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Sample records for integration group provide

  1. Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

    Directory of Open Access Journals (Sweden)

    Dukers-Muijrers Nicole HTM

    2012-12-01

    Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

  2. INTEGRATED INFORMATION SYSTEM ARCHITECTURE PROVIDING BEHAVIORAL FEATURE

    Directory of Open Access Journals (Sweden)

    Vladimir N. Shvedenko

    2016-11-01

    Full Text Available The paper deals with creation of integrated information system architecture capable of supporting management decisions using behavioral features. The paper considers the architecture of information decision support system for production system management. The behavioral feature is given to an information system, and it ensures extraction, processing of information, management decision-making with both automated and automatic modes of decision-making subsystem being permitted. Practical implementation of information system with behavior is based on service-oriented architecture: there is a set of independent services in the information system that provides data of its subsystems or data processing by separate application under the chosen variant of the problematic situation settlement. For creation of integrated information system with behavior we propose architecture including the following subsystems: data bus, subsystem for interaction with the integrated applications based on metadata, business process management subsystem, subsystem for the current state analysis of the enterprise and management decision-making, behavior training subsystem. For each problematic situation a separate logical layer service is created in Unified Service Bus handling problematic situations. This architecture reduces system information complexity due to the fact that with a constant amount of system elements the number of links decreases, since each layer provides communication center of responsibility for the resource with the services of corresponding applications. If a similar problematic situation occurs, its resolution is automatically removed from problem situation metamodel repository and business process metamodel of its settlement. In the business process performance commands are generated to the corresponding centers of responsibility to settle a problematic situation.

  3. Spiritually and religiously integrated group psychotherapy

    DEFF Research Database (Denmark)

    Viftrup, Dorte Toudal; Hvidt, Niels Christian; Buus, Niels

    2013-01-01

    WE SYSTEMATICALLY REVIEWED THE RESEARCH LITERATURE ON SPIRITUALLY AND RELIGIOUSLY INTEGRATED GROUP PSYCHOTHERAPY TO ANSWER THE FOLLOWING THREE QUESTIONS: first, how are spirituality and religiosity defined; second, how are spiritual and religious factors characterized and integrated into group......, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from...... for spiritually or religiously integrated group psychotherapy and conducting research in this field are propounded....

  4. Due diligence during the integration of physician groups.

    Science.gov (United States)

    Ealey, Tom

    2011-12-01

    While contemplating physician group integration, providers should perform due diligence and ask questions in several key areas to ensure successful integrations: Financial--Is the group producing the revenue expected, and is the revenue cycle managed effectively? Statistical--What are the numbers of encounters, procedures, surgeries, and ancillaries? Compliance--Has the group developed and operated a sound compliance program, and has compliance been a priority? Succession--How many physicians are within three to five years of retirement?

  5. Integrable lattice models and quantum groups

    International Nuclear Information System (INIS)

    Saleur, H.; Zuber, J.B.

    1990-01-01

    These lectures aim at introducing some basic algebraic concepts on lattice integrable models, in particular quantum groups, and to discuss some connections with knot theory and conformal field theories. The list of contents is: Vertex models and Yang-Baxter equation; Quantum sl(2) algebra and the Yang-Baxter equation; U q sl(2) as a symmetry of statistical mechanical models; Face models; Face models attached to graphs; Yang-Baxter equation, braid group and link polynomials

  6. IGSC - Integration Group for the Safety Case

    International Nuclear Information System (INIS)

    2015-01-01

    Countries that rely on nuclear energy and materials have an ethical obligation to manage radioactive waste in a safe and environmentally responsible manner. For society to support the sustainable solutions envisaged, disposal concepts must be technologically sound and the safety of these concepts must be convincingly demonstrated. The Nuclear Energy Agency's Integration Group for the Safety Case (IGSC) establishes and documents the technical and scientific basis for developing and reviewing safety cases as a platform for dialogue among technical experts and as a tool for decision making. The IGSC addresses various strategic and policy aspects of radioactive waste management as the technical advisory body to the NEA Radioactive Waste Management Committee (RWMC) for all issues related to repository development. For more than two decades, the IGSC and its predecessor technical groups have promoted the exchange of national experience in evaluating and implementing geological repositories. IGSC activities foster consensus on best practices and encourage the development of innovative, advanced approaches covering the technical aspects at all stages of repository implementation, including: - strategies to characterise and evaluate potential disposal sites; - methods to design and test engineered barrier systems; - priorities for research and development programmes to improve the understanding of important processes and interactions; - tools for safety assessments; - techniques for the effective presentation and communication of the results of safety cases and other factors that provide the basis for increased confidence in the safety of geological disposal facilities. The IGSC has been instrumental in further developing the 'modern safety case', a concept that originally emerged from NEA work in the 1990's. Cooperation with the International Atomic Energy Agency (IAEA) and the European Commission (EC) has led to the worldwide adoption of this safety

  7. Integration between manufacturers and third party logistics providers?

    DEFF Research Database (Denmark)

    Mortensen, Ole; Lemoine, Olga W.

    2008-01-01

    Purpose - The purpose of this study is to analyse the extent of the integration between manufacturers and third party logistics (TPL) providers at present and how the integration is expected to develop in the near future. The focus is on studying what tasks are part of the cooperation, what...... of the eight business processes studied. Further integration in the same processes is expected, based on ICT tools and with a focus on cost. ICT competences are primarily seen as a qualifier not a differentiator. Because the future TPL industry is expected to be characterised by more standardised services...

  8. Providing Effective Speech-Language Pathology Group Treatment in the Comprehensive Inpatient Rehabilitation Setting.

    Science.gov (United States)

    Baron, Christine; Holcombe, Molly; van der Stelt, Candace

    2018-02-01

    Group treatment is an integral part of speech-language pathology (SLP) practice. The majority of SLP literature concerns group treatment provided in outpatient settings. This article describes the goals, procedures, and benefits of providing quality SLP group therapy in the comprehensive inpatient rehabilitation (CIR) setting. Effective CIR groups must be designed with attention to type and severity of communication impairment, as well physical stamina of group members. Group leaders need to target individualized patient goals while creating a challenging, complex, and dynamic group context that supports participation by all group members. Direct patient-to-patient interaction is fostered as much as possible. Peer feedback supports goal acquisition by fellow group members. The rich, complex group context fosters improved insight, initiation, social connectedness, and generalization of communication skills. Group treatment provides a unique type of treatment not easily replicated with individual treatment. SLP group treatment in a CIR is an essential component of an intensive, high-quality program. Continued advocacy for group therapy provision and research into its efficacy and effectiveness are warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Provider integration and local market conditions: a contingency theory perspective.

    Science.gov (United States)

    Young, G J; Parker, V A; Charns, M P

    2001-01-01

    In recent years we have witnessed an expanding array of organizational arrangements for providing health care services in the U.S. These arrangements integrate previously independent providers at one or more points on the continuum of care. The presence of so many of these arrangements raises the question of whether certain types are more effective than are others to help providers adapt to their environment. This article discusses contingency theory as a conceptual lens for guiding empirical studies of the effectiveness of different types of arrangements.

  10. Integrating advanced practice providers into medical critical care teams.

    Science.gov (United States)

    McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

    2013-03-01

    Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

  11. OPPS Provider Summary for 30 Selected APC Groups - CY2011

    Data.gov (United States)

    U.S. Department of Health & Human Services — A provider level summary of Outpatient Prospective Payment System (OPPS) average estimated submitted charges and average Medicare Payments for 30 selected Ambulatory...

  12. Determinants of patient loyalty to healthcare providers: An integrative review.

    Science.gov (United States)

    Zhou, Wei-Jiao; Wan, Qiao-Qin; Liu, Cong-Ying; Feng, Xiao-Lin; Shang, Shao-Mei

    2017-08-01

    Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  13. Integrating Instrumental Data Provides the Full Science in 3D

    Science.gov (United States)

    Turrin, M.; Boghosian, A.; Bell, R. E.; Frearson, N.

    2017-12-01

    Looking at data sparks questions, discussion and insights. By integrating multiple data sets we deepen our understanding of how cryosphere processes operate. Field collected data provide measurements from multiple instruments supporting rapid insights. Icepod provides a platform focused on the integration of multiple instruments. Over the last three seasons, the ROSETTA-Ice project has deployed Icepod to comprehensively map the Ross Ice Shelf, Antarctica. This integrative data collection along with new methods of data visualization allows us to answer questions about ice shelf structure and evolution that arise during data processing and review. While data are vetted and archived in the field to confirm instruments are operating, upon return to the lab data are again reviewed for accuracy before full analysis. Recent review of shallow ice radar data from the Beardmore Glacier, an outlet glacier into the Ross Ice Shelf, presented an abrupt discontinuity in the ice surface. This sharp 8m surface elevation drop was originally interpreted as a processing error. Data were reexamined, integrating the simultaneously collected shallow and deep ice radar with lidar data. All the data sources showed the surface discontinuity, confirming the abrupt 8m drop in surface elevation. Examining high resolution WorldView satellite imagery revealed a persistent source for these elevation drops. The satellite imagery showed that this tear in the ice surface was only one piece of a larger pattern of "chatter marks" in ice that flows at a rate of 300 m/yr. The markings are buried over a distance of 30 km or after 100 years of travel down Beardmore Glacier towards the front of the Ross Ice Shelf. Using Icepod's lidar and cameras we map this chatter mark feature in 3D to reveal its full structure. We use digital elevation models from WorldView to map the other along flow chatter marks. In order to investigate the relationship between these surface features and basal crevasses, the deep ice

  14. Working Group on Virtual Data Integration

    Energy Technology Data Exchange (ETDEWEB)

    Williams, D. N. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Palanisamy, G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); van Dam, K. K. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-02-04

    This report is the outcome of a workshop commissioned by the U.S. Department of Energy’s (DOE) Climate and Environmental Sciences Division (CESD) to examine current and future data infrastructure requirements foundational for achieving CESD scientific mission goals in advancing a robust, predictive understanding of Earth’s climate and environmental systems. Over the past several years, data volumes in CESD disciplines have risen sharply to unprecedented levels (tens of petabytes). Moreover, the complexity and diversity of this research data— including simulations, observations, and reanalysis— have grown significantly, posing new challenges for data capture, storage, verification, analysis, and integration. With the trends of increased data volume (in the hundreds of petabytes), more complex analysis processes, and growing cross-disciplinary collaborations, it is timely to investigate whether the CESD community has the computational and data support needed to fully realize the scientific potential of its data collections. In recognition of the challenges, a partnership is forming across CESD and among national and international agencies to examine the viability of creating an integrated, collaborative data infrastructure: a Virtual Laboratory. The overarching goal of this report is to identify the community’s key data technology requirements and high-priority development needs for sustaining and growing its scientific discovery potential. The report also aims to map these requirements to existing solutions and to identify gaps in current services, tools, and infrastructure that will need to be addressed in the short, medium, and long term to advance scientific progress.

  15. Fermionic functional integrals and the renormalization group

    CERN Document Server

    Feldman, Joel; Trubowitz, Eugene

    2002-01-01

    This book, written by well-known experts in the field, offers a concise summary of one of the latest and most significant developments in the theoretical analysis of quantum field theory. The renormalization group is the name given to a technique for analyzing the qualitative behavior of a class of physical systems by iterating a map on the vector space of interactions for the class. In a typical nonrigorous application of this technique, one assumes, based on one's physical intuition, that only a certain finite dimensional subspace (usually of dimension three or less) is important. The material in this book concerns a technique for justifying this approximation in a broad class of fermionic models used in condensed matter and high energy physics. This volume is based on the Aisenstadt Lectures given by Joel Feldman at the Centre de Recherches Mathematiques (Montreal, Canada). It is suitable for graduate students and research mathematicians interested in mathematical physics. Included are many problems and so...

  16. Group Therapy Goals: A Comparison of Group Therapy Providers and Male Inmates

    Science.gov (United States)

    Morgan, Robert D.; Garland, J. Travis; Rozycki, Alicia T.; Reich, Darcy A.; Wilson, Scott

    2005-01-01

    This study was designed to identify important process and content goals from the perspective of inmates and compare these goals to the goals identified by group therapists in a previous study conducted by Winterowd, Morgan, and Ferrell (2001). Utilizing survey data from 156 incarcerated adult males, an initial confirmatory factor analysis…

  17. A quantum group structure in integrable conformal field theories

    International Nuclear Information System (INIS)

    Smit, D.J.

    1990-01-01

    We discuss a quantization prescription of the conformal algebras of a class of d=2 conformal field theories which are integrable. We first give a geometrical construction of certain extensions of the classical Virasoro algebra, known as classical W algebras, in which these algebras arise as the Lie algebra of the second Hamiltonian structure of a generalized Korteweg-de Vries hierarchy. This fact implies that the W algebras, obtained as a reduction with respect to the nilpotent subalgebras of the Kac-Moody algebra, describe the intergrability of a Toda field theory. Subsequently we determine the coadjoint operators of the W algebras, and relate these to classical Yang-Baxter matrices. The quantization of these algebras can be carried out using the concept of a so-called quantum group. We derive the condition under which the representations of these quantum groups admit a Hilbert space completion by exploring the relation with the braid group. Then we consider a modification of the Miura transformation which we use to define a quantum W algebra. This leads to an alternative interpretation of the coset construction for Kac-Moody algebras in terms of nonlinear integrable hierarchies. Subsequently we use the connection between the induced braid group representations and the representations of the mapping class group of Riemann surfaces to identify an action of the W algebras on the moduli space of stable curves, and we give the invariants of this action. This provides a generalization of the situation for the Virasoro algebra, where such an invariant is given by the so-called Mumford form which describes the partition function of the bosonic string. (orig.)

  18. International Piping Integrity Research Group (IPIRG) Program. Final report

    International Nuclear Information System (INIS)

    Wilkowski, G.; Schmidt, R.; Scott, P.

    1997-06-01

    This is the final report of the International Piping Integrity Research Group (IPIRG) Program. The IPIRG Program was an international group program managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United States. The program objective was to develop data needed to verify engineering methods for assessing the integrity of circumferentially-cracked nuclear power plant piping. The primary focus was an experimental task that investigated the behavior of circumferentially flawed piping systems subjected to high-rate loadings typical of seismic events. To accomplish these objectives a pipe system fabricated as an expansion loop with over 30 meters of 16-inch diameter pipe and five long radius elbows was constructed. Five dynamic, cyclic, flawed piping experiments were conducted using this facility. This report: (1) provides background information on leak-before-break and flaw evaluation procedures for piping, (2) summarizes technical results of the program, (3) gives a relatively detailed assessment of the results from the pipe fracture experiments and complementary analyses, and (4) summarizes advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG program

  19. International piping integrity research group (IPIRG) program final report

    International Nuclear Information System (INIS)

    Schmidt, R.; Wilkowski, G.; Scott, P.; Olsen, R.; Marschall, C.; Vieth, P.; Paul, D.

    1992-04-01

    This is the final report of the International Piping Integrity Research Group (IPIRG) Programme. The IPIRG Programme was an international group programme managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United states. The objective of the programme was to develop data needed to verify engineering methods for assessing the integrity of nuclear power plant piping that contains circumferential defects. The primary focus was an experimental task that investigated the behaviour of circumferentially flawed piping and piping systems to high-rate loading typical of seismic events. To accomplish these objectives a unique pipe loop test facility was designed and constructed. The pipe system was an expansion loop with over 30 m of 406-mm diameter pipe and five long radius elbows. Five experiments on flawed piping were conducted to failure in this facility with dynamic excitation. The report: provides background information on leak-before-break and flaw evaluation procedures in piping; summarizes the technical results of the programme; gives a relatively detailed assessment of the results from the various pipe fracture experiments and complementary analyses; and, summarizes the advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG Program

  20. International Piping Integrity Research Group (IPIRG) Program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Wilkowski, G.; Schmidt, R.; Scott, P. [and others

    1997-06-01

    This is the final report of the International Piping Integrity Research Group (IPIRG) Program. The IPIRG Program was an international group program managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United States. The program objective was to develop data needed to verify engineering methods for assessing the integrity of circumferentially-cracked nuclear power plant piping. The primary focus was an experimental task that investigated the behavior of circumferentially flawed piping systems subjected to high-rate loadings typical of seismic events. To accomplish these objectives a pipe system fabricated as an expansion loop with over 30 meters of 16-inch diameter pipe and five long radius elbows was constructed. Five dynamic, cyclic, flawed piping experiments were conducted using this facility. This report: (1) provides background information on leak-before-break and flaw evaluation procedures for piping, (2) summarizes technical results of the program, (3) gives a relatively detailed assessment of the results from the pipe fracture experiments and complementary analyses, and (4) summarizes advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG program.

  1. An integral equation arising in two group neutron transport theory

    International Nuclear Information System (INIS)

    Cassell, J S; Williams, M M R

    2003-01-01

    An integral equation describing the fuel distribution necessary to maintain a flat flux in a nuclear reactor in two group transport theory is reduced to the solution of a singular integral equation. The formalism developed enables the physical aspects of the problem to be better understood and its relationship with the corresponding diffusion theory model is highlighted. The integral equation is solved by reducing it to a non-singular Fredholm equation which is then evaluated numerically

  2. Health Providers' Counselling of Caregivers in the Integrated ...

    African Journals Online (AJOL)

    Results: Health providers performed well in assessing the child's problem (85%); listening (100%); use of simple language (95%); use of kind tone of voice (99%); showing interest in caregivers (99%); giving feeding ... Keywords: Child, preschool; infant; health-provider; caregiver; counselling; IMCI-counselling; Uganda

  3. Science Integrating Learning Objectives: A Cooperative Learning Group Process

    Science.gov (United States)

    Spindler, Matt

    2015-01-01

    The integration of agricultural and science curricular content that capitalizes on natural and inherent connections represents a challenge for secondary agricultural educators. The purpose of this case study was to create information about the employment of Cooperative Learning Groups (CLG) to enhance the science integrating learning objectives…

  4. General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

    Science.gov (United States)

    Appleby, N J; Dunt, D; Southern, D M; Young, D

    1999-08-01

    To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

  5. Multi-objective group scheduling optimization integrated with preventive maintenance

    Science.gov (United States)

    Liao, Wenzhu; Zhang, Xiufang; Jiang, Min

    2017-11-01

    This article proposes a single-machine-based integration model to meet the requirements of production scheduling and preventive maintenance in group production. To describe the production for identical/similar and different jobs, this integrated model considers the learning and forgetting effects. Based on machine degradation, the deterioration effect is also considered. Moreover, perfect maintenance and minimal repair are adopted in this integrated model. The multi-objective of minimizing total completion time and maintenance cost is taken to meet the dual requirements of delivery date and cost. Finally, a genetic algorithm is developed to solve this optimization model, and the computation results demonstrate that this integrated model is effective and reliable.

  6. Integrating alternative providers into managed care: a case study.

    Science.gov (United States)

    Broida, M

    1997-09-01

    Alternative medical techniques have become extremely popular, particularly in the western United States. Washington State recently enacted a law requiring certain health plans to include alternative providers on their physician panels. The author describes the efforts of one MCO to comply.

  7. Enriching Group Counseling through Integrating Yoga Concepts and Practices

    Science.gov (United States)

    Rybak, Christopher; Deuskar, Megha

    2010-01-01

    Integrating practices from yoga with group counseling offers many creative paths of therapeutic learning. While yoga emphasizes the increased sense of connection with the self, group counseling emphasizes the increased sense of authenticity in relationship with oneself and with others. Common aims of both yoga and counseling are liberation from…

  8. Integrating Gender and Group Differences into Bridging Strategy

    Science.gov (United States)

    Yilmaz, Serkan; Eryilmaz, Ali

    2010-01-01

    The main goal of this study was to integrate gender and group effect into bridging strategy in order to assess the effect of bridging analogy-based instruction on sophomore students' misconceptions in Newton's Third Law. Specifically, the authors developed and benefited from anchoring analogy diagnostic test to merge the effect of group and gender…

  9. Resource Information and Forecasting Group; Electricity, Resources, & Building Systems Integration (ERBSI) (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2009-11-01

    Researchers in the Resource Information and Forecasting group at NREL provide scientific, engineering, and analytical expertise to help characterize renewable energy resources and facilitate the integration of these clean energy sources into the electricity grid.

  10. Phase 2 of the International Piping Integrity Research Group programme

    International Nuclear Information System (INIS)

    Darlaston, B.J.

    1994-01-01

    The results of phase 1 of the International Piping Integrity Research Group (IPIRG-1) programme have been widely reported. The significance of the results is reviewed briefly, in order to put the phase 2 programme into perspective. The success of phase 1 led the participants to consider further development and validation of pipe and pipe component fracture analysis technology as part of another international group programme (IPIRG-2). The benefits of combined funding and of the technical exchanges and interactions are considered to be of significant advantage and value. The phase 2 programme has been designed with the overall objective of developing and experimentally validating methods of predicting the fracture behaviour of nuclear reactor safety-related piping, to both normal operating and accident loads. The programme will add to the engineering estimation analysis methods that have been developed for straight pipes. The pipe system tests will expand the database to include seismic loadings and flaws in fittings, such as bends, elbows and tees, as well as ''short'' cracks. The results will be used to validate further the analytical methods, expand the capability to make fittings and extend the quasi-static results for the USNRC's new programme on short cracks in piping and piping welds. The IPIRG-2 programme is described to provide a clear understanding of the content, strategy, potential benefits and likely significance of the work. ((orig.))

  11. Integrable systems twistors, loop groups, and Riemann surfaces

    CERN Document Server

    Hitchin, NJ; Ward, RS

    2013-01-01

    This textbook is designed to give graduate students an understanding of integrable systems via the study of Riemann surfaces, loop groups, and twistors. The book has its origins in a series of lecture courses given by the authors, all of whom are internationally known mathematicians and renowned expositors. It is written in an accessible and informal style, and fills a gap in the existing literature. The introduction by Nigel Hitchin addresses the meaning of integrability: how do werecognize an integrable system? His own contribution then develops connections with algebraic geometry, and inclu

  12. Neural network integration during the perception of in-group and out-group members.

    Science.gov (United States)

    Greven, Inez M; Ramsey, Richard

    2017-11-01

    Group biases guide social interactions by promoting in-group favouritism, but the neural mechanisms underpinning group biases remain unclear. While neuroscience research has shown that distributed brain circuits are associated with seeing in-group and out-group members as "us" and "them", it is less clear how these networks exchange signals. This fMRI study uses functional connectivity analyses to investigate the contribution of functional integration to group bias modulation of person perception. Participants were assigned to an arbitrary group and during scanning they observed bodies of in-group or out-group members that cued the recall of positive or negative social knowledge. The results showed that functional coupling between perceptual and cognitive neural networks is tuned to particular combinations of group membership and social knowledge valence. Specifically, coupling between body perception and theory-of-mind networks is biased towards seeing a person that had previously been paired with information consistent with group bias (positive for in-group and negative for out-group). This demonstrates how brain regions associated with visual analysis of others and belief reasoning exchange and integrate signals when evaluating in-group and out-group members. The results update models of person perception by showing how and when interplay occurs between perceptual and extended systems when developing a representation of another person. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Dynamics on the group manifolds and path integral

    International Nuclear Information System (INIS)

    Marinov, M.S.; Terentyev, M.V.

