin, J.P. [Hydro-Quebec, Montreal, PQ (Canada). Dept. of Dam Safety

    2009-07-01

    This paper discussed a method developed by Hydro-Quebec to rank dam spillways according to their ability to react safely to mechanical or electrical component failures, uncertainties in hydrological conditions; unexpected human responses; and spillway component degradation. A computer simulation was used to model assess the impact of the various scenarios of reservoir levels. Four case studies were used to investigate a wide variety of spillway characteristics and hydrological conditions. Results from power plant tripping events using functional equipment were used as an index of the spillway's safety. Results from the sensitivity analyses of equipment failures and modified hydrology simulations were then used to build a vulnerability index for the development of inspection and maintenance priorities. Spillway conditions during flood routing conditions from inspection reports were then used to prepare a functionality index. A sensitivity matrix was then developed to produce a global ranking index for each spillway in the study. The method is now being applied to existing hydro-electric developments as a validation procedure. 3 refs., 11 tabs., 2 figs.

  8. Multi-objective reservoir operation during flood season considering spillway optimization

    Science.gov (United States)

    Liu, Xinyuan; Chen, Lu; Zhu, Yonghui; Singh, Vijay P.; Qu, Geng; Guo, Xiaohu

    2017-09-01

    Flood control and hydropower generation are two main functions of Three Gorges Reservoir (TGR) in China. In this study, a multi-objective operation model for TGR considering these two functions was developed. Since the optimal results of reservoir operation are mostly in the form of gross outflow which is hardly used to directly guide reservoir operation, the optimization of spillways operation was taken into account. For observed historical flood hydrographs and design flood hydrographs, the progressive optimality algorithm (POA) was employed to determine the optimal operation of spillways. For the real-time reservoir operation, a smooth support vector machine (SSVM) model was applied to abstract the optimal operation rules which consider the order and the number of spillways put into use. Results demonstrate that the use of different spillways has a significant impact on reservoir operation. Therefore, it is necessary to consider the order and number of spillways that should be used. Instead of optimizing outflow, direct optimization of the order and number of spillways can yield most reasonable results. The SSVM model simulates the relationship among inflow, water level and outflow satisfactorily and can be used for real-time or short term reservoir operation. Application of the SSVM model can also reduce flood risk and increase hydropower generation during the flood season.

  9. 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.

  10. 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.)

  11. Comparison of Different Turbulence Models for Numerical Simulation of Pressure Distribution in V-Shaped Stepped Spillway

    Directory of Open Access Journals (Sweden)

    Zhaoliang Bai

    2017-01-01

    Full Text Available V-shaped stepped spillway is a new shaped stepped spillway, and the pressure distribution is quite different from that of the traditional stepped spillway. In this paper, five turbulence models were used to simulate the pressure distribution in the skimming flow regimes. Through comparing with the physical value, the realizable k-ε model had better precision in simulating the pressure distribution. Then, the flow pattern of V-shaped and traditional stepped spillways was given to illustrate the unique pressure distribution using realizable k-ε turbulence model.

  12. Effects of salinity variations on CODAR ranges during the 2016 Bonnet Carré Spillway Opening

    Science.gov (United States)

    Howden, S. D.; Diercks, A. R.; Hode, L. E.; Cambazoglu, M. K.; Martin, K. M.

    2017-12-01

    On January 10, 2016 the Bonnet Carré Spillway was opened to relieve flooding on the Mississippi River, diverting river water into Lake Pontchartrain and then through the western Mississippi Sound. As part of the response to understand the effects of the spillway opening on the Mississippi Sound, a pair of 25 MHz CODAR SeaSondes were deployed on the coast of the western Mississippi Sound to monitor surface currents. This presented the additional opportunity to run a natural experiment on the effect of salinity on the range of CODAR signals. During the spillway event, salinities in the CODAR coverage area, as measured by monitoring stations operated by a partnership between the Mississippi Department of Marine Resources and the United States Geological Survey in the Sound ranged from over 30 to less than 2. Ranges from the CODAR stations were significantly correlated with these salinities. Additionally, the Naval Coastal Ocean Model output, run with real-time river input plus the Bonnet Carré Spillway freshwater input, was available for the analyzes for the spillway event time frame. The observations and modeling were used to investigate the role of salinity on SeaSonde range and how well those variations agree with theory.

  13. Design of Spillway Structures of Peatland Rewetting systems

    Directory of Open Access Journals (Sweden)

    Sainov Mihail Petrovich

    2014-03-01

    Full Text Available In summer 2010 drought and heat weather cause numerous peat fires. During two months Moscow was shrouded in acid smoke. To prevent such situations government of Moscow region decided to rewet previously drained peatlands. Peatland rewetting systems can be divided into two types. The first type is watering system based on previously used drainage system. The main idea of this method is rising of groundwater levels with the help of special water retaining constructions installed in drainage canals. The design of water receivers allows keeping up water level in canals and draining excesses. There are two types of water receivers: dock-type water receiver and water receiver as a portal to the gate. The choice of one or another type of water receiver depends on the canal depth. If it is less than 1.5 m, we apply portal construction. At the depth of more than 1.5 m the mine water receiver is more suitable. The second way of watering previously drained peatlands is the creation of ponds, dams on streams and small rivers. Special discharge structures increase water level in the river upstream. In downstream water level rises due to the redistribution of the flow. As a result, the groundwater level rises and peat become watered. There are two types of spillway structures: with direct overflow wall and labyrinth overflow wall. Structure with direct overflow wall is applicable on small rivers. In narrow alignments with high consumptions it is better to use another type of weir. As output it is necessary to notice that all constructions used in peatlands watering were designed as simple and reliable as possible. It is so because unpredictable weather conditions can cause beyond the design flows so weirs must have necessary reserve of passing costs.

  14. Evaluation of Boundary Dam spillway using an Autonomous Sensor Fish Device

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Z. D.; Duncan, J. P.; Arnold, J. L.; Fu, T.; Martinez, J.; Lu, J.; Titzler, P. S.; Zhou, D.; Mueller, R. P.

    2017-03-01

    Fish passage conditions over spillways are important for the operations of hydroelectric dams because spillways are usually considered as a common alternative passage route to divert fish from the turbines. The objectives of this study were to determine the relative potential of fish injury during spillway passage both before and after the installation of baffle blocks at Boundary Dam, and to provide validation data for a model being used to predict total dissolved gas levels. Sensor Fish were deployed through a release system mounted on the face of the dam in the forebay. Three treatments, based on the lateral position on the spillway, were evaluated for both the baseline and post-modification evaluations: Left Middle, Right Middle, and Right. No significant acceleration events were detected in the forebay, gate, or transition regions for any release location; events were only observed on the chute and in the tailrace. Baseline acceleration events observed in the chute region were all classified as strikes, whereas post-modification events included strike and shear on the chute. While the addition of baffle blocks increased the number of significant events observed on the spillway chute, overall fewer events were observed in the tailrace post-modification. Analysis of lateral positioning of passage indicated that the Right Middle treatment was potentially less injurious to fish based on relative frequency of significant events at each location. The construction of baffle blocks on the spillway visibly changed the flow regime. Prior to installation the flow jet was relatively thin, impacting the tailrace as a coherent stream that plunged deeply, possibly contributing to total dissolved gas production. Following baffle block construction, the discharge jet was more fragmented, potentially disrupting the plunge depth and decreasing the time that bubbles would be at depth in the plunge pool. The results in this study support the expected performance of the modified

  15. [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.

  16. Deriner hydropower scheme : geotechnical issues and the particular case of the spillway tunnels design and construction

    Energy Technology Data Exchange (ETDEWEB)

    Cekerevac, C.; Wohnlich, A. [STUCKY SA, Remens (Switzerland)

    2009-07-01

    Geotechnical issues related to the construction of the Deriner dam and overflow spillways in Turkey were discussed in this paper. As the first phase in the Coruh River development plan, the dam will be one of the highest dams in the world with an annual production of 2300 GWh of electrical energy. Excavations for the dam were conducted in a highly fractured and weathered rock mass. Finite element analyses and structural discontinuity analyses were conducted to ensure the dam's future reliability. The rock mass was comprised of granodiorite intruded by diabase dykes. The upper layer of the rock was decompressed and heavily jointed. Unconfined compression tests were conducted to determine the strength of the intact rocks. Triaxial tests were conducted on rock cores in order to determine Mohr-Coulomb shear strength peak parameters. A joint survey was conducted to determine rock mechanical and joint shear strength properties. Two gated spillway tunnels were designed to evacuate floodwater, and static and dynamic in situ tests were conducted to estimate the deformability of the rock mass. The surrounding dam excavation was simulated using the finite element method. Standard rock mass classifications and rock wedge stability analyses were used to design tunnel supports. The design was successfully applied to the spillway excavation area. 10 refs., 5 tabs., 9 figs.

  17. Surface Thermal Insulation and Pipe Cooling of Spillways during Concrete Construction Period

    Directory of Open Access Journals (Sweden)

    Wang Zhenhong

    2014-01-01

    Full Text Available Given that spillways adopt a hydraulic thin concrete plate structure, this structure is difficult to protect from cracks. The mechanism of the cracks in spillways shows that temperature stress is the major reason for cracks. Therefore, an effective way of preventing cracks is a timely and reasonable temperature-control program. Studies show that one effective prevention method is surface thermal insulation combined with internal pipe cooling. The major factors influencing temperature control effects are the time of performing thermal insulation and the ways of internal pipe cooling. To solve this problem, a spillway is taken as an example and a three-dimensional finite element program and pipe cooling calculation method are adopted to conduct simulation calculation and analysis on the temperature fields and stress fields of concretes subject to different temperature-control programs. The temperature-control effects are then compared. Optimization results show that timely and reasonable surface thermal insulation and water-flowing mode can ensure good temperature-control and anticrack effects. The method has reference value for similar projects.

  18. 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.

  19. Survival Rates of Juvenile Salmonids Passing Through the Bonneville Dam and Spillway in 2008

    Energy Technology Data Exchange (ETDEWEB)

    Ploskey, Gene R.; Weiland, Mark A.; Faber, Derrek M.; Deng, Zhiqun; Johnson, Gary E.; Hughes, James S.; Zimmerman, Shon A.; Monter, Tyrell J.; Cushing, Aaron W.; Wilberding, Matthew C.; Durham, Robin E.; Townsend, R. L.; Skalski, J. R.; Buchanan, Rebecca A.; Kim, Jina; Fischer, Eric S.; Meyer, Matthew M.; McComas, Roy L.; Everett, Jason

    2009-12-28

    This report describes a 2008 acoustic telemetry survival study conducted by the Pacific Northwest National Laboratory for the Portland District of the U.S. Army Corps of Engineers. The study estimated the survival of juvenile Chinook salmon and steelhead passing Bonneville Dam (BON) and its spillway. Of particular interest was the relative survival of smolts detected passing through end spill bays 1-3 and 16-18, which had deep flow deflectors immediately downstream of spill gates, versus survival of smolts passing middle spill bays 4-15, which had shallow flow deflectors.

  20. Survival of Juvenile Chinook Salmon Passing the Bonneville Dam Spillway in 2007

    Energy Technology Data Exchange (ETDEWEB)

    Ploskey, Gene R.; Weiland, Mark A.; Hughes, James S.; Zimmerman, Shon A.; Durham, Robin E.; Fischer, Eric S.; Kim, Jina; Townsend, R. L.; Skalski, J. R.; Buchanan, Rebecca A.; McComas, Roy L.

    2008-12-01

    The U.S. Army Corps of Engineers Portland District (CENWP) funds numerous evaluations of fish passage and survival on the Columbia River. In 2007, the CENWP asked Pacific Northwest National Laboratory to conduct an acoustic telemetry study to estimate the survival of juvenile Chinook salmon passing the spillway at Bonneville Dam. This report documents the study results which are intended to be used to improve the conditions juvenile anadromous fish experience when passing through the dams that the Corps operates on the river.

  1. Characterizing the Fish Passage Environment at The Dalles Dam Spillway: 2001-2004

    Energy Technology Data Exchange (ETDEWEB)

    Richmond, Marshall C.; Carlson, Thomas J.; Serkowski, John A.; Cook, Chris B.; Duncan, Joanne P.; Perkins, William A.

    2007-10-10

    The spill environment at The Dalles Dam in 2001-2004 was characterized using a field-deployed autonomous sensor (the so-called Sensor Fish), computational fluid dynamics (CFD) modeling, and Lagrangian particle tracking. The sensor fish has a self-contained capability to digitally the record pressure and triaxial accelerations it was exposed to following its release into the spillway. After recovery downstream of the tailrace, the data stored in the memory of the sensor are downloaded and stored for analysis. The spillway, stilling basin, and tailrace hydrodynamics were simulated using an unsteady, free-surface, three-dimensional CFD code that solved the Reynolds-averaged Navier-Stokes equations in conjunction with a two-equation turbulence model. The results from the CFD simulations were then used in a Lagrangian particle tracking model that included the effects of mass, drag, and buoyancy in the particle equation of motion. A random walk method was used to simulate the effects of small-scale turbulence on the particle motion. Several operational and structural conditions were evaluated using the Sensor Fish, CFD, and particle tracking. Quantifying events such as strike and stilling basin retention time characterized exposure conditions in the spill environment.

  2. 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

  3. 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…

  4. 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.)

  5. 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 ...

  6. Repair, Evaluation, Maintenance, and Rehabilitation Research Program: Geotechnical Aspects of Rock Erosion in Emergency Spillway Channels. Report 3. Remediation

    Science.gov (United States)

    1988-09-01

    exposed, hard sandstone ledge which floors the upper portion of the unlined channel at the Saylorville (Iowa) spillway still bears the elongate scars ...this alluvium was placed 60-cm (2-ft) armour of angular cobble and boulder-size basalt riprap (US Soil Conservation Services 1932). All of the riprap

  7. Discussion of "Simple design criterion for residual energy on embankment dam stepped spillways" by Stefan Felder and Hubert Chanson

    Science.gov (United States)

    Researchers from the University of Queensland of New South Wales provided guidance to designers regarding the hydraulic performance of embankment dam stepped spillways. Their research compares a number of high-quality physical model data sets from multiple laboratories, emphasizing the variability ...

  8. 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.

  9. Application of Displacement Height and Surface Roughness Length to Determination Boundary Layer Development Length over Stepped Spillway

    Directory of Open Access Journals (Sweden)

    Xiangju Cheng

    2014-12-01

    Full Text Available One of the most uncertain parameters in stepped spillway design is the length (from the crest of boundary layer development. The normal velocity profiles responding to the steps as bed roughness are investigated in the developing non-aerated flow region. A detailed analysis of the logarithmic vertical velocity profiles on stepped spillways is conducted through experimental data to verify the computational code and numerical experiments to expand the data available. To determine development length, the hydraulic roughness and displacement thickness, along with the shear velocity, are needed. This includes determining displacement height d and surface roughness length z0 and the relationship of d and z0 to the step geometry. The results show that the hydraulic roughness height ks is the primary factor on which d and z0 depend. In different step height, step width, discharge and intake Froude number, the relations d/ks = 0.22–0.27, z0/ks = 0.06–0.1 and d/z0 = 2.2–4 result in a good estimate. Using the computational code and numerical experiments, air inception will occur over stepped spillway flow as long as the Bauer-defined boundary layer thickness is between 0.72 and 0.79.

  10. Petrographic Composition of Lignite from the Lake Somerville Spillway (East-central Texas)

    Science.gov (United States)

    Pawelec, Sandra; Bielowicz, Barbara

    2017-12-01

    In the presented paper, the macroscopic and microscopic composition of lignite from Lake Somerville Spillway has been examined. The study area is the upper part of the Manning Formation, located north-west of Somerville in the central-eastern part of Texas. There are three exposures: NE, SW and MC (Main Central) with visible parts of late-Eocene lignite seams belonging to the Jackson Group. The Manning section is divided into four marine dominated parasequences (P1 through P4). Lignite samples outlining the P1 parasequence from the MC and NE outcrops and the argillate sample from the lower part of the P2 parasequence, NE outcrop. Macroscopic characterization was carried out based on lithological classifications of humic coal. On this basis, it has been shown that the main lithotype occurring in the deposit is detritic (matrix) coal with a high share of mineral matter. The maceral composition of coal was determined according to the ICCP guidelines. The macerals from liptinite group were determined under fluorescent light. The maceral group content analysis was performed with use of 500-600 equally spaced points on the surface of the polished sections. It has been found that the examined coal is dominated by macerals from the huminite group, with a share ranging from 20.8 to 65.3% volume, including atrinite (9.8-22.8% volume, 17.5% volume on average). In the examined coal, macerals from the inertinite group (10.1 to 44.8%), especially semifusinite (max. 13.9%), fusinite (max. 9.3%) and funginite (max. 6.3 %) are of particularly large share. In the liptinite group, particular attention was paid to the content of alginite (max. 4.5%) and bituminite (max. 1.3 %), which indicate the paralic sedimentation environment of the examined coal. Additionally, the variability of macerals and maceral groups within the exposures and levels of the P1 parasequence was examined. The last step was to compare lignite from Lake Somerville Spillway with other lignites belonging to the

  11. 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...

  12. 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.

  13. 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

  14. Remaining Sites Verification Package for the 116-F-8, 1904-F Outfall Structure and the 100-F-42, 1904-F Spillway, Waste Site Reclassification Form 2006-045

    Energy Technology Data Exchange (ETDEWEB)

    L. M. Dittmer

    2006-09-26

    The 100-F-42 waste site is the portion of the former emergency overflow spillway for the 1904-F Outfall Structure formerly existing above the ordinary high water mark of the Columbia River. The spillway consisted of a concrete flume designed to discharge effluent from the 107-F Retention Basin in the event that flows could not be completely discharged via the river outfall pipelines. The results of verification sampling show that residual contaminant concentrations do not preclude any future uses and allow for unrestricted use of shallow zone soils. The results also demonstrate that residual contaminant concentrations are protective of groundwater and the Columbia River.

  15. 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.

  16. 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.

  17. Railway capacity

    OpenAIRE

    Lavrič, Tadeja

    2012-01-01

    In the first part of the thesis, the concepts of railway capacity and capacity consumption are defined. Experts have in the past defined railway capacity in many different ways. This thesis outlines some definitions of railway capacity and capacity consumption, including the definition of railway capacity in accordance with the UIC code 406 (2004), given by the International Union of Railways in order to standardize the definition of railway capacity. Capacity and capacity consumption are dir...

  18. Effects of Y-type spillway lateral contraction ratios on debris-flowpatterns and scour features downriver of a check dam

    Directory of Open Access Journals (Sweden)

    H. Chen

    2016-11-01

    Full Text Available Debris flows often cause devastating damage to property and can injure or kill residents in mountainous areas. The construction of check dams in debris-flow valleys is considered a useful strategy for mitigating the damages downstream. In this paper, a new type of spillway structure with lateral contraction was proposed to distribute debris flows after the check dam storage filled up. Four different lateral contraction ratios of the spillway were considered in experiments that investigated debris-flow patterns, scour characteristics, and energy dissipation rates when debris flows passed through the spillway. The results indicated that lateral contraction considerably influenced the extension of debris-flow nappes. The drop length of the nappe at η  =  0.7 (η means lateral contraction ratio was approximately 1.4 times larger than at η  =  0.4. The collision, friction, and mixing forces between the debris-flow nappes and debris flows in downstream plunge pools dissipated much of the debris-flow kinetic energy, ranging from 42.03 to 78.08 % at different contraction ratios. Additionally, based on a dimensionless analysis, an empirical model was proposed to predict the maximum scour depth downriver of a check dam. It indicated that the results calculated by the model exhibited good agreement with the experimental results.

  19. Flow characteristics in stepped spillways with 1V: 0,75H slope; Caracterizacao do escoamento sobre vertedouros em degraus de declividade 1V: 0,75H

    Energy Technology Data Exchange (ETDEWEB)

    Sanagiotto, Daniela Guzzon; Marques, Marcelo Giulian [Universidade Federal de Santa Maria (UFSM), RS (Brazil). Dept. de Engenharia Sanitaria e Ambiental. Centro de Tecnologia], E-mail: dsanagiotto@gmail.com

    2011-07-15

    Stepped spillways are structures characterized by the significant resistance imposed to the flow and by the increase in the energy dissipation associated with the friction inserted by the steps. Stepped chutes conduct to economical designs of downstream protection structures in comparison to the ones required in conventional chute spillways (smooth chute). In this work measurements were carried out in physical models of spillways with 1V: 0.75H (53,13 deg) slope and steps height of (1) 0.03 m; (2) 0.06 m and (3) 0.09 m and in a smooth chute with the same slope. The models were installed in a channel with 0.40 m wide and 2.44 m height, evaluating specific discharges between 0.027 and 0.700 m{sup 3}/s/m, that, for a 1:10 scale, corresponds to discharges between 0.8 and 22.1 m{sup 3}/s/m in prototype. According to the results, a methodology was defined for the evaluation of the inception point of air entrainment, the friction factor and the energy dissipation along the flume. (author)

  20. 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).

  1. 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.

  2. 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....

  3. 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 ...

  4. 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.

  5. Potential hydroelectric power. Vertical turbine: spillway combine Broadwater Dam. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Willer, D.C.

    1979-04-23

    A feasibility study was made of the hydroelectric power potential at Broadwater Dam in western Montana. Two alternative configurations for the potential project were evaluated and the economics of four possible sources of project funding were assessed. The configurations analyzed were an apron-mounted configuration, in which the turbine-generator units are located on the downstream apron of the existing dam, and a conventional configuration, in which the units are located in a new powerhouse adjacent to the existing dam. The funding sources considered were the Department of Energy loan program, the United States Bureau of Reclamation PL-984 loan program and conventional revenue bonds, both taxable and tax-exempt. The optimal project alternative was determined to be the apron-mounted configuration. The final choice of funding would be dependent on the power purchaser. It was shown that, regardless of the configuraton or funding source selected, the project would be feasible. The cost of the apron-mounted configuration, which would consist of four turbine-generator units for a total installed capacity of 9.76 MW, was estimated as $13,250,000 with financing provided by either a PL-984 loan or tax-exempt bonds. The cost per installed kilowatt was therefore $1,350, and the cost per kilowatt-hour was 19.6 mills. The average annual energy was estimated to be 56.44 million kWh, the equivalent of approximately 87,000 barrels of oil per y. It is therefore recommended that the Montana Department of Natural Resources and Conservation proceed with the project and that discussions be initiated with potential power purchasers as soon as possible.

  6. 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

  7. Remaining Sites Verification Package for the 116-F-8, 1904-F Outfall Structure and the 100-F-42, 1904-F Spillway. Attachment to Waste Site Reclassification Form 2006-038 and 2006-045

    International Nuclear Information System (INIS)

    Dittmer, L.M.

    2006-01-01

    The 100-F-42 waste site is the portion of the former emergency overflow spillway for the 1904-F Outfall Structure formerly existing above the ordinary high water mark of the Columbia River. The spillway consisted of a concrete flume designed to discharge effluent from the 107-F Retention Basin in the event that flows could not be completely discharged via the river outfall pipelines. The results of verification sampling show that residual contaminant concentrations do not preclude any future uses and allow for unrestricted use of shallow zone soils. The results also demonstrate that residual contaminant concentrations are protective of groundwater and the Columbia River

  8. 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.

  9. Characterization of Fish Passage Conditions through a Francis Turbine, Spillway, and Regulating Outlet at Detroit Dam, Oregon, Using Sensor Fish, 2009

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, Joanne P.; Carlson, Thomas J.

    2011-05-06

    Fish passage conditions through two spillways, a Francis turbine, and a regulating outlet (RO) at Detroit Dam on the North Santiam River in Oregon were evaluated by Pacific Northwest National Laboratory for the U.S. Army Corps of Engineers (USACE), Portland District, using Sensor Fish devices. The objective of the study was to describe and compare passage exposure conditions, identifying potential fish injury regions within the routes. The study was performed in July, October, and December 2009 concurrent with HI-Z balloon-tag studies by Normandeau Associates, Inc. Sensor Fish data were analyzed to estimate 1) exposure conditions, particularly exposure to severe strike, collision, and shear events by passage route sub-regions; 2) differences in passage conditions between passage routes; and 3) relationships to live-fish injury and mortality data estimates. Comparison of the three passage routes evaluated at Detroit Dam indicates that the RO passage route through the 5-ft gate opening was relatively the safest route for fish passage under the operating conditions tested; turbine passage was the most deleterious. These observations were supported also by the survival and malady estimates obtained from live-fish testing. Injury rates were highest for turbine and spillway passage. However, none of the passage routes tested is safe for juvenile salmonid passage.

  10. 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

  11. 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.

  12. 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 ...

  13. National Program for Inspection of Non-Federal Dams. Winsor Dam (MA 00588), Quabbin Spillway (MA 00589), Goodnough Dike (MA 00590), Connecticut River Basin, Ware, Massachusetts. Phase I Inspection Report.

    Science.gov (United States)

    1978-09-01

    prepared under the National Programa for Inspection of Non-Federal Dams. This report is .p4resented for your use and is based upon a visual, inspection, a...in the July 1935 BSCE Journal. Vol. XXI , No. 3, indicates that a runoff of 12 inches in 24 hours would result in a spillway discharge of 9, 000 cfs

  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. 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.

  16. 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.

  17. 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.

  18. Accelerating resistance, inadequate antibacterial drug pipelines and international responses.

    Science.gov (United States)

    Theuretzbacher, Ursula

    2012-04-01

    The pandemic of multidrug-resistant (MDR) pathogens and their continuing spread is beyond dispute. In contrast to the past, today's antibacterial research and development (R&D) pipelines are nearly dry, failing to provide the flow of novel antibiotics required to match the clinical challenges of the multidrug resistance (MDR) crisis. Concerned over the rapidly worsening potential global healthcare crisis caused by MDR bacteria and the lack of robust drug pipelines, several multinational campaigns have issued policy recommendations and have initiated broad discussion with a goal of stimulating the development of novel antibacterial drugs and technologies. These activities have resulted in intensified co-operation between the USA and the EU. The recently announced extensive 'Action plan against the rising threats from antimicrobial resistance' substantially ramps up action within the EU. In recognising the potential crisis caused by MDR and the limited treatment options, the European Commission decided on an unprecedented approach to drive the search for novel antibiotics by integrating the pharmaceutical industry, the research capacities of universities and small companies supported by public funding along with pricing/reimbursement and regulatory bodies. The European Commission has shown leadership and put action plans in place. Only the future will tell whether these initiatives will help curb the impact of the MDR pandemic. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  19. Carrying Capacity

    DEFF Research Database (Denmark)

    Schroll, Henning; Andersen, Jan; Kjærgård, Bente

    2012-01-01

    A spatial planning act was introduced inIndonesia 1992 and renewed in 2008. It emphasised the planning role of decentralised authorities. The spatial planning act covers both spatial and environmental issues. It defines the concept of carrying capacity and includes definitions of supportive....../cities. Four different sectors (water, food production, waste, and forests) were selected as core areas for decentralised spatial planning. Indicators for SCC and ACC were identified and assessed with regard to relevance and quantifiability. For each of the indicators selected, a legal threshold or guiding...... was introduced inIndonesia 1992 and renewed in 2008. It emphasised the planning role of decentralised authorities. The spatial planning act covers both spatial and environmental issues. It defines the concept of carrying capacity and includes definitions of supportive carrying capacity (SCC) and assimilative...

  20. Repair in Mourao power plant spillway: application of recycled material concrete admixtures - stage one; Reparos no vertedouro da UHE Mourao: aplicacao de concretos com adicao de material reciclado - 1a. parte

    Energy Technology Data Exchange (ETDEWEB)

    Galvao, Jose Carlos Alves; Portella, Kleber Franke; Joukoski, Alex; Mendes, Roberto [Instituto de Tecnologia para o Desenvolvimento (LACTEC), Curitiba, PR (Brazil)], Emails: jose.galvao@lactec.org.br, portella@lactec.org.br, alex@lactec.org.br; roberto.mendes@lactec.org.br; Ferreira, Elizeu Santos [Companhia Paranaense de Energia (COPEL), Curitiba, PR (Brazil)], Email: elizeu.sf@copel.com

    2009-10-15

    The Mourao hydroelectric power plant located in the city of Campo Mourao, in the state of Parana, southern region of Brazil, was inaugurated in 1964, with 7500 kW of installed power. Defects in the spillway surface of the dam had been identified throughout the time. With the purpose of recovering the concrete hydraulic surface, repair materials were proposed in this paper, considering technology development and environment conservation. Concrete mixtures containing recycled materials - low-density polyethylene (LDPE), polyethylene terephthalate (PET) and waste tires - had its performance tested in laboratory. Mechanical properties, such as compressive strength, tensile strength and adherence were evaluated using cylindrical concrete specimens. Results were appraised and the best compositions were selected to be tested on spillway surface of Mourao dam. (author)

  1. Station Capacity

    DEFF Research Database (Denmark)

    Landex, Alex

    2011-01-01

    the probability of conflicts and the minimum headway times into account. The last method analyzes how optimal platform tracks are used by examining the arrival and departure pattern of the trains. The developed methods can either be used separately to analyze specific characteristics of the capacity of a station...

  2. 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

  3. 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.

  4. Exerting Capacity.

    Science.gov (United States)

    Leger, J Michael; Phillips, Carolyn A

    2017-05-01

    Patient safety has been at the forefront of nursing research since the release of the Institute of Medicine's report estimating the number of preventable adverse events in hospital settings; yet no research to date has incorporated the perspectives of bedside nurses using classical grounded theory (CGT) methodology. This CGT study explored the perceptions of bedside registered nurses regarding patient safety in adult acute care hospitals. Data analysis used three techniques unique to CGT-the constant comparative method, coding, and memoing-to explore the values, realities, and beliefs of bedside nurses about patient safety. The analysis resulted in a substantive theory, Exerting Capacity, which explained how bedside nurses balance the demands of keeping their patients safe. Exerting Capacity has implications for health care organization leaders, nursing leaders, and bedside nurses; it also has indications for future research into the concept of patient safety.

  5. SOLUTION FOR ICHTHYOFAUNA MIGRATION UPSTREAM- DOWNSTREAM OF THE TWO SPILLWAYS LOCATED NEAR MANASTUR DAM ON THE SOMESUL MIC RIVER IN THE CLUJ NAPOCA CITY (ROMÂNIA

    Directory of Open Access Journals (Sweden)

    Razvan VOICU

    2015-06-01

    Full Text Available Longitudinal connectivity represent the way in which organisms move the energy and material exchanges located throughout the water. Fragmentation the longitudinal connectivity of watercourses caused by dams or other hydrotechnical constructions represent a major impact on sediment transport, hydrological regime, downstream moving and biota migration. The hydromorphological elements (river continuity, as well as chemical, biological, physicochemical elements characterize the ecological status of rivers.Migratory fish species: nase (Chondrostoma nasus - protected by Bern Convention - Appendix III and barbel (Barbus barbus - rare species, protected Habitats Directive (Annex V, annex 4A of Low nr.462 and Red List of RBDD are blocked but the Hydrotechnical constructions (discharge sills, dams etc located across the watercourse Somes Mic River. One of the important think of this system is the gravitational fall of water. This solution will lead to the restoration of the longitudinal connection of the Someşul Mic River in the Manastur neighborhood. România is part of the European Union and it has the obligation to implement the provisions of the Water Framework Directive 2000/60/EC, transposed into Romanian legislation by the Water Law 107/1996 as supplemented and amended (Act 310/2004. This engineering solution for fish fauna migration upstream – downstream of the spillways supports the Water Framework Directive 2000/60/EC, transposed into Romanian legislation by the Water Law 107/1996 as supplemented and amended (Act 310/2004.

  6. 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.

  7. Capacity Building

    International Nuclear Information System (INIS)

    Molloy, Brian; Mallick, Shahid

    2014-01-01

    Outcomes & Recommendations: • Significant increase needed in the nuclear workforce both to replace soon-to-retire current generation and to staff large numbers of new units planned • Key message, was the importance of an integrated approach to workforce development. • IAEA and other International Organisations were asked to continue to work on Knowledge Management, Networks and E&T activities • IAEA requested to conduct Global Survey of HR needs – survey initiated but only 50% of operating countries (30% of capacity) took part, so results inconclusive

  8. 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.

  9. Capacity and Capacity Utilization in Fishing Industries

    OpenAIRE

    Kirkley, James E; Squires, Dale

    1999-01-01

    Excess capacity of fishing fleets is one of the most pressing problems facing the world's fisheries and the sustainable harvesting of resource stocks. Considerable confusion persists over the definition and measurement of capacity and capacity utilization in fishing. Fishing capacity and capacity utilization, rather than capital (or effort) utilization, provide the appropriate framework. This paper provides both technological-economic and economic definitions of capacity and excess capacity i...

  10. 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...

  11. HEAD INJURY ASSESSMENT IN JUVENILE CHINOOK USING THE ALPHA II-SPECTRIN BIOMARKER: EFFECTS OF PRESSURE CHANGES AND PASSAGE THROUGH A REMOVABLE SPILLWAY WEIR

    Energy Technology Data Exchange (ETDEWEB)

    Jonason, C.; Miracle, A.

    2009-01-01

    The cytoskeletal protein alpha II-spectrin has specifi c neurodegenerative mechanisms that allow the necrotic (injury-induced) and apoptotic (non-injury-induced) pathways of proteolysis to be differentiated in an immunoblot. Consequently, αII-spectrin breakdown products (SBDPs) are potential biomarkers for diagnosing traumatic brain injury (TBI). The purpose of the following investigation, consisting of two studies, was to evaluate the utility of the spectrin biomarker in diagnosing TBI in fi sh that travel through hydroelectric dams in the Columbia and Snake Rivers. The fi rst study used hyperbaric pressure chambers to simulate the pressure changes that affect fi sh during passage through a Federal Columbia River Power System (FCRPS) Kaplan turbine. The second study tested the effect of a removable spillway weir (RSW) on the passage of juvenile chinook (Oncorhynchus tshawytscha). This study was conducted in tandem with a balloon-tag study by the U.S. Army Corps of Engineers. Brain samples from fi sh were collected and analyzed using an immunoblot for SBDPs, and imaging software was used to quantify the protein band density and determine the ratio of cleaved protein to total protein. The biomarker analyses found higher SBDP expression levels in fi sh that were exposed to lower pressure nadirs and fi sh that passed through the RSW at a deep orientation. In general, the incidence of injuries observed after treatment positively correlated with expression levels, suggesting that the biomarker method of analysis is comparable to traditional methods of injury assessment. It was also found that, for some treatments, the 110 kDa spectrin fragment (SBDP 110) correlated more strongly with necrotic head injury incidence and mortality rates than did the total cleaved protein or the 120 kDa fragment. These studies will be informative in future decisions regarding the design of turbines and fi sh passage structures in hydroelectric dams and will hopefully contribute to the

  12. Multi-Source Generation Mechanisms for Low Frequency Noise Induced by Flood Discharge and Energy Dissipation from a High Dam with a Ski-Jump Type Spillway.

    Science.gov (United States)

    Lian, Jijian; Wang, Xiaoqun; Zhang, Wenjiao; Ma, Bin; Liu, Dongming

    2017-11-30

    As excess water is discharged from a high dam, low frequency noise (air pulsation lower than 10 Hz, LFN) is generated and propagated in the surrounding areas, causing environmental hazards such as the vibration of windows and doors and the discomfort of local residents. To study the generation mechanisms and key influencing factors of LFN induced by flood discharge and energy dissipation from a high dam with a ski-jump type spillway, detailed prototype observations and analyses of LFN are carried out. The discharge flow field is simulated and analyzed using a gas-liquid turbulent flow model. The acoustic response characteristics of the air cavity, which is formed between the discharge nappe and dam body, are analyzed using an acoustic numerical model. The multi-sources generation mechanisms are first proposed basing on the prototype observation results, vortex sound model, turbulent flow model and acoustic numerical model. Two kinds of sources of LFN are studied. One comes from the energy dissipation of submerged jets in the plunge pool, the other comes from nappe-cavity coupled vibration. The results of the analyses reveal that the submerged jets in the plunge pool only contribute to an on-site LFN energy of 0-1.0 Hz, and the strong shear layers around the high-velocity submerged jets and wall jet development areas are the main acoustic source regions of LFN in the plunge pool. In addition, the nappe-cavity coupled vibration, which is induced when the discharge nappe vibrates with close frequency to the model frequency of the cavity, can induce on-site LFN energy with wider frequency spectrum energy within 0-4.0 Hz. By contrast, the contribution degrees to LFN energy from two acoustic sources are almost same, while the contribution degree from nappe-cavity coupled vibration is slightly higher.

