WorldWideScience

Sample records for include comprehensive assessment

  1. A comprehensive study including monitoring, assessment of health effects and development of a remediation method for chromium pollution.

    Science.gov (United States)

    Yoshinaga, Masafumi; Ninomiya, Hiromasa; Al Hossain, M M Aeorangajeb; Sudo, Makoto; Akhand, Anwarul Azim; Ahsan, Nazmul; Alim, Md Abdul; Khalequzzaman, Md; Iida, Machiko; Yajima, Ichiro; Ohgami, Nobutaka; Kato, Masashi

    2018-06-01

    Chromium (Cr) pollution caused by wastewater from tanneries is a worldwide environmental problem. To develop a countermeasure, we performed a comprehensive study using Hazaribagh, the tannery area in Dhaka City, Bangladesh, as a model. Our environmental monitoring indicated that the soluble form of Cr, but not barium or arsenic, in Buriganga River is derived from Hazaribagh. Our chemical analysis next showed that Cr, the primary pollutant in canal water at Hazaribagh, consisted of ≤0.7 μM hexavalent Cr [Cr(VI)] and ≤1705 μM trivalent Cr [Cr(III)]. Our biological study then showed that coexposure to Cr(VI) and Cr(III) at possible ratios in canal water at Hazaribagh synergistically promotes transforming activity of human non-tumorigenic HaCaT keratinocytes with activated MEK/ERK and AKT. Our environmental engineering study finally indicated that a magnesium and iron-based hydrotalcite-like compound (MF-HT), our original depurative, can maximally adsorb 9.0 mg/g Cr(VI) and 1041 mg/g Cr(III). Our results suggested the importance of removal of Cr(III) as well as Cr(VI) by showing that Cr(III), which is generally recognized as a chemical with low toxicity, synergistically promoted carcinogenicity of a low level of Cr(VI). Therefore, we propose the use of our original high-efficient and low-cost depurative as a countermeasure to address the worldwide problem of environmental Cr pollution. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Metal load assessment in patient pulmonary lavages: towards a comprehensive mineralogical analysis including the nano-sized fraction.

    Science.gov (United States)

    Forest, Valérie; Vergnon, Jean-Michel; Guibert, Cyril; Bitounis, Dimitrios; Leclerc, Lara; Sarry, Gwendoline; Pourchez, Jérémie

    Mineralogical analyses of clinical samples have been proved useful to identify causal relationship between exposure to airborne particles and pulmonary diseases. The most striking example is asbestosis where the assessment of asbestos bodies in patient lung samples has allowed defining values specific of pathologies. However, this type of analyses only considers the micro-sized fraction of the particles, neglecting the specific impact of nano-sized particles which have been otherwise shown to be reactive and able to induce biological effects. Similarly, in nanotoxicology, the mineralogical analysis of pulmonary fluids could be used as an indicator of exposure to inhaled nanoparticles and could help investigations on the relationship between exposure to these nanoparticles and lung diseases. We designed this study first to demonstrate the technical feasibility of this approach, then to get a clear picture of the metals present, and in what form, in patient lungs and finally to determine if indeed it is worth investigating separately the micro, sub-micro and nano fractions. Broncho-alveolar lavages were recovered from 100 patients suffering from interstitial lung diseases. A protocol was specifically developed to isolate three fractions containing respectively microparticles, sub-microparticles and nanoparticles with ions. The metal content in each fraction was qualitatively and quantitatively characterized. Results showed significant differences between the three fractions in terms of metal load confirming that the separate analysis of the fractions is relevant. It also means that the assessment of the micro-sized fraction alone, as commonly done in clinical practice, only gives a partial view of the mineralogical analysis.

  3. A comprehensive assessment protocol including patient reported outcomes, physical tests, and biological sampling in newly diagnosed patients with head and neck cancer: is it feasible?

    NARCIS (Netherlands)

    van Nieuwenhuizen, A.J.; Buffart, L.M.; Smit, J.H.; Brakenhoff, R.H.; Braakhuis, B.J.; de Bree, R.; Leemans, C.; Verdonck-de Leeuw, I.M.

    2014-01-01

    Purpose Large cohort studies are needed taking into account cancer-related, personal, biological, psychobehavioral, and lifestyle-related factors, to guide future research to improve treatment and supportive care. We aimed to evaluate the feasibility of a comprehensive baseline assessment of a

  4. Electroconvulsive Therapy: A Comprehensive Assessment

    Directory of Open Access Journals (Sweden)

    Tayfun Zeren

    2003-08-01

    Full Text Available Electroconvulsive therapy (ECT is one of the most important discoveries of psychiatric treatments. This article comprehensively assesses historical progress, mechanism of actions, practical methods, indications, side effects, complications, drug interactions of ECT and attitudes towards ECT. [Archives Medical Review Journal 2003; 12(4.000: 340-377

  5. Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions.

  6. Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

    International Nuclear Information System (INIS)

    1997-04-01

    To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions

  7. [Comprehensive hygienic assessment of solaria].

    Science.gov (United States)

    Kravchenko, O K

    2011-01-01

    The paper gives data on the positive and negative effects of human exposure to ultraviolet radiation (UVR). It provides the hygienic characteristics of solaria used to produce an artificial tan. This device has been found to present a high health risk to its users. There are considerable problems in the hygienic assessment of this type of exposure. The ways of solving the arising problems in developing the metrological monitoring of UVR and compiling a document regulating the sanitary-and-epidemiological surveillance of solaria are defined.

  8. Comprehension assessment of diabetes education program participants.

    Science.gov (United States)

    McNeal, B; Salisbury, Z; Baumgardner, P; Wheeler, F C

    1984-01-01

    Diabetes education program participants were assessed to determine their reading and comprehension skill levels, and written and oral instructions were evaluated to determine the reading level of information presented in the education program. A significant mismatch was found between the reading and comprehension levels of program participants and the level of oral instruction and printed materials. More than half of the program participants could not fully comprehend educational materials at 5th-grade level, while nearly all written materials and oral instructions were presented at the 9th-grade level or above.

  9. Species for the screening assessment. Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Becker, J.M.; Brandt, C.A.; Dauble, D.D.; Maughan, A.D.; O'Neil, T.K.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Comprehensive Impact Assessment was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of the risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to the environment. The objective of the ecological risk assessment is to determine whether contaminants from the Columbia River pose a significant threat to selected receptor species that exist in the river and riparian communities of the study area. This report (1) identifies the receptor species selected for the screening assessment of ecological risk and (2) describes the selection process. The species selection process consisted of two tiers. In Tier 1, a master species list was developed that included many plant and animal species known to occur in the aquatic and riparian systems of the Columbia River between Priest Rapids Dam and the Columbia River estuary. This master list was reduced to 368 species that occur in the study area (Priest Rapids Dam to McNary Dam). In Tier 2, the 181 Tier 1 species were qualitatively ranked based on a scoring of their potential exposure and sensitivity to contaminants using a conceptual exposure model for the study area

  10. [Reliability and applications of a grammar comprehension assessment test].

    Science.gov (United States)

    López-Higes, Ramón; Martín-Aragoneses, M Teresa; Rubio-Valdehita, Susana

    2010-04-01

    The sentence comprehension test from the sentence comprehension cognitive examination (ECCO) battery can be used to assess children and adults with grammar comprehension disorders by means of a simple verification procedure that requires few memory resources. AIM. To present a psychometric analysis of the sentence comprehension test based on the classical theory of tests and on item response theory, as well as several studies that show its usefulness for assessing grammar comprehension in different populations. The test was applied to 2238 subjects with ages ranging from 6 to 85 years. The analysis shows that the test has a high overall reliability and, through the age groups that were considered, it includes elements that are especially discriminating or informative (lexical and syntactic distractors) and is biased towards medium-low levels of the trait. In view of the results, the sentence comprehension test from the ECCO battery provides a reliable measure of grammar comprehension through a wide variety of constructions and has great potential value for use in the clinical and research domains.

  11. Comprehensive environmental assessment and response program

    International Nuclear Information System (INIS)

    Gunderson, T.C.; Vocke, R.W.; Stoker, A.K.

    1986-01-01

    The U.S. Department of Energy's (USDOE) Albuquerque Operations Office installations are being evaluated under its Comprehensive Environmental Assessment and Response Program (CEARP). The installations consist of eight weapons development and production facilities, which are located across the United States. The evaluation covers the major environmental regulations, with emphasis on the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and on the Resource Conservation and Recovery Act (RCRA). The CEARP is intended to help fulfill USDOE obligations for federal facilities under the U.S. Environmental Protection Agency (USEPA) CERCLA Program and constitutes the same basic approach as contained in USEPA guidance to federal facilities. The Program is a phased program to identify, assess, and correct existing and potential environmental concerns relative to these regulations. The five phases are Phase I - Installation Assessment, Phase II - Confirmation, Phase III - Technological Assessment, Phase IV - Remedial Action, and Phase V - Compliance and Verification. Phase I activities and reports should be completed during 1986. The Phase II generic sampling plans, data management plans, health and safety plans, and quality assurance/quality control plans will be prepared during 1986. Significant characterization of CERCLA sites will be initiated during 1987

  12. Web-Based Assessment of Children's Social-Emotional Comprehension

    Science.gov (United States)

    McKown, Clark; Russo-Ponsaran, Nicole M.; Johnson, Jason K.; Russo, Jaclyn; Allen, Adelaide

    2016-01-01

    This article presents results from two studies that included ethnically and socioeconomically diverse samples totaling 4,462 children in kindergarten through third grade. Each study examined the psychometric properties of a web-based, self-administered battery of assessments of social-emotional comprehension called "SELweb." Assessment…

  13. COMPREHENSIVE ASSESSMENT OF GENE POOL OF CARROT

    Directory of Open Access Journals (Sweden)

    V. I. Burenin

    2015-01-01

    Full Text Available The results of comprehensive assessment of the collection samples of carrot are presented. Such traits as a resistance to carrot psylla and carrot fly, high yield, earlyripeness, high content of carotene were evaluated. The carrot varieties total resistant to psylla were not found. The genotypes with combination of such traits as a mild tolerance to pests, stable productivity and fruits quality are recommended as the initial breeding material for development of new varieties and hybrids of carrot.

  14. Comprehensive wellbore stability analysis utilizing Quantitative Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Moos, Daniel; Peska, Pavel; Finkbeiner, Thomas [GeoMechanics International, Palo Alto, CA 94303 (United States); Zoback, Mark [Stanford University, Stanford, CA 94305 (United States)

    2003-06-01

    A comprehensive geomechanical approach to wellbore stability requires knowledge of rock strength, pore pressure and the magnitude and orientation of the three principal stresses. These parameters are often uncertain, making confidence in deterministic predictions of the risks associated with instabilities during drilling and production difficult to assess. This paper demonstrates the use of Quantitative Risk Assessment (QRA) to formally account for the uncertainty in each input parameter to assess the probability of achieving a desired degree of wellbore stability at a given mud weight. We also utilize QRA to assess how the uncertainty in each parameter affects the mud weight calculated to maintain stability. In one case study, we illustrate how this approach allows us to compute optimal mud weight windows and casing set points at a deep-water site. In another case study, we demonstrate how to assess the feasibility of underbalanced drilling and open-hole completion of horizontal wells utilizing a comprehensive stability analysis that includes application of QRA.

  15. Standardised Testing and Assessment in Comprehensive School in Scandinavian Countries

    DEFF Research Database (Denmark)

    Andreasen, Karen Egedal; Eva, Hjörne,

    Assessments can be considered to be an integrated part of formal educational settings, in different forms and used for different purposes. In this contribution we will discuss and analyse the use of assessments in comprehensive school in Scandinavian countries through time, as we will include....... If the comprehensive school is based on the general idea of a school for all, how can different ways of practising assessment support or work against this idea? What conclusions can be drawn from the experiences in the Scandinavian countries?...... different kinds of documentary and empirical studies in the argumentation. We will focus on which kinds of assessments has been used, for which purposes and the role of this in the perspective of society. More contemporary trends will be discussed, specially the use of standardised testing. Scandinavian...

  16. Extending flood damage assessment methodology to include ...

    African Journals Online (AJOL)

    Optimal and sustainable flood plain management, including flood control, can only be achieved when the impacts of flood control measures are considered for both the man-made and natural environments, and the sociological aspects are fully considered. Until now, methods/models developed to determine the influences ...

  17. Comprehensive environmental assessment: a meta-assessment approach.

    Science.gov (United States)

    Powers, Christina M; Dana, Genya; Gillespie, Patricia; Gwinn, Maureen R; Hendren, Christine Ogilvie; Long, Thomas C; Wang, Amy; Davis, J Michael

    2012-09-04

    With growing calls for changes in the field of risk assessment, improved systematic approaches for addressing environmental issues with greater transparency and stakeholder engagement are needed to ensure sustainable trade-offs. Here we describe the comprehensive environmental assessment (CEA) approach as a holistic way to manage complex information and to structure input from diverse stakeholder perspectives to support environmental decision-making for the near- and long-term. We further note how CEA builds upon and incorporates other available tools and approaches, describe its current application at the U.S. Environmental Protection Agency, and point out how it could be extended in evaluating a major issue such as the sustainability of biofuels.

  18. Methods of Comprehensive Assessment for China’s Energy Sustainability

    Science.gov (United States)

    Xu, Zhijin; Song, Yankui

    2018-02-01

    In order to assess the sustainable development of China’s energy objectively and accurately, we need to establish a reasonable indicator system for energy sustainability and make a targeted comprehensive assessment with the scientific methods. This paper constructs a comprehensive indicator system for energy sustainability from five aspects of economy, society, environment, energy resources and energy technology based on the theory of sustainable development and the theory of symbiosis. On this basis, it establishes and discusses the assessment models and the general assessment methods for energy sustainability with the help of fuzzy mathematics. It is of some reference for promoting the sustainable development of China’s energy, economy and society.

  19. Data Compendium for the Columbia River comprehensive impact assessment

    International Nuclear Information System (INIS)

    Eslinger, P.W.; Huesties, L.R.; Maughan, A.D.; Miley, T.B.; Walters, W.H.

    1994-04-01

    The Columbia River Comprehensive Impact Assessment (CRCIA). The CRCIA is conducted by the Pacific Northwest Laboratory (PNL). The purpose of the CRCIA is to evaluate the current human and ecological risk from the Columbia River attributable to past and present activities on the Hanford Site. Human risk will be addressed for radioactive and hazardous materials over a range of river use options. Ecological risk will be evaluated relative to the health of the current river ecosystem. The initial effort for the CRCIA is the development of a compendium of existing data on Columbia River contamination. This document provides the data compendium. It also includes a discussion of data sources, descriptions of the physical format of the data, and descriptions of the search process used to identify data

  20. A Curriculum-Based Measure of Language Comprehension for Preschoolers: Reliability and Validity of the Assessment of Story Comprehension

    Science.gov (United States)

    Spencer, Trina D.; Goldstein, Howard; Kelley, Elizabeth Spencer; Sherman, Amber; McCune, Luke

    2017-01-01

    Despite research demonstrating the importance of language comprehension to later reading abilities, curriculum-based measures to assess language comprehension abilities in preschoolers remain lacking. The Assessment of Story Comprehension (ASC) features brief, child-relevant stories and a series of literal and inferential questions with a focus on…

  1. Comprehensive rehabilitation of children with malignant tumors by complementary therapy including Dr. Nona agents

    International Nuclear Information System (INIS)

    Borodina, I.D.; Zheludkova, O.G.; Rumyantsev, A.G.; Kukhina, N.; Lazareva, I.O.; Teslenko, B.V.; Yarmonenko, S.P.

    1999-01-01

    The program of the first in Russia onco pediatric study of comprehensive rehabilitation of children with malignant tumors based on the complementary therapy philosophy is presented. The program is aimed at improving the quality of life, correcting the complications chemoradiotherapy, and therapy of concomitant diseases in children with brain tumors and acute lymphoblastic leukemia. Among the complementary rehabilitative agents used during traditional therapy and in remission are drugs manufactured by Dr. Nona International Ltd [ru

  2. Assessing the Doctoral Thesis When It Includes Published Work

    Science.gov (United States)

    Sharmini, Sharon; Spronken-Smith, Rachel; Golding, Clinton; Harland, Tony

    2015-01-01

    In this article we explore how examiners assess a thesis that includes published work. An online survey was used to gather data on approaches to assessing publication-based theses (PBTs). The respondents were 62 supervisors who had experience examining PBTs across a range of disciplines at a research-intensive university in New Zealand. Nearly…

  3. An Interactive View of Reading Comprehension: Implications for Assessment.

    Science.gov (United States)

    Wixson, Karen K

    2017-04-20

    This clinical focus article explores further the multidimensional view of reading comprehension put forward by Catts and Kamhi (2017) in this clinical forum and its implications for reading assessment. It is argued that a multidimensional or interactive view of reading predicts variability in student performance on reading assessments as a function of the interaction among reader, text, and task factors. Student performance on any given reading assessment should be interpreted in relation to the specific reading demands of the assessment, rather than as a fixed ability that generalizes to any given reading situation. This view implies a different approach to the use of both summative and classroom assessment than is currently common practice.

  4. Comprehensive geriatric assessment and its clinical impact in oncology.

    NARCIS (Netherlands)

    Maas, H.A.; Janssen-Heijnen, M.L.; Olde Rikkert, M.G.M.; Wymenga, A.N.

    2007-01-01

    Comprehensive geriatric assessment (CGA) is a process that consists of a multidimensional data-search and a process of analyzing and linking patient characteristics creating an individualized intervention-plan, carried out by a multidisciplinary team. In general, the positive health care effects of

  5. A Framework for Assessing Reading Comprehension of Geometric Construction Texts

    Science.gov (United States)

    Yang, Kai-Lin; Li, Jian-Lin

    2018-01-01

    This study investigates one issue related to reading mathematical texts by presenting a two-dimensional framework for assessing reading comprehension of geometric construction texts. The two dimensions of the framework were formulated by modifying categories of reading literacy and drawing on key elements of geometric construction texts. Three…

  6. Assessing Comprehension During Reading with the Reading Strategy Assessment Tool (RSAT).

    Science.gov (United States)

    Magliano, Joseph P; Millis, Keith K; Levinstein, Irwin

    2011-08-01

    Comprehension emerges as the results of inference and strategic processes that support the construction of a coherent mental model for a text. However, the vast majority of comprehension skills tests adopt a format that does not afford an assessment of these processes as they operate during reading. This study assessed the viability of the Reading Strategy Assessment Tool (RSAT), which is an automated computer-based reading assessment designed to measure readers' comprehension and spontaneous use of reading strategies while reading texts. In the tool, readers comprehend passages one sentence at a time, and are asked either an indirect ("What are your thoughts regarding your understanding of the sentence in the context of the passage?") or direct (e.g., why X?) question after reading each pre-selected target sentence. The answers to the indirect questions are analyzed on the extent that they contain words associated with comprehension processes. The answers to direct questions are coded for the number of content words in common with an ideal answer, which is intended to be an assessment of emerging comprehension. In the study, the RSAT approach was shown to predict measures of comprehension comparable to standardized tests. The RSAT variables were also shown to correlate with human ratings. The results of this study constitute a "proof of concept" and demonstrate that it is possible to develop a comprehension skills assessment tool that assesses both comprehension and comprehension strategies.

  7. Syntax and reading comprehension: a meta-analysis of different spoken-syntax assessments.

    Science.gov (United States)

    Brimo, Danielle; Lund, Emily; Sapp, Alysha

    2017-12-18

    Syntax is a language skill purported to support children's reading comprehension. However, researchers who have examined whether children with average and below-average reading comprehension score significantly different on spoken-syntax assessments report inconsistent results. To determine if differences in how syntax is measured affect whether children with average and below-average reading comprehension score significantly different on spoken-syntax assessments. Studies that included a group comparison design, children with average and below-average reading comprehension, and a spoken-syntax assessment were selected for review. Fourteen articles from a total of 1281 reviewed met the inclusionary criteria. The 14 articles were coded for the age of the children, score on the reading comprehension assessment, type of spoken-syntax assessment, type of syntax construct measured and score on the spoken-syntax assessment. A random-effects model was used to analyze the difference between the effect sizes of the types of spoken-syntax assessments and the difference between the effect sizes of the syntax construct measured. There was a significant difference between children with average and below-average reading comprehension on spoken-syntax assessments. Those with average and below-average reading comprehension scored significantly different on spoken-syntax assessments when norm-referenced and researcher-created assessments were compared. However, when the type of construct was compared, children with average and below-average reading comprehension scored significantly different on assessments that measured knowledge of spoken syntax, but not on assessments that measured awareness of spoken syntax. The results of this meta-analysis confirmed that the type of spoken-syntax assessment, whether norm-referenced or researcher-created, did not explain why some researchers reported that there were no significant differences between children with average and below

  8. Integrative Consensus: A Systematic Approach to Integrating Comprehensive Assessment Data for Young Children with Behavior Problems

    Science.gov (United States)

    Shernoff, Elisa S.; Hill, Carri; Danis, Barbara; Leventhal, Bennett L.; Wakschlag, Lauren S.

    2014-01-01

    Comprehensive assessments that include parents and teachers are essential when assessing young children vulnerable to emotional and behavioral problems given the multiple systems and contexts that influence and support optimal development (U. Bronfenbrenner & P. A. Morris, 2006; M. J. Guralnick, 2011). However, more data complicate clinical…

  9. Assessing Communications Competencies through Reviews of Client Interactions and Comprehensive Rotation Assessment: A Comparison of Methods.

    Science.gov (United States)

    Root Kustritz, Margaret V; Lowum, Susan; Flynn, Kristi; Fairbairn, Heather; Diesch-Chham, Athena

    The primary purpose of this study was to compare two methods for assessing student communication skills: a labor-intensive review of video-recorded interactions and global communications assessment using a comprehensive rotation-assessment tool. Secondary goals of the study were to evaluate student strengths and weaknesses to inform the pre-clinical communications curriculum and to evaluate for consistency between types of reviewers. Video recordings of 43 student encounters with clients presenting their animals for wellness or diagnostic appointments to the primary care service at a veterinary teaching hospital were reviewed by one of three primary care clinicians, a social worker, and a clinical communications instructor, using a common rubric. Scores using the rubric were compared with overall scores for verbal communications on a comprehensive rotation-assessment tool, both for the primary care rotation and for other small-animal rotations. Duration did not vary significantly between wellness and diagnostic appointments, or between dog and cat appointments. Scores achieved by students on video review varied by evaluator, with the clinical communications instructor scoring students the lowest and the social worker scoring students the highest. Strengths identified included greeting the client appropriately, gathering initial information about the reason for the visit, and using lay terminology appropriately. Weaknesses included summarizing information for the client, talking to clients about money, and making strong recommendations.

  10. Comprehensive geriatric assessment in elderly patients with dementia.

    Science.gov (United States)

    Namioka, Nayuta; Hanyu, Haruo; Hatanaka, Hirokuni; Fukasawa, Raita; Sakurai, Hirofumi; Iwamoto, Toshihiko

    2015-01-01

    We have recently developed and validated a screening test for comprehensive geriatric assessment (CGA) named "Dr. SUPERMAN". We compared the results obtained by the CGA of patients with Alzheimer's disease (AD), vascular dementia (VaD) and dementia with Lewy bodies (DLB), and determined the relationship between functional deficits and clinical characteristics in each type of dementia. We used Dr. SUPERMAN to examine patients with AD (24 men and 53 women, mean age 83.0 ± 5.1 years), VaD (10 men and 12 women, mean age 80.4 ± 5.0 years) and DLB (28 men and 20 women, mean age 81.2 ± 5.5 years). Patients with DLB or VaD had functional deficits more frequently than those with AD in many fields. Significant correlations between functional impairments and clinical characteristics, such as age, sex and Mini-Mental State Examination scores, in the non-AD group (including DLB and VaD) were found in more extensive fields than those in the AD group. Patients with dementia, particularly DLB, have several geriatric problems. Correlations between functional deficits and clinical characteristics differ between the AD group and the non-AD group. Non-AD patients of older age who are male and have advanced dementia are more likely have several functional deficits. In addition to age and severity of dementia, the type of dementia should be considered in the treatments and interventions of elderly patients with dementia. © 2014 Japan Geriatrics Society.

  11. ECO: a generic eutrophication model including comprehensive sediment-water interaction.

    Science.gov (United States)

    Smits, Johannes G C; van Beek, Jan K L

    2013-01-01

    The content and calibration of the comprehensive generic 3D eutrophication model ECO for water and sediment quality is presented. Based on a computational grid for water and sediment, ECO is used as a tool for water quality management to simulate concentrations and mass fluxes of nutrients (N, P, Si), phytoplankton species, detrital organic matter, electron acceptors and related substances. ECO combines integral simulation of water and sediment quality with sediment diagenesis and closed mass balances. Its advanced process formulations for substances in the water column and the bed sediment were developed to allow for a much more dynamic calculation of the sediment-water exchange fluxes of nutrients as resulting from steep concentration gradients across the sediment-water interface than is possible with other eutrophication models. ECO is to more accurately calculate the accumulation of organic matter and nutrients in the sediment, and to allow for more accurate prediction of phytoplankton biomass and water quality in response to mitigative measures such as nutrient load reduction. ECO was calibrated for shallow Lake Veluwe (The Netherlands). Due to restoration measures this lake underwent a transition from hypertrophic conditions to moderately eutrophic conditions, leading to the extensive colonization by submerged macrophytes. ECO reproduces observed water quality well for the transition period of ten years. The values of its process coefficients are in line with ranges derived from literature. ECO's calculation results underline the importance of redox processes and phosphate speciation for the nutrient return fluxes. Among other things, the results suggest that authigenic formation of a stable apatite-like mineral in the sediment can contribute significantly to oligotrophication of a lake after a phosphorus load reduction.

  12. Comprehensive Assessment of Marine Coatings in the Laboratory and Field

    Science.gov (United States)

    2015-03-27

    opportunity to pursue the goals of this program as they relate to the students and faculty of Cal Poly University and our business and research community...Title of Research Principal Investigator Organization N000141210474 Comprehensive Assessment of Marine Coatings in the Laboratory and Field. Dean...unicellular alga Dunaliella tertiolecta and the diatom Skeletonema costatum for two weeks, and then a mixture of Dunaliella tertiolecta, Skeletonema

  13. MetaComp: comprehensive analysis software for comparative meta-omics including comparative metagenomics.

    Science.gov (United States)

    Zhai, Peng; Yang, Longshu; Guo, Xiao; Wang, Zhe; Guo, Jiangtao; Wang, Xiaoqi; Zhu, Huaiqiu

    2017-10-02

    During the past decade, the development of high throughput nucleic sequencing and mass spectrometry analysis techniques have enabled the characterization of microbial communities through metagenomics, metatranscriptomics, metaproteomics and metabolomics data. To reveal the diversity of microbial communities and interactions between living conditions and microbes, it is necessary to introduce comparative analysis based upon integration of all four types of data mentioned above. Comparative meta-omics, especially comparative metageomics, has been established as a routine process to highlight the significant differences in taxon composition and functional gene abundance among microbiota samples. Meanwhile, biologists are increasingly concerning about the correlations between meta-omics features and environmental factors, which may further decipher the adaptation strategy of a microbial community. We developed a graphical comprehensive analysis software named MetaComp comprising a series of statistical analysis approaches with visualized results for metagenomics and other meta-omics data comparison. This software is capable to read files generated by a variety of upstream programs. After data loading, analyses such as multivariate statistics, hypothesis testing of two-sample, multi-sample as well as two-group sample and a novel function-regression analysis of environmental factors are offered. Here, regression analysis regards meta-omic features as independent variable and environmental factors as dependent variables. Moreover, MetaComp is capable to automatically choose an appropriate two-group sample test based upon the traits of input abundance profiles. We further evaluate the performance of its choice, and exhibit applications for metagenomics, metaproteomics and metabolomics samples. MetaComp, an integrative software capable for applying to all meta-omics data, originally distills the influence of living environment on microbial community by regression analysis

  14. Towards comprehensive assessment of mitral regurgitation using cardiovascular magnetic resonance.

    Science.gov (United States)

    Chan, K M John; Wage, Ricardo; Symmonds, Karen; Rahman-Haley, Shelley; Mohiaddin, Raad H; Firmin, David N; Pepper, John R; Pennell, Dudley J; Kilner, Philip J

    2008-12-22

    Cardiovascular magnetic resonance (CMR) is increasingly used to assess patients with mitral regurgitation. Its advantages include quantitative determination of ventricular volumes and function and the mitral regurgitant fraction, and in ischemic mitral regurgitation, regional myocardial function and viability. In addition to these, identification of leaflet prolapse or restriction is necessary when valve repair is contemplated. We describe a systematic approach to the evaluation of mitral regurgitation using CMR which we have used in 149 patients with varying etiologies and severity of regurgitation over a 15 month period. Following standard ventricular cine acquisitions, including 2, 3 and 4 chamber long axis views and a short axis stack for biventricular function, we image movements of all parts of the mitral leaflets using a contiguous stack of oblique long axis cines aligned orthogonal to the central part of the line of coaptation. The 8-10 slices in the stack, orientated approximately parallel to a 3-chamber view, are acquired sequentially from the superior (antero-lateral) mitral commissure to the inferior (postero-medial) commissure, visualising each apposing pair of anterior and posterior leaflet scallops in turn (A1-P1, A2-P2 and A3-P3). We use balanced steady state free precession imaging at 1.5 Tesla, slice thickness 5 mm, with no inter-slice gaps. Where the para-commissural coaptation lines curve relative to the central region, two further oblique cines are acquired orthogonal to the line of coaptation adjacent to each commissure. To quantify mitral regurgitation, we use phase contrast velocity mapping to measure aortic outflow, subtracting this from the left ventricular stroke volume to calculate the mitral regurgitant volume which, when divided by the left ventricular stroke volume, gives the mitral regurgitant fraction. In patients with ischemic mitral regurgitation, we further assess regional left ventricular function and, with late gadolinium

  15. Towards comprehensive assessment of mitral regurgitation using cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Firmin David N

    2008-12-01

    Full Text Available Abstract Cardiovascular magnetic resonance (CMR is increasingly used to assess patients with mitral regurgitation. Its advantages include quantitative determination of ventricular volumes and function and the mitral regurgitant fraction, and in ischemic mitral regurgitation, regional myocardial function and viability. In addition to these, identification of leaflet prolapse or restriction is necessary when valve repair is contemplated. We describe a systematic approach to the evaluation of mitral regurgitation using CMR which we have used in 149 patients with varying etiologies and severity of regurgitation over a 15 month period. Following standard ventricular cine acquisitions, including 2, 3 and 4 chamber long axis views and a short axis stack for biventricular function, we image movements of all parts of the mitral leaflets using a contiguous stack of oblique long axis cines aligned orthogonal to the central part of the line of coaptation. The 8–10 slices in the stack, orientated approximately parallel to a 3-chamber view, are acquired sequentially from the superior (antero-lateral mitral commissure to the inferior (postero-medial commissure, visualising each apposing pair of anterior and posterior leaflet scallops in turn (A1-P1, A2-P2 and A3-P3. We use balanced steady state free precession imaging at 1.5 Tesla, slice thickness 5 mm, with no inter-slice gaps. Where the para-commissural coaptation lines curve relative to the central region, two further oblique cines are acquired orthogonal to the line of coaptation adjacent to each commissure. To quantify mitral regurgitation, we use phase contrast velocity mapping to measure aortic outflow, subtracting this from the left ventricular stroke volume to calculate the mitral regurgitant volume which, when divided by the left ventricular stroke volume, gives the mitral regurgitant fraction. In patients with ischemic mitral regurgitation, we further assess regional left ventricular function and

  16. A comprehensive approach to the design of ethanol supply chains including carbon trading effects.

    Science.gov (United States)

    Giarola, Sara; Shah, Nilay; Bezzo, Fabrizio

    2012-03-01

    The optimal design of biofuels production systems is a key component in the analysis of the environmental and economic performance of new sustainable transport systems. In this paper a general mixed integer linear programming modelling framework is developed to assess the design and planning of a multi-period and multi-echelon bioethanol upstream supply chain under market uncertainty. The optimisation design process of biofuels production systems aims at selecting the best biomass and technologies options among several alternatives according to economic and environmental (global warming potential) performance. A key feature in the proposed approach is the acknowledgement of an economic value to the overall GHG emissions, which is implemented through an emissions allowances trading scheme. The future Italian biomass-based ethanol production is adopted as a case study. Results show the effectiveness of the model as a decision making-tool to steer long-term decisions and investments. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Environmental site assessments should include radon gas testing

    International Nuclear Information System (INIS)

    Nardi, M.A.

    1991-01-01

    There are two emerging influences that will require radon gas testing as part of many property transfers and most site assessments. These requirements come from lending regulators and state legislatures. Fannie Mae and others have developed environmental investigation guidelines for the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more lenders and state governments likely to follow this trend, radon gas testing should be performed during all property transfers and site assessment to protect the parties involved from any legal liabilities

  18. Property transfer assessments should include radon gas testing

    International Nuclear Information System (INIS)

    Nardi, M.A.

    1992-01-01

    There are two emerging influences that will require radon gas testing as part of many property transfers and most environmental assessments. These requirements come from lending regulators and state legislatures and affect single family, multifamily, and commercial properties. Fannie Mae and others have developed environmental investigation guidelines for protection from long term legal liabilities in the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more banks and state governments following this trend, radon gas testing should be performed during all property transfers and environmental assessments to protect the parties involved from any long term legal liabilities

  19. Assessing bias in osteoarthritis trials included in Cochrane reviews

    DEFF Research Database (Denmark)

    Hansen, Julie Bolvig; Juhl, Carsten Bogh; Boutron, Isabelle

    2014-01-01

    the first appearing forest plot for overall pain in the Cochrane review. Treatment effect sizes will be expressed as standardised mean differences (SMDs), where the difference in mean values available from the forest plots is divided by the pooled SD. To empirically assess the risk of bias in treatment......INTRODUCTION: The validity of systematic reviews and meta-analysis depends on methodological quality and unbiased dissemination of trials. Our objective is to evaluate the association of estimates of treatment effects with different bias-related study characteristics in meta...... benefits, we will perform stratified analyses of the trials from the included meta-analyses and assess the interaction between trial characteristics and treatment effect. A relevant study-level covariate is defined as one that decreases the between-study variance (τ(2), estimated as Tau...

  20. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  1. Extending Vulnerability Assessment to Include Life Stages Considerations.

    Science.gov (United States)

    Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.

  2. Behavioral Support for Students with Severe Disabilities: Functional Assessment and Comprehensive Intervention.

    Science.gov (United States)

    Horner, Robert H.; Carr, Edward G.

    1997-01-01

    Two major advances in the provision of behavioral support to students with severe disabilities include: (1) procedures for conducting functional assessment, and (2) design of comprehensive interventions. The research foundation for these advances, implications for clinicians, and future research directions are presented. (Author/DB)

  3. Comprehensive geriatric assessment and its clinical impact in oncology.

    Science.gov (United States)

    Maas, Huub A A M; Janssen-Heijnen, Maryska L G; Olde Rikkert, Marcel G M; Machteld Wymenga, A N

    2007-10-01

    Comprehensive geriatric assessment (CGA) is a process that consists of a multidimensional data-search and a process of analyzing and linking patient characteristics creating an individualized intervention-plan, carried out by a multidisciplinary team. In general, the positive health care effects of CGA are established, but in oncology both CGA and the presence of geriatric syndromes still have to be implemented to tailor oncological therapies to the needs of elderly cancer patients. In this paper the conceptualization of geriatric syndromes, their relationship to CGA and results of clinical studies using CGA in oncology are summarized. Geriatric syndromes are associated with increased vulnerability and refer to highly prevalent, mostly single symptom states (falls, incontinence, cognitive impairment, dizziness, immobility or syncope). Multifactorial analysis is common in geriatric syndromes and forms part of the theoretical foundation for using CGA. In oncology patients, we reviewed the value of CGA on the following endpoints: recognition of health problems, tolerance to chemotherapy and survival. Most studies performed CGA to identify prognostic factors and did not include an intervention. The ability of CGA to detect relevant health problems in an elderly population is reported consistently but no randomized studies are available. CGA should explore the pre-treatment presence of (in)dependence in Instrumental Activities of Daily Living (IADL), poor or moderately poor quality of life, depressive symptoms and cognitive decline, and thereby may help to predict survival. However, if scored by the Charlson comorbidity-index, comorbidities are not convincingly related to survival. The few studies that included a CGA-linked intervention show inconsistent results with regard to survival but compared to usual care quality of life is improved in the surviving period. Functional performance scores and dependency at home appeared to be independent predictive factors for

  4. Overall life cycle comprehensive assessment of pneumatic and electric actuator

    Science.gov (United States)

    Zhang, Yeming; Cai, Maolin

    2014-05-01

    Pneumatic actuators and electric actuators have almost been applied to all manufacturing industries. The two kinds of actuators can replace each other in most fields, such as the point to point transmission occasion and some rotating occasions. However, there are very few research results about the advantages and disadvantages of two kinds of actuators under the same working conditions so far. In this paper, a novel comprehensive assessment method, named as overall life cycle comprehensive assessment (OLCCA), is proposed for comparison and assessment of pneumatic and electric actuators. OLCCA contains mechanical properties evaluation (MPE), life cycle cost analysis based on users (LCCABOU) and life cycle environmental impact analysis (LCEIA) algorithm in order to solve three difficult problems: mechanical properties assessment, cost analysis and environmental impact assessment about actuators. The mechanical properties evaluation of actuators is a multi-objective optimization problem. The fuzzy data quantification and information entropy methods are combined to establish MPE algorithm of actuators. Two kinds of pneumatic actuators and electric actuators with similar bearing capacity and similar work stroke were taken for example to verify the correctness of MPE algorithm. The case study of MPE algorithm for actuators verified its correctness. LCCABOU for actuators is also set up. Considering cost complex structure of pneumatic actuators, public device cost even method (PDCEM) is firstly presented to solve cost division of public devices such as compressors, aftercooler, receivers, etc. LCCABOU method is also effective and verified by the three groups of pneumatic actuators and electric actuators. Finally, LCEIA model of actuators is established for the environmental impact assessment of actuators. LCEIA data collection method and model establishment procedure for actuators are also put forward. With Simapro 7, LCEIA comparison results of six actuators can be

  5. TOOLS TO INCLUDE BLIND STUDENTS IN SCHOOL BUILDING PERFORMANCE ASSESSMENTS

    Directory of Open Access Journals (Sweden)

    Tania Pietzschke Abate

    2016-05-01

    Full Text Available This article discusses the design of data collection instruments that include the opinions of blind students, in accordance with the principles of Universal Design (UD. The aim of this study is to understand the importance of adapting data collection instruments for the inclusion of disabled persons in field research in Architecture and Design, among other fields. The data collection instruments developed were a play interview with a tactile map and a 3D survey with the use of tactile models. These instruments sought to assess the school environment experienced by blind students. The study involved students from the early years of a school for the blind who had not yet mastered the Braille system. The participation of these students was evaluated. A multidisciplinary team consisting of architects, designers, educators, and psychologists lent support to the study. The results showed that the data collection instruments adapted to blind students were successful in making the group of authors examine questions regarding UD. An analysis of the participatory phase showed that the limitations resulting from blindness determine the specificities in the adaptation and implementation process of the instruments in schools. Practical recommendations for future studies related to instruments in the UD thematic are presented. This approach is in line with the global trend of including disabled persons in society based on these users’ opinions concerning what was designed by architects and designers.

  6. A short mnemonic to support the comprehensive geriatric assessment model.

    Science.gov (United States)

    Han, Brenda; Grant, Cristin

    2016-10-06

    With an increasing number of older people using emergency services, researchers have raised concerns about the quality of care in an environment that is not designed to address older patients' specific needs and conditions. The comprehensive geriatric assessment (CGA) model was developed to address these issues, and to optimise healthcare delivery to older adults. This article introduces a complementary mnemonic, FRAIL, that refers to important elements of health information to consider before initiating care for older patients - falls/functional decline, reactions, altered mental status, illnesses, and living situation. It is not intended to replace the CGA, but can help to quickly identify high-risk older patients who warrant a more in-depth clinical assessment with CGA.

  7. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  8. A comprehensive environmental assessment approach to engineered nanomaterials.

    Science.gov (United States)

    Davis, J Michael

    2013-01-01

    The anticipated benefits of engineered nanomaterials (ENMs) should be weighed against their possible negative impacts. Comprehensive environmental assessment (CEA) provides a means of evaluating such trade-offs in a holistic and systematic manner. CEA consists of both a framework for organizing information and a process for using collective judgment to identify and prioritize the issues presented by ENMs. As a meta-assessment approach, CEA is designed to assist both research planners and risk managers by building on various assessment and analytic tools used by risk assessors. Given the immature state of the science for ENMs, CEA is currently being primarily used for prioritizing research directions. Therefore, highlights of case studies of selected ENM applications are presented to illustrate how CEA has been applied thus far to help guide research efforts to support future assessment efforts. In addition, CEA is discussed in relation to topical subjects, such as sustainability, transparency, and stakeholder engagement. Finally, comparisons to other life cycle-based assessment approaches directed at ENMs are noted. Copyright © 2012 Wiley Periodicals, Inc.

  9. Assessment of grammar comprehension: Adaptation of TROG for Serbian language

    Directory of Open Access Journals (Sweden)

    Anđelković Darinka Č.

    2007-01-01

    Full Text Available In this study we present our adaptation and preliminary standardization of Test for Reception of Grammar TROG (Bishop, 1989 for Serbian language. TROG is a receptive test of grammatical structures, constructed primarily for an assessment of grammatical development and detection of children with Specific Language Impairment (SLI. Due to the lack of standardized tests for language development in our clinical community, TROG is selected for adaptation as a test which includes two components relevant for discrimination of children with language difficulties: a measure of receptive abilities and b distinguishing knowledge of grammar from semantic aspect of comprehension. Preliminary standardization was done on a sample of 335 participants between 4 and 7 years of age, divided into 8 age subsamples. Since dynamic of language change at early ages is faster, age samples covered range of 3 months at the ages 4;0-4;2, 4;3-4;5, 4;6-4;8, 4;9-4;11, and range of 6 months at the ages 5;0-5;5, 5;6-5;11, 6;00-6;05, 6;06-6;11. Analyses have revealed that the first version of Serbian TROG is discriminative for the differences between age samples, but discrimination is smaller then it was expected. The test discriminates three age-samples (4;0-4;8, 4;9-5;5, and 5;6-6;11. It is easier for the children older then 5 years, which causes statistical significance of discrimination to tilt within a narrow margin around 0,05. Reliability of the whole instrument is estimated very high - between 0,86 and 0,91, depending on the method of estimation. However, reliability estimated for particular blocks (grammatical structure revealed that internal consistency of blocks is not homogeneous. This finding prevents reliable estimation of competence for particular structures, and makes difficult to define which contrast is understood by a child and which is not. Furthermore, internal inconsistency of blocks may also be additional source of low discrimination of test for children

  10. Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children – Working Memory (CABC-WM)

    OpenAIRE

    Cabbage, Kathryn; Brinkley, Shara; Gray, Shelley; Alt, Mary; Cowan, Nelson; Green, Samuel; Kuo, Trudy; Hogan, Tiffany P.

    2017-01-01

    The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of working memory in young school-age children. Working memory deficits have been identified in children with language-based learning disabilities, including dyslexia1 2 and language impairment3 4, but it is not clear whether these children exhibit deficits in subcomponents of working memory, such as visuospatial or phonological working memory. The C...

  11. Supporting nanomaterial risk assessment by case studies of nano-titanium dioxide using comprehensive environmental assessment

    Science.gov (United States)

    Here we describe a comprehensive environmental assessment (CEA) approach for two case studies of nano-titanium dioxide (nano-TiO2) in real world applications: water treatment and sunscreen. CEA combines a product life cycle framework with the risk assessment paradigm.

  12. [A comprehensive assessment of ATMP. Difficulties and approaches].

    Science.gov (United States)

    Thanner, M; Nagel, E

    2011-07-01

    Advanced therapy medicinal products (ATMP) are associated with high expectations because they offer new opportunities for the treatment of diseases, e.g., the possibility of regenerating damaged or lost tissue. What the products (gene therapy, somatic cell therapy, and tissue engineered products) have in common is an innovative and complex development process that combines science and engineering. At the same time, this field of research is becoming increasingly interdisciplinary and requires international cooperation. A comprehensive assessment of ATMP has to take these issues into account. The application of Beauchamp and Childress' Four Principles (Principle-Based Ethics) as well as Discourse Ethics as a framework may lead to a broader consideration of medical ethics issues.

  13. The challenges of including impacts on biodiversity in agricultural life cycle assessments.

    Science.gov (United States)

    Gabel, Vanessa M; Meier, Matthias S; Köpke, Ulrich; Stolze, Matthias

    2016-10-01

    Agriculture is considered to be one of the main drivers for worldwide biodiversity loss but the impacts of agricultural production on biodiversity have not been extensively considered in Life Cycle Assessments (LCAs). Recent realisation that biodiversity impact should be included in comprehensive LCAs has led to attempts to develop and implement methods for biodiversity impact assessment. In this review, twenty-two different biodiversity impact assessment methods have been analysed to identify their strengths and weaknesses in terms of their comprehensiveness in the evaluation of agricultural products. Different criteria, which had to meet the specific requirements of biodiversity research, life cycle assessment methodology, and the evaluation of agricultural products, were selected to investigate the identified methods. Very few of the methods were developed with the specific intention of being used for agricultural LCAs. Furthermore, none of the methods can be applied globally while at the same time being able to differentiate between various agricultural intensities. Global value chains and the increasing awareness of different biodiversity impacts of agricultural production systems demand the development of evaluation methods that are able to overcome these shortcomings. Despite the progress that has already been achieved, there are still unresolved difficulties which need further research and improvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Expanding Health Technology Assessments to Include Effects on the Environment

    DEFF Research Database (Denmark)

    Marsh, Kevin; Ganz, Michael Lee; Hsu, John

    2016-01-01

    for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates...

  15. Comprehensive large-scale assessment of intrinsic protein disorder.

    Science.gov (United States)

    Walsh, Ian; Giollo, Manuel; Di Domenico, Tomás; Ferrari, Carlo; Zimmermann, Olav; Tosatto, Silvio C E

    2015-01-15

    Intrinsically disordered regions are key for the function of numerous proteins. Due to the difficulties in experimental disorder characterization, many computational predictors have been developed with various disorder flavors. Their performance is generally measured on small sets mainly from experimentally solved structures, e.g. Protein Data Bank (PDB) chains. MobiDB has only recently started to collect disorder annotations from multiple experimental structures. MobiDB annotates disorder for UniProt sequences, allowing us to conduct the first large-scale assessment of fast disorder predictors on 25 833 different sequences with X-ray crystallographic structures. In addition to a comprehensive ranking of predictors, this analysis produced the following interesting observations. (i) The predictors cluster according to their disorder definition, with a consensus giving more confidence. (ii) Previous assessments appear over-reliant on data annotated at the PDB chain level and performance is lower on entire UniProt sequences. (iii) Long disordered regions are harder to predict. (iv) Depending on the structural and functional types of the proteins, differences in prediction performance of up to 10% are observed. The datasets are available from Web site at URL: http://mobidb.bio.unipd.it/lsd. Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Identification of contaminants of concern Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.; Batishko, N.C.; Heise-Craff, D.A.; Jarvis, M.F.; Snyder, S.F.

    1995-01-01

    The Columbia River Comprehensive Impact Assessment (CRCIA) Project at the Pacific Northwest Laboratory (PNL) is evaluating the current human and ecological risks from contaminants in the Columbia River. The risks to be studied are those attributable to past and present activities on the Hanford Site. The Hanford Site is located in southcentral Washington State near the town of Richland. Human risk from exposure to radioactive and hazardous materials will be addressed for a range of river use options. Ecological risk will be evaluated relative to the health of the current river ecosystem. The overall purpose of the project is to determine if enough contamination exists in the Columbia River to warrant cleanup actions under applicable environmental regulations. This report documents an initial review, from a risk perspective, of the wealth of historical data concerning current or potential contamination in the Columbia River. Sampling data were examined for over 600 contaminants. A screening analysis was performed to identify those substances present in such quantities that they may pose a significant human or ecological risk. These substances will require a more detailed analysis to assess their impact on humans or the river ecosystem.

  17. Testing and assessment strategies, including alternative and new approaches

    DEFF Research Database (Denmark)

    Meyer, Otto A.

    2003-01-01

    ethical concern. However, irrespective of animal welfare it is an important aspect of the discipline of toxicology that the primary object is human health. The ideal testing and assessment strategy is simple to use all the available test methods and preferably more in laboratory animal species from which...... there are more than 100000 chemicals which are potential for human exposure, so the development of alternative testing and assessment strategies has taken place in the recent years. The toxicological evaluation should enable the society to cope with the simultaneous requirement of many chemicals for different...... uses and of the absence of health problems involved with their use. Thus, the regulatory toxicology is a cocktail of science and pragmatism added a crucial concern for animal welfare. Test methods are most often used in a testing sequence as bricks in a testing strategy. The main key driving forces...

  18. Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM).

    Science.gov (United States)

    Cabbage, Kathryn; Brinkley, Shara; Gray, Shelley; Alt, Mary; Cowan, Nelson; Green, Samuel; Kuo, Trudy; Hogan, Tiffany P

    2017-06-12

    The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of working memory in young school-age children. Working memory deficits have been identified in children with language-based learning disabilities, including dyslexia 1 , 2 and language impairment 3 , 4 , but it is not clear whether these children exhibit deficits in subcomponents of working memory, such as visuospatial or phonological working memory. The CABC-WM is administered on a desktop computer with a touchscreen interface and was specifically developed to be engaging and motivating for children. Although the long-term goal of the CABC-WM is to provide individualized working memory profiles in children, the present study focuses on the initial success and utility of the CABC-WM for measuring central executive, visuospatial, phonological loop, and binding constructs in children with typical development. Immediate next steps are to administer the CABC-WM to children with specific language impairment, dyslexia, and comorbid specific language impairment and dyslexia.

  19. Assessment of a Comprehensive Anti-Aging Neck Cream.

    Science.gov (United States)

    Saxena, Subhash J; Duque, Deysi; Schirripa, Michael J

    2015-09-01

    With many effective anti-aging solutions for the face, consumer focus is now turning to other parts of the body including the delicate skin on the neck. This study investigates the effect of a new neck cream on the appearance of texture, fine lines and wrinkles, laxity, and hydration. 85 adult females ages 35-65 with Fitzpatrick skin types I through IV applied the test neck cream twice daily for a 3-month study period. Screening was conducted at Baseline, 2, 30, 60, and 90 days via a virtual trial. Subjects rated satisfaction in each of 4 anti-aging categories including hydration, texture, appearance of wrinkles, and appearance of laxity as well as three product attributes including application, feel, and smell. Improvement was statistically significant for all measured categories (hydration, texture, appearance of wrinkles, and appearance of laxity) with 94% of study subjects noting improvement in one or more of the measured categories. Further, the quantity of "Satisfied" and "Highly Satisfied" assessments increased 8-fold from baseline with a 94x increase in the quantity of "Highly Satisfied" assessments. The results demonstrate the product's rapid and continuing ability to improve the self-perceived signs of aging in the neck area including improvement in skin texture on the neck and a reduction in the appearance of wrinkles and laxity along the jawline. Future studies are recommended to determine the primary action mechanisms and to assess the degree of improvement by blinded physician assessment.

  20. Comprehensive Adult Student Assessment Systems Braille Reading Assessment: An Exploratory Study

    Science.gov (United States)

    Posey, Virginia K.; Henderson, Barbara W.

    2012-01-01

    Introduction: This exploratory study determined whether transcribing selected test items on an adult life and work skills reading test into braille could maintain the same approximate scale-score range and maintain fitness within the item response theory model as used by the Comprehensive Adult Student Assessment Systems (CASAS) for developing…

  1. Expanding Health Technology Assessments to Include Effects on the Environment.

    Science.gov (United States)

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. Assessing reading comprehension with narrative and expository texts: Dimensionality and relationship with fluency, vocabulary and memory.

    Science.gov (United States)

    Santos, Sandra; Cadime, Irene; Viana, Fernanda L; Chaves-Sousa, Séli; Gayo, Elena; Maia, José; Ribeiro, Iolanda

    2017-02-01

    Reading comprehension assessment should rely on valid instruments that enable adequate conclusions to be taken regarding students' reading comprehension performance. In this article, two studies were conducted to collect validity evidence for the vertically scaled forms of two Tests of Reading Comprehension for Portuguese elementary school students in the second to fourth grades, one with narrative texts (TRC-n) and another with expository ones (TRC-e). Two samples of 950 and 990 students participated in Study 1, the study of the dimensionality of the TRC-n and TRC-e forms, respectively. Confirmatory factor analyses provided evidence of an acceptable fit for the one-factor solution for all test forms. Study 2 included 218 students to collect criterion-related validity. The scores obtained in each of the test forms were significantly correlated with the ones obtained in other reading comprehension measures and with the results obtained in oral reading fluency, vocabulary and working memory tests. Evidence suggests that the test forms are valid measures of reading comprehension. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  3. A comprehensive assessment of medical schools in Bosnia and Herzegovina.

    Science.gov (United States)

    Simunović, Vladimir J; Sonntag, Hans-Günther; Hren, Darko; Dørup, Jens; Krivokuća, Zdenka; Bokonjić, Dejan; Verhaaren, Henry; Horsch, Axel; Mimica, Mladen; Vojniković, Benjamin; Selesković, Hajrija; Marz, Richard; Marusić, Ana; Marusić, Matko

    2006-12-01

    To perform internal and external evaluations of all 5 medical schools in Bosnia and Herzegovina against international standards. We carried out a 2-stage survey study using the same 5-point Likert scale for internal and external evaluations of 5 medical schools in Bosnia and Herzegovina (Banja Luka, Foca/East Sarajevo, Mostar, Sarajevo and Tuzla). Participants consisted of managerial staff, teaching staff and students of medical schools, and external expert assessors. Main outcome measures included scores on internal and external evaluation forms for 10 items concerning aspects of school curriculum and functioning: 'School mission and objectives'; 'Curriculum'; 'Management'; 'Staff'; 'Students'; 'Facilities and technology'; 'Financial issues'; 'International relationships'; 'Internal quality assurance', and 'Development plans'. During internal assessment, schools consistently either overrated their overall functioning (Foca/East Sarajevo, Mostar and Tuzla) or markedly overrated or underrated their performance on individual items on the survey (Banja Luka and Sarajevo). Scores for internal assessment differed from those for external assessment. These differences were not consistent, except for the sections 'School mission and objectives', 'Curriculum' and 'Development plans', which were consistently overrated in the internal assessments. External assessments was more positive than internal assessments on 'Students' and 'Facilities and technology' in 3 of 5 schools. This assessment exercise in 5 medical schools showed that constructive and structured evaluation of medical education is possible, even in complex and unfavourable conditions. Medical schools in Bosnia and Herzegovina have successfully formed a national consortium for formal collaboration in curriculum development and reform.

  4. Hydraulic Load Analysis for RVI Comprehensive Vibration Assessment Program

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Soo; Kim, Kyu Hyung; Lee, Jong Ho [Nuclear Engineering and Technology Institute, Daejeon (Korea, Republic of)

    2010-10-15

    Recently, the US NRC Regulatory Guide 1.20(RG 1.20) was revised to allow the usage of CFD code in the analysis program of a comprehensive vibration assessment program (CVAP) for reactor vessel internals (RVIs). Thus, the analysis program of Shin-Kori no.4 RVI CVAP has been developed according to the revised guideline of RG1.20 Rev. 3. The analysis program consists of a hydraulic analysis to calculate the hydraulic forcing functions and a structural response analysis with inputting the calculated hydraulic forcing functions on each component of RVIs. The hydraulic forcing functions are comprised of the deterministic loads induced by the rotor and blade of reactor coolant pump (RCP) and the random loads generated by the flow turbulence. In this study, according to the RG1.20 Rev. 3, the hydraulic analysis methodology of RVI CVAP was developed to use the CFD codes. In order to verify the developed hydraulic methodology, the deterministic and random loads of Yonggwang no.4 RVIs were calculated with modeling the fluid domain model of reactor vessel in the full 3D and verified through the comparison between the calculated results and the measured data in the Yonggwang no.4 RVI CVAP test

  5. How to assess and improve children's reading comprehension?

    NARCIS (Netherlands)

    Muijselaar, M.M.L.

    2016-01-01

    Reading comprehension is one of the most important skills children have to acquire during the final years of primary education. It is therefore unfortunate that many children have severe problems with a proper understanding of texts. To design methods that foster children’s reading comprehension,

  6. Verb and sentence production and comprehension in aphasia: Northwestern Assessment of Verbs and Sentences (NAVS).

    Science.gov (United States)

    Cho-Reyes, Soojin; Thompson, Cynthia K

    Verbs and sentences are often impaired in individuals with aphasia, and differential impairment patterns are associated with different types of aphasia. With currently available test batteries, however, it is challenging to provide a comprehensive profile of aphasic language impairments because they do not examine syntactically important properties of verbs and sentences. This study presents data derived from the Northwestern Assessment of Verbs and Sentences (NAVS; Thompson, 2011), a new test battery designed to examine syntactic deficits in aphasia. The NAVS includes tests for verb naming and comprehension, and production of verb argument structure in simple active sentences, with each examining the effects of the number and optionality of arguments. The NAVS also tests production and comprehension of canonical and non-canonical sentences. A total of 59 aphasic participants (35 agrammatic and 24 anomic) were tested using a set of action pictures. Participants produced verbs or sentences for the production subtests and identified pictures corresponding to auditorily provided verbs or sentences for the comprehension subtests. The agrammatic group, compared to the anomic group, performed significantly more poorly on all subtests except verb comprehension, and for both groups comprehension was less impaired than production. On verb naming and argument structure production tests both groups exhibited difficulty with three-argument verbs, affected by the number and optionality of arguments. However, production of sentences using three-argument verbs was more impaired in the agrammatic, compared to the anomic, group. On sentence production and comprehension tests, the agrammatic group showed impairments in all types of non-canonical sentences, whereas the anomic group exhibited difficulty primarily with the most difficult, object relative, structures. Results show that verb and sentence deficits seen in individuals with agrammatic aphasia are largely influenced by

  7. Increasing resource allocation and research into tobacco control activities: a comprehensive approach including primary prevention, treatment and brief intervention.

    Science.gov (United States)

    Richmond, R

    1993-01-01

    The range of tobacco control activities should be viewed as essential parts of a complex multi-component puzzle. Intervention strategies designed to address tobacco control should be comprehensive and include both primary and secondary prevention activities and be multi-faceted and capable of bringing about change at both the individual and broader social and cultural levels. In this paper I argue for a mutually inclusive framework in which the various components contribute in important and different ways. I examine the prevalence of smoking and identify the high risk groups, then I examine the range of available strategies and present the evidence for their success. I discuss the primary prevention approaches such as warning labels, taxes, price increases, workplace bans, education in schools, mass media and self-help materials, as well as brief interventions and treatment strategies which are conducted at the worksite, general practice and specialized cessation clinics. The areas for future research are delineated for increased resource allocation and include: the best ways to disseminate brief interventions to smokers, methods to motivate smokers; training of health professionals to deliver brief interventions; enhancing quitting and access to existing treatment resources among specific disadvantaged minority groups, e.g. migrants, unemployed youth, the effect on smoking prevalence of warning labels on cigarette packets and price rises on cigarettes.

  8. Reliability assessment of distribution power systems including distributed generations

    International Nuclear Information System (INIS)

    Megdiche, M.

    2004-12-01

    Nowadays, power systems have reached a good level of reliability. Nevertheless, considering the modifications induced by the connections of small independent producers to distribution networks, there's a need to assess the reliability of these new systems. Distribution networks present several functional characteristics, highlighted by the qualitative study of the failures, as dispersed loads at several places, variable topology and some electrotechnical phenomena which must be taken into account to model the events that can occur. The adopted reliability calculations method is Monte Carlo simulations, the probabilistic method most powerful and most flexible to model complex operating of the distribution system. We devoted a first part on the case of a 20 kV feeder to which a cogeneration unit is connected. The method was applied to a software of stochastic Petri nets simulations. Then a second part related to the study of a low voltage power system supplied by dispersed generations. Here, the complexity of the events required to code the method in an environment of programming allowing the use of power system calculations (load flow, short-circuit, load shedding, management of units powers) in order to analyse the system state for each new event. (author)

  9. Assessment of Sustainability of Urban Water Supply and Demand Management Options: A Comprehensive Approach

    Directory of Open Access Journals (Sweden)

    Kumudu Rathnayaka

    2016-12-01

    Full Text Available A comprehensive evaluation framework that can assess a wide range of water supply and demand management policy options in terms of economic, social, environmental, risk-based, and functional performance is crucial to ascertain their level of sustainability. However, such a detailed, generic, and holistic policy evaluation framework is not found in the literature. This paper reviews studies to evaluate water supply and/or demand management options conducted during 2000–2016. Primarily, the paper reviews the evaluation criteria used by different studies for decision making given their significant difference and the importance of a comprehensive set of criteria to complete a rigorous evaluation. In addition, a comprehensive set of water supply and demand management options are not considered together for a comparative assessment to prioritise best options for a certain area and time. Further, performance of these options needs to be evaluated for a range of uncertainties arising from changes of spatial and temporal variables of the system. While this paper highlights the important aspects that need to be included in a comprehensive policy evaluation framework, available studies collectively present a rich set of information to support it.

  10. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

    Science.gov (United States)

    Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

    2018-05-10

    Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

  11. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis

    Directory of Open Access Journals (Sweden)

    Emily Riley

    2018-02-01

    Full Text Available Background Transport policy and practice impacts health. Environmental Impact Assessments (EIAs are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. Methods We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. Results We found that health was partially considered in all four EISs. In the three New South Wales (NSW projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA. We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Conclusion Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health

  12. A comprehensive assessment of children's activity and travel patterns.

    Science.gov (United States)

    2008-09-01

    This report provides a comprehensive review of previous research on childrens activity engagement and : travel by focusing on the dimensions characterizing childrens activity-travel patterns and the factors : affecting these dimensions. In addi...

  13. Comprehensive Assessment of Milk Composition in Transgenic Cloned Cattle

    Science.gov (United States)

    Sui, Shunchao; Yu, Tian; Wang, Jianwu; Li, Ning

    2012-01-01

    The development of transgenic cloned animals offers new opportunities for agriculture, biomedicine and environmental science. Expressing recombinant proteins in dairy animals to alter their milk composition is considered beneficial for human health. However, relatively little is known about the expression profile of the proteins in milk derived from transgenic cloned animals. In this study, we compared the proteome and nutrient composition of the colostrum and mature milk from three lines of transgenic cloned (TC) cattle that specifically express human α-lactalbumin (TC-LA), lactoferrin (TC-LF) or lysozyme (TC-LZ) in the mammary gland with those from cloned non-transgenic (C) and conventionally bred normal animals (N). Protein expression profile identification was performed, 37 proteins were specifically expressed in the TC animals and 70 protein spots that were classified as 22 proteins with significantly altered expression levels in the TC and C groups compared to N group. Assessment of the relationship of the transgene effect and normal variability in the milk protein profiles in each group indicated that the variation in the endogenous protein profiles of the three TC groups was within the limit of natural variability. More than 50 parameters for the colostrum and mature milk were compared between each TC group and the N controls. The data revealed essentially similar profiles for all groups. This comprehensive study demonstrated that in TC cattle the mean values for the measured milk parameters were all within the normal range, suggesting that the expression of a transgene does not affect the composition of milk. PMID:23185411

  14. Hydrologic Scenario Uncertainty in a Comprehensive Assessment of Hydrogeologic Uncertainty

    Science.gov (United States)

    Nicholson, T. J.; Meyer, P. D.; Ye, M.; Neuman, S. P.

    2005-12-01

    A method to jointly assess hydrogeologic conceptual model and parameter uncertainties has recently been developed based on a Maximum Likelihood implementation of Bayesian Model Averaging (MLBMA). Evidence from groundwater model post-audits suggests that errors in the projected future hydrologic conditions of a site (hydrologic scenarios) are a significant source of model predictive errors. MLBMA can be extended to include hydrologic scenario uncertainty, along with conceptual model and parameter uncertainties, in a systematic and quantitative assessment of predictive uncertainty. Like conceptual model uncertainty, scenario uncertainty is represented by a discrete set of alternative scenarios. The effect of scenario uncertainty on model predictions is quantitatively assessed by conducting an MLBMA analysis under each scenario. We demonstrate that posterior model probability is a function of the scenario only through the possible dependence of prior model probabilities on the scenario. As a result, the model likelihoods (computed from calibration results), are not a function of the scenario and do not need to be recomputed under each scenario. MLBMA results for each scenario are weighted by the scenario probability and combined to render a joint assessment of scenario, conceptual model, and parameter uncertainty. Like model probability, scenario probability represents a subjective evaluation, in this case of the plausibility of the occurrence of the specific scenario. Because the scenarios describe future conditions, the scenario probabilities represent prior estimates and cannot be updated using the (past) system state data as is used to compute posterior model probabilities. Assessment of hydrologic scenario uncertainty is illustrated using a site-specific application considering future changes in land use, dam operations, and climate. Estimation of scenario probabilities and consideration of scenario characteristics (e.g., timing, magnitude) are discussed.

  15. FLS and FES: comprehensive models of training and assessment.

    Science.gov (United States)

    Vassiliou, Melina C; Dunkin, Brian J; Marks, Jeffrey M; Fried, Gerald M

    2010-06-01

    The Fundamentals of Laparoscopic surgery (FLS) is a validated program for the teaching and evaluation of the basic knowledge and skills required to perform laparoscopic surgery. The educational component includes didactic, Web-based material and a simple, affordable physical simulator with specific tasks and a recommended curriculum. FLS certification requires passing a written multiple-choice examination and a proctored manual skills examination in the FLS simulator. The metrics for the FLS program have been rigorously validated to meet the highest educational standards, and certification is now a requirement for the American Board of Surgery. This article summarizes the validation process and the FLS-related research that has been done to date. The Fundamentals of Endoscopic Surgery is a program modeled after FLS with a similar mission for flexible endoscopy. It is currently in the final stages of development and will be launched in April 2010. The program also includes learning and assessment components, and is undergoing the same meticulous validation process as FLS. These programs serve as models for the creation of simulation-based tools to teach skills and assess competence with the intention of optimizing patient safety and the quality of surgical education. Copyright 2010 Elsevier Inc. All rights reserved.