    1979-01-01

    Classical and quantum dynamics onn the compact simple Lie group and on the sphere of arbitrary dimensionality are considered. The accuracy of the semiclassical approximation for Green functions is discussed. Various path integral representations of the Green functions are presented. The special features of these representations due to the compactness and curvature are analysed. Basic results of the theory of Lie algebras and Lie groups used in the main text are presented

  14. Social Group Dynamics and Patterns of Latin American Integration Processes

    Directory of Open Access Journals (Sweden)

    Sébastien Dubé

    2017-04-01

    Full Text Available This article proposes to incorporate social psychology elements with mainstream political science and international relations theories to help understand the contradictions related to the integration processes in Latin America. Through a theoretical analysis, it contributes to the challenge proposed by Dabène (2009 to explain the “resilience” of the Latin American regional integration process in spite of its “instability and crises.” Our main proposition calls for considering Latin America as a community and its regional organizations as “social groups.” In conclusion, three phenomena from the field of social psychology and particularly social group dynamics shed light on these contradictory patterns: the value of the group and the emotional bond, groupthink, and cognitive dissonance.

  15. Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically...... in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...

  16. Integrating family planning into HIV care in western Kenya: HIV care providers' perspectives and experiences one year following integration.

    Science.gov (United States)

    Newmann, Sara J; Zakaras, Jennifer M; Tao, Amy R; Onono, Maricianah; Bukusi, Elizabeth A; Cohen, Craig R; Steinfeld, Rachel; Grossman, Daniel

    2016-01-01

    With high rates of unintended pregnancy in sub-Saharan Africa, integration of family planning (FP) into HIV care is being explored as a strategy to reduce unmet need for contraception. Perspectives and experiences of healthcare providers are critical in order to create sustainable models of integrated care. This qualitative study offers insight into how HIV care providers view and experience the benefits and challenges of providing integrated FP/HIV services in Nyanza Province, Kenya. Sixteen individual interviews were conducted among healthcare workers at six public sector HIV care facilities one year after the implementation of integrated FP and HIV services. Data were transcribed and analyzed qualitatively using grounded theory methods and Atlas.ti. Providers reported a number of benefits of integrated services that they believed increased the uptake and continuation of contraceptive methods. They felt that integrated services enabled them to reach a larger number of female and male patients and in a more efficient way for patients compared to non-integrated services. Availability of FP services in the same place as HIV care also eliminated the need for most referrals, which many providers saw as a barrier for patients seeking FP. Providers reported many challenges to providing integrated services, including the lack of space, time, and sufficient staff, inadequate training, and commodity shortages. Despite these challenges, the vast majority of providers was supportive of FP/HIV integration and found integrated services to be beneficial to HIV-infected patients. Providers' concerns relating to staffing, infrastructure, and training need to be addressed in order to create sustainable, cost-effective FP/HIV integrated service models.

  17. Collision group and renormalization of the Boltzmann collision integral

    Science.gov (United States)

    Saveliev, V. L.; Nanbu, K.

    2002-05-01

    On the basis of a recently discovered collision group [V. L. Saveliev, in Rarefied Gas Dynamics: 22nd International Symposium, edited by T. J. Bartel and M. Gallis, AIP Conf. Proc. No. 585 (AIP, Melville, NY, 2001), p. 101], the Boltzmann collision integral is exactly rewritten in two parts. The first part describes the scattering of particles with small angles. In this part the infinity due to the infinite cross sections is extracted from the Boltzmann collision integral. Moreover, the Boltzmann collision integral is represented as a divergence of the flow in velocity space. Owing to this, the role of collisions in the kinetic equation can be interpreted in terms of the nonlocal friction force that depends on the distribution function.

  18. Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

    Directory of Open Access Journals (Sweden)

    Matthew Harris

    2013-02-01

    Full Text Available Introduction: Multidisciplinary Group meeting (MDGs are seen as key facilitators of integration, moving from individual to multi-disciplinary decision making, and from a focus on individual patients to a focus on patient groups.  We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot.  Methods:  We defined 'integrating' as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken.  Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures - the Valence, the Focus, and the Level.  Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity. Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score.  Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described. Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating.  The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.

  19. Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot

    Directory of Open Access Journals (Sweden)

    Matthew Harris

    2013-02-01

    Full Text Available Introduction: Multidisciplinary Group meeting (MDGs are seen as key facilitators of integration, moving from individual to multi-disciplinary decision making, and from a focus on individual patients to a focus on patient groups.  We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot. Methods:  We defined 'integrating' as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken.  Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures - the Valence, the Focus, and the Level.  Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity.Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score.  Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described.Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating.  The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.

  20. Integrating CERN e-groups into TWiki access control.

    CERN Document Server

    Jones, PL; Hoymr, N; CERN. Geneva. IT Department

    2010-01-01

    Wikis allow for easy collaborative editing of documents on the web for users located in different buildings, cities or even countries. TWiki culture lends to open free form editing and most pages are world readable and editable by CERN authenticated users, however access control is possible and is used to protect sensitive documents. This note discusses the integration of E-groups for authorisation purposes at CERN.

  1. Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces?

    Science.gov (United States)

    La Forgia, Ambar; Maeda, Jared Lane K; Banthin, Jessica S

    2018-04-01

    As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these "vertically" integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.

  2. Integrating a Social Behavior Intervention during Small Group Academic Instruction Using a Total Group Criterion Intervention

    Science.gov (United States)

    Rodriguez, Billie Jo; Anderson, Cynthia M.

    2014-01-01

    Total group contingencies, a variation of interdependent group contingencies, provide educators with an efficient and effective mechanism to improve social behavior and increase academic skills. Their utility has not been examined in small educational groups. This is unfortunate as supplemental instruction frequently is delivered in small group…

  3. Facebook Discussion Groups Provide a Robust Worldwide Platform for Free Pathology Education.

    Science.gov (United States)

    Gonzalez, Raul S; Amer, Sadiq M; Yahia, Nejib Ben; Costa, Felipe D'Almeida; Noatay, Manu; Qiao, Jian-Hua; Rosado, Flavia G; Rosen, Yale; Sedassari, Bruno Tavares; Yantiss, Rhonda K; Gardner, Jerad M

    2017-05-01

    - Facebook (Menlo Park, California) is one of many online sites that provide potential educational tools for pathologists. We have each founded Facebook groups dedicated to anatomic pathology, in which members can share cases, ask questions, and contribute to discussions. - To report our experiences in founding and maintaining these Facebook groups and to characterize the contributed content. - We circulated a survey among the group founders, then compiled and analyzed the responses. - The groups varied in membership and in the quality of member contribution. Most posts were of pathology cases, although other topics (such as research articles) were also shared. All groups remained active and received posts from users all over the world, although all groups had many noncontributing members and received unwanted messages (which were screened and removed). Most founders were glad they had founded the groups because they provided an opportunity to both teach and learn. - Each analyzed Facebook group had a different character, and some downsides exist, but the groups all provided a no-cost way for pathologists and others across the world to interact online with many colleagues.

  4. Evaluation and recommendations for work group integration within the Materials and Processes Lab

    Science.gov (United States)

    Farrington, Phillip A.

    1992-01-01

    The goal of this study was to evaluate and make recommendations for improving the level of integration of several work groups within the Materials and Processes Lab at the Marshall Space Flight Center. This evaluation has uncovered a variety of projects that could improve the efficiency and operation of the work groups as well as the overall integration of the system. In addition, this study provides the foundation for specification of a computer integrated manufacturing test bed environment in the Materials and Processes Lab.

  5. Medicaid and the politics of groups: recipients, providers, and policy making.

    Science.gov (United States)

    Kronebusch, K

    1997-06-01

    There is a substantial heterogeneity of interests within the Medicaid program. Its major beneficiary groups include the elderly, people with disabilities, children in low-income families, and adults receiving Aid to Families with Dependent Children. Providers who deliver medical services to these recipients represent another set of potential claimants. These groups are likely to be treated differently by the politics that affect the design and management of the Medicaid program. The Medicaid recipient groups vary in several important dimensions: First, the groups differ politically, a dimension that includes their political participation, their relationships to parties and electoral coalitions, the images they present to other political actors, and the legacy of public policies that affect them. Second, the groups have different medical and social needs. Third, the groups differ with respect to economic constraints, including the political economy of labor markets and of government spending programs, and they have differing relationships to the various types of medical providers. The medical providers are themselves political actors with a variety of characteristics that create political advantages relative to recipients, although there is also diversity among providers. The politics of the Medicaid program involves more than simply technical decisions about eligibility, coverage of medical services, reimbursement, and the implementation of managed care initiatives. Instead the differences between the program's multiple claimants are an important element of current Medicaid politics and the likely path of future reforms.

  6. Medical care of hepatitis B among Asian American populations: perspectives from three provider groups.

    Science.gov (United States)

    Hwang, Jessica P; Roundtree, Aimee K; Engebretson, Joan C; Suarez-Almazor, Maria E

    2010-03-01

    Physicians can play a significant role in helping to decrease the hepatitis B virus (HBV) burden among Asian Americans. Few studies have described knowledge and practice patterns in the medical community among different provider types regarding HBV and liver cancer. Our study explores the HBV beliefs, attitudes and practice patterns of medical providers serving Asian American communities. We conducted three focus groups with primary care providers, liver specialists, and other providers predominantly serving Asian American community. We asked about practices and barriers to appropriate medical care and outreach. We moderated three focus groups with 23 participants, 18 of whom completed and returned demographic surveys. Twelve were of Asian ethnicity and 13 spoke English as a second language. Only eight screened at least half of their patients, most (72%) using the hepatitis B surface antigen test. We used grounded theory methods to analyze focus group transcripts. Participants frequently discussed cultural and financial barriers to hepatitis care. They admitted reluctance to screen for HBV because patients might be unwilling or unable to afford treatment. Cultural differences were discussed most by primary care providers; best methods of outreach were discussed most by liver specialists; and alternative medicine was discussed most by acupuncturists and other providers. More resources are needed to lower financial barriers complicating HBV care and encourage providing guideline-recommended screenings. Other providers can help promote HBV screening and increase community and cultural awareness.

  7. Provider accountability as a driving force towards physician–hospital integration: a systematic review

    Directory of Open Access Journals (Sweden)

    Jeroen Trybou

    2015-04-01

    Full Text Available Background: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated.Purpose: To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models.Results: Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration.Conclusion: The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately.

  8. Provider accountability as a driving force towards physician–hospital integration: a systematic review

    Directory of Open Access Journals (Sweden)

    Jeroen Trybou

    2015-04-01

    Full Text Available Background: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated. Purpose: To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models. Results: Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration. Conclusion: The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately.

  9. Do group-specific equations provide the best estimates of stature?

    Science.gov (United States)

    Albanese, John; Osley, Stephanie E; Tuck, Andrew

    2016-04-01

    An estimate of stature can be used by a forensic anthropologist with the preliminary identification of an unknown individual when human skeletal remains are recovered. Fordisc is a computer application that can be used to estimate stature; like many other methods it requires the user to assign an unknown individual to a specific group defined by sex, race/ancestry, and century of birth before an equation is applied. The assumption is that a group-specific equation controls for group differences and should provide the best results most often. In this paper we assess the utility and benefits of using group-specific equations to estimate stature using Fordisc. Using the maximum length of the humerus and the maximum length of the femur from individuals with documented stature, we address the question: Do sex-, race/ancestry- and century-specific stature equations provide the best results when estimating stature? The data for our sample of 19th Century White males (n=28) were entered into Fordisc and stature was estimated using 22 different equation options for a total of 616 trials: 19th and 20th Century Black males, 19th and 20th Century Black females, 19th and 20th Century White females, 19th and 20th Century White males, 19th and 20th Century any, and 20th Century Hispanic males. The equations were assessed for utility in any one case (how many times the estimated range bracketed the documented stature) and in aggregate using 1-way ANOVA and other approaches. This group-specific equation that should have provided the best results was outperformed by several other equations for both the femur and humerus. These results suggest that group-specific equations do not provide better results for estimating stature while at the same time are more difficult to apply because an unknown must be allocated to a given group before stature can be estimated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. What Patients and Providers Want to Know About Complementary and Integrative Health Therapies.

    Science.gov (United States)

    Taylor, Stephanie L; Giannitrapani, Karleen F; Yuan, Anita; Marshall, Nell

    2018-01-01

    We conducted a quality improvement project to determine (1) what information providers and patients most wanted to learn about complementary and integrative health (CIH) therapies and (2) in what format they wanted to receive this information. The overall aim was to develop educational materials to facilitate the CIH therapy decision-making processes. We used mixed methods to iteratively pilot test and revise provider and patient educational materials on yoga and meditation. We conducted semistructured interviews with 11 medical providers and held seven focus groups and used feedback forms with 52 outpatients. We iteratively developed and tested three versions of both provider and patient materials. Activities were conducted at four Veterans Administration medical facilities (two large medical centers and two outpatient clinics). Patients want educational materials with clearly stated basic information about: (1) what mindfulness and yoga are, (2) what a yoga/meditation class entails and how classes can be modified to suit different abilities, (3) key benefits to health and wellness, and (4) how to find classes at the hospital/clinic. Diverse media (videos, handouts, pocket guides) appealed to different Veterans. Videos should depict patients speaking to patients and demonstrating the CIH therapy. Written materials should be one to three pages with colors, and images and messages targeting a variety of patients. Providers wanted a concise (one-page) sheet in black and white font with no images listing the scientific evidence for CIH therapies from high-impact journals, organized by either type of CIH or health condition to use during patient encounters, and including practical information about how to refer patients. Providers and patients want to learn more about CIH therapies, but want the information in succinct, targeted formats. The information learned and materials developed in this study can be used by others to educate patients and providers on CIH

  11. Therapeutic Enactment: Integrating Individual and Group Counseling Models for Change

    Science.gov (United States)

    Westwood, Marvin J.; Keats, Patrice A.; Wilensky, Patricia

    2003-01-01

    The purpose of this article is to introduce the reader to a group-based therapy model known as therapeutic enactment. A description of this multimodal change model is provided by outlining the relevant background information, key concepts related to specific change processes, and the differences in this model compared to earlier psychodrama…

  12. Sparse Group Penalized Integrative Analysis of Multiple Cancer Prognosis Datasets

    Science.gov (United States)

    Liu, Jin; Huang, Jian; Xie, Yang; Ma, Shuangge

    2014-01-01

    SUMMARY In cancer research, high-throughput profiling studies have been extensively conducted, searching for markers associated with prognosis. Because of the “large d, small n” characteristic, results generated from the analysis of a single dataset can be unsatisfactory. Recent studies have shown that integrative analysis, which simultaneously analyzes multiple datasets, can be more effective than single-dataset analysis and classic meta-analysis. In most of existing integrative analysis, the homogeneity model has been assumed, which postulates that different datasets share the same set of markers. Several approaches have been designed to reinforce this assumption. In practice, different datasets may differ in terms of patient selection criteria, profiling techniques, and many other aspects. Such differences may make the homogeneity model too restricted. In this study, we assume the heterogeneity model, under which different datasets are allowed to have different sets of markers. With multiple cancer prognosis datasets, we adopt the AFT (accelerated failure time) model to describe survival. This model may have the lowest computational cost among popular semiparametric survival models. For marker selection, we adopt a sparse group MCP (minimax concave penalty) approach. This approach has an intuitive formulation and can be computed using an effective group coordinate descent algorithm. Simulation study shows that it outperforms the existing approaches under both the homogeneity and heterogeneity models. Data analysis further demonstrates the merit of heterogeneity model and proposed approach. PMID:23938111

  13. AN INTEGRATIVE GROUP PSYCHOTHERAPY PROGRAM FOR CHILDREN. THE WIZARDING SCHOOL

    Directory of Open Access Journals (Sweden)

    Oana Maria Popescu

    2012-02-01

    Full Text Available One of the most important tendencies in child psychotherapy is the integration of various psychotherapeutic approaches and technical interventions belonging to different orientations. Based on the Harry Potter stories, the „Wizarding School” structured group therapy program is a 12-step integratively oriented program applicable in personal development, individual and group therapy for children aged 6 to 13 (at present being adapted for adult psychotherapy. The program takes place within a fairy tale, being therefore a type of informal hypnotic trance. The interventions are drawn from the lessons described in Harry Potter’s story at Hogwarts, based on the fundamental principles of child psychotherapy and including elements of play therapy, art therapy, hypnotherapy, cognitive- behavioural therapy, transactional analysis, supportive therapy, family therapy and person centred therapy. From a theoretical point of view the program is based on elements from a number of psychotherapeutic approaches, the main concept being that we need to create a therapeutic myth that is acceptable to a child. The program is not suitable for children with structural deficits, who have difficulties in making the difference between fantasy and reality.

  14. Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study.

    Science.gov (United States)

    Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann

    2018-01-01

    Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

  15. Plan–Provider Integration, Premiums, and Quality in the Medicare Advantage Market

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D; Feldman, Roger

    2013-01-01

    Objective. To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. Data Source. We used public data from the Centers for Medicare and Medicaid Services (CMS) and the Area Resource File and private data from one large insurer. Premiums and quality ratings are from 2009 CMS administrative files and some control variables are historical. Study Design. We estimated ordinary least-squares models for premiums and plan quality ratings, with state fixed effects and firm random effects. The key independent variable was an indicator of plan–provider integration. Data Collection. With the exception of Medigap premium data, all data were publicly available. We ascertained plan–provider integration through examination of plans’ websites and governance documents. Principal Findings. We found that integrated plan–providers charge higher premiums, controlling for quality. Such plans also have higher quality ratings. We found no evidence that integration is associated with more generous benefits. Conclusions. Current policy encourages plan–provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur). PMID:23800017

  16. Plan-provider integration, premiums, and quality in the Medicare Advantage market.

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D; Feldman, Roger

    2013-12-01

    To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. We used public data from the Centers for Medicare and Medicaid Services (CMS) and the Area Resource File and private data from one large insurer. Premiums and quality ratings are from 2009 CMS administrative files and some control variables are historical. We estimated ordinary least-squares models for premiums and plan quality ratings, with state fixed effects and firm random effects. The key independent variable was an indicator of plan-provider integration. With the exception of Medigap premium data, all data were publicly available. We ascertained plan-provider integration through examination of plans' websites and governance documents. We found that integrated plan-providers charge higher premiums, controlling for quality. Such plans also have higher quality ratings. We found no evidence that integration is associated with more generous benefits. Current policy encourages plan-provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur). © Health Research and Educational Trust.

  17. Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

    Science.gov (United States)

    Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

    2012-01-01

    Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

  18. Integrating Collaborative Learning Groups in the Large Enrollment Lecture

    Science.gov (United States)

    Adams, J. P.; Brissenden, G.; Lindell Adrian, R.; Slater, T. F.

    1998-12-01

    Recent reforms for undergraduate education propose that students should work in teams to solve problems that simulate problems that research scientists address. In the context of an innovative large-enrollment course at Montana State University, faculty have developed a series of 15 in-class, collaborative learning group activities that provide students with realistic scenarios to investigate. Focusing on a team approach, the four principle types of activities employed are historical, conceptual, process, and open-ended activities. Examples of these activities include classifying stellar spectra, characterizing galaxies, parallax measurements, estimating stellar radii, and correlating star colors with absolute magnitudes. Summative evaluation results from a combination of attitude surveys, astronomy concept examinations, and focus group interviews strongly suggest that, overall, students are learning more astronomy, believe that the group activities are valuable, enjoy the less-lecture course format, and have significantly higher attendance rates. In addition, class observations of 48 self-formed, collaborative learning groups reveal that female students are more engaged in single-gender learning groups than in mixed gender groups.

  19. 78 FR 10618 - Re-Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and...

    Science.gov (United States)

    2013-02-14

    ..., Health Promotion, and Integrative and Public Health AGENCY: Office of the Assistant Secretary for Health..., Health Promotion, and Integrative and Public Health (hereafter referred to as ``the Advisory Group... Advisory Group provides recommendations and advice to the National Prevention, Health Promotion, and Public...

  20. Group Theory of Wannier Functions Providing the Basis for a Deeper Understanding of Magnetism and Superconductivity

    Directory of Open Access Journals (Sweden)

    Ekkehard Krüger

    2015-05-01

    Full Text Available The paper presents the group theory of optimally-localized and symmetry-adapted Wannier functions in a crystal of any given space group G or magnetic group M. Provided that the calculated band structure of the considered material is given and that the symmetry of the Bloch functions at all of the points of symmetry in the Brillouin zone is known, the paper details whether or not the Bloch functions of particular energy bands can be unitarily transformed into optimally-localized Wannier functions symmetry-adapted to the space group G, to the magnetic group M or to a subgroup of G or M. In this context, the paper considers usual, as well as spin-dependent Wannier functions, the latter representing the most general definition of Wannier functions. The presented group theory is a review of the theory published by one of the authors (Ekkehard Krüger in several former papers and is independent of any physical model of magnetism or superconductivity. However, it is suggested to interpret the special symmetry of the optimally-localized Wannier functions in the framework of a nonadiabatic extension of the Heisenberg model, the nonadiabatic Heisenberg model. On the basis of the symmetry of the Wannier functions, this model of strongly-correlated localized electrons makes clear predictions of whether or not the system can possess superconducting or magnetic eigenstates.

  1. The group coach as a socializing agent for integration?

    DEFF Research Database (Denmark)

    Stelter, Reinhard; Ryom, Knud

    -educated coaches and began in September 2013. All boys from 6th to 9th grade were offered group coaching on a regular basis as part of their school education. The intervention will finish in June 2015. The ambition was to provide a reflective and collaborative space where the whole group helped to support each......-year intervention for migrant boys (6th to 9th graders) at a lower secondary school in Copenhagen with 80+% of pupils having a non-Danish ethnic background. Besides coaching the boys had the opportunity to play soccer in a cooperative and mastery-oriented climate, organized by a local sports club. Group coaching...... other in this process. The focus of the intervention was on identity, on cultural, social and school issues, and on personal development. Qualitative interviews were conducted with ten 7th grade boys and complemented by observations. The (preliminary) results indicate a polarization of the boys...

  2. Surveying the quantum group symmetries of integrable open spin chains

    Science.gov (United States)

    Nepomechie, Rafael I.; Retore, Ana L.

    2018-05-01

    Using anisotropic R-matrices associated with affine Lie algebras g ˆ (specifically, A2n(2), A2n-1 (2) , Bn(1), Cn(1), Dn(1)) and suitable corresponding K-matrices, we construct families of integrable open quantum spin chains of finite length, whose transfer matrices are invariant under the quantum group corresponding to removing one node from the Dynkin diagram of g ˆ . We show that these transfer matrices also have a duality symmetry (for the cases Cn(1) and Dn(1)) and additional Z2 symmetries that map complex representations to their conjugates (for the cases A2n-1 (2) , Bn(1) and Dn(1)). A key simplification is achieved by working in a certain "unitary" gauge, in which only the unbroken symmetry generators appear. The proofs of these symmetries rely on some new properties of the R-matrices. We use these symmetries to explain the degeneracies of the transfer matrices.