  13. 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.

  14. 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.

  15. Building Public Health Capacity through Online Global Learning

    Science.gov (United States)

    Madhok, Rajan; Frank, Erica; Heller, Richard Frederick

    2018-01-01

    Rising disease burden and health inequalities remain global concerns, highlighting the need for health systems strengthening with a sufficient and appropriately trained workforce. The current models for developing such a workforce are inadequate and newer approaches are needed. In this paper we describe a model for public health capacity building…

  16. 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

  17. Strengthening Africa's capacity to design and implement strategies for food and nutrition security

    OpenAIRE

    Babu, Suresh Chandra; Rhoe, Valerie; Temu, Andrew; Hendriks, Sheryl

    2004-01-01

    "Among the capacity-strengthening challenges the region faces are inadequate in-country capacity, institutional weaknesses, lack of multidisciplinary approaches to problem solving, expatriates' limited incountry experience, poor governance, and failure to monitor the sustainability of development efforts and to plan for future capacity generation....The current gaps in capacity are known, but as political, environmental, technical, and social contexts change, new needs will arise. Therefore, ...

  18. 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.

  19. 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...

  20. 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.

  1. 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…

  2. 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...

  3. 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.

  4. 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.

  5. 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…

  6. Simulating endogenous dynamics of intervention-capacity deployment : Ebola outbreak in Liberia

    NARCIS (Netherlands)

    Auping, W.L.; Pruyt, E.; Kwakkel, J.H.

    2016-01-01

    During the first months, the 2014 outbreak of the Ebola virus (EBOV) in West Africa was characterised by inadequate intervention capacities. In this paper, we investigate (1) the influence of limited but dynamic intervention capacities and their effect on the effective reproduction number, and (2)

  7. 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.

  8. 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.

  9. 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...

  10. 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.

  11. 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.

  12. 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...

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. Capacity payments in imperfect electricity markets: Need and design

    International Nuclear Information System (INIS)

    Joskow, Paul L.

    2008-01-01

    This paper argues that a variety of imperfections in wholesale 'energy-only' electricity markets lead to generators earning net revenues that are inadequate to support investment in a least cost portfolio of generating capacity and to satisfy consumer preferences for reliability. Theoretical and numerical examples are used to illustrate the sources of this 'missing money' problem. Improvements in 'energy-only' wholesale electricity markets, especially those that improve pricing when capacity is fully utilized, can reduce the magnitude of the missing money problem. However, these improvements are unlikely to fully ameliorate it. Forward capacity obligations and associated auction mechanisms to determine capacity prices are necessary to restore appropriate wholesale market prices and associated investment incentives to support the optimal portfolio of generating investments. The deficiencies of the original capacity payment mechanisms adopted in the US are discussed and the necessary improvements identified. (author)

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  9. Responsibility and Capacities

    DEFF Research Database (Denmark)

    Ryberg, Jesper

    2014-01-01

    That responsible moral agency presupposes certain mental capacities, constitutes a widely accepted view among theorists. Moreover, it is often assumed that degrees in the development of the relevant capacities co-vary with degrees of responsibility. In this article it is argued that, the move from...... the view that responsibility requires certain mental capacities to the position that degrees of responsibility co-vary with degrees of the development of the mental capacities, is premature....

  10. CDMA systems capacity engineering

    CERN Document Server

    Kim, Kiseon

    2004-01-01

    This new hands-on resource tackles capacity planning and engineering issues that are crucial to optimizing wireless communication systems performance. Going beyond the system physical level and investigating CDMA system capacity at the service level, this volume is the single-source for engineering and analyzing systems capacity and resources.

  11. Can procedural and substantive elements of decision-making be reconciled in assessments of mental capacity?

    Science.gov (United States)

    Banner, Natalie F.

    2016-01-01

    Capacity legislation aims to protect individual autonomy and avoid undue paternalism as far as possible, partly through ensuring patients are not deemed to lack capacity because they make an unwise decision. To this end, the law employs a procedural test of capacity that excludes substantive judgments about patients’ decisions. However, clinical intuitions about patients’ capacity to make decisions about their treatment often conflict with a strict reading of the legal criteria for assessing capacity, particularly in psychiatry. In this article I argue that this tension arises because the procedural conception of capacity is inadequate and does not reflect the clinical or legal realities of assessing capacity. I propose that conceptualising capacity as having ‘recognisable reasons’ for a treatment decision provides a practical way of legitimately incorporating both procedural and substantive elements of decision-making into assessments of capacity. PMID:27891169

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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....

  17. 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.

  18. 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.

  19. 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.

  20. Capacity shortfalls hinder the performance of marine protected areas globally

    Science.gov (United States)

    Gill, David A.; Mascia, Michael B.; Ahmadia, Gabby N.; Glew, Louise; Lester, Sarah E.; Barnes, Megan; Craigie, Ian; Darling, Emily S.; Free, Christopher M.; Geldmann, Jonas; Holst, Susie; Jensen, Olaf P.; White, Alan T.; Basurto, Xavier; Coad, Lauren; Gates, Ruth D.; Guannel, Greg; Mumby, Peter J.; Thomas, Hannah; Whitmee, Sarah; Woodley, Stephen; Fox, Helen E.

    2017-03-01

    Marine protected areas (MPAs) are increasingly being used globally to conserve marine resources. However, whether many MPAs are being effectively and equitably managed, and how MPA management influences substantive outcomes remain unknown. We developed a global database of management and fish population data (433 and 218 MPAs, respectively) to assess: MPA management processes; the effects of MPAs on fish populations; and relationships between management processes and ecological effects. Here we report that many MPAs failed to meet thresholds for effective and equitable management processes, with widespread shortfalls in staff and financial resources. Although 71% of MPAs positively influenced fish populations, these conservation impacts were highly variable. Staff and budget capacity were the strongest predictors of conservation impact: MPAs with adequate staff capacity had ecological effects 2.9 times greater than MPAs with inadequate capacity. Thus, continued global expansion of MPAs without adequate investment in human and financial capacity is likely to lead to sub-optimal conservation outcomes.

  1. Bathymetry and capacity of Shawnee Reservoir, Oklahoma, 2016

    Science.gov (United States)

    Ashworth, Chad E.; Smith, S. Jerrod; Smith, Kevin A.

    2017-02-13

    Shawnee Reservoir (locally known as Shawnee Twin Lakes) is a man-made reservoir on South Deer Creek with a drainage area of 32.7 square miles in Pottawatomie County, Oklahoma. The reservoir consists of two lakes connected by an equilibrium channel. The southern lake (Shawnee City Lake Number 1) was impounded in 1935, and the northern lake (Shawnee City Lake Number 2) was impounded in 1960. Shawnee Reservoir serves as a municipal water supply, and water is transferred about 9 miles by gravity to a water treatment plant in Shawnee, Oklahoma. Secondary uses of the reservoir are for recreation, fish and wildlife habitat, and flood control. Shawnee Reservoir has a normal-pool elevation of 1,069.0 feet (ft) above North American Vertical Datum of 1988 (NAVD 88). The auxiliary spillway, which defines the flood-pool elevation, is at an elevation of 1,075.0 ft.The U.S. Geological Survey (USGS), in cooperation with the City of Shawnee, has operated a real-time stage (water-surface elevation) gage (USGS station 07241600) at Shawnee Reservoir since 2006. For the period of record ending in 2016, this gage recorded a maximum stage of 1,078.1 ft on May 24, 2015, and a minimum stage of 1,059.1 ft on April 10–11, 2007. This gage did not report reservoir storage prior to this report (2016) because a sufficiently detailed and thoroughly documented bathymetric (reservoir-bottom elevation) survey and corresponding stage-storage relation had not been published. A 2011 bathymetric survey with contours delineated at 5-foot intervals was published in Oklahoma Water Resources Board (2016), but that publication did not include a stage-storage relation table. The USGS, in cooperation with the City of Shawnee, performed a bathymetric survey of Shawnee Reservoir in 2016 and released the bathymetric-survey data in 2017. The purposes of the bathymetric survey were to (1) develop a detailed bathymetric map of the reservoir and (2) determine the relations between stage and reservoir storage

  2. Capacity Statement for Railways

    DEFF Research Database (Denmark)

    Landex, Alex

    2007-01-01

    The subject “Railway capacity” is a combination of the capacity consumption and how the capacity is utilized. The capacity utilization of railways can be divided into 4 core elements: The number of trains; the average speed; the heterogeneity of the operation; and the stability. This article desc...... trains. This is due to network effects in the railway system and due to the fact that more trains results in lower punctuality....

  3. The French capacity mechanism

    International Nuclear Information System (INIS)

    2014-01-01

    The French capacity mechanism has been design to ensure security of supply in the context of the energy transition. This energy transition challenges the electricity market design with several features: peak load growth, the development of renewables, demand response,... To ensure security of supply in this context, a capacity mechanism is being implemented in France. It is a market wide capacity obligation on electricity suppliers, based on market principles. Suppliers are responsible for forecasting their obligation, which corresponds to their contribution to winter peak load, and must procure enough capacity certificates to meet their obligations. Capacity certificates are granted to capacities through a certification process, which assesses their contribution to security of supply on the basis of availability commitments. This certification process is technology neutral and performance based, associated with controls and penalties in case of non compliance. Demand Side is fully integrated in the market, either through the reduction of suppliers' capacity obligation or direct participation after certification. In addition to the expected benefits in terms of security of supply, the French capacity market will foster the development of demand response. The participation of foreign capacities will require adaptations which are scheduled in a road-map, and could pave the way for further European integration of energy policies. (authors)

  4. 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

  5. Heat Capacity Analysis Report

    International Nuclear Information System (INIS)

    Findikakis, A.

    2004-01-01

    The purpose of this report is to provide heat capacity values for the host and surrounding rock layers for the waste repository at Yucca Mountain. The heat capacity representations provided by this analysis are used in unsaturated zone (UZ) flow, transport, and coupled processes numerical modeling activities, and in thermal analyses as part of the design of the repository to support the license application. Among the reports that use the heat capacity values estimated in this report are the ''Multiscale Thermohydrologic Model'' report, the ''Drift Degradation Analysis'' report, the ''Ventilation Model and Analysis Report, the Igneous Intrusion Impacts on Waste Packages and Waste Forms'' report, the ''Dike/Drift Interactions report, the Drift-Scale Coupled Processes (DST and TH Seepage) Models'' report, and the ''In-Drift Natural Convection and Condensation'' report. The specific objective of this study is to determine the rock-grain and rock-mass heat capacities for the geologic stratigraphy identified in the ''Mineralogic Model (MM3.0) Report'' (BSC 2004 [DIRS 170031], Table 1-1). This report provides estimates of the heat capacity for all stratigraphic layers except the Paleozoic, for which the mineralogic abundance data required to estimate the heat capacity are not available. The temperature range of interest in this analysis is 25 C to 325 C. This interval is broken into three separate temperature sub-intervals: 25 C to 95 C, 95 C to 114 C, and 114 C to 325 C, which correspond to the preboiling, trans-boiling, and postboiling regimes. Heat capacity is defined as the amount of energy required to raise the temperature of a unit mass of material by one degree (Nimick and Connolly 1991 [DIRS 100690], p. 5). The rock-grain heat capacity is defined as the heat capacity of the rock solids (minerals), and does not include the effect of water that exists in the rock pores. By comparison, the rock-mass heat capacity considers the heat capacity of both solids and pore

  6. Prospects for OPEC capacity

    International Nuclear Information System (INIS)

    Adelman, M.A.

    1995-01-01

    OPEC capacity is not exogenous, but responds to demand. Price increases have not been caused by capacity shortages. OPEC nations find it hard to set aside even very small portions of their revenues for oil investment, despite its extreme profitability. Foreign investors face high risks. Production sharing makes their after-tax return even more unstable. (author)

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. National Dam Inspection Program. Long Run Reservoir Number I Dam (NDI Number PA-00882, DER Number 13-004), Delaware River Basin, Carbon County, Pennsylvania. Phase I Inspection Report,

    Science.gov (United States)

    1981-02-01

    adequate spillway capacity, 2. That the cracked spillway slab be repaired/ 3. That the downstream end of the spillway be protected from washouts during...embankment. The construction reports indicate that the trench was excavated to a depth varying from 5 to 12 feet into a red sandstone or shale. Fissured ...that the spillway deteriorated seriously in the 1930’s and that spillway walls and slab were repaired in 1941. The cement mortar slab showed

  16. 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.

  17. 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

  18. 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.

  19. Vedr.: Military capacity building

    DEFF Research Database (Denmark)

    Larsen, Josefine Kühnel; Struwe, Lars Bangert

    2013-01-01

    Military capacity building has increasingly become an integral part of Danish defence. Military capacity is a new way of thinking Danish defence and poses a new set of challenges and opportunities for the Danish military and the Political leadership. On the 12th of december, PhD. Candidate Josefine...... Kühnel Larsen and researcher Lars Bangert Struwe of CMS had organized a seminar in collaboration with Royal Danish Defense Colleg and the East African Security Governance Network. The seminar focused on some of the risks involved in Military capacity building and how these risks are dealt with from...

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Capacity at Railway Stations

    DEFF Research Database (Denmark)

    Landex, Alex

    2011-01-01

    zone(s) the possible conflicts with other trains (also in the opposite direction) are taken into account leading to more trustworthy results. Although the UIC 406 methodology proposes that the railway network should be divided into line sections when trains turn around and when the train order...... is changed, this paper recommends that the railway lines are not always be divided. In case trains turn around on open (single track) line, the capacity consumption may be too low if a railway line is divided. The same can be the case if only few trains are overtaken at an overtaking station. For dead end......Stations do have other challenges regarding capacity than open lines as it is here the traffic is dispatched. The UIC 406 capacity method that can be used to analyse the capacity consumption can be exposed in different ways at stations which may lead to different results. Therefore, stations need...

  7. Visual attention capacity

    DEFF Research Database (Denmark)

    Habekost, Thomas; Starrfelt, Randi

    2009-01-01

    Psychophysical studies have identified two distinct limitations of visual attention capacity: processing speed and apprehension span. Using a simple test, these cognitive factors can be analyzed by Bundesen's Theory of Visual Attention (TVA). The method has strong specificity and sensitivity...

  8. Revisiting Absorptive Capacity

    DEFF Research Database (Denmark)

    de Araújo, Ana Luiza Lara; Ulhøi, John Parm; Lettl, Christopher

    learning processes of absorptive capacity, which comprise combinative and adaptive capabilities. Drawing on survey data (n=169), the study concludes that combinative capabilities primarily enhance transformative and exploratory learning processes, while adaptive capabilities strengthen all three learning......Absorptive capacity has mostly been perceived as a 'passive' outcome of R&D investments. Recently, however, a growing interest into its 'proactive' potentials has emerged. This paper taps into this development and proposes a dynamic model for conceptualizing the determinants of the complementary...

  9. The American Thoracic Society’s Spirometric Criteria Alone is Inadequate in Asthma Diagnosis

    Directory of Open Access Journals (Sweden)

    John A Gjevre

    2006-01-01

    Full Text Available BACKGROUND: The diagnosis of asthma is based on clinical symptoms, physical examination and pulmonary function tests, and can be very challenging. Most patients with asthma have a significant postbronchodilator response on spirometry indicating airway hyperresponsiveness. However, having a significant bronchodilator response by itself is not diagnostic of asthma. The definition of a ‘significant’ response has also been controversial. Many respirologists use the American Thoracic Society (ATS postbronchodilator response criteria of 12% (provided it is 200 mL or greater improvement in forced expiratory volume in 1 s (or forced vital capacity from the baseline spirometry.

  10. 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

  11. 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...

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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…

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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

  3. Weather and road capacity

    DEFF Research Database (Denmark)

    Jensen, Thomas Christian

    2014-01-01

    The paper presents estimations of the effect of bad weather on the observed speed on a Danish highway section; Køge Bugt Motorvejen. The paper concludes that weather, primarily precipitation and snow, has a clear negative effect on speed when the road is not in hypercongestion mode. Furthermore......, the capacity of the highway seems to be reduced in bad weather and there are indications that travel time variability is also increased, at least in free-flow conditions. Heavy precipitation reduces speed and capacity by around 5-8%, whereas snow primarily reduces capacity. Other weather variables......-parametrically against traffic density and in step 2 the residuals from step 1 are regressed linearly against the weather variables. The choice of a non-parametric method is made to avoid constricting ties from a parametric specification and because the focus here is not on the relationship between traffic flow...

  4. Dual capacity reciprocating compressor

    Science.gov (United States)

    Wolfe, Robert W.

    1984-01-01

    A multi-cylinder compressor 10 particularly useful in connection with northern climate heat pumps and in which different capacities are available in accordance with reversing motor 16 rotation is provided with an eccentric cam 38 on a crank pin 34 under a fraction of the connecting rods, and arranged for rotation upon the crank pin between opposite positions 180.degree. apart so that with cam rotation on the crank pin such that the crank throw is at its normal maximum value all pistons pump at full capacity, and with rotation of the crank shaft in the opposite direction the cam moves to a circumferential position on the crank pin such that the overall crank throw is zero. Pistons 24 whose connecting rods 30 ride on a crank pin 36 without a cam pump their normal rate with either crank rotational direction. Thus a small clearance volume is provided for any piston that moves when in either capacity mode of operation.

  5. Geothermal Plant Capacity Factors

    Energy Technology Data Exchange (ETDEWEB)

    Greg Mines; Jay Nathwani; Christopher Richard; Hillary Hanson; Rachel Wood

    2015-01-01

    The capacity factors recently provided by the Energy Information Administration (EIA) indicated this plant performance metric had declined for geothermal power plants since 2008. Though capacity factor is a term commonly used by geothermal stakeholders to express the ability of a plant to produce power, it is a term frequently misunderstood and in some instances incorrectly used. In this paper we discuss how this capacity factor is defined and utilized by the EIA, including discussion on the information that the EIA requests from operations in their 923 and 860 forms that are submitted both monthly and annually by geothermal operators. A discussion is also provided regarding the entities utilizing the information in the EIA reports, and how those entities can misinterpret the data being supplied by the operators. The intent of the paper is to inform the facility operators as the importance of the accuracy of the data that they provide, and the implications of not providing the correct information.

  6. Value for railway capacity

    DEFF Research Database (Denmark)

    Sameni, Melody Khadem; Preston, John M.

    2012-01-01

    to analyze the efficiency of operators in transforming inputs of allocated capacity of infrastructure and franchise payments into valuable passenger service outputs while avoiding delays. By addressing operational and economic aspects of capacity utilization simultaneously, the paper deviates from existing...... DEA work on the economic efficiency of railways by considering a new combination of input-output that also incorporates quality of service. The constant and variable returns to scale models are applied to the case study of franchised passenger operators in Great Britain. The follow-up Tobit regression...

  7. Potential Links between Impaired One-Carbon Metabolism Due to Polymorphisms, Inadequate B-Vitamin Status, and the Development of Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Barbara Troesch

    2016-12-01

    Full Text Available Alzheimer’s disease (AD is the major cause of dementia and no preventive or effective treatment has been established to date. The etiology of AD is poorly understood, but genetic and environmental factors seem to play a role in its onset and progression. In particular, factors affecting the one-carbon metabolism (OCM are thought to be important and elevated homocysteine (Hcy levels, indicating impaired OCM, have been associated with AD. We aimed at evaluating the role of polymorphisms of key OCM enzymes in the etiology of AD, particularly when intakes of relevant B-vitamins are inadequate. Our review indicates that a range of compensatory mechanisms exist to maintain a metabolic balance. However, these become overwhelmed if the activity of more than one enzyme is reduced due to genetic factors or insufficient folate, riboflavin, vitamin B6 and/or vitamin B12 levels. Consequences include increased Hcy levels and reduced capacity to synthetize, methylate and repair DNA, and/or modulated neurotransmission. This seems to favor the development of hallmarks of AD particularly when combined with increased oxidative stress e.g., in apolipoprotein E (ApoE ε4 carriers. However, as these effects can be compensated at least partially by adequate intakes of B-vitamins, achieving optimal B-vitamin status for the general population should be a public health priority.

  8. Potential Links between Impaired One-Carbon Metabolism Due to Polymorphisms, Inadequate B-Vitamin Status, and the Development of Alzheimer's Disease.

    Science.gov (United States)

    Troesch, Barbara; Weber, Peter; Mohajeri, M Hasan

    2016-12-10

    Alzheimer's disease (AD) is the major cause of dementia and no preventive or effective treatment has been established to date. The etiology of AD is poorly understood, but genetic and environmental factors seem to play a role in its onset and progression. In particular, factors affecting the one-carbon metabolism (OCM) are thought to be important and elevated homocysteine (Hcy) levels, indicating impaired OCM, have been associated with AD. We aimed at evaluating the role of polymorphisms of key OCM enzymes in the etiology of AD, particularly when intakes of relevant B-vitamins are inadequate. Our review indicates that a range of compensatory mechanisms exist to maintain a metabolic balance. However, these become overwhelmed if the activity of more than one enzyme is reduced due to genetic factors or insufficient folate, riboflavin, vitamin B6 and/or vitamin B12 levels. Consequences include increased Hcy levels and reduced capacity to synthetize, methylate and repair DNA, and/or modulated neurotransmission. This seems to favor the development of hallmarks of AD particularly when combined with increased oxidative stress e.g., in apolipoprotein E (ApoE) ε4 carriers. However, as these effects can be compensated at least partially by adequate intakes of B-vitamins, achieving optimal B-vitamin status for the general population should be a public health priority.

  9. Demand and capacity planning in the emergency department: how to do it.

    Science.gov (United States)

    Higginson, I; Whyatt, J; Silvester, K

    2011-02-01

    Unless emergency departments have adequate capacity to meet demand, they will fail to meet clinical and performance standards and will be operating in the 'coping zone'. This carries risks both for staff and patients. As part of a quality improvement programme, the authors undertook an in-depth analysis of demand and capacity for an emergency department in the UK. The paper describes this rigorous approach to capacity planning, which draws on techniques from other industries. Proper capacity planning is vital, but is often poorly done. Planning using aggregated data will lead to inadequate capacity. Understanding demand, and particularly the variation in that demand, is critical to success. Analysis of emergency department demand and capacity is the first step towards effective workforce planning and process redesign.

  10. Maritime Security and Capacity Building in The Gulf of Guinea

    DEFF Research Database (Denmark)

    Jacobsen, Katja Lindskov

    2017-01-01

    It is widely acknowledged that maritime security in the Gulf of Guinea is a highly complex phenomenon, involving a variety issues (legal deficiencies, inadequate military equipment, and challenges like corruption, political unrest, youth unemployment etc.) as well as a multiplicity of external...... response, they are at the same time illustrative of how the maritime capacity building activities of various external actors also ‘succeed’ in having an impact on this regional security landscape – for instance by influencing how certain aspects of this multifaceted problem are prioritized, whilst others...

  11. Evaluation of railway capacity

    DEFF Research Database (Denmark)

    Landex, Alex; Kaas, Anders H.; Schittenhelm, Bernd

    2006-01-01

    capacity consumptions. This paper describes the UIC 406 method and how it is expounded in Denmark. The paper describes the importance of choosing the right length of the line sections examined and how line sections with multiple track sections are examined. Furthermore, the possibility of using idle...

  12. Building capacity in Benin

    International Development Research Centre (IDRC) Digital Library (Canada)

    sigp1. Building capacity in. Benin. Training of technical staff of municipalities in the Okpara Basin of Benin in the use of GIS tools for water management, hydrological .... Practical exercises allowed participants to define the catchment area of the ...

  13. Allergies and Asthma: Do Atopic Disorders Result from Inadequate Immune Homeostasis arising from Infant Gut Dysbiosis?

    Science.gov (United States)

    Johnson, Christine C; Ownby, Dennis R

    2016-01-01

    Our global hypothesis is that atopic conditions and asthma develop because an individual's immune system is not able to appropriately resolve inflammation resulting from allergen exposures. We propose that the failure to appropriately down-regulate inflammation and produce a toleragenic state results primarily from less robust immune homeostatic processes rather than from a tendency to over-respond to allergenic stimuli. An individual with lower immune homeostatic capacity is unable to rapidly and completely terminate, on average over time, immune responses to innocuous allergens, increasing risk of allergic disease. A lack of robust homeostasis also increases the risk of other inflammatory conditions, such as prolonged respiratory viral infections and obesity, leading to the common co-occurrence of these conditions. Further, we posit that the development of vigorous immune homeostatic mechanisms is an evolutionary adaptation strongly influenced by both 1) exposure to a diverse maternal microbiota through the prenatal period, labor and delivery, and, 2) an orderly assemblage process of the infant's gut microbiota ecosystem shaped by breastfeeding and early exposure to a wide variety of ingested foods and environmental microbes. This early succession of microbial communities together with early allergen exposures orchestrate the development of an immune system with a robust ability to optimally control inflammatory responses and a lowered risk for atopic disorders.

  14. 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.

  15. 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.

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. Seismic capacity of switchgear

    International Nuclear Information System (INIS)

    Bandyopadhyay, K.; Hofmayer, C.; Kassir, M.; Pepper, S.

    1989-01-01

    As part of a component fragility program sponsored by the USNRC, BNL has collected existing information on the seismic capacity of switchgear assemblies from major manufacturers. Existing seismic test data for both low and medium voltage switchgear assemblies have been evaluated and the generic results are presented in this paper. The failure modes are identified and the corresponding generic lower bound capacity levels are established. The test response spectra have been used as a measure of the test vibration input. The results indicate that relays chatter at a very low input level at the base of the switchgear cabinet. This change of state of devices including relays have been observed. Breaker tripping occurs at a higher vibration level. Although the structural failure of internal elements have been noticed, the overall switchgear cabinet structure withstands a high vibration level. 5 refs., 2 figs., 2 tabs

  3. Absorptive Capacity and Diversity

    DEFF Research Database (Denmark)

    Kristinsson, Kári

    international business, organizational economics, strategic management, technology management and last but not least neo-Schumpeterian economics. The goal of this dissertation is to examine what many consider as neglected arguments from the work by Cohen and Levinthal and thereby illuminate an otherwise......One of the most influential contributions to neo-Schumpeterian economics is Cohen and Levinthal‘s papers on absorptive capacity. Since their publication in the late 1980s and early 1990s the concept absorptive capacity has had substantial impact on research in economics and management, including...... overlooked area of research. Although research based on Cohen and Levinthal‘s work has made considerable impact, there is scarcity of research on certain fundamental points argued by Cohen and Levinthal. Among these is the importance of employee diversity as well as the type and nature of interaction between...

  4. Heat Capacity Mapping Mission

    Science.gov (United States)

    Nilsson, C. S.; Andrews, J. C.; Scully-Power, P.; Ball, S.; Speechley, G.; Latham, A. R. (Principal Investigator)

    1980-01-01

    The Tasman Front was delineated by airborne expendable bathythermograph survey; and an Heat Capacity Mapping Mission (HCMM) IR image on the same day shows the same principal features as determined from ground-truth. It is clear that digital enhancement of HCMM images is necessary to map ocean surface temperatures and when done, the Tasman Front and other oceanographic features can be mapped by this method, even through considerable scattered cloud cover.

  5. CSTI High Capacity Power

    International Nuclear Information System (INIS)

    Winter, J.M.

    1989-01-01

    The SP-100 program was established in 1983 by DOD, DOE, and NASA as a joint program to develop the technology necessary for space nuclear power systems for military and civil application. During FY-86 and 87, the NASA SP-100 Advanced Technology Program was devised to maintain the momentum of promising technology advancement efforts started during Phase 1 of SP-100 and to strengthen, in key areas, the chances for successful development and growth capability of space nuclear reactor power systems for future space applications. In FY-88, the Advanced Technology Program was incorporated into NASA's new Civil Space Technology Initiative (CSTI). The CSTI Program was established to provide the foundation for technology development in automation and robotics, information, propulsion, and power. The CSTI High Capacity Power Program builds on the technology efforts of the SP-100 program, incorporates the previous NASA SP-100 Advanced Technology project, and provides a bridge to NASA Project Pathfinder. The elements of CSTI High Capacity Power development include Conversion Systems, Thermal Management, Power Management, System Diagnostics, and Environmental Interactions. Technology advancement in all areas, including materials, is required to assure the high reliability and 7 to 10 year lifetime demanded for future space nuclear power systems. The overall program will develop and demonstrate the technology base required to provide a wide range of modular power systems as well as allowing mission independence from solar and orbital attitude requirements. Several recent advancements in CSTI High Capacity power development will be discussed

  6. When civil registration is inadequate: interim methods for generating vital statistics.

    Science.gov (United States)

    AbouZahr, Carla; Rampatige, Rasika; Lopez, Alan; deSavigny, Don

    2012-04-01

    birth and death is properly registered, and that causes of death are accurately certified. Stakeholders wishing to establish sentinel surveillance or sample registration should work in collaboration with national and local authorities responsible for civil registration and should support and promote the formal registration of births and deaths whenever possible. In addition, sentinel or sample registration systems should help strengthen the capacity of the health system to correctly certify the causes of death for each decedent.

  7. Competence building capacity shortage

    International Nuclear Information System (INIS)

    Doorman, Gerard; Wangensteen, Ivar; Bakken, Bjoern

    2005-02-01

    The objective of the project 'Competence Building Capacity Shortage' has been 'to increase knowledge about central approaches aimed at solving the peaking capacity problem in restructured power systems'. With respect to reserve markets, a model was developed in the project to analyze the relations between reserve requirements and prices in the spot and reserve markets respectively. A mathematical model was also developed and implemented, which also includes the balance market, and has a good ability to predict the relations between these markets under various assumptions. With some further development, this model can be used fore realistic analyses of these markets in a Nordic context. It was also concluded that certain system requirements with respect to frequency and time deviation can be relaxed without adverse effects. However, the requirements to system bias, Frequency Activated Operating Reserves and Frequency Activated Contingency Reserves cannot be relaxed, the latter because they must cover the dimensioning fault in the system. On the other hand, Fast Contingency Reserves can be reduced by removing requirements to national balances. Costs can furthermore be reduced by increasingly adapting a Nordic as opposed to national approach. A model for stepwise power flow was developed in the project, which is especially useful to analyze slow power system dynamics. This is relevant when analysing the effects of reserve requirements. A model for the analysis of the capacity balance in Norway and Sweden was also developed. This model is useful for looking at the future balance under various assumptions regarding e.g. weather conditions, demand growth and the development of the generation system. With respect to the present situation, if there is some price flexibility on the demand side and system operators are able to use reserves from the demand side, the probability for load shedding during the peak load hour is close to zero under the weather conditions after

  8. Environmental capacity and the limits of predictive science

    International Nuclear Information System (INIS)

    Taylor, P.

    1991-01-01

    This paper examines the failure of pollution control and hazardous waste management strategies in the light of rapid environmental degradation observed in the decade of the 1980s. It focuses upon the central role of predictive science and assimilative capacity concepts in that failure and the development, a s a consequence, of a paradigm shift in approach, utilising the principles of precautionary action with regard to all substances, programmes of clean production applied to all industrial sectors, and source reduction applied to dissipative activities giving rise to hazardous waste. The past 'assimilative capacity' approaches are criticised as an inadequate foundation for development. In particular the nuclear regulatory concepts of 'justification', 'optimisation' and 'dose-limitation' are seriously deficient. New assessment procedures under development in the London dumping convention are discussed in the light of the precautionary principle. (au)

  9. 1992 Annual Capacity Report

    International Nuclear Information System (INIS)

    1993-05-01

    The Standard Contract for Disposal of Spent Nuclear Fuel and/or High-Level Radioactive Waste (10 CFR Part 961) requires the Department of Energy (DOE) to issue an Annual Capacity Report (ACR) for planning purposes. This report is the fifth in the series published by DOE. In May 1993, DOE published the 1992 Acceptance Priority Ranking (APR) that established the order in which DOE will allocate projected acceptance capacity. As required by the Standard Contract, the acceptance priority ranking is based on the date the spent nuclear fuel (SNF) was permanently discharged, with the owners of the oldest SNF, on an industry-wide basis, given the highest priority. The 1992 ACR applies the projected waste acceptance rates in Table 2.1 to the 1992 APR, resulting in individual allocations for the owners and generators of the SNF. These allocations are listed in detail in the Appendix, and summarized in Table 3.1. The projected waste acceptance rates for SNF presented in Table 2.1 are nominal and assume a site for a Monitored Retrievable Storage (MRS) facility will be obtained; the facility will initiate operations in 1998; and the statutory linkages between the MRS facility and the repository set forth in the Nuclear Waste Policy Act of 1982, as amended (NWPA), will be modified. During the first ten years following projected commencement of Civilian Radioactive Waste Management System (CRWMS) operation, the total quantity of SNF that could be accepted is projected to be 8,200 metric tons of uranium (MTU). This is consistent with the storage capacity licensing conditions imposed on an MRS facility by the NWPA. The annual acceptance rates provide an approximation of the system throughput and are subject to change as the program progresses

  10. Quantum reading capacity

    International Nuclear Information System (INIS)

    Pirandola, Stefano; Braunstein, Samuel L; Lupo, Cosmo; Mancini, Stefano; Giovannetti, Vittorio

    2011-01-01

    The readout of a classical memory can be modelled as a problem of quantum channel discrimination, where a decoder retrieves information by distinguishing the different quantum channels encoded in each cell of the memory (Pirandola 2011 Phys. Rev. Lett. 106 090504). In the case of optical memories, such as CDs and DVDs, this discrimination involves lossy bosonic channels and can be remarkably boosted by the use of nonclassical light (quantum reading). Here we generalize these concepts by extending the model of memory from single-cell to multi-cell encoding. In general, information is stored in a block of cells by using a channel-codeword, i.e. a sequence of channels chosen according to a classical code. Correspondingly, the readout of data is realized by a process of ‘parallel’ channel discrimination, where the entire block of cells is probed simultaneously and decoded via an optimal collective measurement. In the limit of a large block we define the quantum reading capacity of the memory, quantifying the maximum number of readable bits per cell. This notion of capacity is nontrivial when we suitably constrain the physical resources of the decoder. For optical memories (encoding bosonic channels), such a constraint is energetic and corresponds to fixing the mean total number of photons per cell. In this case, we are able to prove a separation between the quantum reading capacity and the maximum information rate achievable by classical transmitters, i.e. arbitrary classical mixtures of coherent states. In fact, we can easily construct nonclassical transmitters that are able to outperform any classical transmitter, thus showing that the advantages of quantum reading persist in the optimal multi-cell scenario. (paper)

  11. Geostationary orbit capacity study

    Science.gov (United States)

    Hansell, P. S.; Norris, P.; Walton, R.

    1982-04-01

    Factors influencing the communications satellite capacity of the geostationary orbit were analyzed to derive an interference model of the orbit environment. Comparison of the total orbit arc length required by each proposed planning method or by using different technology developments indicates that the orbit arc of most interest to Western Europe will not be saturated by the year 2000. The orbit arc occupied in the year 2000 by the satellites in the West European arc of interest can be approximately halved by using digital modulation techniques for TV program transfers which use FM at present, or by adopting an orbital planning method which assigns FM TV services to predefined orbit or spectrum segments.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. Deficiency of employability capacity

    Directory of Open Access Journals (Sweden)

    Pelse I.