  16. What Is the Basis for Self-Assessment of Comprehension When Reading Mathematical Expository Texts?

    Science.gov (United States)

    Österholm, Magnus

    2015-01-01

    The purpose of this study was to characterize students' self-assessments when reading mathematical texts, in particular regarding what students use as a basis for evaluations of their own reading comprehension. A total of 91 students read two mathematical texts, and for each text, they performed a self-assessment of their comprehension and…

  17. An Investigation of the Difference Between Pennsylvania Vocational School and Comprehensive High School Assessment Scores.

    Science.gov (United States)

    Blust, Ross S.; Hertzog, James F.

    In 1982 vocational schools participated in Pennsylvania's state assessment program, the Educational Quality Assessment (EQA). When EQA data were tabulated, the vocational school scores were low in comparison to the comprehensive high school scores. An analysis of the vocational school and comprehensive high school scores using state assessment…

  18. A Comprehensive Assessment of South Carolina's External Review Team Program

    Science.gov (United States)

    Dominguez, Paula Szulc; Nicholls, Craig; Storandt, Barbara

    2006-01-01

    To shed light on how states can use school performance data to support failing schools, the present study examined a subset of underperforming schools in South Carolina in the wake of a series of state-supported interventions. The study, part of a comprehensive evaluation of the South Carolina External Review Team Program, made extensive use of…

  19. Maxillary molar distalization or mandibular enhancement: a cephalometric comparison of comprehensive orthodontic treatment including the pendulum and the Herbst appliances.

    Science.gov (United States)

    Burkhardt, Donald R; McNamara, James A; Baccetti, Tiziano

    2003-02-01

    Several methods of Class II treatment that do not rely on significant patient compliance have become popular during the last decade, including several versions of the Herbst appliance and the pendulum or Pendex molar-distalization appliances. Yet, these 2 general approaches theoretically have opposite treatment effects, one presumably enhancing mandibular growth, and the other moving the maxillary teeth posteriorly. This study examined the treatment effects produced by 2 types of the Herbst appliance (acrylic splint and stainless-steel crown) followed by fixed appliances, and the pendulum appliance followed by fixed appliances. For each of the 3 treatment groups, lateral cephalograms were analyzed before the start of treatment (T1) and after the second phase of treatment (T2). Patients were matched according to age and sex. The comprehensive treatment time for the pendulum group was 31.6 months, and the acrylic and crowned Herbst groups were treated for 29.5 months and 28.0 months, respectively. Overall from T1 to T2, there were no statistically significant differences in mandibular growth among the 3 groups. Skeletal changes accounted for a larger portion of molar correction in the Herbst treatment groups than in the pendulum group. Patients in the pendulum group had an increase in the mandibular plane angle. Conversely, the mandibular plane angle in patients treated with either Herbst appliance closed slightly from T1 to T2. At T2, the chin points (pogonion) of patients in both Herbst groups, however, were located slightly more anteriorly than were the chin points of the pendulum patients. It is likely that the slight downward and backward rotation of the mandible occurring during treatment in the pendulum patients accounted for much of this difference. The treatment effects produced by the 2 types of Herbst appliance were similar at T2, in spite of their differences in design. It is important not to generalize the findings of this comparison beyond the appliance

  20. Comprehensive, blinded assessment of balance in orthostatic tremor.

    Science.gov (United States)

    Bhatti, Danish; Thompson, Rebecca; Xia, Yiwen; Hellman, Amy; Schmaderer, Lorene; Suing, Katie; McKune, Jennifer; Penke, Cynthia; Iske, Regan; Roeder, Bobbi Jo; Siu, Ka-Chun; Bertoni, John M; Torres-Russotto, Diego

    2018-02-01

    Orthostatic Tremor (OT) is a movement disorder characterized by a sensation of unsteadiness and tremors in the 13-18 Hz range present upon standing. The pathophysiology of OT is not well understood but there is a relationship between the sensation of instability and leg tremors. Despite the sensation of unsteadiness, OT patients do not fall often and balance in OT has not been formally assessed. We present a prospective blinded study comparing balance assessment in patients with OT versus healthy controls. We prospectively enrolled 34 surface Electromyography (EMG)-confirmed primary OT subjects and 21 healthy controls. Participants underwent evaluations of balance by blinded physical therapists (PT) with standardized, validated, commonly used balance scales and tasks. OT subjects were mostly female (30/34, 88%) and controls were majority males (13/20, 65%). The average age of OT subjects was 68.5 years (range 54-87) and for controls was 69.4 (range 32-86). The average duration of OT symptoms was 18 years. OT subjects did significantly worse on all the balance scales and on most balance tasks including Berg Balance Scale, Functional Gait Assessment, Dynamic Gait Index, Unipedal Stance Test, Functional Reach Test and pull test. Gait speed and five times sit to stand were normal in OT. Common validated balance scales are significantly abnormal in primary OT. Despite the objective finding of impaired balance, OT patients do not commonly have falls. The reported sensation of unsteadiness in this patient population seems to be out of proportion to the number of actual falls. Further studies are needed to determine which components of commonly used balance scales are affected by a sensation of unsteadiness and fear of falling. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Data for the screening assessment. Volume 1: Text, Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Miley, T.B.; O'Neil, T.K.; Gilbert, R.O.; Klevgard, L.A.; Walters, T.B.

    1996-06-01

    The Columbia River is a critical resource for residents of the Pacific Northwest. This resource drew the Manhattan Project's planners to the site now called Hanford to produce nuclear weapon materials. Production of those materials has left behind a legacy of chemical and radioactive contamination and materials that have, are, and will continue to pose a threat to the Columbia river for the foreseeable future. To evaluate the impact to the river from this Hanford-derived contamination, the US Department of Energy, US Environmental Protection Agency, and State of Washington Department of Ecology (the Tri-Party agencies) initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, stakeholder, tribal, and public involvement, the CRCIA Management Team was formed in August 1995. A major CRCIA Team decision was to organize CRCIA into phases, with additional phases to be identified as warranted after completion of the initial phase. The initial phase is comprised of two parts: (1) a screening assessment to evaluate the current impact to the river resulting from Hanford-derived contamination and (2) identification of requirements considered necessary by the CRCIA Management Team for a comprehensive assessment of impact to the river. The purpose of the screening assessment is to support cleanup decisions. The scope of the screening assessment is to evaluate the current risk to humans and the environment resulting from Hanford-derived contaminants. The screening assessment has the primary components of: identifying contaminants to be assessed; identifying a variety of exposure scenarios to evaluate human contaminant exposure; identifying a variety of other species to evaluate ecological contaminant exposure; and assessing risks posed by exposure of humans and other species to the contaminants

  2. NeuroVRAC--a comprehensive approach to virtual reality-based neurological assessment and treatment systems.

    Science.gov (United States)

    Valvoda, Jakob T; Assenmacher, Ingo; Dohle, Christian; Kuhlen, Torsten; Bischof, Christian

    2003-01-01

    We describe a comprehensive software-oriented approach to virtual reality-based neuroscientific systems in order to establish an easy to use framework for neuroscientific assessment and treatment. We have defined a process model and implemented the NeuroVRAC authoring tool for design and execution of experiments in virtual environments. Our system enables the modeling of virtual world objects and the definition of events, which are used to control the experimental process. We have included the virtual test person concept to enhance the sense of presence during the execution of virtual reality-based neuroscientific experiments.

  3. Challenges and Methodological Development for Comprehensive Assessment of Environmental Quality: application to military land management

    Science.gov (United States)

    Wang, G.; Singer, S.; Howard, H.; Anderson, A.

    2010-12-01

    : Environment functions in various aspects including soil and water conservation, biodiversity and habitat, aesthetics, etc. Comprehensive assessment of environmental quality thus is a great challenge. The issues include how to assess individual functions of environment such as landscape aesthetics and how to integrate them into an indicator that can be used to comprehensively quantifying environmental quality. In this study, remote sensing, geographic information systems (GIS), and spatial multi-criteria decision analysis methods were combined to create an integrated indicator. This approach was applied to a case study in which land condition and its dynamics due to military training activities was assessed. The indicator was derived based on soil erosion, water quality, noise, and spatial metrics that measure landscape fragmentation and aesthetics. The results showed that landscape level indicator well quantified the overall environmental health and its dynamics, while the patch level indicator detailed the local environmental quality. The environmental quality was mostly determined by soil erosion, then landscape fragmentation, water quality, aesthetics, and noise. Moreover, both landscape shape index (LSI) and Aggregation Index (AI) had significant correlation with military training intensity and quantified the landscape fragmentation. Without doubt, this study provided effective tools for army land managers to accurately analyze environmental dynamics. It is also expected this approach can be applied to environmental management of other lands.

  4. Considerations on comprehensive risk assessment and mitigation planning of volcanic ash-fall

    International Nuclear Information System (INIS)

    Toshida, Kiyoshi

    2010-01-01

    Volcanic ash-fall is inevitable hazard throughout Japan, and causes wide range of effects due to its physical and chemical properties. Nuclear power plants in Japan face the necessity to assess the risk from volcanic ash-fall. Risk assessment of the volcanic ash-fall should include engineering solution and mitigation planning as well as the ash-fall hazard. This report points out the characteristics for reducing the various effects of volcanic ash-fall as follows. Large-scale eruptions produce prominent volcanic ash-falls that can approach power plants at a great distance. Aftermath hazards of ash-fall events, such as remobilization of fine ash particles and generation of lahars, require further assessments. The kind and extent of damages becomes greater whenever ash is wet. Wet ash requires separate assessments in contrast to dry ash. The mitigation and recovery measures at power plants involve quick cleanup operations of volcanic ash. Those operations should be prepared through comprehensive risk assessment, and by cooperation with authorities, during pre-eruption repose period. The comprehensive assessment for volcanic ash-fall hazards, however, has yet to be conducted. Development of risk communication method may result in increased implementation mitigation planning. Numerical analysis of the ash-fall hazards provides quantitative data on particle motions that can be used in the risk assessment. In order to implement the quantitative assessment method, the verification on the effect of ambient air condition to the altitude of volcanic ash cloud is necessary. We need to develop a three-dimensional model of volcanic ash cloud, and calculate motions of ash clouds under multiple conditions of ambient air. (author)

  5. A comparative assessment of the economics of plutonium disposition including comparison with other nuclear fuel cycles

    International Nuclear Information System (INIS)

    Williams, K.A.; Miller, J.W.; Reid, R.L.

    1997-01-01

    DOE has been evaluating three technologies for the disposition of approximately 50 metric tons of surplus plutonium from defense-related programs: reactors, immobilization, and deep boreholes. As part of the process supporting an early CY 1997 Record of Decision (ROD), a comprehensive assessment of technical viability, cost, and schedule has been conducted. Oak Ridge National Laboratory has managed and coordinated the life-cycle cost (LCC) assessment effort for this program. This paper discusses the economic analysis methodology and the results prior to ROD. Other objectives of the paper are to discuss major technical and economic issues that impact plutonium disposition cost and schedule. Also to compare the economics of a once-through weapons-derived MOX nuclear fuel cycle to other fuel cycles, such as those utilizing spent fuel reprocessing. To evaluate the economics of these technologies on an equitable basis, a set of cost estimating guidelines and a common cost-estimating format were utilized by all three technology teams. This paper also includes the major economic analysis assumptions and the comparative constant-dollar and discounted-dollar LCCs

  6. ASSESSMENT TECHNIQUES OF ENGLISH READING COMPREHENSION MEDIATED BY TECHNOLOGIES TO IMPROVE COLLEGE STUDENT’S ACHIEVEMENT.

    OpenAIRE

    Ochoa-Vásquez, Miguel A.; Ramírez-Montoya, María S.

    2016-01-01

    Improving reading comprehension skills is fundamental to those students willing to enroll in undergraduate studies. This sequential-explanatory mixed methods research design attempted to measure the impact that English reading comprehension assessment had on 96 college students’ school performance, after receiving a 15-hour instruction on reading evaluating techniques in technological-enriched environments. The data was collected through reading comprehension pre/post-tests and a semi-structu...

  7. Research on fuzzy comprehensive assessment method of nuclear power plant safety culture

    International Nuclear Information System (INIS)

    Xiang Yuanyuan; Chen Xukun; Xu Rongbin

    2012-01-01

    Considering the traits of safety culture in nuclear plant, 38 safety culture assessment indexes are established from 4 aspects such as safety values, safety institution, safety behavior and safety sub- stances. Based on it, a comprehensive assessment method for nuclear power plant safety culture is constructed by using AHP (Analytic Hierarchy Process) approach and fuzzy mathematics. The comprehensive assessment method has the quality of high precision and high operability, which can support the decision making of safety culture development. (authors)

  8. Exploring transcendence in EFL learners’ reading comprehension through computerized dynamic assessment

    Directory of Open Access Journals (Sweden)

    Saman Ebadi

    2016-01-01

    Full Text Available Derived from Vygotsky’s works, dynamic assessment (DA enables learners to move beyond their current level of functioning through offering needs-sensitized mediation. This study aimed at exploring the learners’ development in novel and increasingly more challenging situations called transcendence (TR in an L2 context focusing on reading comprehension through computerized dynamic assessment (CDA. An overall number of 32 BA TEFL advanced students were selected from among undergraduates of a university in Iran to participate in this study. To fulfil the purpose of the study, the researchers developed Computerized Dynamic Reading Assessment to examine Transcendence (CDRAT software which included reading comprehension CDA tests. To monitor the maintenance of learning in different time intervals, two software programs named CDRAT1 and CDRAT2 were utilized in specific time intervals after the posttest. The results indicated that not only did increased task complexity not lead to regression of students’ development, but also it had an effect on enhancing their development. Thus, transcendence had an effect on the generalizability of the contentions to a great extent. In conclusion, it was disclosed that there is no endpoint to progress and merely gaining a low or high score should not be interpreted as the inability of a special learner to surpass. This would more reinforce the need for applying TR in other future DA studies.

  9. Update to the study protocol, including statistical analysis plan for a randomized clinical trial comparing comprehensive cardiac rehabilitation after heart valve surgery with control

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine Laerum; Berg, Selina Kikkenborg; Hansen, Tina Birgitte

    2015-01-01

    , either valve replacement or repair, remains the treatment of choice. However, post-surgery, the transition to daily living may become a physical, mental and social challenge. We hypothesize that a comprehensive cardiac rehabilitation program can improve physical capacity and self-assessed mental health...

  10. Hypertext Glosses for Foreign Language Reading Comprehension and Vocabulary Acquisition: Effects of Assessment Methods

    Science.gov (United States)

    Chen, I-Jung

    2016-01-01

    This study compared how three different gloss modes affected college students' L2 reading comprehension and vocabulary acquisition. The study also compared how results on comprehension and vocabulary acquisition may differ depending on the four assessment methods used. A between-subjects design was employed with three groups of Mandarin-speaking…

  11. Methods and Strategies for Creating a Culture of Collections Assessment at Comprehensive Universities

    Science.gov (United States)

    Martin, Heath; Robles-Smith, Kimberley; Garrison, Julie; Way, Doug

    2009-01-01

    Differing from those of their liberal arts and Association of Research Libraries counterparts, today's comprehensive universities face a variety of unique challenges and opportunities when it comes to assessing their collections. This article looks at the different needs and interests of comprehensive universities and focuses on the challenges…

  12. Epilogue: Reading Comprehension Is Not a Single Ability--Implications for Assessment and Instruction

    Science.gov (United States)

    Kamhi, Alan G.; Catts, Hugh W.

    2017-01-01

    Purpose: In this epilogue, we review the 4 response articles and highlight the implications of a multidimensional view of reading for the assessment and instruction of reading comprehension. Method: We reiterate the problems with standardized tests of reading comprehension and discuss the advantages and disadvantages of recently developed…

  13. Ethics in clinical research: need for assessing comprehension of informed consent form?

    Science.gov (United States)

    Shafiq, Nusrat; Malhotra, Samir

    2011-03-01

    Comprehension of informed consent form has not achieved the attention it deserves. We made a 24-item questionnaire to assess clinical research participants' comprehension of informed consent form (Contemp Clin Trials 2009;30:427-30). Due to repeated requests by clinical researchers in our country and abroad, we are publishing the questionnaire in this article. Copyright © 2010 Elsevier Inc. All rights reserved.

  14. TOXIC SUBSTANCES FROM COAL COMBUSTION-A COMPREHENSIVE ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    C.L. Senior; F. Huggins; G.P. Huffman; N. Shah; N. Yap; J.O.L. Wendt; W. Seames; M.R. Ames; A.F. Sarofim; S. Swenson; J.S. Lighty; A. Kolker; R. Finkelman; C.A. Palmer; S.J. Mroczkowski; J.J. Helble; R. Mamani-Paco; R. Sterling; G. Dunham; S. Miller

    2001-06-30

    The Clean Air Act Amendments of 1990 identify a number of hazardous air pollutants (HAPs) as candidates for regulation. Should regulations be imposed on HAP emissions from coal-fired power plants, a sound understanding of the fundamental principles controlling the formation and partitioning of toxic species during coal combustion will be needed. With support from the National Energy Technology Laboratory (NETL), the Electric Power Research Institute, and VTT (Finland), Physical Sciences Inc. (PSI) has teamed with researchers from USGS, MIT, the University of Arizona (UA), the University of Kentucky (UK), the University of Connecticut (UC), the University of Utah (UU) and the University of North Dakota Energy and Environmental Research Center (EERC) to develop a broadly applicable emissions model useful to regulators and utility planners. The new Toxics Partitioning Engineering Model (ToPEM) will be applicable to all combustion conditions including new fuels and coal blends, low-NOx combustion systems, and new power generation plants. Development of ToPEM will be based on PSI's existing Engineering Model for Ash Formation (EMAF). The work discussed in this report covers the Phase II program. Five coals were studied (three in Phase I and two new ones in Phase II). In this work UK has used XAFS and Moessbauer spectroscopies to characterize elements in project coals. For coals, the principal use was to supply direct information about certain hazardous and other key elements (iron) to complement the more complete indirect investigation of elemental modes of occurrence being carried out by colleagues at USGS. Iterative selective leaching using ammonium acetate, HCl, HF, and HNO3, used in conjunction with mineral identification/quantification, and microanalysis of individual mineral grains, has allowed USGS to delineate modes of occurrence for 44 elements. The Phase II coals show rank-dependent systematic differences in trace-element modes of occurrence. The work at

  15. Comprehensive assessment of toxic chemical pollutants at Trombay region

    International Nuclear Information System (INIS)

    Sahu, S.K.; Saradhi, I.V.; Raghunath, R.; Pandit, G.G.; Puranik, V.D.

    2006-04-01

    Anthropogenic activities like industrial production and transportation, a wide range of chemical pollutants such as trace and toxic metals, pesticides, polycyclic aromatic hydrocarbons etc. eventually found their way into various environmental compartments. These pollutants get distributed among soil, water bodies, air and if left unattended can cause serious health risk to all exposed ecosystem components including human beings. These compounds may produce immediate toxicity to ecosystems or exhibit long term effects such as mutagenicity, carcinogenicity or biomagnify (concentrations of pollutant increase per unit body weight) in higher trophic organism of the food chain. Thus regular monitoring of these toxic chemicals in all the environmental matrices is unquestionably essential for reclaiming our natural resources. This report describes some of the activities of Environmental Assessment Division which are having direct relevance to the public health and regulatory bodies. Extensive studies were carried out in our laboratories for the Trombay site, over the years; on the organic as well as inorganic pollution in the environment to understand inter compartmental behaviour of these chemical pollutants. In this report attempt has been made to compare the data on various toxic chemical pollutants that are being monitored regularly at Trombay site and their levels are compared with existing regulations. For monitoring, methodologies have been standardized for characterization of toxic chemical pollutants using different analytical techniques. Regular sample collection from different environmental matrices has been done. Sample analysis has been carried out using different analytical instruments such as high performance liquid chromatograph, ion chromatograph, gas chromatograph, atomic absorption spectrophotometer, and differential pulse anodic stripping voltammetry. Major portion of the study covers Air quality monitoring of toxic chemical pollutants, as the other

  16. A Comprehensive Evaluation Rubric for Assessing Instructional Apps

    Directory of Open Access Journals (Sweden)

    Cheng-Yuan Lee

    2015-01-01

    Full Text Available There is a pressing need for an evaluation rubric that examines all aspects of educational apps designed for instructional purposes. In past decades, many rubrics have been developed for evaluating educational computer-based programs; however, rubrics designed for evaluating the instructional implications of educational apps are scarce. When an Internet search for existing rubrics was conducted, only two such rubrics were found, and the evaluation criteria used in those rubrics was not clearly linked to previously conducted research nor were their evaluative dimensions clearly defined. These shortcomings result in reviewers being unable to use those rubrics to provide teachers with a precise analysis of an educational app’s instructional potential. In response, this paper presents a comprehensive rubric with 24-evaluative dimensions tailored specifically to analyze the educational potential of instructional apps.

  17. The assessment of eco-design with a comprehensive index incorporating environmental impact and economic profit

    Science.gov (United States)

    Yang, Shuo; Fu, Yun; Wang, Xiuteng; Xu, Bingsheng; Li, Zheng

    2017-11-01

    Eco-design is an advanced design approach which plays an important part in the national innovation project and serves as a key point for the successful transformation of the supply structure. However, the practical implementation of the pro-environmental designs and technologies always faces a dilemma situation, where some processes can effectively control their emissions to protect the environment at relatively high costs, while others pursue the individual interest in making profit by ignoring the possible adverse environmental impacts. Thus, the assessment on the eco-design process must be carried out based on the comprehensive consideration of the economic and environmental aspects. Presently, the assessment systems in China are unable to fully reflect the new environmental technologies regarding their innovative features or performance. Most of the assessment systems adopt scoring method based on the judgments of the experts, which are easy to use but somewhat subjective. The assessment method presented in this paper includes the environmental impact (EI) assessment based on LCA principal and willingness-to-pay theory, and economic profit (EP) assessment mainly based on market price. The results from the assessment are in the form of EI/EP, which evaluate the targeted process from a combined perspective of environmental and economic performance. A case study was carried out upon the utilization process of coal fly ash, which indicates the proposed method can compare different technical processes in an effective and objective manner, and provide explicit and insightful suggestions for decision making.

  18. ANA as part of a comprehensive reading literacy school assessment ...

    African Journals Online (AJOL)

    ... to report on the results of an exploratory action research study that indicate that the Annual National Assessment is overstepping its boundaries in terms of supporting the development of a systematic, dynamic and effective reading literacy assessment system to address the early literacy skills of foundation phase learners.

  19. Comprehensive Assessment of Emotional Disturbance: A Cross-Validation Approach

    Science.gov (United States)

    Fisher, Emily S.; Doyon, Katie E.; Saldana, Enrique; Allen, Megan Redding

    2007-01-01

    Assessing a student for emotional disturbance is a serious and complex task given the stigma of the label and the ambiguities of the federal definition. One way that school psychologists can be more confident in their assessment results is to cross validate data from different sources using the RIOT approach (Review, Interview, Observe, Test).…

  20. Improving L2 Reading Comprehension through Emotionalized Dynamic Assessment Procedures.

    Science.gov (United States)

    Abdolrezapour, Parisa

    2017-06-01

    The paper reports a study on an emotionally-loaded dynamic assessment procedure used with Iranian EFL learners. It focuses on the effect of using emotional intelligence characteristics (based on Goleman's framework) as a tool for motivating learners while performing reading tasks. The study with 50 intermediate learners aged 12-15 used three modalities: a control group, which was taught under institute's normal procedures; a comparison group, which received dynamic assessment (DA); and an experimental group, which received emotionalized dynamic assessment (EDA) procedures, in the form of an intervention focusing on characteristics of Goleman's emotional intelligence framework with the express purpose of inducing them to work with their emotions. Results showed that applying EDA procedures to reading assessment tasks made a difference in learners' level of performance in comparison to those who went through pure DA procedures who in turn performed significantly better than those who did not received DA in any form.

  1. Comprehensive ultrasound assessment of complications post-liver transplantation.

    LENUS (Irish Health Repository)

    O'Brien, J

    2010-04-01

    Human liver transplantation for end-stage liver disease was first performed in 1963. Refinements in surgical technique and new immunosuppressive regimens have improved outcomes. Today, transplant patients have a 5-year survival rate of approximately 75%. Nevertheless, significant complications still occur. Ultrasonography (US), is the initial imaging modality of choice allowing bedside assessment for detection and follow-up of early and delayed graft complications, and facilitating interventional procedures. This review outlines the role of ultrasound in post-transplantation assessment.

  2. A protocol for comprehensive assessment of bulbar dysfunction in amyotrophic lateral sclerosis (ALS).

    Science.gov (United States)

    Yunusova, Yana; Green, Jordan R; Wang, Jun; Pattee, Gary; Zinman, Lorne

    2011-02-21

    Improved methods for assessing bulbar impairment are necessary for expediting diagnosis of bulbar dysfunction in ALS, for predicting disease progression across speech subsystems, and for addressing the critical need for sensitive outcome measures for ongoing experimental treatment trials. To address this need, we are obtaining longitudinal profiles of bulbar impairment in 100 individuals based on a comprehensive instrumentation-based assessment that yield objective measures. Using instrumental approaches to quantify speech-related behaviors is very important in a field that has primarily relied on subjective, auditory-perceptual forms of speech assessment(1). Our assessment protocol measures performance across all of the speech subsystems, which include respiratory, phonatory (laryngeal), resonatory (velopharyngeal), and articulatory. The articulatory subsystem is divided into the facial components (jaw and lip), and the tongue. Prior research has suggested that each speech subsystem responds differently to neurological diseases such as ALS. The current protocol is designed to test the performance of each speech subsystem as independently from other subsystems as possible. The speech subsystems are evaluated in the context of more global changes to speech performance. These speech system level variables include speaking rate and intelligibility of speech. The protocol requires specialized instrumentation, and commercial and custom software. The respiratory, phonatory, and resonatory subsystems are evaluated using pressure-flow (aerodynamic) and acoustic methods. The articulatory subsystem is assessed using 3D motion tracking techniques. The objective measures that are used to quantify bulbar impairment have been well established in the speech literature and show sensitivity to changes in bulbar function with disease progression. The result of the assessment is a comprehensive, across-subsystem performance profile for each participant. The profile, when compared to

  3. The Design and Evaluation of the Comprehensive Hospitalist Assessment and Mentorship with Portfolios (CHAMP) Ultrasound Program.

    Science.gov (United States)

    Mathews, Benji K; Reierson, Kreegan; Vuong, Khuong; Mehta, Ankit; Miller, Paula; Koenig, Seth; Narasimhan, Mangala

    2018-02-28

    Literature supports the use of point-ofcare ultrasound performed by the treating hospitalist in the diagnosis of common diseases. There is no consensus on the training paradigm or the evaluation of skill retention for hospitalists. To evaluate the effectiveness of a comprehensive bedside ultrasound training program with postcourse competency assessments for hospitalists. A retrospective report of a training program with 53 hospitalists. The program consisted of online modules, a 3-day in-person course, portfolios, 1-day refresher training, monthly scanning, and assessments. Hospitalists were rated by using similar pre- and postcourse competency assessments and self-rating parameters during the 3-day and refresher courses. A large tertiary-care center. Skills increased after the 3-day course from a median preassessment score of 15% correct (interquartile range [IQR] 10%-25%) to a median postassessment score of 90% (IQR 80%-95%; P < .0001). At the time of the refresher course, the median precourse skills score had decreased to 65% correct (IQR 35%-90%), which improved to 100% postcourse (IQR 85%-100%; P < .0001). Skills scores decreased significantly less between the post 3-day course assessment and pre 1-day refresher course for hospitalists who completed portfolios (mean decrease 13.6% correct; P < .0001) and/or monthly scanning sessions (mean decrease 7.3% correct; P < .0001) compared with hospitalists who did not complete these items. A comprehensive longitudinal ultrasound training program including competency assessments improved ultrasound acquisition skills with hospitalists. Skill retention remained high in those who completed portfolios and/or monthly scanning sessions along with a 1-day in-person refresher course.

  4. A Comprehensive Assessment Model for Critical Infrastructure Protection

    Directory of Open Access Journals (Sweden)

    Häyhtiö Markus

    2017-12-01

    Full Text Available International business demands seamless service and IT-infrastructure throughout the entire supply chain. However, dependencies between different parts of this vulnerable ecosystem form a fragile web. Assessment of the financial effects of any abnormalities in any part of the network is demanded in order to protect this network in a financially viable way. Contractual environment between the actors in a supply chain, different business domains and functions requires a management model, which enables a network wide protection for critical infrastructure. In this paper authors introduce such a model. It can be used to assess financial differences between centralized and decentralized protection of critical infrastructure. As an end result of this assessment business resilience to unknown threats can be improved across the entire supply chain.

  5. Portfolio: a comprehensive method of assessment for postgraduates in oral and maxillofacial surgery.

    Science.gov (United States)

    Kadagad, Poornima; Kotrashetti, S M

    2013-03-01

    Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a skill based specialty and deliberate practice enhances skill. But the traditional system of assessment of post graduates emphasizes their performance on the summative exam which fails to evaluate the integral picture of the student throughout the course. Emphasis on competency and holistic growth of the post graduate student during training in recent years has lead to research and evaluation of assessment methods to quantify students' progress during training. Portfolio method of assessment has been proposed as a potentially functional method for post graduate evaluation. It is defined as a collection of papers and other forms of evidence that learning has taken place. It allows the collation and integration of evidence on competence and performance from different sources to gain a comprehensive picture of everyday practice. The benefits of portfolio assessment in health professions education are twofold: it's potential to assess performance and its potential to assess outcomes, such as attitudes and professionalism that are difficult to assess using traditional instruments. This paper is an endeavor for the development of portfolio method of assessment for post graduate student in oral and maxillofacial surgery.

  6. Comprehensive Environmental Assessment and U.S. EPA Nanomaterial Case Studies

    Science.gov (United States)

    These case studies are not completed risk assessments but are structured around an approach known as comprehensive environmental assessment (CEA), which combines a product life cycle framework with the risk assessment paradigm (Davis, J.M., J. Nanosci. Nanotech. 7:402-9, 2007). ...

  7. Comprehensive Geriatric Assessment in the Office: Uncovering all the problems of geriatric patients

    OpenAIRE

    Pereles, Laurie R.M.; Boyle, Neil G.H.

    1991-01-01

    Because of their increased incidence of illness and disability, geriatric patients require extra time and diligence to assess and track medical problems. This article describes a comprehensive geriatirc assessment, organized on a one-page, easily updated checklist, that can be used to generate a medical and functional problem list and a risk assessment.

  8. Assessing College Student Needs for Comprehensive Financial Counseling

    Science.gov (United States)

    Choi, Shinae; Gudmunson, Clinton G.; Griesdorn, Timothy S.; Hong, Gong-Soog

    2016-01-01

    To meet college student needs for financial counseling, it is important to assess why they seek counseling and the extent to which differing financial situations are tied to financial stress. This study examined these issues with a sample of 554 college students who participated in financial counseling and found financial problems in various…

  9. Connecticut's New Comprehensive and Universal Early Childhood Health Assessment Form

    Science.gov (United States)

    Crowley, Angela A.; Whitney, Grace-Ann C.

    2005-01-01

    Health assessments are required for entrance into child care, Head Start, and preschool programs. However, state and federal screening and documentation mandates vary, and programs create their own forms for keeping required data on file. Inconsistent recording formats present challenges for primary care providers who must document each child's…

  10. Potocki-Shaffer syndrome: comprehensive clinical assessment, review of the literature, and proposals for medical management.

    Science.gov (United States)

    Swarr, Daniel T; Bloom, Douglas; Lewis, Richard Alan; Elenberg, Ewa; Friedman, Ellen M; Glotzbach, Caron; Wissman, Scott D; Shaffer, Lisa G; Potocki, Lorraine

    2010-03-01

    Potocki-Shaffer syndrome is a rare contiguous gene deletion syndrome due to haploinsufficiency of the 11p11.2p12 region and is characterized by craniofacial abnormalities, developmental delay, intellectual disability, multiple exostoses, and biparietal foramina. In this study, six patients with the Potocki-Shaffer syndrome were identified and evaluated using a multidisciplinary protocol that included assessments by a geneticist, ophthalmologist, otolaryngologist, orthopedist, nephrologist, audiologist, and neuropsychologist. Diagnostic studies included skeletal survey, magnetic resonance imaging of the brain, renal ultrasound, complete blood count, comprehensive metabolic panel, thyroid studies, and urinalysis. Using array comparative genomic hybridization, we further characterized the deletion in five of these patients. The results of these evaluations were combined with a comprehensive review of reported cases. Our data highlight the characteristic facial features, biparietal foramina, moderate-to-severe developmental delay and intellectual disability, myopia and strabismus, and multiple exostoses seen with this disorder. We also identify for the first time an association of Potocki-Shaffer syndrome with sensorineural hearing loss and autistic behaviors. Finally, we provide recommendations for the health maintenance of patients with Potocki-Shaffer syndrome. (c) 2010 Wiley-Liss, Inc.

  11. Cognitive approach to assessing pragmatic language comprehension in children with specific language impairment.

    Science.gov (United States)

    Ryder, Nuala; Leinonen, Eeva; Schulz, Joerg

    2008-01-01

    Pragmatic language impairment in children with specific language impairment has proved difficult to assess, and the nature of their abilities to comprehend pragmatic meaning has not been fully investigated. To develop both a cognitive approach to pragmatic language assessment based on Relevance Theory and an assessment tool for identifying a group of children with pragmatic language impairment from within an specific language impairment group. The authors focused on Relevance Theory's view of the role of context in pragmatic language comprehension using questions of increasing pragmatic complexity in different verbal contexts (scenarios with and without pictures and a story with supporting pictures). The performances of the children with and without pragmatic impairment on the most pragmatically demanding Implicature questions were examined. This study included 99 children: 27 with specific language impairment (including nine pragmatically impaired children) and two groups of typically developing children (32 children aged 5-6 years and 40 children aged 7-11 years). The specific language impairment group performed similarly to their peers when utilizing context in inferring referents, inferring semantic meaning, and generating Implicatures, only when the answer was provided by pictorial context. Both the children with specific language impairment and the 5-6 year olds were not yet competent at utilizing verbal context when answering the most pragmatically demanding questions (targeting Implicature). On these questions the children with pragmatic language impairment performed significantly poorer than the rest of the specific language impairment group and performance scores on Implicature questions were found to identify accurately the children with pragmatic language impairment from the rest of the specific language impairment group (sensitivity = 89%). Children's ability to infer and integrate information in the comprehension of pragmatic meaning was found to be

  12. Cognitive Frailty in China: Results from China Comprehensive Geriatric Assessment Study

    Directory of Open Access Journals (Sweden)

    Lina Ma

    2017-10-01

    Full Text Available ObjectiveCognitive frailty (CF refers to the co-occurrence of physical frailty (PF and cognitive impairment in persons without dementia. We aimed to explore the prevalence and associated factors of CF in China.MethodData were obtained from the China Comprehensive Geriatric Assessment Study. A total of 5,708 community-dwelling older adults without dementia were included. CF was assessed using the Mini–Mental State Examination for the evaluation of cognitive status and the Comprehensive Geriatric Assessment-Frailty Index for the evaluation of PF. Participants with both cognitive impairment and PF were classified as having CF. Sociodemographic and clinical history was also collected. Logistic analysis was used to explore the association between the associated factors and CF.ResultsThe overall crude prevalence of CF was 3.3% [95% confidence interval (CI = 3.0–4.0], and the standard prevalence of CF was 2.7% (95% CI = 2.0–3.0. The prevalence of CF was significantly higher in women than men and higher in residents of rural areas than urban areas. Moreover, the prevalence of CF was found to increase with age. Multiple factor analysis showed that depression (OR = 2.462, 95% CI = 1.066–5.687 and hearing impairment (OR = 2.713, 95% CI = 1.114–6.608 were independent associated factors of CF in elderly individuals with PF.ConclusionOur results provide the first empirical evidence of CF in China. We have identified several associated factors with CF which should be considered while assessing older adults. More studies in Chinese population with CF are demanded to confirm with our findings.

  13. Assessing Viability and Sustainability: a Systems-based Approach for Deriving Comprehensive Indicator Sets

    Directory of Open Access Journals (Sweden)

    Hartmut Bossel

    2002-01-01

    Full Text Available Performance assessment in holistic approaches such as integrated natural resource management has to deal with a complex set of interacting and self-organizing natural and human systems and agents, all pursuing their own "interests" while also contributing to the development of the total system. Performance indicators must therefore reflect the viability of essential component systems as well as their contributions to the viability and performance of other component systems and the total system under study. A systems-based derivation of a comprehensive set of performance indicators first requires the identification of essential component systems, their mutual (often hierarchical or reciprocal relationships, and their contributions to the performance of other component systems and the total system. The second step consists of identifying the indicators that represent the viability states of the component systems and the contributions of these component systems to the performance of the total system. The search for performance indicators is guided by the realization that essential interests (orientations or orientors of systems and actors are shaped by both their characteristic functions and the fundamental and general properties of their system environments (e.g., normal environmental state, scarcity of resources, variety, variability, change, other coexisting systems. To be viable, a system must devote an essential minimum amount of attention to satisfying the "basic orientors" that respond to the properties of its environment. This fact can be used to define comprehensive and system-specific sets of performance indicators that reflect all important concerns. Often, qualitative indicators and the study of qualitative systems are sufficient for reliable performance assessments. However, this approach can also be formalized for quantitative computer-assisted assessment. Examples are presented of indicator sets for the sustainable development of

  14. Epilogue: Reading Comprehension Is Not a Single Ability-Implications for Assessment and Instruction.

    Science.gov (United States)

    Kamhi, Alan G; Catts, Hugh W

    2017-04-20

    In this epilogue, we review the 4 response articles and highlight the implications of a multidimensional view of reading for the assessment and instruction of reading comprehension. We reiterate the problems with standardized tests of reading comprehension and discuss the advantages and disadvantages of recently developed authentic tests of reading comprehension. In the "Instruction" section, we review the benefits and limitations of strategy instruction and highlight suggestions from the response articles to improve content and language knowledge. We argue that the only compelling reason to administer a standardized test of reading comprehension is when these tests are necessary to qualify students for special education services. Instruction should be focused on content knowledge, language knowledge, and specific task and learning requirements. This instruction may entail the use of comprehension strategies, particularly those that are specific to the task and focus on integrating new knowledge with prior knowledge.

  15. Community Hazard Vulnerability Assessments: How Technology Can Assist in Comprehension

    Science.gov (United States)

    2013-09-01

    2001). GIS: geographic information systems and public safety. 9-1-1 Magazine, 14(2), 34–36. Wikipedia. (n.d.). Gestalt psychology . Retrieved...learning process. A differing viewpoint than that of Kolb was presented by Wilson (2000), including behaviorism, gestalt , cognitive theory and humanist...in which people learn: 1) behaviorism, 2) neo-behaviorism, 3) gestalt , 4) cognitive theory and 5) humanist theory (Wilson, 2000). The first type

  16. [Usefulness of the comprehensive geriatric assessment for evaluating the health of older adults].

    Science.gov (United States)

    Gálvez-Cano, Miguel; Chávez-Jimeno, Helver; Aliaga-Diaz, Elizabeth

    2016-06-01

    Older adults comprise a heterogeneous population group that usually has a high disease burden, comorbidities, and, in many cases, subclinical conditions that compromise their health and quality of life. In addition to the physical component, the health conditions of elderly individuals are significantly influenced by cognitive and affective components, social and family factors such as abandonment, and functional factors including the ability to perform everyday activities. In response to this complex scenario, the comprehensive geriatric evaluation constitutes a multidimensional and interdisciplinary diagnostic tool that assesses the health of older adults in all of its complexity by considering the physical, mental, social/family, and functional needs to obtain full knowledge of older person's health status and creating a plan that consists of appropriate and individualized interventions that considers the preferences and values of older individuals and their families.

  17. Autism genetic database (AGD: a comprehensive database including autism susceptibility gene-CNVs integrated with known noncoding RNAs and fragile sites

    Directory of Open Access Journals (Sweden)

    Talebizadeh Zohreh

    2009-09-01

    Full Text Available Abstract Background Autism is a highly heritable complex neurodevelopmental disorder, therefore identifying its genetic basis has been challenging. To date, numerous susceptibility genes and chromosomal abnormalities have been reported in association with autism, but most discoveries either fail to be replicated or account for a small effect. Thus, in most cases the underlying causative genetic mechanisms are not fully understood. In the present work, the Autism Genetic Database (AGD was developed as a literature-driven, web-based, and easy to access database designed with the aim of creating a comprehensive repository for all the currently reported genes and genomic copy number variations (CNVs associated with autism in order to further facilitate the assessment of these autism susceptibility genetic factors. Description AGD is a relational database that organizes data resulting from exhaustive literature searches for reported susceptibility genes and CNVs associated with autism. Furthermore, genomic information about human fragile sites and noncoding RNAs was also downloaded and parsed from miRBase, snoRNA-LBME-db, piRNABank, and the MIT/ICBP siRNA database. A web client genome browser enables viewing of the features while a web client query tool provides access to more specific information for the features. When applicable, links to external databases including GenBank, PubMed, miRBase, snoRNA-LBME-db, piRNABank, and the MIT siRNA database are provided. Conclusion AGD comprises a comprehensive list of susceptibility genes and copy number variations reported to-date in association with autism, as well as all known human noncoding RNA genes and fragile sites. Such a unique and inclusive autism genetic database will facilitate the evaluation of autism susceptibility factors in relation to known human noncoding RNAs and fragile sites, impacting on human diseases. As a result, this new autism database offers a valuable tool for the research

  18. Autism Genetic Database (AGD): a comprehensive database including autism susceptibility gene-CNVs integrated with known noncoding RNAs and fragile sites.

    Science.gov (United States)

    Matuszek, Gregory; Talebizadeh, Zohreh

    2009-09-24

    Autism is a highly heritable complex neurodevelopmental disorder, therefore identifying its genetic basis has been challenging. To date, numerous susceptibility genes and chromosomal abnormalities have been reported in association with autism, but most discoveries either fail to be replicated or account for a small effect. Thus, in most cases the underlying causative genetic mechanisms are not fully understood. In the present work, the Autism Genetic Database (AGD) was developed as a literature-driven, web-based, and easy to access database designed with the aim of creating a comprehensive repository for all the currently reported genes and genomic copy number variations (CNVs) associated with autism in order to further facilitate the assessment of these autism susceptibility genetic factors. AGD is a relational database that organizes data resulting from exhaustive literature searches for reported susceptibility genes and CNVs associated with autism. Furthermore, genomic information about human fragile sites and noncoding RNAs was also downloaded and parsed from miRBase, snoRNA-LBME-db, piRNABank, and the MIT/ICBP siRNA database. A web client genome browser enables viewing of the features while a web client query tool provides access to more specific information for the features. When applicable, links to external databases including GenBank, PubMed, miRBase, snoRNA-LBME-db, piRNABank, and the MIT siRNA database are provided. AGD comprises a comprehensive list of susceptibility genes and copy number variations reported to-date in association with autism, as well as all known human noncoding RNA genes and fragile sites. Such a unique and inclusive autism genetic database will facilitate the evaluation of autism susceptibility factors in relation to known human noncoding RNAs and fragile sites, impacting on human diseases. As a result, this new autism database offers a valuable tool for the research community to evaluate genetic findings for this complex

  19. Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome

    DEFF Research Database (Denmark)

    Reiman, M P; Thorborg, K; Covington, K

    2017-01-01

    for diagnosis and assessment of FAIS. Diagnostic imaging was the domain with the highest level of agreement. Domains such as patient-reported outcome measures (PRO's) and physical examination were identified as non-diagnostic measures (rather as assessments of disease impact). CONCLUSION: Although it also had...... the greatest level of variability in description of examination domains, diagnostic imaging continues to be the preeminent diagnostic measure for FAIS. No single domain should be utilized as the sole diagnostic or assessment parameter for FAIS. While not all investigated domains provide diagnostic capability...... for FAIS, those that do not are able to serve purpose as a measure of disease impact (e.g., impairments and activity limitations). The clinical relevance of this Delphi survey is the understanding that a comprehensive assessment measuring both diagnostic capability and disease impact most accurately...

  20. Towards a comprehensive climate impacts assessment of solar geoengineering

    Science.gov (United States)

    Irvine, Peter J.; Kravitz, Ben; Lawrence, Mark G.; Gerten, Dieter; Caminade, Cyril; Gosling, Simon N.; Hendy, Erica J.; Kassie, Belay T.; Kissling, W. Daniel; Muri, Helene; Oschlies, Andreas; Smith, Steven J.

    2017-01-01

    Despite a growing literature on the climate response to solar geoengineering—proposals to cool the planet by increasing the planetary albedo—there has been little published on the impacts of solar geoengineering on natural and human systems such as agriculture, health, water resources, and ecosystems. An understanding of the impacts of different scenarios of solar geoengineering deployment will be crucial for informing decisions on whether and how to deploy it. Here we review the current state of knowledge about impacts of a solar-geoengineered climate and identify the major research gaps. We suggest that a thorough assessment of the climate impacts of a range of scenarios of solar geoengineering deployment is needed and can be built upon existing frameworks. However, solar geoengineering poses a novel challenge for climate impacts research as the manner of deployment could be tailored to pursue different objectives making possible a wide range of climate outcomes. We present a number of ideas for approaches to extend the survey of climate impacts beyond standard scenarios of solar geoengineering deployment to address this challenge. Reducing the impacts of climate change is the fundamental motivator for emissions reductions and for considering whether and how to deploy solar geoengineering. This means that the active engagement of the climate impacts research community will be important for improving the overall understanding of the opportunities, challenges, and risks presented by solar geoengineering.

  1. On the Effect of Online Formative Assessment on Iranian Lower Intermediate EFL Learners Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Farideh Peyghambarian

    2015-03-01

    Full Text Available Online Formative Assessment (OFA improves EFL students’ reading comprehension enabling them to have a better performance in reading comprehension tests. To lend support to the above mentioned claim, a quasi-experimental study was conducted in Mashhad, Iran. 48 female lower intermediate EFL students took part in this study. Participants were assigned to control and treatment groups.  Participants in both groups received a formative assessment program lasting for 10 sessions. Formative assessment in treatment group was conducted by the site itself, and participants in control group were assessed by the teacher. It was found that participants in treatment group significantly outperformed those in control group. This finding indicated OFA as an effective learning tool in EFL reading comprehension classrooms.

  2. A procedural evaluation of an analytic-deliberative process: the Columbia River Comprehensive Impact Assessment.

    Science.gov (United States)

    Kinney, Aimee Guglielmo; Leschine, Thomas M

    2002-02-01

    The U.S. Department of Energy's Columbia River Comprehensive Impact Assessment (CRCIA) was an ambitious attempt to direct its cleanup of the Hanford Nuclear Reservation toward the most significant risks to the Columbia River resulting from past plutonium production. DOE's approach was uncommonly open, including tribal, regulatory agency, and other Hanford interest group representatives on the board that was to develop the assessment approach. The CRCIA process had attributes of the "analytic-deliberative" process for risk assessment recommended by the National Research Council. Nevertheless, differences between the DOE and other participants over what was meant by the term "comprehensive" in the group's charge, coupled with differing perceptions of the likely effectiveness of remediation efforts in reducing risks, were never resolved. The CRCIA effort became increasingly fragmented and the role its products were to play in influencing future clean-up decisions increasingly ambiguous. A procedural evaluation of the CRCIA process, based on Thomas Webler's procedural normative model of public participation, reveals numerous instances in which theoretical-normative discourse disconnects occurred. These had negative implications for both the basic procedural dimensions of Webler's model-fairness and competence. Tribal and other interest group representatives lacked the technical resources necessary to make or challenge what philosopher Jurgens Habermas terms cognitive validity claims, while DOE and its contractors did not challenge normative claims made by tribal representatives. The results are cautionary for implementation of the analytic-deliberative process. They highlight the importance of bringing rigor to the evaluation of the quality of the deliberation component of risk characterization via the analytic-deliberative process, as well as to the analytic component.

  3. Establishing a comprehensive risk assessment document for Fernald

    International Nuclear Information System (INIS)

    Nelson, K.A.; Janke, R.C.

    1995-01-01

    While in active operation from 1952 until 1989, the Feed Material Production Center (FMPC),currently referred to as the Fernald Environmental Management Project (FEMP), produced highly purified uranium metal for ultimate use in the manufacture of nuclear weapons. In 1986 the U.S. Environmental Protection Agency (EPA) and the DOE entered into a Federal Facility Compliance Agreement covering environmental impacts associated with the FMPC. In response to the FFCA, a sitewide Remedial Investigation/Feasibility Study (RI/FS) was initiated. Production was permanently suspended at the facility in 1989, and the focus has since shifted to environmental restoration and waste management activities. The original RI/FS work plan identified 39 units, but these were later categorized and grouped into 5 larger, more manageable units as follows: (1) operable unit 1 - waste pit area; (2) operable unit 2 - other solid waste units; (3) operable unit 3 - former production area; (4) operable unit 4- silos I through 4; and (5) operable unit 5 - environmental media. On June 29, 1990, a consent agreement (under Sec. 120 and 106[a] of CERCLA) between the DOE and EPA became effective. The purpose of this agreement was to achieve consistency between the operable units and ensure commitments to the RI/FS program without altering the underlying objectives. The consent agreement was amended the following year to revise the schedules for completing the remediation of the five operable units and to direct operable unit integration to ensure compliance with the residual risk requirements of the National Hazardous Substances and Oil Contingency Plan. This Amended Consent Agreement (ACA) was signed on September 20, 1991, and became effective on December 19, 1991. In accordance with provisions of the ACA, a methodology has been prepared for performing risk assessments and establishing risk-based remedial action goals at the FEMP

  4. Measuring New Media Literacies: Towards the Development of a Comprehensive Assessment Tool

    Science.gov (United States)

    Literat, Ioana

    2014-01-01

    This study assesses the psychometric properties of a newly tested self-report assessment tool for media literacy, based on the twelve new media literacy skills (NMLs) developed by Jenkins et al. (2006). The sample (N = 327) consisted of normal volunteers who completed a comprehensive online survey that measured their NML skills, media exposure,…

  5. Immune-related tumour response assessment criteria: a comprehensive review.

    Science.gov (United States)

    Somarouthu, Bhanusupriya; Lee, Susanna I; Urban, Trinity; Sadow, Cheryl A; Harris, Gordon J; Kambadakone, Avinash

    2018-04-01

    Growing emphasis on precision medicine in oncology has led to increasing use of targeted therapies that encompass a spectrum of drug classes including angiogenesis inhibitors, immune modulators, signal transduction inhibitors, DNA damage modulators, hormonal agents etc. Immune therapeutic drugs constitute a unique group among the novel therapeutic agents that are transforming cancer treatment, and their use is rising. The imaging manifestations in patients on immune therapies appear to be distinct from those typically seen with conventional cytotoxic therapies. Patients on immune therapies may demonstrate a delayed response, transient tumour enlargement followed by shrinkage, stable size, or initial appearance of new lesions followed by stability or response. These newer patterns of response to treatment have rendered conventional criteria such as World Health Organization and response evaluation criteria in solid tumours suboptimal in monitoring changes in tumour burden. As a consequence, newer imaging response criteria such as immune-related response evaluation criteria in solid tumours and immune-related response criteria are being implemented in many trials to effectively monitor patients on immune therapies. In this review, we discuss the traditional and new imaging response criteria for evaluation of solid tumours, review the outcomes of various articles which compared traditional criteria with the new immune-related criteria and discuss pseudo-progression and immune-related adverse events.

  6. Toxic substances from coal combustion -- A comprehensive assessment

    Energy Technology Data Exchange (ETDEWEB)

    Senior, C.L.; Huggins, F.E.; Huffman, G.P.; Shan, N.; Yap, N.; Wendt, J.O.L.; Seames, W.; Ames, M.R.; Sarofim, A.F.; Swenson, S.; Lighty, J.; Kolker, A.; Finkelman, R.; Palmer, C.; Mroczkowski, S.; Helble, J.; Mamani-Paco, R.; Sterling, R.; Dunham, G.; Miller, S.

    2000-08-17

    The final program review meeting of Phase II was held on June 22 in Salt Lake City. The goals of the meeting were to present work in progress and to identify the remaining critical experiments or analyses, particularly those involving collaboration among various groups. The information presented at the meeting is summarized in this report. Remaining fixed bed, bench-scale experiments at EERC were discussed. There are more ash samples which can be run. Of particular interest are high carbon ash samples to be generated by the University of Arizona this summer and some ash-derived sorbents that EERC has evaluated on a different program. The use of separation techniques (electrostatic or magnetic) was also discussed as a way to understand the active components in the ash with respect to mercury. XAFS analysis of leached and unleached ash samples from the University of Arizona was given a high priority. In order to better understand the fixed bed test results, CCSEM and Moessbauer analyses of those ash samples need to be completed. Utah plans to analyze the ash from the single particle combustion experiments for those major elements not measured by INAA. USGS must still complete mercury analyses on the whole coals and leaching residues. Priorities for further work at the SHRIMP-RG facility include arsenic on ash surfaces and mercury in sulfide minerals. Moessbauer analyses of coal samples from the University of Utah were completed; samples from the top and bottom layers of containers of five different coals showed little oxidation of pyrite in the top relative to the bottom except for Wyodak.

  7. Comprehensive Red List assessment reveals exceptionally high extinction risk to Madagascar palms.

    Science.gov (United States)

    Rakotoarinivo, Mijoro; Dransfield, John; Bachman, Steven P; Moat, Justin; Baker, William J

    2014-01-01

    The establishment of baseline IUCN Red List assessments for plants is a crucial step in conservation planning. Nowhere is this more important than in biodiversity hotspots that are subject to significant anthropogenic pressures, such as Madagascar. Here, all Madagascar palm species are assessed using the IUCN Red List categories and criteria, version 3.1. Our results indicate that 83% of the 192 endemic species are threatened, nearly four times the proportion estimated for plants globally and exceeding estimates for all other comprehensively evaluated plant groups in Madagascar. Compared with a previous assessment in 1995, the number of Endangered and Critically Endangered species has substantially increased, due to the discovery of 28 new species since 1995, most of which are highly threatened. The conservation status of most species included in both the 1995 and the current assessments has not changed. Where change occurred, more species have moved to lower threat categories than to higher categories, because of improved knowledge of species and their distributions, rather than a decrease in extinction risk. However, some cases of genuine deterioration in conservation status were also identified. Palms in Madagascar are primarily threatened by habitat loss due to agriculture and biological resource use through direct exploitation or collateral damage. The recent extension of Madagascar's protected area network is highly beneficial for palms, substantially increasing the number of threatened species populations included within reserves. Notably, three of the eight most important protected areas for palms are newly designated. However, 28 threatened and data deficient species are not protected by the expanded network, including some Critically Endangered species. Moreover, many species occurring in protected areas are still threatened, indicating that threatening processes persist even in reserves. Definitive implementation of the new protected areas combined with

  8. Comprehensive Red List assessment reveals exceptionally high extinction risk to Madagascar palms.

    Directory of Open Access Journals (Sweden)

    Mijoro Rakotoarinivo

    Full Text Available The establishment of baseline IUCN Red List assessments for plants is a crucial step in conservation planning. Nowhere is this more important than in biodiversity hotspots that are subject to significant anthropogenic pressures, such as Madagascar. Here, all Madagascar palm species are assessed using the IUCN Red List categories and criteria, version 3.1. Our results indicate that 83% of the 192 endemic species are threatened, nearly four times the proportion estimated for plants globally and exceeding estimates for all other comprehensively evaluated plant groups in Madagascar. Compared with a previous assessment in 1995, the number of Endangered and Critically Endangered species has substantially increased, due to the discovery of 28 new species since 1995, most of which are highly threatened. The conservation status of most species included in both the 1995 and the current assessments has not changed. Where change occurred, more species have moved to lower threat categories than to higher categories, because of improved knowledge of species and their distributions, rather than a decrease in extinction risk. However, some cases of genuine deterioration in conservation status were also identified. Palms in Madagascar are primarily threatened by habitat loss due to agriculture and biological resource use through direct exploitation or collateral damage. The recent extension of Madagascar's protected area network is highly beneficial for palms, substantially increasing the number of threatened species populations included within reserves. Notably, three of the eight most important protected areas for palms are newly designated. However, 28 threatened and data deficient species are not protected by the expanded network, including some Critically Endangered species. Moreover, many species occurring in protected areas are still threatened, indicating that threatening processes persist even in reserves. Definitive implementation of the new protected

  9. Rate of Clinical Complete Response for 1 Year or More in Bone-Metastatic Breast Cancer after Comprehensive Treatments including Autologous Formalin-Fixed Tumor Vaccine.

    Science.gov (United States)

    Kuranishi, Fumito; Imaoka, Yuki; Sumi, Yuusuke; Uemae, Yoji; Yasuda-Kurihara, Hiroko; Ishihara, Takeshi; Miyazaki, Tsubasa; Ohno, Tadao

    2018-01-01

    No effective treatment has been developed for bone-metastatic breast cancer. We found 3 cases with clinical complete response (cCR) of the bone metastasis and longer overall survival of the retrospectively examined cohort treated comprehensively including autologous formalin-fixed tumor vaccine (AFTV). AFTV was prepared individually for each patient from their own formalin-fixed and paraffin-embedded breast cancer tissues. Three patients maintained cCR status of the bone metastasis for 17 months or more. Rate of cCR for 1 year or more appeared to be 15% (3/20) after comprehensive treatments including AFTV. The median overall survival time (60.0 months) and the 3- to 8-year survival rates after diagnosis of bone metastasis were greater than those of historical control cohorts in Japan (1988-2002) and in the nationwide population-based cohort study of Denmark (1999-2007). Bone-metastatic breast cancer may be curable after comprehensive treatments including AFTV, although larger scale clinical trial is required.

  10. Rate of Clinical Complete Response for 1 Year or More in Bone-Metastatic Breast Cancer after Comprehensive Treatments including Autologous Formalin-Fixed Tumor Vaccine

    Directory of Open Access Journals (Sweden)

    Fumito Kuranishi

    2018-01-01

    Full Text Available Introduction. No effective treatment has been developed for bone-metastatic breast cancer. We found 3 cases with clinical complete response (cCR of the bone metastasis and longer overall survival of the retrospectively examined cohort treated comprehensively including autologous formalin-fixed tumor vaccine (AFTV. Patients and Methods. AFTV was prepared individually for each patient from their own formalin-fixed and paraffin-embedded breast cancer tissues. Results. Three patients maintained cCR status of the bone metastasis for 17 months or more. Rate of cCR for 1 year or more appeared to be 15% (3/20 after comprehensive treatments including AFTV. The median overall survival time (60.0 months and the 3- to 8-year survival rates after diagnosis of bone metastasis were greater than those of historical control cohorts in Japan (1988–2002 and in the nationwide population-based cohort study of Denmark (1999–2007. Conclusion. Bone-metastatic breast cancer may be curable after comprehensive treatments including AFTV, although larger scale clinical trial is required.

  11. Application of improved topsis method to comprehensive assessment of radiological environmental quality

    International Nuclear Information System (INIS)

    Shi Dongsheng; Di Yuming; Zhou Chunlin

    2007-01-01

    TOPSIS is a method for multiobjective decision-making, which can be applied to comprehensive assessment of radiological environmental quality. This paper introduces the principle of TOPSIS method and sets up the model of improved TOPSIS method, discusses the application of improved TOPSIS method to comprehensive assessment of radiological environmental quality. This method sufficiently makes use of the information of the optimal matrix. Analysis of practical examples using MATLAB program shows that it is objectively reasonable and feasible to comprehensively assess radiological environmental quality by improved TOPSIS method. This paper also provides the result of optimum number of sites and compares it with optimal index method based on TOPSIS method and traditional method. (authors)

  12. Comprehensive capacitance-voltage analysis including quantum effects for high-k interfaces on germanium and other alternative channel materials

    Science.gov (United States)

    Anwar, Sarkar R. M.

    High mobility alternative channel materials to silicon are critical to the continued scaling of metal oxide semiconductor (MOS) devices. However, before they can be incorporated into advanced devices, some major issues need to be solved. The high mobility materials suffer from lower allowable thermal budgets compared to Si (before desorption and defect formation becomes an issue) and the absence of a good quality native oxide has further increased the interest in the use of high-k dielectrics. However, the high interface state density and high electric fields at these semiconductor/high-k interfaces can significantly impact the capacitance-voltage (C-V) profile, and current C-V modeling software cannot account for these effects. This in turn affects the parameters extracted from the C-V data of the high mobility semiconductor/high-k interface, which are crucial to fully understand the interface properties and expedite process development. To address this issue, we developed a model which takes into account quantum corrections which can be applied to a number of these alternative channel materials including SixGe1-x, Ge, InGaAs, and GaAs. The C-V simulation using this QM correction model is orders of magnitude faster compared to a full band Schrodinger-Poisson solver. The simulated C-V is directly benchmarked to a self consistent Schrodinger-Poisson solution for each bulk semiconductor material, and from the benchmarking process the QM correction parameters are extracted. The full program, C-V Alternative Channel Extraction (CV ACE), incorporates a quantum mechanical correction model, along with the interface state density model, and can extract device parameters such as equivalent oxide thickness (EOT), doping density and flat band voltage (Vfb) as well as the interface state density profile using multiple measurements performed at different frequencies and temperatures, simultaneously. The program was used to analyze experimentally measured C-V profiles and the

  13. Alternative Assessment Strategy and Its Impact on Student Comprehension in an Undergraduate Microbiology Course

    Directory of Open Access Journals (Sweden)

    Barry J. Margulies

    2009-12-01

    Full Text Available Medical Microbiology is a content-intensive course that requires a large time commitment from the students. Students are typically biology or prenursing majors, including students headed for professional schools, such as medical school and pharmacy school. This group is somewhat diverse in terms of background science coursework, so it can be difficult to teach in a way that benefits all the students. Numerous changes have been implemented in our microbiology curriculum to address the different abilities of our students by altering assessment and teaching strategies. It was hypothesized that changing the assessment strategy from the traditional scheme of two or three exams and one final to a new model of seven or eight shorter exams would have a positive impact on student comprehension and retention. The quantity of material taught or expected of the students to learn did not change, but there was definitely an impact on them. Although 30.0% of students routinely did not pass microbiology in previous semesters, the new method of assessment resulted in only 9.63% not completing the semester successfully, as determined by earning a grade of C or better. There is some evidence from conversations and interviews with students that indicates a positive impact of this methodology on student attitude. Implementation of these changes in other courses and their current effectiveness will be examined in the future, with an eye towards more broadly applicable successful teaching techniques in the sciences, especially for nonmajors.

  14. Assessment of comprehensive HIV/AIDS knowledge level among in-school adolescents in eastern Ethiopia.

    Science.gov (United States)

    Oljira, Lemessa; Berhane, Yemane; Worku, Alemayehu

    2013-03-20

    In Ethiopia, more adolescents are in school today than ever before; however, there are no studies that have assessed their comprehensive knowledge of HIV/AIDS. Thus, this study tried to assess the level of this knowledge and the factors associated with it among in-school adolescents in eastern Ethiopia. A cross-sectional school-based study was conducted using a facilitator-guided self-administered questionnaire. The respondents were students attending regular school in 14 high schools located in 14 different districts in eastern Ethiopia. The proportion of in-school adolescents with comprehensive HIV/AIDS knowledge was computed and compared by sex. The factors that were associated with the comprehensive HIV/AIDS knowledge were assessed using bivariate and multivariable logistic regression. Only about one in four, 677 (24.5%), in-school adolescents have comprehensive HIV/AIDS knowledge. The knowledge was better among in-school adolescents from families with a relatively middle or high wealth index (adjusted OR [95% CI]=1.39 [1.03-1.87] and 1.75 [1.24-2.48], respectively), who got HIV/AIDS information mainly from friends or mass media (adjusted OR [95% CI]=1.63 [1.17-2.27] and 1.55 [1.14-2.11], respectively) and who received education on HIV/AIDS and sexual matters at school (adjusted OR [95% CI]=1.59 [1.22-2.08]). The females were less likely to have comprehensive HIV/AIDS knowledge compared to males (adjusted OR and [95% CI]=0.60 [0.49-0.75]). In general, only about a quarter of in-school adolescents had comprehensive HIV/AIDS knowledge. Although the female adolescents are highly vulnerable to HIV infection and its effects, they were by far less likely to have comprehensive HIV/AIDS knowledge. HIV/AIDS information, education and communication activities need to be intensified in high schools.

  15. Comprehensive Assessment of Integration Activity of Business Structures in Russian Regions

    Directory of Open Access Journals (Sweden)

    Mariya Gennad’evna Karelina

    2016-11-01

    Full Text Available In the context of economic sanctions and growing international isolation, the research into regional differences in integration development acquires special relevance for Russia; this fact determines the need for a comprehensive assessment of integration activity of business structures in Russian regions. The diversity of approaches to the study of problems and prospects of economic integration and the current debate about the role of integration processes in the development of regional economies determined a comprehensive approach to the concepts of “integration” and “integration activity” in order to create objective prerequisites for analyzing integration activity of business structures in the regions of Russia. The information base of the research is the data of Russian information and analytical agencies. The tools used in the research include methods for analyzing structural changes, methods for analyzing economic differentiation and concentration, nonparametric statistics methods, and econometric analysis methods. The first part of the paper shows that socio-economic development in constituent entities of Russia is closely connected with the operation of integrated business structures located on their territory. Having studied the structure and dynamics of integration activity, we reveal the growing heterogeneity of integration activity of business structures in Russian regions. The hypothesis about significant divergence of mergers and acquisitions for corporate structures in Russian regions was confirmed by high values of the Gini coefficient, the Herfindahl index and the decile differentiation coefficient. The second part of the paper contains a comparative analysis and proposes an econometric approach to the measurement of integration activity of business structures in subjects of the Russian Federation on the basis of integral synthetic categories. The approach we propose focuses on the development of a system of indicators

  16. [Comprehensive Assessment of Psychiatric Residents: An Addition to the Program Admission Process].

    Science.gov (United States)

    Luis, E Jaramillo G; Elena, Martín C

    2012-01-01

    The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is handled by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  17. Reliability and normative data for the comprehensive assessment of prospective memory (CAPM).