  3. Globus Nexus: A Platform-as-a-Service Provider of Research Identity, Profile, and Group Management.

    Science.gov (United States)

    Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

    2016-03-01

    Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

  4. Globus Nexus: A Platform-as-a-Service provider of research identity, profile, and group management

    Energy Technology Data Exchange (ETDEWEB)

    Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

    2016-03-01

    Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

  5. Integration of a hand-reared chimpanzee (Pan troglodytes) infant into a social group of conspecifics.

    Science.gov (United States)

    Thunström, Maria; Persson, Tomas; Björklund, Mats

    2013-01-01

    Rejections of infants among non-human primates occasionally occur in the wild as well as in captive settings. Controlled adoptions of orphans and introductions of individuals into new groups are therefore sometimes necessary in captivity. Consequently, behavioral research on integration procedures and on the acceptance of infants by adoptive mothers is much needed. In this study, the introduction and subsequent adoption were examined in an 18-month-old hand-reared chimpanzee (Pan troglodytes). The infant was introduced into an age/sex-diversified social group of conspecifics at Furuvik Zoo, Gävle, Sweden, and continuous focal data was collected during the final stage of integration, including infant care exhibited by the group members and the infant's secure base behavior. The infant was successfully integrated into the group and engaged in positive social interactions with all group members. An adult primiparous female chimpanzee formed a bond resembling a mother-infant relationship with the infant, which continues to be maintained at publication. However, the female initially showed very limited interest in the infant. It was, in fact, two other younger female group members that exhibited most infant care. The infant's secure base behavior patterns indicate that she adapted well to the new circumstances in the chimpanzee group as the integration progressed. This provides evidence that a final adopter does not necessarily initially show maternal interest and that there can be flexibility in maternal behavior in adult chimpanzee females. Moreover, the methods applied employing gradual familiarization with all the group members and the use of an integration enclosure, may have contributed to a successful result. These findings extend our knowledge of introduction procedures in captivity as well as provide information on foster mother-infant attachment in chimpanzees.

  6. Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

    Science.gov (United States)

    Jenaro, C; Vega, V; Flores, N; Cruz, M

    2013-06-01

    Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  7. Managing Climate Risk. Integrating Adaptation into World Bank Group Operations

    International Nuclear Information System (INIS)

    Van Aalst, M.

    2006-08-01

    Climate change is already taking place, and further changes are inevitable. Developing countries, and particularly the poorest people in these countries, are most at risk. The impacts result not only from gradual changes in temperature and sea level but also, in particular, from increased climate variability and extremes, including more intense floods, droughts, and storms. These changes are already having major impacts on the economic performance of developing countries and on the lives and livelihoods of millions of poor people around the world. Climate change thus directly affects the World Bank Group's mission of eradicating poverty. It also puts at risk many projects in a wide range of sectors, including infrastructure, agriculture, human health, water resources, and environment. The risks include physical threats to the investments, potential underperformance, and the possibility that projects will indirectly contribute to rising vulnerability by, for example, triggering investment and settlement in high-risk areas. The way to address these concerns is not to separate climate change adaptation from other priorities but to integrate comprehensive climate risk management into development planning, programs, and projects. While there is a great need to heighten awareness of climate risk in Bank work, a large body of experience on climate risk management is already available, in analytical work, in country dialogues, and in a growing number of investment projects. This operational experience highlights the general ingredients for successful integration of climate risk management into the mainstream development agenda: getting the right sectoral departments and senior policy makers involved; incorporating risk management into economic planning; engaging a wide range of nongovernmental actors (businesses, nongovernmental organizations, communities, and so on); giving attention to regulatory issues; and choosing strategies that will pay off immediately under current

  8. Business process integration between European manufacturers and transport and logistics service providers

    DEFF Research Database (Denmark)

    Mortensen, Ole; Lemoine, W

    2005-01-01

    The goal of the Supply Chain Management process is to create value for customers, stakeholders and all supply chain members, through the integration of disparate processes like manufacturing flow management, customer service and order fulfillment. However, many firms fail in the path of achieving...... a total integration. This study illustrates, from an empirical point of view, the problems associated to SC integration among European firms operating in global/international markets. The focus is on the relationship between two echelons in the supply chain: manufacturers and their transport and logistics...... service providers (TLSPs). The paper examines (1) the characteristics of the collaborative partnerships established between manufacturers and their TLSPs; (2) to what extent manufacturers and their TLSPs have integrated SC business processes; (3) the IT used to support the SC cooperation and integration...

  9. Vertical integration of teaching in Australian general practice--a survey of regional training providers.

    Science.gov (United States)

    Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

    2011-06-06

    To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

  10. Core drilling provides information about Santa Fe Group aquifer system beneath Albuquerque's West Mesa

    Science.gov (United States)

    Allen, B.D.; Connell, S.D.; Hawley, J.W.; Stone, B.D.

    1998-01-01

    Core samples from the upper ???1500 ft of the Santa Fe Group in the Albuquerque West Mesa area provide a first-hand look at the sediments and at subsurface stratigraphic relationships in this important part of the basin-fill aquifer system. Two major hydrostratigraphic subunits consisting of a lower coarse-grained, sandy interval and an overlying fine-grained, interbedded silty sand and clay interval lie beneath the water table at the 98th St core hole. Borehole electrical conductivity measurements reproduce major textural changes observed in the recovered cores and support subsurface correlations of hydrostratigraphic units in the Santa Fe Group aquifer system based on geophysical logs. Comparison of electrical logs from the core hole and from nearby city wells reveals laterally consistent lithostratigraphic patterns over much of the metropolitan area west of the Rio Grande that may be used to delineate structural and related stratigraphic features that have a direct bearing on the availability of ground water.

  11. Unbounded representations of symmetry groups in gauge quantum field theory. II. Integration

    International Nuclear Information System (INIS)

    Voelkel, A.H.

    1986-01-01

    Within the gauge quantum field theory of the Wightman--Garding type, the integration of representations of Lie algebras is investigated. By means of the covariance condition (substitution rules) for the basic fields, it is shown that a form skew-symmetric representation of a Lie algebra can be integrated to a form isometric and in general unbounded representation of the universal covering group of a corresponding Lie group provided the conditions (Nelson, Sternheimer, etc.), which are well known for the case of Hilbert or Banach representations, hold. If a form isometric representation leaves the subspace from which the physical Hilbert space is obtained via factorization and completion invariant, then the same is proved to be true for its differential. Conversely, a necessary and sufficient condition is derived for the transmission of the invariance of this subspace under a form skew-symmetric representation of a Lie algebra to its integral

  12. The integrated evaluation of the macro environment of companies providing transport services

    Directory of Open Access Journals (Sweden)

    A. Žvirblis

    2008-09-01

    Full Text Available The article presents the main principles of the integrated evaluation of macro environment components and factors influencing the performance of transport companies as well as providing the validated quantitative evaluation models and results obtained in evaluating the macro environment of Lithuanian companies providing transport services. Since quantitative evaluation is growing in importance, the process of developing the principles and methods of business macro environment quantitative evaluation is becoming relevant from both theoretical and practical perspectives. The created methodology is based on the concept of macro environment as an integrated whole of components, formalization and the principle of three-stage quantitative evaluation. The methodology suggested involves the quantitative evaluation of primary factors and macro environment components as an integral dimension (expressed in points. On the basis of this principle, an integrated macro environment evaluation parameter is established as its level index. The methodology integrates the identification of significant factors, building scenarios, a primary analysis of factors, expert evaluation, the quantitative evaluation of macro environment components and their whole. The application of the multi-criteria Simple Additive Weighting (SAW method is validated. The integrated evaluation of the macro environment of Lithuanian freight transportation companies was conducted. As a result, the level indices of all components as well as the level index of macro environment considered as a whole of components were identified. The latter reflects the extent of deviation from an average level of a favourable macro environment. This is important for developing strategic marketing decisions and expanding a strategic area.

  13. Service-provider and utility task-leadership integration. Paper D

    Energy Technology Data Exchange (ETDEWEB)

    Bagshaw, S.; Van Tassell, D. [AP Services, Inc., Freeport, PA (United States)

    2011-07-01

    As nuclear power utilities strive to stream-line their organizations, while improving outage and refurbishment project performance, the necessity for effective relationships and interaction between utility and service-providers becomes paramount. Successful integration of Service-Provider into the Utility's environment is achievable and has been demonstrated. Early and extensive engagement in front-end planning, single-point-of-continuity, and the use of integrated execution teams, are some of the critical elements for ensuring success. The paper discusses Task-Leadership Integration at the three levels of; utility executive level 'need-statement'; a 'why is this important' discussion; and as a 'thoughtful tutorial' on its features and practice. (author)

  14. Service-provider and utility task-leadership integration. Paper D

    International Nuclear Information System (INIS)

    Bagshaw, S.; Van Tassell, D.

    2011-01-01

    As nuclear power utilities strive to stream-line their organizations, while improving outage and refurbishment project performance, the necessity for effective relationships and interaction between utility and service-providers becomes paramount. Successful integration of Service-Provider into the Utility's environment is achievable and has been demonstrated. Early and extensive engagement in front-end planning, single-point-of-continuity, and the use of integrated execution teams, are some of the critical elements for ensuring success. The paper discusses Task-Leadership Integration at the three levels of; utility executive level 'need-statement'; a 'why is this important' discussion; and as a 'thoughtful tutorial' on its features and practice. (author)

  15. Logistics Service Provider Selection through an Integrated Fuzzy Multicriteria Decision Making Approach

    OpenAIRE

    Gülşen Akman; Kasım Baynal

    2014-01-01

    Nowadays, the demand of third-party logistics provider becomes an increasingly important issue for companies to improve their customer service and to decrease logistics costs. This paper presents an integrated fuzzy approach for the evaluation and selection of 3rd party logistics service providers. This method consists of two techniques: (1) use fuzzy analytic hierarchy process to identify weights of evaluation criteria; (2) apply fuzzy technique for order preference by similarity to ideal so...

  16. National survey provides average power quality profiles for different customer groups

    International Nuclear Information System (INIS)

    Hughes, B.; Chan, J.

    1996-01-01

    A three year survey, beginning in 1991, was conducted by the Canadian Electrical Association to study the levels of power quality that exist in Canada, and to determine ways to increase utility expertise in making power quality measurements. Twenty-two utilities across Canada were involved, with a total of 550 sites being monitored, including residential and commercial customers. Power disturbances, power outages and power quality were recorded for each site. To create a group average power quality plot, the transient disturbance activity for each site was normalized to a per channel, per month basis and then divided into a grid. Results showed that the average power quality provided by Canadian utilities was very good. Almost all the electrical disturbance within a customer premises were created and stayed within those premises. Disturbances were generally beyond utility control. Utilities could, however, reduce the amount of time the steady-state voltage exceeds the CSA normal voltage upper limit. 5 figs

  17. Integral pentavalent Cayley graphs on abelian or dihedral groups

    Indian Academy of Sciences (India)

    MOHSEN GHASEMI

    ghasemi@urmia.ac.ir. MS received 8 July 2015; revised 10 July 2016. Abstract. A graph is called integral, if all of its eigenvalues are integers. In this paper, we give some results about integral pentavalent Cayley graphs on abelian or dihedral.

  18. Quality of integrated chronic disease care in rural South Africa: user and provider perspectives.

    Science.gov (United States)

    Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier

    2017-03-01

    The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while

  19. Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ toolkit.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R

    2017-02-01

    The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes. Twelve mental health providers working in Department of Veterans Affairs integrated primary care clinics participated in semistructured interviews to gather quantitative and qualitative data. Descriptive statistics and qualitative content analysis were used to analyze data. Providers identified several positive features of the PPAQ toolkit organization and structure that resulted in high ratings of acceptability, while also identifying several toolkit components in need of modification to improve usability. Toolkit content was considered highly representative of the (PCBH) model and therefore could be used as a diagnostic self-assessment of model adherence. The toolkit was considered to be high in applicability to providers regardless of their degree of prior professional preparation or current clinical setting. Additionally, providers identified several system-level contextual factors that could impact the usefulness of the toolkit. These findings suggest that frontline mental health providers working in (PCBH) settings may be receptive to using an adherence-focused toolkit for ongoing quality improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Integrity and As-built capacity of bored pile group

    International Nuclear Information System (INIS)

    Shaw, D.E.; Kissenpfennig, J.F.; Huemmer, M.R.

    1983-01-01

    This paper discusses the application of statistical methods to the reliability evaluation of cast-in-place concrete piles. The difficulties associated with pile construction can lead to larger uncertainties than would be associated with normal reinforced concrete structures both due to uncertainty in concrete quality and end bearing capacity. These uncertainties can be dealt with through the use of statistical methods. A statistical model of an individual pile is formulated along with a methodology for determining necessary statistical parameters from results of concrete batch tests, core strength tests and visual logs, sonic geophysical testing methods, and proof tests. Strength models for both static vertical and seismic horizontal loadings are discussed. The overall safety of a pile foundation is dependent upon the distribution of individual pile strength as well as the additional reliability due to the use of a large number of parallel load paths provided by a pile group foundation. The paper presents a mechanical model of global pile behavior which accounts for individual pile ductility along with the possibility of redistribution of loads from weaker to stronger piles. The use of the Monte Carlo method to determine the overall reliability of the pile foundation is discussed. Numerical results for both individual pile behavior as well as overall foundation behavior are presented. (orig.)

  1. An introduction to Lie group integrators – basics, new developments and applications

    International Nuclear Information System (INIS)

    Celledoni, Elena; Marthinsen, Håkon; Owren, Brynjulf

    2014-01-01

    We give a short and elementary introduction to Lie group methods. A selection of applications of Lie group integrators are discussed. Finally, a family of symplectic integrators on cotangent bundles of Lie groups is presented and the notion of discrete gradient methods is generalised to Lie groups

  2. Multiloop integral system test (MIST): Final report, Inter-group comparisons

    Energy Technology Data Exchange (ETDEWEB)

    Gloudemans, J.R.

    1989-07-01

    The multiloop integral system test (MIST) was part of a multiphase program started in 1983 to address small-break loss-of-coolant accidents (SBLOCAs) specific to Babcock and Wilcox-designed plants. MIST was sponsored by the US Nuclear Regulatory Commission, the Babcock and Wilcox Owners Group, the Electric Power Research Institute, and Babcock and Wilcox. The unique features of the Babcock and Wilcox design, specifically the hot leg U-bends and steam generators, prevented the use of existing integral system data or existing integral system facilities to address the thermal-hydraulic SBLOCA questions. MIST and two other supporting facilities were specifically designed and constructed for this program, and an existing facility -- the once-through integral system (OTIS) -- was also used. Data from MIST and the other facilities will be used to benchmark the adequacy of system codes, such as RELAP5 and TRAC, for predicting abnormal plant transients. The individual tests are described in detail in Volumes 2 through 8 and Volume 11, and are summarized in Volume 1. Inter-group comparisons are addressed in this document, Volume 9. These comparisons are grouped as follows: mapping versus SBLOCA transients, SBLOCA, pump effects, and the effects of noncondensible gases. Appendix A provides an index and description of the microfiched plots for each test, which are enclosed with the corresponding Volumes 2 through 8. 147 figs., 5 tabs.

  3. Integrating security in a group oriented distributed system

    Science.gov (United States)

    Reiter, Michael; Birman, Kenneth; Gong, LI

    1992-01-01

    A distributed security architecture is proposed for incorporation into group oriented distributed systems, and in particular, into the Isis distributed programming toolkit. The primary goal of the architecture is to make common group oriented abstractions robust in hostile settings, in order to facilitate the construction of high performance distributed applications that can tolerate both component failures and malicious attacks. These abstractions include process groups and causal group multicast. Moreover, a delegation and access control scheme is proposed for use in group oriented systems. The focus is the security architecture; particular cryptosystems and key exchange protocols are not emphasized.

  4. How do Small Groups Promote Behaviour Change? An Integrative Conceptual Review of Explanatory Mechanisms.

    Science.gov (United States)

    Borek, Aleksandra J; Abraham, Charles

    2018-03-01

    Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions. Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery. Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining individual change in small groups. The final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions. © 2018 The Authors. Applied Psychology: Health and Well-Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.

  5. Integrative analysis of multiple diverse omics datasets by sparse group multitask regression

    Directory of Open Access Journals (Sweden)

    Dongdong eLin

    2014-10-01

    Full Text Available A variety of high throughput genome-wide assays enable the exploration of genetic risk factors underlying complex traits. Although these studies have remarkable impact on identifying susceptible biomarkers, they suffer from issues such as limited sample size and low reproducibility. Combining individual studies of different genetic levels/platforms has the promise to improve the power and consistency of biomarker identification. In this paper, we propose a novel integrative method, namely sparse group multitask regression, for integrating diverse omics datasets, platforms and populations to identify risk genes/factors of complex diseases. This method combines multitask learning with sparse group regularization, which will: 1 treat the biomarker identification in each single study as a task and then combine them by multitask learning; 2 group variables from all studies for identifying significant genes; 3 enforce sparse constraint on groups of variables to overcome the ‘small sample, but large variables’ problem. We introduce two sparse group penalties: sparse group lasso and sparse group ridge in our multitask model, and provide an effective algorithm for each model. In addition, we propose a significance test for the identification of potential risk genes. Two simulation studies are performed to evaluate the performance of our integrative method by comparing it with conventional meta-analysis method. The results show that our sparse group multitask method outperforms meta-analysis method significantly. In an application to our osteoporosis studies, 7 genes are identified as significant genes by our method and are found to have significant effects in other three independent studies for validation. The most significant gene SOD2 has been identified in our previous osteoporosis study involving the same expression dataset. Several other genes such as TREML2, HTR1E and GLO1 are shown to be novel susceptible genes for osteoporosis, as confirmed

  6. 77 FR 33486 - Certain Integrated Circuit Packages Provided With Multiple Heat-Conducting Paths and Products...

    Science.gov (United States)

    2012-06-06

    ...Notice is hereby given that the U.S. International Trade Commission has received a complaint entitled Certain Integrated Circuit Packages Provided With Multiple Heat-Conducting Paths and Products Containing Same, DN 2899; the Commission is soliciting comments on any public interest issues raised by the complaint or complainant's filing under section 210.8(b) of the Commission's Rules of Practice and Procedure (19 CFR 210.8(b)).

  7. Communication Network Integration and Group Uniformity in a Complex Organization.

    Science.gov (United States)

    Danowski, James A.; Farace, Richard V.

    This paper contains a discussion of the limitations of research on group processes in complex organizations and the manner in which a procedure for network analysis in on-going systems can reduce problems. The research literature on group uniformity processes and on theoretical models of these processes from an information processing perspective…

  8. Steam-Generator Integrity Program/Steam-Generator Group Project

    International Nuclear Information System (INIS)

    1982-10-01

    The Steam Generator Integrity Program (SGIP) is a comprehensive effort addressing issues of nondestructive test (NDT) reliability, inservice inspection (ISI) requirements, and tube plugging criteria for PWR steam generators. In addition, the program has interactive research tasks relating primary side decontamination, secondary side cleaning, and proposed repair techniques to nondestructive inspectability and primary system integrity. The program has acquired a service degraded PWR steam generator for research purposes. This past year a research facility, the Steam Generator Examination Facility (SGEF), specifically designed for nondestructive and destructive examination tasks of the SGIP was completed. The Surry generator previously transported to the Hanford Reservation was then inserted into the SGEF. Nondestructive characterization of the generator from both primary and secondary sides has been initiated. Decontamination of the channelhead cold leg side was conducted. Radioactive field maps were established in the steam generator, at the generator surface and in the SGEF

  9. Group sparse canonical correlation analysis for genomic data integration.

    Science.gov (United States)

    Lin, Dongdong; Zhang, Jigang; Li, Jingyao; Calhoun, Vince D; Deng, Hong-Wen; Wang, Yu-Ping

    2013-08-12

    The emergence of high-throughput genomic datasets from different sources and platforms (e.g., gene expression, single nucleotide polymorphisms (SNP), and copy number variation (CNV)) has greatly enhanced our understandings of the interplay of these genomic factors as well as their influences on the complex diseases. It is challenging to explore the relationship between these different types of genomic data sets. In this paper, we focus on a multivariate statistical method, canonical correlation analysis (CCA) method for this problem. Conventional CCA method does not work effectively if the number of data samples is significantly less than that of biomarkers, which is a typical case for genomic data (e.g., SNPs). Sparse CCA (sCCA) methods were introduced to overcome such difficulty, mostly using penalizations with l-1 norm (CCA-l1) or the combination of l-1and l-2 norm (CCA-elastic net). However, they overlook the structural or group effect within genomic data in the analysis, which often exist and are important (e.g., SNPs spanning a gene interact and work together as a group). We propose a new group sparse CCA method (CCA-sparse group) along with an effective numerical algorithm to study the mutual relationship between two different types of genomic data (i.e., SNP and gene expression). We then extend the model to a more general formulation that can include the existing sCCA models. We apply the model to feature/variable selection from two data sets and compare our group sparse CCA method with existing sCCA methods on both simulation and two real datasets (human gliomas data and NCI60 data). We use a graphical representation of the samples with a pair of canonical variates to demonstrate the discriminating characteristic of the selected features. Pathway analysis is further performed for biological interpretation of those features. The CCA-sparse group method incorporates group effects of features into the correlation analysis while performs individual feature

  10. Integrative Analyses of De Novo Mutations Provide Deeper Biological Insights into Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Atsushi Takata

    2018-01-01

    Full Text Available Recent studies have established important roles of de novo mutations (DNMs in autism spectrum disorders (ASDs. Here, we analyze DNMs in 262 ASD probands of Japanese origin and confirm the “de novo paradigm” of ASDs across ethnicities. Based on this consistency, we combine the lists of damaging DNMs in our and published ASD cohorts (total number of trios, 4,244 and perform integrative bioinformatics analyses. Besides replicating the findings of previous studies, our analyses highlight ATP-binding genes and fetal cerebellar/striatal circuits. Analysis of individual genes identified 61 genes enriched for damaging DNMs, including ten genes for which our dataset now contributes to statistical significance. Screening of compounds altering the expression of genes hit by damaging DNMs reveals a global downregulating effect of valproic acid, a known risk factor for ASDs, whereas cardiac glycosides upregulate these genes. Collectively, our integrative approach provides deeper biological and potential medical insights into ASDs.

  11. Basurto-IGPP. A manual-directed approach of integrative group psychotherapy in psychosis.

    Science.gov (United States)

    Ruiz-Parra, Eduardo; González-Torres, M A; Eguiluz, I; de la Sierra, E; Trojaola, B; Catalán, A

    2010-01-01

    A manual on Integrative Group Psychotherapy for outpatients with schizophrenia and other psychoses (Basurto-PGIP) is presented. The model takes into account group specific therapeutic factors. It integrates influences from other integrative psychotherapeutic models, interpersonal group therapy, group analysis and recent developments in cognitive behavioural therapy for psychotic symptoms. The manual is structured in levels of different complexity that can be applied in a progressive manner. The intervention tries to adapt to patients features, therapists ability and training, and centres resources. It can be applied in two possible settings: a short term closed group and a long term open group. Advantages and disadvantages of the model are described.

  12. Renormalization Group Reduction of Non Integrable Hamiltonian Systems

    International Nuclear Information System (INIS)

    Tzenov, Stephan I.

    2002-01-01

    Based on Renormalization Group method, a reduction of non integratable multi-dimensional Hamiltonian systems has been performed. The evolution equations for the slowly varying part of the angle-averaged phase space density and for the amplitudes of the angular modes have been derived. It has been shown that these equations are precisely the Renormalization Group equations. As an application of the approach developed, the modulational diffusion in one-and-a-half degrees of freedom dynamical system has been studied in detail

  13. The meaning of providing caring to obese patients to a group of nurses

    Directory of Open Access Journals (Sweden)

    Emilly Souza Marques

    2014-03-01

    Full Text Available This qualitative study was performed with six nurses of a public hospital, with the objective to describe their view of the meaning of providing care to obese patients. Interviews were conducted using a semi-structured script. The data were organized under themes extracted from the subjects’ statements, after being thoroughly read. Symbolic Interactionism was adopted to interpret the findings. The results from the analysis were organized under the following themes: Being obese is excessive, it is not healthy; Providing care to the obese is a structural issue; Obese patients are troublesome, they require care, no big deal; Providing care to the obese requires teamwork. The grasped meanings can interfere in the care provided. The nurses, however, recognize the need to work as a team to deliver comprehensive care. Making positive changes to the meanings found in this study is possible, thus, contributing to providing prejudice-free nursing care to obese patients. Descriptors: Obesity; Nursing Care; Hospital Care.