    2012-10-01

    Full Text Available Young unemployed people have comprised one of the significantly largest groups of the unemployed people in Latvia in recent years. One of the reasons why young people have difficulty integrating into the labour market is the “expectation gap” that exists in the relations between employers and the new generation of workers. Employers focus on capacity-building for employability such individual factors as strength, patience, self-discipline, self-reliance, self-motivation, etc., which having a nature of habit and are developed in a long-term work socialization process, which begins even before the formal education and will continue throughout the life cycle. However, when the socialization is lost, these habits are depreciated faster than they can be restored. Currently a new generation is entering the labour market, which is missing the succession of work socialization. Factors, such as rising unemployment and poverty in the background over the past twenty years in Latvia have created a very unfavourable employability background of “personal circumstances” and “external factors”, which seriously have impaired formation of the skills and attitudes in a real work environment. The study reveals another paradox – the paradox of poverty. Common sense would want to argue that poverty can be overcome by the job. However, the real state of affairs shows that unfavourable coincidence of the individual, personal circumstances and external factors leads to deficit of employability capacity and possibility of marked social and employment deprivation.

  19. Workshop on moisture buffer capacity

    DEFF Research Database (Denmark)

    2003-01-01

    Summary report of a Nordtest workshop on moisture buffer capacity held at Copenhagen August 21-22 2003......Summary report of a Nordtest workshop on moisture buffer capacity held at Copenhagen August 21-22 2003...

  20. Building a capacity building manual

    CSIR Research Space (South Africa)

    Clinton, DD

    2010-02-01

    Full Text Available ? Capacity building in developed nations ? renewal stage HOW can capacity be developed and maintained? Through mentoring , training, education, physical projects, the infusion of financial and other resources and more importantly the motivation...

  1. 1990s: High Capacity Backbones

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. 1990s: High Capacity Backbones. Backbone capacities increased from 2.5 Gb/s to 100s of Gb/s during the 1990's. Wavelength division multiplexing with 160 waves of 10 Gb/s was commercially available. Several high-capacity backbones built in the US and Europe.

  2. Landfill Construction and Capacity Expansion

    NARCIS (Netherlands)

    Andre, F.J.; Cerda, E.

    2003-01-01

    We study the optimal capacity and lifetime of landfills taking into account their sequential nature.Such an optimal capacity is characterized by the so-called Optimal Capacity Condition.Particular versions of this condition are obtained for two alternative settings: first, if all the landfills are

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Capacity Ten-Seven

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-05-04

    The study was initiated to assemble UK solar experts who would define the parameters for the design of solar cell process plant with a capacity of about 10MWp per annum and establish the optimum substrate size, cell configuration and junction structure and show that these characteristics are suited to high volume low cost production. The study focused on proven materials and techniques rather than on innovative materials and processes. Peak production should deliver panels at a cost of less than $1 per peak watt. The study was reported under the headings of fundamental studies, front contact deposition, semiconductor deposition, rear contact deposition, cell isolation and initial design study. Since much of the work is commercially sensitive, not all findings are divulged in the report. The work, which achieved all its targets, was carried out by ICP Solar Technologies UK Ltd under contract to the DTI.

  9. Completion of Embankment, Spillway and Outlet Works

    Science.gov (United States)

    1990-08-01

    54.0s to 54ja. 68.0’ A~o.0’ Iotto of bole 180E.C.I ITED STATES COSINEElt OFFICE ENGINEERING D1015100 FIELD ;l:I1 !CO SCT !08 GALVESTOX, TEXAS tog or coal...f.tioe, thinly bedded, &, - I’ ;; Tv, €o€ .cov*v o**.37..4- - ollilf¢oc" ’, 46.7.47.41 . SANDSTONE 71- H*~ 0 I0,V 47.943.4 eMo- o. Metro S.4-0.6’ "o...DRAWING-WORK AS BUILT we ~ ~ ~ ~ ’ L[’s1sfoTO o ~~ sct *obo ~ ~ ~ ~ 19y- 0.999 Dam. Site3.0 - .o.,,,A400093 No. I 3S1 U.S. ARMY ENGINEER oitarRIc’r

  10. North American fertilizer capacity data

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    This listing of producers and their fertilizer production capacities was compiled in January 1991 with the cooperation of the US and Canadian fertilizer industry. Capacity is only an indicator of supply. Nameplate capacity differs from planned production levels or actual production because plants often operate above or below design capacity. Unless reported otherwise, plant capacities are based on 340 days per year of operation. No adjustment is made for partial year operation. Numerical data for the production of ammonia, ammonium nitrate, nitrogen solutions, urea, phosphate rock, phosphoric acid and ammonium phosphates is included.

  11. Radio-capacity of ecosystems

    International Nuclear Information System (INIS)

    Kultakhmedov, Yu.; Kultakhmedova-Vyshnyakova, V.

    1997-01-01

    This paper consider a universal approach to ecosystems of different types, based on representation of their radio-capacity. The concept of ecosystem includes reproduction of components (bio-productivity) and conditions such as maintaining of environment quality. Radio-capacity in the case of radionuclide pollution appears in accumulation and redistribution of radionuclides in the ecosystem. As a result the radionuclides are redistributed and buried in soil or lake bottom sediments. Estimation models for the radio-capacity of water and terrestrial ecosystems are represented. The calculations of the radio-capacity factor of water ecosystems are performed, and the high radio-capacity of a freshwater reservoir (F=0.6-0.8) and extremely high radio-capacity of a reservoir cascade (F c =0.99) is shown material from the Dnieper's cascade reservoirs. The methods of radio-capacity estimation of agroecosystems, wood and marine ecosystems are developed. (authors)

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Available transmission capacity assessment

    Directory of Open Access Journals (Sweden)

    Škokljev Ivan

    2012-01-01

    Full Text Available Effective power system operation requires the analysis of vast amounts of information. Power market activities expose power transmission networks to high-level power transactions that threaten normal, secure operation of the power system. When there are service requests for a specific sink/source pair in a transmission system, the transmission system operator (TSO must allocate the available transfer capacity (ATC. It is common that ATC has a single numerical value. Additionally, the ATC must be calculated for the base case configuration of the system, while generation dispatch and topology remain unchanged during the calculation. Posting ATC on the internet should benefit prospective users by aiding them in formulating their requests. However, a single numerical value of ATC offers little for prospect for analysis, planning, what-if combinations, etc. A symbolic approach to the power flow problem (DC power flow and ATC offers a numerical computation at the very end, whilst the calculation beforehand is performed by using symbols for the general topology of the electrical network. Qualitative analysis of the ATC using only qualitative values, such as increase, decrease or no change, offers some new insights into ATC evaluation, multiple transactions evaluation, value of counter-flows and their impact etc. Symbolic analysis in this paper is performed after the execution of the linear, symbolic DC power flow. As control variables, the mathematical model comprises linear security constraints, ATC, PTDFs and transactions. The aim is to perform an ATC sensitivity study on a five nodes/seven lines transmission network, used for zonal market activities tests. A relatively complicated environment with twenty possible bilateral transactions is observed.

  18. Perioperative functional residual capacity.

    Science.gov (United States)

    Wahba, R W

    1991-04-01

    The literature dealing with the magnitude, mechanism and effects of reduced FRC in the perioperative period is reviewed. During general anaesthesia FRC is reduced by approximately 20%. The reduction is greater in the obese and in patients with COPD. The most likely mechanism is the loss of inspiratory muscle tone of the muscles acting on the rib cage. Gas trapping is an additional mechanism. Lung compliance decreases and airways resistance increases, in large part, due to decreased FRC. The larynx is displaced anteriorly and elongated, making laryngoscopy and intubation more difficult. The change in FRC creates or increases intrapulmonary shunt and areas of low ventilation to perfusion. This is due to the occurrence of compression atelectasis, and to regional changes in mechanics and airway closure which tend to reduce ventilation to dependent lung zones which are still well perfused. Abdominal and thoracic operations tend to increase shunting further. Large tidal volume but not PEEP will improve oxygenation, although both increase FRC. Both FRC and vital capacity are reduced following abdominal and thoracic surgery in a predictable pattern. The mechanism is the combined effect of incisional pain and reflex dysfunction of the diaphragm. Additional effects of thoracic surgery include pleural effusion, cooling of the phrenic nerve and mediastinal widening. Postoperative hypoxaemia is a function of reduced FRC and airway closure. There is no real difference among the various methods of active lung expansion in terms of the speed of restoration of lung function, or in preventing postoperative atelectasis/pneumonia. Epidural analgesia does not influence the rate of recovery of lung function, nor does it prevent atelectasis/pneumonia.

  19. Algorithmic complexity of quantum capacity

    Science.gov (United States)

    Oskouei, Samad Khabbazi; Mancini, Stefano

    2018-04-01

    We analyze the notion of quantum capacity from the perspective of algorithmic (descriptive) complexity. To this end, we resort to the concept of semi-computability in order to describe quantum states and quantum channel maps. We introduce algorithmic entropies (like algorithmic quantum coherent information) and derive relevant properties for them. Then we show that quantum capacity based on semi-computable concept equals the entropy rate of algorithmic coherent information, which in turn equals the standard quantum capacity. Thanks to this, we finally prove that the quantum capacity, for a given semi-computable channel, is limit computable.

  20. Capacity Measurement with the UIC 406 Capacity Method

    DEFF Research Database (Denmark)

    Landex, Alex; Schittenhelm, Bernd; Kaas, Anders H.

    2008-01-01

    This article describes the fast and effective UIC 406 method for calculating capacity consumption on railway lines. It is possible to expound the UIC 406 method in different ways which can lead to different capacity consumptions. Therefore, this article describes how the methodology is expounded...

  1. Installed capacity in New York

    International Nuclear Information System (INIS)

    Charlton, J.

    2006-01-01

    This presentation discussed capacity issues related to the New York Independent System Operator (NYISO). The NYISO's market volume was approximately $11 billion in 2005, and it was responsible for providing 32,075 MW of electricity at peak load to its users. Regulatory uncertainty is currently discouraging investment in new generating resources. All load serving entities are required to contract for sufficient capacity in order to meet their capacity obligations. Market participants currently determine capacity and energy revenues. The NYISO market allows suppliers to recover variable costs for providing ancillary services, and the economic value of the revenue source governs decisions made in the wholesale electricity market. The installed capacity market was designed as a spot auction deficiency auction. Phased-in demand curves are used to modify the installed capacity market's design. A sloped demand curve mechanism is used to value capacity above the minimum requirement for both reliability and competition. Participation in the day-ahead market enhances competition and exerts downward pressure on energy and ancillary service market prices. It was concluded that the market structures and design features of the installed capacity markets recognize the need for system reliability in addition to encouraging robust competition and recognizing energy price caps and regulatory oversights. tabs., figs

  2. Checking Capacity for MIMO Configurations

    DEFF Research Database (Denmark)

    Thaysen, Jesper; Jakobsen, Kaj Bjarne

    2007-01-01

    Wireless system capacity can be added by increasing the number of antennas in a MIMO setup or by carefully optimizing the performance of a smaller number of antennas.......Wireless system capacity can be added by increasing the number of antennas in a MIMO setup or by carefully optimizing the performance of a smaller number of antennas....

  3. Estimation of capacities on Florida freeways.

    Science.gov (United States)

    2014-09-01

    Current capacity estimates within Floridas travel time reliability tools rely on the Highway Capacity Manual (HCM 2010) to : estimate capacity under various conditions. Field measurements show that the capacities of Florida freeways are noticeably...

  4. 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

  5. North American fertilizer capacity data

    Energy Technology Data Exchange (ETDEWEB)

    1993-02-01

    This listing of fertilizer producers and their production capacities was compiled in February 1993 with the cooperation of the US and Canadian fertilizer industry. TVA does not guarantee the completeness or accuracy of the information. Capacity is only an indicator of supply. Nameplate capacity differs from planned production levels or actual production because plants often operate above or below design capacity. Unless reported otherwise, plant capacities are based on 340 days per year of operation. No adjustment is made for partial year operation. Information is given on the following types of fertilizers: ammonia, ammonium nitrate, nitrogen solutions, urea, ammonium sulfate, phosphate rock, wet-process phosphoric acid, ammonium phosphates, concentrated superphosphates, potash, nitric acid, superphosphoric acid, upgraded phosphoric acids, normal superphosphate, elemental phosphorus, potassium sulfate, and sulfate of potash/magnesia.

  6. Capacity Building in Land Administration

    DEFF Research Database (Denmark)

    Enemark, Stig; Williamson, I

    2004-01-01

    Capacity building increasingly seen as a key component of land administration projects in developing and countries in transition undertaken by the international development banks and individual country development assistance agencies. However, the capacity building concept is often used within...... infrastructures for implementing land policies in a sustainable way. Where a project is established to create land administration infrastructures in developing or transition countries, it is critical that capacity building is a mainstream component, not as an add-on, which is often the case. In fact such projects...... should be dealt with as capacity building projects in themselves.    The article introduces a conceptual analytical framework that provides some guidance when dealing with capacity building for land administration in support of a broader land policy agenda....

  7. Socio-economy and Related Factors Influencing Condition and Capacity of Human Excreta Disposal and Sewer Systems: a Case Study in Coastal City of Manado

    OpenAIRE

    Kandou, Grace Debbie; Lasut, Markus T

    2010-01-01

    Untreated wastewater containing human excreta from households as well as from other wastewater-generating sources such as restaurants, hotels, hospitals, garbage disposal, and markets, is discharged directly into Manado Bay through ditches, sewers, canals, and rivers. This situation isexacerbated by inadequate capacity of human excreta disposal treatment and improper sewage system. To assess factors influencing condition and capacities of this system that may degrade human health and the envi...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. Capacity Measurement with the UIC 406 Capacity Method

    DEFF Research Database (Denmark)

    Landex, Alex; Schittenhelm, Bernd; Kaas, Anders H.

    2008-01-01

    This article describes the fast and effective UIC 406 method for calculating capacity consumption on railway lines. It is possible to expound the UIC 406 method in different ways which can lead to different capacity consumptions. Therefore, this article describes how the methodology is expounded...... in Denmark. This includes how and where to divide the railway lines into line sections, how to analyze stations and junctions, and how to examine line sections with different amounts of tracks....

  18. Regular capacities on metrizable spaces

    Directory of Open Access Journals (Sweden)

    T. M. Cherkovskyi

    2014-07-01

    Full Text Available It is proved that for a (not necessarily compact metric space: the metrics on the space of capacities in the sense of Zarichnyi and Prokhorov are equal; completeness of the space of capacities is equivalent to completeness of the original space. It is shown that for the capacities on metrizable spaces the properties of $\\omega$-smoothness and of $\\tau$-smoothness are equivalent precisely on the separable spaces, and the properties of $\\omega$-smoothness and of regularity w.r.t. some (then w.r.t. any admissible metric are equivalent precisely on the compact spaces.

  19. Capacity Building in Land Management

    DEFF Research Database (Denmark)

    Enemark, Stig; Ahene, Rexford

    2003-01-01

    There is a significant need for capacity building in the interdisciplinary area of land management especially in developing countries and countries in transition, to deal with the complex issues of building efficient land information systems and sustainable institutional infrastructures. Capacity...... development in this area. Furthermore, capacity building should ensure that the focus is on building sound institutions and governance rather than just high-level IT-infrastructures.    This overall approach to capacity building in land management is used for implementing a new land policy reform in Malawi...... building in land management is not only a question of establishing a sufficient technological level or sufficient economic resources. It is mainly a question of understanding the interdisciplinary and cross-sectoral nature of land administration systems, and understanding the need for human resource...

  20. Building Capacity in Ethical Review

    DEFF Research Database (Denmark)

    Douglas-Jones, Rachel

    2017-01-01

    Capacity building in biomedical research ethics review has been a European priority since the early 2000s. Prompted by the increase in data originating in internationally sponsored trials in emerging economies, a range of capacity building initiatives were put in place in the field of ethical...... review to ensure the protection of human subjects participating in research. Drawing on fieldwork with the Forum for Ethical Review Committees in the Asian and Western Pacific Region, I explore two distinct forms taken by capacity building within that organization to support and train members of ethics...... review committees. The first, with an emphasis on standards and measurability, takes as its priority international accountability for clinical trial research. e second explores how the organization goes about persuading trainees to see and do ‘ethics’ differently. is distinction between forms of capacity...

  1. Capacity Markets and Market Stability

    International Nuclear Information System (INIS)

    Stauffer, Hoff

    2006-01-01

    The good news is that market stability can be achieved through a combination of longer-term contracts, auctions for far enough in the future to permit new entry, a capacity management system, and a demand curve. The bad news is that if and when stable capacity markets are designed, the markets may seem to be relatively close to where we started - with integrated resource planning. Market ideologues will find this anathema. (author)

  2. Research projects and capacity building

    CSIR Research Space (South Africa)

    Breen, CM

    2004-10-01

    Full Text Available - knowledged as necessary and urgent, but is this sufficient? Are ?head counts? and/or ?degree counts? of individuals from marginalised sectors, including gender, participating in research projects appro- priate measures for capacity building? Much depends... numbers of people (including race and gender) gaining higher degrees and papers published in peer-reviewed journals may provide some measure of capacity building, they do not measure the extent to which fundamental enabling conditions have been fostered...

  3. 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.

  4. 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

  5. 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.

  6. 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.

  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. Maximizing the optical network capacity.

    Science.gov (United States)

    Bayvel, Polina; Maher, Robert; Xu, Tianhua; Liga, Gabriele; Shevchenko, Nikita A; Lavery, Domaniç; Alvarado, Alex; Killey, Robert I

    2016-03-06

    Most of the digital data transmitted are carried by optical fibres, forming the great part of the national and international communication infrastructure. The information-carrying capacity of these networks has increased vastly over the past decades through the introduction of wavelength division multiplexing, advanced modulation formats, digital signal processing and improved optical fibre and amplifier technology. These developments sparked the communication revolution and the growth of the Internet, and have created an illusion of infinite capacity being available. But as the volume of data continues to increase, is there a limit to the capacity of an optical fibre communication channel? The optical fibre channel is nonlinear, and the intensity-dependent Kerr nonlinearity limit has been suggested as a fundamental limit to optical fibre capacity. Current research is focused on whether this is the case, and on linear and nonlinear techniques, both optical and electronic, to understand, unlock and maximize the capacity of optical communications in the nonlinear regime. This paper describes some of them and discusses future prospects for success in the quest for capacity. © 2016 The Authors.

  10. Measuring the Capacity Utilization of Public District Hospitals in Tunisia: Using Dual Data Envelopment Analysis Approach

    Directory of Open Access Journals (Sweden)

    Chokri Arfa

    2017-01-01

    Full Text Available Background Public district hospitals (PDHs in Tunisia are not operating at full plant capacity and underutilize their operating budget. Methods Individual PDHs capacity utilization (CU is measured for 2000 and 2010 using dual data envelopment analysis (DEA approach with shadow prices input and output restrictions. The CU is estimated for 101 of 105 PDH in 2000 and 94 of 105 PDH in 2010. Results In average, unused capacity is estimated at 18% in 2010 vs. 13% in 2000. Of PDHs 26% underutilize their operating budget in 2010 vs. 21% in 2000. Conclusion Inadequate supply, health quality and the lack of operating budget should be tackled to reduce unmet user’s needs and the bypassing of the PDHs and, thus to increase their CU. Social health insurance should be turned into a direct purchaser of curative and preventive care for the PDHs.

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. Absorptive capacity and smart companies

    Directory of Open Access Journals (Sweden)

    Patricia Moro González

    2014-12-01

    Full Text Available Purpose: The current competitive environment is substantially modifying the organizations’ learning processes due to a global increase of available information allowing this to be transformed into knowledge. This opportunity has been exploited since the nineties by the tools of “Business Analytics” and “Business Intelligence” but, nevertheless, being integrated in the study of new organizational capacities engaged in the process of creating intelligence inside organizations is still an outstanding task. The review of the concept of absorptive capacity and a detailed study from the perspective of this new reality will be the main objective of study of this paper.Design/methodology/approach: By comparing classical absorptive capacity and absorptive capacity from the point of view of information management tools in each one of the three stages of the organizational learning cycle, some gaps of the former are overcome/fulfilled. The academic/bibliographical references provided in this paper have been obtained from ISI web of knowledge, Scopus and Dialnet data bases, supporting the state of affairs on absorptive capacity and thereafter filtering by "Business Intelligence" and "Business Analytics". Specialized websites and Business Schools` Publications there have also been included, crowning the content on information management tools used that are currently used in the strategic consulting.Findings: Our contribution to the literature is the development of "smart absorptive capacity". This is a new capacity emerging from the reformulation of the classical concept of absorptive capacity wherein some aspects of its definition that might have been omitted are emphasized. The result of this new approach is the creation of a new Theoretical Model of Organizational Intelligence, which aims to explain, within the framework of the Resources and Capabilities Theory, the competitive advantage achieved by the so-called smart companies

  16. Improving African health research capacity

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Wallace, Samantha A; Liljestrand, Jerker

    2010-01-01

    The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront is the migrat...... of beneficial research capacity in the countries of sub-Saharan Africa, this article suggests several recommendations to both donors and governments that have broad application for general health research issues in the region.......The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront...... is the migration of health professionals to countries that offer more lucrative opportunities, like those in western Europe. To combat this ''brain drain'', already back in 1984, the Swedish International Development Cooperation Agency (Sida) created a training programme in which healthcare professionals from...

  17. 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.

  18. 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

  19. 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.

  20. Mental healthcare in Kenya: Exploring optimal conditions for capacity building

    Directory of Open Access Journals (Sweden)

    Elijah Marangu

    2014-01-01

    Full Text Available The global burden of disease related to mental disorders is on the increase, with the World Health Organization (WHO estimating that over 450 million people are affected worldwide. The Mental Health Global Action Program (mhGAP was launched by the WHO in 2002 in order to address the widening gap in access to mental healthcare in low-income countries. Despite these efforts, access to mental healthcare in low-income countries remains poor and is often described as inadequate, inefficient and inequitable, with an 85% estimated treatment gap in low-income countries, as compared with 35% to 50% in high-income countries.In this article, the authors argue that integrating mental health services into primary healthcare settings through capacity building is vital with regard to achieving mhGAP goals. The article explores the challenges to and potential enablers for the improvement of the delivery of broad-based mental healthcare services in Kenya. The authors propose the integration of the conceptual dimensions of both the cosmopolitanism and capabilities approaches as a combined strategy for dealing with capacity building in heterogeneous settings such as Kenya.

  1. 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.

  2. 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.

  3. Capacity Utilization in European Railways

    DEFF Research Database (Denmark)

    Khadem Sameni, Melody; Landex, Alex

    2013-01-01

    At the strategic level, railways currently use different indices to estimate how ‘value’ is generated by using railway capacity. However, railway capacity is a multidisciplinary area, and attempts to develop various indices cannot provide a holistic measure of operational efficiency. European...... and unprecedented approach for this aim. Relative operational efficiency of 24 European railways in capacity utilization is studied for the first time by data envelopment analysis (DEA). It deviates from previous applications of DEA in the railway industry that are conducted to analyze cost efficiency of railways...... aspects of railway services in European countries has recently been quantified by European commission and are used for the first time in the literature. Invaluable insights can be inferred from the results which can provide a ground basis for railway practitioners and policy makers....

  4. Warfare, Fiscal Capacity, and Performance

    DEFF Research Database (Denmark)

    Prado, Mauricio; Dincecco, Mark

    innovations, which persisted and helped to shape current fiscal institutions. Economic historians claim that greater fiscal capacity was the key long-run institutional change brought about by historical conflicts. Using casualties sustained in pre-modern wars to instrument for current fiscal institutions, we......We exploit differences in casualties sustained in pre-modern wars to estimate the impact of fiscal capacity on economic performance. In the past, states fought different amounts of external conflicts, of various lengths and magnitudes. To raise the revenues to wage wars, states made fiscal...... estimate substantial impacts of fiscal capacity on GDP per worker. The results are robust to a broad range of specifications, controls, and sub-samples....

  5. Warfare, Fiscal Capacity, and Performance

    DEFF Research Database (Denmark)

    Dincecco, Mark; Prado, Mauricio

    2012-01-01

    innovations, which persisted and helped to shape current fiscal institutions. Economic historians claim that greater fiscal capacity was the key long-run institutional change brought about by historical conflicts. Using casualties sustained in pre-modern wars to instrument for current fiscal institutions, we......We exploit differences in casualties sustained in pre-modern wars to estimate the impact of fiscal capacity on economic performance. In the past, states fought different amounts of external conflicts, of various lengths and magnitudes. To raise the revenues to wage wars, states made fiscal...... estimate substantial impacts of fiscal capacity on GDP per worker. The results are robust to a broad range of specifications, controls, and sub-samples....

  6. Seismic fragility capacity of equipment

    International Nuclear Information System (INIS)

    Iijima, Toru; Abe, Hiroshi; Suzuki, Kenichi

    2006-01-01

    Seismic probabilistic safety assessment (PSA) is an available method to evaluate residual risks of nuclear plants that are designed on definitive seismic conditions. From our preliminary seismic PSA analysis, horizontal shaft pumps are important components that have significant influences on the core damage frequency (CDF). An actual horizontal shaft pump and some kinds of elements were tested to evaluate realistic fragility capacities. Our test results showed that the realistic fragility capacity of horizontal shaft pump would be at least four times as high as a current value, 1.6 x 9.8 m/s 2 , used for our seismic PSA. We are going to incorporate the fragility capacity data that were obtained from those tests into our seismic PSA analysis, and we expect that the reliability of seismic PSA should increase. (author)

  7. THE LEGAL CAPACITY TO TRADE

    Directory of Open Access Journals (Sweden)

    ADELIN UNGUREANU

    2014-12-01

    Full Text Available Trading is a part of our society. The man has been trading from ancient times so the amount of trades and transactions around the world is huge. In order for us to initiate, organize and deploy such trades we have to have certain rules which can help regulate the social and professional or legal aspect of trades. Therefore the sole trader capacity must be obtained and used in order for the contracts to be valid. The right and obligations that come with this capacity constitute activities that can be reflected and analysed by obtaining and maintain the sole trader status.

  8. THE LEGAL CAPACITY TO TRADE

    OpenAIRE

    ADELIN UNGUREANU

    2014-01-01

    Trading is a part of our society. The man has been trading from ancient times so the amount of trades and transactions around the world is huge. In order for us to initiate, organize and deploy such trades we have to have certain rules which can help regulate the social and professional or legal aspect of trades. Therefore the sole trader capacity must be obtained and used in order for the contracts to be valid. The right and obligations that come with this capacity constitute activities t...

  9. Managing Capacity by Drift Control

    OpenAIRE

    Ormeci Matoglu, Melda; Vande Vate, John

    2009-01-01

    We model the problem of managing capacity in a build-to-order environment as a Brownian drift control problem and seek a policy that minimizes the long-term average cost. We assume the controller can, at some cost, shift the processing rate among a finite set of alternatives by, for example, adding or removing staff, increasing or reducing the number of shifts or opening or closing production lines. The controller incurs a cost for capacity per unit time and a delay cost that reflects th...

  10. Inadequate management of natural ecosystem in the Brazilian Amazon region results in the emergence and reemergence of arboviruses

    Directory of Open Access Journals (Sweden)

    Pedro F. C. Vasconcelos

    Full Text Available A total of 187 different species of arboviruses and other viruses in vertebrates were identified at the Evandro Chagas Institute (IEC from 1954 to 1998, among more than 10,000 arbovirus strains isolated from humans, hematophagous insects, and wild and sentinel vertebrates. Despite intensive studies in the Brazilian Amazon region, especially in Pará State, very little is known about most of these viruses, except for information on date, time, source, and method of isolation, as well as their capacity to infect laboratory animals. This paper reviews ecological and epidemiological data and analyzes the impact of vector and host population changes on various viruses as a result of profound changes in the natural environment. Deforestation, mining, dam and highway construction, human colonization, and urbanization were the main manmade environmental changes associated with the emergence and/or reemergence of relevant arboviruses, including some known pathogens for humans.

  11. Inadequate management of natural ecosystem in the Brazilian Amazon region results in the emergence and reemergence of arboviruses

    Directory of Open Access Journals (Sweden)

    Vasconcelos Pedro F. C.

    2001-01-01

    Full Text Available A total of 187 different species of arboviruses and other viruses in vertebrates were identified at the Evandro Chagas Institute (IEC from 1954 to 1998, among more than 10,000 arbovirus strains isolated from humans, hematophagous insects, and wild and sentinel vertebrates. Despite intensive studies in the Brazilian Amazon region, especially in Pará State, very little is known about most of these viruses, except for information on date, time, source, and method of isolation, as well as their capacity to infect laboratory animals. This paper reviews ecological and epidemiological data and analyzes the impact of vector and host population changes on various viruses as a result of profound changes in the natural environment. Deforestation, mining, dam and highway construction, human colonization, and urbanization were the main manmade environmental changes associated with the emergence and/or reemergence of relevant arboviruses, including some known pathogens for humans.

  12. Sediment transport capacity of concentrated flows on steep loessial slope with erodible beds.

    Science.gov (United States)

    Xiao, Hai; Liu, Gang; Liu, Puling; Zheng, Fenli; Zhang, Jiaqiong; Hu, Feinan

    2017-05-24

    Previous research on sediment transport capacity has been inadequate and incomplete in describing the detachment and transport process of concentrated flows on slope farmlands during rill development. An indoor concentrated flow scouring experiment was carried out on steep loessial soil slope with erodible bed to investigate the sediment transport capacity under different flow rates and slope gradients. The results indicated that the sediment transport capacity increases with increasing flow rate and slope gradient, and these relationships can be described by power functions and exponential functions, respectively. Multivariate, nonlinear regression analysis showed that sediment transport capacity was more sensitive to slope gradient than to flow rate, and it was more sensitive to unit discharge per unit width than to slope gradient for sediment transport capacity in this study. When similar soil was used, the results were similar to those of previous research conducted under both erodible and non-erodible bed conditions. However, the equation derived from previous research under non-erodible bed conditions with for river bed sand tends to overestimate sediment transport capacity in our experiment.

  13. Research projects and capacity building

    African Journals Online (AJOL)

    driniev

    2004-10-04

    Oct 4, 2004 ... strategic alliances interacting in a learning environment that is supported by enabling conditions, we appreciate that capacity building in research projects is not the sole responsibility of the researchers. The responsibility must be shared amongst those individuals and institutions who promote research (for ...

  14. Freeway work zone lane capacity.

    Science.gov (United States)

    2009-01-01

    The focus of this report is a capacity analysis of two long-term urban freeway Work Zones. Work Zone #1 : tapered four mainline lanes to two, using two separate tapers; Work Zone #2 tapered two mainline lanes to one. : Work Zone throughput was analyz...

  15. Model of clinker capacity expansion

    CSIR Research Space (South Africa)

    Stylianides, T

    1998-10-01

    Full Text Available to be introduced each year during a given planning horizon. The optimal solution is defined as the one which maximises the net present value (NPV) of the cash flow generated by the introduction and operation of new kilns subject to capacity and demand constraints...

  16. North American fertilizer capacity data

    Energy Technology Data Exchange (ETDEWEB)

    1991-12-01

    This listing of producers and their fertilizer production capacities was compiled in October 1991 with the cooperation of the US and Canadian fertilizer industries. Yearly production and forecasts are given for 1987 through 1997. Fertilizers reported on include: ammonium sulfate, nitric acid, wet-process superphosphoric acid, normal superphosphate, elemental phosphorus, potassium sulfate, and sulfate of potash/magnesia.

  17. North American fertilizer capacity data

    Energy Technology Data Exchange (ETDEWEB)

    1991-12-01

    This listing of producers and their fertilizer production capacities was compiled in October 1991 with the cooperation of the US and Canadian fertilizer industry. Fertilizers production is reported or forecasted for the years 1987 through 1997. The fertilizers reported on are: ammonia, ammonium nitrate, nitrogen solutions, urea, phosphate rock, wet-process phosphoric acid, ammonium phosphates, concentrated superphosphates, and potash.

  18. Antioxidant capacity and physical exercise

    Directory of Open Access Journals (Sweden)

    A Marciniak

    2009-09-01

    Full Text Available The aim of this article is a presentation of current knowledge regarding the changes of plasma antioxidant capacity observed in response to physical exercise. Human body created the enzymatic and non-enzymatic systems, which play a protective role in the harmful impact of free radicals. Those two systems constitute what is known as the plasma total antioxidant capacity. The amount of reactive oxygen species (ROS and reactive nitrogen species (NOS in combination with oxidation processes increases in some tissues during physiological response to physical exercise. These changes are observed after single bout of exercise as well as after regular training. The response of human body to physical exercise can be analysed using various models of exercise test. Application of repeated type of exhaustion allows for characterizing the ability of human body to adjust to the increased energy loss and increased oxygen consumption. This article presents the characteristics of components of plasma antioxidant capacity, the mechanisms of free radicals production and their role in human body. It discusses also the currently used methods of detecting changes in total antioxidant capacity and its individual elements in response to single bout of exercise and regular training. It presents the review of literature about research performed in groups of both regularly training and low exercise activity individuals as well as in group of healthy subjects and patients with circulation diseases.

  19. Comparative antioxidant capacity, membrane stabilization ...

    African Journals Online (AJOL)

    Comparative antioxidant capacity, membrane stabilization, polyphenol composition and cytotoxicity of the leaf and stem of Cissus multistriata. ... standard anti-inflammatory drug (Indomethacin) used. The extracts are less toxic to the cell (Arthenia salina) with their LC/EC50 higher than that of standard potassium dichromate ...

  20. Livelihood Resilience and Adaptive Capacity

    DEFF Research Database (Denmark)

    Thulstrup, Andreas Waaben

    2015-01-01

    This article analyses the implementation and outcomes of national development programs in a mountainous commune in Vietnam. The article traces the history of State intervention and the capacity of households and the community to adapt to change. The assessment reveals unintended consequences of t...

  1. Comparative antioxidant capacity, membrane stabilization ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-09-03

    Sep 3, 2008 ... In this present study, a comparative evaluation of the antioxidant capacities, phenol and polyphenol composition, membrane stabilization, and cytotoxicity to brine shrimps (Arthemia salina) of the leaf and stem extracts of Cissus multistriata were carried out. 2,2- Diphenyl-1-picryl hydrazyl (DPPH) radical.

  2. Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity.

    Science.gov (United States)

    Hedt-Gauthier, Bethany L; Chilengi, Roma; Jackson, Elizabeth; Michel, Cathy; Napua, Manuel; Odhiambo, Jackline; Bawah, Ayaga

    2017-12-21

    Inadequate research capacity impedes the development of evidence-based health programming in sub-Saharan Africa. However, funding for research capacity building (RCB) is often insufficient and restricted, limiting institutions' ability to address current RCB needs. The Doris Duke Charitable Foundation's African Health Initiative (AHI) funded Population Health Implementation and Training (PHIT) partnership projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia) to implement health systems strengthening initiatives inclusive of RCB. Using Cooke's framework for RCB, RCB activity leaders from each country reported on RCB priorities, activities, program metrics, ongoing challenges and solutions. These were synthesized by the authorship team, identifying common challenges and lessons learned. For most countries, each of the RCB domains from Cooke's framework was a high priority. In about half of the countries, domain specific activities happened prior to PHIT. During PHIT, specific RCB activities varied across countries. However, all five countries used AHI funding to improve research administrative support and infrastructure, implement research trainings and support mentorship activities and research dissemination. While outcomes data were not systematically collected, countries reported holding 54 research trainings, forming 56 mentor-mentee relationships, training 201 individuals and awarding 22 PhD and Masters-level scholarships. Over the 5 years, 116 manuscripts were developed. Of the 59 manuscripts published in peer-reviewed journals, 29 had national first authors and 18 had national senior authors. Trainees participated in 99 conferences and projects held 37 forums with policy makers to facilitate research translation into policy. All five PHIT projects strongly reported an increase in RCB activities and commended the Doris Duke Charitable Foundation for prioritizing RCB, funding RCB at adequate levels and time frames and for allowing

  3. Nigeria's oil production and the need for increased producing capacity

    International Nuclear Information System (INIS)

    Okoroji, C. E. I.