    Science.gov (United States)

    Chau, Lien T; Lee, Jessica B; Fleming, Jennifer; Roche, Nadine; Shum, David

    2007-12-01

    The Comprehensive Assessment of Prospective Memory (CAPM) is a questionnaire designed to evaluate frequency of prospective memory (PM) failures in people with brain injury. The aims of this study were to investigate the psychometric properties of the CAPM, including test-retest reliability and internal consistency, and to establish normative data by comparing CAPM scores between groups on the basis of sex, age, and education. Data were collected on 95 people aged 15-60 years living in the community, with no history of brain injury, using the CAPM. The results showed that the test-retest reliability and internal consistency for the CAPM were within acceptable ranges, indicating that the CAPM provides a stable and homogenous measure of an individual's self-report of PM failures. Normative data are presented in two age groups based on the significant difference found between the age groups 15-30 years and 31-60 years. These established norms can be used to describe perceived or observed behaviours indicative of PM failure in patients with brain injury by comparing CAPM ratings from significant others with the norms. The CAPM questionnaire provides researchers or clinicians with a stable and reliable assessment option that specifically focuses on PM for individuals with brain injury.

  18. Comprehensive geriatric assessment for older women with early breast cancer – a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Parks Ruth M

    2012-05-01

    Full Text Available Abstract Background The Comprehensive Geriatric Assessment (CGA is an analytical tool increasingly implemented in clinical practice. Breast cancer is primarily a disease of older people; however, most evidence-based research is aimed at younger patients. Methods A systematic review of literature was carried out to assess the use of CGA in older breast cancer patients for clinical decision making. The PubMed, Embase and Cochrane databases were searched. Results A total of nine useful full text article results were found. Only five of these were exclusively concerned with early breast cancer; thus, studies involving a variety of cancer types, stages and treatments were accepted, as long as they included early breast cancer.The results comprised a series of low sources of evidence. However, all results shared a common theme: the CGA has a use in determining patient suitability for different types of cancer treatment and subsequently maximizing the patient’s quality of life. Conclusions There is not yet sufficient high level evidence to instate CGA guidelines as a mandatory practice in the management of breast cancer, due to the heterogeneity of available studies. More studies need to be conducted to cement current work on the benefits of the CGA. An area of particular interest is with regard to treatment options, especially surgery and chemotherapy, and identifying patients who may be suitable for these treatments.

  19. Comprehensive geriatric assessment for older women with early breast cancer - a systematic review of literature.

    Science.gov (United States)

    Parks, Ruth M; Lakshmanan, Radhika; Winterbottom, Linda; Al Morgan, David; Cox, Karen; Cheung, Kwok-Leung

    2012-05-17

    The Comprehensive Geriatric Assessment (CGA) is an analytical tool increasingly implemented in clinical practice. Breast cancer is primarily a disease of older people; however, most evidence-based research is aimed at younger patients. A systematic review of literature was carried out to assess the use of CGA in older breast cancer patients for clinical decision making. The PubMed, Embase and Cochrane databases were searched. A total of nine useful full text article results were found. Only five of these were exclusively concerned with early breast cancer; thus, studies involving a variety of cancer types, stages and treatments were accepted, as long as they included early breast cancer.The results comprised a series of low sources of evidence. However, all results shared a common theme: the CGA has a use in determining patient suitability for different types of cancer treatment and subsequently maximizing the patient's quality of life. There is not yet sufficient high level evidence to instate CGA guidelines as a mandatory practice in the management of breast cancer, due to the heterogeneity of available studies. More studies need to be conducted to cement current work on the benefits of the CGA. An area of particular interest is with regard to treatment options, especially surgery and chemotherapy, and identifying patients who may be suitable for these treatments.

  20. Preschool anxiety disorders: comprehensive assessment of clinical, demographic, temperamental, familial, and life stress correlates.

    Science.gov (United States)

    Dougherty, Lea R; Tolep, Marissa R; Bufferd, Sara J; Olino, Thomas M; Dyson, Margaret; Traditi, Jennifer; Rose, Suzanne; Carlson, Gabrielle A; Klein, Daniel N

    2013-01-01

    This study examined correlates of preschoolers' anxiety disorders using a comprehensive, multimethod design. Participants included a community sample of 541 three-year-old children, of whom 106 (19.6%) met criteria for at least 1 anxiety disorder. Child and parental psychopathology and life stress were assessed with clinical interviews. Child temperament and parenting behavior were assessed with laboratory observations. Mothers and fathers reported on their parenting styles. Compared to preschoolers with no anxiety disorder, preschoolers with an anxiety disorder were more likely to meet criteria for comorbid depressive and oppositional defiant disorders and to exhibit greater temperamental behavioral inhibition and lower positive affectivity, and more sleep problems. Children with anxiety disorders also experienced more stressful life events in the previous 6 months, and their mothers had a higher rate of current anxiety disorders. Compared to children with other anxiety disorders, children with only specific phobia exhibited a somewhat different pattern of associations than children with other anxiety disorders. Overall, the findings suggest that many of the correlates observed in older youth with anxiety disorders are also observed in preschoolers.

  1. Beyond Sexual Assault Surveys: A Model for Comprehensive Campus Climate Assessments

    Science.gov (United States)

    McMahon, Sarah; Stepleton, Kate; Cusano, Julia; O'Connor, Julia; Gandhi, Khushbu; McGinty, Felicia

    2018-01-01

    The White House Task Force to Protect Students from Sexual Assault identified campus climate surveys as "the first step" for addressing campus sexual violence. Through a process case study, this article presents one model for engaging in a comprehensive, action-focused campus climate assessment process. Rooted in principles of…

  2. Combining Machine Learning and Natural Language Processing to Assess Literary Text Comprehension

    Science.gov (United States)

    Balyan, Renu; McCarthy, Kathryn S.; McNamara, Danielle S.

    2017-01-01

    This study examined how machine learning and natural language processing (NLP) techniques can be leveraged to assess the interpretive behavior that is required for successful literary text comprehension. We compared the accuracy of seven different machine learning classification algorithms in predicting human ratings of student essays about…

  3. Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project

    Science.gov (United States)

    Cravens, David D.; Mehr, David R.; Campbell, James D.; Armer, Jane; Kruse, Robin L.; Rubenstein, Laurence Z.

    2005-01-01

    Context: Home-based comprehensive geriatric assessment (CGA) has been effective in urban areas but has had little study in rural areas. CGA involves medical history taking, a physical exam, and evaluation of functional status, mental status, cognitive status, gait and balance, medications, vision, extent of social supports, and home safety. We…

  4. Assessing reading comprehension in adolescent low achievers : Subskills identification and task specificity

    NARCIS (Netherlands)

    van Steensel, R.; Oostdam, R.; van Gelderen, A.

    2013-01-01

    On the basis of a validation study of a new test for assessing low-achieving adolescents’ reading comprehension skills – the SALT-reading – we analyzed two issues relevant to the field of reading test development. Using the test results of 200 seventh graders, we examined the possibility of

  5. Comprehensive geriatric assessment : recognition of identified geriatric conditions by community-dwelling older persons

    NARCIS (Netherlands)

    van Rijn, Marjon; Suijker, Jacqueline J.; Bol, Wietske; Hoff, Eva; ter Riet, Gerben; de Rooij, Sophia E.; van Charante, Eric P. Moll; Buurman, Bianca M.

    2016-01-01

    Objectives: to study (i) the prevalence of geriatric conditions in community-dwelling older persons at increased risk of functional decline and (ii) the extent to which older persons recognise comprehensive geriatric assessment (CGA)-identified conditions as relevant problems. Methods: trained

  6. Assessing the Depth and Breadth of Vocabulary Knowledge with Listening Comprehension

    Science.gov (United States)

    Teng, Feng

    2014-01-01

    This study was inspired by Qian (1999) and Staehr (2009) and researched 88 Chinese learners who had already passed the College English Test 4 (CET). These learners volunteered to participate in the study regarding the depth and breadth of vocabulary knowledge and its relationship with listening comprehension, which was assessed by analyzing the…

  7. Enhanced Performance of the Eurostat Method for Comprehensive Assessment of Urban Metabolism

    NARCIS (Netherlands)

    Voskamp, Ilse M.; Stremke, Sven; Spiller, Marc; Perrotti, Daniela; Hoek, van der Jan Peter; Rijnaarts, Huub H.M.

    2017-01-01

    Sustainable urban resource management depends essentially on a sound understanding of a city's resource flows. One established method for analyzing the urban metabolism (UM) is the Eurostat material flow analysis (MFA). However, for a comprehensive assessment of the UM, this method has its

  8. A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)

    OpenAIRE

    Yunusova, Yana; Green, Jordan R.; Wang, Jun; Pattee, Gary; Zinman, Lorne

    2011-01-01

    Improved methods for assessing bulbar impairment are necessary for expediting diagnosis of bulbar dysfunction in ALS, for predicting disease progression across speech subsystems, and for addressing the critical need for sensitive outcome measures for ongoing experimental treatment trials. To address this need, we are obtaining longitudinal profiles of bulbar impairment in 100 individuals based on a comprehensive instrumentation-based assessment that yield objective measures. Using instrumenta...

  9. Comprehensive Assessment of Health Needs of Young Minority Males Attending a Family Planning Clinic.

    Science.gov (United States)

    Pastuszak, Alexander W; Wenker, Evan P; Smith, Peggy B; Abacan, Allyssa; Lamb, Dolores J; Lipshultz, Larry I; Buzi, Ruth

    2017-05-01

    The objective of this study was to assess the overall health, including sexual and reproductive health (SRH) knowledge and needs, sexual behaviors, and testicular health practices among young minority males. Anonymous questionnaires were administered to 18- to 25-year-old males receiving services at health clinics in a large southwestern U.S. city. The survey was completed by 258 males with a mean age of 20.8 years. Most young males (67.1%) identified as African American, and 32.9% as Hispanic. Results suggest study participants lack SRH knowledge related to pregnancy and condom effectiveness, and engage in risky sexual behavior including not using birth control at their last sexual encounter. Although 21.6% of participants had a sexually transmitted infection (STI) in the past year, approximately 80% perceived their STI/HIV risk as very low or low. Respondents had low engagement and lack of knowledge of testicular health practices. The majority of respondents (71.1%) reported having been in a physical fight one or more times and 18.1% reported being victims of intimate partner violence. These data support a need for comprehensive health services for minority young males.

  10. Lake Whitney Comprehensive Water Quality Assessment, Phase 1B- Physical and Biological Assessment (USDOE)

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, Robert D; Byars, Bruce W

    2009-11-24

    Baylor University Center for Reservoir and Aquatic Systems Research (CRASR) has conducted a phased, comprehensive evaluation of Lake Whitney to determine its suitability for use as a regional water supply reservoir. The area along the Interstate 35 corridor between Dallas / Fort Worth Metroplex and the Waco / Temple Centroplex represents one of the fastest growth areas in the State of Texas and reliable water supplies are critical to sustainable growth. Lake Whitney is situated midway between these two metropolitan areas. Currently, the City of Whitney as well as all of Bosque and Hill counties obtain their potable water from the Trinity Sands aquifer. Additionally, parts of the adjoining McLennan and Burleson counties utilize the Trinity sands aquifer system as a supplement to their surface water supplies. Population growth coupled with increasing demands on this aquifer system in both the Metroplex and Centroplex have resulted in a rapid depletion of groundwater in these rural areas. The Lake Whitney reservoir represents both a potentially local and regional solution for an area experiencing high levels of growth. Because of the large scope of this project as well as the local, regional and national implications, we have designed a multifaceted approach that will lead to the solution of numerous issues related to the feasibility of using Lake Whitney as a water resource to the region. Phase IA (USEPA, QAPP Study Elements 1-4) of this research focused on the physical limnology of the reservoir (bathymetry and fine scale salinity determination) and develops hydrodynamic watershed and reservoir models to evaluate how salinity would be expected to change with varying hydrologic and climatic factors. To this end, we implemented a basic water quality modeling program in collaboration with the Texas Parks and Wildlife Department and the Texas Commission on Environmental Quality to add to the developing long-term database on Lake Whitney. Finally, we conducted an initial

  11. The nuances of cognition and depression in older adults: the need for a comprehensive assessment.

    Science.gov (United States)

    Brown, Patrick J; Sneed, Joel R; Rutherford, Bret R; Devanand, D P; Roose, Steven P

    2014-05-01

    This study aimed to examine the confluence of depression, cognitive impairment, and vascular risk factors in older individuals. The study uses baseline data from the National Alzheimer's Coordinating Center. Data were collected across Alzheimer's Disease Centers in the USA. The sample included 12,634 individuals (cognitive intact = 8022; amnestic mild cognitive impairment [aMCI] = 3652; nonamnestic MCI [nonaMCI] = 960). The Geriatric Depression Scale assessed depression; the Trail Making Test assessed executive function. The proportion of participants with depression was higher in the aMCI (18%) and nonaMCI group (21%) as compared with that in the cognitively intact group (8%); there was no difference in rates of depression between aMCI and nonaMCI groups. The proportion of participants with executive dysfunction differed between nondepressed and depressed individuals for the cognitively intact (8% vs. 12%) and aMCI groups (28% vs. 35%), but not for the nonaMCI group (37% vs. 41%). Nine percent of the cognitively intact group had executive dysfunction compared with 31% of the aMCI group and 40% of the nonaMCI group. The proportion of participants with hypertension was greater in individuals with executive dysfunction compared with those with no executive deficits; the presence of hypertension was not associated with depression severity. The confluence of vascular risk factors, episodic memory impairment, and depression and executive dysfunction highlights the need for comprehensive assessment of depressed older adults that can aid clinicians in the formulation of treatment planning and inform clinicians and researchers about long-term prognosis. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Conus: first comprehensive conservation red list assessment of a marine gastropod mollusc genus.

    Directory of Open Access Journals (Sweden)

    Howard Peters

    Full Text Available Marine molluscs represent an estimated 23% of all extant marine taxa, but research into their conservation status has so far failed to reflect this importance, with minimal inclusion on the authoritative Red List of the International Union for the Conservation of Nature (IUCN. We assessed the status of all 632 valid species of the tropical marine gastropod mollusc, Conus (cone snails, using Red List standards and procedures to lay the groundwork for future decadal monitoring, one of the first fully comprehensive global assessments of a marine taxon. Three-quarters (75.6% of species were not currently considered at risk of extinction owing to their wide distribution and perceived abundance. However, 6.5% were considered threatened with extinction with a further 4.1% near threatened. Data deficiency prevented 13.8% of species from being categorised although they also possess characteristics that signal concern. Where hotspots of endemism occur, most notably in the Eastern Atlantic, 42.9% of the 98 species from that biogeographical region were classified as threatened or near threatened with extinction. All 14 species included in the highest categories of Critically Endangered and Endangered are endemic to either Cape Verde or Senegal, with each of the three Critically Endangered species restricted to single islands in Cape Verde. Threats to all these species are driven by habitat loss and anthropogenic disturbance, in particular from urban pollution, tourism and coastal development. Our findings show that levels of extinction risk to which cone snails are exposed are of a similar magnitude to those seen in many fully assessed terrestrial taxa. The widely held view that marine species are less at risk is not upheld.

  13. Multiple flood vulnerability assessment approach based on fuzzy comprehensive evaluation method and coordinated development degree model.

    Science.gov (United States)

    Yang, Weichao; Xu, Kui; Lian, Jijian; Bin, Lingling; Ma, Chao

    2018-05-01

    Flood is a serious challenge that increasingly affects the residents as well as policymakers. Flood vulnerability assessment is becoming gradually relevant in the world. The purpose of this study is to develop an approach to reveal the relationship between exposure, sensitivity and adaptive capacity for better flood vulnerability assessment, based on the fuzzy comprehensive evaluation method (FCEM) and coordinated development degree model (CDDM). The approach is organized into three parts: establishment of index system, assessment of exposure, sensitivity and adaptive capacity, and multiple flood vulnerability assessment. Hydrodynamic model and statistical data are employed for the establishment of index system; FCEM is used to evaluate exposure, sensitivity and adaptive capacity; and CDDM is applied to express the relationship of the three components of vulnerability. Six multiple flood vulnerability types and four levels are proposed to assess flood vulnerability from multiple perspectives. Then the approach is applied to assess the spatiality of flood vulnerability in Hainan's eastern area, China. Based on the results of multiple flood vulnerability, a decision-making process for rational allocation of limited resources is proposed and applied to the study area. The study shows that multiple flood vulnerability assessment can evaluate vulnerability more completely, and help decision makers learn more information about making decisions in a more comprehensive way. In summary, this study provides a new way for flood vulnerability assessment and disaster prevention decision. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Costs of medication in older patients: before and after comprehensive geriatric assessment

    Directory of Open Access Journals (Sweden)

    Unutmaz GD

    2018-04-01

    Full Text Available Gulcin Done Unutmaz,1 Pinar Soysal,2 Busra Tuven,1 Ahmet Turan Isik3 1Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Geriatric Center Kayseri Education and Research Hospital, Kayseri, Turkey; 3Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Background: Polypharmacy and inappropriate drug use cause numerous complications, such as cognitive impairment, frailty, falls, and functional dependence. The present study aimed to determine the effect of the comprehensive geriatric assessment (CGA on polypharmacy, potentially inappropriate medications (PIMs and potential prescribing omissions (PPOs, and to evaluate the economic reflections of medication changes.Methods: One thousand five hundred and seventy-nine older patients, who had undergone CGA, were retrospectively evaluated. The drugs, drug groups, and number of drugs that the patients used were recorded. Appropriate drug therapy was identified by both CGA and STOPP/START criteria. Based on these criteria, PIMs were discontinued and PPOs were started. The monthly cost of these drugs was calculated separately for PIMs and PPOs by using the drugstore records.Results: After CGA, while the prevalence of non-polypharmacy was increased from 43.3% to 65.6%, the prevalence of polypharmacy and hyperpolypharmacy was decreased from 56.7% to 34.4% and 12.0% to 3.6%, respectively. The three most common PIMs discontinued were proton pump inhibitors, anti-dementia drugs, and antipsychotics, respectively. However, the most common PPOs started were vitamin D and B12 supplements, and anti-depressants. After CGA, monthly saved total per capita cost of PIMs was US$12.8 and monthly increased total per capita cost of PPOs was $5.6.Conclusion: It was demonstrated that prevalence of polypharmacy, PIM, and PPO could be decreased by CGA including START/STOPP criteria in older adults. Furthermore, this will have beneficial effects on

  15. Comprehensive assessment of flexible-ligand docking algorithms: current effectiveness and challenges.

    Science.gov (United States)

    Huang, Sheng-You

    2017-03-14

    Protein-ligand docking has been playing an important role in modern drug discovery. To model drug-target binding in real systems, a number of flexible-ligand docking algorithms with different sampling strategies and scoring methods have been subsequently developed over the past three decades, while rigid-ligand docking is still being used because of its compelling computational efficiency. Here, a comprehensive assessment has been conducted to investigate the effectiveness of flexible-ligand docking versus rigid-ligand docking for three representative docking algorithms (global optimization, incremental construction and multi-conformer docking) in virtual screening and pose prediction on the Directory of Useful Decoys. It was found that overall flexible-ligand docking did not achieve a statistically significant improvement in enrichments over rigid-ligand docking in virtual screening, but all docking programs significantly improved the success rates when considering ligand flexibility in pose prediction. The worse effectiveness of flexible-ligand docking in virtual screening than in pose prediction suggests that the challenges of current docking algorithms exist in ranking more than docking, although the use of flexible-ligand docking in virtual screening was justified by its better effectiveness for more flexible ligand in virtual screening. Challenges for scoring, including internal energy, charge polarization, entropy and flexibility, were investigated and discussed. An empirical way was also proposed to consider loss of ligand conformational entropy for virtual screening. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Environmental assessment of passenger transportation should include infrastructure and supply chains

    International Nuclear Information System (INIS)

    Chester, Mikhail V; Horvath, Arpad

    2009-01-01

    To appropriately mitigate environmental impacts from transportation, it is necessary for decision makers to consider the life-cycle energy use and emissions. Most current decision-making relies on analysis at the tailpipe, ignoring vehicle production, infrastructure provision, and fuel production required for support. We present results of a comprehensive life-cycle energy, greenhouse gas emissions, and selected criteria air pollutant emissions inventory for automobiles, buses, trains, and airplanes in the US, including vehicles, infrastructure, fuel production, and supply chains. We find that total life-cycle energy inputs and greenhouse gas emissions contribute an additional 63% for onroad, 155% for rail, and 31% for air systems over vehicle tailpipe operation. Inventorying criteria air pollutants shows that vehicle non-operational components often dominate total emissions. Life-cycle criteria air pollutant emissions are between 1.1 and 800 times larger than vehicle operation. Ranges in passenger occupancy can easily change the relative performance of modes.

  17. Comprehensive Astronaut Immune Assessment Following a Short-Duration Space Flight

    Science.gov (United States)

    Crucian, Brian; Stowe, Raymond; Yetman, Deborah; Pierson, Duane; Sams, Clarence

    2006-01-01

    Immune system dysregulation has been demonstrated to occur during spaceflight and has the potential to cause serious health risks to crewmembers participating in exploration class missions. As a part of an ongoing NASA flight experiment assessing viral immunity (DSO-500), a generalized immune assessment was performed on 3 crewmembers who participated in the recent STS-114 Space Shuttle mission. The following assays were performed: (1) comprehensive immunophenotype analysis; (2) T cell function/intracellular cytokine profiles; (4) secreted Th1/Th2 cytokine profiles via cytometric bead array. Immunophenotype analysis included a leukocyte differential, lymphocyte subsets, T cell subsets, cytotoxic/effector CD8+ T cells, memory/naive T cell subsets and constitutively activated T cells. Study timepoints were L-180, L-65, L-10, R+0, R+3 and R+14. Detailed data are presented in the poster text. As expected from a limited number of human subjects, data tended to vary with respect to most parameters. Specific post-flight alterations were as follows (subject number in parentheses): Granulocytosis (2/3), reduced NK cells (3/3), elevated CD4/CD8 ratio (3/3), general CD8+ phenotype shift to a less differentiated phenotype (3/3), elevated levels of memory CD4+ T cells (3/3), loss of L-selectin on T cell subsets (3/3), increased levels of activated T cells (2/3), reduced IL-2 producing T cell subsets (3/3), levels of IFNg producing T cells were unchanged. CD8+ T cell expression of the CD69 activation markers following whole blood stimulation with SEA+SEB were dramatically reduced postflight (3/3), whereas other T cell function assessments were largely unchanged. Cytometric bead array assessment of secreted T cell cytokines was performed, following whole blood stimulation with either CD3/CD28 antibodies or PMA+ionomycin for 48 hours. Specific cytokines assessed were IFNg, TNFa, IL-2, IL-4, IL-5, IL-10. Following CD3/CD28 stimulation, all three crewmembers had a mission

  18. A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute’s Comprehensive Research Needs Assessment

    International Nuclear Information System (INIS)

    Jagsi, Reshma; Bekelman, Justin E.; Brawley, Otis W.; Deasy, Joseph O.; Le, Quynh-Thu; Michalski, Jeff M.; Movsas, Benjamin; Thomas, Charles R.; Lawton, Colleen A.; Lawrence, Theodore S.; Hahn, Stephen M.

    2012-01-01

    Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patients and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.

  19. A comprehensive approach to benefit-risk assessment in drug development

    DEFF Research Database (Denmark)

    Sarac, Sinan B; Rasmussen, Christian H; Rasmussen, Morten A.

    2012-01-01

    Major regulatory agencies, for example, FDA and EMA, have started to request comprehensive benefit-risk analyses of pharmaceutical products prior to approval or labelling expansion. The purpose of this study is to develop a generally applicable and reliable data-driven benefit-risk assessment...... method, where two or more drugs/doses can be compared. Our aim is to formulate an approach that is simple to apply, allows direct comparison of different types of risks and benefits, and is tailored for application in different disease areas both during clinical development and in the marketing approval......) discussion and formulation of an overall conclusion. To reduce the impact of subjective judgements, scores are assigned to each criterion on the basis of objective information (data) wherever possible. The proposed benefit-risk evaluation approach offers comprehensive, data-driven assessments that can...

  20. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help......, the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have......, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...

  1. Ecological Equivalence Assessment Methods: What Trade-Offs between Operationality, Scientific Basis and Comprehensiveness?

    Science.gov (United States)

    Bezombes, Lucie; Gaucherand, Stéphanie; Kerbiriou, Christian; Reinert, Marie-Eve; Spiegelberger, Thomas

    2017-08-01

    In many countries, biodiversity compensation is required to counterbalance negative impacts of development projects on biodiversity by carrying out ecological measures, called offset when the goal is to reach "no net loss" of biodiversity. One main issue is to ensure that offset gains are equivalent to impact-related losses. Ecological equivalence is assessed with ecological equivalence assessment methods taking into account a range of key considerations that we summarized as ecological, spatial, temporal, and uncertainty. When equivalence assessment methods take into account all considerations, we call them "comprehensive". Equivalence assessment methods should also aim to be science-based and operational, which is challenging. Many equivalence assessment methods have been developed worldwide but none is fully satisfying. In the present study, we examine 13 equivalence assessment methods in order to identify (i) their general structure and (ii) the synergies and trade-offs between equivalence assessment methods characteristics related to operationality, scientific-basis and comprehensiveness (called "challenges" in his paper). We evaluate each equivalence assessment methods on the basis of 12 criteria describing the level of achievement of each challenge. We observe that all equivalence assessment methods share a general structure, with possible improvements in the choice of target biodiversity, the indicators used, the integration of landscape context and the multipliers reflecting time lags and uncertainties. We show that no equivalence assessment methods combines all challenges perfectly. There are trade-offs between and within the challenges: operationality tends to be favored while scientific basis are integrated heterogeneously in equivalence assessment methods development. One way of improving the challenges combination would be the use of offset dedicated data-bases providing scientific feedbacks on previous offset measures.

  2. Development of a comprehensive survey of sexuality issues including a self-report version of the International Spinal Cord Injury sexual function basic data sets.

    Science.gov (United States)

    New, P W; Currie, K E

    2016-08-01

    Questionnaire development, validation and completion. Develop comprehensive survey of sexuality issues including validated self-report versions of the International Spinal Cord Injury male sexual function and female sexual and reproductive function basic data sets (SR-iSCI-sexual function). People with spinal cord damage (SCD) living in the community, Australia from August 2013 to June 2014. An iterative process involving rehabilitation medicine clinicians, a nurse specialising in sexuality issues in SCD and people with SCD who developed a comprehensive survey that included the SR-iSCI-sexual function. Participants recruitment through spinal rehabilitation review clinic and community organisations that support people with SCD. Surveys completed by 154 people. Most were male (n=101, 65.6%). Respondents' median age was 50 years (interquartile range (IQR) 38-58), and they were a median of 10 years (IQR 4-20) after the onset of SCD. Sexual problems unrelated to SCD were reported by 12 (8%) respondents, and 114 (n=75.5%) reported sexual problems because of SCD. Orgasms were much less likely (χ(2)=13.1, P=0.006) to be normal in males (n=5, 5%) compared with females (n=11, 22%). Males had significantly worse (χ(2)=26.0, P=0.001) psychogenic genital functioning (normal n=9, 9%) than females (normal n=13, 26%) and worse (χ(2)=10.8, P=0.013) reflex genital functioning. Normal ejaculation was reported in only three (3%) men. Most (n=26, 52%) women reported reduced or absent menstruation pattern since SCD. The SR-iSCI-sexual function provides a useful tool for researchers and clinicians to collect information regarding patient-reported sexual functioning after SCD and to facilitate comparative studies.

  3. What should be included in the assessment of laypersons' paediatric basic life support skills?

    DEFF Research Database (Denmark)

    Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim

    2018-01-01

    body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. METHODS: A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts...... resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. The PBLS items included: "Responsiveness"," Call for help", "Open airway"," Check breathing", "Rescue breaths", "Compressions", "Ventilations", "Time factor" and "Use of AED". The FBAOM items included: "Identify......' paediatric basic life support and foreign body airway obstruction management skills was established. The assessment of these skills may help to determine when laypersons have acquired competencies. TRIAL REGISTRATION: Not relevant....

  4. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  5. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  6. The cost-effectiveness of comprehensive school reform and rapid assessment.

    Directory of Open Access Journals (Sweden)

    Stuart S. Yeh

    2008-07-01

    Full Text Available Analysis of the cost-effectiveness of 29 Comprehensive School Reform (CSR models suggests that all 29 models are less cost-effective than an alternative approach for raising student achievement, involving rapid assessment systems that test students 2 to 5 times per week in math and reading and provide rapid feedback of the results to students and teachers. Results suggest that reading and math achievement could increase approximately one order of magnitude greater for every dollar invested in rapid assessment rather than CSR. The results also suggest that reading and math achievement could increase two orders of magnitude for every dollar invested in rapid assessment rather than class size reduction and three orders of magnitude for every dollar invested in rapid assessment rather than high quality preschool.

  7. Access to Medicare-funded annual comprehensive health assessments for rural people with intellectual disability.

    Science.gov (United States)

    Burton, Heather; Walters, Lucie

    2013-01-01

    People with intellectual disability (ID) comprise 2-3% of the Australian population. They mostly rely on their GP for primary health care. In rural areas where there are issues with health workforce shortages, there is a risk that people with ID may not get timely access to primary care or may not be aware of the range of healthcare services available to support them. Internationally, research has shown that regular health assessments are beneficial for people with ID. Annual comprehensive health assessments (ACHAs) have been shown to result in increased detection of medical conditions and could assist in reducing the gap in mortality between people with ID and the broader population. In Australia, people with ID have been eligible to access ACHAs under Medicare since 2007. These provide for a regular review of the person's physical, psychological and social functioning. This study explored the extent to which rural people with ID were accessing these ACHAs, and factors which affected their access to ACHAs. In this qualitative study in-depth interviews were conducted with 18 participants including people with ID, carers/support workers and rural doctors. Interviews were then coded and analysed for themes. Seven themes were identified: (1) healthcare barriers in rural areas; (2) cohesion of rural communities; (3) the way rural doctors practice; (4) lack of knowledge/understanding; (5) venturing into new territory; (6) the role of the practice nurse; and (7) the health communication triangle. Despite the well-known problems of lack of services and distance to specialists in rural Australia, there are compensatory factors which were perceived as improving the wellbeing of people with ID, such as increased social cohesion and community connectedness. More education is needed to ensure that the rationale for ACHAs for people with ID is understood and that doctors feel confident to use them. The number of Medicare reforms implemented in a relatively short period

  8. Comprehensively Assessing Cognitive and Behavioral Risks for HIV Infection among Middle-Aged and Older Adults

    Science.gov (United States)

    Paniagua, Freddy A.; O'Boyle, Michael

    2008-01-01

    A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveyed across such domains.…

  9. Assessment of a pharmacist-led comprehensive medication management and wellness program

    Directory of Open Access Journals (Sweden)

    Daniel L. Janovick

    2015-01-01

    Full Text Available Background: Pharmacists are currently providing comprehensive medication management in the outpatient setting. However, there is little documented evidence demonstrating pharmacists are generating further improved health outcomes utilizing non-pharmacologic support, such as fitness and nutrition counseling. The objective of this study is to determine if a pharmacist-led wellness program with medication management and lifestyle modifications through fitness and nutrition coaching can lead to improved biometric markers. Methods: The wellness program targeted corporate employees and was offered in a corporate headquarters' setting with an on-site workout facility. The program was expected to recruit approximately 15 patients into the wellness program consisting of two treatment arms. The standard group featured nutrition-based classes, medication therapy management and fitness education. The intervention group performed the standard group's activities plus direct, supervised fitness training once weekly. Measured biometric markers were assessed at baseline, 3.5 months, and 7 months and included body mass index (BMI, waist circumference (WC, fasting blood glucose (FBG, systolic and diastolic blood pressure (SBP and DBP, and full lipid panel (TC, TG, HDL, and LDL. Results: Seventeen patients were enrolled in the study. The standard group (n = 11 and intervention group (n = 6 had relatively similar biometric markers at baseline. Seven total patients completed the study (4 from standard group, 3 from intervention group. The majority of biometric markers improved in both groups, and BP and LDL control was maintained for all who completed the study. Conclusion: These data suggest that a licensed pharmacist with certified personal trainer credentials may be capable of maintaining biometric markers at healthy levels and improving where necessary in an employee wellness program through one-on-one medication, fitness and nutrition support. Additional, large

  10. Geological heritage diversity in the Faiyum Oasis (Egypt): A comprehensive assessment

    Science.gov (United States)

    Sallam, Emad S.; Fathy, Esraa E.; Ruban, Dmitry A.; Ponedelnik, Alena A.; Yashalova, Natalia N.

    2018-04-01

    The Faiyum Oasis in the Western Desert of Egypt is famous for its palaeontological localities (Cenozoic whales, primates, etc.) of global importance, but its geological heritage has been not studied in the modern theoretical frame. The new investigation based on the field studies and the literature review permits comprehensive assessment of the geological heritage diversity in this oasis. For this purposes, unique geological features are inventoried with establishment of their geological essence, rank, relative abundance, and intrinsic diversity. As a result, the existence of ten geological heritage types in the Faiyum Oasis is found. These include palaeontological, palaeogeographical, geomorphological, stratigraphical, sedimentary (merged with mineralogical), hydrological coupled with geochemical, igneous, and economical types. From them, the palaeontological and palaeogeographical types are ranked globally, and the geomorphological and hydrological types are ranked nationally. The other types are either of regional (provincial) or local importance. Some hills and cliffs can serve as viewpoint sites for observation of the local geological landscape. The relative abundance and the intrinsic diversity of the unique geological features vary between low and high. Generally, the concentration of this geological heritage in the Faiyum Oasis permits recognition of the geodiversity hotspot that requires conservation and use for tourism purposes. The protected areas located in the oasis and the existing tourism programs do not offer geoconservation and geotourism activities for the entire hotspot. The possible solution of this problem would be creation of a large geopark similar in its design to the Jeju Island Geopark in South Korea. There are important premises for geotourism development in the Faiyum Oasis and its combination with the archaeological and industrial tourism. Nature conservation failures in this geopark should be avoided; some recommendations are given on

  11. JADA: a graphical user interface for comprehensive internal dose assessment in nuclear medicine.

    Science.gov (United States)

    Grimes, Joshua; Uribe, Carlos; Celler, Anna

    2013-07-01

    The main objective of this work was to design a comprehensive dosimetry package that would keep all aspects of internal dose calculation within the framework of a single software environment and that would be applicable for a variety of dose calculation approaches. Our MATLAB-based graphical user interface (GUI) can be used for processing data obtained using pure planar, pure SPECT, or hybrid planar/SPECT imaging. Time-activity data for source regions are obtained using a set of tools that allow the user to reconstruct SPECT images, load images, coregister a series of planar images, and to perform two-dimensional and three-dimensional image segmentation. Curve fits are applied to the acquired time-activity data to construct time-activity curves, which are then integrated to obtain time-integrated activity coefficients. Subsequently, dose estimates are made using one of three methods. The organ level dose calculation subGUI calculates mean organ doses that are equivalent to dose assessment performed by OLINDA/EXM. Voxelized dose calculation options, which include the voxel S value approach and Monte Carlo simulation using the EGSnrc user code DOSXYZnrc, are available within the process 3D image data subGUI. The developed internal dosimetry software package provides an assortment of tools for every step in the dose calculation process, eliminating the need for manual data transfer between programs. This saves times and minimizes user errors, while offering a versatility that can be used to efficiently perform patient-specific internal dose calculations in a variety of clinical situations.

  12. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River.

  13. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River

  14. Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments (Final Report)

    Science.gov (United States)

    In September 2013, EPA announced the availability of the final report, Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments...

  15. [Assessment of comprehensive nutritional status and eating behavior among 311 middle aged and aged women with osteoporosis in Chengdu].

    Science.gov (United States)

    Zhao, R P; Wang, W Z; Cheng, G P; Zhang, H J; Zhou, F M; Li, Y Y; Wu, C; Yang, L Q; Zeng, G

    2017-06-06

    Objective: To investigate the comprehensive nutritional status and diet behavior of middle aged and elderly women with osteoporosis, and thereby to explore the relationship between diet behavior and comprehensive nutritional status. Methods: 311 middle-aged and elderly women with osteoporosis in Chengdu were included in this study. Mini Nutritional Assessment (MNA) was applied to assess their comprehensive nutritional status. Information of social-demographic characteristics and diet behavior (about meals, snacks and water drinking, etc.) of the subjects was collected by questionnaire. Chi square test was used to assess the differences in nutritional status among patients who have different eating behaviors. Logistic regression analysis was performed to evaluate the relationship between diet behaviors and comprehensive nutritional status. Results: The mean MNA score of subjects was 25.8±2.5. 20.3% (63/311) of the subjets were at risk of potential malnutrition, but there was no malnourished subjects found. 46.9% (46/311) of the subjects were in good appetite. 95.2% (296/311) of them had a fixed food intake each meal. 65.8% (198/311) of them had snacks every day, and the most common choice was fruit (86.4% (248/287)). 54.8% (165/311) of them had initiative drinking water habits, and the most common choice was plain boiled water (79.9%, 246/308). 76.5% (238/311) of them had daily portable water less than 1 500 ml. After adjusting the effects of age, occupation and education level, bad appetite ( OR= 3.50, 95% CI: 1.18-10.62), unfixed food intake ( OR= 7.27, 95% CI: 1.40-35.83), and seldom or never intake of snack ( OR= 3.71, 95% CI: 1.42-9.72) were risk factors for malnutrition risk, while tea drinking was protective factor( OR= 0.31, 95% CI: 0.11-0.93). Conclusion: Risk of potential malnutrition and unhealthy diet behavior among the middle aged and elderly women with osteoporosis should be paid more attention. Unhealtghy diet behavior has a negative effect on their

  16. A Study of Wind Turbine Comprehensive Operational Assessment Model Based on EM-PCA Algorithm

    Science.gov (United States)

    Zhou, Minqiang; Xu, Bin; Zhan, Yangyan; Ren, Danyuan; Liu, Dexing

    2018-01-01

    To assess wind turbine performance accurately and provide theoretical basis for wind farm management, a hybrid assessment model based on Entropy Method and Principle Component Analysis (EM-PCA) was established, which took most factors of operational performance into consideration and reach to a comprehensive result. To verify the model, six wind turbines were chosen as the research objects, the ranking obtained by the method proposed in the paper were 4#>6#>1#>5#>2#>3#, which are completely in conformity with the theoretical ranking, which indicates that the reliability and effectiveness of the EM-PCA method are high. The method could give guidance for processing unit state comparison among different units and launching wind farm operational assessment.

  17. Characterization of an investigative safety pharmacology model to assess comprehensive cardiac function and structure in chronically instrumented conscious beagle dogs.

    Science.gov (United States)

    Regan, Christopher P; Stump, Gary L; Detwiler, Theodore J; Chen, Li; Regan, Hillary K; Gilberto, David B; DeGeorge, Joseph J; Sannajust, Frederick J

    2016-01-01

    There has been an increasing need to conduct investigative safety pharmacology studies to complement regulatory-required studies, particularly as it applies to a comprehensive assessment of cardiovascular (CV) risk. We describe refined methodology using a combination of telemetry and direct signal acquisition to record concomitant peripheral hemodynamics, ECG, and left ventricular (LV) structure (LV chamber size and LV wall thickness) and function, including LV pressure-volume (PV) loops to determine load independent measures of contractility (end systolic elastance, Ees, and preload recruitable stroke work, PRSW) in conscious beagle dogs. Following baseline characterization, 28days of chronic rapid ventricular pacing (RVP) was performed and cardiac function monitored: both as a way to compare measures during development of dysfunction and to characterize feasibility of a model to assess CV safety in animals with underlying cardiac dysfunction. While ±dP/dT decreased within a few days of RVP and remained stable, more comprehensive cardiac function measurements, including Ees and PRSW, provided a more sensitive assessment confirming the value of such endpoints for a more clear functional assessment. After 28days of RVP, the inodilator pimobendan was administered to further demonstrate the ability to detect changes in cardiac function. Expectedly pimobendan caused a leftward shift in the PV loop, improved ejection fraction (EF) and significantly improved Ees and PRSW. In summary, the data show the feasibility and importance in measuring enhanced cardiac functional parameters in conscious normal beagle dogs and further describe a relatively stable cardiac dysfunction model that could be used as an investigative safety pharmacology risk assessment tool. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Predictive validity of the comprehensive basic science examination mean score for assessment of medical students' performance

    Directory of Open Access Journals (Sweden)

    Firouz Behboudi

    2002-04-01

    Full Text Available Background Medical education curriculum improvements can be achieved bye valuating students performance. Medical students have to pass two undergraduate comprehensive examinations, basic science and preinternship, in Iran. Purpose To measure validity of the students' mean score in comprehensive basic science exam (CBSE for predicting their performance in later curriculum phases. Methods This descriptive cross-sectional study was conducted on 95 (38 women and 55 men Guilan medical university students. Their admission to the university was 81% by regional quota and 12% by shaheed and other organizations' share. They first enrolled in 1994 and were able to pass CBS£ at first try. Data on gender, regional quota, and average grades of CBS£, PC, and CPIE were collected by a questionnaire. The calculations were done by SPSS package. Results The correlation coefficient between CBS£ and CPIE mean scores (0.65 was higher than correlation coefficient between CBS£ and PC mean scores (0.49. The predictive validity of CBS£ average grade was significant for students' performance in CPIE; however, the predictive validity of CBSE mean scores for students I pe1jormance in PC was lower. Conclusion he students' mean score in CBSE can be a good denominator for their further admission. We recommend further research to assess the predictive validity for each one of the basic courses. Keywords predictive validity, comprehensive basic exam

  19. Risk assessment of groundwater contamination: a multilevel fuzzy comprehensive evaluation approach based on DRASTIC model.

    Science.gov (United States)

    Zhang, Qiuwen; Yang, Xiaohong; Zhang, Yan; Zhong, Ming

    2013-01-01

    Groundwater contamination is a serious threat to water supply. Risk assessment of groundwater contamination is an effective way to protect the safety of groundwater resource. Groundwater is a complex and fuzzy system with many uncertainties, which is impacted by different geological and hydrological factors. In order to deal with the uncertainty in the risk assessment of groundwater contamination, we propose an approach with analysis hierarchy process and fuzzy comprehensive evaluation integrated together. Firstly, the risk factors of groundwater contamination are identified by the sources-pathway-receptor-consequence method, and a corresponding index system of risk assessment based on DRASTIC model is established. Due to the complexity in the process of transitions between the possible pollution risks and the uncertainties of factors, the method of analysis hierarchy process is applied to determine the weights of each factor, and the fuzzy sets theory is adopted to calculate the membership degrees of each factor. Finally, a case study is presented to illustrate and test this methodology. It is concluded that the proposed approach integrates the advantages of both analysis hierarchy process and fuzzy comprehensive evaluation, which provides a more flexible and reliable way to deal with the linguistic uncertainty and mechanism uncertainty in groundwater contamination without losing important information.

  20. The impact of soil amendments on greenhouse gas emissions: a comprehensive life cycle assessment approach

    Science.gov (United States)

    DeLonge, M. S.; Ryals, R.; Silver, W. L.

    2011-12-01

    Soil amendments, such as compost and manure, can be applied to grasslands to improve soil conditions and enhance aboveground net primary productivity. Applying such amendments can also lead to soil carbon (C) sequestration and, when materials are diverted from waste streams (e.g., landfills, manure lagoons), can offset greenhouse gas (GHG) emissions. However, amendment production and application is also associated with GHG emissions, and the net impact of these amendments remains unclear. To investigate the potential for soil amendments to reduce net GHG emissions, we developed a comprehensive, field-scale life cycle assessment (LCA) model. The LCA includes GHG (i.e., CO2, CH4, N2O) emissions of soil amendment production, application, and ecosystem response. Emissions avoided by diverting materials from landfills or manure management systems are also considered. We developed the model using field observations from grazed annual grassland in northern California (e.g., soil C; above- and belowground net primary productivity; C:N ratios; trace gas emissions from soils, manure piles, and composting), CENTURY model simulations (e.g., long-term soil C and trace gas emissions from soils under various land management strategies), and literature values (e.g., GHG emissions from transportation, inorganic fertilizer production, composting, and enteric fermentation). The LCA quantifies and contrasts the potential net GHG impacts of applying compost, manure, and commercial inorganic fertilizer to grazing lands. To estimate the LCA uncertainty, sensitivity tests were performed on the most widely ranging or highly uncertain parameters (e.g., compost materials, landfill emissions, manure management system emissions). Finally, our results are scaled-up to assess the feasibility and potential impacts of large-scale adoption of soil amendment application as a land-management strategy in California. Our base case results indicate that C sinks and emissions offsets associated with

  1. Comprehensive characterization and hazard assessment of the DOE-Niagara Falls storage site

    International Nuclear Information System (INIS)

    Anderson, T.L.; Dettorre, J.F.; Jackson, D.R.; Ausmus, B.S.

    1981-06-01

    A comprehensive radioecological and nonradiological characterization and hazards assessment was conducted on DOE-Niagara Falls Storage Site. Pitchblende residues and other low-level nuclear waste have been stored on the site since 1944. The most highly radioactive residues were stored in four abandoned buildings, while other wastes were deposited in pits or piled on surface soils on the Site. Several ditches were constructed on the Site to facilitate drainage or excess precipitation. Results of the study will permit the US DOE to form an appropriate remedial action plan for the Site

  2. Rapid Damage Assessment by Means of Multi-Temporal SAR — A Comprehensive Review and Outlook to Sentinel-1

    Directory of Open Access Journals (Sweden)

    Simon Plank

    2014-05-01

    Full Text Available Fast crisis response after natural disasters, such as earthquakes and tropical storms, is necessary to support, for instance, rescue, humanitarian, and reconstruction operations in the crisis area. Therefore, rapid damage mapping after a disaster is crucial, i.e., to detect the affected area, including grade and type of damage. Thereby, satellite remote sensing plays a key role due to its fast response, wide field of view, and low cost. With the increasing availability of remote sensing data, numerous methods have been developed for damage assessment. This article gives a comprehensive review of these techniques focusing on multi-temporal SAR procedures for rapid damage assessment: interferometric coherence and intensity correlation. The review is divided into six parts: First, methods based on coherence; second, the ones using intensity correlation; and third, techniques using both methodologies combined to increase the accuracy of the damage assessment are reviewed. Next, studies using additional data (e.g., GIS and optical imagery to support the damage assessment and increase its accuracy are reported. Moreover, selected studies on post-event SAR damage assessment techniques and examples of other applications of the interferometric coherence are presented. Then, the preconditions for a successful worldwide application of multi-temporal SAR methods for damage assessment and the limitations of current SAR satellite missions are reported. Finally, an outlook to the Sentinel-1 SAR mission shows possible solutions of these limitations, enabling a worldwide applicability of the presented damage assessment methods.

  3. An approach to include soil carbon changes in life cycle assessments

    DEFF Research Database (Denmark)

    Petersen, Bjorn Molt; Knudsen, Marie Trydeman; Hermansen, John Erik

    2013-01-01

    Globally, soil carbon sequestration is expected to hold a major potential to mitigate agricultural greenhouse gas emissions. However, the majority of life cycle assessments (LCA) of agricultural products have not included possible changes in soil carbon sequestration. In the present study, a method...... production in China. The suggested approach considers the time of the soil CO2 emissions for the LCA by including the Bern Carbon Cycle Model. Time perspectives of 20,100 and 200 years are used and a soil depth of 0-100 cm is considered. The application of the suggested method showed that the results were...... to estimate carbon sequestration to be included in LCA is suggested and applied to two examples where the inclusion of carbon sequestration is especially relevant: 1) Bioenergy: removal of straw from a Danish soil for energy purposes and 2) Organic versus conventional farming: comparative study of soybean...

  4. The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

    Science.gov (United States)

    Punchick, Boris; Freud, Tamar; Press, Yan

    2016-01-01

    Abstract The prevalence of cognitive impairment and orthostatic hypotension (OH) increases with age, but the results of studies that assessed possible associations between them are inconsistent. The aim of this study is to assess possible associations between cognitive impairment and OH in patients ≥65 years of age who underwent a comprehensive geriatric assessment. A retrospective analysis was conducted of the computerized medical records of the study population from 2005 to 2013. Data collected included blood pressure measurements that enabled the calculation of OH, results of the mini-mental state examination (MMSE), results of the Montreal cognitive assessment (MoCA) test, and cognitive diagnoses that were determined over the course of the assessment. The rate of OH in the study population of 571 adults was 32.1%. The mean MMSE score was 22.5 ± 5.2 among participants with OH and 21.6 ± 5.8 among those without OH (P = 0.09). The absence of a significant association between OH and MMSE remained after adjusting the MMSE score for age and education level. The mean MoCA score was 16.4 ± 5.0 among participants with OH and 16.4 ± 4.8 among those without (P = 0.33). The prevalence of OH was 39% among participants without cognitive impairment, 28.9% among those with mild cognitive impairment (MCI), and 30.6% among those with dementia (P = 0.13). There was no association between OH and cognitive impairment in adults who underwent a comprehensive geriatric assessment. PMID:27442658

  5. A Systematic Review of Technology-Based Dietary Intake Assessment Validation Studies That Include Carotenoid Biomarkers

    Science.gov (United States)

    Burrows, Tracy L.; Rollo, Megan E.; Williams, Rebecca; Wood, Lisa G.; Garg, Manohar L.; Jensen, Megan; Collins, Clare E.

    2017-01-01

    Technological advances have allowed for the evolution of traditional dietary assessment methods. The aim of this review is to evaluate the accuracy of technology-based dietary assessment methods to determine carotenoid and/or fruit and vegetable intake when compared with carotenoid biomarkers. An online search strategy was undertaken to identify studies published in the English language up to July 2016. Inclusion criteria were adults ≥18 years, a measure of dietary intake that used information and communication technologies that specified fruit and/or vegetable intake or dietary carotenoid, a biomarker of carotenoid status and the association between the two. Sixteen articles from 13 studies were included with the majority cross-sectional in design (n = 9). Some studies used multiple dietary assessment methods with the most common: food records (n = 7), 24-h diet recalls (n = 5), food frequency questionnaires (n = 3) and diet quality assessed by dietary screener (n = 1). Two studies were directly web based, with four studies using technology that could be completed offline and data later transferred. Two studies utilised technology in the collection of dietary data, while the majority (n = 11) automated the collection in combination with nutrient analysis of the dietary data. Four studies provided correlation values between dietary carotenoids with biomarkers, ranging from r = 0.13 to 0.62 with the remaining studies comparing a measure of fruit and vegetable intake with biomarkers (r = 0.09 to 0.25). This review provides an overview of technology-based dietary assessment methods that have been used in validation studies with objectively measured carotenoids. Findings were positive with these dietary assessment measures showing mostly moderate associations with carotenoid biomarkers. PMID:28216582

  6. A Systematic Review of Technology-Based Dietary Intake Assessment Validation Studies That Include Carotenoid Biomarkers.

    Science.gov (United States)

    Burrows, Tracy L; Rollo, Megan E; Williams, Rebecca; Wood, Lisa G; Garg, Manohar L; Jensen, Megan; Collins, Clare E

    2017-02-14

    Technological advances have allowed for the evolution of traditional dietary assessment methods. The aim of this review is to evaluate the accuracy of technology-based dietary assessment methods to determine carotenoid and/or fruit and vegetable intake when compared with carotenoid biomarkers. An online search strategy was undertaken to identify studies published in the English language up to July 2016. Inclusion criteria were adults ≥18 years, a measure of dietary intake that used information and communication technologies that specified fruit and/or vegetable intake or dietary carotenoid, a biomarker of carotenoid status and the association between the two. Sixteen articles from 13 studies were included with the majority cross-sectional in design ( n = 9). Some studies used multiple dietary assessment methods with the most common: food records ( n = 7), 24-h diet recalls ( n = 5), food frequency questionnaires ( n = 3) and diet quality assessed by dietary screener ( n = 1). Two studies were directly web based, with four studies using technology that could be completed offline and data later transferred. Two studies utilised technology in the collection of dietary data, while the majority ( n = 11) automated the collection in combination with nutrient analysis of the dietary data. Four studies provided correlation values between dietary carotenoids with biomarkers, ranging from r = 0.13 to 0.62 with the remaining studies comparing a measure of fruit and vegetable intake with biomarkers ( r = 0.09 to 0.25). This review provides an overview of technology-based dietary assessment methods that have been used in validation studies with objectively measured carotenoids. Findings were positive with these dietary assessment measures showing mostly moderate associations with carotenoid biomarkers.

  7. A Systematic Review of Technology-Based Dietary Intake Assessment Validation Studies That Include Carotenoid Biomarkers

    Directory of Open Access Journals (Sweden)

    Tracy L. Burrows

    2017-02-01

    Full Text Available Technological advances have allowed for the evolution of traditional dietary assessment methods. The aim of this review is to evaluate the accuracy of technology-based dietary assessment methods to determine carotenoid and/or fruit and vegetable intake when compared with carotenoid biomarkers. An online search strategy was undertaken to identify studies published in the English language up to July 2016. Inclusion criteria were adults ≥18 years, a measure of dietary intake that used information and communication technologies that specified fruit and/or vegetable intake or dietary carotenoid, a biomarker of carotenoid status and the association between the two. Sixteen articles from 13 studies were included with the majority cross-sectional in design (n = 9. Some studies used multiple dietary assessment methods with the most common: food records (n = 7, 24-h diet recalls (n = 5, food frequency questionnaires (n = 3 and diet quality assessed by dietary screener (n = 1. Two studies were directly web based, with four studies using technology that could be completed offline and data later transferred. Two studies utilised technology in the collection of dietary data, while the majority (n = 11 automated the collection in combination with nutrient analysis of the dietary data. Four studies provided correlation values between dietary carotenoids with biomarkers, ranging from r = 0.13 to 0.62 with the remaining studies comparing a measure of fruit and vegetable intake with biomarkers (r = 0.09 to 0.25. This review provides an overview of technology-based dietary assessment methods that have been used in validation studies with objectively measured carotenoids. Findings were positive with these dietary assessment measures showing mostly moderate associations with carotenoid biomarkers.

  8. Comprehensive processing of high-throughput small RNA sequencing data including quality checking, normalization, and differential expression analysis using the UEA sRNA Workbench.

    Science.gov (United States)

    Beckers, Matthew; Mohorianu, Irina; Stocks, Matthew; Applegate, Christopher; Dalmay, Tamas; Moulton, Vincent

    2017-06-01

    Recently, high-throughput sequencing (HTS) has revealed compelling details about the small RNA (sRNA) population in eukaryotes. These 20 to 25 nt noncoding RNAs can influence gene expression by acting as guides for the sequence-specific regulatory mechanism known as RNA silencing. The increase in sequencing depth and number of samples per project enables a better understanding of the role sRNAs play by facilitating the study of expression patterns. However, the intricacy of the biological hypotheses coupled with a lack of appropriate tools often leads to inadequate mining of the available data and thus, an incomplete description of the biological mechanisms involved. To enable a comprehensive study of differential expression in sRNA data sets, we present a new interactive pipeline that guides researchers through the various stages of data preprocessing and analysis. This includes various tools, some of which we specifically developed for sRNA analysis, for quality checking and normalization of sRNA samples as well as tools for the detection of differentially expressed sRNAs and identification of the resulting expression patterns. The pipeline is available within the UEA sRNA Workbench, a user-friendly software package for the processing of sRNA data sets. We demonstrate the use of the pipeline on a H. sapiens data set; additional examples on a B. terrestris data set and on an A. thaliana data set are described in the Supplemental Information A comparison with existing approaches is also included, which exemplifies some of the issues that need to be addressed for sRNA analysis and how the new pipeline may be used to do this. © 2017 Beckers et al.; Published by Cold Spring Harbor Laboratory Press for the RNA Society.

  9. Assessment and Management of Psychosocial Needs: Social Work Utilization in Comprehensive Cleft Team Care.

    Science.gov (United States)

    Kaye, Alison; Lybrand, Sandra; Chew, William L

    2018-01-01

    To determine family-reported psychosocial stressors and social worker assessments and interventions within a comprehensive cleft team. Single-institution prospective provider-completed survey. Four hundred one families seen by cleft team social worker over a 7-month period. Most families (n = 331; 83%) participated in the team social work assessment. At least 1 active psychosocial stressor was reported by 238 (72%) families, with 63 (19%) families reported 3 or more stressors. There were 34 types of stressors reported. Most common were financial strain, young age of patient, new cleft diagnosis, and distance from clinic (57% of families live over an hour away). Family structure and home environment were assessed in detail for 288 (87%) families. Detailed assessments for access to care and behavioral/developmental issues also figured prominently. Social work interventions were provided in 264 (80%) of the visits, of which 91 were for families of new patients with over half who had infants less than 3 months old. Of the 643 interventions provided, the most frequent were parent mental health screens and counseling, early intervention referrals, transportation assistance, securing local hotel discounts, orthodontic referrals, and orthodontic cost coverage. Approximately 10% of encounters required follow-up contact related to the psychosocial concerns identified in clinic. The inclusion of a cleft team social worker is a critical component of comprehensive cleft team care as evidenced by the large proportion of families who required assistance. Ongoing social work assessments are recommended for each patient to help address the variety of psychosocial stressors families face.

  10. There is another way: The faculty-developed Idaho Comprehensive Literacy Assessment for K-8 pre-service teachers

    Directory of Open Access Journals (Sweden)

    David Squires

    2004-11-01

    Full Text Available In this era of external teacher testing with the intent of ensuring the competence of the teaching force, as well as holding students and institutions accountable for results, the Idaho Comprehensive Literacy Assessment (ICLA stands in sharp contrast. It represents an alternative to external testing of preservice teachers, testing procured from an outside agency unconnected to preservice programs, since it has been developed and is managed by literacy faculty from Idaho’s major institutions of higher learning. This paper provides a brief history of major events in the field of literacy including teacher testing initiatives and policies, which led to the creation of the ICLA. A description of the ICLA assessment and its construction is provided, along with a report of initial performance. Implications and policy consequences of this approach are explored.

  11. Study on quantitative risk assessment model of the third party damage for natural gas pipelines based on fuzzy comprehensive assessment

    International Nuclear Information System (INIS)

    Qiu, Zeyang; Liang, Wei; Lin, Yang; Zhang, Meng; Wang, Xue

    2017-01-01

    As an important part of national energy supply system, transmission pipelines for natural gas are possible to cause serious environmental pollution, life and property loss in case of accident. The third party damage is one of the most significant causes for natural gas pipeline system accidents, and it is very important to establish an effective quantitative risk assessment model of the third party damage for reducing the number of gas pipelines operation accidents. Against the third party damage accident has the characteristics such as diversity, complexity and uncertainty, this paper establishes a quantitative risk assessment model of the third party damage based on Analytic Hierarchy Process (AHP) and Fuzzy Comprehensive Evaluation (FCE). Firstly, risk sources of third party damage should be identified exactly, and the weight of factors could be determined via improved AHP, finally the importance of each factor is calculated by fuzzy comprehensive evaluation model. The results show that the quantitative risk assessment model is suitable for the third party damage of natural gas pipelines and improvement measures could be put forward to avoid accidents based on the importance of each factor. (paper)

  12. Applying comprehensive environmental assessment to research planning for multiwalled carbon nanotubes: Refinements to inform future stakeholder engagement.

    Science.gov (United States)

    Powers, Christina M; Grieger, Khara; Meacham, Connie A; Gooding, Meredith Lassiter; Gift, Jeffrey S; Lehmann, Geniece M; Hendren, Christine O; Davis, J Michael; Burgoon, Lyle

    2016-01-01

    Risk assessments and risk management efforts to protect human health and the environment can benefit from early, coordinated research planning by researchers, risk assessors, and risk managers. However, approaches for engaging these and other stakeholders in research planning have not received much attention in the environmental scientific literature. The Comprehensive Environmental Assessment (CEA) approach under development by the United States Environmental Protection Agency (USEPA) is a means to manage complex information and input from diverse stakeholder perspectives on research planning that will ultimately support environmental and human health decision making. The objectives of this article are to 1) describe the outcomes of applying lessons learned from previous CEA applications to planning research on engineered nanomaterial, multiwalled carbon nanotubes (MWCNTs) and 2) discuss new insights and refinements for future efforts to engage stakeholders in research planning for risk assessment and risk management of environmental issues. Although framed in terms of MWCNTs, this discussion is intended to enhance research planning to support assessments for other environmental issues as well. Key insights for research planning include the potential benefits of 1) ensuring that participants have research, risk assessment, and risk management expertise in addition to diverse disciplinary backgrounds; 2) including an early scoping step before rounds of formal ratings; 3) using a familiar numeric scale (e.g., US dollars) versus ordinal rating scales of "importance"; 4) applying virtual communication tools to supplement face-to-face interaction between participants; and 5) refining criteria to guide development of specific, actionable research questions. © 2015 SETAC.

  13. Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

    Science.gov (United States)

    Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

    2017-08-01

    This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

  14. Dairy reproductive management: assessing a comprehensive continuing education program for veterinary practitioners.

    Science.gov (United States)

    Schuenemann, Gustavo M; Bas, Santiago; Workman, Jeffrey D; Rajala-Schultz, Päivi J

    2010-01-01

    Comprehensive continuing veterinary medical education (CVME) programs are critical for veterinary practitioners to update their knowledge and improve their skills and services. CVME must offer an educational environment in which veterinarians can effectively rejuvenate their knowledge and skills and learn about new practices. The Ohio Dairy Health and Management Certificate Program is a comprehensive CVME program for practicing dairy veterinarians that was developed to provide advanced training on previously identified needs of the dairy industry. Our objectives in this article were (1) to provide a description of a comprehensive CVME program designed to enhance the flow of applied, research-based knowledge from educators and researchers to dairy veterinary practitioners and (2) to provide an assessment of outcomes achieved and experiences gained after the delivery of the first two modules on advanced dairy reproductive management. Findings from the two reproductive modules suggested that (1) the designed dairy reproductive management program was able to meet the participants' educational needs, (2) the implemented delivery methods significantly increased participants' knowledge level, and (3) additional educational needs should be addressed with future programming. In conclusion, results from the participants' self-reports suggested that both reproductive modules were relevant and effective, offering new information with immediate field application. These types of educational programs are important for dairy veterinary practitioners because they are a vital source of information and service providers for dairy producers. For the program to be considered completely successful, a detailed follow-up assessment of participants' behavior change, adoption of new practices and skills, and their on-farm impact is needed.

  15. Interventions for rosacea: abridged updated Cochrane systematic review including GRADE assessments.

    Science.gov (United States)

    van Zuuren, E J; Fedorowicz, Z

    2015-09-01

    Rosacea is a common chronic facial dermatosis. This update of our Cochrane review on interventions for rosacea summarizes the evidence, including Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group assessments, of the effects of the currently available treatments. Searches included the following: Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS and the Science Citation Index, and ongoing trials registries (July 2014). We included 106 randomized controlled trials (RCTs) with 13 631 participants, a more than 80% increase since the last update in 2011. Pooling of data was feasible for a few outcomes, for topical metronidazole and azelaic acid and both appeared to be more effective than placebo (moderate and high-quality evidence, respectively). Topical ivermectin was more effective than placebo based on two studies (high-quality evidence), and slightly more effective than metronidazole in one study. Brimonidine was more effective than vehicle in reducing erythema in rosacea (high-quality evidence). Ciclosporin ophthalmic emulsion was effective for ocular rosacea (low-quality evidence). For oral treatments there was moderate-quality evidence for the effectiveness of tetracycline based on two old studies, and high-quality evidence for doxycycline 40 mg compared with placebo according to physician assessments. One study at high risk of bias demonstrated equivalent effectiveness for azithromycin and doxycycline 100 mg. Minocycline 45 mg may be effective for papulopustular rosacea (low-quality evidence). Low-dose isotretinoin appeared to be slightly more effective than doxycycline 50-100 mg (high-quality evidence). Laser and light-based therapies for erythema in rosacea were effective (low-quality evidence). Further RCTs are required for ocular rosacea. © 2015 British Association of Dermatologists.

  16. Comprehensive Multi-Dimensional MRI for the Simultaneous Assessment of Cardiopulmonary Anatomy and Physiology.

    Science.gov (United States)

    Cheng, Joseph Y; Zhang, Tao; Alley, Marcus T; Uecker, Martin; Lustig, Michael; Pauly, John M; Vasanawala, Shreyas S

    2017-07-13

    Diagnostic testing often assesses the cardiovascular or respiratory systems in isolation, ignoring the major pathophysiologic interactions between the systems in many diseases. When both systems are assessed currently, multiple modalities are utilized in costly fashion with burdensome logistics and decreased accessibility. Thus, we have developed a new acquisition and reconstruction paradigm using the flexibility of MRI to enable a comprehensive exam from a single 5-15 min scan. We constructed a compressive-sensing approach to pseudo-randomly acquire highly subsampled, multi-dimensionally-encoded and time-stamped data from which we reconstruct volumetric cardiac and respiratory motion phases, contrast-agent dynamics, and blood flow velocity fields. The proposed method, named XD flow, is demonstrated for (a) evaluating congenital heart disease, where the impact of bulk motion is reduced in a non-sedated neonatal patient and (b) where the observation of the impact of respiration on flow is necessary for diagnostics; (c) cardiopulmonary imaging, where cardiovascular flow, function, and anatomy information is needed along with pulmonary perfusion quantification; and in (d) renal function imaging, where blood velocities and glomerular filtration rates are simultaneously measured, which highlights the generality of the technique. XD flow has the ability to improve quantification and to provide additional data for patient diagnosis for comprehensive evaluations.

  17. The Effect of Dynamic Assessment on Iranian EFL Learners’ Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Amirian

    2014-06-01

    Full Text Available Dynamic Assessment (DA, is grounded in Vygotsky's idea on Sociocultural Theory (SCT of mind, his concept of Zone of Proximal Development (ZPD and its related metaphor; scaffolding. This study examined the effects of dynamic assessment on improving reading comprehension of Iranian intermediate students who were learning English as a foreign language. The participants, a group of Iranian male intermediate EFL learners ranging in age from 17 to 20, were randomly assigned to two groups of 14. In this study, the experimental and control groups’ performances on pre-tests and post-tests were compared through paired-samples and independent-samples t-tests. The treatment period lasted for 2 months (16 sessions. The results showed that the experimental group, which was instructed through DA, outperformed the control group which was instructed in a non-dynamic way.