  14. Integrating Academic Interventions into Small Group Counseling in Elementary School

    Science.gov (United States)

    Steen, Sam; Kaffenberger, Carol J.

    2007-01-01

    Professional school counselors face the challenge of delivering guidance and counseling services to students while connecting to the educational mission of schools. This article is a summary and evaluation of a small group counseling program that targets academic issues while addressing personal/social issues with elementary-aged children. Results…

  15. Poisson processes on groups and Feynamn path integrals

    International Nuclear Information System (INIS)

    Combe, P.; Rodriguez, R.; Aix-Marseille-2 Univ., 13 - Marseille; Sirugue, M.; Sirugue-Collin, M.; Centre National de la Recherche Scientifique, 13 - Marseille; Hoegh-Krohn, R.

    1980-01-01

    We give an expression for the perturbed evolution of a free evolution by gentle, possibly velocity dependent, potential, in terms of the expectation with respect to a Poisson process on a group. Various applications are given in particular to usual quantum mechanics but also to Fermi and spin systems. (orig.)

  16. Poisson processes on groups and Feynman path integrals

    International Nuclear Information System (INIS)

    Combe, P.; Rodriguez, R.; Sirugue-Collin, M.; Centre National de la Recherche Scientifique, 13 - Marseille; Sirugue, M.

    1979-09-01

    An expression is given for the perturbed evolution of a free evolution by gentle, possibly velocity dependent, potential, in terms of the expectation with respect to a Poisson process on a group. Various applications are given in particular to usual quantum mechanics but also to Fermi and spin systems

  17. Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

    Science.gov (United States)

    Hobgood, Cherri; Weiner, Bryan; Tamayo-Sarver, Joshua H

    2006-04-01

    To determine if the three types of emergency medicine providers--physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs])--differ in their identification, disclosure, and reporting of medical error. A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p error types, identification, disclosure, and reporting increased with increasing severity. Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type.

  18. Inpatient Prospective Payment System (IPPS) Provider Summary for the Top 100 Diagnosis-Related Groups (DRG)

    Data.gov (United States)

    U.S. Department of Health & Human Services — A provider level summary of Inpatient Prospective Payment System (IPPS) discharges, average charges and average Medicare payments for the Top 100 Diagnosis-Related...

  19. The Performance Enhancement Group Program: Integrating Sport Psychology and Rehabilitation

    Science.gov (United States)

    Granito, Vincent J.; Hogan, Jeffery B.; Varnum, Lisa K.

    1995-01-01

    In an effort to improve the psychological health of the athlete who has sustained an injury, the Performance Enhancement Group program for injured athletes was created. This paper will offer a model for the Performance Enhancement Group program as a way to: 1) support the athlete, both mentally and physically; 2) deal with the demands of rehabilitation; and 3) facilitate the adjustments the athlete has to make while being out of the competitive arena. The program consists of responsibilities for professionals in sport psychology (ie, assessment/orientation, support, education, individual counseling, and evaluation) and athletic training (ie, organization/administration, recruitment and screening, support, application of techniques, and program compliance). The paper will emphasize that the success of the program is dependent on collaboration between professionals at all levels. PMID:16558357

  20. An integrated conceptual framework for selecting reverse logistics providers in the presence of vagueness

    Science.gov (United States)

    Fırdolaş, Tugba; Önüt, Semih; Kongar, Elif

    2005-11-01

    In recent years, relating organization's attitude towards sustainable development, environmental management is gaining an increasing interest among researchers in supply chain management. With regard to a long term requirement of a shift from a linear economy towards a cycle economy, businesses should be motivated to embrace change brought about by consumers, government, competition, and ethical responsibility. To achieve business goals and objectives, a company must reply to increasing consumer demand for "green" products and implement environmentally responsible plans. Reverse logistics is an activity within organizations delegated to the customer service function, where customers with warranted or defective products would return them to their supplier. Emergence of reverse logistics enables to provide a competitive advantage and significant return on investment with an indirect effect on profitability. Many organizations are hiring third-party providers to implement reverse logistics programs designed to retain value by getting products back. Reverse logistics vendors play an important role in helping organizations in closing the loop for products offered by the organizations. In this regard, the selection of third-party providers issue is increasingly becoming an area of reverse logistics concept and practice. This study aims to assist managers in determining which third-party logistics provider to collaborate in the reverse logistics process with an alternative approach based on an integrated model using neural networks and fuzzy logic. An illustrative case study is discussed and the best provider is identified through the solution of this model.

  1. Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems.

    Science.gov (United States)

    Meyerhoefer, Chad D; Sherer, Susan A; Deily, Mary E; Chou, Shin-Yi; Guo, Xiaohui; Chen, Jie; Sheinberg, Michael; Levick, Donald

    2018-05-16

    The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR. Data on patient satisfaction were drawn from Press Ganey surveys issued by the healthcare network through a standard process. Using multivariable models, we determined how provider satisfaction with information transmission and patient satisfaction with their care experience changed as the EHR system allowed greater information flow between OB/GYN practices and the hospital. Outpatient OB/GYN providers became more satisfied with their access to information from the inpatient perinatal triage unit once system capabilities included automatic data flow from triage back to the OB/GYN offices. Yet physicians were generally less satisfied with how the EHR affected their work processes than other clinical and non-clinical staff. Patient satisfaction dropped after initial EHR installation, and we find no evidence of increased satisfaction linked to system integration. Dissatisfaction of providers with an EHR system and difficulties incorporating EHR technology into patient care may negatively impact patient satisfaction. Care must be taken during EHR implementations to maintain good communication with patients while satisfying documentation requirements.

  2. Simple group password-based authenticated key agreements for the integrated EPR information system.

    Science.gov (United States)

    Lee, Tian-Fu; Chang, I-Pin; Wang, Ching-Cheng

    2013-04-01

    The security and privacy are important issues for electronic patient records (EPRs). The goal of EPRs is sharing the patients' medical histories such as the diagnosis records, reports and diagnosis image files among hospitals by the Internet. So the security issue for the integrated EPR information system is essential. That is, to ensure the information during transmission through by the Internet is secure and private. The group password-based authenticated key agreement (GPAKE) allows a group of users like doctors, nurses and patients to establish a common session key by using password authentication. Then the group of users can securely communicate by using this session key. Many approaches about GAPKE employ the public key infrastructure (PKI) in order to have higher security. However, it not only increases users' overheads and requires keeping an extra equipment for storing long-term secret keys, but also requires maintaining the public key system. This investigation presents a simple group password-based authenticated key agreement (SGPAKE) protocol for the integrated EPR information system. The proposed SGPAKE protocol does not require using the server or users' public keys. Each user only remembers his weak password shared with a trusted server, and then can obtain a common session key. Then all users can securely communicate by using this session key. The proposed SGPAKE protocol not only provides users with convince, but also has higher security.

  3. Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

    NARCIS (Netherlands)

    Staats, H

    2005-01-01

    Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

  4. Program Experiences of Adults with Autism, Their Families, and Providers: Findings from a Focus Group Study

    Science.gov (United States)

    Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.

    2018-01-01

    A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…

  5. Quality of Services and Quality of Life from Service Providers' Perspectives: Analysis with Focus Groups

    Science.gov (United States)

    Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.

    2013-01-01

    Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…

  6. Functional Foods Programs Serve as a Vehicle to Provide Nutrition Education to Groups

    Science.gov (United States)

    Cirignano, Sherri M.

    2011-01-01

    An increase in consumer interest in functional foods provides an opportunity for FCS educators to use this topic in Extension programming to promote current nutrition recommendations. The Functional Foods for Life Educational Programs (FFL) are a curriculum of six evidence-based mini-seminars that highlight specific functional foods that have the…

  7. On integral representation of the Clebsh-Gordan coefficients of SU(3) group

    International Nuclear Information System (INIS)

    Mal'tsev, V.M.

    1985-01-01

    The projection of arbitrary quark-gluon state on a singlet representation of SU(3) group is considered. It is given by an integral on the group. In this case the square of a Clebsch-Gordan coefficient is evaluated as the eight-fold integral over corresponding Eulerian angles

  8. Collaborative Teaching and Learning through Multi-Institutional Integrated Group Projects

    Science.gov (United States)

    Long, Suzanna K.; Carlo, Héctor J.

    2013-01-01

    This teaching brief describes an innovative multi-institutional initiative through which integrated student groups from different courses collaborate on a common course project. In this integrated group project, students are asked to design a decentralized manufacturing organization for a company that will manufacture industrial Proton-Exchange…

  9. Integrating CHWs as part of the team leading diabetes group visits: A randomized controlled feasibility study

    Science.gov (United States)

    The purpose of the study was to evaluate the feasibility of integrating Community Health Workers (CHWs) as part of the team leading diabetes group visits. This was a randomized controlled study that integrated CHWs as part of the team leading diabetes group visits for low-income Hispanic adults (n=5...

  10. Small Marine Protected Areas in Fiji Provide Refuge for Reef Fish Assemblages, Feeding Groups, and Corals

    Science.gov (United States)

    Pires, Mathias M.; Guimarães, Paulo Roberto; Hoey, Andrew S.; Hay, Mark E.

    2017-01-01

    The establishment of no-take marine protected areas (MPAs) on coral reefs is a common management strategy for conserving the diversity, abundance, and biomass of reef organisms. Generally, well-managed and enforced MPAs can increase or maintain the diversity and function of the enclosed coral reef, with some of the benefits extending to adjacent non-protected reefs. A fundamental question in coral reef conservation is whether these benefits arise within small MPAs (fish assemblages, composition of fish feeding groups, benthic cover, and key ecosystem processes (grazing, macroalgal browsing, and coral replenishment) in three small (0.5–0.8 km2) no-take MPAs and adjacent areas where fisheries are allowed (non-MPAs) on coral reefs in Fiji. The MPAs exhibited greater species richness, density, and biomass of fishes than non-MPAs. Furthermore, MPAs contained a greater abundance and biomass of grazing herbivores and piscivores as well as a greater abundance of cleaners than fished areas. We also found differences in fish associations when foraging, with feeding groups being generally more diverse and having greater biomass within MPAs than adjacent non-MPAs. Grazing by parrotfishes was 3–6 times greater, and macroalgal browsing was 3–5 times greater in MPAs than in non-MPAs. On average, MPAs had 260–280% as much coral cover and only 5–25% as much macroalgal cover as their paired non-MPA sites. Finally, two of the three MPAs had three-fold more coral recruits than adjacent non-MPAs. The results of this study indicate that small MPAs benefit not only populations of reef fishes, but also enhance ecosystem processes that are critical to reef resilience within the MPAs. PMID:28122006

  11. What does «integrative medicine» provide to daily scientific clinical care?

    Science.gov (United States)

    Bataller-Sifre, R; Bataller-Alberola, A

    2015-11-01

    Integrative medicine is an ambitious and noble-minded attempt to address the shortcomings of the current public health systems in our Western societies, which is restricted by the limited time available, especially in outpatient clinics. Integrative medicine also does not limit the possibilities of useful therapies that have been tested over the centuries (from China, India, etc.) or of certain resources that do not achieve the level of desired scientific credibility but that present certain therapeutic support in specific cases (homeopathy, acupuncture, etc.) but still require a scientific approach. Finally, the resource of botanical products (phytotherapy) constitutes a wide range of possibilities that universities can (and do) make progress on by providing drug brands for these products through the use of the scientific method and evidence-based medical criteria. This approach will help avoid the irrationality of the daily struggle between conventional scientific medicine (which we apply to the immense majority of patients) and the other diagnostic-therapeutic «guidelines» (natural medicine, alternative medicine, complementary medicine, patient-focused medicine and others). Copyright © 2015. Published by Elsevier España, S.L.U.

  12. 77 FR 39735 - Certain Integrated Circuit Packages Provided With Multiple Heat-Conducting Paths and Products...

    Science.gov (United States)

    2012-07-05

    ...Notice is hereby given that a complaint was filed with the U.S. International Trade Commission on May 31, 2012, under section 337 of the Tariff Act of 1930, as amended, on behalf of Industrial Technology Research Institute of Taiwan and ITRI International of San Jose, California. The complaint alleges violations of section 337 based upon the importation into the United States, the sale for importation, and the sale within the United States after importation of certain integrated circuit packages provided with multiple heat-conducting paths and products containing same by reason of infringement of certain claims of U.S. Patent No. 5,710,459 (``the `459 patent''). The complaint further alleges that an industry in the United States exists as required by subsection (a)(2) of section 337. The complainants request that the Commission institute an investigation and, after the investigation, issue an exclusion order and cease and desist order.

  13. Do NHS walk-in centres in England provide a model of integrated care?

    Directory of Open Access Journals (Sweden)

    C. Salisbury

    2003-08-01

    Full Text Available Purpose: To undertake a comprehensive evaluation of NHS walk-in centres against criteria of improved access, quality, user satisfaction and efficiency. Context: Forty NHS walk-in centres have been opened in England, as part of the UK governments agenda to modernise the NHS. They are intended to improve access to primary care, provide high quality treatment at convenient times, and reduce inappropriate demand on other NHS providers. Care is provided by nurses rather than doctors, using computerised algorithms, and nurses use protocols to supply treatments previously only available from doctors. Data sources: Several linked studies were conducted using different sources of data and methodologies. These included routinely collected data, site visits, patient interviews, a survey of users of walk-in centres, a study using simulated patients to assess quality of care, analysis of consultation rates in NHS services near to walk-in centres, and audit of compliance with protocols. Conclusion & discussion: The findings illustrate many of the issues described in a recent WHO reflective paper on Integrated Care, including tensions between professional judgement and use of protocols, problems with incompatible IT systems, balancing users' demands and needs, the importance of understanding health professionals' roles and issues of technical versus allocative efficiency.

  14. An integrated Biophysical CGE model to provide Sustainable Development Goal insights

    Science.gov (United States)

    Sanchez, Marko; Cicowiez, Martin; Howells, Mark; Zepeda, Eduardo

    2016-04-01

    Future projected changes in the energy system will inevitably result in changes to the level of appropriation of environmental resources, particularly land and water, and this will have wider implications for environmental sustainability, and may affect other sectors of the economy. An integrated climate, land, energy and water (CLEW) system will provide useful insights, particularly with regard to the environmental sustainability. However, it will require adequate integration with other tools to detect economic impacts and broaden the scope for policy analysis. A computable general equilibrium (CGE) model is a well suited tool to channel impacts, as detected in a CLEW analysis, onto all sectors of the economy, and evaluate trade-offs and synergies, including those of possible policy responses. This paper will show an application of such integration in a single-country CGE model with the following key characteristics. Climate is partly exogenous (as proxied by temperature and rainfall) and partly endogenous (as proxied by emissions generated by different sectors) and has an impact on endogenous variables such as land productivity and labor productivity. Land is a factor of production used in agricultural and forestry activities which can be of various types if land use alternatives (e.g., deforestation) are to be considered. Energy is an input to the production process of all economic sectors and a consumption good for households. Because it is possible to allow for substitution among different energy sources (e.g. renewable vs non-renewable) in the generation of electricity, the production process of energy products can consider the use of natural resources such as oil and water. Water, data permitting, can be considered as an input into the production process of agricultural sectors, which is particularly relevant in case of irrigation. It can also be considered as a determinant of total factor productivity in hydro-power generation. The integration of a CLEW

  15. Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost.

    Science.gov (United States)

    Gouge, Natasha; Polaha, Jodi; Rogers, Rachel; Harden, Amy

    2016-12-01

    Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not. Data were collected across a 10-day period when a BHC provided services and 10 days when she was not available. Data included time stamps of patient direct care; providers' direct reports of problems raised; and a review of medical and administrative records, including billing codes and reimbursement. This study took place in a rural, stand-alone private pediatric primary care practice. The participants were five pediatric primary care providers (PCPs; two doctors of medicine, 1 doctor of osteopathy, 2 nurse practitioners) and two supervised doctoral students in psychology (BHCs). Pediatric patients (N = 668) and their parents also participated. On days when a BHC was present, medical providers spent 2 fewer minutes on average for every patient seen, saw 42% more patients, and collected $1142 more revenue than on days when no consultant was present. The time savings demonstrated on days when the consultant was available point to the efficiency and potential financial viability of this model. These results have important implications for the feasibility of hiring behavioral health professionals in a fee-for-service system. They have equally useful implications for the utility of moving to a bundled system of care in which collaborative practice is valued.

  16. The Role of a Provider-Sponsored Health Plan in Achieving Scale and Integration.

    Science.gov (United States)

    Johnson, Steven P

    2016-01-01

    In pursuit of two primary strategies-to become an integrated delivery network (IDN) on the local level and to achieve additional overall organizational scale to sustain operations-Health First, based in Rockledge, Florida, relies on the success of its provider-sponsored health plan (PSHP) as a critical asset. For Health First, the PSHP serves as an agent for holding and administering financial risk for the health of populations. In addition, we are learning that our PSHP is a critical asset in support of integrating the components of our care delivery system to manage that financial risk effectively, efficiently, and in a manner that creates a unified experience for the customer.Health First is challenged by continuing pressure on reimbursement, as well as by a substantial regulatory burden, as we work to optimize the environments and tools of care and population health management. Even with strong margins and a healthy balance sheet, we simply do not have the resources needed to bring an IDN robustly to life. However, we have discovered that our PSHP can be the vehicle that carries us to additional scale. Many health systems do not own or otherwise have access to a PSHP to hold and manage financial risk. Health First sought and found a not-for-profit health system with complementary goals and a strong brand to partner with, and we now provide private-label health plan products for that system using its strong name while operating the insurance functions under our license and with our capabilities.

  17. Integrated model for providing tactical emergency medicine support (TEMS): analysis of 120 tactical situations.

    Science.gov (United States)

    Vainionpää, T; Peräjoki, K; Hiltunen, T; Porthan, K; Taskinen, A; Boyd, J; Kuisma, M

    2012-02-01

    Various models for organising tactical emergency medicine support (TEMS) in law enforcement operations exist. In Helsinki, TEMS is organised as an integral part of emergency medical service (EMS) and applied in hostage, siege, bomb threat and crowd control situations and in other tactical situations after police request. Our aim was to analyse TEMS operations, patient profile, and the level of on-site care provided. We conducted a retrospective cohort study of TEMS operations in Helsinki from 2004 to 2009. Data were retrieved from EMS, hospital and dispatching centre files and from TEMS reports. One hundred twenty TEMS operations were analysed. Median time from dispatching to arrival on scene was 10 min [Interquartile Range (IQR) 7-14]. Median duration of operations was 41 min (IQR 19-63). Standby was the only activity in 72 operations, four patients were dead on arrival, 16 requests were called off en route and patient examination or care was needed in 28 operations. Twenty-eight patients (records retrieved) were alive on arrival and were classified as trauma (n = 12) or medical (n = 16). Of traumas, two sustained a gunshot wound, one sustained a penetrating abdominal wound, three sustained medium severity injuries and nine sustained minor injuries. There was neither on-scene nor in-hospital mortality among patients who were alive on arrival. The level of on-site care performed was basic life support in all cases. The results showed that TEMS integrated to daily EMS services including safe zone working only was a feasible, rapid and efficient way to provide medical support to law enforcement operations. © 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

  18. Successful Integration of Cooperative Groups: The Origin of the Children's Oncology Group.

    Science.gov (United States)

    Reaman, Gregory H

    2012-01-01

    In March 2000, the four legacy pediatric cooperative groups officially merged to become the Children's Oncology Group (COG). This was accomplished by the ratification of a new constitution by the respective executive committees and voting membership of the four legacy groups. The actual merger was preceded by a 12 to 18 month period of planning, negotiation, and transition, overseen by a Transition Committee of select executive leadership under the direction of the four current chairs of the existing pediatric groups. Despite the constant threat of budget reductions and questions related to the judicious use of National Cancer Institute (NCI) funds to support four pediatric groups when "children constitute only 3% of the US cancer problem," the decision to unify was initiated and driven internally. The merger was envisioned as an opportunity to create efficiency by reducing duplicative systems and processes, which was becoming increasingly apparent as more planned clinical trials required intergroup collaboration. It was also recognized that such intergroup efforts would become more of a reality as clinical trial paradigms were built on risk-adjusted approaches. Clinically, biologically, and molecularly defined homogeneous subgroups of patients were of insufficient sample size within each group to design and conduct studies within a reasonable time frame. In essence, this merger was motivated by an overwhelming sense of necessity to preserve our mission of defining and delivering compassionate and state-of-the-art care through scientific discovery. The merger process itself was challenging, time consuming, not supported by any supplemental funding, and at times painful. What has emerged as a result is the largest pediatric cancer research organization in the world. Accomplishments in epidemiology, biology, translational science, and improved clinical outcomes for some pediatric cancers would have never been achieved without the merger. The very fact that outcome

  19. Patient's and health care provider's perspectives on music therapy in palliative care - an integrative review.

    Science.gov (United States)

    Schmid, W; Rosland, J H; von Hofacker, S; Hunskår, I; Bruvik, F

    2018-02-20

    psycho-physiological well-being. The integration of the users´ and providers´ perspectives within future research applicable for example in mixed-methods designs is recommended.

  20. Information for Child Care Providers about Pesticides/Integrated Pest Management

    Science.gov (United States)

    Learn about pesticides/integrated pest management, the health effects associated with exposure to pests and pesticides, and the steps that can be taken to use integrated pest management strategies in childcare facilities.

  1. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age 26 Under... Information and Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage...

  2. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive Services... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in...

  3. Multimedia Bootcamp: a health sciences library provides basic training to promote faculty technology integration.

    Science.gov (United States)

    Ramsey, Ellen C

    2006-04-25

    Recent research has shown a backlash against the enthusiastic promotion of technological solutions as replacements for traditional educational content delivery. Many institutions, including the University of Virginia, have committed staff and resources to supporting state-of-the-art, showpiece educational technology projects. However, the Claude Moore Health Sciences Library has taken the approach of helping Health Sciences faculty be more comfortable using technology in incremental ways for instruction and research presentations. In July 2004, to raise awareness of self-service multimedia resources for instructional and professional development needs, the Library conducted a "Multimedia Bootcamp" for nine Health Sciences faculty and fellows. Case study. Program stewardship by a single Library faculty member contributed to the delivery of an integrated learning experience. The amount of time required to attend the sessions and complete homework was the maximum fellows had to devote to such pursuits. The benefit of introducing technology unfamiliar to most fellows allowed program instructors to start everyone at the same baseline while not appearing to pass judgment on the technology literacy skills of faculty. The combination of wrapping the program in the trappings of a fellowship and selecting fellows who could commit to a majority of scheduled sessions yielded strong commitment from participants as evidenced by high attendance and a 100% rate of assignment completion. Response rates to follow-up evaluation requests, as well as continued use of Media Studio resources and Library expertise for projects begun or conceived during Bootcamp, bode well for the long-term success of this program. An incremental approach to integrating technology with current practices in instruction and presentation provided a supportive yet energizing environment for Health Sciences faculty. Keys to this program were its faculty focus, traditional hands-on instruction, unrestricted

  4. Path integral quantization of the Symplectic Leaves of the SU(2)*Poisson-Lie Group

    International Nuclear Information System (INIS)

    Morariu, B.