    1998-01-01

    After 40 years of commercial oil production, Nigeria's crude oil production is moving through difficult times. This transition period has been made more difficult because of recurring international economic recession, lack-luster crude prices, and slow oil demand growth and Government funding problems etc. Crude oil remains the most important export revenue earner in Nigeria, and more efforts are required to encourage higher output levels to support more foreign exchange generation. Nigeria's crude oil production at present stands at 2.2 million barrels per day (mbpd). This study, covers the period 1998-2005, during which oil production is forecast to grow to about 2.85 mbpd while potential for new discoveries could raise production to more than 3.0 mbpd. These projected rates could depend to a large extent on the rate and size of new discoveries. However, Nigeria's crude oil potential is being constrained by both lack of infrastructure and inadequate investment. The massive investment needed to raise the country's productive capacity will require foreign capital, yet the current fiscal environment leaves much to be desired. The purpose of this paper is to present a review of Nigeria's past, present and future oil production. To meet the projected production capacity very early in the next millennium, current estimates put the overall potential investment needed for an accelerated capacity-expansion drive in order to ensure that there is adequate cushion of crude potential at $19.7 billion during the next seven years. Furthermore, not more than $12.0 billion of this requirement can be generated from Nigeria's government cash flow

  4. Existing capacity to manage pharmaceuticals and related commodities in East Africa: an assessment with specific reference to antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Anokbonggo Willy W

    2009-03-01

    Full Text Available Abstract Background East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University, with technical assistance from the USAID supported Rational Pharmaceutical Management Plus (RPM Plus Program of Management Sciences for Health (MSH established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity. The initiative conducted a regional assessment to determine the existing capacity for the management of antiretroviral drugs and related commodities. Methods Heads and implementing workers of fifty HIV/AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to-face interviews guided by structured questionnaires. The assessment explored categories of health workers involved in the management of ARVs, their knowledge and practices in selection, quantification, distribution and use of ARVs, nature of existing training programs, training preferences and resources for capacity building. Results Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. Training opportunities and resources for capacity development were limited particularly for workers in remote facilities. On-the-job training and short courses were the preferred modes of training. Conclusion There

  5. Existing capacity to manage pharmaceuticals and related commodities in East Africa: an assessment with specific reference to antiretroviral therapy.

    Science.gov (United States)

    Waako, Paul J; Odoi-adome, Richard; Obua, Celestino; Owino, Erisa; Tumwikirize, Winnie; Ogwal-Okeng, Jasper; Anokbonggo, Willy W; Matowe, Lloyd; Aupont, Onesky

    2009-03-09

    East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University, with technical assistance from the USAID supported Rational Pharmaceutical Management Plus (RPM Plus) Program of Management Sciences for Health (MSH) established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity. The initiative conducted a regional assessment to determine the existing capacity for the management of antiretroviral drugs and related commodities. Heads and implementing workers of fifty HIV/AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to-face interviews guided by structured questionnaires. The assessment explored categories of health workers involved in the management of ARVs, their knowledge and practices in selection, quantification, distribution and use of ARVs, nature of existing training programs, training preferences and resources for capacity building. Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. Training opportunities and resources for capacity development were limited particularly for workers in remote facilities. On-the-job training and short courses were the preferred modes of training. There is inadequate capacity for managing medicines and related

  6. Controle integrado de espécies de Simulium (Diptera, Simuliidae por Bacillus thuringiensis e manejos mecânicos no riacho e nos vertedouros de tanques de piscicultura, Almirante Tamandaré, Paraná, Brasil Integrated pest control of Simulium (Diptera, Simuliidae with Bacillus thuringiensis and mechanical handling in creek and pisciculture spillway, Almirante Tamandaré, Paraná, Brazil

    Directory of Open Access Journals (Sweden)

    Fabiane Petry

    2004-03-01

    , ubicated in Curitiba's Metropolitan Area, simuliid populations boast high proliferation rates, delivering serious impact to local people with their noxious bites, to such an extent as to impair the daily meetings of people. From January to August 2002, 24,021 pupae were collected from which the following species and respective frequencies were identified: Simulium inaequale (55.24%, Simulium perflavum (16.81%, Simulium pertinax (13.93%, Simulium orbitale (8.03%, Simulium subnigrum (4.92%, Simulium distinctum (1.03% and Simulium incrustatum (0.04%. Local pest control measures were carried out from the February 28 to August 8, 2002. Main integrated pest control measures taken consisted in the application of biopesticide Bacillus thuringiensis israelensis (Bti and mechanical handling, not only by removing the immatures (eggs, larvae and pupae by means of drain brushing, but also by removing natural and artificial substrates from the bed. Larval mean density, monitored at artificial polythene strips substrates (area 13,500 cm², averaged 6.7 and 11.5 larvae/cm² before the application of Bti at the creek bed extension 75 m and on the dam spillway, respectively. Larval mass reduction at creek bed and at the spillway with application of Bti from 1.77 to 2.09 mg/litre of active ingredient for one minute exposure time and means of mechanical handlings monitored at polythene strips substrates (area 20,250 cm² varied, respectively from 72.61% to 99.97% and from 74.91% to 99.45 with outflows from 0.39 to 0.45 and from 0.38 to 0.43 m³/minute. At the one of the dam spillways with area of 5,110 cm², average larval density in the first mechanic handling was 10.27 larvae/cm². However, at this spillway, larval reduction by means of mechanical handlings was from 53.81% to 99.59%. Integrated pest control did down sized the number of bytes to the level wished, thus obtaining the positive effect aimed.

  7. Proposed method for the hydraulic design of ski-jump energy dissipators in dam spillways considering the occurrence of scour holes downstream of the structure; Metodo propuesto para el diseno hidraulico de trampolines empleados como disipadores de energia en aliviaderos para presas, considerando la ocurrencia del cono de socavacion al pie del mismo

    Energy Technology Data Exchange (ETDEWEB)

    Pardo-Gomez, Rafael [Centro de Investigaciones Hidraulicas (Cuba)

    2008-04-15

    Ski-jump energy dissipators are widely used in hydraulic engineering because of their well-known effectiveness. Nevertheless, some uncertainty exits associated with the dimensions of the scour hole appearing downstream of the structure. This paper presents a new method for solving this problem. This method includes spillway stability checking as part of the design process and also stability checking of any other construction near the energy dissipation zone. [Spanish] Los disipadores de energia tipo trampolin tienen amplia utilizacion en la practica de la ingenieria hidraulica por su probada eficacia; sin embargo, su diseno esta sujeto a cierto grado de incertidumbre en cuanto a la prediccion de las dimensiones del cono de socavacion que habra de producirse aguas abajo de la estructura. En el presente trabajo se muestra un metodo novedoso, mediante el cual el autor soluciona el aspecto antes referido, toda vez que se incluye como parte del proceso de diseno la comprobacion de la estabilidad del propio aliviadero o de cualquier otra obra cercana a la zona de disipacion de energia.

  8. Remarks on entanglement assisted classical capacity

    OpenAIRE

    Fan, Heng

    2003-01-01

    The property of the optimal signal ensembles of entanglement assisted channel capacity is studied. A relationship between entanglement assisted channel capacity and one-shot capacity of unassisted channel is obtained. The data processing inequalities, convexity and additivity of the entanglement assisted channel capacity are reformulated by simple methods.

  9. 7 CFR 983.27 - Proprietary capacity.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Proprietary capacity. 983.27 Section 983.27 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing..., ARIZONA, AND NEW MEXICO Definitions § 983.27 Proprietary capacity. Proprietary capacity means the capacity...

  10. 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.

  11. 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.

  12. Outage capacity of multicarrier systems

    KAUST Repository

    Yilmaz, Ferkan

    2010-01-01

    The probability density function and the cumulative distribution function of the product of shifted Gamma variates are obtained in terms of the generalized Fox\\'s H function. Using these new results, the exact outage capacity of multi carrier transmission through a slow Nakagami-m fading channel is presented. Moreover, it is shown that analytical and simulation results are in perfect agreement. © 2009 IEEE.

  13. Health Reform Requires Policy Capacity

    Directory of Open Access Journals (Sweden)

    Pierre-Gerlier Forest

    2015-05-01

    Full Text Available Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility

  14. Seven Experiment Designs Addressing Problems of Safety and Capacity on Two-Lane Rural Highways : Volume 8. Experimental Design and Evaluate Remedial Aids for Intersections with Inadequate Sight Distance

    Science.gov (United States)

    1978-05-01

    The experiment is planned for low-volume rural intersections on or near the Maine Facility. A number of remedial aids, both active and dynamic, are tested. The devices are designed either to focus the motorist's attention on existing conditions or to...

  15. Capacity to consent in mental health care bill 2013: A critique

    Directory of Open Access Journals (Sweden)

    Suresh Bada Math

    2015-01-01

    Full Text Available Mental capacity refers to the ability of an individual to make one's own decisions. Decision-making capacity has been described as the “key to autonomy” and an important ingredient of informed consent. Limited or impaired mental capacity embarks on a minefield of ethical and legal issues, which doctors need to be aware of while dealing with a particular patient. The objective of this article is to critically analyze the provisions of “capacity to consent” in Mental Health Care Bill (MHC Bill 2013, under the framework of the United Nations Convention on the Rights of Person with Disabilities (UNCRPD 2006. This article also attempts to offer a practical legal framework and some concrete suggestions, for psychiatrists operating in an ethically and legally challenging area of mental capacity. Some of the highlights include attempts to translate aspirations of the UNCRPD into MHC Bill 2013, which were out of context given the available resources, the family structure of our society, and inadequate research inputs. However, there is a need to introduce the capacity to consent to the MHC Bill 2013 after comprehensive research and to study the impact of such a revolutionary idea on the family aspects of our society. There is an urgent need to formulate and validate a capacity assessment tool for our population. The MHC Bill needs to consider the repercussion and impact of capacity to consent, thereby making room for the compulsory community treatment order empowering affected family members in providing much needed treatment for persons with mental illness.

  16. Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

    Science.gov (United States)

    2012-01-01

    Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases), to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6%) cases were benign, including mastopathy (fibrocystic disease) in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9%) cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC) being significantly more frequent (49.5%) than papillotubular growing type (Papi-tub) (P fibroadenoma, 27.8%; papilloma, 26.0%) and 73/139 (52.5%) were malignant, with SIDC being the most frequent malignant tumor (37.0%). Among 52 false-negative cases, SIDC was significantly more frequent (42.3%) than DCIS (P = 0.0049) and Papi-tub (P = 0.001). There were three false-positive cases, with one each of fibroadenoma, epidermal cyst and papilloma. Conclusions The inadequate, indeterminate, false-negative and false-positive cases showed similar histological types, notably SIDC for malignant tumors, and mastopathy, fibroadenoma and papilloma for benign cases. We need to pay particular attention to the collection and assessment of aspirates for these histological types of breast disease. In particular, several

  17. Psychiatric Mental Health Nursing Workforce Agenda: Optimizing Capabilities and Capacity to Address Workforce Demands.

    Science.gov (United States)

    Delaney, Kathleen R

    2016-01-01

    The mental health service delivery transformation has created models of care that generate demand for a workforce with particular competencies. This article develops a psychiatric mental health (PMH) nursing workforce agenda in light of demand generated by new models of care and the capacity/capabilities of the PMH RN and advanced practice nurse (APN) workforce. Examine the current capacity of the PMH nursing workforce and how health care reform and related service delivery models create demand for a particular set of behavioral health workforce competencies. PMH RNs and APNs have an educational background that facilitates development of competencies in screening, care coordination, leveling care, and wellness education. PMH RNs are a large workforce but the size of the PMH APN group is inadequate to meet demand. The specialty must strategize on how to build requisite PMH RN and APN competencies for the evolving service landscape. © The Author(s) 2016.

  18. Revenue Generation Capacity in Developing Countries: Implications ...

    African Journals Online (AJOL)

    It employs the co-integration and error-correction modeling framework to analyze the effects of erratic and inadequate revenue generation on physical and human capital development in Tanzania, Kenya, and Uganda using time-series data over the period 1970-2005.The results unambiguously demonstrate that changes in ...

  19. Leveraging Existing Laboratory Capacity towards Universal Health ...

    African Journals Online (AJOL)

    2016 including francophone Burkina Faso and Benin,. Anglophone Tanzania, Kenya and Uganda among others. ... without laboratory infrastructure and inadequate staffing levels, point of care testing provided by non- ... However, laboratory services are challenged with low funding, poor laboratory infrastructure and low.

  20. Measuring melting capacity with calorimetry

    OpenAIRE

    Betten, Linda

    2014-01-01

    Road salting is an important aspect of winter maintenance. There has been an increase in the usage of salt in later years to keep the road safe and accessible. It is a desire to reduce the amount of salt due to environmental aspects. To achieve better practices for winter maintenance it is necessary to obtain more knowledge about the different properties of salt. The motivation for this thesis is to develop a better method for determining the melting capacity for salt, which is an important p...

  1. UN OPEN GIS CAPACITY BUILDING

    Directory of Open Access Journals (Sweden)

    A. Albertella

    2017-07-01

    Full Text Available The UN Open GIS Initiative is to identify and develop, under UN guidance, an Open Source GIS bundle that meets the requirements of UN operations, taking full advantage of the expertise of mission partners (partner nations, technology contributing countries, international organizations, academia, NGO’s, private sector. The project, started in 2016, is composed by 4 working groups. One of the working group is specifically related to Capacity Building, given its importance for the success of the project. UN Open GIS will be based on some existing open source geospatial software (packages and libraries with many extensions specifically developed. The users of the platform will be the UN staff supporting with mapping and GIS the peacekeeping missions. Therefore, they are generally expert of this specific domain, even if they are currently using proprietary software. UN Open GIS Capacity Building is specifically thought for covering this gap, providing them the suitable background about open source geospatial software in general and the education tailored to the solution that has been being developed within the project itself.

  2. World nuclear power plant capacity

    International Nuclear Information System (INIS)

    1991-01-01

    This report provides the background information for statistics and analysis developed by NUKEM in its monthly Market Report on the Nuclear Fuel Cycle. The assessments in this Special Report are based on the continuous review of individual nuclear power plant projects. This Special Report begins with tables summarizing a variety of nuclear power generating capacity statistics for 1990. It continues with a brief review of the year's major events regarding each country's nuclear power program. The standard NUKEM Market Report tables on nuclear plant capacity are given on pages 24 and 25. Owing to space limitations, the first year shown is 1988. Please refer to previous Special Reports for data covering earlier years. Detailed tables for each country list all existing plants as well as those expected by NUKEM to be in commercial operation by the end of 2005. An Appendix containing a list of abbreviations can be found starting on page 56. Only nuclear power plants intended for civilian use are included in this Special Report. Reactor lifetimes are assumed to be 35 years for all light water reactors and 30 years for all other reactor types, unless other data or definite decommissioning dates have been published by the operators. (orig./UA) [de

  3. Carrying capacity of the eastern ecological gradient of Kenya.

    Science.gov (United States)

    Bernard, F E; Campbell, D J; Thom, D J

    1989-01-01

    Kenya's rate of natural population increase exceeds 4.0%/year. At this rate, Kenya's population of 23.5 million will expand to 35 million by the year 2000. Rural migrants are being forced out of the highlands into marginal arid and semiarid regions to the east and south in the eastern ecological gradient including Meru, Kitui, Machakos, and Kajiado districts. The people have become victims of marginalization by which the productivity of a unit of land declines relative to the demands of its occupants. The concept of carrying capacity means the number of people a given area can sustain over the long term. In Maasailand, 3.5 standard stock units (450 kg each) are required per adult equivalent for full subsistence, about 7 cows/person. For the Maasai pastoralists, carrying capacities were examined at 2 levels of subsistence: 100% from the herds and 80% from the herds; 2 technological levels; and population-growth rates of 2%, 2.5%, and 3%/annum. Using the median, 3.5%/year, population-growth scenario these districts will have almost 5 million inhabitants in the year 2000. Poverty at technology level I for 40% of them, or for 2 million people, is implausible. Technology level II implies that current rural-development programs will succeed with technological innovations for farm households, access to credit, and markets for their produce. Level II is likely to prevail toward the end of the century for the majority of farmers. Level III necessitates best agricultural and livestock technology as well as the best management. At most, 25% of the households of the eastern ecological gradient could enter this realm by the year 2000. Current strategies of voluntary family planning, rural development emerging from an antiquated extension system, inability to address inequity in land distribution, and laissez-faire resource management are inadequate to deal with the pace of change.

  4. Estimation of railroad capacity using parametric methods.

    Science.gov (United States)

    2013-12-01

    This paper reviews different methodologies used for railroad capacity estimation and presents a user-friendly method to measure capacity. The objective of this paper is to use multivariate regression analysis to develop a continuous relation of the d...

  5. Outlet diffusers to increase culvert capacity.

    Science.gov (United States)

    2016-06-01

    Aging infrastructure and changing weather patterns present the need to increase the capacity of existing highway culverts. This research approaches this challenge through the use of diffuser outlet systems to increase pipe capacity and reduce outlet ...

  6. Capacity-building for health research in developing countries: a manager's approach

    Directory of Open Access Journals (Sweden)

    Franklin White

    2002-09-01

    Full Text Available Research may be viewed as rigorous inquiry to advance knowledge and improve practices. An international commission has argued that strengthening research capacity is one of the most powerful, cost-effective, and sustainable means of advancing health and development. However, the global effort to promote research in developing countries has been mostly policy driven, and largely at the initiative of donor agencies based in developed countries. This policy approach, although essential, both contrasts with and is complementary to that of research managers, who must build capacity "from the ground up" in a variety of health service settings within countries and with differing mandates, resources, and constraints. In health organizations the concept of research is broad, and practices vary widely. However, building research capacity is not altogether different from building other kinds of organizational capacity, and it involves two major dimensions: strategic and operational. In organizations in the health field, if reference to research is not in the mission statement, then developing a relevant research capacity is made vastly more difficult. Research capacities that take years to develop can be easily damaged through inadequate support, poor management, or other negative influences associated with both internal and external environments. This paper draws from key international research policy documents and observations on the behavior of research and donor agencies in relation to developing countries. It examines capacity-building primarily as a challenge for research managers, realities underlying operational effectiveness and efficiency, approaches to resource mobilization, and the need for marketing the research enterprise. Selected examples from South Asia and Latin America and the Caribbean are presented.

  7. Evolution of poor reporting and inadequate methods over time in 20 920 randomised controlled trials included in Cochrane reviews: research on research study.

    Science.gov (United States)

    Dechartres, Agnes; Trinquart, Ludovic; Atal, Ignacio; Moher, David; Dickersin, Kay; Boutron, Isabelle; Perrodeau, Elodie; Altman, Douglas G; Ravaud, Philippe

    2017-06-08

    Objective  To examine how poor reporting and inadequate methods for key methodological features in randomised controlled trials (RCTs) have changed over the past three decades. Design  Mapping of trials included in Cochrane reviews. Data sources  Data from RCTs included in all Cochrane reviews published between March 2011 and September 2014 reporting an evaluation of the Cochrane risk of bias items: sequence generation, allocation concealment, blinding, and incomplete outcome data. Data extraction  For each RCT, we extracted consensus on risk of bias made by the review authors and identified the primary reference to extract publication year and journal. We matched journal names with Journal Citation Reports to get 2014 impact factors. Main outcomes measures  We considered the proportions of trials rated by review authors at unclear and high risk of bias as surrogates for poor reporting and inadequate methods, respectively. Results  We analysed 20 920 RCTs (from 2001 reviews) published in 3136 journals. The proportion of trials with unclear risk of bias was 48.7% for sequence generation and 57.5% for allocation concealment; the proportion of those with high risk of bias was 4.0% and 7.2%, respectively. For blinding and incomplete outcome data, 30.6% and 24.7% of trials were at unclear risk and 33.1% and 17.1% were at high risk, respectively. Higher journal impact factor was associated with a lower proportion of trials at unclear or high risk of bias. The proportion of trials at unclear risk of bias decreased over time, especially for sequence generation, which fell from 69.1% in 1986-1990 to 31.2% in 2011-14 and for allocation concealment (70.1% to 44.6%). After excluding trials at unclear risk of bias, use of inadequate methods also decreased over time: from 14.8% to 4.6% for sequence generation and from 32.7% to 11.6% for allocation concealment. Conclusions  Poor reporting and inadequate methods have decreased over time, especially for sequence generation

  8. Saxagliptin is non-inferior to glipizide in patients with type 2 diabetes mellitus inadequately controlled on metformin alone: a 52-week randomised controlled trial

    OpenAIRE

    Gause-Nilsson, Ingrid; Göke, Burkhard; Gallwitz, Baptist; Eriksson, Johan; Hellqvist, Asa

    2010-01-01

    Abstract Aim: Assess the efficacy and safety of saxagliptin vs. glipizide, as add-on therapy to metformin in patients with type 2 diabetes mellitus and inadequate glycaemic control on metformin alone. Methods and patients: A total of 858 patients (age ?18 years; glycated haemoglobin [HbA1c] >6.5?10.0%; on stable metformin doses ?1500mg/day) were randomised 1:1 to saxagliptin 5mg/day or glipizide up-titrated as needed from 5?20mg/day for 52 weeks. The primary objective wa...

  9. The Efficacy and Safety of Imeglimin as Add-on Therapy in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy

    OpenAIRE

    Fouqueray, Pascale; Pirags, Valdis; Inzucchi, Silvio E.; Bailey, Clifford J.; Schernthaner, Guntram; Diamant, Michaela; Lebovitz, Harold E.

    2013-01-01

    OBJECTIVE - A 12-week study assessed the efficacy and safety of a new oral antidiabetic agent, imeglimin, as add-on therapy in type 2 diabetes patients inadequately controlled with metformin alone. RESEARCH DESIGN AND METHODS - A total of 156 patients were randomized 1:1 to receive imeglimin (1,500mg twice a day) or placebo added to a stable dose of metformin (1,500-2,000 mg/day). Change in A1C from baseline was the primary efficacy outcome; secondary outcomes included fasting plasma glucose ...

  10. Light water reactor capacity factor investigation

    International Nuclear Information System (INIS)

    Meachum, T.R.; Monnie, D.I.; Whitacre, R.F. Jr.

    1985-01-01

    One of the internationally accepted measurements of an electrical generating station's productivity is the capacity factor. Comparison of the United States domestic nuclear facilities' cumulative capacity factors to the world shows that the US, while leading the western world in number of operating nuclear facilities, is near the bottom in the overall cumulative capacity factor. The purpose of this report is to identify the institutional and technological factors, which both adversely and favorably affect the domestic nuclear utilities' cumulative capacity factors

  11. Why Are We Talking About Capacity Markets?

    Energy Technology Data Exchange (ETDEWEB)

    Frew, Bethany

    2017-06-28

    Revenue sufficiency or 'missing money' concerns in wholesale electricity markets are important because they could lead to resource (or capacity) adequacy shortfalls. Capacity markets or other capacity-based payments are among the proposed solutions to remedy these challenges. This presentation provides a high-level overview of the importance of and process for ensuring resource adequacy, and then discusses considerations for capacity markets under futures with high penetrations of variable resources such as wind and solar.

  12. Global Development Network: Supporting Global Research Capacity

    International Development Research Centre (IDRC) Digital Library (Canada)

    GDN's capacity-building objective is being strengthened through their Global Research Capacity Building program, which provides up to six years of direct support for collaborative and cross-disciplinary research through regional competitions. This increased focus on capacity building enhances the commonalities with ...

  13. Carrying capacity: maintaining outdoor recreation quality

    Science.gov (United States)

    David W. Lime; George H. Stankey

    1971-01-01

    A discussion of (1) what is meant by the concept of recreational carrying capacity; (2) what is known about capacities in terms of both how resources and experience of visitors are affected by recreational use; and (3) what alternative procedures the administrator can use to manage both resources and visitors for capacity.

  14. Electrochemical impedance studies of capacity fading of ...

    Indian Academy of Sciences (India)

    2017-06-09

    Jun 9, 2017 ... Abstract. Electrodeposited ZnO coatings suffer severe capacity fading when used as conversion anodes in sealed Li cells. Capacity fading is ... coating delivered a stable reversible capacity 16% higher than that delivered by the ..... Ni3+ which not only imparts better electronic conductivity to the material, but ...

  15. The product of capacities and belief functions

    DEFF Research Database (Denmark)

    Hendon, Ebbe; Whitta-Jacobsen, Hans Jørgen; Sloth, Birgitte

    1996-01-01

    Capacities (monotone, non-additive set functions) have been suggested to describe situations of uncertainty. We examine the question of how to define the product of two independent capacities. In particular, for the product of two belief functions (totally monotone capacities), there is a unique...... minimal product belief function. This is characterized in several ways...

  16. The product of capacities and belief functions

    DEFF Research Database (Denmark)

    Hendon, Ebbe; Jacobsen, Hans Jørgen; Sloth, Birgitte

    1996-01-01

    Capacities (monotone, non-additive set functions) have been suggested to describe situations of uncertainty. We examine the question of how to define the product of two independent capacities. In particular, for the product of two belief functions (totally monotone capacities), there is a unique...... minimal product belief function. This is characterized in several ways....

  17. Frequency-dependent heat capacity

    DEFF Research Database (Denmark)

    Behrens, Claus Flensted

    The frequency–dependent heat capacity of super-cooled glycerol near the glass transition is measured using the 3w detection technique. An electrical conducting thin film with a temperature–dependent electrical resistance is deposited on a substrate. The thin film is used simultaneously as a heater...... and as a thermometer. The aim of the work is to improve and understand this planar heater experiment. I find: • Carbon has advantages as heater material over the traditionally used metal (nickel) heaters. • The thermal coupling to the surrounding temperature bath should not be made through the liquid but through...... the substrate. • Edge effects, as a result of the finite size of the heater, play an important role. The traditionally way of dealing with these effects are not entirely correct. • The Cole–Davidson function with bCD...

  18. High current capacity electrical connector

    International Nuclear Information System (INIS)

    Bettis, E.S.; Watts, H.L.

    1976-01-01

    An electrical connector is provided for coupling high current capacity electrical conductors such as copper busses or the like. The connector is arranged in a ''sandwiched'' configuration in which a conductor plate contacts the busses along major surfaces clamped between two stainless steel backing plates. The conductor plate is provided with contact buttons in a spaced array such that the caps of the buttons extend above the conductor plate surface to contact the busses. When clamping bolts provided through openings in the sandwiched arrangement are tightened, Belleville springs provided under the rim of each button cap are compressed and resiliently force the caps into contact with the busses' contacting surfaces to maintain a predetermined electrical contact area provided by the button cap tops. The contact area does not change with changing thermal or mechanical stresses applied to the coupled conductors

  19. The heat capacity mapping mission

    Science.gov (United States)

    Short, N. M.

    1981-01-01

    The first in a series of low cost Atmospheric Explorer Satellites, the Heat Capacity Mapping Mission (HCMM) was designed to evaluate the utility of thermal inertial and other thermal and reflectance data for: (1) discriminating bedrock and unconsolidated regolith types; (2) mapping soil moisture; (3) measuring plant canopy temperatures; (4) examining thermal circulation in large bodies of water; and (5) monitoring urban heat islands. Final reports from the HCMM investigator's program are beginning to define the utility of day/the night thermal data. Under favorable circumstances, some major rock types can be identified, soil moisture in extensive agricultural and alluvial terrains can be detected and at least semiqualitatively assessed; and circulation of currents in large bodies of water can be followed by noting thermal patterns.

  20. Pile Load Capacity – Calculation Methods

    Directory of Open Access Journals (Sweden)

    Wrana Bogumił

    2015-12-01

    Full Text Available The article is a review of the current problems of the foundation pile capacity calculations. The article considers the main principles of pile capacity calculations presented in Eurocode 7 and other methods with adequate explanations. Two main methods are presented: α – method used to calculate the short-term load capacity of piles in cohesive soils and β – method used to calculate the long-term load capacity of piles in both cohesive and cohesionless soils. Moreover, methods based on cone CPTu result are presented as well as the pile capacity problem based on static tests.

  1. Capacity analysis of vehicular communication networks

    CERN Document Server

    Lu, Ning

    2013-01-01

    This SpringerBrief focuses on the network capacity analysis of VANETs, a key topic as fundamental guidance on design and deployment of VANETs is very limited. Moreover, unique characteristics of VANETs impose distinguished challenges on such an investigation. This SpringerBrief first introduces capacity scaling laws for wireless networks and briefly reviews the prior arts in deriving the capacity of VANETs. It then studies the unicast capacity considering the socialized mobility model of VANETs. With vehicles communicating based on a two-hop relaying scheme, the unicast capacity bound is deriv

  2. Field evaluation of the error arising from inadequate time averaging in the standard use of depth-integrating suspended-sediment samplers

    Science.gov (United States)

    Topping, David J.; Rubin, David M.; Wright, Scott A.; Melis, Theodore S.

    2011-01-01

    Several common methods for measuring suspended-sediment concentration in rivers in the United States use depth-integrating samplers to collect a velocity-weighted suspended-sediment sample in a subsample of a river cross section. Because depth-integrating samplers are always moving through the water column as they collect a sample, and can collect only a limited volume of water and suspended sediment, they collect only minimally time-averaged data. Four sources of error exist in the field use of these samplers: (1) bed contamination, (2) pressure-driven inrush, (3) inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration, and (4) inadequate time averaging. The first two of these errors arise from misuse of suspended-sediment samplers, and the third has been the subject of previous study using data collected in the sand-bedded Middle Loup River in Nebraska. Of these four sources of error, the least understood source of error arises from the fact that depth-integrating samplers collect only minimally time-averaged data. To evaluate this fourth source of error, we collected suspended-sediment data between 1995 and 2007 at four sites on the Colorado River in Utah and Arizona, using a P-61 suspended-sediment sampler deployed in both point- and one-way depth-integrating modes, and D-96-A1 and D-77 bag-type depth-integrating suspended-sediment samplers. These data indicate that the minimal duration of time averaging during standard field operation of depth-integrating samplers leads to an error that is comparable in magnitude to that arising from inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration. This random error arising from inadequate time averaging is positively correlated with grain size and does not largely depend on flow conditions or, for a given size class of suspended sediment, on elevation above the bed. Averaging over time scales >1 minute is the likely minimum duration required

  3. Inadequate recording of alcohol-drinking, tobacco-smoking and discharge diagnosis in medical in-patients: failure to recognize risks including drug interactions.

    Science.gov (United States)

    Bairstow, B M; Burke, V; Beilin, L J; Deutscher, C

    1993-11-01

    The records of 62 men and 43 women, 14-88 years old, admitted to general medical wards in a public teaching hospital during 1991 were examined for discharge medications and for the recording of alcohol-drinking, tobacco-smoking and discharge diagnosis. Drinking and smoking status was unrecorded in 22.9% and 21.9% of patients respectively. Twenty-four patients had 31 potential drug interactions which were related to the number of drugs prescribed and to drinking alcohol; 10.5% of the patients had interactions involving alcohol and 2.9% tobacco. Six patients received relatively or absolutely contraindicated drugs, including one asthmatic given two beta-blockers. The drugs prescribed indicated that some patients had conditions such as gastro-oesophageal disorders, diabetes and obstructive airways disease which had not been recorded. Inadequate recording of diagnoses, alcohol and smoking status creates risks to patients and may cause opportunities for preventive care to be missed. This study provides the basis for the development of undergraduate and postgraduate education programmes to address these issues and so decrease risks to patients which arise from inadequate recording practices. Incomplete diagnoses also adversely affect hospital funding where this depends on case-mix diagnostic groups. Quality assurance programmes and other strategies are being implemented to improve medical recording and prescribing habits.

  4. Are the Level of Knowledge and Practices of Pregnant Women Regarding Folic Acid Supplementation Still Inadequate? A Cross-Sectional Study in a Middle Eastern Urban Setting.

    Science.gov (United States)

    Aoun, Antoine; Faddoul, Lara; El Jabbour, Flora; El Osta, Nada; Hlais, Sani; El Osta, Lana

    2017-11-13

    This observational cross-sectional study aimed to examine the knowledge and practices of pregnant women in North Lebanon regarding periconceptional folic acid (FA) supplementation. A convenience sample of pregnant women attending gynecology clinics in North Lebanon was recruited between May and September 2013. Data were collected from a face-to-face interview performed by a trained local dietician as well as from review of obstetric charts. A total of 465 women were included in the study. Only 37 (7.9%) were aware of the role of FA in preventing birth defects, while 129 (27.7%) were able to identify one food item rich in FA or folate. Only 125 (26.9%) were taking FA supplementation before pregnancy. While 440 (94.6%) participants were taking FA supplements during pregnancy, 158 (34%) were receiving an inadequate dose. Adequate preconceptional supplementation of FA was significantly associated with the women's level of education (p =.008), planned pregnancy (p knowledge and inadequate intake of FA supplements before and during pregnancy.

  5. Assessing urban adaptive capacity to climate change.

    Science.gov (United States)

    Araya-Muñoz, Dahyann; Metzger, Marc J; Stuart, Neil; Wilson, A Meriwether W; Alvarez, Luis

    2016-12-01

    Despite the growing number of studies focusing on urban vulnerability to climate change, adaptive capacity, which is a key component of the IPCC definition of vulnerability, is rarely assessed quantitatively. We examine the capacity of adaptation in the Concepción Metropolitan Area, Chile. A flexible methodology based on spatial fuzzy modelling was developed to standardise and aggregate, through a stepwise approach, seventeen indicators derived from widely available census statistical data into an adaptive capacity index. The results indicate that all the municipalities in the CMA increased their level of adaptive capacity between 1992 and 2002. However, the relative differences between municipalities did not change significantly over the studied timeframe. Fuzzy overlay allowed us to standardise and to effectively aggregate indicators with differing ranges and granularities of attribute values into an overall index. It also provided a conceptually sound and reproducible means of exploring the interplay of many indicators that individually influence adaptive capacity. Furthermore, it captured the complex, aggregated and continued nature of the adaptive capacity, favouring to deal with gaps of data and knowledge associated with the concept of adaptive capacity. The resulting maps can help identify municipalities where adaptive capacity is weak and identify which components of adaptive capacity need strengthening. Identification of these capacity conditions can stimulate dialogue amongst policymakers and stakeholders regarding how to manage urban areas and how to prioritise resources for urban development in ways that can also improve adaptive capacity and thus reduce vulnerability to climate change. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Determining anaerobic capacity in sporting activities.

    Science.gov (United States)

    Noordhof, Dionne A; Skiba, Philip F; de Koning, Jos J

    2013-09-01

    Anaerobic capacity/anaerobically attributable power is an important parameter for athletic performance, not only for short high-intensity activities but also for breakaway efforts and end spurts during endurance events. Unlike aerobic capacity, anaerobic capacity cannot be easily quantified. The 3 most commonly used methodologies to quantify anaerobic capacity are the maximal accumulated oxygen deficit method, the critical power concept, and the gross efficiency method. This review describes these methods, evaluates if they result in similar estimates of anaerobic capacity, and highlights how anaerobic capacity is used during sporting activities. All 3 methods have their own strengths and weaknesses and result in more or less similar estimates of anaerobic capacity but cannot be used interchangeably. The method of choice depends on the research question or practical goal.

  7. Uranium enrichment: technology, economics, capacity

    International Nuclear Information System (INIS)

    Voigt, W.R. Jr.; Vanstrum, P.R.; Saire, D.E.; Gestson, D.K.; Peske, S.E.

    1982-01-01

    Large-scale enrichment of uranium has now been carried out for 40 years. While the gaseous diffusion process was the original choice of several countries and continues today to provide the major component of the world production of separative work, the last two decades have witnessed the development of a number of alternative processes for enrichment. These processes, which are being studied and deployed around the world, offer a wide range of technical and economic characteristics which will be useful in assuring adequate capacity to meet projected reactor fuel market needs through the rest of this century at competitive prices. With present uncertainties in future enriched uranium needs, it is apparent that flexibility in the deployment and operation of any enrichment process will be one of the prime considerations for the future. More economical production of separative work not only can have a beneficial impact on reactor fuel costs, but also tends to conserve natural uranium resources. This paper reviews the world scene in the enrichment component of the fuel cycle, including existing or planned commercial-scale facilities and announced R and D efforts on various processes

  8. Novelties that change carrying capacity.

    Science.gov (United States)

    Erwin, Douglas H

    2012-09-01

    Comparative developmental studies have revealed a rich array of details about the patterns and processes of morphological change in animals and increasingly in plants. But, applying these insights to the study of major episodes of evolutionary innovation requires understanding how these novel morphologies become established and sufficiently abundant (either as individuals within a species or as a clade of species) to be preserved in the fossil record, and, in many cases, to influence ecological processes. Evolutionary novelties may: (1) disappear without changing the species; (2) be associated with the generation (through selection or drift) of a new species; and if the latter (3) may or may not become ecologically significant. Only the latter are commonly preserved in the fossil record. These alternatives mirror the distinction among historians of technology between innovation and invention. Here, I argue that specific sorts of evolutionary inventions drive ecological transformation, essentially constructing an environment for themselves and ancillary organisms through ecological spillover effects, increasing the "carrying capacity" of an ecosystem. Copyright © 2011 Wiley Periodicals, Inc.