  18. Risk assessment of supply chain for pharmaceutical excipients with AHP-fuzzy comprehensive evaluation.

    Science.gov (United States)

    Li, Maozhong; Du, Yunai; Wang, Qiyue; Sun, Chunmeng; Ling, Xiang; Yu, Boyang; Tu, Jiasheng; Xiong, Yerong

    2016-04-01

    As the essential components in formulations, pharmaceutical excipients directly affect the safety, efficacy, and stability of drugs. Recently, safety incidents of pharmaceutical excipients posing seriously threats to the patients highlight the necessity of controlling the potential risks. Hence, it is indispensable for the industry to establish an effective risk assessment system of supply chain. In this study, an AHP-fuzzy comprehensive evaluation model was developed based on the analytic hierarchy process and fuzzy mathematical theory, which quantitatively assessed the risks of supply chain. Taking polysorbate 80 as the example for model analysis, it was concluded that polysorbate 80 for injection use is a high-risk ingredient in the supply chain compared to that for oral use to achieve safety application in clinic, thus measures should be taken to control and minimize those risks.

  19. Comprehensive vulnerability assessment method for nodes considering anti-interference ability and influence

    Science.gov (United States)

    LUO, Jianchun; WANG, Yunyu; YANG, Jun; RAN, hong; PENG, Xiaodong; HUANG, Ming; FENG, Hao; LIU, Meijun

    2018-03-01

    The vulnerability assessment of power grid is of great significance in the current research. Power system faces many kinds of uncertainty factors, and the disturbance caused by them has become one of the main factors which restrict the safe operation of power grid. To solve this problem, considering the anti-interference ability of the system when the system is disturbed and the effect of the system when the node is out of operation, a set of index to reflect the anti-interference ability and the influence of nodes are set up. On this basis, a new comprehensive vulnerability assessment method of nodes is put forward by using super efficiency data envelopment analysis to scientific integration. Finally, the simulative results of IEEE30-bus system indicated that the proposed model is rational and valid.

  20. Comprehensive assessment of xerostomia in patients receiving radiation for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Vijaya Aditya Yadaraju

    2016-06-01

    Full Text Available Purpose: Xerostomia is a well known complication of radiation for head and neck cancer. It causes significant impairment of Quality Of Life (QOL.Comprehensive assessment is possible with the help of scintigraphy, Dose-volume histogram (DVH parameters as well as QOL questionnaire.Methods: Thirty patients of head and neck cancer undergoing radiation were assessed for xerostomia. Scintigraphic assessment of parotid gland function was done before and at six weeks after radiation. QOL questionnaire was administered before, during, and at six weeks after radiation as well as at two years of follow up. Dose received by parotids were correlated with scintigraphic and QOL outcomes.Results: Mean parotid gland volume and dose received were 24.9 cc and 45.3 Gy respectively. Mean Salivary Excretion Factor (SEF decreased from 54.1 to 12 at six weeks after radiation. QOL scores worsened from first week (mean value: 2.37 of radiotherapy (RT to fourth week (mean value: 15.50, p < 0.0000 , remained same till completion of RT (mean value: 17.57, p = 0.1063 and at six weeks after radiation (mean value:16.10, p = 0.2519 . There was a significant decrease in QOL scores between post RT six weeks versus two years follow up (p < 0.0000. Mean parotid dose and QOL scores correlated at six weeks (p < 0.0000, whereas no correlation was found between SEF and QOL.Conclusion: Comprehensive assessment of parotid gland function with Scintigraphy, QOL questionnaire and its correlation with dose volume parameters is helpful in quantifying xerostomia. Even though radiation induced xerostomia persisted for a long time after radiation, it did not translate to decreased QOL.

  1. Improving assessment in dental education through a paradigm of comprehensive care: a case report.

    Science.gov (United States)

    Nulty, Duncan D; Short, Leonie M; Johnson, Newell W

    2010-12-01

    The assessment of clinical competence in health disciplines is a critical issue. Universities have a responsibility to graduate students who can demonstrate fitness to practice because clinical competence relates directly to the quality of patients' care-the quality of their treatment, their health outcomes, and their experience. In respect of the last of these, this article argues that the nature of what we term "clinical competence" ought to recognize the patient before the medical/dental condition or clinical intervention and, in order to achieve this, dental education should adopt learning, teaching, and assessment strategies that develop integrated learning outcomes consistent with a paradigm of comprehensive care. The article describes the ways in which this paradigm has been operationalized in the learning, teaching, and assessment strategies at Griffith University in Australia. It places a particular focus upon the assessment methods used in the Bachelor of Oral Health program. In this way, the article aims to illustrate ways that the quality of the assessment of clinical competence can, and should, be improved. While this is a work in progress, this description may be useful for educators at other academic dental institutions who wish to adopt, adapt, and develop similar approaches.

  2. Abuse liability assessment of tobacco products including potential reduced exposure products.

    Science.gov (United States)

    Carter, Lawrence P; Stitzer, Maxine L; Henningfield, Jack E; O'Connor, Rich J; Cummings, K Michael; Hatsukami, Dorothy K

    2009-12-01

    The harm produced by tobacco products is a result of frequent use of a highly toxic product. Reducing the adverse public health impact of tobacco products might be most effectively achieved by reducing the likelihood of their use and the toxicity of the products. Products that retain some characteristics of cigarettes but have been altered with the intention of reducing toxicity have been referred to as modified risk tobacco products or potential reduced exposure products (MRTP/PREP). Evaluation of their content, emission, and toxicity is discussed in other articles in this special issue. Here, we discuss the methodology that has been used to examine the likelihood of abuse or addiction. Abuse liability assessment (ALA) methodology has been used by the Food and Drug Administration (FDA) and other drug regulatory agencies world-wide for decades to assess the risks posed by a wide variety of pharmacologically active substances. ALA is routinely required among other evaluations of safety during the pre-market assessment of new drugs, and is continually adapted to meet the challenges posed by new drug classes and drug formulations. In the 2009 law giving FDA regulation over tobacco products, FDA is now required to evaluate new tobacco products including MRTP/PREPs to determine their risk for abuse and toxicity at the population level. This article describes the traditional tools and methods of ALA that can be used to evaluate new tobacco and nicotine products including MRTP/PREPs. Such ALA data could contribute to the scientific foundation on which future public policy decisions are based.

  3. Abuse Liability Assessment of Tobacco Products Including Potential Reduced Exposure Products (PREPs)

    Science.gov (United States)

    Carter, Lawrence P.; Stitzer, Maxine L.; Henningfield, Jack E.; O'Connor, Rich J.; Cummings, K. Michael; Hatsukami, Dorothy K.

    2009-01-01

    The harm produced by tobacco products is a result of frequent use of a highly toxic product. Reducing the adverse public health impact of tobacco products might be most effectively achieved by reducing the likelihood of their use and the toxicity of the products. Products that retain some characteristics of cigarettes, but have been altered with the intention of reducing toxicity have been referred to as modified risk tobacco products or potential reduced exposure products (MRTP/PREPS). Evaluation of their content, emission, and toxicity is discussed in other articles in this special issue. Here, we discuss the methodology that has been used to examine the likelihood of abuse or addiction. Abuse liability assessment (ALA) methodology has been used by the Food and Drug Administration (FDA) and other drug regulatory agencies world-wide for decades to assess the risks posed by a wide variety of pharmacologically active substances. ALA is routinely required among other evaluations of safety during the premarket assessment of new drugs, and is continually adapted to meet the challenges posed by new drug classes and drug formulations. In the 2009 law giving FDA regulation over tobacco products, FDA is now required to evaluate new tobacco products including MRTP/PREPs to determine their risk for abuse and toxicity at the population level. This paper describes the traditional tools and methods of ALA that can be used to evaluate new tobacco and nicotine products including MRTP/PREPs. Such ALA data could contribute to the scientific foundation on which future public policy decisions are based. PMID:19959676

  4. A global call for action to include gender in research impact assessment.

    Science.gov (United States)

    Ovseiko, Pavel V; Greenhalgh, Trisha; Adam, Paula; Grant, Jonathan; Hinrichs-Krapels, Saba; Graham, Kathryn E; Valentine, Pamela A; Sued, Omar; Boukhris, Omar F; Al Olaqi, Nada M; Al Rahbi, Idrees S; Dowd, Anne-Maree; Bice, Sara; Heiden, Tamika L; Fischer, Michael D; Dopson, Sue; Norton, Robyn; Pollitt, Alexandra; Wooding, Steven; Balling, Gert V; Jakobsen, Ulla; Kuhlmann, Ellen; Klinge, Ineke; Pololi, Linda H; Jagsi, Reshma; Smith, Helen Lawton; Etzkowitz, Henry; Nielsen, Mathias W; Carrion, Carme; Solans-Domènech, Maite; Vizcaino, Esther; Naing, Lin; Cheok, Quentin H N; Eckelmann, Baerbel; Simuyemba, Moses C; Msiska, Temwa; Declich, Giovanna; Edmunds, Laurel D; Kiparoglou, Vasiliki; Buchan, Alison M J; Williamson, Catherine; Lord, Graham M; Channon, Keith M; Surender, Rebecca; Buchan, Alastair M

    2016-07-19

    Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.

  5. Reliability and validity of the C-BiLLT: a new instrument to assess comprehension of spoken language in young children with cerebral palsy and complex communication needs.

    Science.gov (United States)

    Geytenbeek, Joke J; Mokkink, Lidwine B; Knol, Dirk L; Vermeulen, R Jeroen; Oostrom, Kim J

    2014-09-01

    In clinical practice, a variety of diagnostic tests are available to assess a child's comprehension of spoken language. However, none of these tests have been designed specifically for use with children who have severe motor impairments and who experience severe difficulty when using speech to communicate. This article describes the process of investigating the reliability and validity of the Computer-Based Instrument for Low Motor Language Testing (C-BiLLT), which was specifically developed to assess spoken Dutch language comprehension in children with cerebral palsy and complex communication needs. The study included 806 children with typical development, and 87 nonspeaking children with cerebral palsy and complex communication needs, and was designed to provide information on the psychometric qualities of the C-BiLLT. The potential utility of the C-BiLLT as a measure of spoken Dutch language comprehension abilities for children with cerebral palsy and complex communication needs is discussed.

  6. Carbon sequestration by patch fertilization: A comprehensive assessment using coupled physical-ecological-biogeochemical models

    Energy Technology Data Exchange (ETDEWEB)

    Sarmiento, Jorge L. [Princeton Univ., NJ (United States); Gnanadesikan, Anand [Princeton Univ., NJ (United States); Gruber, Nicolas [Univ. of California, Los Angeles, CA (United States); Jin, Xin [Univ. of California, Los Angeles, CA (United States); Armstrong, Robert [State Univ. of New York (SUNY), Plattsburgh, NY (United States)

    2007-06-21

    This final report summarizes research undertaken collaboratively between Princeton University, the NOAA Geophysical Fluid Dynamics Laboratory on the Princeton University campus, the State University of New York at Stony Brook, and the University of California, Los Angeles between September 1, 2000, and November 30, 2006, to do fundamental research on ocean iron fertilization as a means to enhance the net oceanic uptake of CO2 from the atmosphere. The approach we proposed was to develop and apply a suite of coupled physical-ecological-biogeochemical models in order to (i) determine to what extent enhanced carbon fixation from iron fertilization will lead to an increase in the oceanic uptake of atmospheric CO2 and how long this carbon will remain sequestered (efficiency), and (ii) examine the changes in ocean ecology and natural biogeochemical cycles resulting from iron fertilization (consequences). The award was funded in two separate three-year installments: September 1, 2000 to November 30, 2003, for a project entitled “Ocean carbon sequestration by fertilization: An integrated biogeochemical assessment.” A final report was submitted for this at the end of 2003 and is included here as Appendix 1; and, December 1, 2003 to November 30, 2006, for a follow-on project under the same grant number entitled “Carbon sequestration by patch fertilization: A comprehensive assessment using coupled physical-ecological-biogeochemical models.” This report focuses primarily on the progress we made during the second period of funding subsequent to the work reported on in Appendix 1. When we began this project, we were thinking almost exclusively in terms of long-term fertilization over large regions of the ocean such as the Southern Ocean, with much of our focus being on how ocean circulation and biogeochemical cycling would interact to control the response to a given fertilization scenario. Our research on these types of scenarios, which was carried out largely during the

  7. Reliability of the qualitative behavior assessment as included in the Welfare Quality Assessment protocol for growing pigs.

    Science.gov (United States)

    Czycholl, I; Beilage, E Grosse; Henning, C; Krieter, J

    2017-08-01

    Positive emotions constitute a very important part of animal welfare. They are, however, also the most challenging elements to be objectively measured. Due to its feasibility, the qualitative behavior assessment (QBA) is included in the Welfare Quality Assessment protocol for growing pigs as the animal-based measurement tool for positive emotions. Reliability testing on the QBA in the form as included in the protocols is, however, rare. Therefore, the present study aimed at the evaluation of the inter- and intraobserver as well as test-retest reliability of the QBA in growing pigs. This was done by trained observers based on 19 joint on-farm assessments, the repeated assessments of 24 farms during 2 growing periods, and 107 video sequences. The results were compared between the observers and the repeated farm visits. Therefore, millimeter values were directly compared by calculation of Spearman's rank correlation coefficients (RS), and furthermore, the results were subjected to a principal component analysis (PCA). The results identified 2 main principal components (PC; PC1 and PC2) together explaining from 42 to 75% of the variation in the recorded variables of the different PCA. The factor loadings that the adjectives reached on PC1 and PC2 were compared by calculation of RS between observers and farm visits, respectively. Reliability was interpreted as acceptable if at least a moderate correlation was detected; that is, RS was greater than or equal to 0.4. Regarding the on-farm assessments, and, therefore, under practical conditions, no sufficient interobserver reliability (RS = -0.16 for PC1 and RS = 0.13 for PC2) was found. In terms of the test-retest reliability, only 1 comparison of 2 farm visits showed a positive correlation for PC1 (RS = 0.79) as well as for PC2 (RS = 0.64). The other 5 comparisons presented negative to weak positive correlations. However, based on video sequences, good interobserver (RS = 0.67 for PC1 and RS = 0.60 for PC2) and

  8. A comparison of end-stage renal disease and Alzheimer's disease in the elderly through a comprehensive geriatric assessment.

    Science.gov (United States)

    Soysal, Pinar; Isik, Ahmet Turan; Buyukaydin, Banu; Kazancioglu, Rumeyza

    2014-08-01

    The percentage of patients receiving haemodialysis (HD) treatment and of patients with Alzheimer's disease (AD) within the elderly population is increasing day by day. Functional dependence, malnutrition, cognitive impairment or depression impairs the quality of life and increases mortality in both diseases. This study aims to assess HD and AD patients through comprehensive geriatric assessment (CGA) and compare their results. A total of 579 patients (121 HD, 188 AD patients and 270 control subjects) over the age of 65, who were followed at geriatric and nephrology departments between January 2011 and July 2012, were included in this prospective cross-sectional study. Mini-Mental State Examination, Mini-Nutritional Assessment, Geriatric Depression Scale and basic and Instrumental Activities of Daily Living indexes were applied to all patients. The results obtained were compared among the patient groups. The mean age of the participants was 72.6 ± 8.2. Based on the CGA findings, the results for both groups were considerably different from control group. While depression scores were observed higher in HD patients than in AD patients, cognition, nutrition and functional capacity were mostly affected in AD patients. The management of geriatric HD patients is substantially complex. Depression, cognitive impairment and decrease in functional capacity can often be overlooked, so findings may be ascribed to underlying kidney impairment. Therefore, comprehensive geriatric assessment should be regularly performed in HD patients in order to detect problems at an early stage, to take necessary preventative measures, to initiate treatment as soon as possible and to enhance quality of life.

  9. Fuzzy comprehensive evaluation of multiple environmental factors for swine building assessment and control.

    Science.gov (United States)

    Xie, Qiuju; Ni, Ji-Qin; Su, Zhongbin

    2017-10-15

    In confined swine buildings, temperature, humidity, and air quality are all important for animal health and productivity. However, the current swine building environmental control is only based on temperature; and evaluation and control methods based on multiple environmental factors are needed. In this paper, fuzzy comprehensive evaluation (FCE) theory was adopted for multi-factor assessment of environmental quality in two commercial swine buildings using real measurement data. An assessment index system and membership functions were established; and predetermined weights were given using analytic hierarchy process (AHP) combined with knowledge of experts. The results show that multi-factors such as temperature, humidity, and concentrations of ammonia (NH 3 ), carbon dioxide (CO 2 ), and hydrogen sulfide (H 2 S) can be successfully integrated in FCE for swine building environment assessment. The FCE method has a high correlation coefficient of 0.737 compared with the method of single-factor evaluation (SFE). The FCE method can significantly increase the sensitivity and perform an effective and integrative assessment. It can be used as part of environmental controlling and warning systems for swine building environment management to improve swine production and welfare. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Comprehensive assessment of cytochromes P450 and transporter genetics with endoxifen concentration during tamoxifen treatment.

    Science.gov (United States)

    Marcath, Lauren A; Deal, Allison M; Van Wieren, Emily; Danko, William; Walko, Christine M; Ibrahim, Joseph G; Weck, Karen E; Jones, David R; Desta, Zeruesenay; McLeod, Howard L; Carey, Lisa A; Irvin, William J; Hertz, Daniel L

    2017-11-01

    Tamoxifen bioactivation to endoxifen is mediated primarily by CYP2D6; however, considerable variability remains unexplained. Our aim was to perform a comprehensive assessment of the effect of genetic variation in tamoxifen-relevant enzymes and transporters on steady-state endoxifen concentrations. Comprehensive genotyping of CYP enzymes and transporters was performed using the iPLEX ADME PGx Pro Panel in 302 tamoxifen-treated breast cancer patients. Predicted activity phenotype for 19 enzymes and transporters were analyzed for univariate association with endoxifen concentration, and then adjusted for CYP2D6 and clinical covariates. In univariate analysis, higher activity of CYP2C8 (regression β=0.22, P=0.020) and CYP2C9 (β=0.20, P=0.04), lower body weight (β=-0.014, P<0.0001), and endoxifen measurement during winter (each β<-0.39, P=0.002) were associated with higher endoxifen concentrations. After adjustment for the CYP2D6 diplotype, weight, and season, CYP2C9 remained significantly associated with higher concentrations (P=0.02), but only increased the overall model R by 1.3%. Our results further support a minor contribution of CYP2C9 genetic variability toward steady-state endoxifen concentrations. Integration of clinician and genetic variables into individualized tamoxifen dosing algorithms would marginally improve their accuracy and potentially enhance tamoxifen treatment outcomes.

  11. Psychometric validation of the Sentence Verification Technique to assess L2 reading comprehension ability

    Directory of Open Access Journals (Sweden)

    François Pichette

    2014-09-01

    Full Text Available English teachers use the Sentence Verification Technique (Royer et al., 1979 to determine the readability of written material for their classes. This process requires students to read short passages from a book, followed by isolated sentences. These sentences can be either identical or different from the original passages, in their meaning as well as in their form. For each sentence, students must indicate whether or not itscontent corresponds to that of the original passage. This paper reports on the design and assessment of an SVT test created for measuring reading comprehension ability, based on four English texts. The instrument was administered to 171 adult English learners, of various levels of English proficiency. The data were analysed using both traditional psychometric methods and the Raschmodel. Results indicate that the test shows high internal consistency, that it respects the basic assumptions behind the Rasch model, and that it is in the recommended range of difficulty for that technique.

  12. 77 FR 61012 - Expansion of Importer Self-Assessment Program To Include Qualified Importers of Focused...

    Science.gov (United States)

    2012-10-05

    ... announces changes to the Importer Self- Assessment (ISA) program and describes the requirements for... . SUPPLEMENTARY INFORMATION: Background Importer Self-Assessment Program and the Focused Assessment The Importer Self-Assessment (ISA) program is a joint government- business initiative designed to build cooperative...

  13. Towards a comprehensive assessment and framework for low and high flow water risks

    Science.gov (United States)

    Motschmann, Alina; Huggel, Christian; Drenkhan, Fabian; León, Christian

    2017-04-01

    Driven by international organizations such as the Intergovernmental Panel on Climate Change (IPCC) the past years have seen a move from a vulnerability concept of climate change impacts towards a risk framework. Risk is now conceived at the intersection of climate-driven hazard and socioeconomic-driven vulnerability and exposure. The concept of risk so far has been mainly adopted for sudden-onset events. However, for slow-onset and cumulative climate change impacts such as changing water resources there is missing clarity and experience how to apply a risk framework. Research has hardly dealt with the challenge of how to integrate both low and high flow risks in a common framework. Comprehensive analyses of risks related to water resources considering climate change within multi-dimensional drivers across different scales are complex and often missing in climate-sensitive mountain regions where data scarcity and inconsistencies represent important limitations. Here we review existing vulnerability and risk assessments of low and high flow water conditions and identify critical conceptual and practical gaps. Based on this, we develop an integrated framework for low and high flow water risks which is applicable to both past and future conditions. The framework explicitly considers a water balance model simulating both water supply and demand on a daily basis. We test and apply this new framework in the highly glacierized Santa River catchment (SRC, Cordillera Blanca, Peru), representative for many developing mountain regions with both low and high flow water risks and poor data availability. In fact, in the SRC, both low and high flow hazards, such as droughts and floods, play a central role especially for agricultural, hydropower, domestic and mining use. During the dry season (austral winter) people are increasingly affected by water scarcity due to shrinking glaciers supplying melt water. On the other hand during the wet season (austral summer) high flow water

  14. Comprehensive, Quantitative Risk Assessment of CO{sub 2} Geologic Sequestration

    Energy Technology Data Exchange (ETDEWEB)

    Lepinski, James

    2013-09-30

    A Quantitative Failure Modes and Effects Analysis (QFMEA) was developed to conduct comprehensive, quantitative risk assessments on CO{sub 2} capture, transportation, and sequestration or use in deep saline aquifers, enhanced oil recovery operations, or enhanced coal bed methane operations. The model identifies and characterizes potential risks; identifies the likely failure modes, causes, effects and methods of detection; lists possible risk prevention and risk mitigation steps; estimates potential damage recovery costs, mitigation costs and costs savings resulting from mitigation; and ranks (prioritizes) risks according to the probability of failure, the severity of failure, the difficulty of early failure detection and the potential for fatalities. The QFMEA model generates the necessary information needed for effective project risk management. Diverse project information can be integrated into a concise, common format that allows comprehensive, quantitative analysis, by a cross-functional team of experts, to determine: What can possibly go wrong? How much will damage recovery cost? How can it be prevented or mitigated? What is the cost savings or benefit of prevention or mitigation? Which risks should be given highest priority for resolution? The QFMEA model can be tailored to specific projects and is applicable to new projects as well as mature projects. The model can be revised and updated as new information comes available. It accepts input from multiple sources, such as literature searches, site characterization, field data, computer simulations, analogues, process influence diagrams, probability density functions, financial analysis models, cost factors, and heuristic best practices manuals, and converts the information into a standardized format in an Excel spreadsheet. Process influence diagrams, geologic models, financial models, cost factors and an insurance schedule were developed to support the QFMEA model. Comprehensive, quantitative risk assessments

  15. Nutritional status of an elderly population in Southwest China: a cross-sectional study based on comprehensive geriatric assessment.

    Science.gov (United States)

    Shi, R; Duan, J; Deng, Y; Tu, Q; Cao, Y; Zhang, M; Zhu, Q; Lü, Y

    2015-01-01

    Few data is available on the nutritional status of old Chinese. The present study aimed to describe the nutritional status and clinical correlates for malnutrition risk in the older people. Cross-sectional study. Hospital- and community-based older people were recruited in the region of Chongqing, China. 558 individuals aged 60 years old or over between April 2011 and October 2012. Comprehensive geriatric assessment was performed and nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). Nutrition-associated factors were analyzed, including health status (chronic diseases, depression, cognition, function impaired), social factors (education status, marital status, the type of work before 60 years old) and life style factors (smoking, drinking, diet). The mean age was 73.1±8.0 years and 43.9% were men. Prevalence of malnutrition and risk for malnutrition were 3.2% and 19.3 %, respectively. Several factors increased poor nutrition independently including self-rated health, comorbidity, chronic obstructive pulmonary disease, gastrointestinal disease and cognitive impairment. Fish decreased the risk of poor nutrition. The prevalence was relatively low in older people of Chongqing, Southwest China. Poor nutrition was found to be increased due to the common health problems. Thus the patients with these problems should pay more attention on nutritional status. The older people should often have fish because of their nutritional benefit.

  16. A Comprehensive Evaluation of Standardized Assessment Tools in the Diagnosis of Fibromyalgia and in the Assessment of Fibromyalgia Severity

    OpenAIRE

    Boomershine, Chad S.

    2012-01-01

    Standard assessments for fibromyalgia (FM) diagnosis and core FM symptom domains are needed for biomarker development and treatment trials. Diagnostic and symptom assessments are reviewed and recommendations are made for standards. Recommendations for existing assessments include the American College of Rheumatology FM classification criteria using the manual tender point Survey for diagnosis, the brief pain inventory average pain visual analogue scale for pain intensity, the function subscal...

  17. A comprehensive plant-wide assessment of Amcor PET Packaging at Fairfield, California

    Energy Technology Data Exchange (ETDEWEB)

    Kevin Losh; Hui Choi; Yin Yin Wu; Bryan W. Hackett; Ahmad R. Ganji

    2008-02-29

    This report includes the results of the plant-wide assessment of AMCOR PET plants in Fairfield, City of Commerce, and Lathrop California. The project (except the assessment of Lathrop plant) was a cost shared effort between US Department of Energy through Golden Field Office, Golden CO and AMCOR PET Packaging Co. The DOE share of the plant-wide assessment cost was awarded to AMCOR PET in response to the RFP DE-PS36-05GO95009, the 2005 round of funding for “Plant-Wide Energy Efficiency Opportunity Assessments.” The plant-wide assessment included the processes, electrical and gas equipment. Current production practices have been evaluated against best practice standards, as well as utilization of modern technology to improve energy efficiency, reduce the wastes, and improve productivity.

  18. Strategic Materials in the Automobile: A Comprehensive Assessment of Strategic and Minor Metals Use in Passenger Cars and Light Trucks.

    Science.gov (United States)

    Field, Frank R; Wallington, Timothy J; Everson, Mark; Kirchain, Randolph E

    2017-12-19

    A comprehensive component-level assessment of several strategic and minor metals (SaMMs), including copper, manganese, magnesium, nickel, tin, niobium, light rare earth elements (LREEs; lanthanum, cerium, praseodymium, neodymium, promethium, and samarium), cobalt, silver, tungsten, heavy rare earth elements (yttrium, europium, gadolinium, terbium, dysprosium, holmium, erbium, thulium, ytterbium, and lutetium), and gold, use in the 2013 model year Ford Fiesta, Focus, Fusion, and F-150 is presented. Representative material contents in cars and light-duty trucks are estimated using comprehensive, component-level data reported by suppliers. Statistical methods are used to accommodate possible errors within the database and provide estimate bounds. Results indicate that there is a high degree of variability in SaMM use and that SaMMs are concentrated in electrical, drivetrain, and suspension subsystems. Results suggest that trucks contain greater amounts of aluminum, nickel, niobium, and silver and significantly greater amounts of magnesium, manganese, gold, and LREEs. We find tin and tungsten use in automobiles to be 3-5 times higher than reported by previous studies which have focused on automotive electronics. Automotive use of strategic and minor metals is substantial, with 2013 vehicle production in the United States, Canada, EU15, and Japan alone accounting for approximately 20% of global production of Mg and Ta and approximately 5% of Al, Cu, and Sn. The data and analysis provide researchers, recyclers, and decision-makers additional insight into the vehicle content of strategic and minor metals of current interest.

  19. Radiology residents' comprehension of the breast imaging reporting and data system: The ultrasound lexicon and final assessment category

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sun Hye; Lee, Eun Hye [Bucheon Hospital, Bucheon (Korea, Republic of); Roh, Yun Ho; Kim, Min Jung; Youk, Ji Hyun [Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoon, Jung Hyun; Kim, Sung Hun [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, You Me [Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2017-07-15

    To evaluate radiology residents' performance in interpretation and comprehension of breast ultrasonographic descriptors in the Breast Imaging Reporting and Data System (BI-RADS) to suggest the adequate duration of training in breast ultrasonography. A total of 102 radiology residents working in the Department of Radiology were included in this study. They were asked to answer 16 questions about the ultrasonographic lexicon and 11 questions about the BI-RADS category. We analyzed the proportion of correct answers according to the radiology residents’ year of training and duration of breast imaging training. With respect to the duration of breast imaging training, the proportion of correct answers for lexicon descriptors ranged from 77.2% to 81.3% (p = 0.368) and the proportion of correct answers for the BI-RADS category was highest after three-four months of training compared with after one month of training (p = 0.033). The proportion of correct answers for lexicon descriptors and BI-RADS category did not differ significantly according to the year of residency training. Radiology residents' comprehension of the BI-RADS category on breast ultrasonography was not associated with their year of residency training. Based on our findings, radiology residents' assessment of the BI-RADS category was significantly improved with three-four months of training compared with one month of training.

  20. Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD : A Delphi Panel Study among Dutch Experts

    NARCIS (Netherlands)

    van den Akker, Edmée F M M; van't Hul, Alex J.; Birnie, Erwin; Chavannes, Niels H.; Rutten-van Mölken, Maureen P M H; In't Veen, Johannes C C M

    2017-01-01

    A comprehensive diagnostic assessment is needed to improve understanding of the health status of patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, this study investigated which components and subsequent instruments should be part of a holistic assessment in secondary

  1. A science plan for a comprehensive assessment of water supply in the region underlain by fractured rock in Maryland

    Science.gov (United States)

    Fleming, Brandon J.; Hammond, Patrick A.; Stranko, Scott A.; Duigon, Mark T.; Kasraei, Saeid

    2012-01-01

    The fractured rock region of Maryland, which includes land areas north and west of the Interstate 95 corridor, is the source of water supply for approximately 4.4 million Marylanders, or approximately 76 percent of the State's population. Whereas hundreds of thousands of residents rely on wells (both domestic and community), millions rely on surface-water sources. In this region, land use, geology, topography, water withdrawals, impoundments, and other factors affect water-flow characteristics. The unconfined groundwater systems are closely interconnected with rivers and streams, and are affected by seasonal and climatic variations. During droughts, groundwater levels drop, thereby decreasing well yields, and in some cases, wells have gone dry. Low ground-water levels contribute to reduced streamflows, which in turn, can lead to reduced habitat for aquatic life. Increased demand, over-allocation, population growth, and climate change can affect the future sustainability of water supplies in the region of Maryland underlain by fractured rock. In response to recommendations of the 2008 Advisory Committee on the Management and Protection of the State's Water Resources report, the Maryland Department of the Environment's Water Supply Program, the Maryland Geological Survey, the Maryland Department of Natural Resources, Monitoring and Non-Tidal Assessment (MANTA) Division, and the U.S. Geological Survey have developed a science plan for a comprehensive assessment that will provide new scientific information, new data analysis, and new tools for the State to better manage water resources in the fractured rock region of Maryland. The science plan lays out five goals for the comprehensive assessment: (1) develop tools for the improved management and investigation of groundwater and surface-water resources; (2) characterize factors affecting reliable yields of individual groundwater and surface-water supplies; (3) investigate impacts on nearby water withdrawal users caused

  2. Assessing metaphor comprehension as a metasemantic ability in students from 9-to-14 years-old.

    Directory of Open Access Journals (Sweden)

    Paolo Iliceto

    2011-01-01

    Full Text Available This article presents a test for assessing metaphor comprehension (MCT in explicit linguistic form for subjects aged 9- to 14 years-old, i.e. in a transitional age where significant qualitative changes appear for this type of ability. Metaphor is viewed as a form of semantic conflict induced by the anomalous combination of the conventional meanings of its main constituents - tenor and vehicle - and metaphor comprehension is framed as a metasemantic ability based on the analysis of these meanings (Gombert 1990, that can have implications both for teaching and for learning strategies.The authors propose a functionalist piagetian frame, based on Piaget’s latest equilibration model (1975, for analysing how this semantic conflict can be faced and solved by children in the developmental span considered. The test is paper-and-pencil, composed of 12 items subdivided into 2 groups of metaphors: Psycho-physical (PP and Conceptual (C, mainly drawn and adapted to Italian language from international literature on metaphor comprehension. The sample is composed of 874 Italian children from 4th to 8th grade, with gender balance, of average social background. By means of Principal Components Analysis, with oblimin rotation, a two-factor solution emerged, that espouses the C/PP metaphors distinction. All corrected item-total correlation coefficients >.30 were representative and acceptable. Correlation coefficients between MCT and Standard progressive Matrices (SPM38 and some validated metalinguistic subtests were all significant at p <0.01 level, showing good convergent validity. Cronbach’s Alpha coefficients for the two subscales were: .62 (C, .51 (PP and .70 for MCT total score. Test-retest correlation oefficients for the two subscales were .79 (C, .69 (PP, and .83 for MCT total score. Cohen’s Kappa coefficients for interrater reliability are: .75 (4th-5th, .74 (6th, .67 (7th, .81 (8th. A twofactor ANOVA (gender and age showed that the test is gender

  3. Hemophilia and von Willebrand's disease: 1. Diagnosis, comprehensive care and assessment. Association of Hemophilia Clinic Directors of Canada.

    Science.gov (United States)

    1995-07-01

    To present current strategies for the assessment and comprehensive care of patients with hemophilia and von Willebrand's disease. Hospital care, home care, single-provider care and multidisciplinary care. Morbidity and quality of life associated with bleeding and treatment. Relevant clinical studies and reports published from 1974 to 1994 were examined. A search was conducted of own reprint files, MEDLINE, citations in the articles reviewed and references provided by colleagues. In the MEDLINE search the following terms were used singly or in combination: "hemophilia," "von Willebrand's disease," "Factor VIII," "Factor IX," "von Willebrand factor," "diagnosis," "management," "home care," "comprehensive care," "inhibitor," "AIDS," "hepatitis," "life expectancy," "complications," "practice guidelines," "consensus statement" and "controlled trial." The in-depth review included only articles written in English from North America and Europe that were relevant to human disease and to a predetermined outline. The availability of treatment products in Canada was also considered. Minimizing morbidity and maximizing functional status and quality of life were given a high value. The optimal use of treatment procedures and home care offers patients the advantages of minimized disability, improved survival and financial benefit. It is also cost effective. Potential harm, including the risk of hepatitis B, hepatitis C and HIV infection, has now been minimized through viral inactivation of plasma-derived coagulation-factor concentrates and through the use of recombinant clotting factor concentrates and other non-plasma-derived hemostatic agents. Patients with hemophilia and severe von Willebrand's disease should be followed in comprehensive care centres that offer expertise in the diagnosis, assessment and management of bleeding and complications and that can meet the educational and counselling needs of patients, family members and health care providers. Eligible patients should

  4. Comprehensive calculation and safety assessment of parametric roll of very large container ship

    Directory of Open Access Journals (Sweden)

    MA Chengyuan

    2017-05-01

    Full Text Available As the significant variation of GM in waves for very large container ships, strict demands are raised for this ship type in the evaluation and safety assessment of parametric roll. Targeting a 10 000 TEU container ship sailing in head sea, this study conducts a series of calculations and evaluations on parametric roll motion in which each loading condition is calculated step-by-step. Direct calculation is conducted if neither Level 1 nor Level 2 is satisfied. In this paper, an independently developed time-domain simulation is conducted for loading conditions that fail to match the Level 2 criteria, which is based on a typical 3-DOF weakly nonlinear numerical model. Ship velocity and wave conditions are taken into consideration to explore sensible conditions concerning parametric roll. Finally, according to the results, corresponding safety assessments and several avoidance measures are proposed, such as reducing the height of the center of gravity and raising the speed moderately. In addition, if wave predictions can be detected in advance, the circumstance of the natural rolling period being twice as great as the encountering period should be avoided, which is the most sensible factor for inducing parametric roll. Comprehensive calculation and checking for the 10 000 TEU ship can instruct the general design and improve safety for very large container ships; as a result, remarkable engineering applications and reference value can be recognized.

  5. Fuzzy Comprehensive Evaluation-Based Disaster Risk Assessment of Desertification in Horqin Sand Land, China

    Directory of Open Access Journals (Sweden)

    Yongfang Wang

    2015-02-01

    Full Text Available Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the methodology and procedure for risk assessment and zoning of desertification disasters in Horqin Sand Land. Based on natural disaster risk theory and the desertification disaster formation mechanism, the Desertification Disaster Risk Index (DDRI combined hazard, exposure, vulnerability and restorability factors and was developed mainly by using multi-source data and the fuzzy comprehensive evaluation method. The results showed that high risk and middle risk areas account for 28% and 23% of the study area, respectively. They are distributed with an “S” type in the study area. Low risk and very low risk areas account for 21% and 10% of the study area, respectively. They are distributed in the west-central and southwestern parts. Very high risk areas account for 18% of the study area and are distributed in the northeastern parts. The results can be used to know the desertification disaster risk level. It has important theoretical and practical significance to prevention and control of desertification in Horqin Sand Land and even in Northern China.

  6. Portfolio: A Comprehensive Method of Assessment for Postgraduates in Oral and Maxillofacial Surgery

    OpenAIRE

    Kadagad, Poornima; Kotrashetti, S. M.

    2012-01-01

    Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a...

  7. Does the component processes task assess text-based inferences important for reading comprehension? A path analysis in primary school children

    NARCIS (Netherlands)

    S.I. Wassenburg (Stephanie); B.B. de Koning (Björn); de Vries, M.H. (Meinou H.); M. van der Schoot (Menno)

    2016-01-01

    textabstractUsing a component processes task (CPT) that differentiates between higher-level cognitive processes of reading comprehension provides important advantages over commonly used general reading comprehension assessments. The present study contributes to further development of the CPT by

  8. Does the component processes task assess text-based inferences important for reading comprehension? A path analysis in primary school children

    NARCIS (Netherlands)

    Wassenburg, Stephanie I.; de Koning, Björn B.; de Vries, Meinou H.; van der Schoot, Menno

    2016-01-01

    Using a component processes task (CPT) that differentiates between higher-level cognitive processes of reading comprehension provides important advantages over commonly used general reading comprehension assessments. The present study contributes to further development of the CPT by evaluating the

  9. Including climate change in pest risk assessment: the peach fruit fly, Bactrocera zonata (Diptera: Tephritidae).

    Science.gov (United States)

    Ni, W L; Li, Z H; Chen, H J; Wan, F H; Qu, W W; Zhang, Z; Kriticos, D J

    2012-04-01

    Bactrocera zonata (Saunders) is one of the most harmful species of Tephritidae. It causes extensive damage in Asia and threatens many countries located along or near the Mediterranean Sea. The climate mapping program, CLIMEX 3.0, and the GIS software, ArcGIS 9.3, were used to model the current and future potential geographical distribution of B. zonata. The model predicts that, under current climatic conditions, B. zonata will be able to establish itself throughout much of the tropics and subtropics, including some parts of the USA, southern China, southeastern Australia and northern New Zealand. Climate change scenarios for the 2070s indicate that the potential distribution of B. zonata will expand poleward into areas which are currently too cold. The main factors limiting the pest's range expansion are cold, hot and dry stress. The model's predictions of the numbers of generations produced annually by B. zonata were consistent with values previously recorded for the pest's occurrence in Egypt. The ROC curve and the AUC (an AUC of 0.912) were obtained to evaluate the performance of the CLIMEX model in this study. The analysis of this information indicated a high degree of accuracy for the CLIMEX model. The significant increases in the potential distribution of B. zonata projected under the climate change scenarios considered in this study suggest that biosecurity authorities should consider the effects of climate change when undertaking pest risk assessments. To prevent the introduction and spread of B. zonata, enhanced quarantine and monitoring measures should be implemented in areas that are projected to be suitable for the establishment of the pest under current and future climatic conditions.

  10. Comprehensively Measuring Health-Related Subjective Well-Being: Dimensionality Analysis for Improved Outcome Assessment in Health Economics.

    Science.gov (United States)

    de Vries, Marieke; Emons, Wilco H M; Plantinga, Arnoud; Pietersma, Suzanne; van den Hout, Wilbert B; Stiggelbout, Anne M; van den Akker-van Marle, M Elske

    2016-01-01

    Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions. To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure. We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors. Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments. We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Including Performance Assessments in Accountability Systems: A Review of Scale-Up Efforts

    Science.gov (United States)

    Tung, Rosann

    2010-01-01

    The purpose of this literature and field review is to understand previous efforts at scaling up performance assessments for use across districts and states. Performance assessments benefit students and teachers by providing more opportunities for students to demonstrate their knowledge and complex skills, by providing teachers with better…

  12. A Comprehensive Evaluation of Standardized Assessment Tools in the Diagnosis of Fibromyalgia and in the Assessment of Fibromyalgia Severity

    Directory of Open Access Journals (Sweden)

    Chad S. Boomershine

    2012-01-01

    Full Text Available Standard assessments for fibromyalgia (FM diagnosis and core FM symptom domains are needed for biomarker development and treatment trials. Diagnostic and symptom assessments are reviewed and recommendations are made for standards. Recommendations for existing assessments include the American College of Rheumatology FM classification criteria using the manual tender point Survey for diagnosis, the brief pain inventory average pain visual analogue scale for pain intensity, the function subscale of the revised fibromyalgia impact questionnaire (FIQR for physical function, the patient global impression of change and FIQR for overall/global improvement, the hospital anxiety and depression scale depression subscale for depression, the multiple ability self-report questionnaire for cognitive dysfunction, the fatigue severity scale for fatigue, the FIQR for multidimensional function/health-related quality of life, the jenkins sleep scale for sleep disturbance, and the fibromyalgia intensity score for tenderness. Forthcoming assessments including the FIQR for diagnosis, NIH PROMIS, and FIBRO Change scales are discussed.

  13. A comprehensive assessment program to improve blood-administering practices using the FOCUS-PDCA model.

    Science.gov (United States)

    Saxena, Sunita; Ramer, Lois; Shulman, Ira A

    2004-09-01

    The Joint Commission on the Accreditation of Healthcare Organizations requires that hospitals have a planned approach to systematically collect data on processes related to the use, ordering, and administering of blood components. This study describes how a comprehensive blood-administering assessment program and the FOCUS-PDCA approach improved overall blood-administering practices. Nurses were trained to observe blood issuance, blood administering, and patient monitoring steps, and to audit patient's charts to measure compliance with blood-ordering procedures. The observations were recorded on a standardized scannable form, which allowed automatic entry of recorded data directly into a computer database. A total of 982 assessments were completed during the 51-month study period. Documentation of informed consent improved from 80 percent to 100 percent. Compliance with a California law that requires patients to receive information on the risks, benefits, and alternatives to transfusion rose from 30 percent to 100 percent. Physicians' compliance in specifying the rate of blood administration improved from 30 percent to 100 percent, and verification of information on the patient's identification band with the patient's self-identification rose from 50 percent to 100 percent. For all other blood-administering steps, compliance remained high throughout the study period. For the past 9 months, 100-percent compliance has been maintained for all transfusion processes, and during this period no mistransfusions or blood administration near-misses have been reported. The blood-administering assessment program described above has improved transfusion practice, reduced the number of near-miss events, and may have prevented mistransfusions.

  14. Comprehensive Assessments of RNA-seq by the SEQC Consortium: FDA-Led Efforts Advance Precision Medicine.

    Science.gov (United States)

    Xu, Joshua; Gong, Binsheng; Wu, Leihong; Thakkar, Shraddha; Hong, Huixiao; Tong, Weida

    2016-03-15

    Studies on gene expression in response to therapy have led to the discovery of pharmacogenomics biomarkers and advances in precision medicine. Whole transcriptome sequencing (RNA-seq) is an emerging tool for profiling gene expression and has received wide adoption in the biomedical research community. However, its value in regulatory decision making requires rigorous assessment and consensus between various stakeholders, including the research community, regulatory agencies, and industry. The FDA-led SEquencing Quality Control (SEQC) consortium has made considerable progress in this direction, and is the subject of this review. Specifically, three RNA-seq platforms (Illumina HiSeq, Life Technologies SOLiD, and Roche 454) were extensively evaluated at multiple sites to assess cross-site and cross-platform reproducibility. The results demonstrated that relative gene expression measurements were consistently comparable across labs and platforms, but not so for the measurement of absolute expression levels. As part of the quality evaluation several studies were included to evaluate the utility of RNA-seq in clinical settings and safety assessment. The neuroblastoma study profiled tumor samples from 498 pediatric neuroblastoma patients by both microarray and RNA-seq. RNA-seq offers more utilities than microarray in determining the transcriptomic characteristics of cancer. However, RNA-seq and microarray-based models were comparable in clinical endpoint prediction, even when including additional features unique to RNA-seq beyond gene expression. The toxicogenomics study compared microarray and RNA-seq profiles of the liver samples from rats exposed to 27 different chemicals representing multiple toxicity modes of action. Cross-platform concordance was dependent on chemical treatment and transcript abundance. Though both RNA-seq and microarray are suitable for developing gene expression based predictive models with comparable prediction performance, RNA-seq offers

  15. Comprehensive Assessments of RNA-seq by the SEQC Consortium: FDA-Led Efforts Advance Precision Medicine

    Directory of Open Access Journals (Sweden)

    Joshua Xu

    2016-03-01

    Full Text Available Studies on gene expression in response to therapy have led to the discovery of pharmacogenomics biomarkers and advances in precision medicine. Whole transcriptome sequencing (RNA-seq is an emerging tool for profiling gene expression and has received wide adoption in the biomedical research community. However, its value in regulatory decision making requires rigorous assessment and consensus between various stakeholders, including the research community, regulatory agencies, and industry. The FDA-led SEquencing Quality Control (SEQC consortium has made considerable progress in this direction, and is the subject of this review. Specifically, three RNA-seq platforms (Illumina HiSeq, Life Technologies SOLiD, and Roche 454 were extensively evaluated at multiple sites to assess cross-site and cross-platform reproducibility. The results demonstrated that relative gene expression measurements were consistently comparable across labs and platforms, but not so for the measurement of absolute expression levels. As part of the quality evaluation several studies were included to evaluate the utility of RNA-seq in clinical settings and safety assessment. The neuroblastoma study profiled tumor samples from 498 pediatric neuroblastoma patients by both microarray and RNA-seq. RNA-seq offers more utilities than microarray in determining the transcriptomic characteristics of cancer. However, RNA-seq and microarray-based models were comparable in clinical endpoint prediction, even when including additional features unique to RNA-seq beyond gene expression. The toxicogenomics study compared microarray and RNA-seq profiles of the liver samples from rats exposed to 27 different chemicals representing multiple toxicity modes of action. Cross-platform concordance was dependent on chemical treatment and transcript abundance. Though both RNA-seq and microarray are suitable for developing gene expression based predictive models with comparable prediction performance, RNA

  16. Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Shields, Lynn; Henderson, Victoria; Caslake, Robert

    2017-07-01

    To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. Systematic review and metaanalysis. Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions. MEDLINE, EMBASE, CINAHL and PsycINFO databases; Clinicaltrials.gov; and the Central Register of Controlled Trials were searched. Reference lists from full-text articles were reviewed. Incidence of delirium was the primary outcome. Length of stay, delirium severity, institutionalization, long-term cognition and mortality were predefined secondary outcomes. Duration of delirium was included as a post hoc outcome. There was a significant reduction in delirium overall (relative risk (RR) = 0.81, 95% confidence interval (CI) = 0.69-0.94) in the intervention group. Post hoc subgroup analysis found this effect to be preserved in the team-based intervention group (RR = 0.77, 95% CI = 0.61-0.98) but not the ward-based group. No significant effect was observed on any secondary outcome. There was a reduction in the incidence of delirium after hip fracture with CGA. This is in keeping with results of non-randomized controlled trials and trials in other populations. Team-based interventions appeared superior in contrast to the Ellis CGA paper, but it is likely that heterogeneity in interventions and population studied affected this. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  17. Comprehensive, Mixed-Methods Assessment of a Blended Learning Model for Geospatial Literacy Instruction

    Science.gov (United States)

    Brodeur, J. J.; Maclachlan, J. C.; Bagg, J.; Chiappetta-Swanson, C.; Vine, M. M.; Vajoczki, S.

    2013-12-01

    Geospatial literacy -- the ability to conceptualize, capture, analyze and communicate spatial phenomena -- represents an important competency for 21st Century learners in a period of 'Geospatial Revolution'. Though relevant to in-course learning, these skills are often taught externally, placing time and resource pressures on the service providers - commonly libraries - that are relied upon to provide instruction. The emergence of online and blended modes of instruction has presented a potential means of increasing the cost-effectiveness of such activities, by simultaneously reducing instructional costs, expanding the audience for these resources, and addressing student preferences for asynchronous learning and '24-7' access. During 2011 and 2012, McMaster University Library coordinated the development, implementation and assessment of blended learning modules for geospatial literacy instruction in first-year undergraduate Social Science courses. In this paper, we present the results of a comprehensive mixed-methods approach to assess the efficacy of implementing blended learning modules to replace traditional (face-to-face), library-led, first-year undergraduate geospatial literacy instruction. Focus groups, personal interviews and an online survey were used to assess modules across dimensions of: student use, satisfaction and accessibility requirements (via Universal Instructional Design [UID] principles); instructor and teaching staff perception of pedagogical efficacy and instructional effectiveness; and, administrator cost-benefit assessment of development and implementation. Results showed that both instructors and students identified significant value in using the online modules in a blended-learning setting. Reaffirming assumptions of students' '24/7' learning preferences, over 80% of students reported using the modules on a repeat basis. Students were more likely to use the modules to better understand course content than simply to increase their grade in

  18. SURROGATE SPECIES IN ASSESSING CONTAMINANT RISK FOR ENDANGERED FISHES, INCLUDING INTERSPECIES TOXICITY CORRELATIONS

    Science.gov (United States)

    Rainbow trout, fathead minnows, and sheepshead minnows were tested as surrogate species to assess contaminant risk for 17 endangered fishes and one toad species. Acute toxicity tests were conducted with carbaryl, copper, 4-nonylphenol, pentachlorophenol, and permethrin in accorda...

  19. The total assessment profile, volume 1. [including societal impact cost effectiveness, and economic analysis

    Science.gov (United States)

    Leininger, G.; Jutila, S.; King, J.; Muraco, W.; Hansell, J.; Lindeen, J.; Franckowiak, E.; Flaschner, A.

    1975-01-01

    A methodology is described for the evaluation of societal impacts associated with the implementation of a new technology. Theoretical foundations for the methodology, called the total assessment profile, are established from both the economic and social science perspectives. The procedure provides for accountability of nonquantifiable factors and measures through the use of a comparative value matrix by assessing the impacts of the technology on the value system of the society.

  20. Drawing the Line: The Development of a Comprehensive Assessment of Infidelity Judgments.

    Science.gov (United States)

    Thompson, Ashley E; O'Sullivan, Lucia F

    2015-11-18

    Infidelity is a leading cause of relationship discord and dissolution, and couples generally report expectations to maintain monogamy. However, a majority of men and women report engaging in some form of infidelity at least once in their lives. Research assessing judgments of the behaviors that constitute infidelity is lacking. The three studies reported here advanced the literature by developing and validating the Definitions of Infidelity Questionnaire (DIQ), a comprehensive measure examining infidelity judgments. Exploratory and confirmatory factor analyses indicated four factors to the scale: sexual/explicit behaviors, technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors. Investigation of the psychometric properties demonstrated the DIQ to be reliable and valid. Participants agreed that sexual/explicit behaviors comprised infidelity to the largest extent, whereas other types of behaviors (technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors) were judged as comprising infidelity to a lesser extent. Men reported more permissive judgments than did women. This study provides insights regarding operationalizing infidelity and identifying areas of ambiguity and consensus. Implications of the findings for educators and practitioners working with individuals in intimate relationships are discussed.

  1. Comprehensive evaluation of municipal garbage disposal in Changchun City by the strategic environmental assessment.

    Science.gov (United States)

    Xu, Jianling L; Tang, Zhanhui H; Shang, Jincheng C; Zhao, Yuanhui H

    2010-06-01

    The environmental issues caused by the municipal solid waste disposal are becoming a worldwide concern. We studied the situations both domestically and abroad by the strategic environmental assessment (SEA) approach and also conducted comprehensive evaluations of garbage disposal in Changchun City. On the basis of this study, we found that SEA is of great importance in the municipal solid waste disposal. Moreover, with the rapid socioeconomic development of Changchun City, municipal solid waste production increases on an annual basis, and thus, good waste management planning is of great significance. Considering the situation of the economic development of Changchun City, garbage disposal was handled mainly in the major sanitary landfills with appropriate use of incineration technology. This plan is environmentally friendly at a relatively high degree and has met the requirements of minimum investment. It also takes into account the requirements of the development of incineration technology. Regarding environmental pollution in terms of groundwater pollution and atmospheric pollution, this plan is a feasible one by meeting various requirements with low environmental impact among the three plans discussed in this study.

  2. Assessing the Relation between Language Comprehension and Performance in General Chemistry

    Science.gov (United States)

    Pyburn, Daniel T.; Pazicni, Samuel; Benassi, Victor A.; Tappin, Elizabeth E.

    2013-01-01

    Few studies have focused specifically on the role that language plays in learning chemistry. We report here an investigation into the ability of language comprehension measures to predict performance in university introductory chemistry courses. This work is informed by theories of language comprehension, which posit that high-skilled…

  3. Proarrhythmia liability assessment and the comprehensive in vitro Proarrhythmia Assay (CiPA): An industry survey on current practice.

    Science.gov (United States)

    Authier, Simon; Pugsley, Michael K; Koerner, John E; Fermini, Bernard; Redfern, William S; Valentin, Jean-Pierre; Vargas, Hugo M; Leishman, Derek J; Correll, Krystle; Curtis, Michael J

    2017-07-01

    The Safety Pharmacology Society (SPS) has conducted a survey of its membership to identify industry practices related to testing considered in the Comprehensive In vitro Proarrhythmia Assay (CiPA). Survey topics included nonclinical approaches to address proarrhythmia issues, conduct of in silico studies, in vitro ion channel testing methods used, drugs used as positive controls during the conduct of cardiac ion channel studies, types of arrhythmias observed in non-clinical studies and use of the anticipated CiPA ion channel assay. In silico studies were used to evaluate effects on ventricular action potentials by only 15% of responders. In vitro assays were used mostly to assess QT prolongation (95%), cardiac Ca 2+ and Na + channel blockade (82%) and QT shortening or QRS prolongation (53%). For de-risking of candidate drugs for proarrhythmia, those assays most relevant to CiPA including cell lines stably expressing ion channels used to determine potency of drug block were most frequently used (89%) and human stem cell-derived or induced pluripotent stem cell cardiomyocytes (46%). Those in vivo assays related to general proarrhythmia derisking include ECG recording using implanted telemetry technology (88%), jacketed external telemetry (62%) and anesthetized animal models (53%). While the CiPA initiative was supported by 92% of responders, there may be some disconnect between current practice and future expectations, as explained. Proarrhythmia liability assessment in drug development presently includes study types consistent with CiPA. It is anticipated that CiPA will develop into a workable solution to the concern that proarrhythmia liability testing remains suboptimal. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty.

    Science.gov (United States)

    Baccetti, Tiziano; Franchi, Lorenzo; Stahl, Franka

    2009-06-01

    The aim of this clinical trial was to compare the effects of 2 protocols for single-phase comprehensive treatment of Class II Division 1 malocclusion (bonded Herbst followed by fixed appliances [BH + FA] vs headgear followed by fixed appliances and Class II elastics [HG + FA]) at the pubertal growth spurt. Fifty-six Class II patients were enrolled in the trial and allocated by personal choice to 2 practices, where they underwent 1 of 2 treatment protocols (28 patients were treated consecutively with BH + FA, and 28 patients were treated consecutively with HG + FA). All patients started treatment at puberty (cervical stage [CS] 3 or CS 4) and completed treatment after puberty (CS 5 or CS 6). Lateral cephalograms were taken before therapy and 6 months after the end of comprehensive therapy, with an average interval of 28 months. Longitudinal observations of a matched group of 28 subjects with untreated Class II malocclusions were compared with the 2 treated groups. Analysis of variance (ANOVA) with post-hoc tests was used for statistical comparisons. Discriminant analysis was applied to identify preferential candidates for the BH + FA protocol on the basis of profile changes (advancement of the soft tissues of the chin). The success rate (full occlusal correction of the malocclusion after treatment) was 92.8% in both treatment groups. The BH + FA group showed a significant increase in mandibular protrusion. The increase in effective mandibular length (Co-Gn) was significantly greater in both treatment groups when compared with natural growth changes in the Class II controls. Significantly greater improvement in sagittal maxillomandibular relationships was found in the BH + FA group. Retrusion of maxillary incisors and mesial movement of mandibular molars were significant in the HG + FA group. The BH + FA group showed significantly greater forward movements of soft-tissue B-point and pogonion compared with both the HG + FA and the control groups. Two pretreatment

  5. A National Study of the Validity and Utility of the Comprehensive Assessment of School Environment (CASE) Survey

    Science.gov (United States)

    McGuffey, Amy R.

    2016-01-01

    A healthy school climate is necessary for improvement. The purpose of this study was to evaluate the construct validity and usability of the Comprehensive Assessment of School Environment (CASE) as it was purportedly realigned to the three dimensions of the Breaking Ranks Framework developed by the National Association of Secondary School…

  6. Applying Comprehensive Environmental Assessment to Research Planning for Multiwalled Carbon Nanotubes: Refinements to Inform Future Stakeholder Engagement

    Science.gov (United States)

    We previously described our collective judgment methods to engage expert stakeholders in the Comprehensive Environmental Assessment (CEA) workshop process applied to nano-TiO2 and nano-Ag research planning. We identified several lessons learned in engaging stakeholders to identif...

  7. A Ten-Year Assessment of a Biomedical Engineering Summer Research Internship within a Comprehensive Cancer Center

    Science.gov (United States)

    Wright, A. S.; Wu, X.; Frye, C. A.; Mathur, A. B.; Patrick, C. W., Jr.

    2007-01-01

    A Biomedical Engineering Internship Program conducted within a Comprehensive Cancer Center over a 10 year period was assessed and evaluated. Although this is a non-traditional location for an internship, it is an ideal site for a multidisciplinary training program for science, technology, engineering, and mathematics (STEM) students. We made a…

  8. Life cycle assessment of genetically modified products as a basis for a comprehensive assessment of possible environmental effects

    International Nuclear Information System (INIS)

    Kloepffer, W.; Renner, I.; Schmidt, E.; Tappeser, B.; Gensch, C.O.; Gaugitsch, H.

    2001-01-01

    In the preceding project 'Life Cycle Assessment of genetically modified products as a basis for a comprehensive assessment of possible environmental effects' for the first time the risks of deliberate release of genetically modified organisms (GMOs) into the environment have been taken into account in a Life Cycle Assessment (LCA). This was performed by a risk assessment in addition to a quantitative impact assessment. As from a methodological perspective this was not satisfactory, the Federal Environment Agency commissioned the C.A.U. GmbH and the Institute of Applied Ecology Freiburg to further develop the impact assessment methodology for the risks of GMOs. Any further development of the methodology of impact assessment in LCAs has to be performed on the basis of the standard EN/ISO 14042. There are 2 options for taking into account risks of deliberate release of GMOs: 1. allocation of the potential effects resulting from the genetic modification on human beings and the environment to existing categories of the impact assessment and attempt to quantify within those existing methods of characterization; 2. development of a new category, e.g. 'effects of genetically modified crop plants'. In order to asses the possibilities under option 1 various models of characterization within the categories human toxicity, ecotoxicity and land use (appropriation of environmental space) have been analyzed. The risks of GMOs identified and dealt with in the preceding study were allocated to these categories. It seemed to be impossible to integrate the risks in existing models of characterization for human toxicity and ecotoxicity, as these are based on exposure and impact factors. The development of a factor for exposure seems possible for GMOs, however a suitable impact factor is not possible to generate. In addition it was analyzed if in other impact categories which are difficult to quantify any solutions for operationalization exist. This does not seem to be the case. As a

  9. The Value of a Comprehensive Geriatric Assessment for Patient Care in Acutely Hospitalized Older Patients with Cancer

    Science.gov (United States)

    Buurman, Bianca M.; van Munster, Barbara C.; Kuper, Ingeborg M.J.A.; Smorenburg, Carolien H.; de Rooij, Sophia E.

    2011-01-01

    Introduction. A comprehensive geriatric assessment systematically collects information on geriatric conditions and is propagated in oncology as a useful tool when assessing older cancer patients. Objectives. The objectives were: (a) to study the prevalence of geriatric conditions in cancer patients aged ≥65 years, acutely admitted to a general medicine ward; (b) to determine functional decline and mortality within 12 months after admission; and (c) to assess which geriatric conditions and cancer-related variables are associated with 12-month mortality. Methods. This was an observational cohort study of 292 cancer patients aged ≥65 years, acutely admitted to the general medicine and oncology wards of two university hospitals and one secondary teaching hospital. Baseline assessments included patient characteristics, reason for admission, comorbidity, and geriatric conditions. Follow-up at 3 and 12 months was aimed at functional decline (loss of one or more activities of daily living [ADL]) and mortality. Results. The median patient age was 74.9 years, and 95% lived independently; 126 patients (43%) had metastatic disease. A high prevalence of geriatric conditions was found for instrumental ADL impairment (78%), depressive symptoms (65%), pain (65%), impaired mobility (48%), malnutrition (46%), and ADL impairment (38%). Functional decline was observed in 8% and 33% of patients at 3 and 12 months, respectively. Mortality rates were 38% at 3 months and 64% at 12 months. Mortality was associated with cancer-related factors only. Conclusion. In these acutely hospitalized older cancer patients, mortality was only associated with cancer-related factors. The prevalence of geriatric conditions in this population was high. Future research is needed to elucidate if addressing these conditions can improve quality of life. PMID:21914699

  10. The total assessment profile, volume 2. [including societal impact, cost effectiveness, and economic analysis

    Science.gov (United States)

    Leininger, G.; Jutila, S.; King, J.; Muraco, W.; Hansell, J.; Lindeen, J.; Franckowiak, E.; Flaschner, A.

    1975-01-01

    Appendices are presented which include discussions of interest formulas, factors in regionalization, parametric modeling of discounted benefit-sacrifice streams, engineering economic calculations, and product innovation. For Volume 1, see .

  11. Including Life Cycle Assessment for decision-making in controlling wastewater nutrient removal systems

    DEFF Research Database (Denmark)

    Corominas, Lluís; Larsen, Henrik Fred; Flores-Alsina, Xavier

    2013-01-01

    of the impact categories is conducted to assess how value choices (policy decisions) may affect the management of WWTPs. For the scenarios with only N-limitation, the LCA-based ranking of the control strategies is sensitive to the choice of weighting factors, whereas this is not the case for N&P or P......This paper focuses on the use of Life Cycle Assessment (LCA) to evaluate the performance of seventeen control strategies in wastewater treatment plants (WWTPs). It tackles the importance of using site-specific factors for nutrient enrichment when decision-makers have to select best operating....../or energy savings present an environmental benefit for N&P and P-deficient systems. This is not the case when addressing N-deficient systems for which the use of chemicals (even for improving N removal efficiencies) is not always beneficial for the environment. A sensitivity analysis on using weighting...

  12. Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

    Science.gov (United States)

    Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

    2015-03-01

    The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

  13. An assessment of PCB degradation by microogransims including methods for measuring mineralization

    International Nuclear Information System (INIS)

    Hadden, C.; Edenborn, H.; Osborne, T.; Holdsworth, G.; Revis, N.

    1990-01-01

    These studies sought to isolate and identify organism(s) from PCB contaminated soil and sediment that degrade PCB; to provide information on the potential of organisms in soil samples taken from a PCB-contaminated area to mineralize or dechlorinate PCB congeners; to assess potential enhancement of PCB biodegradation as a result of nutritional amendment of the samples; and to carry out analyses of successive lysimeter samples to determine whether field treatments have had an effect on the capacity of soil microbes to mineralize PCBS. We have expended considerable effort to validate the fractionation procedure used to assess mineralization and conversion of PCB substrates. The assessment relies on the ability to measure [ 14 C]-labeled CO 2 in the presence of potentially volatile [ 14 C]-labeled PCB and degradation products to differentiate between volatile and non-volatile [ 14 C]-labeled compounds between water-soluble products of metabolism and a mixture of unchanged substrate and other water-insoluble products and between metabolism and loss or non-extractability of the substrate

  14. Development of a quantitative safety assessment method for nuclear I and C systems including human operators

    International Nuclear Information System (INIS)

    Kim, Man Cheol

    2004-02-01

    Conventional PSA (probabilistic safety analysis) is performed in the framework of event tree analysis and fault tree analysis. In conventional PSA, I and C systems and human operators are assumed to be independent for simplicity. But, the dependency of human operators on I and C systems and the dependency of I and C systems on human operators are gradually recognized to be significant. I believe that it is time to consider the interdependency between I and C systems and human operators in the framework of PSA. But, unfortunately it seems that we do not have appropriate methods for incorporating the interdependency between I and C systems and human operators in the framework of Pasa. Conventional human reliability analysis (HRA) methods are not developed to consider the interdependecy, and the modeling of the interdependency using conventional event tree analysis and fault tree analysis seem to be, event though is does not seem to be impossible, quite complex. To incorporate the interdependency between I and C systems and human operators, we need a new method for HRA and a new method for modeling the I and C systems, man-machine interface (MMI), and human operators for quantitative safety assessment. As a new method for modeling the I and C systems, MMI and human operators, I develop a new system reliability analysis method, reliability graph with general gates (RGGG), which can substitute conventional fault tree analysis. RGGG is an intuitive and easy-to-use method for system reliability analysis, while as powerful as conventional fault tree analysis. To demonstrate the usefulness of the RGGG method, it is applied to the reliability analysis of Digital Plant Protection System (DPPS), which is the actual plant protection system of Ulchin 5 and 6 nuclear power plants located in Republic of Korea. The latest version of the fault tree for DPPS, which is developed by the Integrated Safety Assessment team in Korea Atomic Energy Research Institute (KAERI), consists of 64

  15. An assessment of PCB degradation by microogransims including methods for measuring mineralization

    Energy Technology Data Exchange (ETDEWEB)

    Hadden, C.; Edenborn, H.; Osborne, T.; Holdsworth, G.; Revis, N.