    1997-01-01

    The Feynman path integral is used to quantize the symplectic leaves of the Poisson-Lie group SU(2)*. In this way we obtain the unitary representations of Uq(su(2)). This is achieved by finding explicit Darboux coordinates and then using a phase space path integral. I discuss the *-structure of SU(2)* and give a detailed description of its leaves using various parameterizations and also compare the results with the path integral quantization of spin

  5. Anaesthesiology as an integral part of Slovene partisan medical services provided during the second world war

    Directory of Open Access Journals (Sweden)

    Aleksander Manohin

    2006-01-01

    Full Text Available Background: The aim of this work was to describe the practice of anaesthesia in partisan military hospitals in Slovenia during the Second World War. The organisation of anaesthetic services delivered as an integral part of partisan medical care was unique in Europe and in the world. Healthcare givers exhibited a high level of professsional knowledge as well as exceptional resourcefulness, adaptability, and willigness to cope with physical and psychological demands of their work.Conclusions: During the Second World War, a number of healthcare facilities for treatment of wounded and severly ill soldiers, run by partisan forces, were established on the territory of Slovenia. The paper deals with the first and most important, Slovene central military partisan hospital in Kočevski Rog, and the best-known, Franja and Pavla Hospitals in Primorska region (Franja was proposed for entry in UNESCO’s list of World Heritage Sites. The authors used a large body of written documentation, as well as the testimony provided by the living witnesses of war events. The main characteristics of partisan fighting were constant movement of troops and absence of hinterland. Therefore, it was not possible to apply the basic principle of war medical services, i. e. to evacuate wounded soldiers to the hinterland through graded units of care. No handbooks on the organization of partisan medical services were available at the time, and there were no hard and fast rules for action. Frequently, healthcare had to be provided before any arrangements for the management of wounded soldiers had been made. The apparently unsolvable problems had to be solved on the spot. The paper gives information not only on anaesthesia but also on general conditions characteristic of that period. It is only in the light of this dramatically different situation that the role of anaesthetic services provided during the war can be understood correctly. The material is illustrated with more, mostly

  6. A Cooperative Learning Group Procedure for Improving CTE and Science Integration

    Science.gov (United States)

    Spindler, Matt

    2016-01-01

    The purpose of this case study was to create information about the employment of Cooperative Learning Groups (CLG) to enhance the science integrating learning objectives utilized in secondary CTE courses. The objectives of the study were to determine if CLGs were an effective means for increasing the number of: a) science integrating learning…

  7. An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education

    DEFF Research Database (Denmark)

    Stenov, Vibeke; Hempler, Nana Folmann; Reventlow, Susanne

    2017-01-01

    AIM: To investigate approaches among healthcare providers (HCPs) that support or hinder person-centredness in group-based diabetes education programmes targeting persons with type 2 diabetes. METHODS: Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes....... Applying person-centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person-centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person...

  8. The effect of integration of hospitals and post-acute care providers on Medicare payment and patient outcomes.

    Science.gov (United States)

    Konetzka, R Tamara; Stuart, Elizabeth A; Werner, Rachel M

    2018-02-07

    In this paper we examine empirically the effect of integration on Medicare payment and rehospitalization. We use 2005-2013 data on Medicare beneficiaries receiving post-acute care (PAC) in the U.S. to examine integration between hospitals and the two most common post-acute care settings: skilled nursing facilities (SNFs) and home health agencies (HHA), using two measures of integration-formal vertical integration and informal integration representing preferential relationships between providers without formal relationships. Our identification strategy is twofold. First, we use longitudinal models with a fixed effect for each hospital-PAC pair in a market to test how changes in integration impact patient outcomes. Second, we use an instrumental variable approach to account for patient selection into integrated providers. We find that vertical integration between hospitals and SNFs increases Medicare payments and reduces rehospitalization rates. However, vertical integration between hospitals and HHAs has little effect, nor does informal integration between hospitals and either PAC setting. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

  9. Improving the United States airline industry's capacity to provide safe and dignified services to travelers with disabilities: focus group findings.

    Science.gov (United States)

    McCarthy, Michael J

    2011-01-01

    As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.

  10. 76 FR 45248 - PJM Interconnection, L.L.C., PJM Power Providers Group v. PJM Interconnection, L.L.C...

    Science.gov (United States)

    2011-07-28

    ...-002; Docket No. EL11-20-001] PJM Interconnection, L.L.C., PJM Power Providers Group v. PJM Interconnection, L.L.C.; Supplemental Notice of Staff Technical Conference On June 13, 2011, the Commission issued... Resources Services, Inc., Maryland Public Service Commission, Monitoring Analytics, L.L.C., National Rural...

  11. 76 FR 39870 - PJM Interconnection, LLC; PJM Power Providers Group v. PJM Interconnection, LLC; Notice of Date...

    Science.gov (United States)

    2011-07-07

    .... EL11-20-001] PJM Interconnection, LLC; PJM Power Providers Group v. PJM Interconnection, LLC; Notice of... Sell Offers for Planned Generation Capacity Resources submitted into PJM's Reliability Pricing Model... presents an opportunity to exercise buyer market power; (2) whether the Fixed Resource Requirement (FRR...

  12. Emotional Literacy Support Assistants' Views on Supervision Provided by Educational Psychologists: What EPs Can Learn from Group Supervision

    Science.gov (United States)

    Osborne, Cara; Burton, Sheila

    2014-01-01

    The Educational Psychology Service in this study has responsibility for providing group supervision to Emotional Literacy Support Assistants (ELSAs) working in schools. To date, little research has examined this type of inter-professional supervision arrangement. The current study used a questionnaire to examine ELSAs' views on the supervision…

  13. Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalised older veterans.

    Science.gov (United States)

    Wu, Li-Fen

    2011-08-01

    The purpose of this study was to use group integrative reminiscence as a nursing intervention to evaluate the immediate effects on self-esteem, life satisfaction and depressive symptoms for a special group named 'institutionalised older veterans' after a 12-week intervention. The study group comprised institutionalised older veterans with combat experience, including being wounded in war and who were twice forced to relocate. The group participants had lower life satisfaction, and greater use for mental health services and greater non-specific health complaints were reported from this group. Reminiscence therapy has been considered an effective nursing intervention, but the effects on institutionalised older veterans have not been studied. A quasi-experimental design and purposive sampling were conducted. A total of 74 participants were studied with pre- and post-tests to measure the effect of group integrative reminiscence therapy. The activity was held once weekly for 12 weeks. The Life Satisfaction Index A, self-esteem scale and Geriatric Depression Scale Short Form were used as research tools, and the t-test, Fisher's exact test and generalised estimating equation were used for data analysis. All participants were male, with an average age of 81·34 years old, 91·9% unmarried and were in bad health. After 12 weeks of intervention, the reminiscence groups significantly improved their self-esteem and life satisfaction and decreased depressive symptoms compared with control groups. Group integrative reminiscence revealed immediate effects on improving the self-esteem and life satisfaction of institutionalised older veterans, and depressive symptoms were also decreased. Moreover, a sense of positive self-value and belonging to the institution was produced. Group integrative reminiscence is an applicable nursing intervention for vulnerable persons such as institutionalised older veterans. A structured protocol based on the characteristics of the residents and the

  14. Whether integrating refining and petrochemical business can provide opportunities for development of petrochemical industry in Serbia

    Directory of Open Access Journals (Sweden)

    Popović Zoran M.

    2016-01-01

    Full Text Available Since the beginning of 90s of last century both the petroleum industry and petrochemical industry have operated in difficult circumstances. In particularly, margins of petroleum and petrochemical industry were exacerbated during global economic crisis in 2008-2009 years. At that time, as one option that could be the solution, the global analysts had started to more intense investigate the benefits of Refining-Petrochemical Integration. Shortly afterwards, more and more petroleum refineries and petrochemical manufacturers began to see the future in this kind of operational, managerial, marketing and commercial connection. This paper evaluates, in particular, the achieved level of integration of refinery and petrochemical businesses in Central and South-Eastern Europe. And specifically, the paper identifies current capabilities and future chances of linking this kind of integration between Serbian refining and petrochemical players. The viability of integration between possible actors and benefits of every single refining-petrochemical interface in Serbia depend on many factors, and therefore each integrated system is unique and requires prior serious Cost Benefit Analysis.

  15. Quality of integrated chronic disease care in rural South Africa : user and provider perspectives

    NARCIS (Netherlands)

    Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier

    2017-01-01

    The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme

  16. Defining Intercloud Federation Framework for Multi-provider Cloud Services Integration

    NARCIS (Netherlands)

    Makkes, M.X.; Ngo, C.; Demchenko, Y.; Strijkers, R.J.; Meijer, R.J.; Laat, C. de

    2013-01-01

    This paper presents the on-going research to define the Intercloud Federation Framework (ICFF) which is a part of the general Intercloud Architecture Framework (ICAF) proposed by the authors. ICFF attempts to address the interoperability and integration issues in provisioning on-demand

  17. Do nurses provide a safe sleep environment for infants in the hospital setting? An integrative review.

    Science.gov (United States)

    Patton, Carla; Stiltner, Denise; Wright, Kelly Barnhardt; Kautz, Donald D

    2015-02-01

    Sudden infant death syndrome (SIDS) may be the most preventable cause of death for infants 0 to 6 months of age. The American Academy of Pediatrics (AAP) first published safe sleep recommendations for parents and healthcare professionals in 1992. In 1994, new guidelines were published and they became known as the "Back to Sleep" campaign. After this, a noticeable decline occurred in infant deaths from SIDS. However, this number seems to have plateaued with no continuing significant improvements in infant deaths. The objective of this review was to determine whether nurses provide a safe sleep environment for infants in the hospital setting. Research studies that dealt with nursing behaviors and nursing knowledge in the hospital setting were included in the review. A search was conducted of Google Scholar, CINAHL, PubMed, and Cochrane, using the key words "NICU," "newborn," "SIDS," "safe sleep environment," "nurse," "education," "supine sleep," "prone sleep," "safe sleep," "special care nursery," "hospital policy for safe sleep," "research," "premature," "knowledge," "practice," "health care professionals," and "parents." The review included research reports on nursing knowledge and behaviors as well as parental knowledge obtained through education and role modeling of nursing staff. Only research studies were included to ensure that our analysis was based on rigorous research-based findings. Several international studies were included because they mirrored findings noted in the United States. All studies were published between 1999 and 2012. Healthcare professionals and parents were included in the studies. They were primarily self-report surveys, designed to determine what nurses, other healthcare professionals, and parents knew or had been taught about SIDS. Integrative review. Thirteen of the 16 studies included in the review found that some nurses and some mothers continued to use nonsupine positioning. Four of the 16 studies discussed nursing knowledge and

  18. Information Interpretation Code For Providing Secure Data Integrity On Multi-Server Cloud Infrastructure

    OpenAIRE

    Sathiya Moorthy Srinivsan; Chandrasekar Chaillah

    2014-01-01

    Data security is one of the biggest concerns in cloud computing environment. Although the advantages of storing data in cloud computing environment is extremely high, there arises a problem related to data missing. CyberLiveApp (CLA) supports secure application development between multiple users, even though cloud users distinguish their vision privileges during storing of data. But CyberLiveApp failed to integrate the system with certain cloud-based computing environments on multi-server. En...

  19. Providing Power Supply to Other Use Cases Integrated in the System of Public Lighting

    OpenAIRE

    Perko, Jurica; Topić, Danijel; Šljivac, Damir

    2017-01-01

    Smart city is an attractive way of making the city more livable through intelligent solutions that are enabled by information and communication technology. Regarding the lighting system, it achieves the perfect balance between beautiful city ambience and preserving the darkness that makes cities more livable. As a smart city component, a public lighting system offers much more than light itself. Integration of other use cases has given a new dimension to the public lighting system in visual a...

  20. Dissecting stimulus-response binding effects: Grouping by color separately impacts integration and retrieval processes.

    Science.gov (United States)

    Laub, Ruth; Frings, Christian; Moeller, Birte

    2018-04-23

    In selection tasks, target and distractor features can be encoded together with the response into the same short-lived memory trace, or event file (see Hommel, 2004), leading to bindings between stimulus and response features. The repetition of a stored target or distractor feature can lead to the retrieval of the entire episode, including the response-so-called "binding effects." Binding effects due to distractor repetition are stronger for grouped than for nongrouped target and distractor stimulus configurations. Modulation of either of two mechanisms that lead to the observed binding effects might be responsible here: Grouping may influence either stimulus-response integration or stimulus-response retrieval. In the present study we investigated the influences of grouping on both mechanisms independently. In two experiments, target and distractor letters were grouped (or nongrouped) via color (dis)similarity separately during integration and retrieval. Grouping by color similarity affected integration and retrieval mechanisms independently and in different ways. Color dissimilarity enhanced distractor-based retrieval, whereas color similarity enhanced distractor integration. We concluded that stimulus grouping is relevant for binding effects, but that the mechanisms that contribute to binding effects should be carefully separated.

  1. Integration of an OWL-DL knowledge base with an EHR prototype and providing customized information.

    Science.gov (United States)

    Jing, Xia; Kay, Stephen; Marley, Tom; Hardiker, Nicholas R

    2014-09-01

    When clinicians use electronic health record (EHR) systems, their ability to obtain general knowledge is often an important contribution to their ability to make more informed decisions. In this paper we describe a method by which an external, formal representation of clinical and molecular genetic knowledge can be integrated into an EHR such that customized knowledge can be delivered to clinicians in a context-appropriate manner.Web Ontology Language-Description Logic (OWL-DL) is a formal knowledge representation language that is widely used for creating, organizing and managing biomedical knowledge through the use of explicit definitions, consistent structure and a computer-processable format, particularly in biomedical fields. In this paper we describe: 1) integration of an OWL-DL knowledge base with a standards-based EHR prototype, 2) presentation of customized information from the knowledge base via the EHR interface, and 3) lessons learned via the process. The integration was achieved through a combination of manual and automatic methods. Our method has advantages for scaling up to and maintaining knowledge bases of any size, with the goal of assisting clinicians and other EHR users in making better informed health care decisions.

  2. Integrating CHWs as Part of the Team Leading Diabetes Group Visits: A Randomized Controlled Feasibility Study.

    Science.gov (United States)

    Vaughan, Elizabeth M; Johnston, Craig A; Cardenas, Victor J; Moreno, Jennette P; Foreyt, John P

    2017-12-01

    Purpose The purpose of the study was to evaluate the feasibility of integrating Community Health Workers (CHWs) as part of the team leading diabetes group visits. Methods This was a randomized controlled study that integrated CHWs as part of the team leading diabetes group visits for low-income Hispanic adults (n = 50). Group visits met for 3 hours each month for a 6-month duration. Main measures included baseline and 6-month clinical outcomes (ie, A1C, lipids), concordance with 8 standard of care guidelines (ie, screens for cervical, breast, and colon cancer) from the US Preventive Task Force and American Diabetes Association, and participant acceptability. Results Compared to control participants, the intervention group resulted in significantly better clinical outcomes or guideline concordance for the following areas: target A1C levels, retinal eye exams, diabetes foot exams, mammograms, and urine microalbumin. Significantly more individuals in the control group gained weight, whereas a greater number of participants in the intervention group lost weight. Intervention participants found the group visits highly acceptable. Conclusions Integrating CHWs as part a comprehensive diabetes group visit program is a feasible and effective system-level intervention to improve glycemic control and achieve guideline concordance.

  3. Role of Third Party Logistics Providers with Advanced it to Increase Customer Satisfaction in Supply Chain Integration

    OpenAIRE

    Zaryab Sheikh; Shafaq Rana

    2012-01-01

    The main area of change in organizational strategy is the extensive use of third party logistics providers who are using advanced information technology tools and integration of supply chain to enhance customer satisfaction. By outsourcing the logistics operations, companies can focus on their core competencies and other important areas of organization which can’t be outsourced. The analysis of this paper is conducted by discussing different concepts of supply chain integration, customer sati...

  4. New approach to the adjustment of group cross sections fitting integral measurements - 2

    International Nuclear Information System (INIS)

    Chao, Y.A.

    1980-01-01

    The method developed in the first paper concerning group cross sections fitting integral measurements is generalized to cover the case when the source of the extracted negligence discrepancy cannot be identified and the theoretical relation between the integral and differential measurements is also subject to uncertainty. The question of how to divide in such a case the negligence discrepancy between the integral and differential data is resolved. Application to a specific problem with real experimental data is shown as a demonstration of the method. 4 refs

  5. Literacy and Technology: Integrating Technology with Small Group, Peer-led Discussions of Literature

    Directory of Open Access Journals (Sweden)

    Genya Coffey

    2012-03-01

    Full Text Available This review examines research of computer-mediated small group discussion of literature. The goal of this review is to explore several instructional formats for integrating print-based and new literacies skills. First, the theoretical foundations for the shift from teacher-led to student led discussion are outlined. Research exploring ways in which technology has been infused into several common elements of literature discussion groups are presented next. Benefits and challenges of such integration are highlighted and suggestions for future research are presented.

  6. Integrating Modeling and Monitoring to Provide Long-Term Control of Contaminants

    International Nuclear Information System (INIS)

    Fogwell, Th.

    2009-01-01

    An introduction is presented of the types of problems that exist for long-term control of radionuclides at DOE sites. A breakdown of the distributions at specific sites is given, together with the associated difficulties. A paradigm for remediation showing the integration of monitoring with modeling is presented. It is based on a feedback system that allows for the monitoring to act as principal sensors in a control system. Currently the establishment of a very prescriptive monitoring program fails to have a mechanism for improving models and improving control of the contaminants. The resulting system can be optimized to improve performance. Optimizing monitoring automatically entails linking the monitoring with modeling. If monitoring designs were required to be more efficient, thus requiring optimization, then the monitoring automatically becomes linked to modeling. Records of decision could be written to accommodate revisions in monitoring as better modeling evolves. The technical pieces of the required paradigm are already available; they just need to be implemented and applied to solve the long-term control of the contaminants. An integration of the various parts of the system is presented. Each part is described, and examples are given. References are given to other projects which bring together similar elements in systems for the control of contaminants. Trends are given for the development of the technical features of a robust system. Examples of monitoring methods for specific sites are given. The examples are used to illustrate how such a system would work. Examples of technology needs are presented. Finally, other examples of integrated modeling-monitoring approaches are presented. (authors)

  7. Interactions between parents of technology-dependent children and providers: an integrative review.

    Science.gov (United States)

    Jachimiec, Jennifer A; Obrecht, Jennifer; Kavanaugh, Karen

    2015-03-01

    This article is a review of the literature on the experiences of parents and their interactions with healthcare providers while caring for their technology-dependent child(ren) in their homes. Results are presented in the following themes: information needs, respect and partnership with healthcare providers, care coordination, and experiences with home healthcare nurses. Parents needed information and guidance and felt supported when providers recognized parents' expertise with the child's care, and offered reassurance and confirmation about their practices. Home healthcare clinicians provided supportive care in the home, but their presence created challenges for the family. By acknowledging and valuing the parents' expertise, healthcare providers can empower parents to confidently care for their child.

  8. Does Environmental Enrichment Reduce Stress? An Integrated Measure of Corticosterone from Feathers Provides a Novel Perspective

    Science.gov (United States)

    Fairhurst, Graham D.; Frey, Matthew D.; Reichert, James F.; Szelest, Izabela; Kelly, Debbie M.; Bortolotti, Gary R.

    2011-01-01

    Enrichment is widely used as tool for managing fearfulness, undesirable behaviors, and stress in captive animals, and for studying exploration and personality. Inconsistencies in previous studies of physiological and behavioral responses to enrichment led us to hypothesize that enrichment and its removal are stressful environmental changes to which the hormone corticosterone and fearfulness, activity, and exploration behaviors ought to be sensitive. We conducted two experiments with a captive population of wild-caught Clark's nutcrackers (Nucifraga columbiana) to assess responses to short- (10-d) and long-term (3-mo) enrichment, their removal, and the influence of novelty, within the same animal. Variation in an integrated measure of corticosterone from feathers, combined with video recordings of behaviors, suggests that how individuals perceive enrichment and its removal depends on the duration of exposure. Short- and long-term enrichment elicited different physiological responses, with the former acting as a stressor and birds exhibiting acclimation to the latter. Non-novel enrichment evoked the strongest corticosterone responses of all the treatments, suggesting that the second exposure to the same objects acted as a physiological cue, and that acclimation was overridden by negative past experience. Birds showed weak behavioral responses that were not related to corticosterone. By demonstrating that an integrated measure of glucocorticoid physiology varies significantly with changes to enrichment in the absence of agonistic interactions, our study sheds light on potential mechanisms driving physiological and behavioral responses to environmental change. PMID:21412426

  9. An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education.

    Science.gov (United States)

    Stenov, Vibeke; Hempler, Nana Folmann; Reventlow, Susanne; Wind, Gitte

    2017-08-22

    To investigate approaches among healthcare providers (HCPs) that support or hinder person-centredness in group-based diabetes education programmes targeting persons with type 2 diabetes. Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes included 21 participants and 10 HCPs and were observed over 5 weeks. Additionally, 10 in-depth semi-structured interviews were conducted with patients (n = 7) and HCPs (n = 3). Data were analysed using systematic text condensation. Hindering approaches included a teacher-centred focus on delivering disease-specific information. Communication was dialog based, but HCPs primarily asked closed-ended questions with one correct answer. Additional hindering approaches included ignoring participants with suboptimal health behaviours and a tendency to moralize that resulted in feelings of guilt among participants. Supporting approaches included letting participants set the agenda using broad, open-ended questions. Healthcare providers are often socialized into a biomedical approach and trained to be experts. However, person-centredness involves redefined roles and responsibilities. Applying person-centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person-centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person-centred approaches in a group context. Teacher-centredness undermined person-centredness because HCPs primarily delivered disease-specific recommendations, leading to biomedical information overload for participants. © 2017 Nordic College of Caring Science.

  10. Experiences and meanings of integration of TCAM (Traditional, Complementary and Alternative Medical) providers in three Indian states: results from a cross-sectional, qualitative implementation research study.

    Science.gov (United States)

    Nambiar, D; Narayan, V V; Josyula, L K; Porter, J D H; Sathyanarayana, T N; Sheikh, K

    2014-11-25

    Efforts to engage Traditional, Complementary and Alternative Medical (TCAM) practitioners in the public health workforce have growing relevance for India's path to universal health coverage. We used an action-centred framework to understand how policy prescriptions related to integration were being implemented in three distinct Indian states. Health departments and district-level primary care facilities in the states of Kerala, Meghalaya and Delhi. In each state, two or three districts were chosen that represented a variation in accessibility and distribution across TCAM providers (eg, small or large proportions of local health practitioners, Homoeopaths, Ayurvedic and/or Unani practitioners). Per district, two blocks or geographical units were selected. TCAM and allopathic practitioners, administrators and representatives of the community at the district and state levels were chosen based on publicly available records from state and municipal authorities. A total of 196 interviews were carried out: 74 in Kerala, and 61 each in Delhi and Meghalaya. We sought to understand experiences and meanings associated with integration across stakeholders, as well as barriers and facilitators to implementing policies related to integration of Traditional, Complementary and Alternative (TCA) providers at the systems level. We found that individual and interpersonal attributes tended to facilitate integration, while system features and processes tended to hinder it. Collegiality, recognition of stature, as well as exercise of individual personal initiative among TCA practitioners and of personal experience of TCAM among allopaths enabled integration. The system, on the other hand, was characterised by the fragmentation of jurisdiction and facilities, intersystem isolation, lack of trust in and awareness of TCA systems, and inadequate infrastructure and resources for TCA service delivery. State-tailored strategies that routinise interaction, reward individual and system

  11. Perspectives on Research Participation and Facilitation Among Dialysis Patients, Clinic Personnel, and Medical Providers: A Focus Group Study.