  9. HIV communication capacity strengthening: a critical review.

    Science.gov (United States)

    Lettenmaier, Cheryl; Kraft, Joan Marie; Raisanen, Keris; Serlemitsos, Elizabeth

    2014-08-15

    HIV communication is most effective and sustainable when it is designed and implemented locally and tailored to the local context. This requires capacity strengthening at national, subnational, and community levels. Through a review of the published and selected "grey" literature, we examine HIV communication capacity strengthening: definitions, measurements, implementation, and effects. We found limited documentation of HIV communication capacity needs or systematic approaches to address them. Most HIV communication capacity strengthening to date has focused on building individual competencies to design and manage social and behavior change communication programs through training courses, often coupled with networking opportunities for participants, post-training mentoring, and technical assistance. A few of these efforts have been evaluated through pre- and post-training tests and qualitative interviews with participants and have shown potential for improvement in individual skills and knowledge. Health communication capacity assessment tools that measure individual and organizational competencies exist, but they have most often been used to identify capacity building needs, not for evaluating capacity strengthening efforts. A new definition of capacity strengthening, grown out of recent efforts to improve effectiveness of international health and development programs, focuses on improving organizational and societal systems that support performance and individual competencies. We propose a holistic model for HIV communication capacity strengthening and call for rigorous documentation and evaluation to determine and scale-up optimal capacity building interventions for strengthening social and behavior change communication for HIV prevention, care, and treatment in developing countries.

  10. Rethinking clinical trials of transcranial direct current stimulation: participant and assessor blinding is inadequate at intensities of 2mA.

    Directory of Open Access Journals (Sweden)

    Neil E O'Connell

    Full Text Available BACKGROUND: Many double-blind clinical trials of transcranial direct current stimulation (tDCS use stimulus intensities of 2 mA despite the fact that blinding has not been formally validated under these conditions. The aim of this study was to test the assumption that sham 2 mA tDCS achieves effective blinding. METHODS: A randomised double blind crossover trial. 100 tDCS-naïve healthy volunteers were incorrectly advised that they there were taking part in a trial of tDCS on word memory. Participants attended for two separate sessions. In each session, they completed a word memory task, then received active or sham tDCS (order randomised at 2 mA stimulation intensity for 20 minutes and then repeated the word memory task. They then judged whether they believed they had received active stimulation and rated their confidence in that judgement. The blinded assessor noted when red marks were observed at the electrode sites post-stimulation. RESULTS: tDCS at 2 mA was not effectively blinded. That is, participants correctly judged the stimulation condition greater than would be expected to by chance at both the first session (kappa level of agreement (κ 0.28, 95% confidence interval (CI 0.09 to 0.47 p=0.005 and the second session (κ=0.77, 95%CI 0.64 to 0.90, p=<0.001 indicating inadequate participant blinding. Redness at the reference electrode site was noticeable following active stimulation more than sham stimulation (session one, κ=0.512, 95%CI 0.363 to 0.66, p<0.001; session two, κ=0.677, 95%CI 0.534 to 0.82 indicating inadequate assessor blinding. CONCLUSIONS: Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution.

  11. Effective capacity of correlated MISO channels

    KAUST Repository

    Zhong, Caijun

    2011-06-01

    This paper presents an analytical performance investigation of the capacity limits of correlated multiple-input single-output (MISO) channels in the presence of quality-of-service (QoS) requirements. Exact closed-form expression for the effective capacity of correlated MISO channels is derived. In addition, simple expressions are obtained at the asymptotic high and low signal-to-noise ratio (SNR) regimes, which provide insights into the impact of various system parameters on the effective capacity of the system. Also, a complete characterization of the impact of spatial correlation on the effective capacity is provided with the aid of a majorization theory result. The findings suggest that antenna correlation reduce the effective capacity of the channels. Moreover, a stringent QoS requirement causes a significant reduction in the effective capacity but this can be effectively alleviated by increasing the number of antennas. © 2011 IEEE.

  12. North Dakota Refining Capacity Study

    Energy Technology Data Exchange (ETDEWEB)

    Dennis Hill; Kurt Swenson; Carl Tuura; Jim Simon; Robert Vermette; Gilberto Marcha; Steve Kelly; David Wells; Ed Palmer; Kuo Yu; Tram Nguyen; Juliam Migliavacca

    2011-01-05

    According to a 2008 report issued by the United States Geological Survey, North Dakota and Montana have an estimated 3.0 to 4.3 billion barrels of undiscovered, technically recoverable oil in an area known as the Bakken Formation. With the size and remoteness of the discovery, the question became 'can a business case be made for increasing refining capacity in North Dakota?' And, if so what is the impact to existing players in the region. To answer the question, a study committee comprised of leaders in the region's petroleum industry were brought together to define the scope of the study, hire a consulting firm and oversee the study. The study committee met frequently to provide input on the findings and modify the course of the study, as needed. The study concluded that the Petroleum Area Defense District II (PADD II) has an oversupply of gasoline. With that in mind, a niche market, naphtha, was identified. Naphtha is used as a diluent used for pipelining the bitumen (heavy crude) from Canada to crude markets. The study predicted there will continue to be an increase in the demand for naphtha through 2030. The study estimated the optimal configuration for the refinery at 34,000 barrels per day (BPD) producing 15,000 BPD of naphtha and a 52 percent refinery charge for jet and diesel yield. The financial modeling assumed the sponsor of a refinery would invest its own capital to pay for construction costs. With this assumption, the internal rate of return is 9.2 percent which is not sufficient to attract traditional investment given the risk factor of the project. With that in mind, those interested in pursuing this niche market will need to identify incentives to improve the rate of return.

  13. The reactor accident in Fukushima Daiichi. The consequence of design deficiencies and inadequate safety engineering; Der Reaktorunfall in Fukushima Daiichi. Folge fehlerhafter Auslegung und unzureichender Sicherheitstechnik

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-03-15

    The reactor accident in Fukushima Daiichi is discussed in the frame of design deficiencies and inadequate safety engineering. The progress of the accident as consequence of the earthquake and the tsunami is described. The radiological situation for the public is supposed to be blow the dose limit of 20 mSv/year. The WHO and UNSCEAR (United Nations Scientific Committee on the Effects of Atomic radiation) did not observe acute radiation injuries. The Japanese authorities have classified the accident to 7 of the INES scale. The German Atomforum e.V. considers the safety engineering of German NPPs to be superior to the Japanese situation due to higher emergency energy supply, extensive measures to reduce the hydrogen accumulation and mitigating measures for the accident management. German NPPS are considered highly robust as the EU stress tests have shown.

  14. [Inadequate burials as an important factor in plague epidemic amongst Serbs in the Habsburg monarchy by the end of the 18th century: a historical analysis].

    Science.gov (United States)

    Vasin, Goran; Božanić, Snežana; Božić, Milica Kisić

    2014-01-01

    Analysis of the archaic customs of burying the deceased in Srem, primarily amongst Serbs, in the second half of the 18th century is the essential part of the paper that aims at clarifying the consequences of this negative habit onto the spreading of plague epidemic. The Austrian Empire tried to stop and prevent the epidemic with an array of legal norms, but in practice, these orders were often not upheld. Serbian Metropolitans Pavle Nenadović and Stefan Stratimirović insisted on eradicating superstition and retrograde, often uncivilized actions in burial rituals, and they partially succeeded. The example of plague in Irig and the surroundings in 1795-1796 explicitly shows the hazardous effects of the inadequate attitude towards the deceased as one of the factors in spreading the epidemic. Using primary archives, and published sources, with adequate literature, authors depict this complex historical process.

  15. Inadequate birth spacing is perceived as riskier than all family planning methods, except sterilization and abortion, in a qualitative study among urban Nigerians.

    Science.gov (United States)

    Schwandt, Hilary M; Skinner, Joanna; Hebert, Luciana Estelle; Cobb, Lisa; Saad, Abdulmumin; Odeku, Mojisola

    2017-09-11

    Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians. A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four pregnancy related risks. The data were coded in ATLAS.ti 6 and analyzed using the thematic content analysis approach. The ten family planning and pregnancy related items ranked as follows from most to least risky: sterilization, abortion, getting pregnant soon after having a baby (no birth spacing), pill, IUD, injectable, having a birth under 18 years of age (teenage motherhood), condom use, having six children, and fertility awareness methods. Risk of family planning methods was often categorized in terms of side effects and complications. Positive perceptions of teenage motherhood and having many children influenced the low ranking of these items. Inadequate birth spacing was rated as more risky than all contraceptive methods and pregnancy related events except for sterilization and abortion. Some of the participants' risk perceptions of contraceptives and pregnancy related scenarios does not correspond to actual risk of methods and practices. Instead, the items' perceived riskiness largely correspond with prevailing social norms. However, there was a high level of understanding of the risks of inadequate birth spacing. This study is not a randomized control trial so the study has not been registered as such.

  16. Addressing inadequate compensation | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-08-12

    Aug 12, 2016 ... Communities' land and land use need to be fairly valuated for them to receive equitable compensation and a fair share of benefits and risks in land deals. Researchers in some projects are using “participatory valuation” processes with communities to help them appraise their lands' value and strengthening ...

  17. The capacity of digital links in tandem

    Science.gov (United States)

    Posner, E. C.; Rubin, A. L.

    1984-01-01

    The present investigation is concerned with the error control strategy used in connection with digital data networks, taking into account the capacity of the end-to-end channel. It is assumed that the only source of noise is Gaussian and that bandwidth limitation on capacity can be ignored. Attention is given to L links in tandem with binary repeaters, the asymptotic capacity with a large number of links, some alternative repeater strategies, and approaches for lowering the bit error probability. Numerical results are presented, taking into consideration capacity versus link error probability for various numbers of links.

  18. Strategic Mobility 21: Rail Network Capacity Analysis

    National Research Council Canada - National Science Library

    Mallon, Lawrence G; Leachman, Robert C; Fetty, George R

    2006-01-01

    This analysis examined the rail network capacity and average transit times for commercial and surge military deployments through the proposed Victorville - Joint Power Projection Support Platform (JPPSP...

  19. Narrative medicine and decision-making capacity.

    Science.gov (United States)

    Mahr, Greg

    2015-06-01

    The author proposes a new model for the assessment of decision-making capacity based on the principles of narrative medicine. The narrative method proposed by the author addresses the hidden power realtionships implicit in the current model of capacity assessment. Sample cases are reviewed using the traditional model in comparison with the narrative model. Narrative medicine provides an effective model for the assessment of decision-making capacity. Deficiencies in the traditional model capacity assessment can be effectively addressed using narrative strategies. © 2015 John Wiley & Sons, Ltd.

  20. Population growth and earth's human carrying capacity.

    Science.gov (United States)

    Cohen, J E

    1995-07-21

    Earth's capacity to support people is determined both by natural constraints and by human choices concerning economics, environment, culture (including values and politics), and demography. Human carrying capacity is therefore dynamic and uncertain. Human choice is not captured by ecological notions of carrying capacity that are appropriate for nonhuman populations. Simple mathematical models of the relation between human population growth and human carrying capacity can account for faster-than-exponential population growth followed by a slowing population growth rate, as observed in recent human history.

  1. A comparative analysis of capacity adequacy policies

    International Nuclear Information System (INIS)

    Doorman, Gerard; Botterud, Audun; Wolfgang, Ove

    2007-06-01

    In this paper a stochastic dynamic optimization model is used to analyze the effect of different generation adequacy policies in restructured power systems. The expansion decisions of profit-maximizing investors are simulated under a number of different market designs: Energy Only with and without a price cap, Capacity Payment, Capacity Obligation, Capacity Subscription, and Demand Elasticity. The results show that the overall social welfare is reduced compared to a centralized social welfare optimization for all policies except Capacity Subscription and Demand Elasticity. In particular, an energy only market with a low price cap leads to a significant increase in involuntary load shedding. Capacity payments and obligations give additional investment incentives and more generating capacity, but also result in a considerable transfer of wealth from consumers to producers due to the capacity payments. Increased demand elasticity increases social welfare, but also results in a transfer from producers to consumers, compared to the theoretical social welfare optimum. In contrast, the capacity subscription policy increases the social welfare, and both producers and consumers benefit. This is possible because capacity subscription explicitly utilizes differences in consumers' preferences for uninterrupted supply. This advantage must be weighed against the cost of implementation, which is not included in the model.

  2. Measures of Financial Capacity: A Review.

    Science.gov (United States)

    Ghesquiere, Angela R; McAfee, Caitlin; Burnett, Jason

    2017-05-23

    Capacity to manage finances and make financial decisions can affect risk for financial exploitation and is often the basis for legal determinations of conservatorship/guardianship. Several structured assessments of financial capacity have been developed, but have not been compared regarding their focus, validity, or reliability. Therefore, we conducted a review of financial capacity measures to examine these factors. We searched electronic databases, reference lists in identified articles, conference proceedings and other grey literature for measures of financial capacity. We then extracted data on the length and domains of each measure, the population for which they were intended, and their validity and reliability. We identified 10 structured measures of financial capacity. Most measures could be completed in 25-30 min, and were designed to be administered to older adults with some level of cognitive impairment. Reliability and validity were high for most. Measurement of financial capacity is complex and multidimensional. When selecting a measure of financial capacity, consideration should be made of the population of focus and the domains of capacity to be assessed. More work is needed on the cultural sensitivity of financial capacity measures, their acceptability, and their use in clinical work. Better understanding of when, and to whom, to administer different financial capacity measures could enhance the ability to accurately detect those suffering from impaired financial capacity, and prevent related negative outcomes like financial exploitation. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Emergent biosynthetic capacity in simple microbial communities.

    Directory of Open Access Journals (Sweden)

    Hsuan-Chao Chiu

    2014-07-01

    Full Text Available Microbes have an astonishing capacity to transform their environments. Yet, the metabolic capacity of a single species is limited and the vast majority of microorganisms form complex communities and join forces to exhibit capabilities far exceeding those achieved by any single species. Such enhanced metabolic capacities represent a promising route to many medical, environmental, and industrial applications and call for the development of a predictive, systems-level understanding of synergistic microbial capacity. Here we present a comprehensive computational framework, integrating high-quality metabolic models of multiple species, temporal dynamics, and flux variability analysis, to study the metabolic capacity and dynamics of simple two-species microbial ecosystems. We specifically focus on detecting emergent biosynthetic capacity--instances in which a community growing on some medium produces and secretes metabolites that are not secreted by any member species when growing in isolation on that same medium. Using this framework to model a large collection of two-species communities on multiple media, we demonstrate that emergent biosynthetic capacity is highly prevalent. We identify commonly observed emergent metabolites and metabolic reprogramming patterns, characterizing typical mechanisms of emergent capacity. We further find that emergent secretion tends to occur in two waves, the first as soon as the two organisms are introduced, and the second when the medium is depleted and nutrients become limited. Finally, aiming to identify global community determinants of emergent capacity, we find a marked association between the level of emergent biosynthetic capacity and the functional/phylogenetic distance between community members. Specifically, we demonstrate a "Goldilocks" principle, where high levels of emergent capacity are observed when the species comprising the community are functionally neither too close, nor too distant. Taken together

  4. Capacity reconsidered: Finding consensus and clarifying differences

    Science.gov (United States)

    Doug Whittaker; Bo Shelby; Robert Manning; David Cole; Glenn Haas

    2011-01-01

    In a world where populations and resource demands continue to grow, there is a long history of concern about the "capacity" of the environment to support human uses, including timber, rangelands, fish and wildlife, and recreation. In the context of recreation, work on visitor capacities has evolved considerably since the late 1960s as a result of...

  5. Manufacturing Capacity Utilization and Industrial Development in ...

    African Journals Online (AJOL)

    This paper investigates the impact of manufacturing capacity utilization on industrial development in Nigeria during the period of 1976 – 2005. Manufacturing capacity utilization, value added and employment generation were regressed on index of industrial productivity (which served as the proxy for industrial development) ...

  6. A Capacity Supply Model for Virtualized Servers

    Directory of Open Access Journals (Sweden)

    Alexander PINNOW

    2009-01-01

    Full Text Available This paper deals with determining the capacity supply for virtualized servers. First, a server is modeled as a queue based on a Markov chain. Then, the effect of server virtualization on the capacity supply will be analyzed with the distribution function of the server load.

  7. Bivalve carrying capacity in coastal ecosystems

    NARCIS (Netherlands)

    Dame, R.F.; Prins, T.C.

    1998-01-01

    carrying capacity of suspension feeding bivalves in 11 coastal and estuarine ecosystems is examined. Bivalve carrying capacity is defined in terms of water mass residence time, primary production time and bivalve clearance time. Turnover times for the 11 ecosystems are compared both two and three

  8. Time to reassess capacity-building partnerships

    Directory of Open Access Journals (Sweden)

    Brooke Lauten

    2007-07-01

    Full Text Available Since 2001 the Watchlist on Children and Armed Conflict has worked with local civil society organisations, child protection networks and grassroots organisations to build capacity to monitor and respond to abuses of children’s rights. Through our capacity-building partnerships, we work to shift the power structure that defines the roles of national and international NGO's in humanitarian programming.

  9. Establishing Criteria for Sexual Consent Capacity.

    Science.gov (United States)

    Kennedy, Carrie Hill; Niederbuhl, John

    2001-01-01

    Psychologists (N=305) completed a questionnaire concerning criteria for sexual consent capacity by individuals with mental retardation. Factor analysis identified five factors of which basic sexual knowledge, knowledge of the consequences of sexual behavior, and abilities related to self-protection were most critical for sexual consent capacity.…

  10. Embedding capacity estimation of reversible watermarking schemes

    Indian Academy of Sciences (India)

    Abstract. Estimation of the embedding capacity is an important problem specif- ically in reversible multi-pass watermarking and is required for analysis before any image can be watermarked. In this paper, we propose an efficient method for estimating the embedding capacity of a given cover image under multi-pass embed-.

  11. Thinking about Community Capacity Building & Asset Mapping.

    Science.gov (United States)

    Community Building Resources, Spruce Grove (Alberta).

    This book describes the mindshift that is the key to successful community capacity building and to the development of social and economic structures that nurture local sustainability. Its focus is how the development of community, through community capacity building, connects, animates, and informs citizens. Chapter I introduces community building…

  12. Embedding capacity estimation of reversible watermarking schemes

    Indian Academy of Sciences (India)

    Estimation of the embedding capacity is an important problem specifically in reversible multi-pass watermarking and is required for analysis before any image can be watermarked. In this paper, we propose an efficient method for estimating the embedding capacity of a given cover image under multi-pass embedding, ...

  13. Capacity building for sustainable energy development

    International Nuclear Information System (INIS)

    Rogner, Hans-Holger

    2006-01-01

    Capacity Building for Sustainable Energy Development - Mission: To build capacity in Member States (MS) for comprehensive energy system, economic and environmental analyses to assist in: - making informed policy decisions for sustainable energy development; - assessing the role of nuclear power; - understanding environmental and climate change issues related to energy production and use

  14. Developing Evaluation Capacity in Information and Communication ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    17 août 2009 ... Case study : PAN Asian Collaboration for Evidence-based e-Health Adoption and Application (PANACeA). Études. Case study : Developing evaluation capacity (DECI); building an organization's capacity to conduct use focused evaluations using a mentoring approach - LIRNEasia's CPRsouth Program ...

  15. Measuring excess capital capacity in agricultural production

    NARCIS (Netherlands)

    Zhengfei, G.; Kumbhakar, S.C.; Myers, R.J.; Oude Lansink, A.G.J.M.

    2009-01-01

    We introduce the concept "excess capital capacity" and employ a stochastic input requirement frontier to measure excess capital capacity in agricultural production. We also propose a two-step estimation method that allows endogenous regressors in stochastic frontier models. The first step uses

  16. Storage capacity of the Tilinglike Learning Algorithm

    International Nuclear Information System (INIS)

    Buhot, Arnaud; Gordon, Mirta B.

    2001-01-01

    The storage capacity of an incremental learning algorithm for the parity machine, the Tilinglike Learning Algorithm, is analytically determined in the limit of a large number of hidden perceptrons. Different learning rules for the simple perceptron are investigated. The usual Gardner-Derrida rule leads to a storage capacity close to the upper bound, which is independent of the learning algorithm considered

  17. Reliabilities of the Groningen Functional Capacity Test

    NARCIS (Netherlands)

    de Greef, MHG; Dijkstra, Y; Ottens, NM; Jansma, FFI

    The purpose of this study was to make a preliminary evaluation of the test-retest reliability of the Groningen Functional Capacity Test, a test developed to assess the functional capacity of people with a chronic disease and/or physical handicap and participating in a recreational sports stimulation

  18. Liberating Leadership Capacity: Pathways to Educational Wisdom

    Science.gov (United States)

    Lambert, Linda; Zimmerman, Diane P.; Gardner, Mary E.

    2016-01-01

    During the past quarter century, conceptions of leadership have evolved in concert with breakthrough discoveries in science and generative learning. "Liberating Leadership Capacity" captures these new ideas through the integration of the authors' earlier works in constructivist leadership and leadership capacity. What emerges is a…

  19. 25 CFR 168.5 - Grazing capacity.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Grazing capacity. 168.5 Section 168.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GRAZING REGULATIONS FOR THE HOPI PARTITIONED LANDS AREA § 168.5 Grazing capacity. (a) The Area Director shall prescribe the maximum number of each...

  20. An assessment of roadway capacity estimation methods

    NARCIS (Netherlands)

    Minderhoud, M.M.; Botma, H.; Bovy, P.H.L.

    1996-01-01

    This report is an attempt to describe existing capacity estimation methods with their characteristic data demands and assumptions. After studying the methods, one should have a better idea about the capacity estimation problem which can be encountered in traffic engineering. Moreover, decisions to

  1. Measuring the Capacity Utilization of Public District Hospitals in Tunisia: Using Dual Data Envelopment Analysis Approach.

    Science.gov (United States)

    Arfa, Chokri; Leleu, Hervé; Goaïed, Mohamed; van Mosseveld, Cornelis

    2016-06-06

    Public district hospitals (PDHs) in Tunisia are not operating at full plant capacity and underutilize their operating budget. Individual PDHs capacity utilization (CU) is measured for 2000 and 2010 using dual data envelopment analysis (DEA) approach with shadow prices input and output restrictions. The CU is estimated for 101 of 105 PDH in 2000 and 94 of 105 PDH in 2010. In average, unused capacity is estimated at 18% in 2010 vs. 13% in 2000. Of PDHs 26% underutilize their operating budget in 2010 vs. 21% in 2000. Inadequate supply, health quality and the lack of operating budget should be tackled to reduce unmet user's needs and the bypassing of the PDHs and, thus to increase their CU. Social health insurance should be turned into a direct purchaser of curative and preventive care for the PDHs. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. The Concept of Carrying Capacity in Tourism

    Directory of Open Access Journals (Sweden)

    Josef Zelenka

    2014-05-01

    Full Text Available Carrying capacity is often pragmatically, theoretically as well as purely intuitively considered as a concept in the context of tourism sustainability. The carrying capacity application has the greatest potential in protected areas, in frequently visited cultural and natural attractions, and in relation to sustaining of the lifestyle of the local community and tourism destination potential in general. Despite its importance, partial applications, determination of basic theoretical principles, and specifying connection to the other theoretical concepts in tourism (particularly destination life cycle, LAC concept, visitors management, there still is a rightful opinion of some authors suggesting that there is no consistent theory of tourism carrying capacity. This theory would be the base for sophisticated practical carrying capacity applications. This paper is therefore focused on introduction of the theoretical concept of carrying capacity, which can be discussed and possibly further elaborated.

  3. Capacity mechanisms and effects on market structure

    International Nuclear Information System (INIS)

    Elberg, Christina; Kranz, Sebastian

    2014-01-01

    Liberalized electricity markets are characterized by fluctuating priceinelastic demand of non-storable electricity, often defined by a substantial market share held by one or few incumbent firms. These characteristics have led to a controversial discussion concerning the need for and the design of capacity mechanisms, which combine some form of capacity payments with price caps in the spot market. The purpose of this study is to understand the effects of capacity mechanisms on the market structure. We consider a model with dominant firms and a competitive fringe and investigate the impact of price caps and capacity payments on investment incentives and market concentration. While lower price caps reduce the potential for the exercise of market power in static models, we find that in the dynamic model with endogenous investments, lower price caps result in an increase in market concentration, the frequency of capacity withholding and the profits of the dominant firms.

  4. Health promotion capacity mapping: the Korean situation.

    Science.gov (United States)

    Nam, Eun Woo; Engelhardt, Katrin

    2007-06-01

    Ten years ago the Republic of Korea enacted the National Health Promotion Act, setting the stage for health promotion action in the country. A National Health Promotion Fund was established, financed through tobacco taxes, which is now one of the largest in the world. However, despite abundant financial resources, the infrastructure needed to plan, implement, coordinate and evaluate health promotion efforts is still underdeveloped. Currently, health promotion capacity mapping efforts are emerging in Korea. Two international capacity mapping tools have been used to assess the Korean situation, namely HP-Source and the Health Promotion Capacity Profile, which was developed prior to the sixth Global Conference of Health Promotion, held in August 2005 in Bangkok, Thailand. The article summarizes and discusses the results of the capacity mapping exercise, highlights its challenges and suggest ways to improve the accuracy of health promotion capacity mapping.

  5. Higher education and capacity building in Africa

    DEFF Research Database (Denmark)

    Higher education has recently been recognised as a key driver for societal growth in the Global South and capacity building of African universities is now widely included in donor policies. The question is; how do capacity-building projects affect African universities, researchers and students......? Universities and their scientific knowledges are often seen to have universal qualities; therefore, capacity building may appear straightforward. Higher Education and Capacity Building in Africa contests such universalistic notions. Inspired by ideas about the ‘geography of scientific knowledge’ it explores......, the chapters draw on discussions about the hegemony of Western thought in education and knowledge production. The authors’ own experiences with higher education capacity building and knowledge production are discussed and used to contribute to the reflexive turn and rise of auto-ethnography. This book...

  6. Capacity building for oncology programmes in sub-Saharan Africa: the Rwanda experience.

    Science.gov (United States)

    Stulac, Sara; Binagwaho, Agnes; Tapela, Neo M; Wagner, Claire M; Muhimpundu, Marie Aimee; Ngabo, Fidele; Nsanzimana, Sabin; Kayonde, Leonard; Bigirimana, Jean Bosco; Lessard, Adam J; Lehmann, Leslie; Shulman, Lawrence N; Nutt, Cameron T; Drobac, Peter; Mpunga, Tharcisse; Farmer, Paul E

    2015-08-01

    Despite an estimated 456,000 deaths caused by cancer in sub-Saharan Africa in 2012 and a cancer burden that is predicted to double by 2030, the region accounts for only 0·3% of worldwide medical expenditure for cancer. Challenges to cancer care in sub-Saharan Africa include a shortage of clinicians and training programmes, weak healthcare infrastructure, and inadequate supplies. Since 2011, Rwanda has developed a national cancer programme by designing comprehensive, integrated frameworks of care, building local human resource capacity through partnerships, and delivering equitable, rights-based care. In the 2 years since the inauguration of Rwanda's first cancer centre, more than 2500 patients have been enrolled, including patients from every district in Rwanda. Based on Rwanda's national cancer programme development, we suggest principles that could guide other nations in the development of similar cancer programmes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Qualitative study to develop processes and tools for the assessment and tracking of African institutions' capacity for operational health research.

    Science.gov (United States)

    Wallis, Selina; Cole, Donald C; Gaye, Oumar; Mmbaga, Blandina T; Mwapasa, Victor; Tagbor, Harry; Bates, Imelda

    2017-09-05

    Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps. Four African universities. 83 university staff and students from 11 cadres. A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified. Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges. Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be

  8. Capacity market design and renewable energy: Performance incentives, qualifying capacity, and demand curves

    Energy Technology Data Exchange (ETDEWEB)

    Botterud, Audun; Levin, Todd; Byers, Conleigh

    2018-01-01

    A review of capacity markets in the United States in the context of increasing levels of variable renewable energy finds substantial differences with respect to incentives for operational performance, methods to calculate qualifying capacity for variable renewable energy and energy storage, and demand curves for capacity. The review also reveals large differences in historical capacity market clearing prices. The authors conclude that electricity market design must continue to evolve to achieve cost-effective policies for resource adequacy.

  9. The efficacy and safety of imeglimin as add-on therapy in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy.

    Science.gov (United States)

    Fouqueray, Pascale; Pirags, Valdis; Diamant, Michaela; Schernthaner, Guntram; Lebovitz, Harold E; Inzucchi, Silvio E; Bailey, Clifford J

    2014-07-01

    This 12-week study assessed the efficacy and tolerability of imeglimin as add-on therapy to the dipeptidyl peptidase-4 inhibitor sitagliptin in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy. In a multicenter, randomized, double-blind, placebo-controlled, parallel-group study, imeglimin (1,500 mg b.i.d.) or placebo was added to sitagliptin (100 mg q.d.) over 12 weeks in 170 patients with type 2 diabetes (mean age 56.8 years; BMI 32.2 kg/m(2)) that was inadequately controlled with sitagliptin alone (A1C ≥7.5%) during a 12-week run-in period. The primary efficacy end point was the change in A1C from baseline versus placebo; secondary end points included corresponding changes in fasting plasma glucose (FPG) levels, stratification by baseline A1C, and percentage of A1C responders. Imeglimin reduced A1C levels (least-squares mean difference) from baseline (8.5%) by 0.60% compared with an increase of 0.12% with placebo (between-group difference 0.72%, P < 0.001). The corresponding changes in FPG were -0.93 mmol/L with imeglimin vs. -0.11 mmol/L with placebo (P = 0.014). With imeglimin, the A1C level decreased by ≥0.5% in 54.3% of subjects vs. 21.6% with placebo (P < 0.001), and 19.8% of subjects receiving imeglimin achieved a decrease in A1C level of ≤7% compared with subjects receiving placebo (1.1%) (P = 0.004). Imeglimin was generally well tolerated, with a safety profile comparable to placebo and no related treatment-emergent adverse events. Imeglimin demonstrated incremental efficacy benefits as add-on therapy to sitagliptin, with comparable tolerability to placebo, highlighting the potential for imeglimin to complement other oral antihyperglycemic therapies. © 2014 by the American Diabetes Association.

  10. Capacity factors and solar job creation

    International Nuclear Information System (INIS)

    Croucher, Matt

    2011-01-01

    We discuss two main job creation statistics often used by solar advocates to support increased solar deployment. Whilst overall solar technologies have a tendency to be labor-intensive, we find that the jobs per gigawatt hour statistic is relatively mis-leading as it has a tendency to reward technologies that have a low capacity factor. Ultimately the lower the capacity factor the more amplified the solar job creation number. - Highlights: → Solar generation is labor intensive. → Jobs per gigawatt hour statistics are often mis-leading. → The lower the capacity factor the higher the jobs per gigawatt. → Reliance on job creation statistics may lead to inefficient deployment.

  11. Capacitated Dynamic Lot Sizing with Capacity Acquisition

    DEFF Research Database (Denmark)

    Li, Hongyan; Meissner, Joern

    directly. In this paper, we address the joint capacitated lot sizing and capacity acquisition problem. The firm can produce goods in each of the finite periods into which the production season is partitioned. Fixed as well as variable production costs are incurred for each production batch, along...... a model which combines the complexity of time-varying demand and cost functions and that of scale economies arising from dynamic lot-sizing costs with the purchase cost of capacity. We propose a heuristic algorithm that runs in polynomial time to determine a good capacity level and corresponding lot...

  12. Capacity choices in liberalised electricity markets

    International Nuclear Information System (INIS)

    Castro-Rodriguez, Fidel; Marin, Pedro L.; Siotis, Georges

    2009-01-01

    This paper addresses the issue of investment in electricity generation in the context of a liberalised market. We use the main results derived from a theoretical model where firms invest strategically to simulate the Spanish electricity system with real-world data. Our results indicate that, under reasonable parameter constellations regarding the number of agents, the level of capacity resulting from private decisions falls well short of the social optimum. Last, we show that two regulatory mechanisms that have been used to generate additional incentives for private agents to install capacity (capacity payment and price-adder) are ineffective and/or prohibitively costly. (author)

  13. Transience and capacity of minimal submanifolds

    DEFF Research Database (Denmark)

    Markvorsen, Steen; Palmer, V.

    2003-01-01

    We prove explicit lower bounds for the capacity of annular domains of minimal submanifolds P-m in ambient Riemannian spaces N-n with sectional curvatures bounded from above. We characterize the situations in which the lower bounds for the capacity are actually attained. Furthermore we apply...... these bounds to prove that Brownian motion defined on a complete minimal submanifold is transient when the ambient space is a negatively curved Hadamard-Cartan manifold. The proof stems directly from the capacity bounds and also covers the case of minimal submanifolds of dimension m > 2 in Euclidean spaces....

  14. Statistical methods to correct for verification bias in diagnostic studies are inadequate when there are few false negatives: a simulation study

    Directory of Open Access Journals (Sweden)

    Vickers Andrew J

    2008-11-01

    Full Text Available Abstract Background A common feature of diagnostic research is that results for a diagnostic gold standard are available primarily for patients who are positive for the test under investigation. Data from such studies are subject to what has been termed "verification bias". We evaluated statistical methods for verification bias correction when there are few false negatives. Methods A simulation study was conducted of a screening study subject to verification bias. We compared estimates of the area-under-the-curve (AUC corrected for verification bias varying both the rate and mechanism of verification. Results In a single simulated data set, varying false negatives from 0 to 4 led to verification bias corrected AUCs ranging from 0.550 to 0.852. Excess variation associated with low numbers of false negatives was confirmed in simulation studies and by analyses of published studies that incorporated verification bias correction. The 2.5th – 97.5th centile range constituted as much as 60% of the possible range of AUCs for some simulations. Conclusion Screening programs are designed such that there are few false negatives. Standard statistical methods for verification bias correction are inadequate in this circumstance.

  15. Systematic Review and Meta-Analysis of Diagnostic Accuracy of Serum Refractometry and Brix Refractometry for the Diagnosis of Inadequate Transfer of Passive Immunity in Calves.

    Science.gov (United States)

    Buczinski, S; Gicquel, E; Fecteau, G; Takwoingi, Y; Chigerwe, M; Vandeweerd, J M

    2018-01-01

    Transfer of passive immunity in calves can be assessed by direct measurement of immunoglobulin G (IgG) by methods such as radial immunodiffusion (RID) or turbidimetric immunoassay (TIA). IgG can also be measured indirectly by methods such as serum refractometry (REF) or Brix refractometry (BRIX). To determine the accuracy of REF and BRIX for assessment of inadequate transfer of passive immunity (ITPI) in calves. Systematic review and meta-analysis of diagnostic accuracy studies. Databases (PubMed and CAB Abstract, Searchable Proceedings of Animal Science) and Google Scholar were searched for relevant studies. Studies were eligible if the accuracy (sensitivity and specificity) of REF or BRIX was determined using direct measurement of IgG by RID or turbidimetry as the reference standard. The study population included calves refractometry, including the optimal cutoff, are sparse (especially for BRIX). When using REF to rule out ITPI in herds, the 5.5 g/dL cutoff may be used whereas for ruling in ITPI, the 5.2 g/dL cutoff may be used. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  16. Patients with Crohn's disease on anti-tumor necrosis factor therapy are at significant risk of inadequate response to the 23-valent pneumococcal polysaccharide vaccine.