    1990-12-31

    These studies sought to isolate and identify organism(s) from PCB contaminated soil and sediment that degrade PCB; to provide information on the potential of organisms in soil samples taken from a PCB-contaminated area to mineralize or dechlorinate PCB congeners; to assess potential enhancement of PCB biodegradation as a result of nutritional amendment of the samples; and to carry out analyses of successive lysimeter samples to determine whether field treatments have had an effect on the capacity of soil microbes to mineralize PCBS. We have expended considerable effort to validate the fractionation procedure used to assess mineralization and conversion of PCB substrates. The assessment relies on the ability to measure [{sup 14}C]-labeled CO{sub 2} in the presence of potentially volatile [{sup 14}C]-labeled PCB and degradation products to differentiate between volatile and non-volatile [{sup 14}C]-labeled compounds between water-soluble products of metabolism and a mixture of unchanged substrate and other water-insoluble products and between metabolism and loss or non-extractability of the substrate.

  16. When nature frowns: A comprehensive impact assessment of the 2012 Babessi floods on people’s livelihoods in rural Cameroon

    Directory of Open Access Journals (Sweden)

    Roland A. Balgah

    2015-11-01

    Full Text Available Floods are the most common natural disasters worldwide. Much of the growing literature on the impact of floods, especially in developed countries, and to a lesser extent in rural areas of developing countries, concentrates on economic rather than a comprehensive assessment of combined effects on people’s livelihoods. Holistic floods impact assessments are often done long after the shock, raising problems of data reliability following long recall periods, although post-disaster needs assessments when carried out earlier can facilitate appropriate disaster recovery, relief and reconstruction activities. We applied the sustainable livelihoods framework as a comprehensive approach to assess the impacts of the Babessi floods in 2012 on livelihoods in rural (north western region of Cameroon 6 weeks after the floods. Using a structured questionnaire, data was collected from victims before and after the floods, using recall methods. A matched sample of nonvictims randomly selected from the same village as the victims was used to assess vulnerability to the floods by household type. Floods were found to have serious economic, social, human and food security impacts on victims. Both government and nongovernmental support were jointly crucial for household recovery. Comparatively observed high levels of recovery were attributed to the low loss of human lives. The article concludes with the need for comprehensive approaches to floods impact assessments. The need for combining formal and informal instruments in post-disaster management in rural areas is also emphasised.

  17. The Family Socialization Interview—Revised (FSI-R): a Comprehensive Assessment of Parental Disciplinary Behaviors

    Science.gov (United States)

    O’Dor, Sarah L.; Grasso, Damion J.; Forbes, Danielle; Bates, John E.; McCarthy, Kimberly J.; Wakschlag, Lauren S.

    2017-01-01

    Elucidating the complex mechanisms by which harsh parenting increases risk of child psychopathology is key to targeted prevention. This requires nuanced methods that capture the varied perceptions and experiences of diverse families. The Family Socialization Interview—Revised (FSI-R), adapted from an interview developed by Dodge et al. (Child Development, 65,649–665,1994), is a comprehensive, semi-structured interview for characterizing methods of parental discipline used with young children. The FSI-R coding system systematically rates parenting style, usual discipline techniques, and most intense physical and psychological discipline based on rater judgment across two eras: (1) birth to the previous year, and (2) the previous year to present. The current study examined the psychometric properties of the FSI-R in a diverse, high-risk community sample of 386 mothers and their children, ages 3 to 6 years. Interrater reliability was good to excellent for codes capturing physically and psychologically harsh parenting, and restrictive/punitive parenting styles. Findings supported the FSI-R’s convergent and incremental validity. Importantly, the FSI-R demonstrated incremental utility, explaining unique variance in children’s externalizing and internalizing symptoms beyond that explained by traditional surveys and observed parenting. The FSI-R appeared particularly promising for capturing risk associated with young children’s depressive symptoms, as these were generally not significantly associated with other measures of harsh parenting. Overall, findings support the added value of the FSI-R within a multi-method assessment of disciplinary practices across early child development. Future implications for prevention are discussed. PMID:27718104

  18. The Family Socialization Interview-Revised (FSI-R): a Comprehensive Assessment of Parental Disciplinary Behaviors.

    Science.gov (United States)

    O'Dor, Sarah L; Grasso, Damion J; Forbes, Danielle; Bates, John E; McCarthy, Kimberly J; Wakschlag, Lauren S; Briggs-Gowan, Margaret J

    2017-04-01

    Elucidating the complex mechanisms by which harsh parenting increases risk of child psychopathology is key to targeted prevention. This requires nuanced methods that capture the varied perceptions and experiences of diverse families. The Family Socialization Interview-Revised (FSI-R), adapted from an interview developed by Dodge et al. (Child Development, 65, 649-665, 1994), is a comprehensive, semi-structured interview for characterizing methods of parental discipline used with young children. The FSI-R coding system systematically rates parenting style, usual discipline techniques, and most intense physical and psychological discipline based on rater judgment across two eras: (1) birth to the previous year, and (2) the previous year to present. The current study examined the psychometric properties of the FSI-R in a diverse, high-risk community sample of 386 mothers and their children, ages 3 to 6 years. Interrater reliability was good to excellent for codes capturing physically and psychologically harsh parenting, and restrictive/punitive parenting styles. Findings supported the FSI-R's convergent and incremental validity. Importantly, the FSI-R demonstrated incremental utility, explaining unique variance in children's externalizing and internalizing symptoms beyond that explained by traditional surveys and observed parenting. The FSI-R appeared particularly promising for capturing risk associated with young children's depressive symptoms, as these were generally not significantly associated with other measures of harsh parenting. Overall, findings support the added value of the FSI-R within a multi-method assessment of disciplinary practices across early child development. Future implications for prevention are discussed.

  19. Optimal management of elderly cancer patients: usefulness of the Comprehensive Geriatric Assessment

    Directory of Open Access Journals (Sweden)

    Caillet P

    2014-09-01

    Full Text Available Philippe Caillet,1,2 Marie Laurent,1,2 Sylvie Bastuji-Garin,1,3,4 Evelyne Liuu,2 Stephane Culine,5 Jean-Leon Lagrange,6 Florence Canoui-Poitrine,1,2,3,* Elena Paillaud1,2,* 1Laboratoire d’Investigation Clinique (LIC, Faculté de Medecine, Université Paris Est Créteil (UPEC, Créteil, Paris, 2Unité de Coordination d’Onco-Gériatrie, Département de Médecine Interne et Gériatrie, Hôpital Henri-Mondor, Assistance Publique – Hopitaux de Paris (AP-HP, Créteil, 3Service de Santé Publique, Hôpital Henri-Mondor, AP-HP, Créteil, 4Unité de Recherche Clinique, Hôpital Henri-Mondor, AP-HP, Créteil, 5Service d’Oncologie Médicale, Hôpital Saint-Louis, AP-HP, Paris, 6Service de Radiotherapie, Hôpital Henri-Mondor, AP-HP, Créteil, France*These authors contributed equally to this workBackground: Cancer is common in older patients, who raise specific treatment challenges due to aging-related, organ-specific physiologic changes and the presence in most cases of comorbidities capable of affecting treatment tolerance and outcomes. Identifying comorbid conditions and physiologic changes due to aging allows oncologists to better assess the risk/benefit ratio and to adjust the treatment accordingly. Conducting a Comprehensive Geriatric Assessment (CGA is one approach developed for this purpose. We reviewed the evidence on the usefulness of CGA for assessing health problems and predicting cancer treatment outcomes, functional decline, morbidity, and mortality in older patients with solid malignancies. Methods: We searched Medline for articles published in English between January 1, 2000 and April 14, 2014, and reporting prospective observational or interventional studies of CGA feasibility or effectiveness in patients aged ≥65 years with solid malignancies. We identified studies with at least 100 patients, a multivariate analysis, and assessments of at least five of the following CGA domains: nutrition, cognition, mood, functional status

  20. Dairy nutrition management: Assessing a comprehensive continuing education program for veterinary practitioners.

    Science.gov (United States)

    Schuenemann, G M; Eastridge, M L; Weiss, W P; Workman, J D; Bas, S; Rajala-Schultz, P

    2011-05-01

    The purpose of this study was to assess the effectiveness of a team-based educational program designed to enhance the flow of applied, research-based, nutrition information to dairy veterinarians. A comprehensive dairy cattle nutrition curriculum was developed and participants from 11 veterinary practices located in 5 states (IN, NY, PA, NM, and OH), serving an estimated 186,150 dairy cattle in 469 herds, attended the 2 advanced nutrition modules (∼2.5 d each and ∼40 h of learning) held in 2009. Nutrients, feeding transition cows, calves, and heifers, dry matter intake, feed storage, metabolic diseases, evaluating cows (scoring body condition, manure, and lameness), metabolic blood profiles, and feeding behavior were discussed. Educational materials were delivered through in-class lectures, followed by case-based learning and group discussions. A farm visit and out-of-class assignments were also implemented. Attendees were assessed using pre- and post-tests of knowledge to determine the level of knowledge gained in both nutrition modules. Participants evaluated the program and provided feedback at the conclusion of each module. Veterinarians (100%) reported that the overall program, presentations, and discussions were useful. Attendees found the presented information relevant for their work (agree=60% and strongly agree=40%) and of great immediate use to them (neutral=6.5%, agree=56%, and strongly agree=37.5%). The presented materials and the implemented educational delivery methods substantially increased the knowledge level of the attendees (16.9% points increase from pre-test to post-test scores). Importance of feed particle size, ration evaluation, interpreting feed analysis, balancing carbohydrate components, and metabolic profiling in fresh cows were listed as learned concepts that participants could apply in their practices. Results suggested that both nutrition modules were relevant and effective, offering new information with immediate field

  1. Probabilistic safety assessment. A systematic and comprehensive method to evaluate risk

    International Nuclear Information System (INIS)

    Berg, H.P.

    2009-01-01

    Probabilistic safety assessment (PSA) is a systematic and comprehensive methodology to evaluate risks with every life-cycle aspect of a complex engineered technological entity such as a chemical facility, a spacecraft or a nuclear power plant. PSA can help to identify possible weaknesses of the plant design but also to provide insights into the existing safety margins for event sequences exceeding the design limits. A further benefit of PSA in this context is to show the existing safety margins correlating the original design criteria and boundary conditions and the real operating experience (e.g. by comparing the expected loads on structures, systems and components with the actual situation since a lot of years of operation). In that sense PSA is a very useful tool to complement deterministic insights in safety evaluation, as far its quality, scope and documentation is sufficient, and a strong co-ordination between both areas exist. At present, probabilistic tools to support the safety assessment of operating nuclear power plants built to earlier standards and/or the judgement of the safety relevance of certain back fitting measures are applied by the utilities, experts and regulators. Therefore, most operating nuclear power plants worldwide have been studied using PSA methods. Usually, a level 1 internal events PSA has been performed on all plants. In the last years, in some countries this has been extended to a level 1, also investigating some external hazards, or a level 2 PSA. However, in several cases the level 2 PSA is limited to the determination of the large early release frequency and is not a complete Level 2 analysis of plant damage states. The importance to use PSA already in the design phase of a nuclear power plant is growing because the model combines front-line safety systems and support systems in a manner that allows designers to determine the risk importance of structures, systems and components, to classify the respective requirements and to

  2. Including ecosystem dynamics in risk assessment of radioactive waste in coastal regions

    International Nuclear Information System (INIS)

    Kumblad, L.; Kautsky, U.; Gilek, M.

    2000-01-01

    Radiation protection has mainly focused on assessing and minimising risks of negative effects on human health. Although some efforts have been made to estimate effects on non-human populations, modelling of radiation risks to other components of the ecosystem have often lead to more or less disappointing results. In this paper an ecosystem approach is suggested and exemplified with a preliminary 14 C model of a coastal Baltic ecosystem. Advantages with the proposed ecosystem approach are for example the possibility to detect important but previously neglected pathways to humans since the whole ecosystem is analysed. The results from the model indicate that a rather small share of hypothetical released 14 C would accumulate in biota due to large water exchange in the modelled area. However, modelled future scenarios imply opposite results, i.e. relatively high doses in biota, due to changes of the physical properties in the area that makes a larger accumulation possible. (author)

  3. Probabilistic assessment of fatigue life including statistical uncertainties in the S-N curve

    International Nuclear Information System (INIS)

    Sudret, B.; Hornet, P.; Stephan, J.-M.; Guede, Z.; Lemaire, M.

    2003-01-01

    A probabilistic framework is set up to assess the fatigue life of components of nuclear power plants. It intends to incorporate all kinds of uncertainties such as those appearing in the specimen fatigue life, design sub-factor, mechanical model and applied loading. This paper details the first step, which corresponds to the statistical treatment of the fatigue specimen test data. The specimen fatigue life at stress amplitude S is represented by a lognormal random variable whose mean and standard deviation depend on S. This characterization is then used to compute the random fatigue life of a component submitted to a single kind of cycles. Precisely the mean and coefficient of variation of this quantity are studied, as well as the reliability associated with the (deterministic) design value. (author)

  4. Assessing school disaster preparedness by applying a comprehensive school safety framework: A case of elementary schools in Banda Aceh City

    Science.gov (United States)

    Sakurai, A.; Bisri, M. B. F.; Oda, T.; Oktari, R. S.; Murayama, Y.

    2017-02-01

    The study assessed the depth of school disaster safety at public elementary schools in Banda Aceh City, Indonesia in terms of comprehensive school safety, especially school location, disaster management and disaster education. The findings indicate that 56% of public elementary schools in Banda Aceh City are exposed to high tsunami risk, and most externally driven school disaster preparedness activities were not continued by the schools due to lack of ownership and funding. To realize comprehensive school safety, disaster preparedness programs should neither be brought in by external donors, nor be in a patchwork. Rather, it should be conducted jointly and sustainably by the local school and the community and supported by multi-sectoral support in the city. Comprehensive school safety of public elementary schools in Banda Aceh City could be realized by reviewing, updating and localizing school disaster preparedness programs by all the education partners in the city with strong political will and commitment.

  5. Functional assessment of the elderly with the use of EASY-Care Standard 2010 and Comprehensive Geriatric Assessment.

    Science.gov (United States)

    Talarska, Dorota; Pacholska, Renata; Strugała, Magdalena; Wieczorowska-Tobis, Katarzyna

    2016-06-01

    The wide variation in performance among the elderly leads to the search for a suitable instrument to identify the necessary support. The aim of this study was to examine the scope of independent functioning of the elderly and to indicate the necessary support using basic instruments, Comprehensive Geriatric Assessment (CGA) and EASY-Care Standard 2010. For statistical analysis were qualified 101 questionnaires of patients from oncological surgery clinic. The study group was dominated by women (79.2%). The average age for the entire group was 74.7 ± 7.5 years. In terms of basic life activities (Barthel Index), 75.2% of the elderly performed most of their activities independently. The Lawton IADL (Instrumental Activity of Daily Living Scale) median was 25 points. Moderate depression (Geriatric Depression Scale) reported 37.6% of the group. The influence of age, education, mode of movement and efficiency in basic and instrumental life activities and depression (Geriatric Depression Scale) was demonstrated in the results in three scales of the EASY-Care Standard 2010 questionnaire: Independence score, Risk of break down in care and Risk of falls. There was no difference in terms of gender and the nature of the residence. The study group of the elderly was characterised by a good level of efficiency in basic and instrumental activities of daily living. Questionnaire EASY-Care Standard 2010 enables to identify functional limitations of the elderly that may form the basis for planning individual support. © 2015 Nordic College of Caring Science.

  6. Transparent stakeholder engagement in practice: Lessons learned from applying comprehensive environmental assessment to research planning for nanomaterials.

    Science.gov (United States)

    Powers, Christina; Hendren, Christine; Wang, Amy; Davis, J Michael

    2014-10-01

    As efforts to develop new applications of engineered nanoscale materials (ENMs) continue to grow, so too has interest in the environmental, health, and safety (EHS) implications of these materials. However, thorough evaluation and interpretation of such implications could require substantial resources (e.g., estimated as >$120 million per year in federal funding 2013-2017). A structured, strategic approach for transparently planning research would support improved linkages between ENM research and risk assessments, and thereby enhance the utility of financial and other resources for EHS studies of ENMs. For this reason, we applied Comprehensive Environmental Assessment (CEA) as an approach to provide transparent input into research planning for 2 types of ENMs: nanoscale titanium dioxide and nanoscale silver. For each of these CEA applications, we employed a collective judgment method known as Nominal Group Technique (NGT) in 2 workshops sponsored by the US Environmental Protection Agency (USEPA). The objective of this paper is to present the outcomes of these CEA applications in the context of how our methodology can inform future efforts to identify collective goals in science (e.g., research priorities) through structured decision support approaches. Outcomes include clear lists of research priorities for each ENM developed through transparently engaging stakeholders having diverse technical and sector perspectives. In addition, we identified several procedural aspects that could be refined, including emphasizing breakout group interactions, identifying broad information priorities before more detailed research questions, and using rating rather than ranking prioritization methods. Beyond the research directions identified for specific ENMs, lessons learned about engaging stakeholders in research planning are expected to inform future research planning efforts for ENMs and other emerging materials across the scientific community. © 2014 SETAC.

  7. [Frail-VIG index: Design and evaluation of a new frailty index based on the Comprehensive Geriatric Assessment].

    Science.gov (United States)

    Amblàs-Novellas, Jordi; Martori, Joan Carles; Molist Brunet, Núria; Oller, Ramon; Gómez-Batiste, Xavier; Espaulella Panicot, Joan

    Frailty is closely linked to health results. Frailty indexes (FI) and the Comprehensive Geriatric Assessment (CGA) are multidimensional tools. FI serve to quantitatively measure frailty levels. They have shown to have an excellent correlation with mortality. However, they are infrequently used in clinical practice. Given the need for new, more concise, and pragmatic FI, a new FI is proposed based on a CGA (Frail-VIG Index). A prospective, observational, longitudinal study was conducted, with cohort follow up at 12 months or death. Participants were patients admitted in the Geriatric Unit of the University Hospital of Vic (Barcelona, Spain) during 2014. Contrast of hypothesis log-rank for survival curves according to Frail-VIG index, and analysis of ROC curves were performed to assess prognostic capacity. A total of 590 patients were included (mean age=86.39). Mortality rate at 12 months was 46.4%. The comparative analysis showed statistically significant differences (P<.05) for almost all variables included in the Frail-VIG index. Survival curves also show significant differences (X 2 =445, P<.001) for the different Frail-VIG index scores. The area under the ROC curve at 12 months was 0.9 (0.88-0.92). An administration time of the Index is estimated at less than 10minutes. Results endorse the Frail-VIG index as a simple (as for contents), rapid (for administration time) tool, with discriminative (for situational diagnosis) and predictive capacity (high correlation with mortality). Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. A robust and versatile mass spectrometry platform for comprehensive assessment of the thiol redox metabolome

    Directory of Open Access Journals (Sweden)

    T.R. Sutton

    2018-06-01

    Full Text Available Several diseases are associated with perturbations in redox signaling and aberrant hydrogen sulfide metabolism, and numerous analytical methods exist for the measurement of the sulfur-containing species affected. However, uncertainty remains about their concentrations and speciation in cells/biofluids, perhaps in part due to differences in sample processing and detection principles. Using ultrahigh-performance liquid chromatography in combination with electrospray-ionization tandem mass spectrometry we here outline a specific and sensitive platform for the simultaneous measurement of 12 analytes, including total and free thiols, their disulfides and sulfide in complex biological matrices such as blood, saliva and urine. Total assay run time is < 10 min, enabling high-throughput analysis. Enhanced sensitivity and avoidance of artifactual thiol oxidation is achieved by taking advantage of the rapid reaction of sulfhydryl groups with N-ethylmaleimide. We optimized the analytical procedure for detection and separation conditions, linearity and precision including three stable isotope labelled standards. Its versatility for future more comprehensive coverage of the thiol redox metabolome was demonstrated by implementing additional analytes such as methanethiol, N-acetylcysteine, and coenzyme A. Apparent plasma sulfide concentrations were found to vary substantially with sample pretreatment and nature of the alkylating agent. In addition to protein binding in the form of mixed disulfides (S-thiolation a significant fraction of aminothiols and sulfide appears to be also non-covalently associated with proteins. Methodological accuracy was tested by comparing the plasma redox status of 10 healthy human volunteers to a well-established protocol optimized for reduced/oxidized glutathione. In a proof-of-principle study a deeper analysis of the thiol redox metabolome including free reduced/oxidized as well as bound thiols and sulfide was performed

  9. SOCIO-PEDAGOGICAL EVALUATION OF TEACHING STAFF ACTIVITIES IN COMPREHENSIVE SCHOOLS AS AN INDEPENDENT MECHANISM OF EDUCATION QUALITY ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Irina О. Antipina

    2014-01-01

    Full Text Available The aim of the research is to reveal various ways for developing the independent mechanisms of education quality assessment.Methods involve the analysis of the existing views concerning the quality assessment of teaching staff activities.Results: The research findings demonstrate functional specificity of comprehensive schools, the main phases of socio-pedagogic assessment of teaching staff activities, and the main criteria and indices of their monitoring. The author considers professional educational activity as a general assessment criterion. The main feature of socio-pedagogic assessment procedures involves participation of different categories of teaching and research staff, along with students’ parents and the neighboring society members.Scientific novelty: The author specifies the concept of socio-pedagogic assessment of teaching staff activities.Practical significance: Implementation of the research outcomes can stimulate professional activity of pedagogical society in developing the independent system of education quality assessment.

  10. A Multiobjective Optimization Including Results of Life Cycle Assessment in Developing Biorenewables-Based Processes.

    Science.gov (United States)

    Helmdach, Daniel; Yaseneva, Polina; Heer, Parminder K; Schweidtmann, Artur M; Lapkin, Alexei A

    2017-09-22

    A decision support tool has been developed that uses global multiobjective optimization based on 1) the environmental impacts, evaluated within the framework of full life cycle assessment; and 2) process costs, evaluated by using rigorous process models. This approach is particularly useful in developing biorenewable-based energy solutions and chemicals manufacturing, for which multiple criteria must be evaluated and optimization-based decision-making processes are particularly attractive. The framework is demonstrated by using a case study of the conversion of terpenes derived from biowaste feedstocks into reactive intermediates. A two-step chemical conversion/separation sequence was implemented as a rigorous process model and combined with a life cycle model. A life cycle inventory for crude sulfate turpentine was developed, as well as a conceptual process of its separation into pure terpene feedstocks. The performed single- and multiobjective optimizations demonstrate the functionality of the optimization-based process development and illustrate the approach. The most significant advance is the ability to perform multiobjective global optimization, resulting in identification of a region of Pareto-optimal solutions. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Evaluation of the Treatment of Congenital Penile Curvature Including Psychosexual Assessment.

    Science.gov (United States)

    Zachalski, Wojciech; Krajka, Kazimierz; Matuszewski, Marcin

    2015-08-01

    Penile corporoplasty is a well-established treatment method of congenital penile deviation (CPD). Anatomical results are good with only slight differences between surgical procedures used. The disease however has huge influence on young male quality of life. This issue is not well analyzed in the literature. The aim of the study was to evaluate quality of life of the patients affected with CPD before and after the surgical treatment Study population consisted of 107 patients with CPD referred for surgical management. Patients were evaluated with not only clinical assessment, but also by four questionnaires measuring various aspects of quality of life. They were: Short-Form Medical Outcomes, Sexual Quality of Life Questionnaire for Man, Beck Depression Inventory, and International Index of Erectile Function. Quality of life measurements showed deep decrease in the general quality of life, sexual performance, depression scale, as well as in physical and mental health in men with CPD. All these parameters were restored to normal after the successful surgical treatment with any method. CPD deeply decreases the quality of life of the affected men in many aspects. Surgical treatment is able to repair the anatomical deformity and as well as significantly restore the patients' psychosocial well-being. © 2015 International Society for Sexual Medicine.

  12. QMRAcatch: Microbial Quality Simulation of Water Resources including Infection Risk Assessment.

    Science.gov (United States)

    Schijven, Jack; Derx, Julia; de Roda Husman, Ana Maria; Blaschke, Alfred Paul; Farnleitner, Andreas H

    2015-09-01

    Given the complex hydrologic dynamics of water catchments and conflicts between nature protection and public water supply, models may help to understand catchment dynamics and evaluate contamination scenarios and may support best environmental practices and water safety management. A catchment model can be an educative tool for investigating water quality and for communication between parties with different interests in the catchment. This article introduces an interactive computational tool, QMRAcatch, that was developed to simulate concentrations in water resources of , a human-associated microbial source tracking (MST) marker, enterovirus, norovirus, , and as target microorganisms and viruses (TMVs). The model domain encompasses a main river with wastewater discharges and a floodplain with a floodplain river. Diffuse agricultural sources of TMVs that discharge into the main river are not included in this stage of development. The floodplain river is fed by the main river and may flood the plain. Discharged TMVs in the river are subject to dilution and temperature-dependent degradation. River travel times are calculated using the Manning-Gauckler-Strickler formula. Fecal deposits from wildlife, birds, and visitors in the floodplain are resuspended in flood water, runoff to the floodplain river, or infiltrate groundwater. Fecal indicator and MST marker data facilitate calibration. Infection risks from exposure to the pathogenic TMVs by swimming or drinking water consumption are calculated, and the required pathogen removal by treatment to meet a health-based quality target can be determined. Applicability of QMRAcatch is demonstrated by calibrating the tool for a study site at the River Danube near Vienna, Austria, using field TMV data, including a sensitivity analysis and evaluation of the model outcomes. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  13. Canadian Environmental Assessment Act : A comprehensive study report on the Peribonka hydroelectric power project

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the results of an environmental assessment of Hydro-Quebec's proposed project to build a new facility on the Peribonka River. The facility includes a run-of-river generating station with an installed capacity of 385 MW. The Quebec Region of the Department of Fisheries and Oceans Canada has conducted an environmental assessment of the project's effects. A summary of the project and the environment in which it will be carried out was presented along with the results of public consultations conducted by Hydro-Quebec. A summary of the main environmental effects was included along with cumulative effects and the effects caused by accidents or malfunctions that may occur. In addition, the terms and conditions of mitigation measures and follow-up programs were described and the significance of any environmental impacts were assessed. The project includes the construction of a 80 metre high dam, two dikes and one spillway upstream of the mouth of the Manouane River. The level of the reservoir would remain at close to its maximum level of 244.2 metres to optimize hydroelectric production. The power house would be integrated into the Hydro-Quebec transmission network. The main impacts of the project would result from the construction of the reservoir, the encroachment caused by associated facilities and the changes in hydrological conditions. This report outlined the current use of lands and resources for traditional purposes by Aboriginals. It also discussed the effects of natural events such as flooding, waves and climate that may cause damage to the facilities. It was determined that the project is not likely to cause significant effects on the renewable resources of the forest and the fisheries. The Department of Fisheries and Oceans, after having taking into account proposed mitigation measures, has rendered a preliminary conclusion which states that the project is not likely to have significant negative environmental effects. 29 refs., 7 tabs., 2

  14. Life Cycle Assessment, ExternE and Comprehensive Analysis for an integrated evaluation of the environmental impact of anthropogenic activities

    Energy Technology Data Exchange (ETDEWEB)

    Pietrapertosa, F.; Cosmi, C. [National Research Council, Institute of Methodologies for Environmental Analysis C.N.R.-I.M.A.A. C.da S.Loja, I-85050 Tito Scalo (PZ) (Italy); National Research Council, National Institute for the Physics of Matter, C.N.R.-I.N.F.M. Via Cinthia, I-80126 Naples (Italy); Macchiato, M. [Federico II University, Department of Physical Sciences, Via Cinthia, I-80126 Naples (Italy); National Research Council, National Institute for the Physics of Matter, C.N.R.-I.N.F.M. Via Cinthia, I-80126 Naples (Italy); Salvia, M.; Cuomo, V. [National Research Council, Institute of Methodologies for Environmental Analysis C.N.R.-I.M.A.A. C.da S.Loja, I-85050 Tito Scalo (PZ) (Italy)

    2009-06-15

    The implementation of resource management strategies aimed at reducing the impacts of the anthropogenic activities system requires a comprehensive approach to evaluate on the whole the environmental burdens of productive processes and to identify the best recovery strategies from both an environmental and an economic point of view. In this framework, an analytical methodology based on the integration of Life Cycle Assessment (LCA), ExternE and Comprehensive Analysis was developed to perform an in-depth investigation of energy systems. The LCA methodology, largely utilised by the international scientific community for the assessment of the environmental performances of technologies, combined with Comprehensive Analysis allows modelling the overall system of anthropogenic activities, as well as sub-systems, the economic consequences of the whole set of environmental damages. Moreover, internalising external costs into partial equilibrium models, as those utilised by Comprehensive Analysis, can be useful to identify the best paths for implementing technology innovation and strategies aimed to a more sustainable energy supply and use. This paper presents an integrated application of these three methodologies to a local scale case study (the Val D'Agri area in Basilicata, Southern Italy), aimed to better characterise the environmental impacts of the energy system, with particular reference to extraction activities. The innovative methodological approach utilised takes advantage from the strength points of each methodology with an added value coming from their integration as emphasised by the main results obtained by the scenario analysis. (author)

  15. The prospective relationship between work stressors and cardiovascular disease, using a comprehensive work stressor measure for exposure assessment.

    Science.gov (United States)

    Szerencsi, Karolina; van Amelsvoort, Ludovic; Prins, Martin; Kant, Ijmert

    2014-02-01

    The currently used instruments which measure the psychosocial work environment have been criticized. We analyzed the association between work stressors and cardiovascular disease, using the Maastricht Cohort Study Work Stressor Score (MCS-WSS), a comprehensive measure which has been associated with work strain. At baseline 11,489 employees of the Maastricht Cohort Study were participating. This prospective cohort study started in 1998 in the Netherlands and includes a heterogeneous population of employees. The psychosocial work environment, cardiovascular risk factors and the occurrence of cardiovascular disease were measured with questionnaires at various time points during follow-up, the last follow-up was in 2008. For a subsample of employees, CVD extracted from medical records was available. The MCS-WSS consists of items from emotional demands, psychological demands, role clarity, career possibilities, working overtime, job insecurity, cognitive demands, skills discretion and decision authority. Each item has its own contribution in inducing work strain, represented by its own weighting factor. The association between a high exposure to work stressors at baseline and cardiovascular morbidity was assessed with Cox regression analyses. Analyses were adjusted for age, gender, educational level, smoking, body mass index, alcohol consumption and leisure physical activity. During a median follow-up of 49 months, 309 employees developed incident cardiovascular disease. Overall, no significant associations were found between a high exposure to work stressors at baseline and cardiovascular morbidity. The results of this study indicate that high exposure to work stressors has no considerable impact on cardiovascular disease.

  16. The Natural History of Flare-Ups in Fibrodysplasia Ossificans Progressiva (FOP): A Comprehensive Global Assessment.

    Science.gov (United States)

    Pignolo, Robert J; Bedford-Gay, Christopher; Liljesthröm, Moira; Durbin-Johnson, Blythe P; Shore, Eileen M; Rocke, David M; Kaplan, Frederick S

    2016-03-01

    glucocorticoids. This study is the first comprehensive global assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.

  17. Does the Component Processes Task Assess Text-Based Inferences Important for Reading Comprehension? A Path Analysis in Primary School Children.

    Science.gov (United States)

    Wassenburg, Stephanie I; de Koning, Björn B; de Vries, Meinou H; van der Schoot, Menno

    2016-01-01

    Using a component processes task (CPT) that differentiates between higher-level cognitive processes of reading comprehension provides important advantages over commonly used general reading comprehension assessments. The present study contributes to further development of the CPT by evaluating the relative contributions of its components (text memory, text inferencing, and knowledge integration) and working memory to general reading comprehension within a single study using path analyses. Participants were 173 third- and fourth-grade children. As hypothesized, knowledge integration was the only component of the CPT that directly contributed to reading comprehension, indicating that the text-inferencing component did not assess inferential processes related to reading comprehension. Working memory was a significant predictor of reading comprehension over and above the component processes. Future research should focus on finding ways to ensure that the text-inferencing component taps into processes important for reading comprehension.

  18. A Comparative Study of the Effects of Two Approaches of Dynamic Assessment on the Reading Comprehension of Iranian EFL Learners

    Directory of Open Access Journals (Sweden)

    Jila Naeini

    2015-03-01

    Full Text Available The aim of this study was to examine and compare the impact of two Dynamic Assessment (DA approaches, that is, Feuerstein’s Mediated Learning Experience (MLE and Brown’s Graduated Prompt (GP on Iranian EFL learners’ reading comprehension. Therefore, a mixed methods approach consisting of a semi-structured interview, a pretest, an intervention program, a posttest, and a transfer test was applied to assess and compare the efficacy of two DA approaches. One hundred and two EFL learners taking a General English course at Islamic Azad University were assigned to two experimental groups (MLEG and GPG and one comparison group (CG. The participants in the MLEG took part in the MLE, and the participants in the GPG participated in the GP intervention program.  The results of the qualitative as well as the aggregate and disaggregated quantitative data analyses indicated that both intervention approaches of DA were effective in enhancing the learners’ reading comprehension.

  19. Should Pantomime and Gesticulation Be Assessed Separately for Their Comprehensibility in Aphasia? A Case Study

    Science.gov (United States)

    van Nispen, Karin; van de Sandt-Koenderman, Mieke; Mol, Lisette; Krahmer, Emiel

    2014-01-01

    Background: Gesticulation (gestures accompanying speech) and pantomime (gestures in the absence of speech) can each be comprehensible. Little is known about the differences between these two gesture modes in people with aphasia. Aims: To discover whether there are differences in the communicative use of gesticulation and pantomime in QH, a person…

  20. Corrosion risk assessment and comprehensive evaluation of ship sea water pipe systems

    Directory of Open Access Journals (Sweden)

    YANG Guangfu

    2017-05-01

    Full Text Available In order to propose a comprehensive corrosion risk evaluation model based on an analysis of the corrosion risk of sea water pipe systems of ships in service,the modes of potential corrosion and their causes were first analyzed by identifying the origins of the inner and outer corrosion of the sea water pipe systems. In accordance with the matrixes of corrosion occurrence possibility and corrosion risk consequence,a corrosion risk matrix was established for a sea water pipe system. The method for the quantitative evaluation value of each mode of corrosion possibly occurring in a sea water pipe system was then presented. The comprehensive evaluation model of the corrosion was first built using the Analytical Hierarchy Process(AHP,which can be used for the comprehensive corrosion evaluation. The results show that the comprehensive evaluation value will be expressed as the corrosion risk level and corrosion-induced consequence of the sea water pipe system. This will be very useful for accurately protecting the sea water pipe systems of ships in service from corrosion,thereby attaining the goals of economy,rationality and timeliness.

  1. Comparing Students with and without Reading Difficulties on Reading Comprehension Assessments: A Meta-Analysis

    Science.gov (United States)

    Collins, Alyson A.; Lindström, Esther R.; Compton, Donald L.

    2018-01-01

    Researchers have increasingly investigated sources of variance in reading comprehension test scores, particularly with students with reading difficulties (RD). The purpose of this meta-analysis was to determine if the achievement gap between students with RD and typically developing (TD) students varies as a function of different reading…

  2. Chemical Technology Division Comprehensive Self-Assessment and Upgrade Program (CSAUP). Performance Objectives and Criteria

    International Nuclear Information System (INIS)

    1990-05-01

    The U.S. Department of Energy (DOE) has placed strong emphasis on a new way of doing business patterned on the lessons learned in the nuclear power industry after the accident at Three Mile Island Unit 2. The new way relies on strict adherence to policies and procedures, a greatly expanded training program, and much more rigor and formality in operations. Another key element is more visible oversight by upper management and auditability by DOR Although the Chemical Technology Division (Chem Tech) has functioned in a safe manner since its beginning, the policies and methods of the past are no longer appropriate. Therefore, in accordance with these directives, Chem Tech is improving its operational performance by making a transition to greater formality in the observance of policies and procedures and a more deliberate consideration of the interrelationships between organizations at ORNL. This transition to formality is vitally important because both our staff and our facilities are changing with time. For example, some of the inventors and developers of the processes and facilities in use are now ''passing the torch'' to the next generation of Chem Tech staff. Our faculties have also served us well for many years, but the newest of these are now over 20 years old. All have increasing needs of refurbishment and repair, and some of the older ones need to be replaced. The Comprehensive Self-Assessment and Upgrade Program (CSAUP) has been patterned on a similar activity performed at the High Flux Isotope Reactor. Using the Draft DOE Performance Objectives and Criteria for Technical Safety Appraisals (May 1987) as a starting point, it was determined that 14 functional areas for evaluation listed in the report were suitable for Chem Tech use. An additional 5 functional areas were added for completeness since Chem Tech has a broader set of missions than a reactor facility. The Performance Objectives and Criteria (POC) for each functional area in the DOE report were

  3. Army Pacific Pathways: Comprehensive Assessment and Planning Needed to Capture Benefits Relative to Costs and Enhance Value for Participating Units

    Science.gov (United States)

    2016-11-01

    capture its value for decision makers. USARPAC and other Army officials have stated that Pacific Pathways provides certain benefits, including the...initiative’s benefits relative to its costs to fully capture the value of the initiative for external stakeholders. Several Pacific Pathways individual...achieving its intended objectives, including increasing readiness, and to improve subsequent Pathways—not to capture the comprehensive value of

  4. Delphi consensus of an expert committee in oncogeriatrics regarding comprehensive geriatric assessment in seniors with cancer in Spain.

    Science.gov (United States)

    Molina-Garrido, Maria-Jose; Guillén-Ponce, Carmen; Blanco, Remei; Saldaña, Juana; Feliú, Jaime; Antonio, Maite; López-Mongil, Rosa; Ramos Cordero, Primitivo; Gironés, Regina

    2017-12-13

    The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66.7% coincidence in responses and by the stability of said coincidence (changes ≤15% between rounds). The study was conducted between July and December 2016. Of the 17 people invited to participate, 16 agreed. The panel concluded by consensus that the following domains should be included in the CGA:(and the scales to evaluate them): functional (Barthel Index, Lawton-Brody scale, gait speed), cognitive (Pfeiffer questionnaire), nutritional (Mini Nutritional Assessment - MNA), psychological/mood (Yesavage scale), social-familial (Gijon scale), comorbidity (Charlson index), medications, and geriatric syndromes (urinary and/or fecal incontinence, low auditory and/or visual acuity, presence of falls, pressure sores, insomnia, and abuse). Also by consensus, the CGA should be administered to older patients with cancer for whom there is a subsequent therapeutic intent and who scored positive on a previous frailty-screening questionnaire. After 3 rounds, consensus was reached regarding CGA domains to be used in older patients with cancer, the scales to be administered for each of these domains, as well as the timeline to be followed during consultation. Copyright © 2017. Published by Elsevier Ltd.

  5. Comprehensive genomic analyses of the OM43 clade including a novel species from Red Sea indicate ecotype differentiation among marine methylotrophs

    KAUST Repository

    Jimenez Infante, Francy M.

    2015-12-11

    The OM43 clade within the family Methylophilaceae of Betaproteobacteria represents a group of methylotrophs playing important roles in the metabolism of C1 compounds in marine environments and other aquatic environments around the globe. Using dilution-to-extinction cultivation techniques, we successfully isolated a novel species of this clade (designated here as MBRS-H7) from the ultra-oligotrophic open ocean waters of the central Red Sea. Phylogenomic analyses indicate that MBRS-H7 is a novel species, which forms a distinct cluster together with isolate KB13 from Hawaii (H-RS cluster) that is separate from that represented by strain HTCC2181 (from the Oregon coast). Phylogenetic analyses using the robust 16S–23S internal transcribed spacer revealed a potential ecotype separation of the marine OM43 clade members, which was further confirmed by metagenomic fragment recruitment analyses that showed trends of higher abundance in low chlorophyll and/or high temperature provinces for the H-RS cluster, but a preference for colder, highly productive waters for the HTCC2181 cluster. This potential environmentally driven niche differentiation is also reflected in the metabolic gene inventories, which in the case of H-RS include those conferring resistance to high levels of UV irradiation, temperature, and salinity. Interestingly, we also found different energy conservation modules between these OM43 subclades, namely the existence of the NADH:quinone oxidoreductase NUO system in the H-RS and the non-homologous NQR system in HTCC2181, which might have implications on their overall energetic yields.

  6. Comprehensive Genomic Analyses of the OM43 Clade, Including a Novel Species from the Red Sea, Indicate Ecotype Differentiation among Marine Methylotrophs.

    Science.gov (United States)

    Jimenez-Infante, Francy; Ngugi, David Kamanda; Vinu, Manikandan; Alam, Intikhab; Kamau, Allan Anthony; Blom, Jochen; Bajic, Vladimir B; Stingl, Ulrich

    2016-02-15

    The OM43 clade within the family Methylophilaceae of Betaproteobacteria represents a group of methylotrophs that play important roles in the metabolism of C1 compounds in marine environments and other aquatic environments around the globe. Using dilution-to-extinction cultivation techniques, we successfully isolated a novel species of this clade (here designated MBRS-H7) from the ultraoligotrophic open ocean waters of the central Red Sea. Phylogenomic analyses indicate that MBRS-H7 is a novel species that forms a distinct cluster together with isolate KB13 from Hawaii (Hawaii-Red Sea [H-RS] cluster) that is separate from the cluster represented by strain HTCC2181 (from the Oregon coast). Phylogenetic analyses using the robust 16S-23S internal transcribed spacer revealed a potential ecotype separation of the marine OM43 clade members, which was further confirmed by metagenomic fragment recruitment analyses that showed trends of higher abundance in low-chlorophyll and/or high-temperature provinces for the H-RS cluster but a preference for colder, highly productive waters for the HTCC2181 cluster. This potential environmentally driven niche differentiation is also reflected in the metabolic gene inventories, which in the case of the H-RS cluster include those conferring resistance to high levels of UV irradiation, temperature, and salinity. Interestingly, we also found different energy conservation modules between these OM43 subclades, namely, the existence of the NADH:quinone oxidoreductase complex I (NUO) system in the H-RS cluster and the nonhomologous NADH:quinone oxidoreductase (NQR) system in the HTCC2181 cluster, which might have implications for their overall energetic yields. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  7. Similar but Different: Differences in Comprehension Diagnosis on the Neale Analysis of Reading Ability and the York Assessment of Reading for Comprehension

    Science.gov (United States)

    Colenbrander, Danielle; Nickels, Lyndsey; Kohnen, Saskia

    2017-01-01

    Background: Identifying reading comprehension difficulties is challenging. There are many comprehension tests to choose from, and a child's diagnosis can be influenced by various factors such as a test's format and content and the choice of diagnostic criteria. We investigate these issues with reference to the Neale Analysis of Reading Ability…

  8. Improvement of comprehensive assessment of specially trained childhood and adolescence gymnasts

    Directory of Open Access Journals (Sweden)

    V.A. Zaporozhanov

    2014-10-01

    Full Text Available In terms of the age of development and formation of sportsmanship athletes reliability and data set of benchmarks used in the management of the training process varies due to various circumstances. Purpose: to improve unit performance special psychophysical readiness gymnasts used in the management of the training process (n=38, n=44. Material: surveyed a group of gymnasts of children and youth of both sexes, members of the specialized sports schools for eight common indicators of psychophysical readiness. Results: reliability of measurements of these indicators and their information content in connection with the specific requirements of gymnastics metrically calculated using the methods of mathematical statistics. Conclusions: substantiated minimum set of the five most reliable informative indicators. The expediency of the calculation and use of the control system integrated assessment preparedness gymnasts, including index kinesthesia.

  9. Comprehensive geriatric assessment in elderly cancer patients: an experience in an outpatient population.

    Science.gov (United States)

    Arnoldi, Ermenegildo; Dieli, Maria; Mangia, Marina; Minetti, Bruno; Labianca, Roberto

    2007-01-01

    Cancer is an age-related disease, and the increase in life expectancy will lead to a progressive increase of cancer cases in the elderly (> or =70 years of age). We have created a group called GONG (Gruppo Oncologico Geriatrico) to apply cancer geriatric assessment in elderly cancer patients, in order to select which of them are eligible for oncological treatment or supportive care only. We applied this model to evaluate 153 patients from March 2004 to August 2005. Our model included three categories of patients: frail (at least one of the following items: Activities of Daily Living scale or =3 comorbidities unrelated to the tumor according to the Charlson Index, performance status or =3 according respectively to Karnofsky and the ECOG scale, > or =1 geriatric syndrome); borderline (patients with multiple comorbidities not affecting performance status or ability in daily activities); non-frail. Applying the aforementioned criteria, we found 30 borderline, 14 frail and 109 non-frail patients. Statistical analysis showed a significant difference in mortality between frail and non-frail patients (P patients. Our model was thus able to identify patients at higher risk of death. These results confirm the importance of cancer geriatric assessment also for the clinical evaluation of oncological patients. Additional randomized studies with a larger number of patients, also in an adjuvant setting, should be performed to confirm the effectiveness of this approach.

  10. Comprehensive risk assessment method of catastrophic accident based on complex network properties

    Science.gov (United States)

    Cui, Zhen; Pang, Jun; Shen, Xiaohong

    2017-09-01

    On the macro level, the structural properties of the network and the electrical characteristics of the micro components determine the risk of cascading failures. And the cascading failures, as a process with dynamic development, not only the direct risk but also potential risk should be considered. In this paper, comprehensively considered the direct risk and potential risk of failures based on uncertain risk analysis theory and connection number theory, quantified uncertain correlation by the node degree and node clustering coefficient, then established a comprehensive risk indicator of failure. The proposed method has been proved by simulation on the actual power grid. Modeling a network according to the actual power grid, and verified the rationality of the proposed method.

  11. Minimal second language exposure, SES, and early word comprehension: New evidence from a direct assessment*

    Science.gov (United States)

    Deanda, Stephanie; Arias-Trejo, Natalia; Poulin-Dubois, Diane; Zesiger, Pascal; Friend, Margaret

    2015-01-01

    Although the extant literature provides robust evidence of the influence of language exposure and socioeconomic status (SES) on language acquisition, it is unknown how sensitive the early receptive vocabulary system is to these factors. The current study investigates effects of minimal second language exposure and SES on the comprehension vocabulary of 16-month-old children in the language in which they receive the greatest exposure. Study 1 revealed minimal second language exposure and SES exert significant and independent effects on a direct measure of vocabulary comprehension in English-dominant and English monolingual children (N = 72). In Study 2, we replicated the effect of minimal second language exposure in Spanish-dominant and Spanish monolingual children (N = 86), however no effect of SES on vocabulary was obtained. Our results emphasize the sensitivity of the language system to minimal changes in the environment in early development. PMID:26957947

  12. Comprehensive assessment of hazard and risk generated by different fuel cycles of electric energy production - results of completed and ongoing EU programmes

    International Nuclear Information System (INIS)

    Borysiewicz, M.; Garanty, I.; Kozubal, A.

    2007-01-01

    A number of international organizations and research institutions attempted to develop recommended approaches to holistic assessment of hazards and risk generated by fuel cycles of electrical energy production from fuel mining, transportation, plant construction and operation, wastes generation to installation decommissioning. It includes an interagency project coordinated by IAEA and series of projects completed in the EU programme: ExternE and a new project: NEEDS extending the methodology of ExternE for more comprehensive treatment various factors impacting health, environment, economy and energy security. The paper is a brief overview methods used in these projects and the results obtained. (author)

  13. Assessment of surface ship environment adaptability in seaways: A fuzzy comprehensive evaluation method

    OpenAIRE

    Jiao, Jialong; Ren, Huilong; Sun, Shuzheng

    2016-01-01

    Due to the increasing occurrence of maritime accidents and high-level requirements and modernization of naval wars, the concept of ship environment adaptability becomes more and more important. Therefore, it is of great importance to carry out an evaluation system for ship environment adaptability, which contributes to both ship design and classification. This paper develops a comprehensive evaluation system for ship environment adaptability based on fuzzy mathematics theory. An evaluation in...

  14. A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees.

    Science.gov (United States)

    Allami, Mostafa; Mousavi, Batool; Masoumi, Mehdi; Modirian, Ehsan; Shojaei, Hadi; Mirsalimi, Fatemeh; Hosseini, Maryam; Pirouzi, Pirouz

    2016-01-01

    Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation. The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees (206 amputations) from the Iran-Iraq war were evaluated, and a detailed questionnaire was also administered. The most common level of amputation was the finger or wrist level (108, 52.4 %). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis (65, 31.6 %), rotator cuff injury (24, 11.7 %), bicipital tendonitis (69, 33.5 %), shoulder drop (42, 20.4 %) and muscle atrophy (19, 9.2 %). Peripheral nerve disorders included carpal tunnel syndrome in 13 (6.3 %) and unilateral brachial plexus injury in 1 (1 %). Fifty-three (51.5 %) were diagnosed with facet joint syndrome at the level of the cervical spine (the most frequent site). Using a prosthesis was reported by 65 (63.1 %), both left and right sides. The back was the most common site of pain (71.8 %). The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.

  15. Comprehensive risk assessment for rail transportation of dangerous goods: a validated platform for decision support

    International Nuclear Information System (INIS)

    Gheorghe, Adrian V.; Birchmeier, Juerg; Vamanu, Dan; Papazoglou, Ioannis; Kroeger, Wolfgang

    2005-01-01

    Currently, the most advanced and well documented risk assessments for the transportation of dangerous goods by railway take into account:(i)statistics-based loss of containment frequencies, (ii) specification of potential consequences for a given release situations using event tree methodology as an organisational tool and (iii) consequence calculation models to determine a risk figure known as CCDF (Complementary Cumulative Distribution Function). Such procedures for the risk assessment (including for example decision-making on preventive measures) may offer only a limited insight into the causes and sequences leading to an accident and do not allow for any kind of predictive analysis. The present work introduces an enhanced solution, and a related software platform, which attempts to integrate loss of containment causes and consequences with system's infrastructure and its environment. The solution features:(i)the use of a detailed Master Logical Diagram, including fault/event tree analysis to determine a loss of containment frequency based on different initiating events, scenarios and specific basic data, (ii) the characterization of a resulting source term following a release situation, and (iii) the calculation of various potential impacts on the neighbouring site. Results are wrapped into a CCDF format for each selected traffic segment. The risk-related results are integrated on a software platform, structured as a decision support system using intelligent maps and a variety of GIS (Geographical Information System) data processing procedures. The introduction of the hot spot approach, allows us to focus on the most risk-relevant areas and to use information on various railway infrastructure elements (e.g. points, tunnels), are the basis of the new models employed. The software is applicable to any railway transportation system, comprising its technical infrastructure, rolling stock, human actions, regulation and management procedures. It provides the

  16. What should be included in the assessment of laypersons' paediatric basic life support skills? Results from a Delphi consensus study.

    Science.gov (United States)

    Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim; Bohnstedt, Cathrine; Sønderskov, Claus; Østergaard, Doris; Tolsgaard, Martin Grønnebæk

    2018-01-18

    Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts suggested items to assess laypersons' PBLS and FBAOM skills. In the second round, the suggested items received comments from and were rated by 26 experts (93%) on a 5-point scale (1 = not relevant to 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) experts completed a re-rating. Items with a score above 3 by more than 80% of the experts in the third round were included in an assessment instrument. In the first round, 19 and 15 items were identified to assess PBLS and FBAOM skills, respectively. The ratings and comments from the last two rounds resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. The PBLS items included: "Responsiveness"," Call for help", "Open airway"," Check breathing", "Rescue breaths", "Compressions", "Ventilations", "Time factor" and "Use of AED". The FBAOM items included: "Identify different stages of foreign body airway obstruction", "Identify consciousness", "Call for help", "Back blows", "Chest thrusts/abdominal thrusts according to age", "Identify loss of consciousness and change to CPR", "Assessment of breathing" and "Ventilation". For assessment of laypersons some PBLS and FBAOM skills described in guidelines are more important than others. Four out of nine of PBLS skills focus on airway and breathing skills, supporting the major importance of these skills for

  17. USGS world petroleum assessment 2000; new estimates of undiscovered oil and natural gas, including reserve growth, outside the United States

    Science.gov (United States)

    ,

    2000-01-01

    Oil and natural gas account for approximately 63 percent of the world’s total energy consumption. The U.S. Geological Survey periodically estimates the amount of oil and gas remaining to be found in the world. Since 1981, each of the last four of these assessments has shown a slight increase in the combined volume of identified reserves and undiscovered resources. The latest assessment estimates the volume of technically recoverable conventional oil and gas that may be added to the world's reserves, exclusive of the United States, in the next 30 years. The USGS World Petroleum Assessment 2000 reports an increase in global petroleum resources, including a 20-percent increase in undiscovered oil and a 14-percent decrease in undiscovered natural gas compared to the previous assessment (table 1). These results have important implications for energy prices, policy, security, and the global resource balance.

  18. Cognitive Approach to Assessing Pragmatic Language Comprehension in Children with Specific Language Impairment

    Science.gov (United States)

    Ryder, Nuala; Leinonen, Eeva; Schulz, Joerg

    2008-01-01

    Background: Pragmatic language impairment in children with specific language impairment has proved difficult to assess, and the nature of their abilities to comprehend pragmatic meaning has not been fully investigated. Aims: To develop both a cognitive approach to pragmatic language assessment based on Relevance Theory and an assessment tool for…

  19. Usability assessment of an electronic health record in a comprehensive dental clinic.

    Science.gov (United States)

    Suebnukarn, Siriwan; Rittipakorn, Pawornwan; Thongyoi, Budsara; Boonpitak, Kwanwong; Wongsapai, Mansuang; Pakdeesan, Panu

    2013-12-01

    In this paper we present the development and usability of an electronic health record (EHR) system in a comprehensive dental clinic.The graphic user interface of the system was designed to consider the concept of cognitive ergonomics.The cognitive task analysis was used to evaluate the user interface of the EHR by identifying all sub-tasks and classifying them into mental or physical operators, and to predict task execution time required to perform the given task. We randomly selected 30 cases that had oral examinations for routine clinical care in a comprehensive dental clinic. The results were based on the analysis of 4 prototypical tasks performed by ten EHR users. The results showed that on average a user needed to go through 27 steps to complete all tasks for one case. To perform all 4 tasks of 30 cases, they spent about 91 min (independent of system response time) for data entry, of which 51.8 min were spent on more effortful mental operators. In conclusion, the user interface can be improved by reducing the percentage of mental effort required for the tasks.

  20. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    Directory of Open Access Journals (Sweden)

    Ekerstad N

    2016-12-01

    Full Text Available Niklas Ekerstad,1,2 Björn W Karlson,3 Synneve Dahlin Ivanoff,4 Sten Landahl,5 David Andersson,6 Emelie Heintz,7 Magnus Husberg,2 Jenny Alwin2 1Department of Cardiology, NU (NÄL-Uddevalla Hospital Group, Trollhattan, 2Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, 3Department of Molecular and Clinical Medicine, Institute of Medicine, 4Centre for Ageing and Health, AGECAP, Department of Health and Rehabilitation, 5Department of Geriatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 6Division of Economics, Department of Management and Engineering, Linköping University, Linköping, 7Health Outcomes and Economic Evaluation Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden Objective: The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA unit is superior to the care in a conventional acute medical care unit. Design: This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting: This study was conducted in a large county hospital in western Sweden. Participants: The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206 or control group (n=202. Mean age of the patients was 85.7 years, and 56% were female. Intervention: This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements: The primary outcome was the change in health-related quality of life (HRQoL 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3. Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results: After adjustment by

  1. Decoding and Reading Comprehension: A Meta-Analysis to Identify Which Reader and Assessment Characteristics Influence the Strength of the Relationship in English

    Science.gov (United States)

    García, J. Ricardo; Cain, Kate

    2014-01-01

    The twofold purpose of this meta-analysis was to determine the relative importance of decoding skills to reading comprehension in reading development and to identify which reader characteristics and reading assessment characteristics contribute to differences in the decoding and reading comprehension correlation. A meta-analysis of 110 studies…

  2. Reading comprehension assessment through retelling: differences between dyslexic and language-based learning disable students

    Directory of Open Access Journals (Sweden)

    Adriana Souza Batista Kida

    2016-06-01

    Full Text Available AbstractPurpose: To study reading comprehension performance profiles of children with dyslexia as well as language-based learning disability by means of retelling tasks. Method: 105 children from second to fifth grades of elementary school were gathered into six groups: Dyslexia group (D; n=19, Language-based learning disability group (LBLD; n=16; their respective control groups paired according to different variables - age, gender, grade and school system (public or private (D-control and LBLD-control; and other control groups paired according to different reading accuracy (D-accuracy; LBLD-accuracy. All of the children read an expository text and orally retold the story as they understood it. The analysis quantified propositions (main ideas and details and retold links. A retelling reference standard (3-0 was also established from the best to the worst performance. We compared both clinical groups (D and LBLD with their respective control groups by means of Mann-Whitney tests.Results: D showed the same total of propositions, links and reference standards as D-control, but performed better than D-accuracy in macro structural (total of links and super structural (retelling reference standard measures. Results suggest that dyslexic children are able to use their linguistic competence and their own background knowledge to minimize the effects of their decoding deficit, especially at the highest text processing levels. LBLD performed worse than LBLD-control in all of the retelling measures and LBLD showed worse performance than LBLD-accuracy in the total retold links and retelling reference standard. Those results suggest that both decoding and linguistic difficulties affect reading comprehension. Moreover, the linguistic deficits presented by LBLD students do not allow these pupils to perform as competently in terms of text comprehension as the children with dyslexia do. Thus, failure in the macro and super-structural information processing of the

  3. A comprehensive assessment of options for the legal form of the Paris Climate Agreement

    International Nuclear Information System (INIS)

    Maljean-Dubois, Sandrine; Wemaere, Matthieu; Thomas Spencer

    2014-01-01

    For many years, the issue of the legal form of the new climate agreement has hovered over the international negotiations. Countries have insisted on first discussing substance. Indeed, it is here that the main divergences remain. However, one year out from the Paris climate conference, it is time to open the discussion on the legal form of the final agreement. The issue of legal form is often reduced to the negotiation of a 'binding' or 'non-binding' agreement. The bindingness of an international environmental agreement however depends on multiple parameters. We propose four parameters to be considered: the form of the core agreement; the 'anchoring' of commitments; mechanisms for transparency, accountability and facilitation; and mechanisms for compliance. Parties should assess pros and cons of these options, and the agreement be optimised across all four. Negotiations appear to be heading towards a hybrid agreement. Some provisions would be contained in a core agreement, and some in implementing documents such as decisions or schedules. This structure can help to balance legal certainty with flexibility. The core agreement should contain a binding provision to implement and regularly update a 'nationally determined contribution' (NDC). If these NDCs were to be housed outside the agreement, this could give more flexibility on their content, submission and updating. The core agreement should contain strong provisions on transparency, accountability and facilitation, including independent institutional arrangements (a Transparency Committee). At this stage in global cooperation and given inherent weaknesses in international environmental law, a punitive compliance mechanism seems unfeasible. However, the agreement should contain a compliance mechanism regarding procedural obligations, such as submission and updating of NDCs. (authors)

  4. Role of comprehension on performance at higher levels of Bloom's taxonomy: Findings from assessments of healthcare professional students.

    Science.gov (United States)

    Verenna, Anne-Marie A; Noble, Kim A; Pearson, Helen E; Miller, Susan M

    2018-01-18

    The first four levels of Bloom's taxonomy were used to create quiz questions designed to assess student learning of the gross anatomy, histology, and physiology of the gastrointestinal (GI) system. Information on GI histology and physiology was presented to separate samples of medical, dental, and podiatry students in computer based tutorials where the information from the two disciplines was presented either separately or in an integrated fashion. All students were taught GI gross anatomy prior to this study by course faculty as part of the required curriculum of their respective program. Student responses to the quiz questions were analyzed to assess both the validity of Bloom's cumulative hierarchy and the effectiveness of an integrated curriculum. No statistically significant differences were found between quiz scores from students who received the integrated tutorial and from those who received the separate tutorials. Multiple regression analyses provided partial support for a cumulative hierarchy where scores on the lower levels of Bloom's taxonomy predicted scores on higher levels. Notably, in the majority of regression analyses, the comprehension score was the key foundational predictor for application and analysis scores. This study supports the suggestion that educators increase the number of comprehension level questions, even at the expense of knowledge level questions, in course assessments both to evaluate lower order cognitive skills and also as a predictor of success on questions requiring application and analysis levels of the higher order cognitive skills of Bloom's taxonomy. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

  5. Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients.

    Science.gov (United States)

    Wang, Kai; Zeng, Guang-Qiao; Li, Rui; Luo, Yu-Wen; Wang, Mei; Hu, Yu-He; Xu, Wen-Hui; Zhou, Lu-Qian; Chen, Rong-Chang; Chen, Xin

    2017-01-01

    Cycle ergometer training (CET) has been shown to improve exercise performance of the quadriceps muscles in patients with COPD, and inspiratory muscle training (IMT) may improve the pressure-generating capacity of the inspiratory muscles. However, the effects of combined CET and IMT remain unclear and there is a lack of comprehensive assessment. Eighty-one patients with COPD were randomly allocated to three groups: 28 received 8 weeks of CET + IMT (combined training group), 27 received 8 weeks of CET alone (CET group), and 26 only received 8 weeks of free walking (control group). Comprehensive assessment including respiratory muscle strength, exercise capacity, pulmonary function, dyspnea, quality of life, emotional status, nutritional status, and body mass index, airflow obstruction, and exercise capacity index were measured before and after the pulmonary rehabilitation program. Respiratory muscle strength, exercise capacity, inspiratory capacity, dyspnea, quality of life, depression and anxiety, and nutritional status were all improved in the combined training and CET groups when compared with that in the control group ( P Inspiratory muscle strength increased significantly in the combined training group when compared with that in the CET group (ΔPI max [maximal inspiratory pressure] 5.20±0.89 cmH 2 O vs 1.32±0.91 cmH 2 O; P 0.05). Patients with weakened respiratory muscles in the combined training group derived no greater benefit than those without respiratory muscle weakness ( P >0.05). There were no significant differences in these indices between the patients with malnutrition and normal nutrition after pulmonary rehabilitation program ( P >0.05). Combined training is more effective than CET alone for increasing inspiratory muscle strength. IMT may not be useful when combined with CET in patients with weakened inspiratory muscles. Nutritional status had slight impact on the effects of pulmonary rehabilitation. A comprehensive assessment approach can be more

  6. A Comprehensive Approach for Assessing Person Fit with Test-Retest Data

    Science.gov (United States)

    Ferrando, Pere J.

    2014-01-01

    Item response theory (IRT) models allow model-data fit to be assessed at the individual level by using person-fit indices. This assessment is also feasible when IRT is used to model test-retest data. However, person-fit developments for this type of modeling are virtually nonexistent. This article proposes a general person-fit approach for…

  7. Repeatability of food frequency assessment tools in relation to the number of items and response categories included

    OpenAIRE

    Bountziouka, V. (Vassiliki); Bathrellou, E. (Eirini); Zazpe, I. (Itziar); Ezquer, L. (Leyre); Martinez-Gonzalez, M.A. (Miguel Ángel); Panagiotakos, D.B. (Demosthenes B.)

    2012-01-01

    Background: Accuracy of a measurement is a cornerstone in research in order to make robust conclusions about the research hypothesis. Objective: To examine whether the number of items (questions) and the number of responses of consumption included in nutritional assessment tools influence their repeatability. Methods: During 2009, 400 participants (250 from Greece, 37±13 yrs, 34% males and 150 participants from Spain, 39±17 yrs, 41% males) completed a diet index with 11-items a...

  8. Developing a Comprehensive Risk Assessment Framework for Geological Storage CO2

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, Ian [Univ. of Texas, Austin, TX (United States)

    2014-08-31

    The operational risks for CCS projects include: risks of capturing, compressing, transporting and injecting CO₂; risks of well blowouts; risk that CO2 will leak into shallow aquifers and contaminate potable water; and risk that sequestered CO2 will leak into the atmosphere. This report examines these risks by using information on the risks associated with analogue activities such as CO2 based enhanced oil recovery (CO2-EOR), natural gas storage and acid gas disposal. We have developed a new analysis of pipeline risk based on Bayesian statistical analysis. Bayesian theory probabilities may describe states of partial knowledge, even perhaps those related to non-repeatable events. The Bayesian approach enables both utilizing existing data and at the same time having the capability to adsorb new information thus to lower uncertainty in our understanding of complex systems. Incident rates for both natural gas and CO2 pipelines have been widely used in papers and reports on risk of CO2 pipelines as proxies for the individual risk created by such pipelines. Published risk studies of CO2 pipelines suggest that the individual risk associated with CO2 pipelines is between 10-3 and 10-4, which reflects risk levels approaching those of mountain climbing, which many would find unacceptably high. This report concludes, based on a careful analysis of natural gas pipeline failures, suggests that the individual risk of CO2 pipelines is likely in the range of 10-6 to 10-7, a risk range considered in the acceptable to negligible range in most countries. If, as is commonly thought, pipelines represent the highest risk component of CCS outside of the capture plant, then this conclusion suggests that most (if not all) previous quantitative- risk assessments of components of CCS may be orders of magnitude to high. The potential lethality of unexpected CO2 releases

  9. Role of a comprehensive toxicity assessment and monitoring program in the management and ecological recovery of a wastewater receiving stream.

    Science.gov (United States)

    Greeley, Mark S; Kszos, Lynn A; Morris, Gail W; Smith, John G; Stewart, Arthur J

    2011-06-01

    National Pollution Discharge Elimination Permit (NPDES)-driven effluent toxicity tests using Ceriodaphnia dubia and fathead minnows were conducted for more than 20 years to assess and monitor the effects of wastewaters at the United States (U.S.) Department of Energy Y-12 National Security Complex (Y-12 Complex) in Oak Ridge, Tennessee. Toxicity testing was also conducted on water samples from East Fork Poplar Creek (EFPC), the wastewater receiving stream, as part of a comprehensive biological monitoring and assessment program. In this paper, we evaluate the roles of this long-term toxicity assessment and monitoring program in the management and ecological recovery of EFPC. Effluent toxicity testing, associated toxicant evaluation studies, and ambient toxicity monitoring were instrumental in identifying toxicant sources at the Y-12 Complex, guiding modifications to wastewater treatment procedures, and assessing the success of various pollution-abatement actions. The elimination of untreated wastewater discharges, the dechlorination of remaining wastewater streams, and the implementation of flow management at the stream headwaters were the primary actions associated with significant reductions in the toxicity of stream water in the upper reaches of EFPC from the late 1980s through mid 1990s. Through time, as regulatory requirements changed and water quality improved, emphasis shifted from comprehensive toxicity assessments to more focused toxicity monitoring efforts. Ambient toxicity testing with C. dubia and fathead minnows was supplemented with less-standardized but more sensitive alternative laboratory toxicity tests and in situ bioassays. The Y-12 Complex biological monitoring experience demonstrates the value of toxicity studies to the management of a wastewater receiving stream.