    Science.gov (United States)

    Flythe, Jennifer E; Narendra, Julia H; Dorough, Adeline; Oberlander, Jonathan; Ordish, Antoinette; Wilkie, Caroline; Dember, Laura M

    2017-12-19

    Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers. We also sought to elucidate stakeholder preferences for research communication. Qualitative study. 7 focus groups (59 participants: 8 clinic managers, 14 nurses/patient care technicians, 8 social workers/dietitians, 11 nephrologists/advanced practice providers, and 18 patients/care partners) from 7 North Carolina dialysis clinics. Clinics and participants were purposively sampled. Focus groups were recorded and transcribed. Thematic analysis. We identified 11 themes that captured barriers to and facilitators of research participation by patients and research facilitation by clinic personnel and medical providers. We collapsed these themes into 4 categories to create an organizational framework for considering stakeholder (narrow research understanding, competing personal priorities, and low patient literacy and education levels), relationship (trust, buy-in, and altruistic motivations), research design (convenience, follow-up, and patient incentives), and dialysis clinic (professional demands, teamwork, and communication) aspects that may affect stakeholder interest in participating in or facilitating research. These themes appear to shape the degree of research readiness of a dialysis clinic environment. Participants preferred short research communications delivered in multiple formats. Potential selection bias and inclusion of English-speaking participants only. Our findings

  12. SPAN: A Network Providing Integrated, End-to-End, Sensor-to-Database Solutions for Environmental Sciences

    Science.gov (United States)

    Benzel, T.; Cho, Y. H.; Deschon, A.; Gullapalli, S.; Silva, F.

    2009-12-01

    In recent years, advances in sensor network technology have shown great promise to revolutionize environmental data collection. Still, wide spread adoption of these systems by domain experts has been lacking, and these have remained the purview of the engineers who design them. While there are many data logging options for basic data collection in the field currently, scientists are often required to visit the deployment sites to retrieve their data and manually import it into spreadsheets. Some advanced commercial software systems do allow scientists to collect data remotely, but most of these systems only allow point-to-point access, and require proprietary hardware. Furthermore, these commercial solutions preclude the use of sensors from other manufacturers or integration with internet based database repositories and compute engines. Therefore, scientists often must download and manually reformat their data before uploading it to the repositories if they wish to share their data. We present an open-source, low-cost, extensible, turnkey solution called Sensor Processing and Acquisition Network (SPAN) which provides a robust and flexible sensor network service. At the deployment site, SPAN leverages low-power generic embedded processors to integrate variety of commercially available sensor hardware to the network of environmental observation systems. By bringing intelligence close to the sensed phenomena, we can remotely control configuration and re-use, establish rules to trigger sensor activity, manage power requirements, and control the two-way flow of sensed data as well as control information to the sensors. Key features of our design include (1) adoption of a hardware agnostic architecture: our solutions are compatible with several programmable platforms, sensor systems, communication devices and protocols. (2) information standardization: our system supports several popular communication protocols and data formats, and (3) extensible data support: our

  13. Health care providers' perceived barriers to and need for the implementation of a national integrated health care standard on childhood obesity in the Netherlands - a mixed methods approach.

    Science.gov (United States)

    Schalkwijk, Annemarie A H; Nijpels, Giel; Bot, Sandra D M; Elders, Petra J M

    2016-03-08

    In 2010, a national integrated health care standard for (childhood) obesity was published and disseminated in the Netherlands. The aim of this study is to gain insight into the needs of health care providers and the barriers they face in terms of implementing this integrated health care standard. A mixed-methods approach was applied using focus groups, semi-structured, face-to-face interviews and an e-mail-based internet survey. The study's participants included: general practitioners (GPs) (focus groups); health care providers in different professions (face-to-face interviews) and health care providers, including GPs; youth health care workers; pediatricians; dieticians; psychologists and physiotherapists (survey). First, the transcripts from the focus groups were analyzed thematically. The themes identified in this process were then used to analyze the interviews. The results of the analysis of the qualitative data were used to construct the statements used in the e-mail-based internet survey. Responses to items were measured on a 5-point Likert scale and were categorized into three outcomes: 'agree' or 'important' (response categories 1 and 2), 'disagree' or 'not important'. Twenty-seven of the GPs that were invited (51 %) participated in four focus groups. Seven of the nine health care professionals that were invited (78 %) participated in the interviews and 222 questionnaires (17 %) were returned and included in the analysis. The following key barriers were identified with regard to the implementation of the integrated health care standard: reluctance to raise the subject; perceived lack of motivation and knowledge on the part of the parents; previous negative experiences with lifestyle programs; financial constraints and the lack of a structured multidisciplinary approach. The main needs identified were: increased knowledge and awareness on the part of both health care providers and parents/children; a social map of effective intervention; structural

  14. Group theoretical symmetries and generalized Bäcklund transformations for integrable systems

    Science.gov (United States)

    Haak, Guido

    1994-05-01

    A notion of symmetry for 1+1-dimensional integrable systems is presented which is consistent with their group theoretic description. It is shown how a group symmetry may be used together with a dynamical reduction to produce new generalizations of the Bäcklund transformation for the Korteweg-de Vries equation to its SL(n,C) generalization. An additional application to the relativistic invariance of the Leznov-Saveliev systems is given.

  15. Nevada Applied Ecology Information Center: a review of technical information support provided to the Nevada Applied Ecology Group

    International Nuclear Information System (INIS)

    Fore, C.S.; Pfuderer, H.A.

    1983-01-01

    The Nevada Applied Ecology Information Center (NAEIC) was established in January 1972 to serve the needs of the Nevada Applied Ecology Group (NAEG) by identifying, collecting, analyzing, and disseminating technical information relevant to NAEG programs. Since its inception, the NAEIC has been active in providing specialized information support to NAEG staff in the following research areas: (1) environmental aspects of the transuranics; (2) historic literature (pre-1962) on plutonium and uranium; (3) cleanup and treatment of radioactively contaminated land; (4) bioenvironmental aspects of europium and rhodium; (5) NAEG contractor reports; and (6) uptake of radioactivity by food crops

  16. Basis of integrated approach to sports and recreational activities of students of special medical groups

    Directory of Open Access Journals (Sweden)

    L.V. Zaharova

    2014-02-01

    Full Text Available Purpose : to prove the superiority of techniques integrated approach to sports and recreational activities of students of special medical groups in the educational institution. Material / methods : the annual pedagogical experiment conducted on three groups that have been formed based on the results of preliminary studies based on diagnosis. Learning process based on the principle of improving training. Results : the advantages of an integrated approach to sports and recreational activities of students with disorders of the musculoskeletal system. Recommended approaches to increase physical and functional training. Also - the formation of a stable demand of motor activity, leading healthy lifestyles, in the acquisition of social status in the educational activity. Conclusions : the integrated approach will meet the educational needs of students to form a cultural competence of the individual in the preservation and conservation of health, ability to adapt and successfully implement their professional activities.

  17. Combining Identity and Integration: Comparative Analysis of Schools for Two Minority Groups in Ukraine

    Science.gov (United States)

    Kulyk, Volodymyr

    2013-01-01

    This article analyses school systems for two of Ukraine's minorities, the Hungarians and the Crimean Tatars with the aim of assessing their success in promoting ethnocultural identity and social integration of the minority youth. I demonstrate that the exclusive instruction in Hungarian ensures the reproduction of group language knowledge and…

  18. Owning Up to Negative Ingroup Traits: How Personal Autonomy Promotes the Integration of Group Identity.

    Science.gov (United States)

    Legault, Lisa; Weinstein, Netta; Mitchell, Jahlil; Inzlicht, Michael; Pyke, Kristen; Upal, Afzal

    2017-10-01

    Our experiences, attributes, and behaviors are diverse, inconsistent, and often negative. Consequently, our capacity to assimilate divergent experiences-particularly negative aspects-is important to the development of a unified self. Whereas this process of integration has received attention at the level of personal identity, it has not been assessed at the level of group identity. We examined the mechanisms involved in integrating positive and negative ingroup identities, as well as related outcomes. In three experiments, participants (N = 332) high and low in autonomy identified either positive or negative aspects of their ingroup and then indicated the extent to which they integrated the attribute. Those high in personal autonomy integrated both positive and negative identities, whereas those low in autonomy acknowledged only positive identities. Study 2 showed that, regardless of identity valence, those high in autonomy felt satisfied and close with their group. Conversely, those low in autonomy felt less close and more dissatisfied with their group after reflecting on negative identities. Finally, reflecting on a negative identity reduced prejudice, but only for those high in autonomy. Owning up to negative group traits is facilitated by autonomy and demonstrates benefits for ingroup and intergroup processes. © 2016 Wiley Periodicals, Inc.

  19. Developing an Integrative Play Therapy Group Model for Middle School Male Students to Address Bullying Behaviors

    Science.gov (United States)

    Jordan, Jakarla

    2016-01-01

    This research examines the systematic process of developing an integrative play therapy group model for middle school male students, ages 11-15 who participate in bullying behaviors. Play therapy approaches and evidence-based practices are documented as effective measures for addressing bullying behaviors with children and adolescents. This group…

  20. Integrating a social network group with a 3D collaborative learning environment

    NARCIS (Netherlands)

    Pourmirza, S.; Gardner, M.; Callaghan, V; Augusto, J.C.; Zhang, T.

    2014-01-01

    Although extensive research has been carried out on virtual learning environments and the role of groups and communities in social networks, few studies exist which adequately cover the relationship between these two domains. In this paper, the authors demonstrate the effectiveness of integrating

  1. Integration Processes of a Romanian Group in a Huelva Village through Family Life Stories

    Science.gov (United States)

    Díaz-Reales, Antonia-María; Aguaded-Gómez, Ignacio

    2015-01-01

    This paper examines the integration of Romanian immigrants in Lucena del Puerto (Huelva, Spain) through the life stories of two families of Romanian origin. The experiences of the groups presented in this study were analyzed. Both families were in the town for work, to grow and harvest strawberries. We observed a contrast between idealistic views…

  2. An Integral Representation of Standard Automorphic L Functions for Unitary Groups

    Directory of Open Access Journals (Sweden)

    Yujun Qin

    2007-01-01

    Full Text Available Let F be a number field, G a quasi-split unitary group of rank n. We show that given an irreducible cuspidal automorphic representation π of G(A, its (partial L function LS(s,π,σ can be represented by a Rankin-Selberg-type integral involving cusp forms of π, Eisenstein series, and theta series.

  3. Chaotic Feedback Loops within Decision Making Groups: Towards an Integration of Chaos Theory and Cybernetics.

    Science.gov (United States)

    Keaten, James A.

    This paper offers a model that integrates chaos theory and cybernetics, which can be used to describe the structure of decision making within small groups. The paper begins with an overview of cybernetics and chaos. Definitional characteristics of cybernetics are reviewed along with salient constructs, such as goal-seeking, feedback, feedback…

  4. Polarization and Persuasion: Integrating the Elaboration Likelihood Model with Explanations of Group Polarization.

    Science.gov (United States)

    Mongeau, Paul A.

    Interest has recently focused on group polarization as a function of attitude processes. Several recent reviewers have challenged polarization researchers to integrate the explanations of polarization to existing theories of attitude change. This review suggests that there exists a clear similarity between the social comparison and persuasive…

  5. The effect of financing hospital health care providers through updated Diagnosis Related Groups. Case studies: the municipal hospitals in Romania

    Directory of Open Access Journals (Sweden)

    Emil OLTEANU

    2014-11-01

    Full Text Available In our scientific approach we tried to develop a model with which to highlight the effect of financing hospital health care providers using the hospital 's Diagnosis Related Groups (DRG and Mean Relative Values (MRV. The econometric model used is simple linear regression model form. Development of the model was performed by using the EViews 7 to the municipal hospitals in Romania during 2010 - 2012, being considered DRG dependent variable and independent variables: C and MRV. Analyzing in detail the results recorded by providers following simple regression model is observed that there are units which, although recorded low values in the number of patients discharged, they were able to achieve a relatively high VRM or to contract a level of TAC over average of the entire sample.

  6. An integrated decision making model for the selection of sustainable forward and reverse logistic providers

    DEFF Research Database (Denmark)

    Govindan, Kannan; Agarwal, Vernika; Darbari, Jyoti Dhingra

    2017-01-01

    Due to rising concerns for environmental sustainability, the Indian electronic industry faces immense pressure to incorporate effective sustainable practices into the supply chain (SC) planning. Consequently, manufacturing enterprises (ME) are exploring the option of re-examining their SC...... strategies and taking a formalized approach towards a sustainable partnership with logistics providers. To begin with, it is imperative to associate with sustainable forward and reverse logistics providers to manage effectively the upward and downstream flows simultaneously. In this context, this paper...... improve the sustainable performance value of the SC network and secure reasonable profits. The managerial implications drawn from the result analysis provide a sustainable framework to the ME for enhancing its corporate image....

  7. Science in Sync: Integrating Science with Literacy Provides Rewarding Learning Opportunities in Both Subjects

    Science.gov (United States)

    Wallace, Carolyn S.; Coffey, Debra

    2016-01-01

    The "Next Generation Science Standards'" ("NGSS") eight scientific and engineering practices invite teachers to develop key investigative skills while addressing important disciplinary science ideas (NGSS Lead States 2013). The "NGSS" can also provide direct links to "Common Core English Language Arts…

  8. Integrating inventory control and capacity management at a maintenance service provider

    NARCIS (Netherlands)

    Buyukkaramikli, N.C.; Ooijen, van H.P.G.; Bertrand, J.W.M.

    2015-01-01

    In this paper, we study the capacity flexibility problem of a maintenance service provider, who is running a repair shop and is responsible for the availability of numerous specialized systems which contain a critical component that is prone to failure. Upon a critical component failure, the

  9. Integrating Family as a Discipline by Providing Parent Led Curricula: Impact on LEND Trainees' Leadership Competency.

    Science.gov (United States)

    Keisling, Bruce L; Bishop, Elizabeth A; Roth, Jenness M

    2017-05-01

    Background While the MCH Leadership Competencies and family as a discipline have been required elements of Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs for over a decade, little research has been published on the efficacy of either programmatic component in the development of the next generation of leaders who can advocate and care for Maternal and Child Health (MCH) populations. Objective To test the effectiveness of integrating the family discipline through implementation of parent led curricula on trainees' content knowledge, skills, and leadership development in family-centered care, according to the MCH Leadership Competencies. Methods One hundred and two long-term (≥ 300 h) LEND trainees completed a clinical and leadership training program which featured intensive parent led curricula supported by a full-time family faculty member. Trainees rated themselves on the five Basic and Advanced skill items that comprise MCH Leadership Competency 8: Family-centered Care at the beginning and conclusion of their LEND traineeship. Results When compared to their initial scores, trainees rated themselves significantly higher across all family-centered leadership competency items at the completion of their LEND traineeship. Conclusions The intentional engagement of a full-time family faculty member and parent led curricula that include didactic and experiential components are associated with greater identification and adoption by trainees of family-centered attitudes, skills, and practices. However, the use of the MCH Leadership Competencies as a quantifiable measure of program evaluation, particularly leadership development, is limited.

  10. Nuclear reactors in de-regulated markets: Integration between providers and customers?

    International Nuclear Information System (INIS)

    Girard, Philippe

    2006-01-01

    The deregulation of electricity markets has in most cases coincided with the end of state monopolies, where financial risks were borne by customers/citizens. Today, despite an economic advantage, nuclear power development faces two main problems: public acceptance and reticence of investors (banks, utilities shareholders). The development of electricity markets provides different financial instruments in order to hedge financial risks, but it is currently difficult to fix forward contracts for more than three to four years, and this period is insufficient for the financing of a nuclear reactor. A solution could be the evolution of nuclear providers into nuclear operators selling electricity (MWh) rather than selling nuclear capacity (MW), nuclear fuel and services. In this case, their customers would be utilities and big customers aiming to hedge a part of their supplies with long-term contracts or stakes in nuclear reactors without some nuclear constraints. (author)

  11. Falls prevention among older people and care providers: protocol for an integrative review

    OpenAIRE

    Cuesta Benjumea, Carmen de la; Henriques, Maria Adriana; Abad Corpa, Eva; Roe, Brenda; Orts-Cortés, María Isabel; Lidón-Cerezuela, Beatriz; Avendaño-Céspedes, Almudena; Oliver-Carbonell, José Luis; Sánchez Ardila, Carmen

    2017-01-01

    Aim. To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions. Background. Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes ...

  12. Interval-Valued Intuitionistic Fuzzy Multicriteria Group Decision Making Based on VIKOR and Choquet Integral

    Directory of Open Access Journals (Sweden)

    Chunqiao Tan

    2013-01-01

    Full Text Available An effective decision making approach based on VIKOR and Choquet integral is developed to solve multicriteria group decision making problem with conflicting criteria and interdependent subjective preference of decision makers in a fuzzy environment where preferences of decision makers with respect to criteria are represented by interval-valued intuitionistic fuzzy sets. First, an interval-valued intuitionistic fuzzy Choquet integral operator is given. Some of its properties are investigated in detail. The extended VIKOR decision procedure based on the proposed operator is developed for solving the multicriteria group decision making problem where the interactive criteria weight is measured by Shapley value. An illustrative example is given for demonstrating the applicability of the proposed decision procedure for solving the multi-criteria group decision making problem in interval-valued intuitionistic fuzzy environment.

  13. Effect of difference between group constants processed by codes TIMS and ETOX on integral quantities

    International Nuclear Information System (INIS)

    Takano, Hideki; Ishiguro, Yukio; Matsui, Yasushi.

    1978-06-01

    Group constants of 235 U, 238 U, 239 Pu, 240 Pu and 241 Pu have been produced with the processing code TIMS using the evaluated nuclear data of JENDL-1. The temperature and composition dependent self-shielding factors have been calculated for the two cases with and without considering mutual interference resonant nuclei. By using the group constants set produced by the TIMS code, the integral quantities, i.e. multiplication factor, Na-void reactivity effect and Doppler reactivity effect, are calculated and compared with those calculated with the use of the cross sections set produced by the ETOX code to evaluate accuracy of the approximate calculation method in ETOX. There is much difference in self-shielding factor in each energy group between the two codes. For the fast reactor assemblies under study, however, the integral quantities calculated with these two sets are in good agreement with each other, because of eventual cancelation of errors. (auth.)

  14. A payer-provider partnership for integrated care of patients receiving dialysis.

    Science.gov (United States)

    Kindy, Justin; Roer, David; Wanovich, Robert; McMurray, Stephen

    2018-04-01

    Patients with end-stage renal disease (ESRD) are clinically complex, requiring intensive and costly care. Coordinated care may improve outcomes and reduce costs. The objective of this study was to determine the impact of a payer-provider care partnership on key clinical and economic outcomes in enrolled patients with ESRD.  Retrospective observational study. Data on patient demographics and clinical outcomes were abstracted from the electronic health records of the dialysis provider. Data on healthcare costs were collected from payer claims. Data were collected for a baseline period prior to initiation of the partnership (July 2011-June 2012) and for two 12-month periods following initiation (April 2013-March 2014 and April 2014-March 2015). Among both Medicare Advantage and commercial insurance program members, the rate of central venous catheter use for vascular access was lower following initiation of the partnership compared with the baseline period. Likewise, hospital admission rates, emergency department visit rates, and readmission rates were lower following partnership initiation. Rates of influenza and pneumococcal vaccination were higher than 95% throughout all 3 time periods. Total medical costs were lower for both cohorts of members in the second 12-month period following partnership initiation compared with the baseline period. Promising trends were observed among members participating in this payer-provider care partnership with respect to both clinical and economic outcomes. This suggests that collaborations with shared incentives may be a valuable approach for patients with ESRD.

  15. Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups: a case study.

    Science.gov (United States)

    Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, Bert

    2015-08-21

    Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two Dutch care groups. An embedded single case study was conducted including 26 interviews with management staff, care purchasers and health professionals. The Context + Mechanism = Outcome Model was used to study the relationship between context factors, mechanisms and outcomes. Dutch integrated care involves care groups, bundled payments, patient involvement, health professional cooperation and task substitution, evidence-based care protocols and a shared clinical information system. Community involvement is not (yet) part of Dutch integrated care. Barriers to the implementation of integrated care included insufficient integration between the patient databases, decreased earnings for some health professionals, patients' insufficient medical and policy-making expertise, resistance by general practitioner assistants due to perceived competition, too much care provided by practice nurses instead of general practitioners and the funding system incentivising the provision of care exactly as described in the care protocols. Facilitators included performance monitoring via the care chain information system, increased earnings for some health professionals, increased focus on self-management, innovators in primary and secondary care, diabetes nurses acting as integrators and financial incentives for guideline adherence. Economic and political context and health IT-related barriers were discussed as the most problematic areas of integrated care implementation. The implementation of integrated care led to improved communication and cooperation but also to insufficient and unnecessary care provision and deteriorated preconditions for person-centred care. Dutch integrated diabetes care is still a

  16. Hypertension management research priorities from patients, caregivers, and healthcare providers: A report from the Hypertension Canada Priority Setting Partnership Group.

    Science.gov (United States)

    Khan, Nadia; Bacon, Simon L; Khan, Samia; Perlmutter, Sara; Gerlinsky, Carline; Dermer, Mark; Johnson, Lonni; Alves, Finderson; McLean, Donna; Laupacis, Andreas; Pui, Mandy; Berg, Angelique; Flowitt, Felicia

    2017-11-01

    Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care. ©2017 Wiley Periodicals, Inc.

  17. Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout.

    Science.gov (United States)

    Dreison, Kimberly C; White, Dominique A; Bauer, Sarah M; Salyers, Michelle P; McGuire, Alan B

    2018-01-01

    Limited progress has been made in reducing burnout in mental health professionals. Accordingly, we identified factors that might protect against burnout and could be productive focal areas for future interventions. Guided by self-determination theory, we examined whether supervisor autonomy support, self-efficacy, and staff cohesion predict provider burnout. 358 staff from 13 agencies completed surveys. Higher levels of supervisor autonomy support, self-efficacy, and staff cohesion were predictive of lower burnout, even after accounting for job demands. Although administrators may be limited in their ability to reduce job demands, our findings suggest that increasing core job resources may be a viable alternative.