    Science.gov (United States)

    Lee, Chang Kyun; Kim, Hyun-Soo; Ye, Byong Duk; Lee, Kang-Moon; Kim, You Sun; Rhee, Sang Youl; Kim, Hyo-Jong; Yang, Suk-Kyun; Moon, Won; Koo, Ja-Seol; Lee, Suck-Ho; Seo, Geom Seog; Park, Soo Jung; Choi, Chang Hwan; Jung, Sung-Ae; Hong, Sung Noh; Im, Jong Pil; Kim, Eun Soo

    2014-05-01

    The effect of immunosuppressants on the efficacy of a variety of vaccines is a controversial issue in patients with inflammatory bowel disease (IBD). In this study we determined whether specific immunosuppressants impair the serological response to the standard 23-valent pneumococcal polysaccharide vaccine (PPSV23) in a large cohort of patients with Crohn's disease (CD). This was a multi-center, prospective observational study of adult patients with CD at 15 academic teaching hospitals in Korea. The study population received one intramuscular injection of PPSV23. Anti-pneumococcal IgG antibody titers were measured by immunoassay prior to and 4weeks after vaccination. All vaccination-related adverse events and the effect of the vaccine on disease activity were also evaluated. The overall serological response rate was 67.5% (133/197). The serological response rate was significantly lower in patients on anti-tumor necrosis factor (anti-TNF) therapy (50.0% on anti-TNF alone; 58.0% on anti-TNF combined with an immunomodulator, IM) than patients on 5-aminosalicylate (78.4%; all P-values vs. 5-aminosalicylaterisk of an inadequate response to PPSV23. The pneumococcal vaccination strategy should be optimized for patients with CD on anti-TNF therapy. © 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  17. Effects of proximal grooves and abutment height on the resistance of resin-cemented crowns in teeth with inadequate resistance: An in vitro study.

    Science.gov (United States)

    Huang, Yi-Chen; Lin, Chun-Li; Ko, Ellen Wen-Ching

    2015-01-01

    The resistance form is a key factor for a successful crown fabrication. This in vitro study evaluates the effects of proximal grooves and abutment height on the resistance of single cast crowns in molars with inadequate resistance. Sixty extracted human molars were prepared to possess 20° of total occlusal convergence for single crown fabrication. All of the prepared teeth were divided into six groups and prepared according to three axial heights (2, 3, and 4 mm) with or without preparing a pair of proximal grooves. Alloy metal copings of 5% titanium were casted and cemented. A self-adhesive modified-resin cement was used for cementation. A lateral dislodgement test was performed with an increasing external force applied at a 45° angulation on a universal testing machine. The force required to dislodge the crown from the tooth or to break the core was recorded. Proximal grooves increased the dislodgement resistance in groups with an abutment height of 4 mm, whereas adding grooves made no significant differences in resistance in groups with abutment heights of 2 and 3 mm. The 2 mm groups exhibited worse performance than the other groups, whether they had proximal grooves or not. An abutment height of 3 mm provided adequate resistance for single cast crowns when self-adhesive modified-resin cement was used. Preparing a pair of proximal grooves on abutments shorter than 4 mm had no significant influence on the resistance.

  18. Invasive salivary duct carcinoma ex pleomorphic adenoma of the parotid gland: a teaching case giving rise to the genuine diagnostic difficulty on an inadequate cytology specimen

    Directory of Open Access Journals (Sweden)

    Yamada Sohsuke

    2012-05-01

    Full Text Available Abstract A history of a recent rapid increase in long-standing swelling mass was presented in the right parotid gland of an 85-year-old male. The inadequate cytologic specimens contained few small clusters of three-dimensional malignant epithelial cells having hyperchromatic pleomorphic nuclei and prominent nucleoli, adjacent to a cluster of benign monomorphic myoepithelial cells. We first interpreted it merely as an adenocarcinoma, not otherwise specified. A radical parotidectomy was performed, and gross examination revealed an encapsulated and firm tumor lesion, looking grayish-blue to yellowish-white, focally associated with extracapsular invasion. On microscopic examination, the tumor was predominantly composed of a proliferation of highly atypical epithelial cells having abundant eosinophilic cytoplasm, often arranged in a Roman-bridge appearance with foci of comedo necrosis, alternating with extensive infiltration to adjacent stroma in a trabecular or alveolar fashion with severe vessel permeation. Within the background of pleomorphic adenoma, the carcinoma cells sometimes replaced ductal luminal cells while retaining an intact-like myoepithelial layer. Therefore, we finally made a diagnosis of invasive salivary duct carcinoma ex pleomorphic adenoma. We should be aware that owing to its characteristic features, cytopathologists might be able to determine correct diagnosis, based on multiple and adequate samplings. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2126158270695815

  19. The efficacy and safety of imeglimin as add-on therapy in patients with type 2 diabetes inadequately controlled with metformin monotherapy.

    Science.gov (United States)

    Fouqueray, Pascale; Pirags, Valdis; Inzucchi, Silvio E; Bailey, Clifford J; Schernthaner, Guntram; Diamant, Michaela; Lebovitz, Harold E

    2013-03-01

    A 12-week study assessed the efficacy and safety of a new oral antidiabetic agent, imeglimin, as add-on therapy in type 2 diabetes patients inadequately controlled with metformin alone. A total of 156 patients were randomized 1:1 to receive imeglimin (1,500 mg twice a day) or placebo added to a stable dose of metformin (1,500-2,000 mg/day). Change in A1C from baseline was the primary efficacy outcome; secondary outcomes included fasting plasma glucose (FPG) and proinsulin/insulin ratio. After 12 weeks, the placebo-subtracted decrease in A1C with metformin-imeglimin was -0.44% (P < 0.001). Metformin-imeglimin also significantly improved FPG and the proinsulin/insulin ratio from baseline (-0.91 mg/dL and -7.5, respectively) compared with metformin-placebo (0.36 mg/dL and 11.81). Metformin-imeglimin therapy was generally well-tolerated with a comparable safety profile to metformin-placebo. Addition of imeglimin to metformin improved glycemic control and offers potential as a new treatment for type 2 diabetes.

  20. Examination of core Highway capacity manual concepts.

    Science.gov (United States)

    2002-01-01

    The Highway Capacity Manual (HCM) is one of the most widely used traffic engineering guidance documents in the world. It was originally published in 1950, and has been under constant revision since. Unfortunately, due to past cost and time constraint...

  1. Capacity of Intelligent Underlay and Overlay Network

    DEFF Research Database (Denmark)

    Ling, Yim; Elling, Jan; Nielsen, Thomas Toftegaard

    1996-01-01

    traffic. The formulas of the model have been implemented with the use of MatLab. To verify the model, measurement methods have been developed to collect the teletraffic information in a real-live GSM network. The measured data indicates that the teletraffic model describes the capacity with high accuracy......This paper suggests a method of dimensioning the cell configuration of radio sites in a cellular network using the intelligent overlay and underlay (IOU) technique. The traffic capacity has been analysed by means of a teletraffic model, which is developed based on the classical theory of overflow...... and therefore can be used to dimension the network. The model shows that the increase of capacity for a GSM network with 34 frequencies is about 30%. Further capacity enhancement can be achieved by intelligent frequency planning method which is currently being developed...

  2. Unveiling the Microfoundations of Absorptive Capacity

    DEFF Research Database (Denmark)

    Distel, Andreas Philipp

    2017-01-01

    explores the multilevel antecedents of absorptive capacity using survey data gathered from 342 informants at different levels of analysis in 106 medical technology firms. Multilevel structural equation modeling analyses indicate that formal and informal integration mechanisms are positively related......Although the concept of absorptive capacity has gained wide acceptance in the literature, our understanding of the origins of a firm’s ability to absorb and leverage new knowledge is limited. Drawing on Coleman’s (1990) bathtub framework for macro-micro-macro-relations in social science, this study...... to absorptive capacity at the organizational level and that this relationship is mediated through a microlevel process. The findings reveal that knowledge workers’ cognitive process of perspective taking and their creative behavior are important microfoundations of absorptive capacity. Moreover, the results...

  3. Predictors of exercise capacity in heart failure

    Directory of Open Access Journals (Sweden)

    Pranvera Ibrahimi

    2013-01-01

    Conclusion: In patients with HF, the limited exercise capacity assessed by 6-MWT, is multifactorial being related both to the severity of right ventricular systolic dysfunction as well as to raised LV filling pressures and global dyssynchrony.

  4. Reflexivity and the capacity to think.

    Science.gov (United States)

    Doyle, Sarah

    2013-02-01

    Reflexivity is fundamental to qualitative health research, yet notoriously difficult to unpack. Drawing on Wilfred Bion's work on the development of the capacity to think and to learn, I show how the capacity to think is an impermanent and fallible capacity, with the potential to materialize or evaporate at any number of different points. I use this conceptualization together with examples from published interview data to illustrate the difficulties for researchers attempting to sustain a reflexive approach, and to direct attention toward the possibilities for recovering and supporting the capacity to think. I counter some of the criticisms suggesting that reflexivity can be self-indulgent, and suggest instead that self-indulgence constitutes a failure of reflexivity. In the concluding discussions I acknowledge tensions accompanying the use of psychoanalytic theories for research purposes, and point to emerging psychosocial approaches as one way of negotiating these.

  5. Lack of import capacity for electricity?

    International Nuclear Information System (INIS)

    De Beus, J.P.J.

    2001-01-01

    Dutch electricity is relatively expensive as a result of which there exists a large and rising demand for electricity. Yet, uncontrolled expansion of the import capacity is not desirable. It is argued why this is the case. 3 refs

  6. DIFFUSION CAPACITY IN HEART-TRANSPLANT RECIPIENTS

    NARCIS (Netherlands)

    GROEN, HJM; BOGAARD, JM; BALK, AHMM; KHO, SG; HOP, WCJ; HILVERING, C

    Preoperative diffusion capacity per liter alveolar volume (Kco) in cardiac transplant recipients with an intrinsic normal lung is within the normal range. In the first postoperative year, Kco showed a significant mean decrease of 12 percent (p

  7. Strengthening Agricultural Research Capacity for Viable Extension ...

    African Journals Online (AJOL)

    Strengthening Agricultural Research Capacity for Viable Extension Policies in Nigeria: An Exploration of Ricoeur's Hermeneutic Theory for Analysing Extension Research. ... Progressively more, researchers use hermeneutic philosophy to inform the conduct of interpretive research. Analogy between the philosophical ...

  8. Modified MIMO Cube for Enhanced Channel Capacity

    Directory of Open Access Journals (Sweden)

    Lajos Nagy

    2012-01-01

    Full Text Available This paper deals with the optimization of MIMO antenna elements' position in modified MIMO cube for getting maximal channel capacity in indoor environment. The dependence of the channel capacity on the antenna orientation was analyzed by simulations. We have also examined the effect of the frequency dependence of the antenna system (in case of conjugate matching and nonconjugate matching for the channel capacity. Based on the simulation results in the created and measured antenna system, the antennas were at a right angle to each other. At the two chosen different structures, we measured the antenna parameters and the channel capacity. In this paper, we present the results of the measurements which clearly confirm our simulations. We will point out the differences between the two antenna structures.

  9. Assessing Capacity Value of Wind Power

    Energy Technology Data Exchange (ETDEWEB)

    Frew, Bethany A.

    2017-04-18

    This presentation provides a high-level overview of assessing capacity value of wind power, including Impacts of multiple-year data sets, impacts of transmission assumptions, and future research needs.

  10. Capacity-speed relationships in prefrontal cortex.

    Directory of Open Access Journals (Sweden)

    Vivek Prabhakaran

    Full Text Available Working memory (WM capacity and WM processing speed are simple cognitive measures that underlie human performance in complex processes such as reasoning and language comprehension. These cognitive measures have shown to be interrelated in behavioral studies, yet the neural mechanism behind this interdependence has not been elucidated. We have carried out two functional MRI studies to separately identify brain regions involved in capacity and speed. Experiment 1, using a block-design WM verbal task, identified increased WM capacity with increased activity in right prefrontal regions, and Experiment 2, using a single-trial WM verbal task, identified increased WM processing speed with increased activity in similar regions. Our results suggest that right prefrontal areas may be a common region interlinking these two cognitive measures. Moreover, an overlap analysis with regions associated with binding or chunking suggest that this strategic memory consolidation process may be the mechanism interlinking WM capacity and WM speed.

  11. Strengthening mathematics, science and economic policy capacity ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    responsive teaching methods; enhance scientific teaching and climate change research in Afghan and Tajik universities with a special focus on advancing women scientists; and build the capacity of officials and civil society organizations in all three ...

  12. Innovation capacity in the public sector

    DEFF Research Database (Denmark)

    Lewis, Jenny M; Ricard, Lykke Margot

    2015-01-01

    This article examines the innovation capacity of municipal governments by examining their innovation environments – governance structures, social networks and leadership qualities. An empirical study of this has been recently completed through a survey of politicians and senior administrators...

  13. Capacity Bounds for Parallel Optical Wireless Channels

    KAUST Repository

    Chaaban, Anas

    2016-01-01

    A system consisting of parallel optical wireless channels with a total average intensity constraint is studied. Capacity upper and lower bounds for this system are derived. Under perfect channel-state information at the transmitter (CSIT), the bounds have to be optimized with respect to the power allocation over the parallel channels. The optimization of the lower bound is non-convex, however, the KKT conditions can be used to find a list of possible solutions one of which is optimal. The optimal solution can then be found by an exhaustive search algorithm, which is computationally expensive. To overcome this, we propose low-complexity power allocation algorithms which are nearly optimal. The optimized capacity lower bound nearly coincides with the capacity at high SNR. Without CSIT, our capacity bounds lead to upper and lower bounds on the outage probability. The outage probability bounds meet at high SNR. The system with average and peak intensity constraints is also discussed.

  14. Capacity subscription and its market design impact

    International Nuclear Information System (INIS)

    Doorman, Gerard; Solem, Gerd

    2005-04-01

    Capacity Subscription (CS) implies that consumers buy (subscribe to) a certain amount of capacity. Their demand is limited to this capacity when the total power system is short of capacity and the System Operator activates controllable Load Limiting Devices (LLDs). The objective is to maintain system security by avoiding involuntary load shedding. The report describes a market design with CS. As a case study, an analysis is made of the changes in the market design of the Nordic system that would be necessary to implement CS. First the present Nordic market design is described. Focus is on the various market participants, their roles within various time horizons and their interactions. So it is described how CS works, why it works and what is necessary to make it work. Subsequently the necessary changes in the Nordic market structure are described. The major changes are the installation of the LLDs, the establishment of the necessary infrastructure to control the LLDs and the rules governing their control and the establishment of a capacity market. The major rule is that the System Operator announces LLD activation when a shortage situation is expected. In the capacity market generators offer available capacity during system peak conditions, while consumers bid their need for capacity. Market participants are the same as on the spot market, while small consumers buy through retailer. Generators are obliged to offer the capacity sold on the capacity market on the spot market during LLD activation. Failure to do so results in a penalty payment. The report further discusses issues like the need for verification procedures, import and export, generation pooling, the handling of small consumers, reserves and a possible implementation path of CS. With respect to transmission constraints it is argued that market splitting can be a viable option. It is concluded that CS can be a possible solution to maintain generation adequacy, but there are some serious challenges. The

  15. Self-Aerated Flow on Corps of Engineers Spillways

    Science.gov (United States)

    1994-05-01

    cm.- ( Techical (rport3;W-94-2 MANRESAROH OITERVA•.27Wu Inclueras biligrphricam eeentSain ces.gn-i-ul inDt 1.lfWaterae flo Arton -oTestif ng.ne2...determined. Table 4 gives these values for XJ( obo ) for Straub and Anderson’s 30- and 45-deg tests. Developing aerated flow from Straub and Anderson’s

  16. 75 FR 50777 - Minidoka Dam Spillway Replacement, Minidoka County, ID

    Science.gov (United States)

    2010-08-17

    ... management approach, which includes monitoring of effects resulting from changes in operations, has been... at the Minidoka Dam has reached the end of its functional lifespan. The concrete that forms the... water levels be dropped each winter. The headgate structures at the North Side Canal and South Side...

  17. Granger Lake, Embankment-Outlet Works-Spillway. Volume 2.

    Science.gov (United States)

    1983-08-01

    9O30 T,~~j - ------ 1779 \\.r V 00 C j46-- ~ N W ’ \\ M US ARMY ’P. td 9 ,F Or’ FL2V ’HIN GSSS0, v .F C 0 0 AL 9 3 35j-0 ACN[)5RA 34 100 33 .00 -rop...8217IH2j8 32.5 Il L’- L2 111112.2 36 *36 111111 1jj .8 l~u~l~l111 IIIIU MICROCOPY RESOLUTION TEST CHART NATtONAL BUREAU OF STANDAFDb ,Q6 A -0 : . .. ,i...6mi .e. 2 14 .0 76 ,T ~J asg hS S AWr tZ1 E ~o Ap- 8 (iv dwbvl ~4) lf7 ,nOs~o Af WMO,,r 44- oc A0- Jcapsi Za 1do ’,, tD sr,,- s 8 , , c 4 9 4 4 t4 , . f

  18. Generation capacity adequacy in interdependent electricity markets

    International Nuclear Information System (INIS)

    Cepeda, Mauricio; Finon, Dominique

    2011-01-01

    This paper deals with the practical problems related to long-term security of supply in regional electricity markets with transmission constraints. Differences between regulatory policies and market designs in terms of generation adequacy policies may distort the normal functioning of the neighboring markets, as well as the reliability of supply. We test the effect of heterogeneous regulatory design between two interdependent markets: energy-only market, price-capped market without capacity mechanisms and price-capped markets with forward capacity contracts obligation. We rely on a long-term market simulation model in system dynamics that characterizes expansion decision in a competitive regime. The results show that differences in market designs affect both price and reliability of supply in the two markets. We examine both the short and long terms effect, and how free-riding may occur where capacity adequacy policies are adopted in one market but not the other. The main finding is that the lack of harmonization between local markets in policies to ensure capacity adequacy may lead to undesirable side effects. - Research highlights: → We model the long-term dynamic of two interdependent markets. → We examine both the short and long terms effect of heterogeneous regulatory design: energy-only market, price-capped market without capacity mechanisms and price-capped markets with forward capacity contracts obligation. → Differences in market designs affect both price and reliability of supply in the two markets. → Lack of harmonization between local markets in policies to ensure capacity adequacy may lead to undesirable side effects. → Free-riding may occur where capacity adequacy policies are adopted in one market but not the other.

  19. Principles, components and appropriateness of capacity building

    CSIR Research Space (South Africa)

    Wall, K

    2010-10-01

    Full Text Available : Individual? ? it is vital that the needs of the individual are met. In the case of the engineering practitioner, this would imply that his/her needs are fulfilled in terms of a career with sufficient status, standing and rewards and support... even be ignored. Capacity of a variety of institutions and individuals, and in respect of this understanding needs to be built.? A generic definition of capacity building, setting out its core principles, is: ?The building of human, institutional...

  20. Throughput capacity of the Asbestos Conversion Unit

    International Nuclear Information System (INIS)

    Hyman, M.H.

    1996-10-01

    An engineering assessment is presented for factors that could significantly limit the throughput capacity of the Asbestos Conversion Unit. The assessment focuses mainly on volumetric throughput capacity (and related mass rate and feed density), and energy input. Important conclusions that were reached during this assessment are that the throughput is limited by feed densification capability and that the design energy input rating appears to be adequate

  1. Commercial treatment/recovery capacity data set

    Energy Technology Data Exchange (ETDEWEB)

    1990-05-01

    The commercial treatment and recovery capacity data base consists of data sets on incineration/reuse as fuel and on other treatment systems. The original data set used for the proposed rule was generated by review and engineering evaluation of TSDR survey responses, transfer of data in the questionnaires to computer data entry sheets, entering of data in a PC data base, and final consolidation of all facility capacities to arrive at national totals.

  2. Understanding Collaborative capacity in an ICT context

    DEFF Research Database (Denmark)

    Rai, Sudhanshu

    In this paper my endeavor is to explore the meaning and implication of collaberation within a dynamic frame which I refer to a capacity. First I review the collaboration literature from an innovation perspective and then develop a framework that enables me to engage with the data we collected dur...... this paper discussing the new insight on collaborative capacity (CC) of firms and their implications for ICT collaboration and firm innovativness....

  3. Mapping Individual Variations in Learning Capacity

    OpenAIRE

    Mercado III, Eduardo

    2011-01-01

    Individual differences in learning capacity are evident in humans and most other animals. Traditionally, such differences are described in terms of variations along a relatively small number of psychological dimensions corresponding to behavioral traits. Here, an alternative approach is considered in which individual differences in learning capacity are characterized by spatially sorting behavioral patterns. To illustrate this approach, a two-dimensional self-organizing feature map wasused to...

  4. Measuring Social carrying Capacity: An Exploratory Study

    OpenAIRE

    López-Bonilla, Jesús Manuel; López-Bonilla, Luis Miguel

    2007-01-01

    The tourist carrying capacity commands a growing interest given that it is closely linked with sustainable tourist development. The justification of the utility of this concept is given by means of a simple and efficient methodological proposal, by analysing the social carrying capacity. To this end, an empirical application is carried out in the Western Andalusia. In some of the cases analysed, the satisfaction of the tourist is found to decline when the levels of the tourist use are higher ...

  5. Working Memory Capacity as a Dynamic Process

    Science.gov (United States)

    Simmering, Vanessa R.; Perone, Sammy

    2013-01-01

    A well-known characteristic of working memory (WM) is its limited capacity. The source of such limitations, however, is a continued point of debate. Developmental research is positioned to address this debate by jointly identifying the source(s) of limitations and the mechanism(s) underlying capacity increases. Here we provide a cross-domain survey of studies and theories of WM capacity development, which reveals a complex picture: dozens of studies from 50 papers show nearly universal increases in capacity estimates with age, but marked variation across studies, tasks, and domains. We argue that the full pattern of performance cannot be captured through traditional approaches emphasizing single causes, or even multiple separable causes, underlying capacity development. Rather, we consider WM capacity as a dynamic process that emerges from a unified cognitive system flexibly adapting to the context and demands of each task. We conclude by enumerating specific challenges for researchers and theorists that will need to be met in order to move our understanding forward. PMID:23335902

  6. Working memory capacity as a dynamic process

    Directory of Open Access Journals (Sweden)

    Vanessa R Simmering

    2013-01-01

    Full Text Available A well-known characteristic of working memory is its limited capacity. The source of such limitations, however, is a continued point of debate. Developmental research is positioned to address this debate by jointly identifying the source(s of limitations and the mechanism(s underlying capacity increases. Here we provide a cross-domain survey of studies and theories of working memory capacity development, which reveals a complex picture: dozens of studies from 50 papers show nearly universal increases in capacity estimates with age, but marked variation across studies, tasks, and domains. We argue that the full pattern of performance cannot be captured through traditional approaches emphasizing single causes, or even multiple separable causes, underlying capacity development. Rather, we consider working memory capacity as a dynamic process that emerges from a unified cognitive system flexibly adapting to the context and demands of each task. We conclude by enumerating specific challenges for researchers and theorists that will need to be met in order to move our understanding forward.

  7. Groundwater environmental capacity and its evaluation index.

    Science.gov (United States)

    Xing, Li Ting; Wu, Qiang; Ye, Chun He; Ye, Nan

    2010-10-01

    To date, no unified and acknowledged definition or well-developed evaluation index system of groundwater environment capacity can be found in the academia at home or abroad. The article explores the meaning of water environment capacity, and analyzes the environmental effects caused by the exploitation of groundwater resources. This research defines groundwater environmental capacity as a critical value in terms of time and space, according to which the groundwater system responds to the external influences within certain goal constraint. On the basis of observing the principles of being scientific, dominant, measurable, and applicable, six level 1 evaluation indexes and 11 constraint factors are established. Taking Jinan spring region for a case study, this research will adopt groundwater level and spring flow as constraint factors, and the allowable groundwater yield as the critical value of groundwater environmental capacity, prove the dynamic changeability and its indicating function of groundwater environmental capacity through calculation, and finally point out the development trends of researches on groundwater environmental capacity.

  8. Efficacy and safety of teneligliptin in Indian patients with inadequately controlled Type 2 diabetes mellitus: A randomized, double-blind study

    Directory of Open Access Journals (Sweden)

    Piyush Agarwal

    2018-01-01

    Full Text Available Aims: This study evaluated the efficacy and safety of teneligliptin in patients with inadequately controlled type 2 diabetes mellitus (T2DM. Settings and Design: This was a randomized, doubleblind, placebocontrolled, parallelgroup, multicenter, Phase III study. Subjects and Methods: Patients with T2DM and inadequate glycemic control (glycosylated hemoglobin [HbA1c]: >7.0-≤8.5% were enrolled. Patients were randomly assigned (ratio: 2:1 to receive teneligliptin 20 mg (Glenmark or placebo. The primary efficacy variable was change from baseline in HbA1c at week 16. Additional analyses included the proportion of patients who achieved target of HbA1c ≤7.0%, changes in fasting plasma glucose (FPG, and postprandial glucose (PPG. Statistical Analysis: Mean change in HbA1c was analyzed using an analysis of covariance model, least square (LS means, 95% confidence intervals (CIs, and P values were calculated. Results: Overall, 237 patients were included. Patients of the teneligliptin group showed reduced HbA1c levels (LS mean difference = −0.304% for intent-to-treat [ITT]; −0.291% for per-protocol (PP populations after 16 weeks of treatment, and a statistically significant difference was observed between the ITT (LS mean difference = 0.555; 95% CI: 0.176–0.934; P = 0.0043 and PP populations (LS mean difference = 0.642; 95% CI: 0.233–1.052; P = 0.0023. Target HbA1c level was achieved by a greater proportion of teneligliptin group patients (ITT, 43.4%; PP, 43.6% than placebo group patients (ITT, 27.3%; PP, 26.6%. Reduction in FPG levels was observed in ITT (LS mean difference: 8.829; 95% CI: −4.357–22.016; P = 0.1883 and PP populations (LS mean difference: 11.710 mg/dL; 95% CI: −2.893-26.312; P = 0.1154. Reduction in PPG levels was higher in teneligliptin group than placebo group in both ITT (LS mean difference = 25.849 mg/dL; 95% CI: 7.143–44.556; P = 0.0070 and PP populations (LS mean difference = 25.683 mg/dL; 95% CI: 5.830–45.536; P

  9. 31P MAS refocused INADEQUATE spin-echo (REINE) NMR spectroscopy: revealing J coupling and chemical shift two-dimensional correlations in disordered solids.

    Science.gov (United States)

    Guerry, Paul; Smith, Mark E; Brown, Steven P

    2009-08-26

    Two-dimensional (2D) variations in (2)J(P(1),P(1)), (2)J(P(1),P(2)), and (2)J(P(2),P(2)) are obtained--using the REINE (REfocused INADEQUATE spin-Echo) pulse sequence presented by Cadars et al. (Phys. Chem. Chem. Phys. 2007, 9, 92-103)--from pixel-by-pixel fittings of the spin-echo modulation for the 2D correlation peaks due to linked phosphate tetrahedra (P(1)-P(1), P(1)-P(2), P(2)-P(1), and P(2)-P(2)) in a (31)P refocused INADEQUATE solid-state MAS NMR spectrum of a cadmium phosphate glass, 0.575CdO-0.425P(2)O(5). In particular, separate variations for each 2D (31)P REINE peak are obtained which reveal correlations between the J couplings and the (31)P chemical shifts of the coupled nuclei that are much clearer than those evident in previously presented 2D z-filtered (31)P spin-echo spectra. Notably, such correlations between the J couplings and the (31)P chemical shifts are observed even though the conditional probability distributions extracted using the protocol of Cadars et al. (J. Am. Chem. Soc. 2005, 127, 4466-4476) indicate that there is no marked correlation between the (31)P chemical shifts of neighboring phosphate tetrahedra. For 2D peaks at the P(2) (31)P chemical shift in the direct dimension, there can be contributions from chains of three units (P(1)-P(2)-P(1)), chains of four units (P(1)-P(2)-P(2)-P(1)), or longer chains or rings (-P(2)-P(2)-P(2)-): for the representative glass considered here, best fits are obtained assuming a glass comprised predominantly of chains of four units. The following variations are found: (2)J(P(1),P(1)) = 13.4 +/- 0.3 to 14.8 +/- 0.5 Hz, (2)J(P(1),P(2)) = 15.0 +/- 0.3 to 18.2 +/- 0.3 Hz, and (2)J(P(2),P(2)) = 5.9 +/- 0.6 to 9.1 +/- 0.9 Hz from the fits to the P(1)-P(1), P(1)-P(2), and P(2)-P(2) peaks, respectively. The correlation of a particular J coupling with the (31)P chemical shifts of the considered nucleus and the coupled nucleus is quantified by the coefficients C(F(2)) and C(F(1)) that correspond to the

  10. Efficacy and Safety of Teneligliptin in Indian Patients with Inadequately Controlled Type 2 Diabetes Mellitus: A Randomized, Double-blind Study

    Science.gov (United States)

    Agarwal, Piyush; Jindal, Chhavi; Sapakal, Vinayak

    2018-01-01

    Aims: This study evaluated the efficacy and safety of teneligliptin in patients with inadequately controlled type 2 diabetes mellitus (T2DM). Settings and Design: This was a randomized, doubleblind, placebocontrolled, parallelgroup, multicenter, Phase III study. Subjects and Methods: Patients with T2DM and inadequate glycemic control (glycosylated hemoglobin [HbA1c]: >7.0-≤8.5%) were enrolled. Patients were randomly assigned (ratio: 2:1) to receive teneligliptin 20 mg (Glenmark) or placebo. The primary efficacy variable was change from baseline in HbA1c at week 16. Additional analyses included the proportion of patients who achieved target of HbA1c ≤7.0%, changes in fasting plasma glucose (FPG), and postprandial glucose (PPG). Statistical Analysis: Mean change in HbA1c was analyzed using an analysis of covariance model, least square (LS) means, 95% confidence intervals (CIs), and P values were calculated. Results: Overall, 237 patients were included. Patients of the teneligliptin group showed reduced HbA1c levels (LS mean difference = −0.304% for intent-to-treat [ITT]; −0.291% for per-protocol (PP) populations) after 16 weeks of treatment, and a statistically significant difference was observed between the ITT (LS mean difference = 0.555; 95% CI: 0.176–0.934; P = 0.0043) and PP populations (LS mean difference = 0.642; 95% CI: 0.233–1.052; P = 0.0023). Target HbA1c level was achieved by a greater proportion of teneligliptin group patients (ITT, 43.4%; PP, 43.6%) than placebo group patients (ITT, 27.3%; PP, 26.6%). Reduction in FPG levels was observed in ITT (LS mean difference: 8.829; 95% CI: −4.357–22.016; P = 0.1883) and PP populations (LS mean difference: 11.710 mg/dL; 95% CI: −2.893-26.312; P = 0.1154). Reduction in PPG levels was higher in teneligliptin group than placebo group in both ITT (LS mean difference = 25.849 mg/dL; 95% CI: 7.143–44.556; P = 0.0070) and PP populations (LS mean difference = 25.683 mg/dL; 95% CI: 5.830–45.536; P = 0

  11. A higher sport-related reinjury risk does not mean inadequate rehabilitation: the methodological challenge of choosing the correct comparison group.

    Science.gov (United States)

    Shrier, Ian; Zhao, Meng; Piché, Alexandre; Slavchev, Pavel; Steele, Russell J

    2017-04-01

    Previous injury is a well-established predictor of subsequent injury in sports medicine. Some have interpreted this to mean that either our current methods of rehabilitation are inadequate or there is some permanent damage to the tissue and 100% rehabilitation is not possible. In 2011, we illustrated that these analyses and interpretations failed to account for the fact that some athletes are more prone to get injured, either physiologically, or because of their role/type of play. We suggested that the appropriate analysis would simply require using statistical methods that measured how each individual athlete's risk changed from preinjury to postinjury.In this paper, we revisit our recommendation and illustrate that it too would be flawed if the risk of injury changed over time independent of an injury ever occurring. This might be expected if general fitness were to decline over the season, or if the style of play changed between early season games and postseason championship games. Acknowledging that risk may change regardless of whether an injury occurred or not leads to three different general definitions of 100% rehabilitation: (1) a return to the baseline state, (2) a return to the immediate preinjury state and (3) a return to the state that would have been present had the initial injury never occurred. We guide the reader on how to estimate the risks for each definition and the assumptions that must be acknowledged. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Empirically Reduced Dosages of Tinzaparin in Patients with Moderate-to-Severe Renal Insufficiency Lead to Inadequate Anti-Xa Levels.

    Science.gov (United States)

    Olie, Renske H; Meertens, Nathalie E L; Henskens, Yvonne M C; Ten Cate, Hugo

    2017-01-01

    Due to the higher molecular weight of tinzaparin, the low molecular weight heparin (LMWH) is less dependent on renal excretion than other LMWH preparations. However, several international guidelines recommend the same preemptive dosage reduction for all therapeutic dose LMWHs prescribed in renal insufficient patients, to ensure that there is no accumulation of anticoagulant activity and increased risk of bleeding. This study is aimed at assessing whether a preemptive dosage reduction of tinzaparin in all renal insufficient patients (comprising 25% reduction in patients with Modification of Diet in Renal Disease - estimated glomerular filtration rate (MDRD-eGFR) 30-60 mL/min/1.73 m2 and 50% reduction in patients with MDRD-eGFR renal insufficiency (MDRD-eGFR 0.85 IU/mL for therapeutic indications. Unadjusted dosages led to a median anti-Xa activity of 0.74 IU/mL (IQR 0.56-0.92). The preemptive dosage reduction was significantly associated with anti-Xa activity below therapeutic range (p = 0.007). No difference in anti-Xa activity was observed between patients with moderate (0.71 IU/mL, IQR 0.61-0.95) versus severe (0.65 IU/mL, IQR 0.41-1.06) renal insufficiency in whom an unadjusted dose had been administered (p = 0.77). None of the anti-Xa levels were above the upper margin of the presumed therapeutic range of 2.0 IU/mL. In renal insufficient patients, the preemptive dosage reduction of tinzaparin leads to inadequate anti-Xa levels. © 2017 S. Karger AG, Basel.

  13. Association of breast-fed neonatal hyperbilirubinemia with UGT1A1 polymorphisms: 211G>A (G71R) mutation becomes a risk factor under inadequate feeding.

    Science.gov (United States)

    Sato, Hiroko; Uchida, Toshihiko; Toyota, Kentaro; Kanno, Miyako; Hashimoto, Taeko; Watanabe, Masashi; Nakamura, Tomohiro; Tamiya, Gen; Aoki, Kuraaki; Hayasaka, Kiyoshi

    2013-01-01

    Breastfeeding jaundice is a well-known phenomenon, but its pathogenesis is still unclear. Increased production of bilirubin, impaired hepatic uptake and metabolism of bilirubin, and increased enterohepatic circulation of bilirubin account for most cases of pathological neonatal hyperbilirubinemia. We previously reported that 211G>A (G71R) mutation of the UGT1A1 gene is prevalent in East Asians and is associated with the development of neonatal hyperbilirubinemia. Recently, significant association of G71R mutation with hyperbilirubinemia in breast-fed neonates was reported. We enrolled 401 full-term Japanese infants, who were exclusively breast-fed without supplementation of formula before developing hyperbilirubinemia, and classified them into two groups based on the degree of maximal body weight loss during the neonatal period. We analyzed the sex, gestational age, delivery mode, body weight at birth, maximal body weight loss and genotypes of G71R and (TA)(7) polymorphic mutations of UGT1A1. Statistical analysis revealed that maximal body weight loss during the neonatal period is the only independent risk factor for the development of neonatal hyperbilirubinemia. The effect of G71R mutation on neonatal hyperbilirubinemia is significant in neonates with 5% or greater maximal body weight loss and its influence increases in parallel with the degree of maximal body weight loss. Our study indicates that G71R mutation is a risk factor for neonatal hyperbilirubinemia only in infants with inadequate breastfeeding and suggests that adequate breastfeeding may overcome the genetic predisposing factor, G71R mutation, for the development of neonatal hyperbilirubinemia.