  10. New Stream-reach Development: A Comprehensive Assessment of Hydropower Energy Potential in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Kao, Shih-Chieh [ORNL; McManamay, Ryan A [ORNL; Stewart, Kevin M [ORNL; Samu, Nicole M [ORNL; Hadjerioua, Boualem [ORNL; DeNeale, Scott T [ORNL; Yeasmin, Dilruba [California State University, Fresno; Pasha, M. Fayzul K. [California State University, Fresno; Oubeidillah, Abdoul A [ORNL; Smith, Brennan T [ORNL

    2014-04-01

    The rapid development of multiple national geospatial datasets related to topography, hydrology, and environmental characteristics in the past decade have provided new opportunities for the refinement of hydropower resource potential from undeveloped stream-reaches. Through 2011 to 2013, the Oak Ridge National Laboratory (ORNL) was tasked by the Department of Energy (DOE) Water Power Program to evaluate the new stream-reach development (NSD) resource potential for more than 3 million US streams. A methodology was designed that contains three main components: (1) identification of stream-reaches with high energy density, (2) topographical analysis of stream-reaches to estimate inundated surface area and reservoir storage, and (3) environmental attribution to spatially join information related to the natural ecological systems, social and cultural settings, policies, management, and legal constraints to stream-reaches of energy potential. An initial report on methodology (Hadjerioua et al., 2013) was later reviewed and revised based on the comments gathered from two peer review workshops. After implementing the assessment across the entire United States, major findings were summarized in this final report. The estimated NSD capacity and generation, including both higher-energy-density (>1 MW per reach) and lower-energy-density (<1 MW per reach) stream-reaches is 84.7 GW, around the same size as the existing US conventional hydropower nameplate capacity (79.5 GW; NHAAP, 2013). In terms of energy, the total undeveloped NSD generation is estimated to be 460 TWh/year, around 169% of average 2002 2011 net annual generation from existing conventional hydropower plants (272 TWh/year; EIA, 2013). Given the run-of-river assumption, NSD stream-reaches have higher capacity factors (53 71%), especially compared with conventional larger-storage peaking-operation projects that usually have capacity factors of around 30%. The highest potential is identified in the Pacific Northwest

  11. A comprehensive assessment of the life cycle energy demand of passive houses

    International Nuclear Information System (INIS)

    Stephan, André; Crawford, Robert H.; Myttenaere, Kristel de

    2013-01-01

    Highlights: • The life cycle energy demand of a passive house (PH) is measured over 100 years. • Embodied, operational and user transport energy demand are considered. • Embodied energy represents the highest energy consumption in all variations. • A PH might not save energy compared to a standard house. • A poorly insulated city apartment can use less energy than a best case suburban PH. - Abstract: Certifications such as the Passive House aim to reduce the final space heating energy demand of residential buildings. The latter are responsible for a significant share of final energy consumption in Europe of which nearly 70% is associated with space conditioning, notably heating. The improvement of the energy efficiency of residential buildings, in terms of space heating, can therefore reduce their total energy demand. However, most certifications totally overlook other energy requirements associated with residential buildings. Studies on passive houses do not take into consideration the embodied energy required to manufacture the building materials, especially the large amount of insulation required to achieve high operational efficiencies. At an urban scale, most passive houses are single family detached houses located in low density suburbs with a high car usage, resulting in considerable transport related energy demand. This paper analyses the total life cycle energy demand of a typical Belgian passive house, comprising embodied, operational and transport energy. It relies on a comprehensive technique developed by Stephan et al. [1] and conducts a parametric analysis as well as a comparison to alternative building types. Results show that current building energy efficiency certifications might not ensure a lower energy demand and can, paradoxically result in an increased energy consumption because of their limited scope. More comprehensive system boundaries should be used to make sure that net energy savings do occur. The embodied energy of passive

  12. Comprehensive Cognitive Assessments are not Necessary for the Identification and Treatment of Learning Disabilities.

    Science.gov (United States)

    Fletcher, Jack M; Miciak, Jeremy

    2017-02-01

    There is considerable controversy about the necessity of cognitive assessment as part of an evaluation for learning and attention problems. The controversy should be adjudicated through an evaluation of empirical research. We review five sources of evidence commonly provided as support for cognitive assessment as part of the learning disability (LD) identification process, highlighting significant gaps in empirical research and where existing evidence is insufficient to establish the reliability and validity of cognitive assessments used in this way. We conclude that current evidence does not justify routine cognitive assessment for LD identification. As an alternative, we offer an instructional conceptualization of LD: a hybrid model that directly informs intervention and is based on documenting low academic achievement, inadequate response to intensive interventions, and a consideration of exclusionary factors. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. [Comprehensive assessment on the outcome of Tianjin Act of Tobacco Control].

    Science.gov (United States)

    Jiang, Guohong; Li, Wei; Zheng, Wenlong; Xu, Zhongliang; Wang, Dezheng; Pan, Yi; Shen, Chengfeng; Yang, Yi; Wang, Zhuo; Ma, Jie; Xue, Xiaodan; Shen, Wenda

    2015-06-01

    To evaluate the integrated effects of tobacco control programs through comparing the pre- and post-implementation of the Tianjin Tobacco Control Act (Act), in 4 successive years. Case-related data on myocardial infarction was collected by Tianjin Surveillance System, New Case Registry. Both the representative sample size of indoor working places and public places for observation and PM2.5 monitored were selected through the calculation of Survey System, while the representative sample size of people involved in the survey for interview was under the Door to Door and Intercept. Through comparing the pre- and post-implementation programs on Act, the posting of "No Smoking Sign" had become much more visible in hospitals, schools, governmental buildings and the waiting areas of public transportation. People smoked much less in the main public places, excepting for hotels and public bath rooms (P infarction presented at the hospitals were declining annually, among the indoor workers. Act showed a positive effect in decreasing the number of smokers in public places thus protecting people from the negative effects on SHS. Message on health effect and social benefits on tobacco control should be disseminated to facilitate the comprehensive implementation of the Act.

  14. Association of anemia and hypoalbuminemia in German geriatric inpatients: Relationship to nutritional status and comprehensive geriatric assessment.

    Science.gov (United States)

    Röhrig, G; Becker, I; Polidori, M C; Schulz, R-J; Noreik, M

    2015-10-01

    Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; however, there is a lack of information on the association between HA, anemia and nutritional status in older people. This study retrospectively analyzed 626 patients admitted to a German geriatrics department (average age 81.1 years, 68.2% female and 31.8% male) for anemia and HA. Data from the comprehensive geriatric assessment (CGA) and from the mini-nutritional assessment (MNA) were available in all patients. Patients with anemia suffered significantly more often from HA (pGeriatric inpatients with anemia should be evaluated in terms of the presence of malnutrition risk and HA.

  15. MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffeler, Christoph [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kantonsspital Graubuenden, Musculoskeletal Imaging, Chur (Switzerland); Waldt, Simone; Bauer, Jan S.; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kirchhoff, Chlodwig [Technische Universitaet Muenchen, Department of Traumatology, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Munich (Germany); Schroeder, Michael [Center for Sports Orthopedics and Medicine, Orthosportiv, Munich (Germany); Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Orthopedic Sports Medicine, Munich (Germany)

    2014-06-15

    To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images. Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes. The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups. Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate. (orig.)

  16. Including pathogen risk in life cycle assessment of wastewater management. 1. Estimating the burden of disease associated with pathogens.

    Science.gov (United States)

    Harder, Robin; Heimersson, Sara; Svanström, Magdalena; Peters, Gregory M

    2014-08-19

    The environmental performance of wastewater and sewage sludge management is commonly assessed using life cycle assessment (LCA), whereas pathogen risk is evaluated with quantitative microbial risk assessment (QMRA). This study explored the application of QMRA methodology with intent to include pathogen risk in LCA and facilitate a comparison with other potential impacts on human health considered in LCA. Pathogen risk was estimated for a model wastewater treatment system (WWTS) located in an industrialized country and consisting of primary, secondary, and tertiary wastewater treatment, anaerobic sludge digestion, and land application of sewage sludge. The estimation was based on eight previous QMRA studies as well as parameter values taken from the literature. A total pathogen risk (expressed as burden of disease) on the order of 0.2-9 disability-adjusted life years (DALY) per year of operation was estimated for the model WWTS serving 28,600 persons and for the pathogens and exposure pathways included in this study. The comparison of pathogen risk with other potential impacts on human health considered in LCA is detailed in part 2 of this article series.

  17. Comprehensive assessment of sequence variation within the copy number variable defensin cluster on 8p23 by target enriched in-depth 454 sequencing

    Directory of Open Access Journals (Sweden)

    Zhang Xinmin

    2011-05-01

    Full Text Available Abstract Background In highly copy number variable (CNV regions such as the human defensin gene locus, comprehensive assessment of sequence variations is challenging. PCR approaches are practically restricted to tiny fractions, and next-generation sequencing (NGS approaches of whole individual genomes e.g. by the 1000 Genomes Project is confined by an affordable sequence depth. Combining target enrichment with NGS may represent a feasible approach. Results As a proof of principle, we enriched a ~850 kb section comprising the CNV defensin gene cluster DEFB, the invariable DEFA part and 11 control regions from two genomes by sequence capture and sequenced it by 454 technology. 6,651 differences to the human reference genome were found. Comparison to HapMap genotypes revealed sensitivities and specificities in the range of 94% to 99% for the identification of variations. Using error probabilities for rigorous filtering revealed 2,886 unique single nucleotide variations (SNVs including 358 putative novel ones. DEFB CN determinations by haplotype ratios were in agreement with alternative methods. Conclusion Although currently labor extensive and having high costs, target enriched NGS provides a powerful tool for the comprehensive assessment of SNVs in highly polymorphic CNV regions of individual genomes. Furthermore, it reveals considerable amounts of putative novel variations and simultaneously allows CN estimation.

  18. Comprehensive assessment of fruits and vegetables human health effects in a LCA context

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Jolliet, O.; Fantke, Peter

    2016-01-01

    in which the substituted food items are associated with negative health effects, such as red meat and trans-fat. Overall environmental health impacts associated with this addition are substantially smaller compared to nutritional benefits in each scenario, even when considering an uncertainty factor of 400......Nutritional effects from the ‘use stage’ of food items life cycle can have a substantial effect on human health; yet, they are often not considered in life cycle assessment (LCA). In our study we explore the case of increased fruit and vegetable consumption, a healthy dietary option – that could...... the environmental and nutritional effects of foods expressed in Disability Adjusted Life Years (DALYs). For the environmental health assessment we consider impact categories such as global warming and particulate matter (PM) as well as chemical exposure due to pesticide residues. Global warming and PM are assessed...

  19. Impact of a quality-assessment dashboard on the comprehensive review of pharmacist performance.

    Science.gov (United States)

    Trinh, Long D; Roach, Erin M; Vogan, Eric D; Lam, Simon W; Eggers, Garrett G

    2017-09-01

    The impact of a quality-assessment dashboard and individualized pharmacist performance feedback on the adherence of order verification was evaluated. A before-and-after study was conducted at a 1,440-bed academic medical center. Adherence of order verification was defined as orders verified according to institution-derived, medication-related guidelines and policies. Formulas were developed to assess the adherence of verified orders to dosing guidelines using patient-specific height, weight, and serum creatinine clearance values from the electronic medical record at the time of pharmacist verification. A total of 5 medications were assessed by the formulas for adherence and displayed on the dashboard: ampicillin-sulbactam, ciprofloxacin, piperacillin-tazobactam, acyclovir, and enoxaparin. Adherence of order verification was assessed before (May 1-July 31, 2015) and after (November 1, 2015-January 31, 2016) individualized performance feedback was given based on trends identified by the quality-assessment dashboard. There was a significant increase in the overall adherence rate postintervention (90.1% versus 91.9%, p = 0.040). Among the 34 pharmacists who participated, the percentage of pharmacists with at least 90% overall adherence increased postintervention (52.9% versus 70.6%, p = 0.103). Time to verification was similar before and after the study intervention (median, 6.0 minutes; interquartile range, 3-13 minutes). The rate of documentation for nonadherent orders increased significantly postintervention (57.1% versus 68.5%, p = 0.019). The implementation of the quality-assessment dashboard, educational sessions, and individualized performance feedback significantly improved pharmacist order-verification adherence to institution-derived, medication-related guidelines and policies and the documentation rate of nonadherent orders. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    Science.gov (United States)

    Ekerstad, Niklas; Karlson, Björn W; Dahlin Ivanoff, Synneve; Landahl, Sten; Andersson, David; Heintz, Emelie; Husberg, Magnus; Alwin, Jenny

    2017-01-01

    The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. This is a clinical, prospective, randomized, controlled, one-center intervention study. This study was conducted in a large county hospital in western Sweden. The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female. This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. After adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14-0.79), ambulation (OR =0.19, 95% CI =0.1-0.37), dexterity (OR =0.38, 95% CI =0.19-0.75), emotion (OR =0.43, 95% CI =0.22-0.84), cognition (OR = 0.076, 95% CI =0.033-0.18) and pain (OR =0.28, 95% CI =0.15-0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32-0.96), and the two groups did not differ significantly in terms of hospital care costs ( P >0.05). Patients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality, at no higher cost.

  1. Comprehensive Ultrasound Assessment of the Craniocervical Circulation in Transient Global Amnesia.

    Science.gov (United States)

    Jovanovic, Zagorka B; Pavlovic, Aleksandra M; Vujisic Tesic, Bosiljka P; Pekmezovic, Tatjana P; Kostic Boricic, Marija V; Cvitan, Edita Z; Covickovic Sternic, Nadezda M

    2018-02-01

    Structural changes and metabolic stress have been reported on diffusion-weighted magnetic resonance imaging in the cornu ammonis 1 area of the hippocampus in patients with transient global amnesia (TGA), but a consensus on pathogenesis is still lacking. The aim of our study was to perform a comprehensive ultrasound analysis of the cerebrovascular circulation in our population of patients with TGA. One hundred patients with TGA and 50 age- and sex-matched control participants underwent ultrasound examinations of the cervicocranial circulation. The most significant risk factor for TGA was arterial hypertension (P  .05). Rarely detected microembolic signals or a right-left cardiopulmonary shunt excluded an emboligenic mechanism of TGA (P > .05). The internal jugular vein valves were incompetent in 54% of patients with TGA, and this condition was associated with an increased risk of TGA (odds ratio, 4.16; 95% confidence interval, 1.91-9.04). The mean values of the breath holding index and pulsatility index, as parameters of small-vessel function, were within normal ranges and without differences between the TGA and control groups (P > .05). Our ultrasound examination did not detect significant structural atherosclerotic changes of cervicocranial arteries, and an emboligenic mechanism was excluded. Only a significant rise of blood pressure in TGA and significant valvular insufficiency of the internal jugular vein were established. New research should clarify whether these simultaneous functional circulatory changes have relevance for metabolic stress in the cornu ammonis of the hippocampus. © 2017 by the American Institute of Ultrasound in Medicine.

  2. Comprehensive description of blood microbiome from healthy donors assessed by 16S targeted metagenomic sequencing.

    Science.gov (United States)

    Païssé, Sandrine; Valle, Carine; Servant, Florence; Courtney, Michael; Burcelin, Rémy; Amar, Jacques; Lelouvier, Benjamin

    2016-05-01

    Recent studies have revealed that the blood of healthy humans is not as sterile as previously supposed. The objective of this study was to provide a comprehensive description of the microbiome present in different fractions of the blood of healthy individuals. The study was conducted in 30 healthy blood donors to the French national blood collection center (Établissement Français du Sang). We have set up a 16S rDNA quantitative polymerase chain reaction assay as well as a 16S targeted metagenomics sequencing pipeline specifically designed to analyze the blood microbiome, which we have used on whole blood as well as on different blood fractions (buffy coat [BC], red blood cells [RBCs], and plasma). Most of the blood bacterial DNA is located in the BC (93.74%), and RBCs contain more bacterial DNA (6.23%) than the plasma (0.03%). The distribution of 16S DNA is different for each fraction and spreads over a relatively broad range among donors. At the phylum level, blood fractions contain bacterial DNA mostly from the Proteobacteria phylum (more than 80%) but also from Actinobacteria, Firmicutes, and Bacteroidetes. At deeper taxonomic levels, there are striking differences between the bacterial profiles of the different blood fractions. We demonstrate that a diversified microbiome exists in healthy blood. This microbiome has most likely an important physiologic role and could be implicated in certain transfusion-transmitted bacterial infections. In this regard, the amount of 16S bacterial DNA or the microbiome profile could be monitored to improve the safety of the blood supply. © 2016 AABB.

  3. Assessing the Applicability of Currently Available Methods for Attributing Foodborne Disease to Sources, Including Food and Food Commodities

    DEFF Research Database (Denmark)

    Pires, Sara Monteiro

    2013-01-01

    hazards. These articles have described strengths and weaknesses of each method, but no guidance on how to choose the most appropriate tool to address different public health questions has thus far been provided. We reviewed available source attribution methods; assessed their applicability to attribute...... that the proportion of disease that can be attributed to specific foods items or transmission routes may be estimated for the majority of the evaluated hazards by applying one or more of the source attribution methods assessed. It was also recognized that the use of source attribution methods may be limited......Abstract A variety of approaches to attribute foodborne diseases to specific sources are available, including hazard occurrence analysis, epidemiological methods, intervention studies, and expert elicitations. The usefulness of each method to attribute disease caused by a foodborne hazard depends...

  4. The University Environment: A Comprehensive Assessment of Health-Related Advertisements

    Science.gov (United States)

    Szymona, Katie; Quick, Virginia; Olfert, Melissa; Shelnutt, Karla; Kattlemann, Kendra K.; Brown-Esters, Onikia; Colby, Sarah E.; Beaudoin, Christina; Lubniewski, Jocelyn; Maia, Angelina Moore; Horacek, Tanya; Byrd-Bredbenner, Carol

    2012-01-01

    Purpose: Little is known about health-related advertising on university environments. Given the power of advertising and its potential effect on health behaviors, the purpose of this paper is to assess the health-related advertisement environment and policies on university campuses. Design/methodology/approach: In total, ten geographically and…

  5. Towards a comprehensive evaluation system for the quality of tests and assessments

    NARCIS (Netherlands)

    Wools, Saskia; Eggen, Theodorus Johannes Hendrikus Maria; Veldkamp, Bernard P.

    2012-01-01

    To evaluate the quality of educational assessments, several evaluation systems are available. These systems are, however, focused around the evaluation of a single type of test. Furthermore, within these systems, quality is defined as a non-flexible construct, whereas in this paper it is argued that

  6. Assessing the Quality of Expertise Differences in the Comprehension of Medical Visualizations

    Science.gov (United States)

    Gegenfurtner, Andreas; Siewiorek, Anna; Lehtinen, Erno; Saljo, Roger

    2013-01-01

    Understanding how best to assess expertise, the situational variations of expertise, and distinctive qualities of expertise that arises from particular workplace experiences, presents an important challenge. Certainly, at this time, there is much interest in identifying standard occupational measures and competences, which are not well aligned…

  7. Assessing the role of prevention partnerships in STD prevention: a review of comprehensive STD prevention systems progress reports.

    Science.gov (United States)

    Hogben, Matthew; Hood, Julia; Collins, Dayne; McFarlane, Mary

    2013-11-01

    Systematic analysis of STD programme data contributes to a national portrait of sexually transmitted disease (STD) prevention activities, including research and evaluation specifically designed to optimise programme efficiency and impact. We analysed the narrative of the 2009 annual progress reports of the US Comprehensive STD Prevention Systems cooperative agreement for 58 STD programmes, concentrating on programme characteristics and partnerships. Programmes described 516 unique partnerships with a median of seven organisations cited per STD programme. Non-profit organisations (including service providers) were most frequently cited. Higher gonorrhoea morbidity was associated with reporting more partnerships; budget problems were associated with reporting fewer. Challenges to engaging in partnerships included budget constraints, staff turnover and low interest. Data provide a source of information for judging progress in programme collaboration and for informing a sustained programme-focused research and evaluation agenda.

  8. 42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

    Science.gov (United States)

    2010-10-01

    ..., identification of the following: (i) Effectiveness of drug therapy. (ii) Drug side effects. (iii) Actual or... factors that affect care planning. (3) Functional status, including the patient's ability to understand...

  9. 75 FR 30423 - Draft Comprehensive Conservation Plan and Environmental Assessment; Canaan Valley National...

    Science.gov (United States)

    2010-06-01

    ... levels, including the West Virginia northern flying squirrel, bald eagle, and the Federal listed Cheat... protect the federally threatened Cheat Mountain salamander, the federally endangered Indiana bat, and the...

  10. Assessment of pulmonary artery pressure by echocardiography—A comprehensive review

    Directory of Open Access Journals (Sweden)

    Sathish Parasuraman

    2016-09-01

    Full Text Available Pulmonary hypertension is a pathological haemodynamic condition defined as an increase in mean pulmonary arterial pressure ≥ 25 mmHg at rest, assessed using gold standard investigation by right heart catheterisation. Pulmonary hypertension could be a complication of cardiac or pulmonary disease, or a primary disorder of small pulmonary arteries. Elevated pulmonary pressure (PAP is associated with increased mortality, irrespective of the aetiology. The gold standard for diagnosis is invasive right heart catheterisation, but this has its own inherent risks. In the past 30 years, immense technological improvements in echocardiography have increased its sensitivity for quantifying pulmonary artery pressure (PAP and it is now recognised as a safe and readily available alternative to right heart catheterisation. In the future, scores combining various echo techniques can approach the gold standard in terms of sensitivity and accuracy, thereby reducing the need for repeated invasive assessments in these patients.

  11. Robustness assessments are needed to reduce bias in meta-analyses that include zero-event randomized trials

    DEFF Research Database (Denmark)

    Keus, F; Wetterslev, J; Gluud, C

    2009-01-01

    of statistical method on inference. RESULTS: In seven meta-analyses of seven outcomes from 15 trials, there were zero-event trials in 0 to 71.4% of the trials. We found inconsistency in significance in one of seven outcomes (14%; 95% confidence limit 0.4%-57.9%). There was also considerable variability...... in the confidence limits, the intervention-effect estimates, and heterogeneity for all outcomes. CONCLUSIONS: The statistical method may influence the inference drawn from a meta-analysis that includes zero-event trials. Robustness assessments are needed to reduce bias in meta-analyses that include zero......OBJECTIVES: Meta-analysis of randomized trials with binary data can use a variety of statistical methods. Zero-event trials may create analytic problems. We explored how different methods may impact inferences from meta-analyses containing zero-event trials. METHODS: Five levels of statistical...

  12. Comprehensive assessment of firm financial performance using financial ratios and linguistic analysis of annual reports

    OpenAIRE

    Renáta Myšková; Petr Hájek

    2017-01-01

    Indicators of financial performance, especially financial ratio analysis, have become important financial decision-support information used by firm management and other stakeholders to assess financial stability and growth potential. However, additional information may be hidden in management communication. The article deals with the analysis of the annual reports of U.S. firms from both points of view, a financial one based on a set of financial ratios, and a linguistic one based on the anal...

  13. Clams sensitivity towards As and Hg: A comprehensive assessment of native and exotic species.

    Science.gov (United States)

    Velez, Cátia; Freitas, Rosa; Antunes, Sara C; Soares, Amadeu M V M; Figueira, Etelvina

    2016-03-01

    To assess the environmental impact of As and Hg, bioindicator organisms such as bivalves have been used. Nevertheless, few studies have assessed the impacts of As and Hg in Ruditapes decussatus and Ruditapes philippinarum, which are native and exotic species in Europe, respectively. The main goal of the present study was to assess elements' partitioning and detoxification strategies of R. decussatus and R. philippinarum. Both clams showed a higher capacity to bioconcentrate Hg (BCF 2.29-7.49), when compared to As (0.59-1.09). Furthermore, As accumulation in both species was similar in the soluble and insoluble fractions, while in both species the majority of Hg was found in the insoluble fraction. Clams exposed to As showed different detoxification strategies, since R. decussatus had higher ability to enhance antioxidant enzymes and metallothioneins in order to reduce toxicity, and R.philippinarum increased glutathione S-transferase Ω activity, that catalyzes monomethyl arsenate reduction, the rate-limiting reaction in arsenic biotransformation. When exposed to Hg, R. decussatus presented, higher synthesis of antioxidant enzymes and lower LPO, being able to better tolerate Hg than the exotic species R. philippinarum. Thus under relevant levels of As and Hg contamination our work evidenced the higher ability of R. decussatus to survive and inhabit coastal environments not heavily contaminated by Hg and As. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Technical Feasibility and Comprehensive Sustainability Assessment of Sweet Sorghum for Bioethanol Production in China

    Directory of Open Access Journals (Sweden)

    Xiaolin Yang

    2018-03-01

    Full Text Available Under dual pressures of energy and environmental security, sweet sorghum is becoming one of the most promising feedstocks for biofuel production. In the present study, the technical feasibility of sweet sorghum production was assessed in eight agricultural regions in China using the Sweet Sorghum Production Technique Maturity Model. Three top typical agricultural zones were then selected for further sustainability assessment of sweet sorghum production: Northeast China (NEC, Huang-Huai-Hai Basin (HHHB and Ganxin Region (GX. Assessment results demonstrated that NEC exhibited the best sustainable production of sweet sorghum, with a degree of technical maturity value of 0.8066, followed by HHHB and GX, with corresponding values of 0.7531 and 0.6594, respectively. Prospective economic profitability analysis indicated that bioethanol production from sweet sorghum was not feasible using current technologies in China. More efforts are needed to dramatically improve feedstock mechanization logistics while developing new bioethanol productive technology to reduce the total cost. This study provides insight and information to guide further technological development toward profitable industrialization and large-scale sweet sorghum bioethanol production.

  15. Repeatability of food frequency assessment tools in relation to the number of items and response categories included.

    Science.gov (United States)

    Bountziouka, Vassiliki; Bathrellou, Eirini; Zazpe, Itziar; Ezquer, Leyre; Martínez-González, Miguel-Angel; Panagiotakos, Demosthenes B

    2012-12-01

    Accuracy of measurement is a cornerstone of research in order to make robust conclusions about the research hypothesis. To examine whether the number of items (questions) and the number of consumption responses (the coding used to measure the frequency of consumption) included in nutritional assessment tools influence their repeatability. During 2009, 400 participants (250 from Greece, mean age 37 +/- 13 years, 34% males, and 150 from Spain, mean age 39 +/- 17 years, 41% males) completed a diet index with 11 items and binary (yes/ no) responses, a diet index with 11 items and 6-scale responses, and 36-item and 76-item food frequency questionnaires (FFQs) with 6-scale responses. The participants completed these tools twice, with 15 days between the two administrations of the tools. The Spearman-Brown coefficient (r(sb)), Kendall's tau coefficients, and the Bland-Altman method were applied to answer the research hypothesis. The highest repeatability coefficient was observed for the diet index with 11 items and binary (yes/no) responses (r(sb) = 0.948, p tools (p > .23), whereas these three tools had significantly higher repeatability coefficients than the 76-item FFQ (p = .002). Subgroup analyses by sex, education, smoking, and clinical status confirmed these results. Repeatability was found for all food frequency assessment tools used, irrespective of the number of items or the number of responses included.

  16. Pulmonary embolism: comprehensive diagnosis by using electron-beam CT for detection of emboli and assessment of pulmonary blood flow.

    Science.gov (United States)

    Schoepf, U J; Bruening, R; Konschitzky, H; Becker, C R; Knez, A; Weber, J; Muehling, O; Herzog, P; Huber, A; Haberl, R; Reiser, M F

    2000-12-01

    To comprehensively assess thoracic anatomy and pulmonary microcirculation in pulmonary embolism by using computed tomographic (CT) angiography of the pulmonary arteries combined with functional CT imaging of blood flow. Twenty-two patients suspected of having acute pulmonary embolism underwent contrast material-enhanced thin-section electron-beam CT angiography of the pulmonary arteries. In addition, in each patient, a dynamic multisection blood flow CT study was performed on a 7.6-cm lung volume with electrocardiographic gating. Pulmonary blood flow was calculated, and perfusion parameters were visualized on color-coded maps. The color-coded maps and CT angiograms were independently evaluated, segment by segment, by two readers for perfusion deficits and the presence of clots, respectively. The results were compared. Mean pulmonary blood flow was 0.63 mL/min/mL in the occluded segments versus 2.27 mL/min/mL in the nonoccluded segments (P: =.001). The sensitivity and specificity of perfusion maps for the presence of segmental pulmonary embolism compared with those of CT angiography were 75.4% and 82.3%, respectively, with positive and negative predictive values of 79.6% and 84.7%, respectively. The false-negative findings were caused mainly by partial occlusion of vessels. In eight patients, a substantial alternative or additional pathologic entity was diagnosed. By combining CT angiography and dynamic CT imaging, a comprehensive and noninvasive diagnosis of thoracic structure and function is feasible with a single modality.

  17. Development of a 'ready-to-use' tool that includes preventability, for the assessment of adverse drug events in oncology.

    Science.gov (United States)

    Hébert, Guillaume; Netzer, Florence; Kouakou, Sylvain Landry; Lemare, François; Minvielle, Etienne

    2018-02-14

    Background Adverse drug events (ADEs) occur frequently in oncology and justify continuous assessment and monitoring. There are several methods for detecting them, but the trigger tool method seems the most appropriate. Although a generic tool exists, its use for ADEs in oncology has not been convincing. The development of a focused version is therefore necessary. Objective To provide an oncology-focused trigger tool that evaluates the prevalence, harm, and preventability in a standardised method for pragmatic use in ADE surveillance. Setting Hospitals with cancer care in France. Method The tool has been constructed in two steps: (1) constitution of an oncology-centred list of ADEs; 30 pharmacists/practitioners in cancer care from nine hospitals selected a list of ADEs using a method of agreement adapted from the RAND/UCLA Appropriateness Method; and (2) construction of three standardised dimensions for the characterisation of each ADE (including causality, severity, and preventability). Main outcome measure The main outcome measure was validation of the tool, including preventability criteria. Results The tool is composed of a final list of 15 ADEs. For each ADE, a 'reviewer form' has been designed and validated by the panel. It comprises (1) the trigger(s), (2) flowcharts to guide the reviewer, (3) criteria for grading harm, and (4) a standardised assessment of preventability with 6-14 closed sentences for each ADE in terms of therapeutic management and/or prevention of side-effects. Conclusion A complete 'ready-to-use' tool for ADE monitoring in oncology has been developed that allows the assessment of three standardised dimensions.

  18. Methods of comprehensive geriatric assessment of older patients with rectal cancer

    Directory of Open Access Journals (Sweden)

    S. S. Gordeev

    2017-01-01

    Full Text Available The article presents a literature review on application of modern risk predictors of complications and morbidity necessary for selection of oncologically justified treatment methods for older patients with rectal cancer taking into account advancement of the disease and concomitant pathology. Use of modern scales, calculators, and questionnaires for evaluation of functional and physical status of this complex patient category by a multidisciplinary team allows to personalize therapy approach, minimize complications and morbidity after specific treatment. Application of the developed algorithms of assessment of older patients creates satisfactory conditions for their treatment based on oncological adequacy, functionality, and safety.  

  19. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    , all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...... and barriers, stating important differences between multidisciplinary and interdisciplinary processes. Checklists and assessment scales may be very useful when performing a geriatric work-up, but they should be used with caution. Specific scales covering different functional areas of the geriatric patient...

  20. MODARIA WG5: Towards a practical guidance for including uncertainties in the results of dose assessment of routine releases

    Energy Technology Data Exchange (ETDEWEB)

    Mora, Juan C. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas - CIEMAT (Spain); Telleria, Diego [International Atomic Energy Agency - IAEA (Austria); Al Neaimi, Ahmed [Emirates Nuclear Energy Corporation - ENEC (United Arab Emirates); Blixt Buhr, Anna Ma [Vattenfall AB (Sweden); Bonchuk, Iurii [Radiation Protection Institute - RPI (Ukraine); Chouhan, Sohan [Atomic Energy of Canada Limited - AECL (Canada); Chyly, Pavol [SE-VYZ (Slovakia); Curti, Adriana R. [Autoridad Regulatoria Nuclear - ARN (Argentina); Da Costa, Dejanira [Instituto de Radioprotecao e Dosimetria - IRD (Brazil); Duran, Juraj [VUJE Inc (Slovakia); Galeriu, Dan [Horia Hulubei National Institute of Physics and Nuclear Engineering - IFIN-HH (Romania); Haegg, Ann- Christin; Lager, Charlotte [Swedish Radiation Safety Authority - SSM (Sweden); Heling, Rudie [Nuclear Research and Consultancy Group - NRG (Netherlands); Ivanis, Goran; Shen, Jige [Ecometrix Incorporated (Canada); Iosjpe, Mikhail [Norwegian Radiation Protection Authority - NRPA (Norway); Krajewski, Pawel M. [Central Laboratory for Radiological Protection - CLOR (Poland); Marang, Laura; Vermorel, Fabien [Electricite de France - EdF (France); Mourlon, Christophe [Institut de Radioprotection et de Surete Nucleaire - IRSN (France); Perez, Fabricio F. [Belgian Nuclear Research Centre - SCK (Belgium); Woodruffe, Andrew [Federal Authority for Nuclear Regulation - FANR (United Arab Emirates); Zorko, Benjamin [Jozef Stefan Institute (Slovenia)

    2014-07-01

    MODARIA (Modelling and Data for Radiological Impact Assessments) project was launched in 2012 with the aim of improving the capabilities in radiation dose assessment by means of acquisition of improved data for model testing, model testing and comparison, reaching consensus on modelling philosophies, approaches and parameter values, development of improved methods and exchange of information. The project focuses on areas where uncertainties remain in the predictive capability of environmental models, emphasizing in reducing associated uncertainties or developing new approaches to strengthen the evaluation of the radiological impact. Within MODARIA, four main areas were defined, one of them devoted to Uncertainty and Variability. In this area four working groups were included, Working Group 5 dealing with the 'uncertainty and variability analysis for assessments of radiological impacts arising from routine discharges of radionuclides'. Whether doses are estimated by using measurement data, by applying models, or through a combination of measurements and calculations, the variability and uncertainty contribute to a distribution of possible values. The degree of variability and uncertainty is represented by the shape and extent of that distribution. The main objective of WG5 is to explore how to consider uncertainties and variabilities in the results of assessment of doses in planned situations for controlling the impact of routine releases from radioactive and nuclear installations to the environment. The final aim is to produce guidance for the calculation of uncertainties in these exposure situations and for the presentation of such results to the different stakeholders. To achieve that objective the main tasks identified were: to find tools and methods for uncertainty and variability analysis applicable to dose assessments in routine radioactive discharges, to define scenarios where information on uncertainty and variability of parameters is available

  1. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction.

    Science.gov (United States)

    Gratzke, Christian; Bachmann, Alexander; Descazeaud, Aurelien; Drake, Marcus J; Madersbacher, Stephan; Mamoulakis, Charalampos; Oelke, Matthias; Tikkinen, Kari A O; Gravas, Stavros

    2015-06-01

    Lower urinary tract symptoms (LUTS) represent one of the most common clinical complaints in adult men and have multifactorial aetiology. To develop European Association of Urology (EAU) guidelines on the assessment of men with non-neurogenic LUTS. A structured literature search on the assessment of non-neurogenic male LUTS was conducted. Articles with the highest available level of evidence were selected. The Delphi technique consensus approach was used to develop the recommendations. As a routine part of the initial assessment of male LUTS, a medical history must be taken, a validated symptom score questionnaire with quality-of-life question(s) should be completed, a physical examination including digital rectal examination should be performed, urinalysis must be ordered, post-void residual urine (PVR) should be measured, and uroflowmetry may be performed. Micturition frequency-volume charts or bladder diaries should be used to assess male LUTS with a prominent storage component or nocturia. Prostate-specific antigen (PSA) should be measured only if a diagnosis of prostate cancer will change the management or if PSA can assist in decision-making for patients at risk of symptom progression and complications. Renal function must be assessed if renal impairment is suspected from the history and clinical examination, if the patient has hydronephrosis, or when considering surgical treatment for male LUTS. Uroflowmetry should be performed before any treatment. Imaging of the upper urinary tract in men with LUTS should be performed in patients with large PVR, haematuria, or a history of urolithiasis. Imaging of the prostate should be performed if this assists in choosing the appropriate drug and when considering surgical treatment. Urethrocystoscopy should only be performed in men with LUTS to exclude suspected bladder or urethral pathology and/or before minimally invasive/surgical therapies if the findings may change treatment. Pressure-flow studies should be performed

  2. A comprehensive risk assessment framework for offsite transportation of inflammable hazardous waste.

    Science.gov (United States)

    Das, Arup; Gupta, A K; Mazumder, T N

    2012-08-15

    A framework for risk assessment due to offsite transportation of hazardous wastes is designed based on the type of event that can be triggered from an accident of a hazardous waste carrier. The objective of this study is to design a framework for computing the risk to population associated with offsite transportation of inflammable and volatile wastes. The framework is based on traditional definition of risk and is designed for conditions where accident databases are not available. The probability based variable in risk assessment framework is substituted by a composite accident index proposed in this study. The framework computes the impacts due to a volatile cloud explosion based on TNO Multi-energy model. The methodology also estimates the vulnerable population in terms of disability adjusted life years (DALY) which takes into consideration the demographic profile of the population and the degree of injury on mortality and morbidity sustained. The methodology is illustrated using a case study of a pharmaceutical industry in the Kolkata metropolitan area. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Assessing the Sustainability of Decentralized Renewable Energy Systems: A Comprehensive Framework with Analytical Methods

    Directory of Open Access Journals (Sweden)

    Aparna Katre

    2018-04-01

    Full Text Available The number of models of Decentralized Renewable Energy (DRE systems, particularly for rural electrification, is growing globally. Most approaches to assess the sustainability of these solutions beyond simple techno-economic considerations are comparative in nature, and only allow us to evaluate performance within a set of other interventions. This leaves a gap in our understanding of the conditions for a specific model to be sustainable and whether its replication is likely to succeed. The approach suggested develops a framework to evaluate the sustainability of specific models for energy access individually and proposes analytical methods to illustrate its use. It combines the multi-dimensional analysis over five sustainability dimensions and the Multi-Tier Framework (MTF to assess technical sustainability, extending MTF’s rigorous scoring methodology to the other dimensions. The scores are based on qualitative and quantitative data collected from key stakeholders, taking into account different perspectives and aims. The framework and analytical methods are exemplified using a subset of data collected in over 40 off-grid DRE systems utilizing a common community ownership and hybrid financial structure. The proposed methodology can be used to understand the sustainability conditions of a given approach to energy access and can therefore be used by practitioners and policy makers to develop strategies and guide policies to roll out effective solutions.

  4. Prospective memory in healthy Chinese people: the latent structure of the Comprehensive Assessment of Prospective Memory Questionnaire.

    Science.gov (United States)

    Chan, Raymond C K; Qing, Yonghong; Wu, Qiuping; Shum, David

    2010-06-01

    This study aimed to examine the latent structure of the Chinese version of the Comprehensive Assessment of Prospective Memory (CAPM) using confirmatory factor analysis. A total of 264 healthy Chinese participants (118 men and 146 women) took part in the study and their ages ranged from 17 to 90 years. There was no gender effect upon the frequency of prospective memory (PM) forgetting but age and education were found to be correlated significantly with these frequencies in the current sample. Results of the study also showed that the model with the best fit had a tripartite structure which consisted of a general memory factor (with all items loading on it) plus a basic activities of daily living as well as an instrumental activities of daily living factor. Furthermore, this tripartite model was robust across subgroups with respect to gender, education, and age. These findings provide support for the construct validity of the original CAPM and demonstrate its utility in another culture.

  5. Assessment of training needs and preferences for geographic information systems (GIS) mapping in state comprehensive cancer-control programs.

    Science.gov (United States)

    Hopfer, Suellen; Chadwick, Amy E; Parrott, Roxanne L; Ghetian, Christie B; Lengerich, Eugene J

    2009-10-01

    Geographic information systems (GIS) mapping technologies have potential to advance public health promotion by mapping regional differences in attributes (e.g., disease burden, environmental exposures, access to health care services) to suggest priorities for public health interventions. Training in GIS for comprehensive cancer control (CCC) has been overlooked. State CCC programs' GIS training needs were assessed by interviewing 49 state CCC directors. A majority perceived a need for GIS training, slightly more than half of state CCC programs had access to geocoded data, and the majority of programs did not require continuing education credits of their staff. CCC directors perceived judging maps and realizing their limitations as important skills and identified epidemiologists, CCC staff, public health officials, policy makers, and cancer coalition members as training audiences. They preferred in-class training sessions that last a few hours to a day. Lessons learned are shared to develop training programs with translatable GIS skills for CCC.

  6. Alternative Assessment Strategy and Its Impact on Student Comprehension in an Undergraduate Microbiology Course

    OpenAIRE

    Barry J. Margulies; Cynthia A. Ghent

    2009-01-01

    Medical Microbiology is a content-intensive course that requires a large time commitment from the students. Students are typically biology or prenursing majors, including students headed for professional schools, such as medical school and pharmacy school. This group is somewhat diverse in terms of background science coursework, so it can be difficult to teach in a way that benefits all the students. Numerous changes have been implemented in our microbiology curriculum to address the differen...

  7. Comprehensive Assessment of Human Health Impacts and Benefits of Fruits and Vegetables in a LCA Context

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Fantke, Peter; Fulgoni, Victor L.

    2017-01-01

    following a traditional LCA approach. For PM, we couple emissions with an epidemiology-based dose-response to estimate impacts. For pesticide residues exposure, we use publically available health impacts derived by combining exposure modelling of pesticide residue with toxicological studies for numerous...... pesticide active ingredients. The nutritional assessment is based on effect factors estimated using the 2010 health burden attributable to corresponding dietary risk factors in DALY from the global burden of disease (GBD) and daily consumption food consumption based on the National Health and Nutrition...... Examination Survey (NHANES) 2009-2012.One fruits serving is linked to 0.07 g PM2.5-eq (0.03 g PM2.5-eq/servingvegetables, Figure 1), 40% due to NH3 as PM precursor, corresponding to 0.08 mu DALY (0.03 mu DALY/servingvegetables). From a nutritional perspective, adding one serving of fruits to the average US...

  8. Elements for a comprehensive assessment of natural resources: bridging environmental economics with ecological economics

    International Nuclear Information System (INIS)

    Rodriguez Romero, Paulo Cesar; Cubillos Gonzalez, Alexander

    2012-01-01

    The predominance of economic assessments regarding the value of natural resources has caused a sub-valuing of the real benefits which societies can obtain from nature. This is due to a lack of knowledge about the complexity of ecological functions, as well as a dismissal of the integrated relations of the sub-systems which make up the environment. It is therefore necessary to establish conceptual bridges between environmental sciences to fill in the gaps in economic valuation methods by recurring to diverse measuring scales, participation from the different actors involved, and a principle of precaution regarding the limits of nature. This paper explores the concepts of value and economic valuation methods from the perspectives of Environmental Economics and Ecological Economics. It then proposes an integration of valuing methodologies which take into account how complementary and complex natures value relations are. This proposal of valuing integrally ecosystem goods and services contributes to adjusting political decisions more accordingly to real environmental conditions.

  9. Comprehensive assessment of health needs 2 months after Hurricane Andrew--Dade County, Florida, 1992.

    Science.gov (United States)

    1993-06-11

    On August 24, 1992, Hurricane Andrew struck southern Florida. More than 28,000 houses, mobile homes, and apartment buildings were destroyed, and approximately 107,000 additional dwellings sustained major damage. An estimated 180,000 persons were left homeless; insured damages were estimated at $15.5 billion and total damages at more than $30 billion. During the recovery period, many private and public health-care facilities damaged or destroyed in the storm were not functional. During November 3-13, to help prioritize health needs and direct public health resources, the Dade County Public Health Unit of the Florida Department of Health and Rehabilitative Services conducted a survey to assess health needs and the availability of health-care services during the recovery phase with funds provided by the Federal Emergency Management Agency (FEMA). This report summarizes the results of the survey.

  10. SU-F-T-636: Comprehensive Approach to Motion Assessment for Liver and Pancreas SBRT Patients

    Energy Technology Data Exchange (ETDEWEB)

    Halvorsen, P; Iftimia, I; Hunter, K [Lahey Hospital and Medical Center, Burlington, MA (United States)

    2016-06-15

    Purpose: Our past practice for liver and pancreas SBRT consisted of free breathing (FB) with gated treatment delivery using a 30-70% phase window. We have recently adopted an assessment method leading to individualized motion management to minimize target motion. We present our results from 47 patients treated with this new approach. Methods: We perform an initial patient coaching and assessment session in our conventional simulator suite to observe the motion of the implanted fiducials with FB anterior and lateral 20-second cine acquisitions. The physician decides whether to attempt inhale or exhale breath-hold (BH). The patient is coached while observing with cine to ascertain their ability to achieve the desired BH mode for long periods as needed for treatment delivery. If the patient cannot comply, a FB approach is adopted using gating or simple ITV method (for patients without fiducials). After achieving a patient-specific motion management mode, we perform CT-simulation using the Varian RPM system to reproduce the chosen mode and record a reference session for treatment delivery. For pre-treatment imaging, the fiducials are observed under fluoro while coaching the patient. Results: Of 47 SBRT cases analyzed, 32 were liver and 15 were pancreas. The chosen techniques were: 32 exhale BH (12 with abdominal compression), 7 FB gated, 4 inhale BH, and 4 FB ITV. Maximum fiducial motion amplitude was 5 mm for the FB gated patients, and less than 5 mm for all BH patients with most able to achieve a maximum amplitude of 3 mm. Conclusion: This study showed that an individualized motion management approach can reduce the target volume and, therefore, the volume of irradiated healthy tissue from liver or pancreas SBRT. Effective coaching is essential in achieving consistent BH with 3 mm amplitude. The fluoro/cine session is helpful in establishing the right coaching approach for each patient.

  11. SU-F-T-636: Comprehensive Approach to Motion Assessment for Liver and Pancreas SBRT Patients

    International Nuclear Information System (INIS)

    Halvorsen, P; Iftimia, I; Hunter, K

    2016-01-01

    Purpose: Our past practice for liver and pancreas SBRT consisted of free breathing (FB) with gated treatment delivery using a 30-70% phase window. We have recently adopted an assessment method leading to individualized motion management to minimize target motion. We present our results from 47 patients treated with this new approach. Methods: We perform an initial patient coaching and assessment session in our conventional simulator suite to observe the motion of the implanted fiducials with FB anterior and lateral 20-second cine acquisitions. The physician decides whether to attempt inhale or exhale breath-hold (BH). The patient is coached while observing with cine to ascertain their ability to achieve the desired BH mode for long periods as needed for treatment delivery. If the patient cannot comply, a FB approach is adopted using gating or simple ITV method (for patients without fiducials). After achieving a patient-specific motion management mode, we perform CT-simulation using the Varian RPM system to reproduce the chosen mode and record a reference session for treatment delivery. For pre-treatment imaging, the fiducials are observed under fluoro while coaching the patient. Results: Of 47 SBRT cases analyzed, 32 were liver and 15 were pancreas. The chosen techniques were: 32 exhale BH (12 with abdominal compression), 7 FB gated, 4 inhale BH, and 4 FB ITV. Maximum fiducial motion amplitude was 5 mm for the FB gated patients, and less than 5 mm for all BH patients with most able to achieve a maximum amplitude of 3 mm. Conclusion: This study showed that an individualized motion management approach can reduce the target volume and, therefore, the volume of irradiated healthy tissue from liver or pancreas SBRT. Effective coaching is essential in achieving consistent BH with 3 mm amplitude. The fluoro/cine session is helpful in establishing the right coaching approach for each patient.

  12. Comprehensive assessment of dam impacts on flow regimes with consideration of interannual variations

    Science.gov (United States)

    Zhang, Yongyong; Shao, Quanxi; Zhao, Tongtiegang

    2017-09-01

    Assessing the impact of human intervention on flow regimes is important in policy making and resource management. Previous impact assessments of dam regulation on flow regimes have focused on long-term average patterns, but interannual variations, which are important characteristics to be considered, have been ignored. In this study, the entire signatures of hydrograph variations of Miyun Reservoir in northern China were described by forty flow regime metrics that incorporate magnitude, variability and frequency, duration, timing, and rate of change for flow events based on a long-term synchronous observation series of inflow and outflow. Principal component analysis and cluster analysis were used to reduce the multidimensionality of the metrics and time and to determine impact patterns and their interannual shifts. Statistically significant driving factors of impact pattern variations were identified. We found that dam regulation resulted in four main impact classes on the flow regimes and that the regulated capacity was interannually attenuated from 1973 to 2010. The impact patterns alternated between the highly regulated class with extremely decreasing flow magnitude, slight variability, and extreme intermittency and the slightly regulated class with extremely increasing flow magnitude, slight variability, and extreme intermittency from 1973 to 1987 and then stabilized in the latter class from 1988 to 2001. After 2001, the pattern gradually changed from the moderately regulated class with moderately decreasing flow magnitude, extreme variability, and extreme intermittency to the slightly regulated class with slightly decreasing flow magnitude, slight variability, and no intermittency. Decreasing precipitation and increasing drought were the primary drivers for the interannual variations of the impact patterns, and inflow variability was the most significant factor affecting the patterns, followed by flow event frequency and duration, magnitude, and timing. This

  13. Carbon Footprint of Inbound Tourism to Iceland: A Consumption-Based Life-Cycle Assessment including Direct and Indirect Emissions

    Directory of Open Access Journals (Sweden)

    Hannah Sharp

    2016-11-01

    Full Text Available The greenhouse gas (GHG emissions caused by tourism have been studied from several perspectives, but few studies exist that include all direct and indirect emissions, particularly those from aviation. In this study, an input/output-based hybrid life-cycle assessment (LCA method is developed to assess the consumption-based carbon footprint of the average tourist including direct and indirect emissions. The total inbound tourism-related GHG emissions are also calculated within a certain region. As a demonstration of the method, the full carbon footprint of an average tourist is assessed as well as the total GHG emissions induced by tourism to Iceland over the period of 2010–2015, with the presented approach applicable in other contexts as well. Iceland provides an interesting case due to three features: (1 the tourism sector in Iceland is the fastest-growing industry in the country with an annual growth rate of over 20% over the past five years; (2 almost all tourists arrive by air; and (3 the country has an almost emissions-free energy industry and an import-dominated economy, which emphasise the role of the indirect emissions. According to the assessment, the carbon footprint for the average tourist is 1.35 tons of CO2-eq, but ranges from 1.1 to 3.2 tons of CO2-eq depending on the distance travelled by air. Furthermore, this footprint is increasing due to the rise in average flight distances travelled to reach the country. The total GHG emissions caused by tourism in Iceland have tripled from approximately 600,000 tons of CO2-eq in 2010 to 1,800,000 tons in 2015. Aviation accounts for 50%–82% of this impact (depending on the flight distance underlining the importance of air travel, especially as tourism-related aviation is forecasted to grow significantly in the near future. From a method perspective, the carbon footprinting application presented in the study would seem to provide an efficient way to study both the direct and indirect

  14. Contamination and comprehensive risk assessment of heavy metals in Liangtan River, Chongqing, China

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2016-10-01

    Full Text Available Distribution and fraction of heavy metals (Pb, Cr, Zn, and Mn in water and sediment in Liangtan River, Chongqing was analyzed using the atomic absorption spectrometry method. Pearson correlation coefficient, bioavailability index, geoaccumulation index and potential ecological risk index were introduced to classify the source and assess the environmental risk of the heavy metal. Pb, Cr, and Zn mainly existed in residual fraction and fraction bounded to Fe–Mn oxides while Mn mainly existed in the fraction bounded to carbonates and the residual fraction. Mn and Pb, Zn and Cr in the sediment were confirmed originating from, separate common sources. Igeo and $E_\\text{r}^{i}$ were both in the order of Pb > Zn > Cr > Mn. Geoaccumulation indexes demonstrated that the Liangtan River has been heavily polluted by Pb and Zn with the class of 2–4 and 2–3, independently. From viewpoint of the whole Liangtan River, the mean RI (45.1 belonged to low risk level.

  15. Comprehensive assessment of hormones, phytoestrogens, and estrogenic activity in an anaerobic swine waste lagoon

    Science.gov (United States)

    Yost, Erin E.; Meyer, Michael T.; Dietze, Julie E.; Meissner, Benjamin M.; Williams, Mike; Worley-Davis, Lynn; Lee, Boknam; Kullman, Seth W.

    2013-01-01

    In this study, the distribution of steroid hormones, phytoestrogens, and estrogenic activity was thoroughly characterized within the anaerobic waste lagoon of a typical commercial swine sow operation. Three independent rounds of sampling were conducted in June 2009, April 2010, and February 2011. Thirty-seven analytes in lagoon slurry and sludge were assessed using LC/MS-MS, and yeast estrogen screen was used to determine estrogenic activity. Of the hormone analytes, steroidal estrogens were more abundant than androgens or progesterone, with estrone being the predominant estrogen species. Conjugated hormones were detected only at low levels. The isoflavone metabolite equol was by far the predominant phytoestrogen species, with daidzein, genistein, formononetin, and coumestrol present at lower levels. Phytoestrogens were often more abundant than steroidal estrogens, but contributed minimally towards total estrogenic activity. Analytes were significantly elevated in the solid phases of the lagoon; although low observed log KOC values suggest enhanced solubility in the aqueous phase, perhaps due to dissolved or colloidal organic carbon. The association with the solid phase, as well as recalcitrance of analytes to anaerobic degradation, results in a markedly elevated load of analytes and estrogenic activity within lagoon sludge. Overall, findings emphasize the importance of adsorption and transformation processes in governing the fate of these compounds in lagoon waste, which is ultimately used for broadcast application as a fertilizer.

  16. Comprehensive Assessment of Models and Events based on Library tools (CAMEL)

    Science.gov (United States)

    Rastaetter, L.; Boblitt, J. M.; DeZeeuw, D.; Mays, M. L.; Kuznetsova, M. M.; Wiegand, C.

    2017-12-01

    At the Community Coordinated Modeling Center (CCMC), the assessment of modeling skill using a library of model-data comparison metrics is taken to the next level by fully integrating the ability to request a series of runs with the same model parameters for a list of events. The CAMEL framework initiates and runs a series of selected, pre-defined simulation settings for participating models (e.g., WSA-ENLIL, SWMF-SC+IH for the heliosphere, SWMF-GM, OpenGGCM, LFM, GUMICS for the magnetosphere) and performs post-processing using existing tools for a host of different output parameters. The framework compares the resulting time series data with respective observational data and computes a suite of metrics such as Prediction Efficiency, Root Mean Square Error, Probability of Detection, Probability of False Detection, Heidke Skill Score for each model-data pair. The system then plots scores by event and aggregated over all events for all participating models and run settings. We are building on past experiences with model-data comparisons of magnetosphere and ionosphere model outputs in GEM2008, GEM-CEDAR CETI2010 and Operational Space Weather Model challenges (2010-2013). We can apply the framework also to solar-heliosphere as well as radiation belt models. The CAMEL framework takes advantage of model simulations described with Space Physics Archive Search and Extract (SPASE) metadata and a database backend design developed for a next-generation Run-on-Request system at the CCMC.

  17. An Assessment of Comprehensive Code Prediction State-of-the-Art Using the HART II International Workshop Data

    Science.gov (United States)

    vanderWall, Berend G.; Lim, Joon W.; Smith, Marilyn J.; Jung, Sung N.; Bailly, Joelle; Baeder, James D.; Boyd, D. Douglas, Jr.

    2012-01-01

    Despite significant advancements in computational fluid dynamics and their coupling with computational structural dynamics (= CSD, or comprehensive codes) for rotorcraft applications, CSD codes with their engineering level of modeling the rotor blade dynamics, the unsteady sectional aerodynamics and the vortical wake are still the workhorse for the majority of applications. This is especially true when a large number of parameter variations is to be performed and their impact on performance, structural loads, vibration and noise is to be judged in an approximate yet reliable and as accurate as possible manner. In this paper, the capabilities of such codes are evaluated using the HART II Inter- national Workshop data base, focusing on a typical descent operating condition which includes strong blade-vortex interactions. Three cases are of interest: the baseline case and two cases with 3/rev higher harmonic blade root pitch control (HHC) with different control phases employed. One setting is for minimum blade-vortex interaction noise radiation and the other one for minimum vibration generation. The challenge is to correctly predict the wake physics - especially for the cases with HHC - and all the dynamics, aerodynamics, modifications of the wake structure and the aero-acoustics coming with it. It is observed that the comprehensive codes used today have a surprisingly good predictive capability when they appropriately account for all of the physics involved. The minimum requirements to obtain these results are outlined.

  18. The HART II International Workshop: An Assessment of the State-of-the-Art in Comprehensive Code Prediction

    Science.gov (United States)

    vanderWall, Berend G.; Lim, Joon W.; Smith, Marilyn J.; Jung, Sung N.; Bailly, Joelle; Baeder, James D.; Boyd, D. Douglas, Jr.

    2013-01-01

    Significant advancements in computational fluid dynamics (CFD) and their coupling with computational structural dynamics (CSD, or comprehensive codes) for rotorcraft applications have been achieved recently. Despite this, CSD codes with their engineering level of modeling the rotor blade dynamics, the unsteady sectional aerodynamics and the vortical wake are still the workhorse for the majority of applications. This is especially true when a large number of parameter variations is to be performed and their impact on performance, structural loads, vibration and noise is to be judged in an approximate yet reliable and as accurate as possible manner. In this article, the capabilities of such codes are evaluated using the HART II International Workshop database, focusing on a typical descent operating condition which includes strong blade-vortex interactions. A companion article addresses the CFD/CSD coupled approach. Three cases are of interest: the baseline case and two cases with 3/rev higher harmonic blade root pitch control (HHC) with different control phases employed. One setting is for minimum blade-vortex interaction noise radiation and the other one for minimum vibration generation. The challenge is to correctly predict the wake physics-especially for the cases with HHC-and all the dynamics, aerodynamics, modifications of the wake structure and the aero-acoustics coming with it. It is observed that the comprehensive codes used today have a surprisingly good predictive capability when they appropriately account for all of the physics involved. The minimum requirements to obtain these results are outlined.

  19. Comprehensive assessment of chronic pain management in primary care: a first phase of a quality improvement initiative at a multisite Community Health Center.

    Science.gov (United States)

    Anderson, Daren; Wang, Sissi; Zlateva, Ianita

    2012-01-01

    The objective of this study was to conduct a comprehensive formative assessment of chronic pain management in a large, multisite community health centre and use the results to design a quality improvement initiative based on an evidence-based practice model developed by the Veterans Health Administration. Improving quality and safety by incorporating evidence-based practices (EBP) is challenging, particularly in busy clinical practices such as Federally Qualified Health Centers (FQHCs). FQHCs grapple with financial constraints, lack of resources and complex patient populations. The Promoting Action on Research Implementation in Health Services (PARIHS) Framework served as a basis for the comprehensive assessment. We used a range of measures and tools to examine pain care from a variety of perspectives. Patients with chronic pain were identified using self-reported pain scores and opioid prescription records. We employed multiple data collection strategies, including querying our electronic health records system, manual chart reviews and staff surveys. We found that patients with chronic pain had extremely high primary care utilisation rates while referral rates to pain-related specialties were low for these patients. Large gaps existed in primary care provider adherence to standards for pain care documentation and practice. There was wide provider variability in the prescription of opioids to treat pain. Staff surveys found substantial variation in both pain care knowledge and readiness to change, as well as low confidence in providers' ability to manage pain, and dissatisfaction with the resources available to support chronic pain care. Improving chronic pain management at this Community Health Center requires a multifaceted intervention aimed at addressing many of the problems identified during the assessment phase. During the intervention we will put a greater emphasis on increasing options for behavioural health and complementary medicine support, increasing

  20. Comprehensive assessment of drought from 1960 to 2013 in China based on different perspectives

    Science.gov (United States)

    Lai, Wenli; Wang, Hongrui; Zhang, Jie

    2017-10-01

    Using daily and monthly precipitation data collected from 520 meteorological stations from 1960 to 2013, we compared a widely used drought index, the standardized precipitation index (SPI), with an extreme index, the maximum consecutive dry days index (CDD). Two other homogeneity test methods, namely the Gini coefficient (including both Total-Gini and Wet-Gini) and the precipitation concentration degree (PCD) were also applied to indirectly estimate extreme droughts. The changes in droughts determined using the SPI and the CDD exhibited similar spatial and temporal patterns throughout most parts of China, with the exception of Southwestern China. Comparison of the five indices indicated that Wet-Gini exhibited different or even opposite trends of drought across all of China. Finally, a trend analysis from 2000 to 2013 was applied to perform a regional empirical analysis of a classic extreme drought event in Southwestern China. All indices, except for Wet-Gini, indicated increasing drought risk.

  1. Comprehensive assessment of conditions of human activity in stable risk regions of Republic of Kazakhstan

    International Nuclear Information System (INIS)

    Bajbolov, S.M.

    2000-01-01

    It is noted that dozens of hectares of Kazakhstan's land are removed from national use due to high level of ecologically permissible effect. In some regions there is treat of complete loss of lands due to technogene pollution. There are areales of toxic and radioactive industrial wastes and environmental radiation contamination zones forming in result of: activity of Semipalatinsk nuclear test site and nuclear explosions of period 1949-1961; activity of military-industrial, atomic-industrial and military-space enterprises; mining and processing of mineral resources with high content of radioactive elements; wind transfer of radionuclides and radioactive particles of both the natural and the technogene origin; radiation background of natural (In average by Republic 11-18 μR/h) landscapes. Most dangerous are consequences of tests on nuclear and space sites. Kazakhstan is single place on the Earth where nuclear strategic programs were carried out in full volume, beginning from mining and processing of uranium containing raw by producing and testing of nuclear warheads, missiles destroying and disposal of uranium and other radioactive and toxic wastes of military-industrial complex. So, there were 500 atmosphere and underground explosions in former Semipalatinsk, Kostanaj, Akmola, Aktyube, South-Kazakhstan, West-Kazakhstan, Mangistau and Atyrau oblasts. In West Kazakhstan on known nuclear sites (Azgir, Tojsogan, Central) and on Kapustin Yar fly-test complex more than 30 nuclear explosions were carried out in both the atmosphere and the underground. More than hundred military units were tested and exposed and 20 thousand of missiles were destroyed. Powerful sources of pollution are Bojkonyr spaceport and Saryshgan and Elba test sites. Authors noted, that it is necessary develop criteria of definition of payments for resources use, indexes to base taxes, pay for damages. Some problems of regional management could be solved with help this assessment mechanism

  2. Comprehensive assessment of parameterization methods for estimating clear-sky surface downward longwave radiation

    Science.gov (United States)

    Guo, Yamin; Cheng, Jie; Liang, Shunlin

    2018-02-01

    Surface downward longwave radiation (SDLR) is a key variable for calculating the earth's surface radiation budget. In this study, we evaluated seven widely used clear-sky parameterization methods using ground measurements collected from 71 globally distributed fluxnet sites. The Bayesian model averaging (BMA) method was also introduced to obtain a multi-model ensemble estimate. As a whole, the parameterization method of Carmona et al. (2014) performs the best, with an average BIAS, RMSE, and R 2 of - 0.11 W/m2, 20.35 W/m2, and 0.92, respectively, followed by the parameterization methods of Idso (1981), Prata (Q J R Meteorol Soc 122:1127-1151, 1996), Brunt and Sc (Q J R Meteorol Soc 58:389-420, 1932), and Brutsaert (Water Resour Res 11:742-744, 1975). The accuracy of the BMA is close to that of the parameterization method of Carmona et al. (2014) and comparable to that of the parameterization method of Idso (1981). The advantage of the BMA is that it achieves balanced results compared to the integrated single parameterization methods. To fully assess the performance of the parameterization methods, the effects of climate type, land cover, and surface elevation were also investigated. The five parameterization methods and BMA all failed over land with the tropical climate type, with high water vapor, and had poor results over forest, wetland, and ice. These methods achieved better results over desert, bare land, cropland, and grass and had acceptable accuracies for sites at different elevations, except for the parameterization method of Carmona et al. (2014) over high elevation sites. Thus, a method that can be successfully applied everywhere does not exist.

  3. Assessing the value of Landsat imagery: Results from a 2012 comprehensive user survey

    Science.gov (United States)

    Miller, H. M.; Richardson, L.; Loomis, J.; Koontz, S.; Koontz, L.