  18. Integrating Project Management, Product Design with Industry Sponsored Projects provides Stimulating Senior Capstone Experiences

    Directory of Open Access Journals (Sweden)

    Phillip A. Sanger

    2011-07-01

    Full Text Available

    Abstract ¾ Many students are uncomfortable with real world engineering problems where needs and requirements must be concretely defined and the selection of design solutions is not black and white. This paper describes a two semester, multi-disciplinary senior capstone project for students from three Engineering and Technology Department programs (electrical engineering, electrical and computer engineering technology, and engineering technology that brings together the tools of project management and the creative product development process into industry sponsored projects.  The projects are fully integrated with the Center for Rapid Product Realization with its dual goals of economic development and enhanced learning.  The stage/gate development process is used with six formal reviews covering the development of the proposal through to the fabrication and testing of the project’s output.  Over the past four years thirty five (35 projects have been undertaken with students getting an exciting

  19. Integration of children school age with ADHD in to a peer group

    OpenAIRE

    Zemanová, Hana

    2012-01-01

    This work is focussed on the integration of the children with ADHD into the peer group. Its target is to find out, if the integration proceeds and if it satisfies the children, the parents and the teachers. There's the issue of the ADHD, history of this term, the manifestations, the etiology, and the diagnostics by MKN-10 and DSM-IV and terminology explained. The applied part was realized through the use of the questionaries fullfiled bz the children with ADHD, their parents and the teachers ...

  20. From Introduction to Integration: Providing Community-Engaged Structure for Interprofessional Education

    Directory of Open Access Journals (Sweden)

    Daniel P. Griffin

    2016-01-01

    Full Text Available Background Training future healthcare profession students using interprofessional education (IPE is critical to improve quality of health care and patient safety. Objective The objective of this study was to implement an IPE program and determine student satisfaction with each session, including a clinical case requiring teams with members from each profession addressing clinical scenarios. Subjects The subjects of this study were students from Athletic Training, Medicine, Nursing, Pharmacy, Physical Therapy, Physician Assistant, Social Work, and Speech-Language Pathology. Methods Evaluations, administered to all participating students, consisted of Likert-style responses, rating agreement with a series of questions, and space for descriptive comments. Score differences for each question were compared using independent group t -tests with a P -value of 0.05 to determine statistical significance. Results There were statistically higher satisfaction ratings for the problem-based learning case when compared to less interactive sessions ( P < 0.0001. Conclusion Students perceived benefits of the IPE program. Perceptions improved when various students had the opportunity to work together on clinically relevant problems.

  1. Exploring the Potential Emotional and Behavioural Impact of Providing Personalised Genomic Risk Information to the Public: A Focus Group Study.

    Science.gov (United States)

    Smit, Amelia K; Keogh, Louise A; Newson, Ainsley J; Hersch, Jolyn; Butow, Phyllis; Cust, Anne E

    2015-01-01

    To explore the potential emotional and behavioural impact of providing information on personalised genomic risk to the public, using melanoma as an example, to aid research translation. We conducted four focus groups in which 34 participants were presented with a hypothetical scenario of an individual's lifetime genomic risk of melanoma (using the term 'genetic risk'). We asked about understanding of genetic risk, who would choose to receive this risk information, potential emotional and behavioural impacts, and other concerns or potential benefits. Data were analysed thematically. Participants thought this risk information could potentially motivate preventive behaviours such as sun protection and related it to screening for other diseases including breast cancer. Factors identified as influencing the decision to receive genetic risk information included education level, children, age and gender. Participants identified potential negative impacts on the recipient such as anxiety and worry, and proposed that this could be mitigated by providing additional explanatory and prevention information, and contact details of a health professional for further discussion. Participants' concerns included workplace and insurance discrimination. Participants recognised the potential for both positive and negative emotional and behavioural impacts related to receiving information on the personalised genomic risk of melanoma. © 2015 S. Karger AG, Basel.

  2. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Directory of Open Access Journals (Sweden)

    Heather E Douglas

    2017-04-01

    Full Text Available Introduction: There is limited evidence of the benefits of information and communication technology (ICT to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  3. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

    Science.gov (United States)

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-04-10

    There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  4. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Science.gov (United States)

    Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

  5. ‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

    Science.gov (United States)

    2013-01-01

    Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of

  6. Geobiology of the Critical Zone: the Hierarchies of Process, Form and Life provide an Integrated Ontology

    Science.gov (United States)

    Cotterill, Fenton P. D.

    2016-04-01

    geomorphology characterize Africa's older surfaces, many of which qualify as palimpsests: overwritten and reshaped repeatedly over timescales of 10 000-100 000 000 yr. Inheritance, equifinality, and exhumation are commonly invoked to explain such landscape patterns, but are difficult to measure and thus test; here Africa's vast, deep regoliths epitomize the starkness of these challenges facing researchers across much of the continent. These deficiencies and problems are magnified when we consider the knowledge we seek of African landscape evolution toward resolving the complex history of the African plate since its individuation. The credentials of this knowledge are prescribed by the evidence needed to test competing hypotheses, especially invoking first order determinants of landscape dynamics e.g. membrane tectonics (Oxburgh ER & Turcotte DL 1974. Earth Planet. Sci. Lett. 22:133-140) versus plumes (Foulger G 2013. Plates vs Plumes: A Geological Controversy. Wiley Blackwell). The evidence needed to test such competing hypotheses demands robust reconstructions of the individuated histories of landforms; in the African context, robustness pertains to the representativeness of events reconstructed in form and space (up to continental scales) and back through time from the Neogene into the Late Mesozoic. The ideal map of quantitative evidence must aim to integrate salient details in the trajectories of individuated landforms representing the principal landscapes of all Africa's margins, basins and watersheds. This in turn demands measurements - in mesoscale detail - of relief, drainage and regolith back though time, wherever keystone packages of evidence have survived Gondwana break up and its aftermath. Such a strategy is indeed ambitious, and it may well be dismissed as impractical. Nevertheless, the alternatives fall short. If it is to be representative of the history it purports to explain, we need the mesoscale facts to inform any narrative of a larger landscape (regional

  7. Friends forever? The Role of the Visegrad Group and European Integration

    Directory of Open Access Journals (Sweden)

    Schmidt Andrea

    2016-12-01

    Full Text Available The Visegrad Group celebrated its 25th anniversary in February 2016. Established as an initiative of three statesmen from the Central and Eastern European (CEE region, this cooperation has experienced booms and crises. The aim of this paper is to analyse the function of this regional integration in the years following the end of bipolar system as Visegrad Group members headed down the road to Euro-Atlantic integration. To this end, I apply different theoretical approaches and attempt to explain the influence of key former politicians as well as new scenarios for the Visegrad Group’s position in the European Union. This analysis also covers the latest foreign policy changes and challenges facing CEE due to the involvement of a wider region that creates a counter-balance to the core EU. Statistical data and official documents from the Visegrad Group’s website strengthen these findings.

  8. NASA's Functional Task Test: Providing Information for an Integrated Countermeasure System

    Science.gov (United States)

    Bloomberg, J. J.; Feiveson, A. H.; Laurie, S. S.; Lee, S. M. C.; Mulavara, A. P.; Peters, B. T.; Platts, S. H.; Ploutz-Snyder, L. L.; Reschke, M. F.; Ryder, J. W.; hide

    2015-01-01

    postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. Bed rest subjects experienced similar deficits both in functional tests with balance challenges and in sensorimotor tests designed to evaluate postural and gait control as spaceflight subjects indicating that body support unloading experienced during spaceflight plays a central role in post-flight alteration of functional task performance. To determine how differences in body-support loading experienced during in-flight treadmill exercise affect postflight functional performance, the loading history for each subject during in-flight treadmill (T2) exercise was correlated with postflight measures of performance. ISS crewmembers who walked on the treadmill with higher pull-down loads had enhanced post-flight performance on tests requiring mobility. Taken together the spaceflight and bed rest data point to the importance of supplementing inflight exercise countermeasures with balance and sensorimotor adaptability training. These data also support the notion that inflight treadmill exercise performed with higher body loading provides sensorimotor benefits leading to improved performance on functional tasks that require dynamic postural stability and mobility.

  9. Integration of mental health resources in a primary care setting leads to increased provider satisfaction and patient access.

    Science.gov (United States)

    Vickers, Kristin S; Ridgeway, Jennifer L; Hathaway, Julie C; Egginton, Jason S; Kaderlik, Angela B; Katzelnick, David J

    2013-01-01

    This evaluation assessed the opinions and experiences of primary care providers and their support staff before and after implementation of expanded on-site mental health services and related system changes in a primary care clinic. Individual semistructured interviews, which contained a combination of open-ended questions and rating scales, were used to elicit opinions about mental health services before on-site system and resource changes occurred and repeated following changes that were intended to improve access to on-site mental health care. In the first set of interviews, prior to expanding mental health services, primary care providers and support staff were generally dissatisfied with the availability and scheduling of on-site mental health care. Patients were often referred outside the primary care clinic for mental health treatment, to the detriment of communication and coordinated care. Follow-up interviews conducted after expansion of mental health services, scheduling refinements and other system changes revealed improved provider satisfaction in treatment access and coordination of care. Providers appreciated immediate and on-site social worker availability to triage mental health needs and help access care, and on-site treatment was viewed as important for remaining informed about patient care the primary care providers are not delivering directly. Expanding integrated mental health services resulted in increased staff and provider satisfaction. Our evaluation identified key components of satisfaction, including on-site collaboration and assistance triaging patient needs. The sustainability of integrated models of care requires additional study. © 2013.

  10. 'The singing hospital'--integrated group therapy in the Black mentally ill.

    Science.gov (United States)

    Benjamin, B

    1983-06-04

    Integrated group therapy was originally introduced at Sterkfontein Hospital in 1957, and reintroduced 6 years ago in an effort to overcome difficulties in communication with approximately 100 Black male and female mental hospital patients. This therapy consisted mainly of song and dance activation, sociodrama, psychodrama and behavioural modification methods. These techniques are flexible, and can be carried out by proxy therapists working with doctors and psychologists.

  11. Partial valuation of the goods and services that it provides the mangrove ecosystem: An integrated ecological-economic analysis

    International Nuclear Information System (INIS)

    Castiblanco R, Carmenza

    2002-01-01

    The article presents a methodology to value the economic benefits of the use of some goods and services that provides the mangrove ecosystem, located in the municipality of Tumaco. An ecological analysis is developed integrated to an economic evaluation that allows expressing in monetary terms some values of use of the mangrove; this value are compared with the profitability that reports the Camaroniculture, productive activity that is constituted at the moment, in the most profitable alternative use

  12. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    OpenAIRE

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to su...

  13. An Integral Model to Provide Reactive and Proactive Services in an Academic CSIRT Based on Business Intelligence

    OpenAIRE

    Walter Fuertes; Francisco Reyes; Paúl Valladares; Freddy Tapia; Theofilos Toulkeridis; Ernesto Pérez

    2017-01-01

    Cyber-attacks have increased in severity and complexity. That requires, that the CERT/CSIRT research and develops new security tools. Therefore, our study focuses on the design of an integral model based on Business Intelligence (BI), which provides reactive and proactive services in a CSIRT, in order to alert and reduce any suspicious or malicious activity on information systems and data networks. To achieve this purpose, a solution has been assembled, that generates information stores, bein...

  14. Group Development and Integration in a Cross-Disciplinary and Intercultural Research Team

    Science.gov (United States)

    Kirk-Lawlor, Naomi; Allred, Shorna

    2017-04-01

    Cross-disciplinary research is necessary to solve many complex problems that affect society today, including problems involving linked social and environmental systems. Examples include natural resource management or scarcity problems, problematic effects of climate change, and environmental pollution issues. Intercultural research teams are needed to address many complex environmental matters as they often cross geographic and political boundaries, and involve people of different countries and cultures. It follows that disciplinarily and culturally diverse research teams have been organized to investigate and address environmental issues. This case study investigates a team composed of both monolingual and bilingual Chilean and US university researchers who are geoscientists, engineers and economists. The objective of this research team was to study both the natural and human parts of a hydrologic system in a hyper-arid region in northern Chile. Interviews ( n = 8) addressed research questions focusing on the interaction of cross-disciplinary diversity and cultural diversity during group integration and development within the team. The case study revealed that the group struggled more with cross-disciplinary challenges than with intercultural ones. Particularly challenging ones were instances the of disciplinary crosstalk, or hidden misunderstandings, where team members thought they understood their cross-disciplinary colleagues, when in reality they did not. Results showed that translation served as a facilitator to cross-disciplinary integration of the research team. The use of translation in group meetings as a strategy for effective cross-disciplinary integration can be extended to monolingual cross-disciplinary teams as well.

  15. Group Development and Integration in a Cross-Disciplinary and Intercultural Research Team.

    Science.gov (United States)

    Kirk-Lawlor, Naomi; Allred, Shorna

    2017-04-01

    Cross-disciplinary research is necessary to solve many complex problems that affect society today, including problems involving linked social and environmental systems. Examples include natural resource management or scarcity problems, problematic effects of climate change, and environmental pollution issues. Intercultural research teams are needed to address many complex environmental matters as they often cross geographic and political boundaries, and involve people of different countries and cultures. It follows that disciplinarily and culturally diverse research teams have been organized to investigate and address environmental issues. This case study investigates a team composed of both monolingual and bilingual Chilean and US university researchers who are geoscientists, engineers and economists. The objective of this research team was to study both the natural and human parts of a hydrologic system in a hyper-arid region in northern Chile. Interviews (n = 8) addressed research questions focusing on the interaction of cross-disciplinary diversity and cultural diversity during group integration and development within the team. The case study revealed that the group struggled more with cross-disciplinary challenges than with intercultural ones. Particularly challenging ones were instances the of disciplinary crosstalk, or hidden misunderstandings, where team members thought they understood their cross-disciplinary colleagues, when in reality they did not. Results showed that translation served as a facilitator to cross-disciplinary integration of the research team. The use of translation in group meetings as a strategy for effective cross-disciplinary integration can be extended to monolingual cross-disciplinary teams as well.

  16. What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme.

    Science.gov (United States)

    Kealy, David; Joyce, Anthony S; Weber, Rainer; Ehrenthal, Johannes C; Ogrodniczuk, John S

    2018-02-13

    Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction. Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme. Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up. While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change. The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction. This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress

  17. Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers.

    Science.gov (United States)

    Gyasi, Razak Mohammed; Poku, Adjoa Afriyie; Boateng, Simon; Amoah, Padmore Adusei; Mumin, Alhassan Abdul; Obodai, Jacob; Agyemang-Duah, Williams

    2017-01-01

    In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana. In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana. In order to advance any useful intercultural health care policy in

  18. [2-stage group psychotherapy with integrated autogenic training within the scope of a general integrated psychotherapy concept].

    Science.gov (United States)

    Barolin, Gerhard S

    2003-01-01

    Group-therapy and autogenic training in combination show mutual potentiation. Our results have proved the hypothesis to be true and we have also been able to explain it by an analysis of the neurophysiological and psychological findings concerning both methods. Our "model" has proved to be very economical in time and can be easily applied. It needs basic psychotherapeutical education but no special additive schooling. It is particularly well employed in rehabilitation patients, elderly patients and geronto-rehabilitation patients. As numbers of such patients are steadily increasing, it could soon become highly important, and in the technically dominated medicine of today, the particularly communicative component that we postulate in integrated psychotherapy could also grow in importance. By combining the two methods, it is not method that is at the centre of our endeavours but the patient.

  19. The Process Model of Group-Based Emotion: Integrating Intergroup Emotion and Emotion Regulation Perspectives.

    Science.gov (United States)

    Goldenberg, Amit; Halperin, Eran; van Zomeren, Martijn; Gross, James J

    2016-05-01

    Scholars interested in emotion regulation have documented the different goals and strategies individuals have for regulating their emotions. However, little attention has been paid to the regulation of group-based emotions, which are based on individuals' self-categorization as a group member and occur in response to situations perceived as relevant for that group. We propose a model for examining group-based emotion regulation that integrates intergroup emotions theory and the process model of emotion regulation. This synergy expands intergroup emotion theory by facilitating further investigation of different goals (i.e., hedonic or instrumental) and strategies (e.g., situation selection and modification strategies) used to regulate group-based emotions. It also expands emotion regulation research by emphasizing the role of self-categorization (e.g., as an individual or a group member) in the emotional process. Finally, we discuss the promise of this theoretical synergy and suggest several directions for future research on group-based emotion regulation. © 2015 by the Society for Personality and Social Psychology, Inc.

  20. IAEA'S International Working Group on Integrated Transport and Storage Safety case for Dual Purpose Casks

    International Nuclear Information System (INIS)

    Kumano, Yumiko; Varley, Kasturi; ); Droste, Bernhard; Wolff, Dietmar; Hirose, Makoto; Harvey, John; Reiche, Ingo; McConnell, Paul

    2014-01-01

    Spent nuclear fuel is generated from the operation of nuclear reactors and it is imperative that it is safely managed following its removal from reactor cores. Reactor pools are usually designed based on the assumption that the fuel will be removed after a short period of time either for reprocessing, disposal, or further storage. As a result of storing higher burn-up fuel, significantly increased time-frame till disposal solutions are prepared, and delays in decisions on strategies for spent fuel management, the volume of spent fuel discharged from reactors which needs to be managed and stored is on the increase. Consequently, additional storage capacity is needed following the initial storage in reactor pools. Options for additional storage include wet storage or dry storage in a dedicated facility or in storage casks. One of these options is the use of a Dual Purpose Cask (DPC), which is a specially designed cask for both storage and transport. The management of spent fuel using a DPC generally involves on-site and off-site transportation before and after storage. Most countries require package design approval for the DPC to be transported. In addition, it is required in many countries to have a licence for storage of the spent fuel in the DPC or a licence for a storage facility that contains DPCs. Therefore, demonstration of compliance of the DPC with national and international transport regulations as well as with the storage requirements is necessary. In order to address this increasing need among Member States, the IAEA established an international working group in 2010 to develop a guidance for integrating safety cases for both storage and transport in a holistic manner. The working group consists of experts from regulatory bodies, Technical Support Organizations, operators for both transportation and storage, and research institutes. This activity is planned to be completed by 2013. Currently, a technical report has been drafted and is expected to be

  1. Forming and sustaining partnerships to provide integrated services for young people: an overview based on the headspace Geelong experience.

    Science.gov (United States)

    Callaly, Tom; von Treuer, Kathryn; van Hamond, Toni; Windle, Kelly

    2011-02-01

    To discuss critical considerations in the formation and maintenance of agency partnerships designed to provide integrated care for young people. Two years after its establishment, an evaluation of the headspace Barwon collaboration and a review of the health-care and management literature on agency collaboration were conducted. The principal findings together with the authors' experience working at establishing and maintaining the partnership are used to discuss critical issues in forming and maintaining inter-agency partnerships. Structural and process considerations are necessary but not sufficient for the successful formation and maintenance of inter-agency partnerships and integrated care provision. Specifically, organizational culture change and staff engagement is a significant challenge and planning for this is essential and often neglected. Although agreeing on common goals and objectives is an essential first step in forming partnerships designed to provide integrated care, goodwill is not enough, and the literature consistently shows that most collaborations fail to meet their objectives. Principles and lessons of organizational behaviour and management practices in the business sector can contribute a great deal to partnership planning. © 2011 Blackwell Publishing Asia Pty Ltd.

  2. Scenario Development Workshop Synopsis. Integration Group for the Safety Case - June 2015

    International Nuclear Information System (INIS)

    Smith, Paul; Voinis, Sylvie; Griffault, Lise; De Meredieu, Jean; Kwong, Gloria; ); Van Luik, Abraham; Bailey, Lucy; Capouet, Manuel; Depaus, Christophe; Makino, Hitoshi; Leigh, Christi; Kirkes, Ross; Leino, Jaakko; Niemeyer, Matthias; Wolf, Jens; Watson, Sarah; Franke, Bettina; Ilett, Doug; Pastina, Barbara; Weetjens, Eef

    2016-03-01

    Scenario development and selection describes the collection and organisation of the scientific and technical information relevant to the potential paths of evolution of a radioactive waste disposal facility (repository) that is necessary to assess its long-term performance and safety. In 1999, the NEA held its first workshop on scenario development in Madrid, Spain, with the objective to review the methods for developing scenarios in safety assessments and their application. Since then, the process of scenario development and analysis for the disposal of radioactive waste has changed and, in 2015, the NEA Integration Group for the Safety Case (IGSC) held a second workshop on this topic at its offices in Paris to further evaluate the experience acquired in developing scenarios since 1999. To prepare for this workshop, the IGSC also launched a survey in 2014 to gather the latest scenario development and uncertainty management strategies used in IGSC member countries. The purposes of the workshop were to (i) provide a forum to review and discuss methods for scenario development and their contribution to the development of recent safety cases (since the 1999 workshop); (ii) examine the latest methods and compare their scope, consistency and function within the overall safety assessment process, based on practical experience of applications; and (iii) provide a basis for producing the present report summarising the current status of scenario methodologies, identifying where sufficient methods exist and any outstanding problem areas. This report provides an overview of the state of the art in scenario development related to the long-term safety of geological repositories for radioactive waste. In particular, it discusses how potential scenarios are developed in safety assessments of radioactive waste that contains long-lived radionuclides. Safety assessment is the process of quantitatively and qualitatively evaluating the safety of a repository, often in support of a

  3. Differences within the groups of physicians and managers in Dutch hospitals providing leads for intergroup cooperation : Running head: group differences in hospitals

    NARCIS (Netherlands)

    van Harten, Willem H.

    2010-01-01

    Background: Effective cooperation between physicians and managers is difficult to achieve but is an important factor in successfully implementing improvement initiatives in hospitals. Intergroup literature suggests that large differences between groups hinder effective cooperation. - Purposes:

  4. Integrated Multimedia Based Intelligent Group Decision Support System for Electrical Power Network

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Saxena

    2002-05-01

    Full Text Available Electrical Power Network in recent time requires an intelligent, virtual environment based decision process for the coordination of all its individual elements and the interrelated tasks. Its ultimate goal is to achieve maximum productivity and efficiency through the efficient and effective application of generation, transmission, distribution, pricing and regulatory systems. However, the complexity of electrical power network and the presence of conflicting multiple goals and objectives postulated by various groups emphasized the need of an intelligent group decision support system approach in this field. In this paper, an Integrated Multimedia based Intelligent Group Decision Support System (IM1GDSS is presented, and its main components are analyzed and discussed. In particular attention is focused on the Data Base, Model Base, Central Black Board (CBB and Multicriteria Futuristic Decision Process (MFDP module. The model base interacts with Electrical Power Network Load Forecasting and Planning (EPNLFP Module; Resource Optimization, Modeling and Simulation (ROMAS Module; Electrical Power Network Control and Evaluation Process (EPNCAEP Module, and MFDP Module through CBB for strategic planning, management control, operational planning and transaction processing. The richness of multimedia channels adds a totally new dimension in a group decision making for Electrical Power Network. The proposed IMIGDSS is a user friendly, highly interactive group decision making system, based on efficient intelligent and multimedia communication support for group discussions, retrieval of content and multi criteria decision analysis.

  5. 77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-07-18

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

  6. Improving sexual health communication between older women and their providers: how the integrative model of behavioral prediction can help.

    Science.gov (United States)

    Hughes, Anne K; Rostant, Ola S; Curran, Paul G

    2014-07-01

    Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns. © The Author(s) 2013.

  7. Integrative Sparse K-Means With Overlapping Group Lasso in Genomic Applications for Disease Subtype Discovery.

    Science.gov (United States)

    Huo, Zhiguang; Tseng, George

    2017-06-01

    Cancer subtypes discovery is the first step to deliver personalized medicine to cancer patients. With the accumulation of massive multi-level omics datasets and established biological knowledge databases, omics data integration with incorporation of rich existing biological knowledge is essential for deciphering a biological mechanism behind the complex diseases. In this manuscript, we propose an integrative sparse K -means (is- K means) approach to discover disease subtypes with the guidance of prior biological knowledge via sparse overlapping group lasso. An algorithm using an alternating direction method of multiplier (ADMM) will be applied for fast optimization. Simulation and three real applications in breast cancer and leukemia will be used to compare is- K means with existing methods and demonstrate its superior clustering accuracy, feature selection, functional annotation of detected molecular features and computing efficiency.