  14. Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies.

    Science.gov (United States)

    Conaghan, Philip G; Peloso, Paul M; Everett, Sharlette V; Rajagopalan, Srinivasan; Black, Christopher M; Mavros, Panagiotis; Arden, Nigel K; Phillips, Ceri J; Rannou, François; van de Laar, Mart A F J; Moore, R Andrew; Taylor, Stephanie D

    2015-02-01

    To estimate the prevalence of inadequate pain relief (IPR) among patients with symptomatic knee OA prescribed analgesic therapy and to characterize patients with IPR. Patients ≥50 years old with physician-diagnosed knee OA who had taken topical or oral pain medication for at least 14 days were recruited for this prospective non-interventional study in six European countries. Pain and function were assessed using the Brief Pain Inventory (BPI) and the WOMAC; quality of life (QoL) was assessed using the 12-item short form. IPR was defined as an average pain score of >4 out of 10 on BPI question 5. Of 1187 patients enrolled, 68% were female and the mean age was 68 years (s.d. 9); 639 (54%) met the definition of IPR. Patient responses for the BPI average pain question were well correlated with responses on the WOMAC pain subscale (Spearman r = 0.64, P < 0.001). In multivariate logistic regression, patients with IPR had greater odds of being female [adjusted odds ratio (adjOR) 1.90 (95% CI 1.46, 2.48)] and having OA in both knees [adjOR 1.48 (95% CI 1.15, 1.90)], higher BMI, longer OA duration, depression or diabetes. Patients with IPR (vs non-IPR) were more likely to have worse QoL, greater function loss and greater pain interference. IPR is common among patients with knee OA requiring analgesics and is associated with large functional loss and impaired QoL. Patients at particular risk of IPR, as characterized in this study, may require greater attention towards their analgesic treatment options. https://clinicaltrials.gov/ (NCT01294696). © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  15. Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods

    Directory of Open Access Journals (Sweden)

    Maaike J. Bruins

    2015-01-01

    Full Text Available Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk–benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR and above the Tolerable Upper Intake Level (UL are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk–benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk–benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods.

  16. Scrutinized with inadequate control and support: Interns' experiences communicating with and writing referrals to hospital radiology departments – A qualitative study

    International Nuclear Information System (INIS)

    Kruse, J.; Lehto, N.; Riklund, K.; Tegner, Y.; Engström, Å.

    2016-01-01

    Introduction: Interns' experiences communicating with and writing referrals to hospital radiology departments are important for patient safety, image quality, and decision-making in the diagnostic process. Understanding roles within the department and in the diagnostic process is important for communication. This study aimed to describe interns' experiences communicating with and writing referrals to their hospital's radiology department. Method: A qualitative study design was used. Data was collected from focus discussions with ten interns in three focus groups in Northern Sweden during 2012. The data were subjected to qualitative content analysis. Results: One theme, “a feeling of being scrutinized and lacking control”, was identified in the final categories. The interns experienced that the radiology department placed high demands on them and desired more diagnostic skills training, resources and feedback. The interns suggested the following improvements: enhanced dialogue and feedback, improved education, handy guidelines, and practice writing referrals. Conclusion: Interns need more feedback from, and dialogue with, members of the Department of Radiology. They also need more knowledge of referral guidelines, appropriateness criteria and more practice to develop their knowledge and skill for writing referrals. They describe feelings of inadequate support and feel scrutinized in demanding work conditions and need more collaboration. They also need more time and more control of radiology outcomes, and they are eager to learn. - Highlights: • Interns' experiences of writing referrals are important in the diagnostic process. • Communication between referents and radiology staff influences patient safety. • Medical interns experience insufficient diagnostic skills. • Interns need more feedback from, and dialogue with radiology staff. • The learning process could benefit from knowledge of the referrers perspective.

  17. Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study.

    Science.gov (United States)

    Shibata, Mao; Ninomiya, Toshiharu; Anno, Kozo; Kawata, Hiroshi; Iwaki, Rie; Sawamoto, Ryoko; Kubo, Chiharu; Kiyohara, Yutaka; Sudo, Nobuyuki; Hosoi, Masako

    2016-07-07

    Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles "care" and "overprotection" during childhood and sleep disturbance in adulthood. A total of 702 community-dwelling Japanese residents aged ≥ 40 years were assessed in 2011 for their perceptions of the parenting style of their parents by use of the Parental Bonding Instrument (PBI) and for sleep disturbance by use of the Pittsburgh Sleep Quality Index (PSQI). The odds ratio (OR) for sleep disturbance (a global PSQI score > 5) was calculated using a logistic regression model. The prevalence of sleep disturbance was 29 %. After adjusting for sociodemographic, lifestyle, and physical factors in a comparison with the optimal parenting styles (high care and low overprotection), the ORs for sleep disturbance by men were significantly higher for low paternal care, by 2.49 times (95 % confidence interval [CI]: 1.21-5.09), and for high overprotection, by 2.40 times (95 % CI: 1.19-4.85), while the ORs were not significant for low maternal care and high overprotection. For women the only significant factor was high maternal overprotection, by 1.62 times (95 % CI: 1.05-2.52), while the ORs were not significant for low maternal care, low paternal care and high paternal overprotection. The association remained significant for high paternal overprotection for men after additionally controlling for depression. This study suggests that parenting style, especially inadequate care and excessive overprotection during childhood, is related to sleep disturbance in adulthood and that the association is much more significant for parents of the same sex as the child.

  18. Cost-utility evaluation of vortioxetine in patients with Major Depressive Disorder experiencing inadequate response to alternative antidepressants in the United Kingdom.

    Science.gov (United States)

    Young, A H; Evitt, L; Brignone, M; Diamand, F; Atsou, K; Campbell, R; Cure, S; Danchenko, N

    2017-08-15

    Patients frequently require several lines of therapy for treatment of major depressive episodes. This economic analysis details the management of patients who responded inadequately due to lack of efficacy or intolerability to two previous antidepressants in the UK. The model included a decision tree and a Markov component. Health states considered in the decision tree were remission, response, no response, withdrawal due to adverse events, relapse, recovery, and recurrence. The time horizon was 24 months. Patients were on third-line treatment for up to a 3-month acute phase and a 6-month maintenance phase. As third-line efficacy data were not available, inputs were calculated by adjusting original second-line data to third-line based on proportionate reductions observed in STAR*D. Equivalent efficacy was assumed for all comparators. Healthcare resource use and utilities were based on UK estimates. Vortioxetine was a cost-effective treatment option at a threshold of £20,000/QALY vs. escitalopram, citalopram, sertraline, and was associated with more health benefits, less costs (was dominant) versus relevant third-line comparators venlafaxine and duloxetine. Agomelatine was found not to be a cost-effective option. The 22-month maintenance phase treatment scenario results were similar to the 6-month base case. Third-line efficacy data were not available. This highlights the need for studies in patients receiving third-line treatment. This model provides an overview for the management of patients receiving third-line treatment where limited evidence currently exists. Vortioxetine, with its novel mechanism of action, is expected to be a dominant treatment option versus relevant comparators in the UK. Copyright © 2017. Published by Elsevier B.V.

  19. Longterm safety and efficacy of abatacept through 5 years of treatment in patients with rheumatoid arthritis and an inadequate response to tumor necrosis factor inhibitor therapy.

    Science.gov (United States)

    Genovese, Mark C; Schiff, Michael; Luggen, Michael; Le Bars, Manuela; Aranda, Richard; Elegbe, Ayanbola; Dougados, Maxime

    2012-08-01

    To evaluate abatacept safety and efficacy over 5 years in patients with rheumatoid arthritis (RA) who had inadequate response to anti-tumor necrosis factor (TNF) therapy in the ATTAIN trial. Patients completing the 6-month, double-blind (DB) placebo-controlled period were eligible to enter the longterm extension (LTE), where all patients received abatacept every 4 weeks (∼10 mg/kg, according to weight range). Safety, efficacy, physical function, and health-related quality of life were monitored throughout. In total, 317 patients (218 DB abatacept, 99 DB placebo) entered the LTE; 150 (47.3%) completed it. Overall incidences of serious adverse events, infections, serious infections, malignant neoplasms, and autoimmune events did not increase during the LTE versus the DB period. American College of Rheumatology responses with abatacept at Month 6 were maintained over 5 years. At Year 5, among patients who received abatacept for 5 years and had available data, 38/103 (36.9%) achieved low disease activity as defined by the 28-joint Disease Activity Score (DAS28)/C-reactive protein (CRP); 23/103 (22.3%) achieved DAS28/CRP-defined remission. Health Assessment Questionnaire response was achieved by 62.5% of patients remaining on treatment at Year 5; mean improvements from baseline in physical component summary and mental component summary scores were 7.34 and 6.42, respectively. High proportions of patients maintained efficacy and physical function benefits or improved their disease state at each timepoint throughout the LTE, if remaining on abatacept treatment. Safety remained consistent, and abatacept efficacy was maintained from 6 months to 5 years, demonstrating the benefits of switching to abatacept in this difficult-to-treat population of patients with RA previously failing anti-TNF therapy.

  20. Phase III, efficacy and safety study of ertugliflozin monotherapy in people with type 2 diabetes mellitus inadequately controlled with diet and exercise alone.

    Science.gov (United States)

    Terra, Steven G; Focht, Kristen; Davies, Melanie; Frias, Juan; Derosa, Giuseppe; Darekar, Amanda; Golm, Gregory; Johnson, Jeremy; Saur, Didier; Lauring, Brett; Dagogo-Jack, Sam

    2017-05-01

    To conduct a phase III study to evaluate the efficacy and safety of ertugliflozin monotherapy in people with type 2 diabetes. This was a 52-week, double-blind, multicentre, randomized, parallel-group study with a 26-week, placebo-controlled treatment period (phase A), followed by a 26-week active-controlled treatment period (phase B) in 461 men and women, aged ≥18 years with inadequate glycaemic control (glycated haemoglobin [HbA1c] concentration 7.0% to 10.5% [53-91 mmol/mol], inclusive) despite diet and exercise. Results from phase A are reported in the present paper. The primary endpoint was the change in HbA1c from baseline to week 26. At week 26, the placebo-adjusted least squares mean HbA1c changes from baseline were -0.99% and -1.16% for the ertugliflozin 5 and 15 mg doses, respectively ( P  < .001 for both doses). The odds of having HbA1c <7.0% (53 mmol/mol) were significantly greater in the ertugliflozin 5 and 15 mg groups compared with the placebo group. Both doses of ertugliflozin significantly lowered fasting plasma glucose and 2-hour postprandial glucose levels and body weight. The placebo-adjusted differences in changes from baseline in systolic blood pressure were not statistically significant. A higher incidence of genital mycotic infections occurred in men and women treated with ertugliflozin compared with placebo. There was no significant difference between treatments in the proportion of participants with symptomatic hypoglycaemia or adverse events associated with urinary tract infection or hypovolaemia. Ertugliflozin 5 and 15 mg treatment for 26 weeks provides effective glycaemic control, reduces body weight and is generally well tolerated, when used as monotherapy. © 2017 John Wiley & Sons Ltd.

  1. Insufficient amounts and inadequate distribution of dietary protein intake in apparently healthy older adults in a developing country: implications for dietary strategies to prevent sarcopenia

    Directory of Open Access Journals (Sweden)

    Ruiz Valenzuela RE

    2013-09-01

    Full Text Available Roxana E Ruiz Valenzuela, José A Ponce, Gloria Guadalupe Morales-Figueroa, Karina Aguilar Muro, Virginia Ramírez Carreón, Heliodoro Alemán-Mateo Nutrition and Metabolism Department, Division of Nutrition, Research Center for Food and Development, Hermosillo, Sonora, México Background: Both low dietary protein intake and inadequate distribution of protein over the three mealtimes have been reported in older Caucasian adults, but the association between protein intake at each meal and muscle mass has not been studied. The purpose of this study was to evaluate dietary protein intake and distribution by mealtimes, and to explore their association with appendicular skeletal muscle mass in apparently healthy older adults. Methods: This was a cross-sectional pilot study that included 78 people over the age of 60 years. Caloric and protein intake were estimated on the basis of three nonconsecutive 24-hour diet recalls and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry. Results: Men consumed 13.4 g of protein/day more than women (P < 0.05. The estimated value of dietary protein intake was 0.9 g/kg/day. In this sample, 28% of subjects did not cover 100% of the dietary reference intake for protein. Lower consumption of dietary protein was found at breakfast and dinnertime compared with the recommended amount of 25–30 g (P < 0.05. Also, the study observed that appendicular skeletal muscle mass in men and women who consumed <25 g of protein at each mealtime was different from that found in the group that consumed >25 g of protein at one, two, or three mealtimes. Conclusion: While protein intake was higher than current recommendations, it failed to achieve the values reported as necessary to prevent sarcopenia. In addition, there was under-consumption of protein per mealtime, especially at breakfast and dinner. Keywords: dietary protein intake, older adults, appendicular skeletal muscle mass

  2. Review of MRSA screening and antibiotics prophylaxis in orthopaedic trauma patients; The risk of surgical site infection with inadequate antibiotic prophylaxis in patients colonized with MRSA.

    Science.gov (United States)

    Iqbal, H J; Ponniah, N; Long, S; Rath, N; Kent, M

    2017-07-01

    The primary aim of this study was to determine whether orthopaedic trauma patients receive appropriate antibiotic prophylaxis keeping in view the results of their MRSA screening. The secondary aim was to analyse the risk of developing MRSA surgical site infection with and without appropriate antibiotic prophylaxis in those colonized with MRSA. We reviewed 400 consecutive orthopaedic trauma patient episodes. Preoperative MRSA screening results, operative procedures, prophylactic antibiotics and postoperative course were explored. In addition to these consecutive patients, the hospital MRSA database over the previous 5 years identified 27 MRSA colonized acute trauma patients requiring surgery. Of the 400 consecutive patient episodes, 395(98.7%) had MRSA screening performed on admission. However, in 236 (59.0%) cases, the results were not available before the surgery. Seven patient episodes (1.8%) had positive MRSA colonization. Analysis of 27 MRSA colonized patients revealed that 20(74%) patients did not have the screening results available before the surgery. Only 5(18.5%) received Teicoplanin and 22(81.4%) received cefuroxime for antibiotic prophylaxis before their surgery. Of those receiving cefuroxime, five (22.73%) patients developed postoperative MRSA surgical site infection (SSI) but none of those (0%) receiving Teicoplanin had MRSA SSI. The absolute risk reduction for SSI with Teicoplanin as antibiotic prophylaxis was 22.73% (CI=5.22%-40.24%) and NNT (Number Needed to Treat) was 5 (CI=2.5-19.2) CONCLUSION: Lack of available screening results before the surgery may lead to inadequate antibiotic prophylaxis increasing the risk of MRSA surgical site infection. Glycopeptide (e.g.Teicoplanin) prophylaxis should be considered when there is history of MRSA colonization or MRSA screening results are not available before the surgery. Copyright © 2017. Published by Elsevier Ltd.

  3. Treatment Compliance with Fixed-Dose Combination of Vildagliptin/Metformin in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin Monotherapy: A 24-Week Observational Study

    Directory of Open Access Journals (Sweden)

    Grigorios Rombopoulos

    2015-01-01

    Full Text Available Objective. To evaluate the differences in treatment compliance with vildagliptin/metformin fixed-dose versus free-dose combination therapy in patients with type 2 diabetes mellitus (T2DM in Greece. Design. Adult patients with T2DM, inadequately controlled with metformin monotherapy, (850 mg bid, participated in this 24-week, multicenter, observational study. Patients were enrolled in two cohorts: vildagliptin/metformin fixed-dose combination (group A and vildagliptin metformin free-dose combination (group B. Results. 659 patients were enrolled, 360 were male, with mean BMI 30.1, mean T2DM duration 59.6 months, and mean HbA1c at baseline 8%; 366 patients were assigned to group A and 293 to group B; data for 3 patients was missing. In group A, 98.9% of patients were compliant with their treatment compared to 84.6% of group B. The odds ratio for compliance in group A versus B was (OR 18.9 (95% CI: 6.2, 57.7; P<0.001. In group A mean HbA1c decreased from 8.1% at baseline to 6.9% (P<0.001 at the study end and from 7.9% to 6.8% (P<0.001 in group B. Conclusions. Patients in group A were more compliant than patients in group B. These results are in accordance with international literature suggesting that fixed-dose combination therapies lead to increased compliance to treatment.

  4. Factors and Caregiver’s Behavior Affecting Inadequate Complementary Food of Infants Aged 6-12 Months in Naresuan University Hospital

    Directory of Open Access Journals (Sweden)

    Thitima Ngoenmak, M.D.

    2017-09-01

    Full Text Available Objective: Food plays an important role in infant nutrition. Hence, the various factors and behavior that affect the right choice of nutrition for infants aged 6-12 months by caregivers need to be investigated. The objectives were to study the associated factors and caregiver’s behavior affecting inadequate feeding of food to infants aged 6-12 months. Methods: This present work was a cross-sectional study in which 54 caregivers for infants were included. In this study, a survey was performed by using questionnaires for collecting data. The data were analyzed statistically in terms of percentage and mean and by using Chi-Square test (Fisher’s Exact Test and z-test. Results: It was found that most of the infants (79.6 % had normal weight. The age at the start of proper feeding was 5 months and 27 days old. The education level, age, occupation, and income of the caregivers were factors affecting the food choices for the infants at p< 0.05. Inappropriate feeding practices were as follows: feeding pre- masticated foods, liquid food feeding, drinking sweetened juice and soft drinks, eating sweets, and adding salt, sugar, monosodium glutamate and fish sauce to the infants’ food. The caregivers chose food by judging for age and FDA logo on product labels. Advertising did not affect their decision to purchase food. Moreover, occupation, education, and income of the caregivers were not associated with purchasing the right food for the baby. Conclusion: Occupation, income, age, and education level of the infant caregivers were associated with the food selection. The inappropriate feeding behaviors were still persisting.

  5. Inadequação do consumo de nutrientes entre adolescentes brasileiros Consumo inadecuado de nutrientes entre adolescentes brasileños Inadequate nutrient intake in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Rosely Sichieri

    2013-02-01

    -2009. Se consideraron los factores de expansión, la complejidad de diseño de la muestra y la corrección de la variabilidad intra-personal de consumo. La prevalencia de consumo inadecuado de micronutrientes fue estimada por la proporción de adolescentes con ingestión por debajo de la necesidad promedio estimada. Para el sodio, se estimó la prevalencia de consumo por encima del valor de ingestión máxima tolerable. CONCLUSIÓN: Los promedios de consumo energético y la distribución de macronutrientes eran adecuados, sin embargo, se observaron elevadas prevalencias de consumo inadecuado de vitaminas y minerales, destacándose el consumo de sodio muy por encima de lo recomendado, consumo de calcio reducido y en las adolescentes de 14 a 18 años fue observada importante ingestión inadecuada de hierro.OBJECTIVE: To assess energy and nutrient consumption and the prevalence of inadequate micronutrient intake among Brazilian adolescents. METHODS: A random sample composed of 6,797 adolescents (49.7% girls, between 10 and 18 years old, was evaluated in the first National Dietary Survey, part of the Household Budget Survey carried out in 2008-2009. Expansion factors, sample complexity design and correction of intraindividual variability were considered. The prevalence of inadequate micronutrient intake was based on the proportion of adolescents with intake below the Estimated Average Requirement (EAR. The prevalence of intake above the Tolerable Upper Intake Level (UL was estimated for sodium. RESULTS: The mean energy intake ranged between 1,869 kcal (10 to 13 year old females and 2,198 kcal (14 to 18 year old males. Of the total energy intake, 57% came from carbohydrates, 27% from lipids and about 16% from proteins. Inadequacies were higher for calcium (> 95%, phosphorous (54% to 69% and vitamins A (66% to 85%, E (100% and C (27% to 49%. More than 70% of adolescents reported sodium intake above the UL. CONCLUSIONS: Mean energy consumption and distribution of macro

  6. Pullout capacity of batter pile in sand.

    Science.gov (United States)

    Nazir, Ashraf; Nasr, Ahmed

    2013-03-01

    Many offshore structures are subjected to overturning moments due to wind load, wave pressure, and ship impacts. Also most of retaining walls are subjected to horizontal forces and bending moments, these forces are due to earth pressure. For foundations in such structures, usually a combination of vertical and batter piles is used. Little information is available in the literature about estimating the capacity of piles under uplift. In cases where these supporting piles are not vertical, the behavior under axial pullout is not well established. In order to delineate the significant variables affecting the ultimate uplift shaft resistance of batter pile in dry sand, a testing program comprising 62 pullout tests was conducted. The tests are conducted on model steel pile installed in loose, medium, and dense sand to an embedded depth ratio, L/d, vary from 7.5 to 30 and with various batter angles of 0°, 10°, 20°, and 30°. Results indicate that the pullout capacity of a batter pile constructed in dense and/or medium density sand increases with the increase of batter angle attains maximum value and then decreases, the maximum value of Pα occurs at batter angle approximately equal to 20°, and it is about 21-31% more than the vertical pile capacity, while the pullout capacity for batter pile that constructed in loose sand decreases with the increase of pile inclination. The results also indicated that the circular pile is more resistant to pullout forces than the square and rectangular pile shape. The rough model piles tested is experienced 18-75% increase in capacity compared with the smooth model piles. The suggested relations for the pullout capacity of batter pile regarding the vertical pile capacity are well predicted.

  7. Pullout capacity of batter pile in sand

    Directory of Open Access Journals (Sweden)

    Ashraf Nazir

    2013-03-01

    Full Text Available Many offshore structures are subjected to overturning moments due to wind load, wave pressure, and ship impacts. Also most of retaining walls are subjected to horizontal forces and bending moments, these forces are due to earth pressure. For foundations in such structures, usually a combination of vertical and batter piles is used. Little information is available in the literature about estimating the capacity of piles under uplift. In cases where these supporting piles are not vertical, the behavior under axial pullout is not well established. In order to delineate the significant variables affecting the ultimate uplift shaft resistance of batter pile in dry sand, a testing program comprising 62 pullout tests was conducted. The tests are conducted on model steel pile installed in loose, medium, and dense sand to an embedded depth ratio, L/d, vary from 7.5 to 30 and with various batter angles of 0°, 10°, 20°, and 30°. Results indicate that the pullout capacity of a batter pile constructed in dense and/or medium density sand increases with the increase of batter angle attains maximum value and then decreases, the maximum value of Pα occurs at batter angle approximately equal to 20°, and it is about 21–31% more than the vertical pile capacity, while the pullout capacity for batter pile that constructed in loose sand decreases with the increase of pile inclination. The results also indicated that the circular pile is more resistant to pullout forces than the square and rectangular pile shape. The rough model piles tested is experienced 18–75% increase in capacity compared with the smooth model piles. The suggested relations for the pullout capacity of batter pile regarding the vertical pile capacity are well predicted.

  8. Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs.

    Science.gov (United States)

    Nangami, Mabel N; Rugema, Lawrence; Tebeje, Bosena; Mukose, Aggrey

    2014-06-02

    The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy. This study used a cross-sectional study design employing both quantitative and qualitative approaches. An organizational profile tool was administered to senior staff across the seven SPHs to assess existing teaching programs. A self-assessment tool included nine questions relevant to teaching capacity for HSR curricula. The analysis triangulates the data, with reflections on the responses from within and across the seven SPHs. Proportions and average of values from the Likert scale are compared to determine strengths and weaknesses, while themes relevant to the objectives are identified and clustered to elicit in-depth interpretation. None of the SPHs offer an HSR-specific degree program; however, all seven offer courses in the Master of Public Health (MPH) degree that are relevant to HSR. The general MPH curricula partially embrace principles of competency-based education. Different strengths in curricula design and staff interest in HSR at each SPH were exhibited but a number of common constraints were identified, including out-of-date curricula, face-to-face delivery approaches, inadequate staff competencies, and limited access to materials. Opportunities to align health system priorities to teaching programs include existing networks. Each SPH has key strengths that can be leveraged to

  9. Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs

    Science.gov (United States)

    2014-01-01

    Background The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy. Methods This study used a cross-sectional study design employing both quantitative and qualitative approaches. An organizational profile tool was administered to senior staff across the seven SPHs to assess existing teaching programs. A self-assessment tool included nine questions relevant to teaching capacity for HSR curricula. The analysis triangulates the data, with reflections on the responses from within and across the seven SPHs. Proportions and average of values from the Likert scale are compared to determine strengths and weaknesses, while themes relevant to the objectives are identified and clustered to elicit in-depth interpretation. Results None of the SPHs offer an HSR-specific degree program; however, all seven offer courses in the Master of Public Health (MPH) degree that are relevant to HSR. The general MPH curricula partially embrace principles of competency-based education. Different strengths in curricula design and staff interest in HSR at each SPH were exhibited but a number of common constraints were identified, including out-of-date curricula, face-to-face delivery approaches, inadequate staff competencies, and limited access to materials. Opportunities to align health system priorities to teaching programs include existing networks. Conclusions Each SPH has key

  10. Effects of flow reduction and spillways on the composition and structure of benthic macroinvertebrate communities in a Brazilian river reach Efeitos da redução de vazão e construção de soleiras vertentes sobre a composição e estrutura de comunidades de macroinvertebrados bentônicos em um trecho de rio brasileiro

    Directory of Open Access Journals (Sweden)

    DM. Maroneze

    2011-08-01

    Full Text Available Dams are a major threat to aquatic biological diversity. By altering the natural flow of rivers, dams modify fluvial habitats, making them unsuitable for the growth and reproduction of many aquatic species. The aim of this study was to evaluate the effects of a reduced flow reach (RFR on benthic macroinvertebrate communities. Benthic macroinvertebrates were collected at six sites downstream of the Amador Aguiar Power Plant I before (lotic phase and after (semi-lentic phase Araguari River mean flow was reduced from 346 to 7 m³.s-1. Changes in macroinvertebrates richness, diversity and total biomass were not observed. Ablabesmyia, Tanytarsus (Chironomidae, Diptera, Leptoceridae and Polycentropodidae (Trichoptera densities significantly increased the first year after flow reduction and the construction of spillways (t-test; p As represas constituem uma das principais ameaças à diversidade biológica. Ao alterarem a vazão natural de um rio, modificam os habitats fluviais tornando-os inadequados para o crescimento e reprodução de diversas espécies aquáticas. O objetivo deste estudo foi avaliar os efeitos de um trecho de vazão reduzida sobre as comunidades de macroinvertebrados bentônicos. Os organismos foram coletados em seis estações amostrais à jusante da UHE Amador Aguiar I antes (fase lótica e após (fase semilêntica a vazão média do rio Araguari (MG ter sido reduzida de 346 para 7 m³.s-1. Não foram registradas mudanças na riqueza, diversidade e biomassa total dos macroinvertebrados. As densidades (ind.m-2 de Ablabesmyia, Tanytarsus (Diptera, Leptoceridae e Polycentropodidae (Trichoptera aumentaram significativamente no primeiro ano após a redução da vazão e construção das soleiras vertentes (t-test; p < 0,05. Uma análise de similaridade (ANOSIM apontou diferenças significativas na composição taxonômica, porém houve sobreposição das comunidades entre as fases lótica e semilêntica (R = 0,3; p < 0,01. Em ambas as

  11. Refrigerator with variable capacity compressor and cycle priming action through capacity control and associated methods

    Science.gov (United States)

    Gomes, Alberto Regio; Litch, Andrew D.; Wu, Guolian

    2016-03-15

    A refrigerator appliance (and associated method) that includes a condenser, evaporator and a multi-capacity compressor. The appliance also includes a pressure reducing device arranged within an evaporator-condenser refrigerant circuit, and a valve system for directing or restricting refrigerant flow through the device. The appliance further includes a controller for operating the compressor upon the initiation of a compressor ON-cycle at a priming capacity above a nominal capacity for a predetermined or calculated duration.

  12. Unpacking "Health Reform" and "Policy Capacity": Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Legge, David; Gleeson, Deborah H

    2015-07-20

    Health reform is the outcome of dispersed policy initiatives in different sectors, at different levels and across time. Policy work which can drive coherent health reform needs to operate across the governance structures as well as the institutions that comprise healthcare systems. Building policy capacity to support health reform calls for clarity regarding the nature of such policy work and the elements of policy capacity involved; and for evidence regarding effective strategies for capacity building. © 2015 by Kerman University of Medical Sciences.

  13. Metapopulation capacity of evolving fluvial landscapes

    Science.gov (United States)

    Bertuzzo, Enrico; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

    2015-04-01

    The form of fluvial landscapes is known to attain stationary network configurations that settle in dynamically accessible minima of total energy dissipation by landscape-forming discharges. Recent studies have highlighted the role of the dendritic structure of river networks in controlling population dynamics of the species they host and large-scale biodiversity patterns. Here, we systematically investigate the relation between energy dissipation, the physical driver for the evolution of river networks, and the ecological dynamics of their embedded biota. To that end, we use the concept of metapopulation capacity, a measure to link landscape structures with the population dynamics they host. Technically, metapopulation capacity is the leading eigenvalue λM of an appropriate "landscape" matrix subsuming whether a given species is predicted to persist in the long run. λM can conveniently be used to rank different landscapes in terms of their capacity to support viable metapopulations. We study how λM changes in response to the evolving network configurations of spanning trees. Such sequence of configurations is theoretically known to relate network selection to general landscape evolution equations through imperfect searches for dynamically accessible states frustrated by the vagaries of Nature. Results show that the process shaping the metric and the topological properties of river networks, prescribed by physical constraints, leads to a progressive increase in the corresponding metapopulation capacity and therefore on the landscape capacity to support metapopulations—with implications on biodiversity in fluvial ecosystems.

  14. Winnicott and the capacity to believe.

    Science.gov (United States)

    Hopkins, B

    1997-06-01

    Like Freud's, Winnicott's writing displays an enormous interest in words, in their histories as well as their current usage. The author discusses his use of two words, 'capacity' and 'belief' combined in the phrase 'capacity to believe'. What Winnicott has to say about this capacity sheds light on the nature of both religious and cultural experience generally. The paper's argument has two strands that are woven together throughout. The first is Winnicott's concern for words and how a knowledge of their roots can enrich their current meaning. The second is his concern for the nature of belief, the 'capacity to believe', and his conviction that in exploring this capacity psychoanalysis might have something to teach religion. These concerns are interrelated in a number of ways in Winnicott's writing and are ultimately connected with his notion of a 'cultural field', a place to grow, where 'inventiveness', even verbal inventiveness, is 'just one more example ... of the interplay between separateness and union', that is the separateness of individual language users but also their union through the language they share.

  15. Quantum capacity of quantum black holes

    Science.gov (United States)

    Adami, Chris; Bradler, Kamil

    2014-03-01

    The fate of quantum entanglement interacting with a black hole has been an enduring mystery, not the least because standard curved space field theory does not address the interaction of black holes with matter. We discuss an effective Hamiltonian of matter interacting with a black hole that has a precise analogue in quantum optics and correctly reproduces both spontaneous and stimulated Hawking radiation with grey-body factors. We calculate the quantum capacity of this channel in the limit of perfect absorption, as well as in the limit of a perfectly reflecting black hole (a white hole). We find that the white hole is an optimal quantum cloner, and is isomorphic to the Unruh channel with positive quantum capacity. The complementary channel (across the horizon) is entanglement-breaking with zero capacity, avoiding a violation of the quantum no-cloning theorem. The black hole channel on the contrary has vanishing capacity, while its complement has positive capacity instead. Thus, quantum states can be reconstructed faithfully behind the black hole horizon, but not outside. This work sheds new light on black hole complementarity because it shows that black holes can both reflect and absorb quantum states without violating the no-cloning theorem, and makes quantum firewalls obsolete.

  16. Anaerobic Capacity of Sailors with Disabilities

    Directory of Open Access Journals (Sweden)

    Prokopowicz Grzegorz

    2017-03-01

    Full Text Available Introduction. A review of Polish and international literature does not give a clear indication of the level of anaerobic capacity that sailors with disabilities demonstrate with regard to their functional capacities. This study sought to determine differences in functional capacity levels between sailors from three medical and functional groups. Material and methods. The research was carried out during a sports camp at the National Sailing Centre in Górki Zachodnie in 2014. Eighteen males with locomotor disabilities were included in the study. The athletes were members of the National Team of Sailors with Disabilities of the Polish Yachting Association. The sportsmen competed in the Skud 18 and 2.4mR Paralympic classes. A 30-second Wingate test for upper limbs was employed in the study. Results. Significant differences in mean power (MP values were noted between the groups under investigation. The group of wheelchair sailors with improper core stability (A and the group of wheelchair sailors with proper core stability (B had significantly lower scores than the group of study participants who were able to move freely, that is to walk (C. Conclusions. The study revealed that a 30-second anaerobic capacity test performed on an arm ergometer differentiated disabled sailors from selected groups in terms of mean power. Research on anaerobic capacity may be used to verify the current classification in Paralympic sailing and will make it possible to differentiate present competition categories.

  17. Heat capacity of poly(lactic acid)

    International Nuclear Information System (INIS)

    Pyda, M.; Bopp, R.C.; Wunderlich, B.

    2004-01-01

    The heat capacity of poly(lactic acid) (PLA) is reported from T=(5 to 600) K as obtained by differential scanning calorimetry (d.s.c.) and adiabatic calorimetry. The heat capacity of solid PLA is linked to its group vibrational spectrum and the skeletal vibrations, the latter being described by a Tarasov equation with Θ 1 =574 K, Θ 2 =Θ 3 =52 K, and nine skeletal vibrations. The calculated and experimental heat capacities agree to ±3% between T=(5 and 300) K. The experimental heat capacity of liquid PLA can be expressed by C p (liquid)=(120.17+0.076T) J · K -1 · mol -1 and has been compared to the ATHAS Data Bank, using contributions of other polymers with the same constituent groups. The glass transition temperature of amorphous PLA occurs at T=332.5 K with a change in heat capacity of 43.8 J · K -1 · mol -1 . Depending on thermal history, semi-crystalline PLA has a melting endotherm between T=(418 and 432) K with variable heats of fusion. For 100% crystalline PLA, the heat of fusion is estimated to be (6.55 ± 0.02) kJ · mol -1 at T=480 K. With these results, the enthalpy, entropy, and Gibbs function of crystalline and amorphous PLA were obtained. For semi-crystalline samples, one can check changes of crystallinity with temperature and judge the presence of rigid-amorphous fractions

  18. Strengthening and expanding the capacity of health worker education in Zambia.

    Science.gov (United States)

    Michelo, Charles; Zulu, Joseph Mumba; Simuyemba, Moses; Andrews, Benjamin; Katubulushi, Max; Chi, Benjamin; Njelesani, Evariste; Vwalika, Bellington; Bowa, Kasonde; Maimbolwa, Margaret; Chipeta, James; Goma, Fastone; Nzala, Selestine; Banda, Sekelani; Mudenda, John; Ahmed, Yusuf; Hachambwa, Lotti; Wilson, Craig; Vermund, Sten; Mulla, Yakub

    2017-01-01

    Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment. This was achieved by leveraging of existing and new partnerships with other universities and differentiating the old Master in Public Health into specialized curriculum. Furthermore, the MEPI program improved the capacity and quality of training by facilitating installation and integration of new technology such as the eGranary digital library, E-learning methods and clinical skills laboratory into the Schools. This technology enabled easy access to relevant data or information, quicker turn around of experiments and enhanced data recording, display and analysis features for experiments. The program also facilitated transforming of the academic environment into a more conducive work place through strengthening the Staff Development program and support towards research activities. These activities stimulated work motivation and interest in research by faculty. Meanwhile, these processes were inhibited by the inability to upload all courses on to Moodle as well as inadequate operating procedures and feedback mechanisms for the Moodle. Expansion and improvement in training processes for health care workers requires targeted investment within medical institutions and strengthening local and international partnerships.