    2012-12-01

    Landsat satellite imagery has long been recognized as unique among remotely sensed data due to the combination of its extensive archive, global coverage, and relatively high spatial and temporal resolution. Since the imagery became available at no cost in 2008, the number of users registered with the U.S. Geological Survey (USGS) has increased tenfold while the number of scenes downloaded annually has increased a hundredfold. It is clear that the imagery is being used extensively, and understanding the benefits provided by this imagery can help inform decisions involving its provision. However, the value of Landsat imagery is difficult to measure for a variety of reasons, one of which stems from the fact that the imagery has characteristics of a public good and does not have a direct market price to reflect its value to society. Further, there is not a clear understanding of the full range of users of the imagery, as well as how these users are distributed across the many different end uses this data is applied to. To assess the value of Landsat imagery, we conducted a survey of users registered with USGS in early 2012. Over 11,000 current users of Landsat imagery responded to the survey. The value of the imagery was measured both qualitatively and quantitatively. To explore the qualitative value of the imagery, users were asked about the importance of the imagery to their work, their dependence on the imagery, and the impacts on their work if there was no Landsat imagery. The majority of users deemed Landsat imagery important to their work and stated they were dependent on Landsat imagery to do their work. Additionally, if Landsat imagery was no longer available, over half of the users would have to discontinue some of their work. On average, these users would discontinue half of their current work if the imagery was no longer available. The focus of this presentation will be the quantitative results of a double-bounded contingent valuation analysis which reveals

  4. A Needs Assessment of the Number of Comprehensive Addiction Care Physicians Required in a Canadian Setting.

    Science.gov (United States)

    McEachern, Jasmine; Ahamad, Keith; Nolan, Seonaid; Mead, Annabel; Wood, Evan; Klimas, Jan

    2016-01-01

    Medical professionals adequately trained to prevent and treat substance use disorders are in short supply in most areas of the world. Whereas physician training in addiction medicine can improve patient and public health outcomes, the coverage estimates have not been established. We estimated the extent of the need for medical professionals skilled in addiction medicine in a Canadian setting. We used Monte-Carlo simulations to generate medians and 95% credibility intervals for the burden of alcohol and drug use harms, including morbidity and mortality, in British Columbia, by geographic health region. We obtained prevalence estimates for the models from the Medical Services Plan billing, the Discharge Abstract Database data, and the government surveillance data. We calculated a provider availability index (PAI), a ratio of the size of the labor force per 1000 affected individuals, for each geographic health region, using the number of American Board of Addiction Medicine certified physicians in each area. Depending on the data source used for population estimates, the availability of specialized addiction care providers varied across geographic health regions. For drug-related harms, we found the highest PAI of 23.72 certified physicians per 1000 affected individuals, when using the Medical Services Plan and Discharge Abstract Database data. Drawing on the surveillance data, the drug-related PAI dropped to 0.46. The alcohol-related PAI ranged between 0.10 and 86.96 providers, depending on data source used for population estimates. Our conservative estimates highlight the need to invest in healthcare provider training and to develop innovative approaches for more rural health regions.

  5. A Needs Assessment of the Number of Comprehensive Addiction Care Physicians Required in a Canadian Setting

    Science.gov (United States)

    McEachern, Jasmine; Ahamad, Keith; Nolan, Seonaid; Mead, Annabel; Wood, Evan; Klimas, Jan

    2016-01-01

    Objective Medical professionals adequately trained to prevent and treat substance use disorders are in short supply in most areas of the world. While physician training in addiction medicine can improve patient and public health outcomes, the coverage estimates have not been established. We estimated the extent of the need for medical professionals skilled in addiction medicine in a Canadian setting. Methods We used Monte Carlo simulations to generate medians and 95% credibility intervals for the burden of alcohol and drug use harms, including morbidity and mortality, in British Columbia, by geographic health region. We obtained prevalence estimates for the models from the Medical Services Plan (MSP) billing, the Discharge Abstract Database (DAD) data, and the government surveillance data. We calculated a provider availability index (PAI), a ratio of the size of the labour force per 1,000 affected individuals, for each geographic health region, using the number of American Board of Addiction Medicine certified physicians in each area. Results Depending on the data source used for population estimates, the availability of specialized addiction care providers varied across geographic health regions. For drug-related harms, we found the highest PAI of 23.72 certified physicians per 1,000 affected individuals, when using the MSP and DAD data. Drawing on the surveillance data, the drug-related PAI dropped to 0.46. The alcohol-related PAI ranged between 0.10 and 86.96 providers, depending on data source used for population estimates. Conclusions Our conservative estimates highlight the need to invest in health-care provider training and to develop innovative approaches for more rural health regions. PMID:27183295

  6. Comprehensive assessment of the L-lysine production process from fermentation of sugarcane molasses.

    Science.gov (United States)

    Anaya-Reza, Omar; Lopez-Arenas, Teresa

    2017-07-01

    L-Lysine is an essential amino acid that can be produced by chemical processes from fossil raw materials, as well as by microbial fermentation, the latter being a more efficient and environmentally friendly procedure. In this work, the production process of L-lysine-HCl is studied using a systematic approach based on modeling and simulation, which supports decision making in the early stage of process design. The study considers two analysis stages: first, the dynamic analysis of the fermentation reactor, where the conversion of sugars from sugarcane molasses to L-lysine with a strain of Corynebacterium glutamicum is carried out. In this stage, the operation mode (either batch or fed batch) and operating conditions of the fermentation reactor are defined to reach the maximum technical criteria. Afterwards, the second analysis stage relates to the industrial production process of L-lysine-HCl, where the fermentation reactor, upstream processing, and downstream processing are included. In this stage, the influence of key parameters on the overall process performance is scrutinized through the evaluation of several technical, economic, and environmental criteria, to determine a profitable and sustainable design of the L-lysine production process. The main results show how the operating conditions, process design, and selection of evaluation criteria can influence in the conceptual design. The best plant design shows maximum product yield (0.31 g L-lysine/g glucose) and productivity (1.99 g/L/h), achieving 26.5% return on investment (ROI) with a payback period (PBP) of 3.8 years, decreasing water and energy consumption, and with a low potential environmental impact (PEI) index.

  7. Spatial Distribution, Chemical Fraction and Fuzzy Comprehensive Risk Assessment of Heavy Metals in Surface Sediments from the Honghu Lake, China.

    Science.gov (United States)

    Li, Fei; Xiao, Minsi; Zhang, Jingdong; Liu, Chaoyang; Qiu, Zhenzhen; Cai, Ying

    2018-01-26

    Spatial concentrations and chemical fractions of heavy metals (Cr, Cu, Pb, Zn and Cd) in 16 sampling sites from the Honghu Lake were investigated using an atomic absorption spectrophotometer and optimized BCR (the European Community Bureau of Reference) three-stage extraction procedure. Compared with the corresponding probable effect levels (PELs), adverse biological effects of the studied five sediment metals decreased in the sequence of Cr > Cu > Zn > Pb > Cd. Geo-accumulation index ( I geo ) values for Cr, Cu, Pb and Zn in each sampling site were at un-contamination level, while the values for Cd varied from un-contamination level to moderate contamination level. Spatially, the enrichment degree of Cd in lower part of the South Lake, the west part of the North Lake and the outlet were higher than the other parts of Honghu Lake. For metal chemical fractions, the proportions of the acid-extractable fraction of five metal contents were in the descending order: Cd, Cu, Zn, Pb and Cr. Cd had the highest bioaccessibility. Being the above indexes focused always on heavy metals' total content or chemical fraction in deterministic assessment system, which may confuse decision makers, the fuzzy comprehensive risk assessment method was established based on PEI (Potential ecological risk index), RAC (Risk assessment code) and fuzzy theory. Average comprehensive risks of heavy metals in sediments revealed the following orders: Cd (considerable risk) > Cu (moderate risk) > Zn (low risk) > Pb > Cr. Thus, Cd and Cu were determined as the pollutants of most concern. The central part of South Honghu Lake (S4, S5, S6, S9, S12 and S14), east part of the North Honghu Lake (S1) and outlet of outlet of the Honghu Lake (S10) were recommended as the priority control areas. Specifically, it is necessary to pay more attention to S1, S4, S5, S6, S9 and S16 when decision making for their calculated membership values (probabilities) of adjacent risk levels quite close.

  8. Spatial Distribution, Chemical Fraction and Fuzzy Comprehensive Risk Assessment of Heavy Metals in Surface Sediments from the Honghu Lake, China

    Science.gov (United States)

    Xiao, Minsi; Zhang, Jingdong; Liu, Chaoyang; Qiu, Zhenzhen; Cai, Ying

    2018-01-01

    Spatial concentrations and chemical fractions of heavy metals (Cr, Cu, Pb, Zn and Cd) in 16 sampling sites from the Honghu Lake were investigated using an atomic absorption spectrophotometer and optimized BCR (the European Community Bureau of Reference) three-stage extraction procedure. Compared with the corresponding probable effect levels (PELs), adverse biological effects of the studied five sediment metals decreased in the sequence of Cr > Cu > Zn > Pb > Cd. Geo-accumulation index (Igeo) values for Cr, Cu, Pb and Zn in each sampling site were at un-contamination level, while the values for Cd varied from un-contamination level to moderate contamination level. Spatially, the enrichment degree of Cd in lower part of the South Lake, the west part of the North Lake and the outlet were higher than the other parts of Honghu Lake. For metal chemical fractions, the proportions of the acid-extractable fraction of five metal contents were in the descending order: Cd, Cu, Zn, Pb and Cr. Cd had the highest bioaccessibility. Being the above indexes focused always on heavy metals’ total content or chemical fraction in deterministic assessment system, which may confuse decision makers, the fuzzy comprehensive risk assessment method was established based on PEI (Potential ecological risk index), RAC (Risk assessment code) and fuzzy theory. Average comprehensive risks of heavy metals in sediments revealed the following orders: Cd (considerable risk) > Cu (moderate risk) > Zn (low risk) > Pb > Cr. Thus, Cd and Cu were determined as the pollutants of most concern. The central part of South Honghu Lake (S4, S5, S6, S9, S12 and S14), east part of the North Honghu Lake (S1) and outlet of outlet of the Honghu Lake (S10) were recommended as the priority control areas. Specifically, it is necessary to pay more attention to S1, S4, S5, S6, S9 and S16 when decision making for their calculated membership values (probabilities) of adjacent risk levels quite close. PMID:29373483

  9. [The assessment of the dependence between antigen CA 125 and nicotinism in patients with benign ovarian tumors including endometrial cysts].

    Science.gov (United States)

    Posadzka, Ewa; Jach, Robert; Babczyk, Dorota; Knafel, Anna; Pityński, Kazimierz

    2014-01-01

    Cancer antigen CA-125 is a marker that is primarily used to differentiate benign from malignant tumors as well as to monitor response to ovarian cancer treatment. Taken as a separate marker, it displays low sensitivity and specificity in ovarian cancer diagnosis; however, in combination with other markers it may be successfully applied especially in postmenopausal women. Elevated CA-125 levels in blood serum indicate cancerous as well as non-cancerous diseases. Research aiming to determine environmental factors that may have influence on antigen CA-125 level, and thus on the assessment of this marker's application in gynecological and oncological diseases continues. the aim of the present research is an attempt to estimate the influence of nicotinism on antigen CA-125 in blood serum in patients with diagnosed benign ovarian tumors including endometrial cysts. 174 women aged 16-85 years with diagnosed benign ovarian tumor were qualified for the study. In all patients level of antigen CA-125 in blood serum was assessed preoperatively and nicotinism history was taken. Also transvaginal ultrasound was performed to obtain preliminary diagnosis. Smoking and non-smoking patients were classified into two groups, namely of those with histopathologically confirmed cysts of endometrial type and those with non-endometrial benign ovarian tumors. statistical analysis did not prove any dependence between the CS-125 antigen level and nicotinism in any of these groups. Also additional analysis with division into premenopausal and postmenopausal patients did not determine any statistically significant dependence. Nicotinism does not significantly influence the CA-125 antigen level in patients with benign However, the connection between the addiction severity and its influence on antigen CA-125 in blood serum cannot be excluded. ovarian tumors or endometrial cysts.

  10. [The development of a comprehensive assessment of occupational risk by taking into account the total hazard of working conditions].

    Science.gov (United States)

    Bulavka, Iu A

    2013-01-01

    In the paper the methodological problems of establishing a general class of working conditions on the results of certification of workplaces are analyzed There is proposed the use of an additional parameter - the index of harm, characterizing the degree of correspondence of the general level of harmful occupational factors to applicable health standards with taking into account the nonequivalence of their display. The recommendations for the use of hazard index as the main criterion for a priori evaluation ofthe category ofsuspected occupational risk and the tool to establish by the correlation methods cause-and-effect relations between indices of health status and the impact ofoccupational factors are presented. As exemplified by real working conditions the possibilities of the use the index of harm as an indicator describing the hazard probability are considered with comprehensive assessment of occupational risk of health problems on the basis of the matrix method with the use of the table of vectors and nomograms "probability of harm - the severity of the consequences". The use of index of harm will permit to increase the objectivity of the assessment and the efficacy of management of occupational hazards in the workplaces.

  11. Reliability and Validity of a Simplified Comprehensive Assessment Tool for Feeding Support: Kuchi-Kara Taberu Index.

    Science.gov (United States)

    Maeda, Keisuke; Shamoto, Hiroshi; Wakabayashi, Hidetaka; Enomoto, Junko; Takeichi, Mika; Koyama, Tamami

    2016-12-01

    To verify the reliability and validity and develop an English version of an instrument (Kuchi-Kara Taberu Index (KT Index)) to comprehensively assess and intervene in problems with eating and swallowing. Multicenter cross-sectional study. Nursing homes. Individuals aged 65 and older (mean age 88.3 ± 6.8; 80.0% female) who had lived in a nursing home for longer than 1 month (N = 115). The KT index consisted of 13 items: desire to eat, overall condition, respiratory condition, oral condition, cognitive function while eating, oral preparatory and propulsive phases, dysphagia severity, position and endurance while eating, eating, daily life, food intake level, food modification, and nutrition. Weighted kappa coefficients, Cronbach alpha, and Spearman rank correlation coefficients were determined. Weighted kappa values in the inter- and intrarater reliability tests ranged from 0.54 to 0.96 and 0.68 to 0.98, respectively. Cronbach alpha was 0.892. Spearman rank correlation coefficients (r) between the total KT index and external criteria were determined (Functional Oral Intake Scale, r = 0.790; Barthel Index, r = 0.830; Mini Nutritional Assessment Short Form, r = 0.582; Cognitive Performance Scale, r = -0.673; all P eating and swallowing conditions are needed. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. An approach to including protein quality when assessing the net contribution of livestock to human food supply.

    Science.gov (United States)

    Ertl, P; Knaus, W; Zollitsch, W

    2016-11-01

    The production of protein from animal sources is often criticized because of the low efficiency of converting plant protein from feeds into protein in the animal products. However, this critique does not consider the fact that large portions of the plant-based proteins fed to animals may be human-inedible and that the quality of animal proteins is usually superior as compared with plant proteins. The aim of the present study was therefore to assess changes in protein quality in the course of the transformation of potentially human-edible plant proteins into animal products via livestock production; data from 30 Austrian dairy farms were used as a case study. A second aim was to develop an approach for combining these changes with quantitative aspects (e.g. with the human-edible feed conversion efficiency (heFCE), defined as kilogram protein in the animal product divided by kilogram potentially human-edible protein in the feeds). Protein quality of potentially human-edible inputs and outputs was assessed using the protein digestibility-corrected amino acid score and the digestible indispensable amino acid score, two methods proposed by the Food and Agriculture Organization of the United Nations to describe the nutritional value of proteins for humans. Depending on the method used, protein scores were between 1.40 and 1.87 times higher for the animal products than for the potentially human-edible plant protein input on a barn-gate level (=protein quality ratio (PQR)). Combining the PQR of 1.87 with the heFCE for the same farms resulted in heFCE×PQR of 2.15. Thus, considering both quantity and quality, the value of the proteins in the animal products for human consumption (in this case in milk and beef) is 2.15 times higher than that of proteins in the potentially human-edible plant protein inputs. The results of this study emphasize the necessity of including protein quality changes resulting from the transformation of plant proteins to animal proteins when

  13. Probabilistic Safety Assessment (PSA) of Natural External Hazards Including Earthquakes. Workshop Proceedings, Prague, Czech Republic, 17-20 June 2013

    International Nuclear Information System (INIS)

    2014-01-01

    The Fukushima Dai-ichi accident triggered discussions about the significance of external hazards and their treatment in safety analyses. In addition, stress tests results have shown vulnerabilities and potential of cliff-edge effects in plant responses to external hazards and have identified possibilities and priorities for improvements and safety measures' implementation at specific sites and designs. In order to address these issues and provide relevant conclusions and recommendations to CSNI and CNRA, the CSNI Working Group on Risk Assessment (WGRISK) directed, in cooperation with the CSNI Working Group on Integrity and Ageing of Components and Structures (WGIAGE), a workshop hosted by UJV Rez. The key objectives of the workshop were to collect information from the OECD member states on methods and approaches being used, and experience gained in probabilistic safety assessment of natural external hazards, as well as to support the fulfillment of the CSNI task on 'PSA of natural external hazards including earthquakes'. These objectives are described more in detail in the introduction in Chapter 1 of this report. The WGRISK activities preceding the workshop and leading to the decision to organize it are described in Chapter 2 of this report. The focus of the workshop was on external events PSA for nuclear power plants, including all modes of operation. The workshop scope was generally limited to external, natural hazards, including those hazards where the distinction between natural and man-made hazards is not sharp. The detailed information about the presentations, discussions, and results of the workshop is presented in Chapter 3 of this report. Some general conclusions were agreed on during the workshop, which are presented in the following paragraphs. - The lessons learned from the Fukushima Dai-ichi reactor accidents and related actions at the national, regional, and global level have emphasized the importance to assess risks associated (authors) with

  14. The Role of Arsenic Speciation in Dietary Exposure Assessment and the Need to Include Bioaccessibility and Biotransformation

    Science.gov (United States)

    Chemical form specific exposure assessment for arsenic has long been identified as a source of uncertainty in estimating the risk associated with the aggregate exposure for a population. Some speciation based assessments document occurrence within an exposure route; however, the...

  15. How reassuring is a normal breast ultrasound in assessment of a screen-detected mammographic abnormality? A review of interval cancers after assessment that included ultrasound evaluation

    International Nuclear Information System (INIS)

    Bennett, M.L.; Welman, C.J.; Celliers, L.M.

    2011-01-01

    Aim: To review factors resulting in a false-negative outcome or delayed cancer diagnosis in women recalled for further evaluation, including ultrasound, after an abnormal screening mammogram. Materials and methods: Of 646,692 screening mammograms performed between 1 January 1995 and 31 December 2004, 34,533 women were recalled for further assessment. Nine hundred and sixty-four interval cancers were reported in this period. Forty-six of these women had been recalled for further assessment, which specifically included ultrasound evaluation in the preceding 24 months, and therefore, met the inclusion criteria for this study. Screening mammograms, further mammographic views, ultrasound scans, clinical findings, and histopathology results were retrospectively reviewed by two consultant breast radiologists. Results: The interval cancer developed in the contralateral breast (n = 9), ipsilateral breast, but different site (n = 6), and ipsilateral breast at the same site (n = 31) as the abnormality for which they had recently been recalled. In the latter group, 10 were retrospectively classified as a false-negative outcome, nine had a delay in obtaining a biopsy, and 12 had a delay due to a non-diagnostic initial biopsy. Various factors relating to these outcomes are discussed. Conclusion: Out of 34,533 women who attended for an assessment visit and the 46 women who subsequently developed an interval breast cancer, 15 were true interval cancers, 10 had a false-negative assessment outcome, and 21 had a delay to cancer diagnosis on the basis of a number of factors. When there is discrepancy between the imaging and histopathology results, a repeat biopsy rather than early follow-up would have avoided a delay in some cases. A normal ultrasound examination should not deter the radiologist from proceeding to stereotactic biopsy, if the index mammographic lesion is suspicious of malignancy.

  16. Water Quality Assessment for Deep-water Channel area of Guangzhou Port based on the Comprehensive Water Quality Identification Index Method

    Science.gov (United States)

    Chen, Yi

    2018-03-01

    The comprehensive water quality identification index method is able to assess the general water quality situation comprehensively and represent the water quality classification; water environment functional zone achieves pollution level and standard objectively and systematically. This paper selects 3 representative zones along deep-water channel of Guangzhou port and applies comprehensive water quality identification index method to calculate sea water quality monitoring data for different selected zones from year 2006 to 2014, in order to investigate the temporal variation of water quality along deep-water channel of Guangzhou port. The comprehensive water quality level from north to south presents an increased trend, and the water quality of the three zones in 2014 is much better than in 2006. This paper puts forward environmental protection measurements and suggestions for Pearl River Estuary, provides data support and theoretical basis for studied sea area pollution prevention and control.

  17. Prevalence and socio-demographic characteristics of disability in older adults in China: Findings from China Comprehensive Geriatric Assessment Study.

    Science.gov (United States)

    Ma, Lina; Li, Zhenzhen; Tang, Zhe; Sun, Fei; Diao, Lijun; Li, Jian; He, Yao; Dong, Birong; Li, Yun

    2017-11-01

    Disability affects older adults' quality of life. This study aimed to examine the socio-demographic characteristics of disability in older adults in China. Data was obtained from the China Comprehensive Geriatric Assessment Study (CCGAS). The sample comprised 6864 people aged 60 years and above from seven provinces in China. A door-to-door survey was conducted by formally trained interviewers using a unified questionnaire. Disability was assessed with physical health assessment comprising activities of daily living (ADL), and independent activities of daily living (IADL). For the purpose of this study, we analyzed only disability and some socio-demographic dimensions. The rates were standardized based on China's Sixth National Census population distribution. The disability rate in older adults was 7.0%. The disability rate was significantly higher in women than men, significantly higher in rural areas than urban areas, and higher in northern China than southern China. Urban disability rates ranged from 5.7% to 1.2%. The differences were statistically significant, with Beijing having the highest and Shanghai the lowest disability rates. Disability increased with age. In China, the disability rate in older adults is 7.0%, and increases with age. The disability rate is significantly higher in women, rural area, and northern China. This is the first study to report the epidemiology of disability in older adults in China in recent years and indicates the need for further epidemiological data on disability in China to facilitate long-term care and care policy formulation. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Comprehensive geriatric assessment

    African Journals Online (AJOL)

    2007-09-14

    Sep 14, 2007 ... for the toll of illness. Illnesses accumulate with age and increase in severity and number. Frailty (a complex interplay of health and illness, attitudes, resources and .... In some cases tamoxifen, routinely prescribed to treat breast cancer, may help cancer proliferate, according to David Shapiro and colleagues ...

  19. Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients

    Directory of Open Access Journals (Sweden)

    Wang K

    2017-09-01

    Full Text Available Kai Wang,1,* Guang-qiao Zeng,2,* Rui Li,1,* Yu-wen Luo,1 Mei Wang,1 Yu-he Hu,1 Wen-hui Xu,1 Lu-qian Zhou,2 Rong-chang Chen,2 Xin Chen1 1Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; 2Department of Respiratory Medicine, The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China *These authors contributed equally to this work Background: Cycle ergometer training (CET has been shown to improve exercise performance of the quadriceps muscles in patients with COPD, and inspiratory muscle training (IMT may improve the pressure-generating capacity of the inspiratory muscles. However, the effects of combined CET and IMT remain unclear and there is a lack of comprehensive assessment.Materials and methods: Eighty-one patients with COPD were randomly allocated to three groups: 28 received 8 weeks of CET + IMT (combined training group, 27 received 8 weeks of CET alone (CET group, and 26 only received 8 weeks of free walking (control group. Comprehensive assessment including respiratory muscle strength, exercise capacity, pulmonary function, dyspnea, quality of life, emotional status, nutritional status, and body mass index, airflow obstruction, and exercise capacity index were measured before and after the pulmonary rehabilitation program.Results: Respiratory muscle strength, exercise capacity, inspiratory capacity, dyspnea, quality of life, depression and anxiety, and nutritional status were all improved in the combined training and CET groups when compared with that in the control group (P<0.05 after pulmonary rehabilitation program. Inspiratory muscle strength increased significantly in the combined training group when compared with that in the CET group (ΔPImax [maximal inspiratory pressure] 5.20±0.89 cmH2O vs 1.32±0.91 cmH2O

  20. Geriatric problems correlated with cognitive decline using a screening test named "Dr. SUPERMAN" for comprehensive geriatric assessment in elderly inpatients.

    Science.gov (United States)

    Namioka, Nayuta; Sakurai, Hirofumi; Terayama, Hideyuki; Iwamoto, Toshihiko; Fujihira, Teruaki; Tsugehara, Hiromi; Tsuchida, Akihiko; Hanyu, Haruo

    2017-09-01

    We have recently developed and validated a screening test for comprehensive geriatric assessment (CGA). We investigated the prevalence of geriatric problems in elderly inpatients using CGA, and determined the relationship between geriatric problems and cognitive decline. We enrolled consecutive elderly inpatients aged >65 years who were admitted to all of the hospital departments at Tokyo Medical University Hospital, Tokyo, Japan, between July and December 2013. We investigated the prevalence of specific geriatric problems or situations in elderly inpatients using a screening test for CGA named "Dr. SUPERMAN." We examined 3969 elderly inpatients (2211 men and 1758 women; mean age 75.5 ± 6.7 years) using CGA. Inpatients were divided into three groups by age, namely, 65-74 years, 75-84 years and ≥85 years. Inpatients were divided into the two groups of "internal medicine" and "other departments." Geriatric problems were more frequently found in patients who were aged ≥85 years and admitted to "internal medicine" departments. Furthermore, multiple regression analysis found cognitive decline significantly correlated with ADL decline, age, poor medication adherence, upper and lower extremity function disorder, visual/auditory disorder, and urinary disorder. In particular, cognitive decline strongly correlated with a decline in activities of daily living. CGA should be considered for the treatment of elderly inpatients, particularly those with cognitive decline and admitted to "internal medicine" departments. Geriatr Gerontol Int 2017; 17: 1252-1256. © 2016 Japan Geriatrics Society.

  1. Effectiveness of Comprehensive Geriatric Assessment-Based Intervention to Reduce Frequent Emergency Department Visits: A Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Mei-Chen Liao

    2012-06-01

    Full Text Available A small number of clustered visits by emergency department frequent users (EDFUs may over-consume emergency care resources. We report the effectiveness of comprehensive geriatric assessment (CGA-based multidisciplinary team (MDT care for four EDFUs, in reducing ED visits. Case 1 had visited the ED twice/month due to chest discomfort. Her ED visits were significantly reduced to 0.2 visits/month following CGA-based MDT care. Case 2 had failed back surgery syndrome and bipolar disorder. His ED visit was reduced from 2.8 visits to 0.8 visits/month following CGA-based MDT intervention. Case 3 had chronic obstructive pulmonary disease, heart failure, and urinary incontinence, with a urinary catheter in place. He made 31 ED visits (5.1 visits/month before his lung cancer and depression were discovered by CGA. He died 2 months later. Case 4 made 27 ED visits (2.7 visits/month due to dizziness. His problems of early dementia and neglect were identified by CGA, and he visited the ED only once following MDT intervention. In conclusion, CGA-based MDT intervention successfully reduced ED visits among these EDFUs, but further investigation is needed to evaluate the effectiveness of geriatric services in the ED.

  2. eviQ cancer treatments online: how does the web-based protocol system fare in a comprehensive quality assessment?

    Science.gov (United States)

    Langton, Julia M; Pearson, Sallie-Anne

    2011-12-01

    There have been few evaluations of the quality of computerized decision support tools in medical oncology despite their widespread use in clinical practice. In this article, we provide an in-depth quality assessment of eviQ, an Australian web-based protocol system. We used the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument to examine the quality of eviQ chemotherapy protocols across six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, editorial independence and overall quality rating. Domain scores were categorized as high quality (scores of >70%), moderate quality (30-70%), and low quality (development process and the rigor with which protocols were developed were of moderate quality (scores of 34-37%) and the management of editorial independence and conflict of interest issues were rated in the low quality range (22%). Our evaluation demonstrated the eviQ protocol system is generally of high quality. However, we identified a number of areas in which eviQ could improve either its development processes or the means by which these processes are communicated to end-users. This research represents the first comprehensive evaluation of oncology protocols and paves the way for continued quality assurance research to ensure that these tools meet their objective of facilitating evidence-based medicine, standardizing treatment and, ultimately, improving patient outcomes. © 2011 Blackwell Publishing Asia Pty Ltd.

  3. Waste-to-biofuel integrated system and its comprehensive techno-economic assessment in wastewater treatment plants.

    Science.gov (United States)

    Xin, Chunhua; Addy, Min M; Zhao, Jinyu; Cheng, Yanling; Ma, Yiwei; Liu, Shiyu; Mu, Dongyan; Liu, Yuhuan; Chen, Paul; Ruan, Roger

    2018-02-01

    Combining wastewater treatment and biofuel production is considered the cost-effective way for better waste remediation and lowering the environmental impact for biofuel production. In this study, an innovative integrated system incorporating sludge, scum and centrate treatment and biofuel production was developed. A comprehensive techno-economic analysis was conducted to evaluate the technology and economic feasibility of the integrated system with the consideration of biofuel production, wastewater treatment improvement, tax credits, carbon credit, and coproducts utilization. Benefited from the integrated system that the intermediate byproducts can be used in between the sub-systems, such as the glycerol generated from the scum-to-biodiesel production can be used as an organic carbon for the centrate-to-algae production, the estimated breakeven selling price of the bio-oil ($1.85/gallon) is very close to the 5-year averaged crude oil price. The assessment result showed the payback period and the IRRs of the integrated system are superior in comparison with others. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. A comparison of the responses to three comprehension and three production tasks assessing the morpho-syntactic abilities of Afrikaans-speaking preschoolers

    Directory of Open Access Journals (Sweden)

    Southwood, Frenette

    2005-12-01

    Full Text Available The lack of standardised assessment instruments for assessing the morpho-syntactic abilities of Afrikaans-speaking children often leads to the use of informal assessment tools and/or spontaneous language samples. The question that this paper addresses is how best to assess these morpho-syntactic abilities when using nonstandardised assessment instruments of this kind. The general aim of the present study was to answer this question. Eight typically developing, monolingual children (one boy and one girl of 3, 4, 5, and 6 years from monolingual Afrikaans-speaking homes participated. Tasks were administered to assess comprehension and production of grammatical features related to number, person, case, and tense, as well as questions forms, binding relations and passive constructions. The comprehension tasks entailed picture selection, judging the (incorrectness of utterances produced by the researcher, and question answering, whereas the production tasks consisted of sentence completion, question asking and a language sample. A specific aim of the study was to determine which method(s rendered the highest number of (i correct responses and (ii usable responses (i.e., responses strictly related to the aspect under assessment by these typically developing participants. The results indicate that picture selection elicited the highest number of both correct and usable responses in the comprehension tasks. The production task that provided the highest number of both correct and usable responses was language sample elicitation. This suggests that these tasks should receive precedence when assessing the morpho-syntactic abilities of Afrikaans-speaking preschool children.

  5. A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance

    Science.gov (United States)

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and 95% confidence intervals (CIs). Results. Homeless participants had mean rates of 9.1 ambulatory care encounters (maximum = 141.1), 2.0 emergency department (ED) encounters (maximum = 104.9), 0.2 medical–surgical hospitalizations (maximum = 14.9), and 0.1 psychiatric hospitalizations per person-year (maximum = 4.8). Rate ratios for homeless participants compared with matched controls were 1.76 (95% CI = 1.58, 1.96) for ambulatory care encounters, 8.48 (95% CI = 6.72, 10.70) for ED encounters, 4.22 (95% CI = 2.99, 5.94) for medical–surgical hospitalizations, and 9.27 (95% CI = 4.42, 19.43) for psychiatric hospitalizations. Conclusions. In a universal health insurance system, homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services. PMID:24148051

  6. A comprehensive assessment of arsenic in commonly consumed foodstuffs to evaluate the potential health risk in Bangladesh

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Md. Kawser [Faculty of Earth & Environmental Sciences, University of Dhaka, Dhaka 1000 (Bangladesh); Shaheen, Nazma [Institute of Nutrition and Food Science (INFS), University of Dhaka, Dhaka 1000 (Bangladesh); Islam, Md. Saiful [Department of Risk Management and Environmental Sciences, Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Kanagawa 240-8501 (Japan); Habibullah-Al-Mamun, Md., E-mail: habibullah-al-sj@ynu.jp [Department of Risk Management and Environmental Sciences, Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Kanagawa 240-8501 (Japan); Department of Fisheries, University of Dhaka, Dhaka 1000 (Bangladesh); Islam, Saiful [Institute of Nutrition and Food Science (INFS), University of Dhaka, Dhaka 1000 (Bangladesh); Islam, Md. Monirul [Department of Fisheries, University of Dhaka, Dhaka 1000 (Bangladesh); School of Earth and Environment, Leeds University, Leeds LS2, 9JT (United Kingdom); Kundu, Goutam Kumar [Department of Fisheries, University of Dhaka, Dhaka 1000 (Bangladesh); Bhattacharjee, Lalita [National Food Policy Capacity Strengthening Programme, Food and Agriculture Organization of the United Nations (Bangladesh)

    2016-02-15

    Arsenic (As), particularly of its inorganic form (iAs) is highly toxic, and its presence in food composites is a matter of concern for the public health safety, specifically in Bangladesh which is regarded as the most arsenic affected country throughout the world. This study was carried out to investigate the levels of As in the composite samples of commonly consumed foodstuffs collected from 30 different agro-ecological zones for the first time in Bangladesh. Most of the individual food composites contain a considerable amount of As which was, as a whole, in the range of 0.077–1.5 mg/kg fw which was lower than those reported from Spain, EU, France, Korea, whereas higher than those of Mexico, Chile, Japan, Cambodia, Hong Kong, Serbia, respectively. Cereals, vegetables, milk, and fish contribute about 90% to the daily intake of inorganic arsenic. Human health risk of dietary iAs was assessed separately for both the rural and urban adults. The estimated daily dietary intakes (EDI) of iAs for the exposed rural (3.5) and urban residents (3.2 μg/kg-BW/day) clearly exceeded the previous provisional tolerable daily intake (PTDI) value of 2.1 μg/kg-BW/day, recommended by the World Health Organization (WHO). From the health point of view, this study concluded that both the rural and urban residents of Bangladesh are exposed to carcinogenic and non-carcinogenic risks who consume As-contaminated water and foodstuffs. - Highlights: • A comprehensive health risk assessment from dietary arsenic exposure was evaluated. • Sample collected from 30 agro-ecological zones for the first time in Bangladesh. • Rural and urban adults are consuming more arsenic through food than the safe limit. • Cereals, vegetables, milk, and fish contribute about 90% to EDI of inorganic As. • Inhabitants are exposed chronically to arsenic induced risks.

  7. Including cetaceans in multi-species assessment models using strandings data: why, how and what can we do about it?

    Directory of Open Access Journals (Sweden)

    Camilo Saavedra

    2014-07-01

    Full Text Available Single-species models have been commonly used to assess fish stocks in the past. Since these models have relatively simple data requirements, they sometimes provide the only tool available to assess the status of a stock when data are not enough to develop more complex models. However, these models have been criticized for several reasons since they provide reference points independently for each species assessed ignoring their interactions. For example, several studies suggest that even more substantial reductions in fishing mortality may be necessary to ensure MSY is reached when taking into consideration multiespecies interactions. Therefore, and as Pauly et al. (1998 stated, single-species analysis may mislead researchers and managers into neglecting the gear and trophic interactions which ultimately determine stocks long-term yields and ecosystem health. Ecosystem or multispecies models offer a number of advantages over single-species models. As stated in the workshop “Incorporating ecosystem considerations into stock assessments and management advice” (Mace, 2000 two general improvements are: a better appreciation of the fishing on ecosystem structure and function, and a better appreciation of the need to consider de value of marine ecosystems for functions other than harvesting fish. As disadvantages, multispecies models are statistically complex and include trophic relationships requiring more information (e.g. good estimations of biological parameters of each species and generally a full quantification of the diet sometimes available though the analysis of stomach contents. To reduce the number of species and therefore the amount of information needed, Minimum Realistic Models (MRMs represent an intermediate level of complexity, where only the subset of the ecosystem, important for the issue under consideration, is modeled. This approach offers the advantage of allowing a refinement of our estimates and can help answer more targeted

  8. Quality assessment of delineation and dose planning of early breast cancer patients included in the randomized Skagen Trial 1

    DEFF Research Database (Denmark)

    Francolini, Giulio; Thomsen, Mette S; Yates, Esben S

    2017-01-01

    BACKGROUND AND PURPOSE: To report on a Quality assessment (QA) of Skagen Trial 1, exploring hypofractionation for breast cancer patients with indication for regional nodal radiotherapy. MATERIAL AND METHODS: Deviations from protocol regarding target volume delineations and dose parameters (Dmin...

  9. A Comprehensive and Systematic Assessment of Clinical Teaching Skills and Strategies in the Health Sciences. Executive Summary of the Final Report.

    Science.gov (United States)

    Meleca, C. Benjamin; And Others

    A study undertaken by a fourteen member consortium representing five schools each of medicine, dentistry, and nursing had as its objectives to: (1) generate, assess and collectively approve a comprehensive list of teaching skills and strategies that approximates observed and representative behaviors in clinical sciences teaching in medicine,…

  10. Assessing the comprehensive restoration of an urban river: an integrated application of contingent valuation in Shanghai, China.

    Science.gov (United States)

    Zhao, Jun; Liu, Qiuxia; Lin, Liqing; Lv, Huafang; Wang, Yao

    2013-08-01

    Around 2000, China began to address the comprehensive restoration of its urban rivers and attempt to restore river ecosystem services. This paper reports an integrated contingent valuation of the ecosystem services of Zhangjiabang Creek in Shanghai, which is in the most developed region of China. A total of 1440 questionnaires were delivered, and 1153 were returned as usable in August 2008. The willingness to pay for the restoration of the urban river is 20.22 RMB (2.91 USD) per month per household under the payment card and 110.64 RMB (15.92 USD) under the dichotomous format. Several important methodological issues of the contingent valuation method (CVM) are observed, including the disparity between willingness to pay and willingness to accept, the difference between payment card and dichotomous choice question formats, and the comparison of different models in welfare estimation using dichotomous choice data. Several new findings are disclosed for these three issues of CVM. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. A comprehensive assessment of the physical, nutritional, and psychological health status of the elderly populace in the Fayoum Governorate (Egypt).

    Science.gov (United States)

    El-Sherbiny, Naglaa A; Younis, Asmaa; Masoud, Mohamed

    2016-01-01

    Elderly in Egypt is approximately 7.2% of the population. The main physical health problems affecting old age is Non-communicable diseases (NCDs). Depression is the commonest geriatric psychiatric disorder related to various life events. Malnutrition is associated with poor health, and cognitive impairment. To determine the prevalence of chronic non-communicable diseases; malnutrition and depression with identification of related risk factors among Fayoum elderly population. A cross-sectional descriptive community based survey was conducted among elderly population 2219 in Fayoum governorate. The sample was multistage stratified cluster random. An interview structured questionnaire including socio-demographic characteristics, history of chronic NCDs, evaluation of nutritional and psychological status by MNASF and GDSLF tools respectively. More than ninety percent of the studied population was suffering from more than one disease either physiological or pathological. The prevalence of malnutrition and depression was 10.9% and 74.5% respectively. Logistic regression analysis revealed that female gender, with increased age, and disease burden were common risk factor for both malnutrition and depression. Non-communicable disease, malnutrition and depression were prevalent in our older population. These findings indicated the need for comprehensive integrated medical, psychological and nutritional health care at the level of the primary health care units. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. DESIGN OF A VIBRATION AND STRESS MEASUREMENT SYSTEM FOR AN ADVANCED POWER REACTOR 1400 REACTOR VESSEL INTERNALS COMPREHENSIVE VIBRATION ASSESSMENT PROGRAM

    OpenAIRE

    KO, DO-YOUNG; KIM, KYU-HYUNG

    2013-01-01

    In accordance with the US Nuclear Regulatory Commission (US NRC), Regulatory Guide 1.20, the reactor vessel internals comprehensive vibration assessment program (RVI CVAP) has been developed for an Advanced Power Reactor 1400 (APR1400). The purpose of the RVI CVAP is to verify the structural integrity of the reactor internals to flow-induced loads prior to commercial operation. The APR1400 RVI CVAP consists of four programs (analysis, measurement, inspection, and assessment). Thoughtful prepa...

  13. Seismic reliability assessment of RC structures including soil–structure interaction using wavelet weighted least squares support vector machine

    International Nuclear Information System (INIS)

    Khatibinia, Mohsen; Javad Fadaee, Mohammad; Salajegheh, Javad; Salajegheh, Eysa

    2013-01-01

    An efficient metamodeling framework in conjunction with the Monte-Carlo Simulation (MCS) is introduced to reduce the computational cost in seismic reliability assessment of existing RC structures. In order to achieve this purpose, the metamodel is designed by combining weighted least squares support vector machine (WLS-SVM) and a wavelet kernel function, called wavelet weighted least squares support vector machine (WWLS-SVM). In this study, the seismic reliability assessment of existing RC structures with consideration of soil–structure interaction (SSI) effects is investigated in accordance with Performance-Based Design (PBD). This study aims to incorporate the acceptable performance levels of PBD into reliability theory for comparing the obtained annual probability of non-performance with the target values for each performance level. The MCS method as the most reliable method is utilized to estimate the annual probability of failure associated with a given performance level in this study. In WWLS-SVM-based MCS, the structural seismic responses are accurately predicted by WWLS-SVM for reducing the computational cost. To show the efficiency and robustness of the proposed metamodel, two RC structures are studied. Numerical results demonstrate the efficiency and computational advantages of the proposed metamodel for the seismic reliability assessment of structures. Furthermore, the consideration of the SSI effects in the seismic reliability assessment of existing RC structures is compared to the fixed base model. It shows which SSI has the significant influence on the seismic reliability assessment of structures.

  14. In Situ Estuarine and Marine Toxicity Testing: A Review, Including Recommendations for Future Use in Ecological Risk Assessment

    Science.gov (United States)

    2009-09-01

    experiments to assess the toxicity of fenthion following aerial application to control adult salt marsh mosquitoes at an estuarine site in Florida...Genotoxicity testing in sediments: Progress in developing a transgenic polychaete model. ERDC/TN EEDP-01-45. Ireland DS, Burton GA, Jr., and Hess GG, 1996

  15. Including a Service Learning Educational Research Project in a Biology Course-I: Assessing Community Awareness of Childhood Lead Poisoning

    Science.gov (United States)

    Abu-Shakra, Amal; Saliim, Eric

    2012-01-01

    A university course project was developed and implemented in a biology course, focusing on environmental problems, to assess community awareness of childhood lead poisoning. A set of 385 questionnaires was generated and distributed in an urban community in North Carolina, USA. The completed questionnaires were sorted first into yes and no sets…

  16. Including a service learning educational research project in a biology course-I: Assessing community awareness of childhood lead poisoning

    OpenAIRE

    Abu-Shakra, Amal; Saliim, Eric

    2012-01-01

    A university course project was developed and implemented in a biology course, focusing on environmental problems, to assess community awareness of childhood lead poisoning. A set of 385 questionnaires was generated and distributed in an urban community in North Carolina, USA. The completed questionnaires were sorted fırst into yes and no sets based on the responses obtained for the fırst question, which gauged the participants' awareness of lead as an indoor pollutant at 71% (n=273)...

  17. High water-stressed population estimated by world water resources assessment including human activities under SRES scenarios

    Science.gov (United States)

    Kiguchi, M.; Shen, Y.; Kanae, S.; Oki, T.

    2009-04-01

    In an argument of the reduction and the adaptation for the climate change, the evaluation of the influence by the climate change is important. When we argue in adaptation plan from a damage scale and balance with the cost, it is particularly important. Parry et al (2001) evaluated the risks in shortage of water, malaria, food, the risk of the coast flood by temperature function and clarified the level of critical climate change. According to their evaluation, the population to be affected by the shortage of water suddenly increases in the range where temperature increases from 1.5 to 2.0 degree in 2080s. They showed how much we need to reduce emissions in order to draw-down significantly the number at risk. This evaluation of critical climate change threats and targets of water shortage did not include the water withdrawal divided by water availability. Shen et al (2008a) estimated the water withdrawal of projection of future world water resources according to socio-economic driving factors predicted for scenarios A1b, A2, B1, and B2 of the Special Report on Emission Scenarios (SRES). However, these results were in function of not temperature but time. The assessment of the highly water-stressed population considered the socioeconomic development is necessary for a function of the temperature. Because of it is easy to understand to need to reduce emission. We present a multi-GCM analysis of the global and regional populations lived in highly water-stressed basin for a function of the temperature using the socioeconomic data and the outputs of GCMs. In scenario A2, the population increases gradually with warming. On the other hand, the future projection population in scenario A1b and B1 increase gradually until the temperature anomaly exceeds around from +1 to +1.5 degree. After that the population is almost constant. From Shen et al (2008b), we evaluated the HWSP and its ratio in the world with temperature function for scenarios A1B, A2, and B1 by the index of W

  18. Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Brader, Peter; Riccabona, Michael [Medical University Graz, Division of Pediatric Radiology, Department of Radiology, Graz (Austria); Schwarz, Thomas [Medical University Graz, Division of Nuclear Medicine, Department of Radiology, Graz (Austria); Seebacher, Ursula [Medical University Graz, Department of Pediatric Surgery, Graz (Austria); Ring, Ekkehard [Medical University Graz, Department of Pediatrics, Graz (Austria)

    2008-12-15

    The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) {sup 99m}Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

  19. Social Values for Ecosystem Services (SolVES): using GIS to include social values information in ecosystem services assessments

    Science.gov (United States)

    Sherrouse, B.C.; Semmens, D.J.

    2010-01-01

    Ecosystem services can be defined in various ways; simply put, they are the benefits provided by nature, which contribute to human well-being. These benefits can range from tangible products such as food and fresh water to cultural services such as recreation and esthetics. As the use of these benefits continues to increase, additional pressures are placed on the natural ecosystems providing them. This makes it all the more important when assessing possible tradeoffs among ecosystem services to consider the human attitudes and preferences that express underlying social values associated with their benefits. While some of these values can be accounted for through economic markets, other values can be more difficult to quantify, and attaching dollar amounts to them may not be very useful in all cases. Regardless of the processes or units used for quantifying such values, the ability to map them across the landscape and relate them to the ecosystem services to which they are attributed is necessary for effective assessments. To address some of the needs associated with quantifying and mapping social values for inclusion in ecosystem services assessments, scientists at the Rocky Mountain Geographic Science Center (RMGSC), in collaboration with Colorado State University, have developed a public domain tool, Social Values for Ecosystem Services (SolVES). SolVES is a geographic information system (GIS) application designed to use data from public attitude and preference surveys to assess, map, and quantify social values for ecosystem services. SolVES calculates and maps a 10-point Value Index representing the relative perceived social values of ecosystem services such as recreation and biodiversity for various groups of ecosystem stakeholders. SolVES output can also be used to identify and model relationships between social values and physical characteristics of the underlying landscape. These relationships can then be used to generate predicted Value Index maps for areas

  20. Assessment of emerging contaminants including organophosphate esters and pyrethroids during DISCOVER-AQ in Houston, Texas, United States.

    Science.gov (United States)

    Usenko, Sascha; Clark, Addie; Sheesley, Rebecca

    2015-04-01

    DISCOVER-AQ (Deriving Information on Surface conditions from Column and Vertically Resolved Observations Relevant to Air Quality) is a NASA-funded air quality research program that focused on Houston, Texas, United States in September 2013. In conjunction with DISCOVER-AQ, particulate matter was collected for the month of September from four ground-based sampling sites across the Houston metropolitan area. The Houston metropolitan area is one of the most populous cities in the United States. Sampling sites included an upwind and downwind site as well as an urban (i.e. downtown) and industrial/port areas (i.e. Houston Ship Channel). Particulate matter samples were collected to examine both spatial and temporal trends (including day versus night). Particulate matter was collected on quartz fiber filters, which were analyzed for emerging classes of concern including organophosphate esters (OPEs; including flame retardants) and pyrethroids. OPEs have in recent years increased in both use and production as they replaced polybrominated diphenyl ethers flame retardants. Permethrin is one of the most commonly used mosquito adulticides in the United States.

  1. Vulnerability assessment including tangible and intangible components in the index composition: An Amazon case study of flooding and flash flooding.

    Science.gov (United States)

    Andrade, Milena Marília Nogueira de; Szlafsztein, Claudio Fabian

    2018-02-27

    The vulnerability of cities and communities in the Amazon to flooding and flash flooding is increasing. The effects of extreme events on populations vary across landscapes, causing vulnerability to differ spatially. Traditional vulnerability studies in Brazil and across the world have used the vulnerability index for the country and, more recently, municipality scales. The vulnerability dimensions are exposure, sensitivity, and adaptive capacity. For each of these dimensions, there is a group of indicators that constitutes a vulnerability index using quantitative data. Several vulnerability assessments have used sensitivity and exposure analyses and, recently, adaptive capacity has been considered. The Geographical Information Systems (GIS) analysis allows spatial regional modeling using quantitative vulnerability indicators. This paper presents a local-scale vulnerability assessment in an urban Amazonian area, Santarém City, using interdisciplinary methods. Data for exposure and sensitivity were gathered by remote sensing and census data, respectively. However, adaptive capacity refers to local capacities, whether infrastructural or not, and the latter were gathered by qualitative participatory methods. For the mixed data used to study adaptive capacity, we consider tangible components for countable infrastructure that can cope with hazards, and intangible components that reflect social activities based on risk perceptions and collective action. The results indicate that over 80% of the area is highly or moderately vulnerable to flooding and flash flooding. Exposure and adaptive capacity were determinants of the results. Lower values of adaptive capacity play a significant role in vulnerability enhancement. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Comprehensive life cycle assessment by transferring of preventative costs in the supply chain of products. A first draft of the Oiconomy system

    NARCIS (Netherlands)

    Croes, Pim R.; Vermeulen, Walter J.V.

    2015-01-01

    A major part of global unsustainability is embedded in consumption and the processes involved in the lifecycle of products, but there is currently no comprehensive and objective method for product sustainability measurement, including both environmental and social issues. This requires a life cycle

  3. Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey.

    Science.gov (United States)

    Vaughn, Amber E; Dearth-Wesley, Tracy; Tabak, Rachel G; Bryant, Maria; Ward, Dianne S

    2017-02-01

    validity (significant association with child diet, Pgood reliability (intraclass correlation coefficient>0.61). The HomeSTEAD family food practices survey provides a brief, yet comprehensive and psychometrically sound assessment of food parenting practices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. Comprehensive Implementation of the International Caries Detection and Assessment System (ICDAS in a Dental School and University Oral Health Centre: A Stepwise Framework

    Directory of Open Access Journals (Sweden)

    Priya Ahlawat

    2014-02-01

    Full Text Available ICDAS (the International Caries Detection and Assessment System is a new approach to the detection and classification of dental caries, starting with the stage showing the earliest visual changes. Methodology: This article describes the implementation of the ICDAS at the School of Dentistry, International Medical University, and Kuala Lumpur, Malaysia in a step-by-step systematically planned process. Beginning with the setting up of a Task Force in 2011 for the evaluation and preparation of the training resources and the running of exploratory training exercises, it finally culminated in carrying out training workshops for the entire staff and students. After the internal processes had been completed, an international expert (KE was invited to evaluate the process and conduct another workshop using the resources developed within the University, including a reference set of carious teeth. The overall time taken was one and a half years. Conclusions: The implementation of the ICDAS has been comprehensively set into motion within the context of our local curriculum and oral healthcare delivery arrangements. However, this will be an ongoing process with further quality assurance measures being required clinically together with the continuing training of new staff. Sharing this ‘framework’ of the ICDAS implementation process should considerably ease the path and reduce the time period of future implementations by other dental teaching institutions.

  5. Method for assessment of stormwater treatment facilities – Synthetic road runoff addition including micro-pollutants and tracer

    DEFF Research Database (Denmark)

    Cederkvist, Karin; Jensen, Marina Bergen; Holm, Peter Engelund

    2017-01-01

    % in the dual porosity filter, stressing the importance of including a conservative tracer for correction of contaminant retention values. The method is considered useful in future treatment performance testing of STFs. The observed performance of the STFs is presented in coming papers.......Stormwater treatment facilities (STFs) are becoming increasingly widespread but knowledge on their performance is limited. This is due to difficulties in obtaining representative samples during storm events and documenting removal of the broad range of contaminants found in stormwater runoff...

  6. Measured Properties of Turbulent Premixed Flames for Model Assessment, Including Burning Velocities, Stretch Rates, and Surface Densities (Postprint)

    Science.gov (United States)

    2006-10-01

    conditions was stabilized on a large two-dimensional slot Bunsen burner . It was found that the turbulent burning velocity of Bunsen flames depends...burning velocity of Bunsen flames are inadequate because they should include two additional parameters: mean velocity Ū and burner width W. These...corru- gated) flame with well-defined boundary conditions was stabilized on a large two-dimensional slot Bunsen burner . It was found that the turbulent

  7. A study of fish and shellfish consumers near Sellafield: assessment of the critical groups including consideration of children

    International Nuclear Information System (INIS)

    Leonard, D.R.P.; Hunt, G.J.

    1985-01-01

    A survey of people's consumption rates in 1981 and 1982, of fish and shellfish caught near the British Nuclear Fuels plc (BNFL) Sellafield site is described. Particular emphasis has been given to mollusc eaters and consumption rates of children because of the potentially higher radiation doses they may receive. Appropriate critical groups have been selected for dose assessment purposes using principles recommended by the International Commission on Radiological Protection (ICRP). Methods for consideration of children in critical groups are suggested and a comparison of these methods using the present data shows similar results. Combination of seafood consumption pathways is also considered, and it is shown that a simple additive approach is not excessively conservative. (author)

  8. Including the urban heat island in spatial heat health risk assessment strategies: a case study for Birmingham, UK

    Directory of Open Access Journals (Sweden)

    Thornes John E

    2011-06-01

    Full Text Available Abstract Background Heatwaves present a significant health risk and the hazard is likely to escalate with the increased future temperatures presently predicted by climate change models. The impact of heatwaves is often felt strongest in towns and cities where populations are concentrated and where the climate is often unintentionally modified to produce an urban heat island effect; where urban areas can be significantly warmer than surrounding rural areas. The purpose of this interdisciplinary study is to integrate remotely sensed urban heat island data alongside commercial social segmentation data via a spatial risk assessment methodology in order to highlight potential heat health risk areas and build the foundations for a climate change risk assessment. This paper uses the city of Birmingham, UK as a case study area. Results When looking at vulnerable sections of the population, the analysis identifies a concentration of "very high" risk areas within the city centre, and a number of pockets of "high risk" areas scattered throughout the conurbation. Further analysis looks at household level data which yields a complicated picture with a considerable range of vulnerabilities at a neighbourhood scale. Conclusions The results illustrate that a concentration of "very high" risk people live within the urban heat island, and this should be taken into account by urban planners and city centre environmental managers when considering climate change adaptation strategies or heatwave alert schemes. The methodology has been designed to be transparent and to make use of powerful and readily available datasets so that it can be easily replicated in other urban areas.

  9. [Training of residents in obstetrics and gynecology: Assessment of an educational program including formal lectures and practical sessions using simulators].

    Science.gov (United States)

    Jordan, A; El Haloui, O; Breaud, J; Chevalier, D; Antomarchi, J; Bongain, A; Boucoiran, I; Delotte, J

    2015-01-01

    Evaluate an educational program in the training of residents in gynecology-obstetrics (GO) with a theory session and a practical session on simulators and analyze their learning curve. Single-center prospective study, at the university hospital (CHU). Two-day sessions were leaded in April and July 2013. An evaluation on obstetric and gynecological surgery simulator was available to all residents. Theoretical knowledge principles of obstetrics were evaluated early in the session and after formal lectures was taught to them. At the end of the first session, a satisfaction questionnaire was distributed to all participants. Twenty residents agreed to participate to the training sessions. Evaluation of theoretical knowledge: at the end of the session, the residents obtained a significant improvement in their score on 20 testing knowledge. Obstetrical simulator: a statistically significant improvement in scores on assessments simulator vaginal delivery between the first and second session. Subjectively, a larger increase feeling was seen after breech delivery simulation than for the cephalic vaginal delivery. However, the confidence level of the resident after breech delivery simulation has not been improved at the end of the second session. Simulation in gynecological surgery: a trend towards improvement in the time realized on the peg-transfer between the two sessions was noted. In the virtual simulation, no statistically significant differences showed, no improvement for in salpingectomy's time. Subjectively, the residents felt an increase in the precision of their gesture. Satisfaction: All residents have tried the whole program. They considered the pursuit of these sessions on simulators was necessary and even mandatory. The approach chosen by this structured educational program allowed a progression for the residents, both objectively and subjectively. This simulation program type for the resident's training would use this tool in assessing their skills and develop

  10. A Comprehensive Behavioral Test Battery to Assess Learning and Memory in 129S6/Tg2576 Mice

    Science.gov (United States)

    Wolf, Andrea; Bauer, Björn; Abner, Erin L.; Ashkenazy-Frolinger, Tal; Hartz, Anika M. S.

    2016-01-01

    Transgenic Tg2576 mice overexpressing human amyloid precursor protein (hAPP) are a widely used Alzheimer’s disease (AD) mouse model to evaluate treatment effects on amyloid beta (Aβ) pathology and cognition. Tg2576 mice on a B6;SJL background strain carry a recessive rd1 mutation that leads to early retinal degeneration and visual impairment in homozygous carriers. This can impair performance in behavioral tests that rely on visual cues, and thus, affect study results. Therefore, B6;SJL/Tg2576 mice were systematically backcrossed with 129S6/SvEvTac mice resulting in 129S6/Tg2576 mice that lack the rd1 mutation. 129S6/Tg2576 mice do not develop retinal degeneration but still show Aβ accumulation in the brain that is comparable to the original B6;SJL/Tg2576 mouse. However, comprehensive studies on cognitive decline in 129S6/Tg2576 mice are limited. In this study, we used two dementia mouse models on a 129S6 background—scopolamine-treated 129S6/SvEvTac mice (3–5 month-old) and transgenic 129S6/Tg2576 mice (11–13 month-old)–to establish a behavioral test battery for assessing learning and memory. The test battery consisted of five tests to evaluate different aspects of cognitive impairment: a Y-Maze forced alternation task, a novel object recognition test, the Morris water maze, the radial arm water maze, and a Y-maze spontaneous alternation task. We first established this behavioral test battery with the scopolamine-induced dementia model using 129S6/SvEvTac mice and then evaluated 129S6/Tg2576 mice using the same testing protocol. Both models showed distinctive patterns of cognitive impairment. Together, the non-invasive behavioral test battery presented here allows detecting cognitive impairment in scopolamine-treated 129S6/SvEvTac mice and in transgenic 129S6/Tg2576 mice. Due to the modular nature of this test battery, more behavioral tests, e.g. invasive assays to gain additional cognitive information, can easily be added. PMID:26808326

  11. A Comprehensive Behavioral Test Battery to Assess Learning and Memory in 129S6/Tg2576 Mice.

    Directory of Open Access Journals (Sweden)

    Andrea Wolf

    Full Text Available Transgenic Tg2576 mice overexpressing human amyloid precursor protein (hAPP are a widely used Alzheimer's disease (AD mouse model to evaluate treatment effects on amyloid beta (Aβ pathology and cognition. Tg2576 mice on a B6;SJL background strain carry a recessive rd1 mutation that leads to early retinal degeneration and visual impairment in homozygous carriers. This can impair performance in behavioral tests that rely on visual cues, and thus, affect study results. Therefore, B6;SJL/Tg2576 mice were systematically backcrossed with 129S6/SvEvTac mice resulting in 129S6/Tg2576 mice that lack the rd1 mutation. 129S6/Tg2576 mice do not develop retinal degeneration but still show Aβ accumulation in the brain that is comparable to the original B6;SJL/Tg2576 mouse. However, comprehensive studies on cognitive decline in 129S6/Tg2576 mice are limited. In this study, we used two dementia mouse models on a 129S6 background--scopolamine-treated 129S6/SvEvTac mice (3-5 month-old and transgenic 129S6/Tg2576 mice (11-13 month-old-to establish a behavioral test battery for assessing learning and memory. The test battery consisted of five tests to evaluate different aspects of cognitive impairment: a Y-Maze forced alternation task, a novel object recognition test, the Morris water maze, the radial arm water maze, and a Y-maze spontaneous alternation task. We first established this behavioral test battery with the scopolamine-induced dementia model using 129S6/SvEvTac mice and then evaluated 129S6/Tg2576 mice using the same testing protocol. Both models showed distinctive patterns of cognitive impairment. Together, the non-invasive behavioral test battery presented here allows detecting cognitive impairment in scopolamine-treated 129S6/SvEvTac mice and in transgenic 129S6/Tg2576 mice. Due to the modular nature of this test battery, more behavioral tests, e.g. invasive assays to gain additional cognitive information, can easily be added.

  12. Global patterns of socioeconomic biomass flows in the year 2000. A comprehensive assessment of supply, consumption and constraints

    International Nuclear Information System (INIS)

    Krausmann, Fridolin; Erb, Karl-Heinz; Gingrich, Simone; Lauk, Christian; Haberl, Helmut

    2008-01-01

    Human use of biomass has become a major component of the global biogeochemical cycles of carbon and nitrogen. The use of land for biomass production (e.g. cropland) is among the most important pressures on biodiversity. At the same time, biomass is indispensable for humans as food, animal feed, raw material and energy source. In order to support research into these complex issues, we here present a comprehensive assessment of global socioeconomic biomass harvest, use and trade for the year 2000. We developed country-level livestock balances and a consistent set of factors to estimate flows of used biomass not covered by international statistics (e.g. grazed biomass, crop residues) and indirect flows (i.e. biomass destroyed during harvest but not used). We found that current global terrestrial biomass appropriation amounted to 18.7 billion tonnes dry matter per year (Pg/yr) or 16% of global terrestrial NPP of which 6.6 Pg/yr were indirect flows. Only 12% of the economically used plant biomass (12.1 Pg/yr) directly served as human food, while 58% were used as feed for livestock, 20% as raw material and 10% as fuelwood. There are considerable regional variations in biomass supply and use. Distinguishing 11 world regions, we found that extraction of used biomass ranged from 0.3 to 2.8 t/ha/yr, per-capita values varied between 1.2 and 11.7 t/cap/yr (dry matter). Aggregate global biomass trade amounted to 7.5% of all extracted biomass. An analysis of these regional patterns revealed that the level of biomass use per capita is determined by historically evolved patterns of land use and population density rather than by affluence or economic development status. Regions with low population density have the highest level of per-capita biomass use, high-density regions the lowest. Livestock, consuming 30-75% of all harvested biomass, is another important factor explaining regional variations in biomass use. Global biomass demand is expected to grow during the next decades

  13. Comprehensive assessment of the impact of life habits on sleep disturbance, chronotype, and daytime sleepiness among high-school students.

    Science.gov (United States)

    Shimura, Akiyoshi; Hideo, Sakai; Takaesu, Yoshikazu; Nomura, Ryota; Komada, Yoko; Inoue, Takeshi

    2018-04-01

    Sleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted. A cross-sectional survey of 344 high school students (age range 15-17; 171 boys, 173 girls) in Tokyo, Japan was conducted in 2015. Complete responses were provided by 294 students. Demographic variables, Pittsburgh Sleep Quality Index (PSQI), diurnal type scale, Pediatric Daytime Sleepiness Scale (PDSS), and life habits such as dinnertime, viewing electronic displays, caffeine intake, sunlight in the morning, and the brightness of the room in the night were asked. The mean scores were PSQI: 5.9 (±2.3), PDSS: 19.0 (±5.8), and the diurnal type scale: 16.7 (±3.4). Using an electronic display in bed (OR = 3.01; (95%CI) 1.24-7.30), caffeine intake at night always (OR = 2.22; 1.01-4.90), and waking up before dawn (OR = 3.25; 1.34-7.88) were significantly associated with sleep disturbance. Irregular timing of the evening meal (OR = 2.06; 1.10-3.84) and display viewing within 2 h before bedtime (OR = 2.50; 1.01-6.18) or in bed (OR = 3.60; 1.41-9.21) were significantly associated with excessive daytime sleepiness. Using an electronic display within 2 h before bedtime (OR = 2.64; 1.10-6.38) or in bed (OR = 3.50; 1.40-8.76) and a living room which is bright at night (OR = 1.89; 1.06-3.36) were significantly associated with eveningness. Each type of sleep-related problem had its own associated life habit factors. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  14. Toward a sustainable waste management system: a comprehensive assessment of thermal and electric energy recovery from waste incineration

    Energy Technology Data Exchange (ETDEWEB)

    Salvia, Monica; Cosmi, Carmelina; Cuomo, Vincenzo; Macchiato, Maria [Istituto Nazionale per la Fisica della Materia, Napoli (Italy); Mangiamele, Lucia [Univ. della Basilicata, Potenza (Italy). Dipt. Ingegneria e Fisica dell Ambiente; Pietrapertosa, Filomena [Univ. di Napoli Federico II, (Italy). Dipt. di Scienze Fisiche

    2002-12-01

    Energy-environmental planning must join normative, environmental and socio-economic features to obtain effective strategies aimed to a sustainable development. Therefore a comprehensive methodology for the analysis and the optimisation of the anthropogenic activities system configuration, can usefully support decision-makers in the definition of harmonised sector plans, joining waste management issues with resource use problems and exploiting energy and materials feedback among supply and demand sectors. In this paper we present an innovative application of the Advanced Local Energy Environmental Planning methodology (ALEP), aimed to the definition of optimal waste management strategies which comply with comprehensive as well as sectorial issues.

  15. Environmental assessment of bioenergy technologies application in Russia, including their impact on the balance of greenhouse gases

    Science.gov (United States)

    Andreeva, Irina; Vasenev, Ivan

    2017-04-01

    In recent years, Russia adopted a policy towards increasing of the share of renewable energy in total amount of used energy, albeit with some delay comparing to the EU countries and the USA. It was expected that the use of biofuels over time will reduce significantly the dependency of Russian economy on fossil fuels, increase its competitiveness, and increase Russian contribution to the prevention of global climate changes. Russia has significant bio-energy potential and resources which are characterized by great diversity due to the large extent of the territory, which require systematic studies and environmental assessment of used bio-energy technologies. Results of research carried at the Laboratory of agroecological monitoring, modeling and prediction of ecosystems RSAU-MTAA demonstrated significant differences in the assessment of the environmental, economic and social effects of biofuel production and use, depending on the species of bio-energy crops, regional soil-ecological and agro-climatic characteristics, applied farming systems and production processes. The total area of temporarily unused and fallow land, which could be allocated to the active agricultural use in Russia, according to various estimates, ranges from 20 to 33 million hectares, which removes the problem, typical of most European countries, of adverse agro-ecological changes in land use connected with the expansion of bio-energy crops cultivation. However, the expansion of biofuel production through the use of fallow land and conversion of natural lands has as a consequence the problem of greenhouse gas emissions due to land use changes, which, according to FAO, could be even higher than CO2 emission from fossil fuels for some of bio-energy raw materials and production systems. Assessment of the total impacts of biofuels on greenhouse gas emissions in the Russian conditions should be based on regionally adapted calculations of flows throughout the entire life cycle of production, taking

  16. ASSESSMENT OF THE SPECIFIC LOCAL HUMORAL IMMUNITY IN PATIENTS WITH INFERTILITY INCLUDING CASES ASSOCIATED WITH GENITAL TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    A. V. Mordyk

    2013-01-01

    Full Text Available Abstract. In order to optimize the detection and diagnosis of genital tuberculosis evaluation of the specific local antituberculosis immunity in 39 patients with infertility entered to the Department of Gynecology for the implementation of therapeutic and diagnostic laparoscopy has been carried out. All patients were divided into 3 groups: the 1st one included patients with tubal-peritoneal infertility, the group 2 included patients with infertility not associated with the defeat of the fallopian tubes, the third group was presented by patients with tubal-peritoneal infertility associated with genital tuberculosis who completed the basic course of anti-tuberculosis treatment. It was established that in case of the tubal-peritoneal infertility the local humoral immunity was characterised by increasing of IgM in the whole peritoneal fluid. Among women who recovered from genital tuberculosis increasing of IgA and IgG to M. tuberculosis was revealed in contrast to patients with infertility not associated with damage of fallopian tubes (p < 0.05. In 25% of patients of the 1st group genital tuberculosis was diagnosed. The diagnostic criteria for early detection of genital tuberculosis were determined and the algorithm of genital tuberculosis identification have been proposed.