  19. Capacitated dynamic lot sizing with capacity acquisition

    DEFF Research Database (Denmark)

    Li, Hongyan; Meissner, Joern

    2011-01-01

    planning decisions directly. In this article, we address the joint capacitated lot-sizing and capacity-acquisition problems. The firm can produce goods in each of the finite periods into which the production season is partitioned. Fixed as well as variable production costs are incurred for each production....... For this situation, we develop a model which combines the complexity of time-varying demand and cost functions and of scale economies arising from dynamic lot-sizing costs with the purchase cost of capacity. We propose a heuristic algorithm that runs in polynomial time to determine a good capacity level...... and corresponding lot-sizing plan simultaneously. Numerical experiments show that our method is a good trade-off between solution quality and running time....

  20. Adaptive Capacity Management in Bluetooth Networks

    DEFF Research Database (Denmark)

    Son, L.T.

    , such as limited wireless bandwidth operation, routing, scheduling, network control, etc. Currently Bluetooth specification particularly does not describe in details about how to implement Quality of Service and Resource Management in Bluetooth protocol stacks. These issues become significant, when the number...... of Bluetooth devices is increasing, a larger-scale ad hoc network, scatternet, is formed, as well as the booming of Internet has demanded for large bandwidth and low delay mobile access. This dissertation is to address the capacity management issues in Bluetooth networks. The main goals of the network capacity...... management are to increase the network efficiency and throughput, reduce queueing size or delays, increase resilience, stability and fairness among users. To achieve these objectives, several adaptive distributed approaches have been proposed for dynamic capacity management in Bluetooth networks, including...

  1. Visual attention capacity after right hemisphere lesions

    DEFF Research Database (Denmark)

    Habekost, Thomas; Rostrup, Egill

    2007-01-01

    for both VSTM capacity and ipsilesional processing speed. The study also showed that lesions in a large region of the right hemisphere, including the putamen, insula, and inferior frontal cortex, do not lead to general deficits in the capacity of visual attention. Udgivelsesdato: 2007-Apr-8......Recently there has been a growing interest in visual short-term memory (VSTM) including the neural basis of the function. Processing speed, another main aspect of visual attention capacity, has received less investigation. For both cognitive functions human lesion studies are sparse. We used...... a whole report experiment for estimation of these two parameters in 22 patients with right side stroke. Psychophysical performance was analyzed using Bundesen's [Bundesen, C. (1990). A theory of visual attention. Psychological Review, 97, 523-547] Theory of Visual Attention (TVA) and compared...

  2. Legal capacity and biomedicine: Biomedical discrimination

    Directory of Open Access Journals (Sweden)

    Cvetić Radenka

    2011-01-01

    Full Text Available The article begins with the overview of the legal capacity as a general legal qualification recognized by the legal order guaranteeing the right to be a holder of rights and obligations. The article is then focused on the scope of the absolute Constitutional guarantee of the right to legal personality as well as on the Constitutional prohibition of discrimination which gives rise to the general equality before the Constitution and the law. The focus of this article is the moment when the legal capacity, or legal personality, is considered to be acquired. It then moves to the issue whether limiting the access to techniques of assisted reproduction (biomedical conception is contrary to the general rules on legal capacity, and whether this is a genuine form of biomedical discrimination.

  3. Moisture buffer capacity of different insulation materials

    DEFF Research Database (Denmark)

    Peuhkuri, Ruut Hannele; Rode, Carsten; Hansen, Kurt Kielsgaard

    2004-01-01

    There is an increasing focus on the possibilities of utilizing the absorptive ability of porous materials to create passive control of humidity variations in the indoor air. These variations result in peaks in the indoor air humidity due to moisture production, or in the exterior building envelope...... lead to more durable constructions. In this paper, a large range of very different thermal insulation materials have been tested in specially constructed laboratory facilities to determine their moisture buffer capacity. Both isothermal and nonisothermal experimental set-ups have been used...... are discussed, and different ways are presented how to determine the moisture buffer capacity of the materials using partly standard material parameters and partly parameters determined from the actual measurements. The results so far show that the determination of moisture buffer capacity is very sensitive...

  4. Classical fluids of negative heat capacity

    Energy Technology Data Exchange (ETDEWEB)

    Landsberg, P.T. [Southampton Univ., (United Kingdom). Faculty of Mathematical Studies; Woodard, R.P. [Florida Univ., Gainesville, FL (United States). Dept. of Physics

    1992-06-01

    It is shown that new parameters X can be defined such that the heat capacity C{sub X} {equivalent_to} T({partial_derivative}S/{partial_derivative}T)X is negative, even when the canonical ensemble (i.e. at fixed T = ({partial_derivative}U/{partial_derivative}S) and Y {ne} X) is stable. As examples we treat black body radiation and general gas systems with nonsingular {kappa}{sub T}. For the case of a simple ideal gas we even exhibit an apparatus which enforces a constraint X(p,V) = const. that makes C{sub X} < 0. Since it is possible to invent constraints for which canonically stable systems have negative heat capacity we speculate that it may also be possible to infer the statistical mechanics of canonically unstable systems - for which even the traditional heat capacities are negative - by imposing constraints that stabilize the associated, inoncanonical ensembles.

  5. Classical fluids of negative heat capacity

    Energy Technology Data Exchange (ETDEWEB)

    Landsberg, P.T. (Southampton Univ., (United Kingdom). Faculty of Mathematical Studies); Woodard, R.P. (Florida Univ., Gainesville, FL (United States). Dept. of Physics)

    1992-06-01

    It is shown that new parameters X can be defined such that the heat capacity C{sub X} {equivalent to} T({partial derivative}S/{partial derivative}T)X is negative, even when the canonical ensemble (i.e. at fixed T = ({partial derivative}U/{partial derivative}S) and Y {ne} X) is stable. As examples we treat black body radiation and general gas systems with nonsingular {kappa}{sub T}. For the case of a simple ideal gas we even exhibit an apparatus which enforces a constraint X(p,V) = const. that makes C{sub X} < 0. Since it is possible to invent constraints for which canonically stable systems have negative heat capacity we speculate that it may also be possible to infer the statistical mechanics of canonically unstable systems - for which even the traditional heat capacities are negative - by imposing constraints that stabilize the associated, inoncanonical ensembles.

  6. Multi-Capacity Load Cell Concept

    Directory of Open Access Journals (Sweden)

    Seif. M. OSMAN

    2014-09-01

    Full Text Available Force measuring systems are usually used to calibrate force generated systems, it is not preferable to use load cells to measure forces less than 10 % of its nominal capacity. Several load cells are required to offer calibration facilities at sites to cover different ranges, this lead to difficulties in handling procedures, through the need for several carrying cases to carry this overweight in addition to the over cost of purchasing several load cells. This article concerns with introducing a new concept for designing a multi-capacity load cell as a new force standard in the field of measuring the force. This multi-capacity load cell will replace a set of load cells and reflects economically on the total cost and on easiness of handling procedures.

  7. Optimal growth trajectories with finite carrying capacity

    Science.gov (United States)

    Caravelli, F.; Sindoni, L.; Caccioli, F.; Ududec, C.

    2016-08-01

    We consider the problem of finding optimal strategies that maximize the average growth rate of multiplicative stochastic processes. For a geometric Brownian motion, the problem is solved through the so-called Kelly criterion, according to which the optimal growth rate is achieved by investing a constant given fraction of resources at any step of the dynamics. We generalize these finding to the case of dynamical equations with finite carrying capacity, which can find applications in biology, mathematical ecology, and finance. We formulate the problem in terms of a stochastic process with multiplicative noise and a nonlinear drift term that is determined by the specific functional form of carrying capacity. We solve the stochastic equation for two classes of carrying capacity functions (power laws and logarithmic), and in both cases we compute the optimal trajectories of the control parameter. We further test the validity of our analytical results using numerical simulations.

  8. Optimization of ATSC Mobile Handheld Service Capacity

    Directory of Open Access Journals (Sweden)

    Omneya Issa

    2013-01-01

    Full Text Available Mobile TV has become a reality offered on several mobile delivery systems. Among them is the Advanced Television System Committee (ATSC system for mobile and handheld digital television services, known as ATSC Mobile DTV or ATSC M/H, which has moved from standardization to implementation. As the North American broadcast industry is preparing to provide Mobile DTV service to consumers, this work discusses important technical parameters that affect the TV service quality and capacity. Since additional error correction mechanisms were added to overcome mobile transmission problems, the available payload for M/H services is limited. This creates a need to efficiently use the available M/H bandwidth. The paper aims to optimize the Mobile DTV service capacity while maintaining an acceptable perceived quality. It presents tradeoffs between several factors affecting service capacity and signal robustness, which is prominent for designing Mobile TV broadcasting scenarios.

  9. Measuring Innovative Capacities of the Georgia Regions

    Directory of Open Access Journals (Sweden)

    Joseph Gogodze

    2013-10-01

    Full Text Available European Union (EU experience reveal that the composite indicators are probably the most useful instruments for measuring the innovative capacities at the regional (sub-national level. However, some gap exists in the current literature with respect to the elaboration of composite indicators for regional innovation systems (RISs of developing countries. This article introduces the composite indicators GRIS and GCLS for measuring the regional innovative capacities (for GNUTS1 and GNUTS2 territorial classification levels, respectively. Georgia is a useful case-subject because its smallscale developing economy presents special challenges for elaborating the composite indicators for RISs. This article also includes a brief analysis using these composite indicators and indicates the significant heterogeneity among the innovative capacities of the Georgian regions.

  10. The Driving Forces of Subsidiary Absorptive Capacity

    DEFF Research Database (Denmark)

    Schleimer, Stephanie C.; Pedersen, Torben

    2013-01-01

    The study investigates how a multinational corporation (MNC) can promote the absorptive capacity of its subsidiaries. The focus is on what drives the MNC subsidiary's ability to absorb marketing strategies that are initiated by the MNC parent, as well as how the subsidiary enacts on this absorptive...... capacity in order to compete in its focal market. The dual embeddedness of MNC subsidiaries plays a key role in this investigation, as subsidiaries belong to the MNC network and are simultaneously embedded in their host country environment. We argue that subsidiary absorptive capacity is formed...... as a purposeful response to this dual embeddedness. An analysis of marketing strategy absorptions undertaken by 213 subsidiaries reveals that MNCs can assist their subsidiaries to compete in competitive and dynamic focal markets by forming specific organizational mechanisms that are conducive to the development...

  11. Heat capacity of ThO2

    International Nuclear Information System (INIS)

    Peng Shian

    1996-01-01

    The heat capacity C p of ThO 2 can be calculated as the phonon part of C p for other actinide dioxides used as fuel in nuclear reactors. Precise determination of the phonon part of C p of actinide dioxides is helpful to find out the contributions of other factors to C p . In this paper we have, through studying the heat capacity of ThO 2 , developed a general method applicable to the study of C p of other solids. In the developed method the three type -- different experimental measurements made on a solid-heat capacity, thermal expansion and Debye Waller factor -- can be brought together for comparison. The application of this method to the study of C p of ThO 2 has enabled us to propose a better description of C p of ThO 2 than the generally accepted expression

  12. DOE mixed waste treatment capacity analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W.A.; Wehrman, R.R.; Young, J.R.; Shaver, S.R.

    1994-06-01

    This initial DOE-wide analysis compares the reported national capacity for treatment of mixed wastes with the calculated need for treatment capacity based on both a full treatment of mixed low-level and transuranic wastes to the Land Disposal Restrictions and on treatment of transuranic wastes to the WIPP waste acceptance criteria. The status of treatment capacity is reported based on a fifty-element matrix of radiation-handling requirements and functional treatment technology categories. The report defines the classifications for the assessment, describes the models used for the calculations, provides results from the analysis, and includes appendices of the waste treatment facilities data and the waste stream data used in the analysis.

  13. Visual attention capacity after right hemisphere lesions

    DEFF Research Database (Denmark)

    Habekost, Thomas; Rostrup, Egill

    2007-01-01

    Recently there has been a growing interest in visual short-term memory (VSTM) including the neural basis of the function. Processing speed, another main aspect of visual attention capacity, has received less investigation. For both cognitive functions human lesion studies are sparse. We used...... a whole report experiment for estimation of these two parameters in 22 patients with right side stroke. Psychophysical performance was analyzed using Bundesen's [Bundesen, C. (1990). A theory of visual attention. Psychological Review, 97, 523-547] Theory of Visual Attention (TVA) and compared...... for both VSTM capacity and ipsilesional processing speed. The study also showed that lesions in a large region of the right hemisphere, including the putamen, insula, and inferior frontal cortex, do not lead to general deficits in the capacity of visual attention. Udgivelsesdato: 2007-Apr-8...

  14. Representation of Solar Capacity Value in the ReEDS Capacity Expansion Model

    Energy Technology Data Exchange (ETDEWEB)

    Sigrin, B. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sullivan, P. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ibanez, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Margolis, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-03-01

    An important issue for electricity system operators is the estimation of renewables' capacity contributions to reliably meeting system demand, or their capacity value. While the capacity value of thermal generation can be estimated easily, assessment of wind and solar requires a more nuanced approach due to the resource variability. Reliability-based methods, particularly assessment of the Effective Load-Carrying Capacity, are considered to be the most robust and widely-accepted techniques for addressing this resource variability. This report compares estimates of solar PV capacity value by the Regional Energy Deployment System (ReEDS) capacity expansion model against two sources. The first comparison is against values published by utilities or other entities for known electrical systems at existing solar penetration levels. The second comparison is against a time-series ELCC simulation tool for high renewable penetration scenarios in the Western Interconnection. Results from the ReEDS model are found to compare well with both comparisons, despite being resolved at a super-hourly temporal resolution. Two results are relevant for other capacity-based models that use a super-hourly resolution to model solar capacity value. First, solar capacity value should not be parameterized as a static value, but must decay with increasing penetration. This is because -- for an afternoon-peaking system -- as solar penetration increases, the system's peak net load shifts to later in the day -- when solar output is lower. Second, long-term planning models should determine system adequacy requirements in each time period in order to approximate LOLP calculations. Within the ReEDS model we resolve these issues by using a capacity value estimate that varies by time-slice. Within each time period the net load and shadow price on ReEDS's planning reserve constraint signals the relative importance of additional firm capacity.

  15. Extending Organizational Antecedents Of Absorptive Capacity

    DEFF Research Database (Denmark)

    Burcharth, Ana Luiza de Araújo; Lettl, Christopher; Ulhøi, John Parm

    2015-01-01

    on multi-informant survey data collected from SMEs in Denmark (n=169), we find empirical support for the impact of these characteristics (except for tolerance for failure) on various aspects of absorptive capacity (both potential and realized). Before concluding, we discuss the theoretical and managerial......Absorptive capacity has generally been perceived as a ‘passive’ outcome of R&D investments. Recently, however, a renewed debate on its ‘proactive’ dimensions has emerged. We tap into this development and complement the existing discussion on combinative capabilities with a perspective that focuses...

  16. Understanding Collaborative capacity in an ICT context

    DEFF Research Database (Denmark)

    Rai, Sudhanshu

    during the Euro-India Innovation Mapping project funded by the European Union under the FP-7 program. The idea is to refine theory and contribute to a better understanding of collaborative as a capacity firms can build creating the environment of collaboration both within and outside. I conclude......In this paper my endeavor is to explore the meaning and implication of collaberation within a dynamic frame which I refer to a capacity. First I review the collaboration literature from an innovation perspective and then develop a framework that enables me to engage with the data we collected...

  17. Female Sexuality as Capacity and Power?

    DEFF Research Database (Denmark)

    Arnfred, Signe

    2015-01-01

    The article argues for an approach to studies of sexuality in Africa that considers the subject of female sexuality from the perspective of capacity and power. Based on data from Mozambique, and informed by conceptual frameworks as well as by research findings from other African countries......, the article investigates preparations of the erotic female body such as body tattoos, hip belts of glass beads, and elongated labia. It also discusses how “traditional” sexual capacity-building has been transferred from rural contexts into urban settings, empowering young women in love relationships...

  18. Balance Sheet Capacity and Endogenous Risk

    OpenAIRE

    Jon Danielsson; Hyun Song Shin; Jean-Pierre Zigrand

    2011-01-01

    Banks operating under Value-at-Risk constraints give rise to a well-defined aggregate balance sheet capacity for the banking sector as a whole that depends on total bank capital. Equilibrium risk and market risk premiums can be solved in closed form as functions of aggregate bank capital. We explore the empirical properties of the model in light of recent experience in the financial crisis and highlight the importance of balance sheet capacity as the driver of the financial cycle and market r...

  19. A high capacity 3D steganography algorithm.

    Science.gov (United States)

    Chao, Min-Wen; Lin, Chao-hung; Yu, Cheng-Wei; Lee, Tong-Yee

    2009-01-01

    In this paper, we present a very high-capacity and low-distortion 3D steganography scheme. Our steganography approach is based on a novel multilayered embedding scheme to hide secret messages in the vertices of 3D polygon models. Experimental results show that the cover model distortion is very small as the number of hiding layers ranges from 7 to 13 layers. To the best of our knowledge, this novel approach can provide much higher hiding capacity than other state-of-the-art approaches, while obeying the low distortion and security basic requirements for steganography on 3D models.

  20. Capacity Expansion Modeling for Storage Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Hale, Elaine; Stoll, Brady; Mai, Trieu

    2017-04-03

    The Resource Planning Model (RPM) is a capacity expansion model designed for regional power systems and high levels of renewable generation. Recent extensions capture value-stacking for storage technologies, including batteries and concentrating solar power with storage. After estimating per-unit capacity value and curtailment reduction potential, RPM co-optimizes investment decisions and reduced-form dispatch, accounting for planning reserves; energy value, including arbitrage and curtailment reduction; and three types of operating reserves. Multiple technology cost scenarios are analyzed to determine level of deployment in the Western Interconnection under various conditions.

  1. Efficacy and safety of linagliptin in Asian patients with type 2 diabetes mellitus inadequately controlled by metformin: A multinational 24-week, randomized clinical trial.

    Science.gov (United States)

    Wang, Weiqing; Yang, Jinkui; Yang, Gangyi; Gong, Yan; Patel, Sanjay; Zhang, Candice; Izumoto, Toshiyasu; Ning, Guang

    2016-03-01

    Despite the increasing prevalence of type 2 diabetes mellitus (T2DM) in Asia, clinical trials for glucose-lowering therapies are often dominated by Caucasian and/or Western populations. The present Phase III randomized placebo-controlled double-blind, 24-week study evaluated the efficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin added to metformin in Asian T2DM patients. In all, 306 patients (n = 265 Chinese; n = 24 Malaysian; n = 17 Filipino), aged 18-80 years with HbA1c between ≥7.0 and ≤10.0% and on metformin therapy were randomized (2:1) to either linagliptin 5 mg daily or placebo added to metformin. Antidiabetes drugs other than metformin were washed out prior to randomization. The primary endpoint was change in mean HbA1c from baseline after 24 weeks. Baseline characteristics were well-matched between the groups (overall mean [±SD] HbA1c 8.0 ± 0.8%). Adjusted mean (±SE) HbA1c decreased in the linagliptin and placebo groups by -0.66 ± 0.05 and -0.14 ± 0.07%, respectively (placebo-corrected difference -0.52 ± 0.09%; 95% confidence interval [CI] -0.70, -0.34; P < 0.0001). In patients with baseline HbA1c ≥8.5%, the placebo-corrected decrease in HbA1c was -0.89 ± 0.17% (P < 0.0001). Adverse events occurred in similar proportions in the linagliptin and placebo patients (27.3% and 28.0%, respectively) and few were considered drug-related (2.4% and 0.0%, respectively). Hypoglycemia occurred in 1.0% of patients in both groups. Linagliptin therapy was weight neutral. Linagliptin 5 mg was efficacious and well tolerated over 24 weeks in Asian patients with T2DM inadequately controlled by metformin. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  2. Impact of empagliflozin added on to basal insulin in type 2 diabetes inadequately controlled on basal insulin: a 78-week randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Rosenstock, J; Jelaska, A; Zeller, C; Kim, G; Broedl, U C; Woerle, H J

    2015-10-01

    To investigate the efficacy and tolerability of empagliflozin added to basal insulin-treated type 2 diabetes. Patients inadequately controlled [glycated haemoglobin (HbA1c) >7 to ≤10% (>53 to ≤86 mmol/mol)] on basal insulin (glargine, detemir, NPH) were randomized to empagliflozin 10 mg (n = 169), empagliflozin 25 mg (n = 155) or placebo (n = 170) for 78 weeks. The baseline characteristics were balanced among the groups [mean HbA1c 8.2% (67 mmol/mol), BMI 32.2 kg/m(2) ]. The basal insulin dose was to remain constant for 18 weeks, then could be adjusted at investigator's discretion. The primary endpoint was change from baseline in HbA1c at week 18. Key secondary endpoints were changes from baseline in HbA1c and insulin dose at week 78. At week 18, the adjusted mean ± standard error changes from baseline in HbA1c were 0.0 ± 0.1% (-0.1 ± 0.8 mmol/mol) for placebo, compared with -0.6 ± 0.1% (-6.2 ± 0.8 mmol/mol) and -0.7 ± 0.1% (-7.8 ± 0.8 mmol/mol) for empagliflozin 10 and 25 mg, respectively (both p empagliflozin 10 and 25 mg significantly reduced HbA1c, insulin dose and weight vs placebo (all p empagliflozin 10 mg significantly reduced systolic blood pressure vs placebo (p = 0.004). Similar percentages of patients had confirmed hypoglycaemia in all groups (35-36%). Events consistent with urinary tract infection were reported in 9, 15 and 12% of patients on placebo, empagliflozin 10 and 25 mg, and events consistent with genital infection were reported in 2, 8 and 5%, respectively. Empagliflozin for 78 weeks added to basal insulin improved glycaemic control and reduced weight with a similar risk of hypoglycaemia to placebo. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  3. Effect of bromocriptine-QR therapy on glycemic control in subjects with type 2 diabetes mellitus whose dysglycemia is inadequately controlled on insulin.

    Science.gov (United States)

    Chamarthi, Bindu; Cincotta, Anthony H

    2017-05-01

    The concurrent use of an insulin sensitizer in type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control on basal-bolus insulin may help improve glycemic control while limiting further insulin requirement. Bromocriptine-QR (B-QR), a quick release, sympatholytic, dopamine D2 receptor agonist therapy for T2DM, is a postprandial insulin sensitizer. This study evaluated the effect of B-QR on dysglycemia in T2DM subjects with suboptimal glycemic control on basal-bolus insulin plus metformin. The effect of once-daily morning administration of B-QR on dysglycemia was evaluated in 60 T2DM subjects derived from the Cycloset Safety Trial, with HbA1c >7% on basal-bolus insulin plus metformin at baseline, randomized to B-QR (N = 44) versus placebo (N = 16) and completed 12 weeks of study drug treatment. The analyses also included a subset of subjects on high-dose insulin (total daily insulin dose (TDID) ≥70 units; N = 36: 27 B-QR; 9 placebo). Subjects were well matched at baseline. After 12 weeks of B-QR treatment, mean % HbA1c decreased by -0.73% relative to baseline (p QR therapy resulted in % HbA1c reductions of -0.95 and -1.49 relative to baseline (p QR on HbA1c. The fasting plasma glucose (FPG) and TDID changes within each treatment group were not significant. More subjects achieved HbA1c ≤7 at 12 weeks with B-QR relative to placebo (36.4% B-QR vs 0% placebo, Fisher's exact 2-sided p = 0.003 in the entire cohort and 37% vs 0%, 2-sided p = 0.039 in the high-dose insulin subset). B-QR therapy improves glycemic control in T2DM subjects whose glycemia is poorly controlled on metformin plus basal-bolus insulin, including individuals on high-dose basal-bolus insulin. This glycemic impact occurred without significant change in FPG, suggesting a postprandial glucose lowering mechanism of action. Cycloset Safety Trial registration: ClinicalTrials.gov Identifier: NCT00377676.

  4. The risk and consequences of clinical miscoding due to inadequate medical documentation: a case study of the impact on health services funding.

    Science.gov (United States)

    Cheng, Ping; Gilchrist, Annette; Robinson, Kerin M; Paul, Lindsay

    As coded clinical data are used in a variety of areas (e.g. health services funding, epidemiology, health sciences research), coding errors have the potential to produce far-reaching consequences. In this study the causes and consequences of miscoding were reviewed. In particular, the impact of miscoding due to inadequate medical documentation on hospital funding was examined. Appropriate reimbursement of hospital revenue in the casemix-based (output-based) funding system in the state of Victoria, Australia relies upon accurate, comprehensive, and timely clinical coding. In order to assess the reliability of these data in a Melbourne tertiary hospital, this study aimed to: (a) measure discrepancies in clinical code assignment; (b) identify resultant Diagnosis Related Group (DRG) changes; (c) identify revenue shifts associated with the DRG changes; (d) identify the underlying causes of coding error and DRG change; and (e) recommend strategies to address the aforementioned. An internal audit was conducted on 752 surgical inpatient discharges from the hospital within a six-month period. In a blind audit, each episode was re-coded. Comparisons were made between the original codes and the auditor-assigned codes, and coding errors were grouped and statistically analysed by categories. Changes in DRGs and weighted inlier-equivalent separations (WIES) were compared and analysed, and underlying factors were identified. Approximately 16% of the 752 cases audited reflected a DRG change, equating to a significant revenue increase of nearly AU$575,300. Fifty-six percent of DRG change cases were due to documentation issues. Incorrect selection or coding of the principal diagnosis accounted for a further 13% of the DRG changes, and missing additional diagnosis codes for 29%. The most significant of the factors underlying coding error and DRG change was poor quality of documentation. It was concluded that the auditing process plays a critical role in the identification of causes

  5. A systematic review and mixed-treatment comparison of dapagliflozin with existing anti-diabetes treatments for those with type 2 diabetes mellitus inadequately controlled by sulfonylurea monotherapy

    Science.gov (United States)

    2014-01-01

    Background To compare the first-in-class sodium glucose co-transporter 2 (SGLT2) inhibitor, dapagliflozin, with existing type 2 diabetes mellitus (T2DM) treatment options available within the European Union (EU) for add-on therapy to sulfonylureas (SUs). Methods A systematic review was conducted to identify randomised controlled trials (RCTs) in T2DM patients inadequately controlled by SU monotherapy. Direct meta-analysis, Bucher indirect comparisons and Bayesian network meta-analysis (NMA) were conducted on studies meeting predefined inclusion criteria. Sufficient data were available to assess three clinical endpoints at 24 (+/- 6) weeks follow-up: mean change in HbA1c from baseline, mean change in weight from baseline, and the proportion of patients experiencing at least one episode of hypoglycaemia. The effect of confounding baseline factors was explored through covariate analyses. Results The search identified 1,901 unique citations, with 1,870 excluded based on title/abstract. From reviewing full-texts of the remaining 31 articles, 5 studies were considered eligible for analysis. All studies were comparable in terms of baseline characteristics, including: HbA1c, age and body mass index (BMI). In addition to dapagliflozin, sufficient data for meta-analysis was available for three dipeptidyl peptidase-4 (DPP-4) inhibitors and one glucagon-like peptide-1 (GLP-1) analogue. Based on fixed-effect NMA, all treatment classes resulted in statistically significant decreases in HbA1c at follow-up compared to placebo. Dapagliflozin treatment resulted in significantly decreased weight at follow-up compared to placebo (-1.54 kg; 95% CrI -2.16, -0.92), in contrast to treatment with GLP-1 analogues (-0.65 kg; 95% CrI -1.37, 0.07) and DPP-4 inhibitors (0.57 kg; 95% CrI 0.09, 1.06). The odds of hypoglycaemia were similar to placebo for dapagliflozin and DPP-4 inhibitor add-on treatment, but significantly greater than placebo for GLP-1 analogue add-on treatment (10.89; 95% Cr

  6. Capacity and Competition: Empirical Evidence on UK Panel Data.

    OpenAIRE

    Haskel, Jonathan; Martin, Christopher

    1994-01-01

    Following D. Kreps and J. Scheinkman (1983), it is common to view the difference between Cournot and Bertrand competition as depending on production capacity. Bertrand undercutting is only feasible if firms have capacity to serve the market gained. If firms are capacity constrained, the Cournot model is more appropriate. This paper tests the capacity and competition idea by looking at the relationship between profits and capacity constraints; if capacity constrained firms become more Cournot-...

  7. On the Specific Heat Capacity of CuO Nanofluid

    OpenAIRE

    Le-Ping Zhou; Bu-Xuan Wang; Xiao-Feng Peng; Xiao-Ze Du; Yong-Ping Yang

    2010-01-01

    This paper reviews briefly the definition of heat capacity and clarifies the defined specific heat capacity and volumetric heat capacity. The specific heat capacity and volumetric heat capacity, with our measured experimental data for CuO nanofluids, are discussed as an illustrating example. The result indicates that the specific heat capacity of CuO nanofluid decreases gradually with increasing volume concentration of nanoparticles. The measurement and the prediction from the thermal equilib...

  8. Assessing European Capacity for Geological Storage of Carbon Dioxide. Storage capacity

    NARCIS (Netherlands)

    Neele, F.P.; Allier, D.; Anghel, S.; Anthonsen, K.L.; Bossie-Codreanu, D.; Car, M.; Donda, F.; Dudu, A.; Falus, G.; Georgiev, G.; Hatsiyannis, G.; Hegedus, E.; Hladik, V.; Ivanova, O.; Jencsel, H.; Kirk, K.; Knopf, S.; Kolejka, V.; Kotulova, J.; Kucharic, L.; Le Nindre, Y.M.; Marina, M.; Martinez, R.; Maurand, N.; May, F.; Micevski, E.; Nulle, I.; Opovski, K.; Persoglia, S.; Pomeranceva, R.; Poulsen, N.E.; Prifti, I.; Proca, A.; Saftic, B.; Sava, C.; Shogenova, A.; Shogenov, K.; Sliapiene, R.; Sliaupa, S.; Suarez, I.; Szamosfalvi, A.; Tarkowski, R.; Uliasz-Misiask, B.; Vaher, R.; Vangkilde-Pedersen, T.; Willscher, B.; Wojcicki, A.; Xenakis, M.; Zapatero, M.; Zivkovic, S.A.

    2009-01-01

    This document is deliverable D16 WP2 Report Storage Capacity and provides a description of the work carried out in WP2. It also provides a summary of capacity estimates for deep saline aquifers, hydrocarbon field and coal beds for each country and brief descriptions of the methodology used and

  9. Relational Capacity: Broadening the Notion of Decision-Making Capacity in Paediatric Healthcare.

    Science.gov (United States)

    Ruhe, Katharina M; De Clercq, Eva; Wangmo, Tenzin; Elger, Bernice S

    2016-12-01

    Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children's position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity is discussed, followed by an examination of Vygostky's contextualist view on children's development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults' decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties.

  10. Assessing European capacity for geological storage of carbon dioxide-the EU GeoCapacity project

    NARCIS (Netherlands)

    Vangkilde-Pedersen, T.; Anthonsen, K.L.; Smith, N.; Kirk, K.; Neele, F.; Meer, B. van der; Le Gallo, Y. le; Bossie-Codreanu, D.; Wojcicki, A.; Nindre, Y.-M. le; Hendriks, C.; Dalhoff, F.; Peter Christensen, N.

    2009-01-01

    The focus of the GeoCapacity project is GIS mapping of CO2 point sources, infrastructure and geological storage in Europe. The main objective is to assess the European capacity for geological storage of CO2 in deep saline aquifers, oil and gas structures and coal beds. Other priorities are further

  11. Capacity Expansion and Reliability Evaluation on the Networks Flows with Continuous Stochastic Functional Capacity

    Directory of Open Access Journals (Sweden)

    F. Hamzezadeh

    2014-01-01

    Full Text Available In many systems such as computer network, fuel distribution, and transportation system, it is necessary to change the capacity of some arcs in order to increase maximum flow value from source s to sink t, while the capacity change incurs minimum cost. In real-time networks, some factors cause loss of arc’s flow. For example, in some flow distribution systems, evaporation, erosion or sediment in pipes waste the flow. Here we define a real capacity, or the so-called functional capacity, which is the operational capacity of an arc. In other words, the functional capacity of an arc equals the possible maximum flow that may pass through the arc. Increasing the functional arcs capacities incurs some cost. There is a certain resource available to cover the costs. First, we construct a mathematical model to minimize the total cost of expanding the functional capacities to the required levels. Then, we consider the loss of flow on each arc as a stochastic variable and compute the system reliability.

  12. Higher education and capacity building in Africa

    DEFF Research Database (Denmark)

    , the chapters draw on discussions about the hegemony of Western thought in education and knowledge production. The authors’ own experiences with higher education capacity building and knowledge production are discussed and used to contribute to the reflexive turn and rise of auto-ethnography. This book...

  13. Antioxidant Capacity, Radical Scavenging Kinetics and Phenolic ...

    African Journals Online (AJOL)

    HP

    Results: Extract from Rhizophora mangle L and Krameria erecta displayed 5-fold higher antioxidant capacity than ascorbic acid with DPPH reduction values of 95.71 and 91 %, respectively. Anti-radical kinetic analysis and stoichiometric constant values suggest that the compounds responsible for antioxidant activity are ...

  14. Public management, policy capacity, innovation and development

    Directory of Open Access Journals (Sweden)

    Erkki Karo

    2014-03-01

    Full Text Available In this paper we discuss the question of what factors in development policy create specific forms of policy capacity and under what circumstances developmentoriented complementarities or mismatches between the public and private sectors emerge. We argue that specific forms of policy capacity emerge from three interlinked policy choices, each fundamentally evolutionary in nature: policy choices on understanding the nature and sources of technical change and innovation; on the ways of financing economic growth, in particular technical change; and on the nature of public management to deliver and implement both previous sets of policy choices. Thus, policy capacity is not so much a continuum of abilities (from less to more, but rather a variety of modes of making policy that originate from co-evolutionary processes in capitalist development. To illustrate, we briefly reflect upon how the East Asian developmental states of the 1960s-1980s and Eastern European transition policies since the 1990s led to almost opposite institutional systems for financing, designing and managing development strategies, and how this led, through co-evolutionary processes, to different forms of policy capacity.

  15. Strengthening Research Capacity to Enhance Natural Resources ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project aims to strengthen the capacity of national agricultural research and extension systems (NARES) in Africa to apply participatory approaches and cutting-edge ideas to research for development. The project will involve a series of iterative steps including learning, practice, reflection and feedback, and focus on ...

  16. Cultivating Institutional Capacities for Learning Analytics

    Science.gov (United States)

    Lonn, Steven; McKay, Timothy A.; Teasley, Stephanie D.

    2017-01-01

    This chapter details the process the University of Michigan developed to build institutional capacity for learning analytics. A symposium series, faculty task force, fellows program, research grants, and other initiatives are discussed, with lessons learned for future efforts and how other institutions might adapt such efforts to spur cultural…

  17. Evaluating Capacity Development: Experiences from Research and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Although ensuring the effectiveness of a capacity-building effort requires appropriate use of evaluation, few organizations have implemented a system for monitoring or evaluating the changes taking place ... This book shows that a greater impact and a broader vision are both needed in theory and possible in practice.

  18. Strengthening Information Society Research Capacity Alliance ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    There is a disparity between the representation of northern and southern researchers in the literature pertaining to information studies, particularly information and communication for development (ICT4D) research. An earlier project, 104921 Small Grants Program: Strengthening ICTD Research Capacity in Asia (SIRCA), ...

  19. Appraising Capacity Building among Engineering Students in ...

    African Journals Online (AJOL)

    This paper examined capacity building among engineering students in selected universities in south-western Nigeria. One hundred and fifty-one final year engineering students took part in the survey. A structured questionnaire was administered to the respondents as a tool for data collection. The data collected were ...

  20. Innovation capacity in the public sector

    DEFF Research Database (Denmark)

    Lewis, Jenny; Ricard, Lykke Margot

    The aim of this paper is to establish a framework for the comparative analysis of the four cases (municipalities), which will link innovation environments (governance structures, social networks and leadership qualities) to innovation capacity and innovativeness. It begins with a discussion of in...