  17. Improving ecological risk assessment by including bioavailability into species sensitivity distributions: An example for plants exposed to nickel in soil

    Energy Technology Data Exchange (ETDEWEB)

    Semenzin, Elena [Consorzio Venezia Ricerche, c/o VEGApark, Via della Liberta 5-12, 30175 Marghera-Venice (Italy)]. E-mail: semenzin.cvr@vegapark.ve.it; Temminghoff, Erwin J.M. [Wageningen University, Department of Environmental Science, Subdepartment of Soil Quality, PO Box 8005, 6700 EC Wageningen (Netherlands)]. E-mail: erwin.temminghoff@wur.nl; Marcomini, Antonio [Ca' Foscari University of Venice, Department of Environmental Sciences, Santa Marta - Dorsoduro 2137, 30121 Venice (Italy)]. E-mail: marcom@unive.it

    2007-07-15

    The variability of species sensitivity distribution (SSD) due to contaminant bioavailability in soil was explored by using nickel as metal of concern. SSDs of toxicity test results of Avena sativa L. originating from different soils and expressed as total content and available (0.01 M CaCl{sub 2}) extractable concentration were compared to SSDs for terrestrial plants derived from literature toxicity data. Also the 'free' nickel (Ni{sup 2+}) concentration was calculated and compared. The results demonstrated that SSDs based on total nickel content highly depend on the experimental conditions set up for toxicity testing (i.e. selected soil and pH value) and thus on metal bioavailability in soil, resulting in an unacceptable uncertainty for ecological risk estimation. The use in SSDs of plant toxicity data expressed as 0.01 M CaCl{sub 2} extractable metal strongly reduced the uncertainty in the SSD curve and thus can improve the ERA procedure remarkably by taking bioavailability into account. - The use of bioavailability toxicity data can improve species sensitivity distribution (SSD) curves and thus ecological risk assessment (ERA)

  18. Including exposure variability in the life cycle impact assessment of indoor chemical emissions: the case of metal degreasing.

    Science.gov (United States)

    Golsteijn, Laura; Huizer, Daan; Hauck, Mara; van Zelm, Rosalie; Huijbregts, Mark A J

    2014-10-01

    The present paper describes a method that accounts for variation in indoor chemical exposure settings and accompanying human toxicity in life cycle assessment (LCA). Metal degreasing with dichloromethane was used as a case study to show method in practice. We compared the human toxicity related to the degreasing of 1m(2) of metal surface in different exposure scenarios for industrial workers, professional users outside industrial settings, and home consumers. The fraction of the chemical emission that is taken in by exposed individuals (i.e. the intake fraction) was estimated on the basis of operational conditions (e.g. exposure duration), and protective measures (e.g. local exhaust ventilation). The introduction of a time-dependency and a correction for protective measures resulted in reductions in the intake fraction of up to 1.5 orders of magnitude, compared to application of existing, less advanced models. In every exposure scenario, the life cycle impacts for human toxicity were mainly caused by indoor exposure to metal degreaser (>60%). Emissions released outdoors contributed up to 22% of the life cycle impacts for human toxicity, and the production of metal degreaser contributed up to 19%. These findings illustrate that human toxicity from indoor chemical exposure should not be disregarded in LCA case studies. Particularly when protective measures are taken or in the case of a short duration (1h or less), we recommend the use of our exposure scenario-specific approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. 45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

    Science.gov (United States)

    2010-10-01

    ... assessment of the impact of the TANF program(s) in the State on the increase in child poverty? 284.30 Section... TANF PROGRAM § 284.30 What information must the State include in its assessment of the impact of the... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES METHODOLOGY...

  20. Incidental renal stones in potential live kidney donors: prevalence, assessment and donation, including role of ex vivo ureteroscopy.

    Science.gov (United States)

    Olsburgh, Jonathon; Thomas, Kay; Wong, Kathie; Bultitude, Matthew; Glass, Jonathan; Rottenberg, Giles; Silas, Lisa; Hilton, Rachel; Koffman, Geoff

    2013-05-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Previously, donors with asymptomatic stones found incidentally on CT were not considered ideal donor candidates because of the presumed risk of morbidity to both the donor and recipient. Increasingly, studies show that these risks are low. This study aims to evaluate the long-term safety of using ex vivo ureteroscopy to remove the stones from the donor kidney on the bench before donation. Outcomes so far suggest that this technique can safely render a kidney stone-free before transplantation. This has led to 20 more transplants in our institution than would otherwise be possible. To evaluate the prevalence of asymptomatic renal stones in our potential donor population. To assess the safety and success of ex vivo ureteroscopy (ExURS) to remove stones from explanted donor kidneys before transplantation. We conducted a retrospective analysis of 377 computed tomography (CT) angiograms of potential kidney donors between October 2004 and May 2007 to assess the prevalence of asymptomatic renal stones in our donor population. Between October 2005 and October 2011, kidneys from suitable donors underwent ExURS. Stones were removed using basket extraction or were fragmented with holmium laser on bench before transplantation. Immediate and long-term complications of the transplanted recipients were recorded. Donors were followed with yearly ultrasonography of the remaining kidney in addition to standard follow-up protocol. Review of 377 CT angiograms between October 2004 to May 2007 showed a 5% prevalence of asymptomatic renal stones. Out of 55 potential donors (19 identified between October 2004 to May 2007 and a further 36 identified since May 2007), 20 donors with stones proceeded to donation, with stone size ranging from 2 to 12 mm. Of the patients, 17 proceeded to ExURS. Stones were removed in 10 patients; five with basket retrieval, four with laser fragmentation and one with both laser fragmentation and basket

  1. A comprehensive assessment of the effects of Bt cotton on Coleomegilla maculata demonstrates no detrimental effects by Cry1Ac and Cry2Ab.

    Directory of Open Access Journals (Sweden)

    Yunhe Li

    Full Text Available The ladybird beetle, Coleomegilla maculata (DeGeer, is a common and abundant predator in many cropping systems. Its larvae and adults are predaceous, feeding on aphids, thrips, lepidopteran larvae and plant tissues, such as pollen. Therefore, this species is exposed to insecticidal proteins expressed in insect-resistant, genetically engineered cotton expressing Cry proteins derived from Bacillus thuringiensis (Bt. A tritrophic bioassay was conduced to evaluate the potential impact of Cry2Ab- and Cry1Ac-expressing cotton on fitness parameters of C. maculata using Bt-susceptible and -resistant larvae of Trichoplusia ni as prey. Coleomegilla maculata survival, development time, adult weight and fecundity were not different when they were fed with resistant T. ni larvae reared on either Bt or control cotton. To ensure that C. maculata were not sensitive to the tested Cry toxins independent from the plant background and to add certainty to the hazard assessment, C. maculata larvae were fed artificial diet incorporated with Cry2Ab, Cry1Ac or both at >10 times higher concentrations than in cotton tissue. Artificial diet containing E-64 was included as a positive control. No differences were detected in any life-table parameters between Cry protein-containing diet treatments and the control diet. In contrast, larvae of C. maculata fed the E-64 could not develop to the pupal stage and the 7-d larval weight was significantly negatively affected. In both feeding assays, the stability and bioactivity of Cry proteins in the food sources were confirmed by ELISA and sensitive-insect bioassays. Our results show that C. maculata is not affected by Bt cotton and is not sensitive to Cry2Ab and Cry1Ac at concentrations exceeding the levels in Bt cotton, thus demonstrating that Bt cotton will pose a negligible risk to C. maculata. More importantly, this study demonstrates a comprehensive system for assessing the risk of genetically modified plants on non

  2. Comprehensive assessments of long-term sleep habits in epidemiological study: Validity and reliability of sleep factors questionnaire (SFQ) among Chinese women.

    Science.gov (United States)

    Yang, Wan-Shui; Fu, Wen-Xue; Wang, Xin; Deng, Qin; Wang, Ling; Wang, Lin-Yan; Zhao, Hao; Fan, Wen-Yan; Huang, Shao-Xin

    2017-04-01

    Epidemiological studies suggested that poor sleep is a potentially novel risk factor for several health outcomes currently; however, there are no validated questionnaires that can systematically measure sleep parameters within these studies. We evaluated the reliability and validity of 17-item sleep factors questionnaire (SFQ), which was developed to comprehensively assess long-term sleep habits for the Jiujiang Breast Cancer Study (JBCS), Jiujiang, China. The participants included 100 women aged 18-74years, who were randomly selected from the JBCS project, and completed a SFQ at baseline and again 1year later, and 4 quarterly 30 consecutive days (a total of 120days) sleep diaries over this same year. Reliability was tested by comparing the 2 SFQs; validity by comparing the average measures between the SFQ and the 4 sleep diaries. Validity analysis showed moderate correlation (γ=0.41) for sleep duration with the adjusted concordance correlation coefficient (CCC adj ) of 0.54; the weighted κ statistics indicated an excellent agreement for night/shift work and sleep medication use; fair-to-moderate for sleep quality, light at night (LAN), nighttime sleeping with light on, sleep noise and nap time; slight-to-fair for sleep quality and nighttime wakings frequency. Reliability analysis showed excellent correlation for night/shift work and sleep medication use; fair-to-moderate for LAN, nighttime wakings frequency, insomnia frequency, sleep noise and nap time; but slight-to-fair for insomnia frequency and nighttime sleeping with light on; the CCC adj for sleep duration was 0.61. The SFQ showed reasonable reliability and validity for sleep assessments in most domains. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    OpenAIRE

    Suijker, Jacqueline J; Buurman, Bianca M; ter Riet, Gerben; van Rijn, Marjon; de Haan, Rob J; de Rooij, Sophia E; Moll van Charante, Eric P

    2012-01-01

    Abstract Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and n...

  4. Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy

    Directory of Open Access Journals (Sweden)

    Holly Ockenden

    2016-11-01

    Full Text Available The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey, related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG, as well as pregnancy-related health behaviours. Constructs addressed within the questionnaire include self-efficacy, locus of control, perceived barriers, and facilitators of physical activity and diet, outcome expectations, social environment and health practices. Content validity was examined using an expert panel (n = 7 and pilot testing items in a small sample (n = 5 of pregnant women and recent mothers (target population. Test re-test reliability was assessed among a sample (n = 71 of the target population. Reliability scores were calculated for all constructs (r and intra-class correlation coefficients (ICC, those with a score of >0.5 were considered acceptable. The content validity of the questionnaire reflects the degree to which all relevant components of excessive GWG risk in women are included. Strong test-retest reliability was found in the current study, indicating that responses to the questionnaire were reliable in this population. The EMat Health Survey adds to the growing body of literature on maternal health and gestational weight gain by providing the first comprehensive questionnaire that can be self-administered and remotely accessed. The questionnaire can be completed in 15–25 min and collects useful data on various social determinants of health and GWG as well as associated health behaviours. This online tool may assist researchers by providing them with a platform to collect useful information in developing and tailoring interventions to better support women in achieving recommended weight gain targets in pregnancy.

  5. Assessment of commercially available energy-efficient room air conditioners including models with low global warming potential (GWP) refrigerants

    Energy Technology Data Exchange (ETDEWEB)

    Shah, N. K. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Park, W. Y. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gerke, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-08-30

    , the highest-efficiency RAC models employ the low-GWP refrigerants R-32 or R-290. • RACs are available in most regions and worldwide that surpass the highest efficiency levels recognized by labeling programs. • Fixed-speed RACs using high-GWP and ozone-depleting R-22 refrigerant still dominate the market in many emerging economies. There is significant scope to improve RAC efficiency and transition to low-GWP refrigerants using commercially available technology and to design market-transformation programs for high-efficiency, low-GWP equipment including standards, labeling, procurement, and incentive programs.

  6. Idiom Comprehension in Aphasic Patients

    Science.gov (United States)

    Papagno, Costanza; Tabossi, Patrizia; Colombo, Maria Rosa; Zampetti, Patrizia

    2004-01-01

    Idiom comprehension was assessed in 10 aphasic patients with semantic deficits by means of a string-to-picture matching task. Patients were also submitted to an oral explanation of the same idioms, and to a word comprehension task. The stimuli of this last task were the words following the verb in the idioms. Idiom comprehension was severely…

  7. The Importance of Assessments: How Portfolios Can Impact Students' Self-Efficacy and Comprehension in an Online Graphic Design Course

    Science.gov (United States)

    Powell, Terry

    2013-01-01

    The purpose for this study was to find an assessment that is currently being used and is a common assessment familiar to others within the Brick-and-mortar classroom and transform that assessment for use within the online learning environment. By using assessments, teachers can measure whether or not students are learning what it is they are…

  8. Personality, coping, risky behavior, and mental disorders in the offspring of parents with bipolar disorder: a comprehensive psychosocial assessment.

    Science.gov (United States)

    Nijjar, Rami; Ellenbogen, Mark A; Hodgins, Sheilagh

    2014-09-01

    It has been proposed that the offspring of parents with bipolar disorder (OBD), through genetic mechanisms and early family interactions, develop a heightened sensitivity to stress, maladaptive coping, and dysregulated behavior, which ultimately increases the risk for affective disorders. The current study tested certain predictions of this model by assessing different psychosocial and health-related outcomes in the OBD, including personality, coping style, smoking, suicidality, high-risk sexual behaviors, criminality, and mental health. The sample was composed of 74 OBD and 75 control offspring, who were between 14 and 27 years of age (mean: 19.38±3.56). Participants underwent a diagnostic interview and a structured interview to assess high-risk behavior and other maladaptive outcomes, and they completed the Revised NEO Personality Inventory and Coping in Stressful Situations questionnaire. The rates of affective (31.1%) and non-affective (56.8%) disorders were elevated in the OBD compared to controls (9.5% and 32.4%). Relative to controls, OBD endorsed fewer task-oriented and more distraction coping strategies [Wilk׳s λ=.83, F(1, 136) =6.92, p<.01], and were more likely to report engaging in high-risk sexual behavior (OR=2.37; Wald=4.13, 1 df, p<05). Importantly, OBD reported elevated high-risk sexual behavior relative to controls, irrespective of affective disorder diagnosis. The results highlight a potential risk profile for the OBD, consisting of ineffective coping strategies and risky sexual behavior and are discussed in the context of current knowledge of stress and coping in this population. The present findings were based on cross-sectional data and relied on offspring self-report. It would be useful to corroborate these findings with biobehavioural and longitudinal measures. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. A Comprehensive Hydrologic Projections Resource to support Climate Change Vulnerability Assessments in the Western U.S

    Science.gov (United States)

    Brekke, L. D.; Pruitt, T.; Gangopadhyay, S.; Raff, D. A.

    2010-12-01

    . Presentation will highlight development of this hydrologic projections resource, initial assessments conducted by Reclamation, and plans to publically serve the information to the broader Western U.S. water resources management community. Archived monthly hydrologic variables will include: gridded meteorological inputs (mean daily minimum and maximum temperatures, precipitation, wind speed) and gridded model outputs (routed runoff, actual evapotranspiration (ET), potential ET, soil water content, and snow-water equivalent). There is also a preliminary plan to archive daily gridded series for five of the nine hydrologic variables (i.e. the meteorological inputs and routed runoffoutput).

  10. A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension: a cross-sectional study

    OpenAIRE

    Chu, Jiao-Jiao; Chen, Xu-Jiao; Shen, Shan-Shan; Zhang, Xue-Feng; Chen, Ling-Yan; Zhang, Jing-Mei; He, Jing; Zhao, Jun-Feng

    2015-01-01

    Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients (age 79.5 ? 6.7 years, male 63.8%) were recruited to the study. Comprehensive g...

  11. Assessing the Determinants of Renewable Electricity Acceptance Integrating Meta-Analysis Regression and a Local Comprehensive Survey

    Directory of Open Access Journals (Sweden)

    Simona Bigerna

    2015-08-01

    Full Text Available In dealing with renewable electricity (RE, individuals are involved both as end-consumers on the demand side and as stakeholders (citizens in the local production process on the supply side. Empirical evidence shows that in many countries, consumers are willing to pay a significant amount to facilitate adoption of RE. By contrast, environmental externalities are often the cause of strong opposition to RE adoption if local communities are involved as stakeholders in wind, solar or biomass investment projects. Looking at the literature on willingness to pay and on willingness to accept, we have investigated RE acceptance mechanisms. First, we have used the meta-analysis to assess the major determinants of RE acceptance on both demand and supply sides. Meta-analysis has provided some insights useful for managing field research on an onshore wind farm enlargement project located in the Umbria region. Meta-analysis and survey results confirm that the local community plays a central role in local RE acceptance. Furthermore, people who have previous experience with windmills require less compensation, or are willing to pay more, for RE development. Results suggest that these attributes should be included in future research to improve understanding of determinants of RE acceptance.

  12. Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy.

    Science.gov (United States)

    Nakayama, Kazuhiro; Osaka, Wakako; Togari, Taisuke; Ishikawa, Hirono; Yonekura, Yuki; Sekido, Ai; Matsumoto, Masayoshi

    2015-05-23

    Health literacy, or the ability to access, understand, appraise and apply health information, is central to individuals' health and well-being. A comprehensive, concept-based measure of most dimensions of health literacy has been developed for the general population in Europe, which enables comparisons within and between countries. This study seeks to validate this tool for use in Japan, and to use a Japanese translation to compare health literacy levels in Japan and Europe. A total of 1054 Japanese adults recruited through an Internet research service company, completed a Japanese-language version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). The survey was administered via an online questionnaire, and participant demographics were closely matched to those of the most recent Japanese national census. Survey results were compared with those previously reported in an eight-country European study of health literacy. Internal consistency for the translated questionnaire was valid across multiple metrics. Construct validity was checked using confirmatory factor analyses. The questionnaire correlated well with existing scales measuring health literacy and mental health status. In general, health literacy in the Japanese population was lower than in Europe, with Japanese respondents rating all test items as more difficult than European respondents. The largest difference (51.5 %) was in the number of respondents finding it difficult to know where to get professional help when they are ill. This study translated a comprehensive health literacy questionnaire into Japanese and confirmed its reliability and validity. Comparative results suggest that Japanese health literacy is lower than that of Europeans. This discrepancy may be partly caused by inefficiency in the Japanese primary health care system. It is also difficult to access reliable and understandable health information in Japan, as there is no comprehensive national online platform

  13. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Suijker Jacqueline J

    2012-04-01

    Full Text Available Abstract Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. Methods/Design In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC score (≥ 2. These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP. The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. Discussion This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. Trial registration NTR2653 Grant Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201

  14. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial.

    Science.gov (United States)

    Suijker, Jacqueline J; Buurman, Bianca M; ter Riet, Gerben; van Rijn, Marjon; de Haan, Rob J; de Rooij, Sophia E; Moll van Charante, Eric P

    2012-04-01

    Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC) score (≥ 2). These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP). The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. NTR2653 GRANT: Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201.

  15. Demonstrating an Approach for Including Pesticide Use in Life Cycle Assessment: Estimating Human and Ecosystem Toxicity of Pesticide Use in Midwest Corn Farming

    Science.gov (United States)

    Purpose This study demonstrates an approach to assess human health and ecotoxicity impacts of pesticide use by including multiple environmental pathways and various exposure routes using the case of corn grown for bio-based fuel or chemical production in US Midwestern states.Meth...

  16. Demonstrating an approach for including pesticide use in life-cycle assessment: Estimating human and ecosystem toxicity of pesticide use in Midwest corn farming

    Science.gov (United States)

    PurposeThis study demonstrates an approach to assess human health and ecotoxicity impacts of pesticide use by including multiple environmental pathways and various exposure routes using the case of corn grown for bio-based fuel or chemical production in US Midwestern states.Metho...

  17. Teaching reading comprehension strategies

    Directory of Open Access Journals (Sweden)

    Majlinda Lika

    2017-03-01

    Full Text Available The academic debate nowadays is focused on producing an applied science of learning, aiming to teach students how to learn and be strategic in their acquisition. The aim of the study is to identify and discuss the reading comprehension instruction approach applied in the Albanian system of education. Findings from 10 classes of Albanian language and literature with students of third grade were directly observed and analyzed, in order to gather evidence based on indicators and instruments that assess the way of reading comprehension. Findings were categorized according to strategy use; the frequency of their application in different classes was counted and represented in percentages. In this paper we will try to respond to questions like: What are students' main barriers of comprehending? Does the instructional approach respond to students’ needs and level of comprehension? Are teachers prepared to teach comprehension strategies? Furthermore, examples of procedures on how to deliver instruction of comprehension strategies in natural contexts will be represented. Results from teacher practices during lessons of reading comprehension confirmed that teachers use limited teaching strategies to deliver lessons. They mainly use strategies to test comprehension; while the approach of teaching students to read independently and strategically is an unknown practice.

  18. The Assessment of Comprehensive Vulnerability of Chemical Industrial Park Based on Entropy Method and Matter-element Extension Model

    Directory of Open Access Journals (Sweden)

    Yan Jingyi

    2016-01-01

    Full Text Available The paper focuses on studying connotative meaning, evaluation methods and models for chemical industry park based on in-depth analysis of relevant research results in China and abroad, it summarizes and states the feature of menacing vulnerability and structural vulnerability and submits detailed influence factors such as personnel vulnerability, infrastructural vulnerability, environmental vulnerability and the vulnerability of safety managerial defeat. Using vulnerability scoping diagram establishes 21 evaluation indexes and an index system for the vulnerability evaluation of chemical industrial park. The comprehensive weights are calculated with entropy method, combining matter-element extension model to make the quantitative evaluation, then apply to evaluate some chemical industrial park successfully. This method provides a new ideas and ways for enhancing overall safety of the chemical industrial park.

  19. Assessing cognitive therapy skills comprehension, acquisition, and use by means of an independent observer version of the Skills of Cognitive Therapy (SoCT-IO).

    Science.gov (United States)

    Brown, Gregory K; Thase, Michael E; Vittengl, Jeffrey R; Borman, Patricia D; Clark, Lee Anna; Jarrett, Robin B

    2016-02-01

    The purposes of this study were (a) to describe the adaptation and psychometric properties of the Skills for Cognitive Therapy (SoCT) measure for use by an independent observer (SoCT-IO) who rates the cognitive therapy (CT) skill acquisition, comprehension, and use by depressed adults and (b) to compare ratings of CT skill comprehension, acquisition, and use by independent observers to those by patients and therapists. Like the other SoCT versions, the SoCT-IO consists of 8 items that assess patients' comprehension, acquisition, and use of cognitive and behavioral skills for managing depressive symptoms, using a 5-point Likert-type scale. Four experienced raters (2 doctoral-level CT therapists and 2 bachelor-level nontherapists) used the SoCT-IO to rate 80 CT videotapes from both mid and later sessions in acute-phase CT from a randomized controlled trial for outpatients with recurrent major depression. The SoCT-IO ratings showed excellent internal consistency reliability and moderately high interrater reliability. Concurrent validity was demonstrated by convergence of the SoCT-IO with 2 other versions of the SoCT, 1 completed by therapists (SoCT-O) and the other by patients (SoCT-P). SoCT-IO ratings evidenced good predictive validity: Independent observers' ratings of patient CT skills midphase in therapy predicted treatment response even when the predictive effects of SoCT ratings by therapists and patients were controlled. The SoCT-IO is a psychometrically sound measure of CT skill comprehension, acquisition and use for rating outpatients with recurrent depression. The clinical utility and implications for using the SoCT-IO as a measure of CT skills acquisition are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Dutch Patient-Generated Subjective Global Assessment (PG-SGA): training improves scores for comprehensibility and difficulty

    NARCIS (Netherlands)

    Danique Haven; Martine J. Sealy; Jan Roodenburg; Dr. C.P. van der Schans; Dr. Harriët Jager-Wittenaar; Anne van der Braak; Faith Ottery

    2015-01-01

    The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated instrument to assess and monitor malnutrition. The PG-SGA consists of both patient-reported and professional-reported items. A professional should be able to correctly interpret all items. Untrained professionals may

  1. Interruptions disrupt reading comprehension.

    Science.gov (United States)

    Foroughi, Cyrus K; Werner, Nicole E; Barragán, Daniela; Boehm-Davis, Deborah A

    2015-06-01

    Previous research suggests that being interrupted while reading a text does not disrupt the later recognition or recall of information from that text. This research is used as support for Ericsson and Kintsch's (1995) long-term working memory (LT-WM) theory, which posits that disruptions while reading (e.g., interruptions) do not impair subsequent text comprehension. However, to fully comprehend a text, individuals may need to do more than recognize or recall information that has been presented in the text at a later time. Reading comprehension often requires individuals to connect and synthesize information across a text (e.g., successfully identifying complex topics such as themes and tones) and not just make a familiarity-based decision (i.e., recognition). The goal for this study was to determine whether interruptions while reading disrupt reading comprehension when the questions assessing comprehension require participants to connect and synthesize information across the passage. In Experiment 1, interruptions disrupted reading comprehension. In Experiment 2, interruptions disrupted reading comprehension but not recognition of information from the text. In Experiment 3, the addition of a 15-s time-out prior to the interruption successfully removed these negative effects. These data suggest that the time it takes to process the information needed to successfully comprehend text when reading is greater than that required for recognition. Any interference (e.g., an interruption) that occurs during the comprehension process may disrupt reading comprehension. This evidence supports the need for transient activation of information in working memory for successful text comprehension and does not support LT-WM theory. (c) 2015 APA, all rights reserved).

  2. The Validity of Reading Comprehension Rate: Reading Speed, Comprehension, and Comprehension Rates

    Science.gov (United States)

    Skinner, Christopher H.; Williams, Jacqueline L.; Morrow, Jennifer Ann; Hale, Andre D.; Neddenriep, Christine E.; Hawkins, Renee O.

    2009-01-01

    This article describes a secondary analysis of a brief reading comprehension rate measure, percent comprehension questions correct per minute spent reading (%C/M). This measure includes reading speed (seconds to read) in the denominator and percentage of comprehension questions answered correctly in the numerator. Participants were 22 4th-, 29…

  3. Comprehensive Biological Monitoring to Assess Isocyanates and Solvents Exposure in the NSW Australia Motor Vehicle Repair Industry.

    Science.gov (United States)

    Hu, Jimmy; Cantrell, Phillip; Nand, Aklesh

    2017-10-01

    Urethane products that contain isocyanates are extensively used in the motor vehicle repair (MVR) industry and other industries such as furniture and cabinet-making as two-pack spray paints, clears, and adhesives. Attention has recently been refocussed on isocyanate-containing chemicals, particularly in paints. The spray painters in the MVR industry had a propensity to develop industrial asthma at a rate 80 times higher than the general public, which was previously reported in the UK. To track workers exposure to isocyanates, urine samples were collected from 196 spray painters who worked mainly in 78 MVR shops across 54 New South Wales (NSW) towns and suburbs. The biological monitoring also covered exposure testing to a wide variety of solvents including aromatic hydrocarbons, ketones, and alcohols. The main finding of the study was that 2.6% of the spray painters surveyed in the MVR industry in NSW that handled isocyanate-containing paints showed exposure to isocyanates; with 1.0% being moderately exposed, which is more than twice the current UK's Health and Safety Executive (HSE) Biological Monitoring Guidance Value (BMGV) of 1 µmol mol-1 creatinine. Potential exposures to toluene (a solvent often found in paint thinners) was monitored via hippuric acid (HA) urine levels and showed 2.6% of the spray painters surveyed to be over the US' American Conference of Government Industrial Hygienists (ACGIH) Biological Exposure Index (BEI) of 1010 mmol/mole creatinine for HA. The other solvents or their metabolites were all below their respective BEI; these comprised benzene, xylene, ethyl benzene, methyl ethyl ketone, acetone, methanol, and ethanol. These findings indicate that isocyanates and certain solvents exposure were occurring in the NSW Australia vehicle repair industry, albeit at lower levels than previous occupational biological monitoring studies that showed higher exposure levels, particularly for isocyanates. One reason for this could be the increasing use

  4. Long-term prognostic value of a comprehensive assessment of cardiac magnetic resonance indexes after an ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Merlos, Pilar; López-Lereu, Maria P; Monmeneu, Jose V; Sanchis, Juan; Núñez, Julio; Bonanad, Clara; Valero, Ernesto; Miñana, Gema; Chaustre, Fabián; Gómez, Cristina; Oltra, Ricardo; Palacios, Lorena; Bosch, Maria J; Navarro, Vicente; Llácer, Angel; Chorro, Francisco J; Bodí, Vicente

    2013-08-01

    A variety of cardiac magnetic resonance indexes predict mid-term prognosis in ST-segment elevation myocardial infarction patients. The extent of transmural necrosis permits simple and accurate prediction of systolic recovery. However, its long-term prognostic value beyond a comprehensive clinical and cardiac magnetic resonance evaluation is unknown. We hypothesized that a simple semiquantitative assessment of the extent of transmural necrosis is the best resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. One week after a first ST-segment elevation myocardial infarction we carried out a comprehensive quantification of several resonance parameters in 206 consecutive patients. A semiquantitative assessment (altered number of segments in the 17-segment model) of edema, baseline and post-dobutamine wall motion abnormalities, first pass perfusion, microvascular obstruction, and the extent of transmural necrosis was also performed. During follow-up (median 51 months), 29 patients suffered a major adverse cardiac event (8 cardiac deaths, 11 nonfatal myocardial infarctions, and 10 readmissions for heart failure). Major cardiac events were associated with more severely altered quantitative and semiquantitative resonance indexes. After a comprehensive multivariate adjustment, the extent of transmural necrosis was the only resonance index independently related to the major cardiac event rate (hazard ratio=1.34 [1.19-1.51] per each additional segment displaying>50% transmural necrosis, P<.001). A simple and non-time consuming semiquantitative analysis of the extent of transmural necrosis is the most powerful cardiac magnetic resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. Guidelines on the scope, content, and use of comprehensive risk assessment in the management of high-level nuclear waste transportation

    International Nuclear Information System (INIS)

    Golding, D.; White, A.

    1990-12-01

    This report discusses the scope of risk assessment strategies in the management of the transport of high-level radioactive wastes. In spite of the shortcomings of probabilistic risk assessment(PRA), the Transportation Needs Assessment recommended this as the preferred methodology to assess the risks of high level nuclear waste (HLNW) transportation. A PRA also will need to heed the lessons learned from the development and application of PRA elsewhere, such as in the nuclear power industry. A set of guidelines will aid this endeavor by outlining the appropriate scope, content, and use of a risk assessment which is more responsive to the uncertainties, human-technical interactions, social forces, and iterative relationship with risk management strategies, than traditional PRAS. This more expansive definition, which encompasses but is not totally reliant on rigorous data requirements and quantitative probability estimates, we term Comprehensive Risk Assessment (CRA) Guidelines will be developed in three areas: the limitations of existing methodologies and suggested modifications; CRA as part of a flexible, effective, adaptive risk management system for HLNW transportation; and, the use of CRA in risk communication

  6. Use of a mobile device by nursing home residents for long-term care comprehensive geriatric self-assessment: a feasibility study.

    Science.gov (United States)

    Huang, Fanpin; Chang, Polun; Hou, I-Ching; Tu, Ming-Hsiang; Lan, Chung-Fu

    2015-01-01

    Long-term-care comprehensive geriatric assessments, such as the Minimum Data Set 3.0, are used to evaluate the clinical, psychological, and personal status of residents in long-term-care nursing facilities. Nursing staff conducts assessment interviews, thereby increasing the workload of nurses and the cost of patient care. This study explored the ability of nursing home residents to use two different mobile devices for a geriatric self-assessment. Study participants were residents of long-term-care nursing homes. A modified Minimum Data Set 3.0 was converted to a format for use with a 6-inch mobile pad and a 3.7-inch mobile smartphone. The survey completion rate and the response time were measured. A Technology Assessment Model questionnaire analyzed the participants' experience. All participants were able to use a 6-inch pad, with an average completion rate of 92.9% and an average time for completion of 21 minutes. Only 20% of the participants could complete the assessment with the 3.7-inch smartphone. The participants found the 6-inch pad easier to use than the 3.7-inch smartphone. This exploratory study suggests that nursing home residents are able to use a mobile device to perform a geriatric self-assessment and delineates the importance of the ergonomics of the device.

  7. Guidelines on the scope, content, and use of comprehensive risk assessment in the management of high-level nuclear waste transportation

    Energy Technology Data Exchange (ETDEWEB)

    Golding, D.; White, A. [Clark Univ., Worcester, MA (United States). Center for Technology, Environment, and Development

    1990-12-01

    This report discusses the scope of risk assessment strategies in the management of the transport of high-level radioactive wastes. In spite of the shortcomings of probabilistic risk assessment(PRA), the Transportation Needs Assessment recommended this as the preferred methodology to assess the risks of high level nuclear waste (HLNW) transportation. A PRA also will need to heed the lessons learned from the development and application of PRA elsewhere, such as in the nuclear power industry. A set of guidelines will aid this endeavor by outlining the appropriate scope, content, and use of a risk assessment which is more responsive to the uncertainties, human-technical interactions, social forces, and iterative relationship with risk management strategies, than traditional PRAS. This more expansive definition, which encompasses but is not totally reliant on rigorous data requirements and quantitative probability estimates, we term Comprehensive Risk Assessment (CRA) Guidelines will be developed in three areas: the limitations of existing methodologies and suggested modifications; CRA as part of a flexible, effective, adaptive risk management system for HLNW transportation; and, the use of CRA in risk communication.

  8. Based on Fuzzy Comprehensive Evaluation Method The Investment Risk Assessment of Chinese Enterprises in The Countries Along “The Belt and Road”

    Science.gov (United States)

    Chen, Yanyu; Chai, Huaqi; Huang, Yimiao

    2018-01-01

    “Belt and Road Forum for International Cooperation” held in Beijing in May this year. once again, “The Belt and Road” strategic initiative to the world, causing the world’s enthusiastic response. The core of the “One Belt, One Road” strategy initiative is to promote infrastructure construction and interconnection, dock national policies and development strategies, deepen pragmatic cooperation, promote coordinated and coordinated development and achieve common prosperity. With the “The Belt and Road” strategy in-depth, Chinese enterprises will go abroad, in the countries along the country to invest in more and more examples, accompanied by the increasing risk. Analysis of the failure of investment cases, we can easily find that this is the majority of enterprises overseas investment in the lack of careful assessment of risk and risk of foreign investment risk management has a great relationship. In this paper, the risk factors are used to identify the risk factors table, and the fuzzy comprehensive evaluation method is used to estimate the comprehensive risk value of many uncertain factors that cannot be determined by the overseas investment. The risk assessment system is constructed to help Chinese enterprises to follow the " Investment to avoid risks, improve the success rate.

  9. Comprehensive preventive care assessments for adults with intellectual and developmental disabilities: Part 1: How do we know if it is happening?

    Science.gov (United States)

    Smith, Glenys; Ouellette-Kuntz, Hélène; Green, Michael

    2018-04-01

    To determine how best to measure the provision of comprehensive preventive care assessment of adults with intellectual and developmental disabilities (IDD). Cross-sectional study. Ontario. Adults with IDD between 40 and 64 years of age in 2013 and 2014. Health examination was defined using the Ontario Health Insurance Plan billing data fee code A003 (with diagnostic code 917 or 319) or fee code K131, and the Primary Care Quality Composite Score (PCQS), a measure combining 7 different screening maneuvers (lipid, glucose, breast cancer, cervical cancer, colorectal cancer, eye, and hemoglobin A 1c screening), was identified using administrative health data. A total of 28 825 adults with IDD were identified in 2013 and 2014. Overall, 12.1% of adults with IDD received a health examination; 51.2% received a high (≥ 0.6) PCQS. Male patients were more likely to have received all of their eligible screening maneuvers if they had had a health examination compared with female patients (odds ratio of 5.73 vs 3.99, respectively). Less than 60% of adults with IDD appear to be receiving comprehensive preventive care. Future studies assessing the quality of preventive care received by adults with IDD should combine health examination billing codes and the PCQS. Copyright© the College of Family Physicians of Canada.

  10. Evidence-based road safety practice in India: assessment of the adequacy of publicly available data in meeting requirements for comprehensive road safety data systems.

    Science.gov (United States)

    Barffour, Maxwell; Gupta, Shivam; Gururaj, Gopalkrishna; Hyder, Adnan A

    2012-01-01

    To assess the availability and coverage of publicly available road safety data at the national and state levels in India. We reviewed the 2 publicly accessible data sources in India for the availability of data related to traffic injuries and deaths: (1) the National Crime Records Bureau (NCRB) and (2) the Ministry of Road Transport and Highways (MORTH). Using the World Health Organization (WHO) manual for the comprehensive assessment of road safety data, we developed a checklist of indicators required for comprehensive road safety assessment. These indicators were then used to assess the availability of road safety data in India using the NCRB and MORTH data. We assessed the availability of data on outcomes and exposures indicators (i.e., number of crashes, injuries, deaths, timing of deaths, gender and age distribution of injuries and deaths), safety performance indicators (i.e., with reference to select risk factors of speeding, alcohol, and helmet use), and cost indicators (i.e., medical costs, material costs, intervention costs, productivity costs, time costs, and losses to quality of life). Information on outcome indicators was the most comprehensive in terms of availability. Both NCRB and MORTH databases had data for most of the need areas specified by the WHO under outcomes and exposure indicators. Regarding outcome and exposure indicators, data were available for 81 and 91 percent of specified need areas at the national level from NCRB and MORTH databases, respectively. At the state level, data on outcome and exposure indicators were available for only 54 percent of need areas from either of the 2 sources. There were no data on safety performance indicators in the NCRB database. From the MORTH database, data availability on safety performance indicators was 60 percent at both national and state levels. Data availability on costs and process indicators was found to be below 20 percent at the national and state levels. Overall, there is an urgent need to

  11. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  12. Comprehensive and rapid assessment of carotid plaques in acute stroke using a new single sweep method for three-dimensional carotid ultrasound.

    Science.gov (United States)

    Kalashyan, Harapet; Saqqur, Maher; Shuaib, Ashfaq; Romanchuk, Helen; Nanda, Navin C; Becher, Harald

    2013-04-01

    We describe a 68-year-old man with acute stroke in whom the newly developed single sweep method for three-dimensional (3D) carotid ultrasound provided a rapid and comprehensive assessment of atherosclerotic plaque burden in the internal carotid artery. The two-dimensional duplex carotid scan diagnosed 50-69% stenosis, and with the three-dimensional method, the markedly hypoechogenic plaque (total volume 1.42 mL) was shown to occupy 77% of the total arterial volume (1.84 mL), consistent with severe lesion. The ultrasound findings were confirmed by computed tomographic angiography and subsequent carotid endarterectomy. The new single sweep 3D carotid ultrasound has the potential to become a valuable clinical tool in the assessment of stroke patients. © 2013, Wiley Periodicals, Inc.

  13. Validity of anthropometric measurements to assess body composition, including muscle mass, in 3-year-old children from the SKOT cohort

    DEFF Research Database (Denmark)

    Jensen, Signe Marie; Mølgaard, Christian; Ejlerskov, Katrine Tschentscher

    2015-01-01

    Nutritional status of children is commonly assessed by anthropometry both in under and overnutrition. The link between anthropometry and body fat, the body compartment most affected by overnutrition, is well known, but the link with muscle mass, the body compartment most depleted in undernutrition...... to estimate muscle mass. Overall, anthropometric measures were more effective to measure absolute size of fat, lean and muscle mass than their relative sizes. Proportion of the variance explained by anthropometry was 79% for lean mass, 76% for fat mass and 74% for muscle mass. For fat mass and lean mass......, which included only mid-upper arm circumference and subscapular skinfold. The power of height in the weight-to-height ratio to determine fat mass proportion was 1.71 with a 95% confidence interval (0.83-2.60) including the value of 2 used in body mass index (BMI). Limitations of anthropometry to assess...

  14. Painless reading comprehension

    CERN Document Server

    Jones, EdD, Darolyn "Lyn"

    2016-01-01

    Reading comprehension gets easier as students learn what kind of reader they are, discover how to keep facts in their head, and much more. Bonus Online Component: includes additional games, including Beat the Clock, a line match game, and a word scramble.

  15. Digitised audio questionnaire for assessment of informed consent comprehension in a low-literacy African research population: development and psychometric evaluation.

    Science.gov (United States)

    Afolabi, Muhammed O; Bojang, Kalifa; D'Alessandro, Umberto; Ota, Martin O C; Imoukhuede, Egeruan B; Ravinetto, Raffaella; Larson, Heidi J; McGrath, Nuala; Chandramohan, Daniel

    2014-06-24

    To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants. We conducted this study in the Gambia where a high illiteracy rate and absence of standardised writing formats of local languages pose major challenges for research participants to comprehend consent information. We developed a 34-item questionnaire to assess participants' comprehension of key elements of informed consent. The questionnaire was face validated and content validated by experienced researchers. To bypass the challenge of a lack of standardised writing formats, we audiorecorded the questionnaire in three major Gambian languages: Mandinka, Wolof and Fula. The questionnaire was further developed into an audio computer-assisted interview format. The digitised questionnaire was administered to 250 participants enrolled in two clinical trials in the urban and rural areas of the Gambia. One week after first administration, the questionnaire was readministered to half of the participants who were randomly selected. Participants were eligible if enrolled in the parent trials and could speak any of the three major Gambian languages. The primary outcome measure was reliability and validity of the questionnaire. Item reduction by factor analysis showed that 21 of the question items have strong factor loadings. These were retained along with five other items which were fundamental components of informed consent. The 26-item questionnaire has high internal consistency with a Cronbach's α of 0.73-0.79 and an intraclass correlation coefficient of 0.94 (95% CI 0.923 to 0.954). Hypotheses testing also showed that the questionnaire has a positive correlation with a similar questionnaire and discriminates between participants with and without education. We have developed a reliable and valid measure of comprehension of informed consent information for the Gambian context, which might be easily adapted to

  16. Comprehensive assessment of the genes involved in withanolide biosynthesis from Withania somnifera: chemotype-specific and elicitor-responsive expression.

    Science.gov (United States)

    Agarwal, Aditya Vikram; Gupta, Parul; Singh, Deeksha; Dhar, Yogeshwar Vikram; Chandra, Deepak; Trivedi, Prabodh Kumar

    2017-07-01

    Withania somnifera (L.) Dunal (Family, Solanaceae), is among the most valuable medicinal plants used in Ayurveda owing to its rich reservoir of pharmaceutically active secondary metabolites known as withanolides. Withanolides are C 28 -steroidal lactones having a triterpenoidal metabolic origin synthesised via mevalonate (MVA) pathway and methyl-D-erythritol-4-phosphate (MEP) pathway involving metabolic intermediacy of 24-methylene (C 30 -terpenoid) cholesterol. Phytochemical studies suggest differences in the content and/or nature of withanolides in different tissues of different chemotypes. Though development of genomic resources has provided information about putative genes encoding enzymes for biosynthesis of intermediate steps of terpenoid backbone, not much is known about their regulation and response to elicitation. In this study, we generated detailed molecular information about genes catalysing key regulatory steps of withanolide biosynthetic pathway. The full-length sequences of genes encoding enzymes for intermediate steps of terpenoid backbone biosynthesis and their paralogs have been characterized for their functional and structural properties as well as phylogeny using bioinformatics approach. The expression analysis suggests that these genes are differentially expressed in different tissues (with maximal expression in young leaf), chemotypes and in response to salicylic acid (SA) and methyl jasmonate (MJ) treatments. Sub-cellular localization studies suggest that both paralogs of sterol ∆-7 reductase (WsDWF5-1 and WsDWF5-2) are localized in the endoplasmic reticulum (ER) thus supporting their indispensible role in withanolide biosynthesis. Comprehensive information developed, in this study, will lead to elucidation of chemotype- as well as tissue-specific withanolide biosynthesis and development of new tools for functional genomics in this important medicinal plant.

  17. Comprehensively measuring health-related subjective well-being: Dimensionality analysis for improved outcome assessment in health economics

    NARCIS (Netherlands)

    Vries, M. de; Emons, W.H.M.; Plantinga, A.; Pietersma, S.; Hout, W.B. van den; Stiggelbout, A.M.; Akker-van Marle, M.E. van den

    2016-01-01

    Background: Allocation of inevitably limited financial resources for health care requires assessment of an intervention’s effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World

  18. Comprehensively measuring health-related subjective well-being : Dimensionality analysis for improved outcome assessment in health economics

    NARCIS (Netherlands)

    de Vries, Marieke; Emons, W.H.M.; Plantinga, A.; Pietersma, Suzanne; van den Hout, W.B.; Stiggelbout, Anne M.; van den Akker-van Marle, M. Elske

    2016-01-01

    Background Allocation of inevitably limited financial resources for health care requires assessment of an intervention’s effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World

  19. Traditional and new composite endpoints in heart failure clinical trials : facilitating comprehensive efficacy assessments and improving trial efficiency

    NARCIS (Netherlands)

    Anker, Stefan D. t; Schroeder, Stefan; Atar, Dan; Bax, Jeroen J.; Ceconi, Claudio; Cowie, Martin R.; AdamCrisp,; Dominjon, Fabienne; Ford, Ian; Ghofrani, Hossein-Ardeschir; Gropper, Savion; Hindricks, Gerhard; Hlatky, Mark A.; Holcomb, Richard; Honarpour, Narimon; Jukema, J. Wouter; Kim, Albert M.; Kunz, Michael; Lefkowitz, Martin; Le Floch, Chantal; Landmesser, Ulf; McDonagh, Theresa A.; McMurray, John J.; Merkely, Bela; Packer, Milton; Prasad, Krishna; Revkin, James; Rosano, Giuseppe M. C.; Somaratne, Ransi; Stough, Wendy Gattis; Voors, Adriaan A.; Ruschitzka, Frank

    Composite endpoints are commonly used as the primary measure of efficacy in heart failure clinical trials to assess the overall treatment effect and to increase the efficiency of trials. Clinical trials still must enrol large numbers of patients to accrue a sufficient number of outcome events and

  20. Training and Generalization Effects of a Reading Comprehension Learning Strategy on Computer and Paper-Pencil Assessments

    Science.gov (United States)

    Worrell, Jamie; Duffy, Mary Lou; Brady, Michael P.; Dukes, Charles; Gonzalez-DeHass, Alyssa

    2016-01-01

    Many schools use computer-based testing to measure students' progress for end-of-the-year and statewide assessments. There is little research to support whether computer-based testing accurately reflects student progress, particularly among students with learning, performance, and generalization difficulties. This article summarizes an…

  1. Base Rates, Multiple Indicators, and Comprehensive Forensic Evaluations: Why Sexualized Behavior Still Counts in Assessments of Child Sexual Abuse Allegations

    Science.gov (United States)

    Everson, Mark D.; Faller, Kathleen Coulborn

    2012-01-01

    Developmentally inappropriate sexual behavior has long been viewed as a possible indicator of child sexual abuse. In recent years, however, the utility of sexualized behavior in forensic assessments of alleged child sexual abuse has been seriously challenged. This article addresses a number of the concerns that have been raised about the…

  2. Comprehensive assessment of geographic variation in heat tolerance and hardening capacity in populations of Drosophila melanogaster from eastern Australia

    DEFF Research Database (Denmark)

    Sgro, Carla M.; Overgaard, Johannes; Kristensen, Torsten Nygård

    2010-01-01

    We examined latitudinal variation in adult and larval heat tolerance in Drosophila melanogaster from eastern Australia. Adults were assessed using static and ramping assays. Basal and hardened static heat knockdown time showed significant linear clines; heat tolerance increased towards the tropics...

  3. Assessing changes in quality of life using the Oral Health Impact Profile (OHIP) in patients with different classifications of malocclusion during comprehensive orthodontic treatment.

    Science.gov (United States)

    Zheng, De-Hua; Wang, Xu-Xia; Su, Yu-Ran; Zhao, Shu-Ya; Xu, Chao; Kong, Chao; Zhang, Jun

    2015-11-20

    The objectives of this study were to investigated changes in OHRQoL among patients with different classifications of malocclusion during comprehensive orthodontic treatment. Clinical data were collected from 81 patients (aged 15 to 24) who had undergone comprehensive orthodontic treatment. Participants were classified 3 groups: Class I (n = 35), II (n = 32) and III (n = 14) by Angle classification. OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). All subjects were examined and interviewed at baseline (T0), after alignment and leveling (T1), after correction of molar relationship and space closure (T2), after finishing (T3). Friedman 2-way analysis of variance (ANOVA) and Wilcoxon signed rank tests were used to compare the relative changes of OHRQoL among the different time points. A Bonferroni correction with P  0.005) in class I and class II, Handicap in class II and class III (P > 0.005). Class I patients showed significant changes for psychological disability and psychological discomfort domain at T1, functional limitation, physical pain at T2. Class III patients showed a significant benefit in all domains except physical pain and functional limitation. Class II patients showed significant changes in the physical pain, functional disability, and physical disability domains at T1. The impact of comprehensive orthodontic treatment on patients' OHRQoL do not follow the same pattern among patients with different malocclusion. Class II patients benefits the most from the stage of space closure, while class I patients benefits the first stage (alignment and leveling) of treatment in psychological disability and psychological discomfort domains.

  4. A comprehensive assessment of resting state networks: bidirectional modification of functional integrity in cerebro-cerebellar networks in dementia

    Directory of Open Access Journals (Sweden)

    Gloria eCastellazzi

    2014-07-01

    Full Text Available In resting state fMRI (rs-fMRI, only functional connectivity (FC reductions in the default mode network (DMN are normally reported as a biomarker for Alzheimer's disease (AD. In this investigation we have developed a comprehensive strategy to characterize the FC changes occurring in multiple networks and applied it in a pilot study of subjects with AD and Mild Cognitive Impairment (MCI, compared to healthy controls (HC. Resting state networks (RSNs were studied in 14 AD (70±6 years, 12 MCI (74±6 years and 16 HC (69±5 years. RSN alterations were present in almost all the 15 recognized RSNs; overall, 474 voxels presented a reduced FC in MCI and 1244 in AD while 1627 voxels showed an increased FC in MCI and 1711 in AD. The RSNs were then ranked according to the magnitude and extension of FC changes (gFC, putting in evidence 6 RSNs with prominent changes: DMN, frontal cortical network (FCN, lateral visual network (LVN, basal ganglia network (BGN, cerebellar network (CBLN, and the anterior insula network (AIN. Nodes, or hubs, showing alterations common to more than one RSN were mostly localized within the prefrontal cortex and the mesial-temporal cortex. The cerebellum showed a unique behavior where voxels of decreased gFC were only found in AD while a significant gFC increase was only found in MCI. The gFC alterations showed strong correlations (p< 0.001 with psychological scores, in particular MMSE and attention/memory tasks. In conclusion, this analysis revealed that the DMN was affected by remarkable FC increases, that FC alterations extended over several RSNs, that derangement of functional relationships between multiple areas occurred already in the early stages of dementia. These results warrant future work to verify whether these represent compensatory mechanisms that exploit a pre-existing neural reserve through plasticity, which evolve in a state of lack of connectivity between different networks with the worsening of the pathology.

  5. A comprehensive assessment of resting state networks: bidirectional modification of functional integrity in cerebro-cerebellar networks in dementia.

    Science.gov (United States)

    Castellazzi, Gloria; Palesi, Fulvia; Casali, Stefano; Vitali, Paolo; Sinforiani, Elena; Wheeler-Kingshott, Claudia A M; D'Angelo, Egidio

    2014-01-01

    In resting state fMRI (rs-fMRI), only functional connectivity (FC) reductions in the default mode network (DMN) are normally reported as a biomarker for Alzheimer's disease (AD). In this investigation we have developed a comprehensive strategy to characterize the FC changes occurring in multiple networks and applied it in a pilot study of subjects with AD and Mild Cognitive Impairment (MCI), compared to healthy controls (HC). Resting state networks (RSNs) were studied in 14 AD (70 ± 6 years), 12 MCI (74 ± 6 years), and 16 HC (69 ± 5 years). RSN alterations were present in almost all the 15 recognized RSNs; overall, 474 voxels presented a reduced FC in MCI and 1244 in AD while 1627 voxels showed an increased FC in MCI and 1711 in AD. The RSNs were then ranked according to the magnitude and extension of FC changes (gFC), putting in evidence 6 RSNs with prominent changes: DMN, frontal cortical network (FCN), lateral visual network (LVN), basal ganglia network (BGN), cerebellar network (CBLN), and the anterior insula network (AIN). Nodes, or hubs, showing alterations common to more than one RSN were mostly localized within the prefrontal cortex and the mesial-temporal cortex. The cerebellum showed a unique behavior where voxels of decreased gFC were only found in AD while a significant gFC increase was only found in MCI. The gFC alterations showed strong correlations (p < 0.001) with psychological scores, in particular Mini-Mental State Examination (MMSE) and attention/memory tasks. In conclusion, this analysis revealed that the DMN was affected by remarkable FC increases, that FC alterations extended over several RSNs, that derangement of functional relationships between multiple areas occurred already in the early stages of dementia. These results warrant future work to verify whether these represent compensatory mechanisms that exploit a pre-existing neural reserve through plasticity, which evolve in a state of lack of connectivity between different networks with

  6. A comprehensive special educational diagnostic assessment of five-year-old children with developmental coordination disorder (case studies)

    OpenAIRE

    Filipcic, Tjasa; Tercon, Jerneja

    2016-01-01

    Developmental coordination disorder (DCD) is a neurodevelopmental disorder which affects different areas of an individual's everyday living and learning. Children with DCD are often diagnosed late, at school age, when difficulties with writing, organization and executive functions arise, even though one could have seen signs of probable DCD very early in childhood. The aim of this study was to further assess five-year-old, preschool children recognized as children with DCD, and develop a...

  7. Electronic real-time assessment of patient-reported outcomes in routine care-first findings and experiences from the implementation in a comprehensive cancer center.

    Science.gov (United States)

    Trautmann, Freya; Hentschel, Leopold; Hornemann, Beate; Rentsch, Anke; Baumann, Michael; Ehninger, Gerhard; Schmitt, Jochen; Schuler, Markus

    2016-07-01

    Cancer patients suffer from a variety of physical and mental complaints. Since physician assessment of symptoms seems insufficient to reveal the complete range of patients' ailments, patient-reported outcomes (PRO) have become of key importance in modern cancer treatment. The implementation and first results of a systematic electronic real-time assessment of PRO in routine care is described. Consecutive patients presenting for the first time to a German comprehensive cancer center were asked to fill in an adaptive self-administered electronic questionnaire consisting of standardized PRO measures. After completion, patient-reported data was linked to the patients' medical files for discussion in the first consultation with the treating physician. Interviews with staff were conducted to identify barriers in implementation. Out of 160 cancer patients, 126 (79 %; mean age 63 years, 67 % males) agreed to participate. The number of recruited patients increased over time. Of participating patients, 67 % provided complete information on all PRO-related scales. On average, 31 min (range 3-140) were required to fill in the questionnaire. Of participating patients, 53.0 % comprised need for psychooncological support and 62 % revealed moderate to severe psychosocial distress. The mean score for global quality of life according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) was 55.2 (SD ±25.6). Comprehensive oncological treatment needs to consider disease symptoms, quality of life, preferences, and comorbidities of individual patients in a structured, standardized, and transparent way. Our findings indicate that an adaptive, self-administered electronic assessment tool for cancer patients to report a broad set of PRO can be feasibly implemented and is well accepted by patients in a realistic setting.

  8. A comprehensive NMR methodology to assess the composition of biobased and biodegradable polymers in contact with food

    International Nuclear Information System (INIS)

    Gratia, Audrey; Merlet, Denis; Ducruet, Violette; Lyathaud, Cédric

    2015-01-01

    Highlights: • A methodological approach by NMR was developed to assess the safety of food contact materials. • Additives from PLA were rapidly identified by an automatic NMR methodology coupled with dedicated database. • Quantitative NMR (qNMR) allowed to quantify 12 additives in three types of polylactide. • qNMR is as sensitive as chromatographic methods to quantify additives in PLA. - Abstract: A nuclear magnetic resonance (NMR) methodology was assessed regarding the identification and quantification of additives in three types of polylactide (PLA) intended as food contact materials. Additives were identified using the LNE/NMR database which clusters NMR datasets on more than 130 substances authorized by European Regulation No. 10/2011. Of the 12 additives spiked in the three types of PLA pellets, 10 were rapidly identified by the database and correlated with spectral comparison. The levels of the 12 additives were estimated using quantitative NMR combined with graphical computation. A comparison with chromatographic methods tended to prove the sensitivity of NMR by demonstrating an analytical difference of less than 15%. Our results therefore demonstrated the efficiency of the proposed NMR methodology for rapid assessment of the composition of PLA

  9. A comprehensive questionnaire for the assessment of health-related quality of life in coeliac disease (CDQL)

    DEFF Research Database (Denmark)

    Skjerning, Halfdan; Hourihane, Jonathan O'b; Husby, Steffen

    2017-01-01

    Coeliac disease (CD) is a chronic immune-mediated disease in genetically susceptible individuals, induced by ingested gluten. The treatment for CD is a lifelong gluten-free diet (GFD). The GFD involves restrictions in diet that may impact on a person's Health-Related Quality of Life (HRQoL). AIM...... of the CDQL was answered by Danish respondents. The psychometric properties of the CDQL were assessed, and the HRQoL data were analyzed. RESULTS: The CDQL was completed by 422 respondents. The CDQL has 12 patient background items, 2 generic HRQoL items, and 30 CD-specific HRQoL item. The CD-specific HRQo...

  10. Eco-efficient production of spring barley in a changed climate: A Life Cycle Assessment including primary data from future climate scenarios

    DEFF Research Database (Denmark)

    Niero, Monia; Ingvordsen, Cathrine Heinz; Peltonen-Sainio, Pirjo

    2015-01-01

    and including earlier sowing and cultivar selection as measures of adaptation to a changed climate. A baseline scenario describing the current spring barley cultivation in Denmark was defined, and the expected main deviations were identified (differences in pesticide treatment index, modifications in nitrate...... leaching and change in crop yield). The main input data originate from experiments, where spring barley cultivars were cultivated in a climate phytotron under controlled and manipulated treatments. Effects of changed climate on both crop productivity and crop quality were represented, as well as impacts......The paper has two main objectives: (i) to assess the eco-efficiency of spring barley cultivation for malting in Denmark in a future changed climate (700 ppm [CO2] and +5 °C) through Life Cycle Assessment (LCA) and (ii) to compare alternative future cultivation scenarios, both excluding...

  11. The Impact of a Novel Tool for Comprehensive Assessment of Palliative Care (MPCAT) on Assessment Outcome at 6- and 12-Month Follow-Up.

    LENUS (Irish Health Repository)

    O'Reilly, Martina

    2016-07-01

    Assessment in palliative care settings should be focused, sensitive, specific, and effective to minimize discomfort to vulnerable and often highly morbid patients. This report describes the development of an admission assessment protocol for a Specialist Palliative Care Inpatient Unit and its implementation into clinical practice.

  12. 40 CFR 8.8 - Comprehensive environmental evaluation.

    Science.gov (United States)

    2010-07-01

    ... IMPACT ASSESSMENT OF NONGOVERNMENTAL ACTIVITIES IN ANTARCTICA § 8.8 Comprehensive environmental... measures, including monitoring programs, that could be taken to minimize or mitigate impacts of the... assess and verify the impact of the activity. The EPA will transmit the CEE, along with a notice of any...

  13. Analytical approach, dissipation pattern and risk assessment of pesticide residue in green leafy vegetables: A comprehensive review.

    Science.gov (United States)

    Farha, Waziha; Abd El-Aty, A M; Rahman, Md Musfiqur; Jeong, Ji Hoon; Shin, Ho-Chul; Wang, Jing; Shin, Sung Shik; Shim, Jae-Han

    2018-01-01

    The category of 'leafy vegetables' comprises a wide range of plants, including cabbage, lettuce, leeks, spinach, Swiss chard and kale, and it forms a significant component of the human diet. Typically, leafy vegetables are low in calories and fat, are great sources of vitamins, protein, dietary fibre and minerals (including iron, calcium, and nitrates), and are rich in phytochemicals. To counter the impact of pests on vegetables, a broad variety of pesticides are used. Because of their large surface areas, leafy vegetables are expected to have high residual pesticide levels. As such, a sound analytical approach is needed to detect and quantify residue levels that are equal to or lower than the maximum residue limits, thus rendering the products safe for consumption. Overall, leafy vegetables consumed raw (after a tap water wash only), boiled or steamed contribute 2% of total vegetable consumption globally, and they might have a comparatively greater influence on health than cereal ingestion. Consequently, in this review paper, we highlight the importance of leafy vegetables, the pesticides that are commonly used on them and various analytical techniques, including sample preparation, extraction, clean-up and final detection. The effects on dissipation patterns, pre-harvest residue limits and safety/risks imposed by various pesticides are also reviewed and discussed. In conclusion, environmentally friendly extraction methods coupled with high-throughput techniques with greater reproducibility and lower uncertainty are needed for quantifying residues in leafy vegetables at very low concentrations. Commercial and household food preparation, such as washing, peeling, blanching and cooking are effective in removing most of the pesticide residues that are loosely attached on vegetables. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Should nutritional status evaluation be included in the initial needs assessment of leprosy patients with disability prior to socio-economic.

    Science.gov (United States)

    Vaz, M; Diffey, B; Jacob, A J; Vaz, M

    2001-06-01

    Because of the large numbers of leprosy patients with disability and the limited resources available, it is important that socio-economic rehabilitation (SER) is targeted towards those who are most in need. Towards this purpose, current assessments of leprosy patients prior to initiating SER include the evaluation of income, assets and household possessions. Conspicuously absent is the nutritional assessment of the patient. In the absence of weight loss associated with illness, population studies indicate that undernutrition reflects poor socio-economic conditions. In this study of 151 cured leprosy patients with disability, 57% of the patients were found to be undernourished using body mass index (kg/m2) derived from body weight and height, and 10% of the patients were severely undernourished (grade III). Undernutrition in the patients was poorly though significantly correlated with personal income (r = 0.18, P nutritional status evaluation by anthropometry as part of the initial screening of leprosy patients prior to instituting SER. We believe that this simple and objective evaluation can add to the assessment of 'threat' of economic deprivation or actual economic 'dislocation', and thus help in the prioritization of leprosy patients for SER.

  15. Clinician ratings of the Comprehensive Assessment of Psychopathic Personality (CAPP) in a representative sample of Spanish prison inmates: New validity evidence.

    Science.gov (United States)

    Flórez, Gerardo; Ferrer, Ventura; García, Luis S; Crespo, María R; Pérez, Manuel; Saíz, Pilar A; Cooke, David J

    2018-01-01

    The Comprehensive Assessment of Psychopathic Personality (CAPP) is a concept map of psychopathic personality disorder (PPD). The CAPP- Institutional Rating Scale (IRS) is a tool designed to assess CAPP symptoms in institutional settings. The CAPP contains 33 personality traits organized in six domains: attachment, behavioural, cognitive, dominance, emotional and self. Until now, much of the CAPP research has been conducted out of clinical, forensic and correctional settings using self-ratings. In the current study, the psychometric properties and construct validity of the CAPP-IRS were evaluated in a non-convenience sample of 204 Spanish convicts. Clinician ratings were employed. Participants had been imprisoned for at least 6 months at Pereiro de Aguiar Penitentiary. This group of inmates was heterogeneous with respect to type of official charges, and representative as all convicts interned for at least 6 months in this prison were screened for participation. Classical test theory indexes of reliability, correlations between CAPP items and domains and external correlations and structural analyses demonstrated that CAPP assessment is a solid and robust way of evaluating psychopathy in a correctional setting. Best fit was found for a three-factor model: attachment and emotional items associated with a callous and unemotional trait, dominance and self items associated with a pathological interpersonal style, and behavioural and residual items from other domains associated with impulsivity.

  16. Comprehensive assessments of measures mitigating heat island phenomena in urban areas; Heat shinku wo riyoshita daikibo reibo system no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Mizuno, T.; Yamamoto, S.; Yoshikado, H.; Kondo, H.; Kaneho, N.; Saegusa, N.; Inaba, A. [National Institute for Resources and Environment, Tsukuba (Japan); Inoue, M. [New Energy and Industrial Technology Development Organization, Tokyo, (Japan)

    1997-02-01

    This paper describes the assessment method of measures mitigating heat island phenomena in urban areas. The heat island phenomena were classified into meso-scale with 100 km-scale, block-scale with several km-scale, and building-scale with 100 m-scale. Urban thermal environment simulation model was developed in response to each scale. For the development, regional data using aircraft and artificial satellite observations, surface observation and thermal environment observation at Shinjuku new central city of Tokyo, and artificial waste heat actual survey data in the southern Kanto district were utilized. Results of the urban thermal environment simulation were introduced as an application of this model. Temperature distributions of the heat island in the Kanto district were simulated with considering urban conditions near Tokyo and without considering it. Daily changes of wall surfaces of high buildings and road surface were calculated. Increase in the air temperature in the back stream of building roofs with increased temperature was determined. 4 figs.

  17. Indicators of bioenergy-related certification schemes – An analysis of the quality and comprehensiveness