  8. A secure effective dynamic group password-based authenticated key agreement scheme for the integrated EPR information system

    Directory of Open Access Journals (Sweden)

    Vanga Odelu

    2016-01-01

    Full Text Available With the rapid growth of the Internet, a lot of electronic patient records (EPRs have been developed for e-medicine systems. The security and privacy issues of EPRs are important for the patients in order to understand how the hospitals control the use of their personal information, such as name, address, e-mail, medical records, etc. of a particular patient. Recently, Lee et al. proposed a simple group password-based authenticated key agreement protocol for the integrated EPR information system (SGPAKE. However, in this paper, we show that Lee et al.’s protocol is vulnerable to the off-line weak password guessing attack and as a result, their scheme does not provide users’ privacy. To withstand this security weakness found in Lee et al.’s scheme, we aim to propose an effective dynamic group password-based authenticated key exchange scheme for the integrated EPR information system, which retains the original merits of Lee et al.’s scheme. Through the informal and formal security analysis, we show that our scheme provides users’ privacy, perfect forward security and known-key security, and also protects online and offline password guessing attacks. Furthermore, our scheme efficiently supports the dynamic group password-based authenticated key agreement for the integrated EPR information system. In addition, we simulate our scheme for the formal security verification using the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications tool and show that our scheme is secure against passive and active attacks.

  9. Equipping providers with principles, knowledge and skills to successfully integrate behaviour change counselling into practice: a primary healthcare framework.

    Science.gov (United States)

    Vallis, M; Lee-Baggley, D; Sampalli, T; Ryer, A; Ryan-Carson, S; Kumanan, K; Edwards, L

    2018-01-01

    There is an urgent need for healthcare providers and healthcare systems to support productive interactions with patients that promote sustained health behaviour change in order to improve patient and population health outcomes. Behaviour change theories and interventions have been developed and evaluated in experimental contexts; however, most healthcare providers have little training, and therefore low confidence in, behaviour change counselling. Particularly important is how to integrate theory and method to support healthcare providers to engage in behaviour change counselling competently. In this article, we describe a general training model developed from theory, evidence, experience and stakeholder engagement. This model will set the stage for future evaluation research on training needed to achieve competency, sustainability of competency, as well as effectiveness/cost-effectiveness of training in supporting behaviour change. A framework to support competency based training in behaviour change counselling is described in this article. This framework is designed to be integrative, sustainable, scalable and capable of being evaluated in follow-up studies. Effective training in behaviour change counselling is critical to meet the current and future healthcare needs of patients living with, or at risk of, chronic diseases. Increasing competency in establishing change-based relationships, assessing and promoting readiness to change, implementing behaviour modification and addressing psychosocial issues will be value added to the healthcare system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. The effectiveness of support groups in Asian breast cancer patients: An integrative review

    Directory of Open Access Journals (Sweden)

    Fang-Yu Chou

    2016-01-01

    Full Text Available Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries. The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  11. The Effectiveness of Support Groups in Asian Breast Cancer Patients: An Integrative Review.

    Science.gov (United States)

    Chou, Fang-Yu; Lee-Lin, Frances; Kuang, Lily Y

    2016-01-01

    Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC) patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries). The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  12. Asymptotic formulae for solutions of the two-group integral neutron-transport equation

    International Nuclear Information System (INIS)

    Duracz, T.

    1976-01-01

    The steady-state, two-group integral neutron-transport equation is considered for two cases. First, for plane geometry, formulae for the asymptotic flux are obtained, under assumptions of homogeneous medium with isotropic scattering, extended to infinity (whole space and half-space), with sources vanishing at infinity as 0(esup(-IXI)). Next, for spherical geometry, the Milne problem is considered and formulae for the asymptotic flux are obtained. These formulae have the form of asymptotic expansions for small and large radii of the black sphere. (orig.) [de

  13. Monolithic nanoscale photonics-electronics integration in silicon and other group IV elements

    CERN Document Server

    Radamson, Henry

    2014-01-01

    Silicon technology is evolving rapidly, particularly in board-to-board or chip-to chip applications. Increasingly, the electronic parts of silicon technology will carry out the data processing, while the photonic parts take care of the data communication. For the first time, this book describes the merging of photonics and electronics in silicon and other group IV elements. It presents the challenges, the limitations, and the upcoming possibilities of these developments. The book describes the evolution of CMOS integrated electronics, status and development, and the fundamentals of silicon p

  14. Contemporary group estimates adjusted for climatic effects provide a finer definition of the unknown environmental challenges experienced by growing pigs.

    Science.gov (United States)

    Guy, S Z Y; Li, L; Thomson, P C; Hermesch, S

    2017-12-01

    Environmental descriptors derived from mean performances of contemporary groups (CGs) are assumed to capture any known and unknown environmental challenges. The objective of this paper was to obtain a finer definition of the unknown challenges, by adjusting CG estimates for the known climatic effects of monthly maximum air temperature (MaxT), minimum air temperature (MinT) and monthly rainfall (Rain). As the unknown component could include infection challenges, these refined descriptors may help to better model varying responses of sire progeny to environmental infection challenges for the definition of disease resilience. Data were recorded from 1999 to 2013 at a piggery in south-east Queensland, Australia (n = 31,230). Firstly, CG estimates of average daily gain (ADG) and backfat (BF) were adjusted for MaxT, MinT and Rain, which were fitted as splines. In the models used to derive CG estimates for ADG, MaxT and MinT were significant variables. The models that contained these significant climatic variables had CG estimates with a lower variance compared to models without significant climatic variables. Variance component estimates were similar across all models, suggesting that these significant climatic variables accounted for some known environmental variation captured in CG estimates. No climatic variables were significant in the models used to derive the CG estimates for BF. These CG estimates were used to categorize environments. There was no observable sire by environment interaction (Sire×E) for ADG when using the environmental descriptors based on CG estimates on BF. For the environmental descriptors based on CG estimates of ADG, there was significant Sire×E only when MinT was included in the model (p = .01). Therefore, this new definition of the environment, preadjusted by MinT, increased the ability to detect Sire×E. While the unknown challenges captured in refined CG estimates need verification for infection challenges, this may provide a

  15. New approach to the adjustment of group cross sections fitting integral measurements

    International Nuclear Information System (INIS)

    Chao, Y.A.

    1979-01-01

    The adjustment of group cross sections fitting integral measurements is viewed as a process of estimating theoretical and/or experimental negligence errors to bring statistical consistency to the integral and differential data so that they can be combined to form an enlarged ensemble, based on which an improved estimation of the physical constants can be made. A three-step approach is suggested, and its formalism of general validity is developed. In step one, the data of negligence error are extracted from the given integral and differential data. The method of extraction is based on the concepts of prior probability and information entropy. It automatically leads to vanishing negligence error as the two sets of data are statistically consistent. The second step is to identify the sources of negligence error and adjust the data by an amount compensating for the extracted negligence discrepancy. In the last step, the two data sets, already adjusted to mutual consistency are combined as a single unified ensemble. Standard methods of statistics can then be applied to reestimate the physical constants. 1 figure

  16. New approach to the adjustment of group cross-sections fitting integral measurements

    International Nuclear Information System (INIS)

    Chao, Y.A.

    1979-01-01

    The adjustment of group cross-sections fitting integral measurements is viewed as a process of uncovering theoretical and/or experimental negligence errors to bring statistical consistency to the integral and differential data so that they can be combined to form an enlarged ensemble, on which an improved estimation of the physical constants can be based. An approach with three steps is suggested, and its formalism of general validity is developed. In step one, the data of negligence error are extracted from the given integral and differential data. The method of extraction is based on the concepts of prior probability and information entropy. It automatically leads to vanishing negligence error as the two sets of data are statistically consistent. The second step is to identify the sources of negligence error and adjust the data by an amount compensating the extracted negligence discrepancy. In the last step the two data sets, already adjusted to mutual consistency, are combined as a single unified ensemble. Standard methods of statistics can then be applied to re-estimate the physical constants. A simple example is shown as a demonstration of the method. 1 figure

  17. Conserved patterns of integrated developmental plasticity in a group of polyphenic tropical butterflies.

    Science.gov (United States)

    van Bergen, Erik; Osbaldeston, Dave; Kodandaramaiah, Ullasa; Brattström, Oskar; Aduse-Poku, Kwaku; Brakefield, Paul M

    2017-02-27

    Developmental plasticity is thought to have profound macro-evolutionary effects, for example, by increasing the probability of establishment in new environments and subsequent divergence into independently evolving lineages. In contrast to plasticity optimized for individual traits, phenotypic integration, which enables a concerted response of plastic traits to environmental variability, may affect the rate of local adaptation by constraining independent responses of traits to selection. Using a comparative framework, this study explores the evolution of reaction norms for a variety of life history and morphological traits across five related species of mycalesine butterflies from the Old World tropics. Our data indicate that an integrated response of a suite of key traits is shared amongst these species. Interestingly, the traits that make up the functional suite are all known to be regulated by ecdysteroid signalling in Bicyclus anynana, one of the species included in this study, suggesting the same underlying hormonal regulator may be conserved within this group of polyphenic butterflies. We also detect developmental thresholds for the expression of alternative morphs. The phenotypic plasticity of a broad suite of morphological and life history traits is integrated and shared among species from three geographically independent lineages of mycalesine butterflies, despite considerable periods of independent evolution and exposure to disparate environments. At the same time, we have detected examples of evolutionary change where independent traits show different patterns of reaction norms. We argue that the expression of more robust phenotypes may occur by shifting developmental thresholds beyond the boundaries of the typical environmental variation.

  18. Integrating Medication Therapy Management (MTM Services Provided by Community Pharmacists into a Community-Based Accountable Care Organization (ACO

    Directory of Open Access Journals (Sweden)

    Brian Isetts

    2017-10-01

    Full Text Available (1 Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM services provided by community pharmacists into the clinical care teams and the health information technology (HIT infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO. (2 Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3 Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4 Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.

  19. MPA-11: Materials Synthesis and Integrated Devices; Overview of an Applied Energy Group

    Energy Technology Data Exchange (ETDEWEB)

    Dattelbaum, Andrew Martin [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-16

    Our mission is to provide innovative and creative chemical synthesis and materials science solutions to solve materials problems across the LANL missions. Our group conducts basic and applied research in areas related to energy security as well as problems relevant to the Weapons Program.

  20. Does the meld system provide equal access to liver transplantation for patients with different ABO blood groups?

    NARCIS (Netherlands)

    IJtsma, Alexander J. C.; van der Hilst, Christian S.; Nijkamp, Danielle M.; Bottema, Jan T.; Fidler, Vaclav; Porte, Robert J.; Slooff, Maarten J. H.

    This study investigates the relationship between blood group and waiting time until transplantation or death on the waiting list. All patients listed for liver transplantation in the Netherlands between 15 December 2006 and 31 December 2012, were included. Study variables were gender, age, year of

  1. Integrating the Radiology Information System with Computerised Provider Order Entry: The Impact on Repeat Medical Imaging Investigations.

    Science.gov (United States)

    Vecellio, Elia; Georgiou, Andrew

    2016-01-01

    Repeat and redundant procedures in medical imaging are associated with increases in resource utilisation and labour costs. Unnecessary medical imaging in some modalities, such as X-Ray (XR) and Computed Tomography (CT) is an important safety issue because it exposes patients to ionising radiation which can be carcinogenic and is associated with higher rates of cancer. The aim of this study was to assess the impact of implementing an integrated Computerised Provider Order Entry (CPOE)/Radiology Information System (RIS)/Picture Archiving and Communications System (PACS) system on the number of XR and CT imaging procedures (including repeat imaging requests) for inpatients at a large metropolitan hospital. The study found that patients had an average 0.47 fewer XR procedures and 0.07 fewer CT procedures after the implementation of the integrated system. Part of this reduction was driven by a lower rate of repeat procedures: the average inpatient had 0.13 fewer repeat XR procedures within 24-hours of the previous identical XR procedure. A similar decrease was not evident for repeat CT procedures. Reduced utilisation of imaging procedures (especially those within very short intervals from the previous identical procedure, which are more likely to be redundant) has implications for the safety of patients and the cost of medical imaging services.

  2. Enzyme engineering through evolution: thermostable recombinant group II intron reverse transcriptases provide new tools for RNA research and biotechnology.

    Science.gov (United States)

    Collins, Kathleen; Nilsen, Timothy W

    2013-08-01

    Current investigation of RNA transcriptomes relies heavily on the use of retroviral reverse transcriptases. It is well known that these enzymes have many limitations because of their intrinsic properties. This commentary highlights the recent biochemical characterization of a new family of reverse transcriptases, those encoded by group II intron retrohoming elements. The novel properties of these enzymes endow them with the potential to revolutionize how we approach RNA analyses.

  3. Performance Analysis of Hierarchical Group Key Management Integrated with Adaptive Intrusion Detection in Mobile ad hoc Networks

    Science.gov (United States)

    2016-04-05

    applications in wireless networks such as military battlefields, emergency response, mobile commerce , online gaming, and collaborative work are based on the...www.elsevier.com/locate/peva Performance analysis of hierarchical group key management integrated with adaptive intrusion detection in mobile ad hoc...Accepted 19 September 2010 Available online 26 September 2010 Keywords: Mobile ad hoc networks Intrusion detection Group communication systems Group

  4. Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand.

    Science.gov (United States)

    Lovelock, Kirsten; Martin, Greg; Gauld, Robin; MacRae, Jayden

    2017-01-01

    This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were encountered because of inadequate attention to organisational

  5. Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand

    Directory of Open Access Journals (Sweden)

    Kirsten Lovelock

    2017-03-01

    Full Text Available Objectives: This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. Methods: The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Results: Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. Conclusion: The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were

  6. Guideline group composition and group processes: article 3 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

    Science.gov (United States)

    Kunz, Regina; Fretheim, Atle; Cluzeau, Françoise; Wilt, Timothy J; Qaseem, Amir; Lelgemann, Monika; Kelson, Marcia; Guyatt, Gordon; Schünemann, Holger J

    2012-12-01

    Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the third of a series of 14 articles that were prepared to advise guideline developers in respiratory and other diseases on considerations for group compositions and group processes in guideline development, and how this can be effectively integrated in the context of respiratory disease guidelines on a national and international level. We updated a review of the literature addressing group composition and group process, focusing on the following questions: 1. How to compose a functioning and representative guideline group; Who should be included in a guideline panel?; How to select organizations, groups, and individuals; What expertise is needed?; Consultation with non-included groups. 2. How to assure a functioning group process; How to make the process constructive; Balancing participation and finding agreement; Administrative support; What constitutes sufficient resources? Our conclusions are based on available evidence from published literature, experience from guideline developers, and workshop discussions. Formal studies addressing optimal processes in developing guidelines are limited, and experience from guideline organizations supplement the formal studies. When resources are available, guideline development groups should aim for multidisciplinary groups, including patients. Prerequisites for a multidisciplinary group include: a strong chair experienced in group facilitation with broad acceptance in the group, training the group in guideline methodology, and professional technical support. Formal consensus developing methods have proved effective in reaching agreement on the final recommendations.

  7. A pre-operative group rehabilitation programme provided limited benefit for people with severe hip and knee osteoarthritis.

    Science.gov (United States)

    Wallis, Jason A; Webster, Kate E; Levinger, Pazit; Fong, Cynthia; Taylor, Nicholas F

    2014-01-01

    To determine if a pre-operative group rehabilitation programme can improve arthritis self-efficacy for people with severe hip and knee osteoarthritis. Single group, repeated measures design: 4-week baseline phase followed by a 6-week intervention phase of water exercise, and education with self-management strategies. The primary outcome was arthritis self-efficacy. The secondary outcomes were measures of pain (WOMAC), activity limitation (WOMAC), activity performance (30 s chair stand test, 10 m walk test) and health-related quality of life (EuroQol). Twenty participants (10 knee osteoarthritis and 10 hip osteoarthritis) with a mean age of 71 years (SD 7) attended 92% (SD 10%) of the scheduled sessions. All measures demonstrated baseline stability between two time points for measurements at week 1 and measurements at week 4. After the 6-week intervention programme there were no significant improvements for arthritis self-efficacy. There was a 12% increase for fast walking speed (mean increase of 0.14 m/s, 95% CI 0.07, 0.22). There were no significant improvements for other secondary outcomes. A pre-operative water-based exercise and educational programme did not improve arthritis self-efficacy, self-reported pain and activity limitation, and health-related quality of life for people with hip and knee osteoarthritis who were candidates for joint replacement. While there was a significant increase in one measure of activity performance (walking speed), these findings suggest the current programme may be of little value. Implications for Rehabilitation This pre-operative group rehabilitation programme for people with severe hip and knee osteoarthritis did not change arthritis self-efficacy, pain, activity limitation and health-related quality of life. This programme may have little value in preparing people for joint replacement surgery. The optimal pre-operative programme requires further design and investigation.

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

    Directory of Open Access Journals (Sweden)

    Mar Pérez-Sanagustín

    2008-07-01

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

  9. Conjugacy classes in the Weyl group admitting a regular eigenvector and integrable hierarchies

    International Nuclear Information System (INIS)

    Delduc, F.; Feher, L.

    1994-10-01

    The classification of the integrable hierarchies in the Drinfeld-Sokolov (DS) approach is studied. The DS construction, originally based on the principal Heisenberg subalgebra of an affine Lie algebra, has been recently generalized to arbitrary graded Heisenberg subalgebras. The graded Heisenberg subalgebras of an untwisted loop algebra l(G) are classified by the conjugacy classes in the Weyl group of G, but a complete classification of the hierarchies obtained from generalized DS reductions is still missing. The main result presented here is the complete list of the graded regular elements of l(G) for G a classical Lie algebra or G 2 , extending previous results on the gl n case. (author). 9 refs., 4 tabs

  10. Positive is usually good, negative is not always bad: The effects of group affect on social integration and task performance.

    Science.gov (United States)

    Knight, Andrew P; Eisenkraft, Noah

    2015-07-01

    Grounded in a social functional perspective, this article examines the conditions under which group affect influences group functioning. Using meta-analysis, the authors leverage heterogeneity across 39 independent studies of 2,799 groups to understand how contextual factors-group affect source (exogenous or endogenous to the group) and group life span (one-shot or ongoing)-moderate the influence of shared feelings on social integration and task performance. As predicted, results indicate that group positive affect has consistent positive effects on social integration and task performance regardless of contextual idiosyncrasies. The effects of group negative affect, on the other hand, are context-dependent. Shared negative feelings promote social integration and task performance when stemming from an exogenous source or experienced in a 1-shot group, but undermine social integration and task performance when stemming from an endogenous source or experienced in an ongoing group. The authors discuss implications of their findings and highlight directions for future theory and research on group affect. (c) 2015 APA, all rights reserved).

  11. Mosasauroid phylogeny under multiple phylogenetic methods provides new insights on the evolution of aquatic adaptations in the group.

    Directory of Open Access Journals (Sweden)

    Tiago R Simões

    Full Text Available Mosasauroids were a successful lineage of squamate reptiles (lizards and snakes that radiated during the Late Cretaceous (95-66 million years ago. They can be considered one of the few lineages in the evolutionary history of tetrapods to have acquired a fully aquatic lifestyle, similarly to whales, ichthyosaurs and plesiosaurs. Despite a long history of research on this group, their phylogenetic relationships have only been tested so far using traditional (unweighted maximum parsimony. However, hypotheses of mosasauroid relationships and the recently proposed multiple origins of aquatically adapted pelvic and pedal features in this group can be more thoroughly tested by methods that take into account variation in branch lengths and evolutionary rates. In this study, we present the first mosasauroid phylogenetic analysis performed under different analytical methods, including maximum likelihood, Bayesian inference, and implied weighting maximum parsimony. The results indicate a lack of congruence in the topological position of halisaurines and Dallasaurus. Additionally, the genus Prognathodon is paraphyletic under all hypotheses. Interestingly, a number of traditional mosasauroid clades become weakly supported, or unresolved, under Bayesian analyses. The reduced resolutions in some consensus trees create ambiguities concerning the evolution of fully aquatic pelvic/pedal conditions under many analyses. However, when enough resolution was obtained, reversals of the pelvic/pedal conditions were favoured by parsimony and likelihood ancestral state reconstructions instead of independent origins of aquatic features in mosasauroids. It is concluded that most of the observed discrepancies among the results can be associated with different analytical procedures, but also due to limited postcranial data on halisaurines, yaguarasaurines and Dallasaurus.

  12. Mosasauroid phylogeny under multiple phylogenetic methods provides new insights on the evolution of aquatic adaptations in the group

    Science.gov (United States)

    Vernygora, Oksana; Paparella, Ilaria; Jimenez-Huidobro, Paulina; Caldwell, Michael W.

    2017-01-01

    Mosasauroids were a successful lineage of squamate reptiles (lizards and snakes) that radiated during the Late Cretaceous (95–66 million years ago). They can be considered one of the few lineages in the evolutionary history of tetrapods to have acquired a fully aquatic lifestyle, similarly to whales, ichthyosaurs and plesiosaurs. Despite a long history of research on this group, their phylogenetic relationships have only been tested so far using traditional (unweighted) maximum parsimony. However, hypotheses of mosasauroid relationships and the recently proposed multiple origins of aquatically adapted pelvic and pedal features in this group can be more thoroughly tested by methods that take into account variation in branch lengths and evolutionary rates. In this study, we present the first mosasauroid phylogenetic analysis performed under different analytical methods, including maximum likelihood, Bayesian inference, and implied weighting maximum parsimony. The results indicate a lack of congruence in the topological position of halisaurines and Dallasaurus. Additionally, the genus Prognathodon is paraphyletic under all hypotheses. Interestingly, a number of traditional mosasauroid clades become weakly supported, or unresolved, under Bayesian analyses. The reduced resolutions in some consensus trees create ambiguities concerning the evolution of fully aquatic pelvic/pedal conditions under many analyses. However, when enough resolution was obtained, reversals of the pelvic/pedal conditions were favoured by parsimony and likelihood ancestral state reconstructions instead of independent origins of aquatic features in mosasauroids. It is concluded that most of the observed discrepancies among the results can be associated with different analytical procedures, but also due to limited postcranial data on halisaurines, yaguarasaurines and Dallasaurus. PMID:28467456

  13. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    Science.gov (United States)

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  14. 78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-11-21

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

  15. 76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-11-02

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

  16. 78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-08-12

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

  17. 76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-05-06

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

  18. 77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2012-06-05

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

  19. 78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-06-26

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

  20. 76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-09-19

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

  1. 77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-03-15

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

  2. The Effect of WhatsApp Messenger As Mobile Learning Integrated with Group Investigation Method of Learning Achievement

    Directory of Open Access Journals (Sweden)

    Hendrik Pratama

    2017-12-01

    Full Text Available The purpose of this research was determined the effect of application WhatsApp Messenger in the Group Investigation (GI method on learning achievement. The methods used experimental research with control group pretest-postest design. The sampling procedure used the purposive sampling technique that consists of 17 students as a control group and 17 students as an experimental group. The sample in this research is students in Electrical Engineering Education Study Program. The experimental group used the GI method that integrated with WhatsApp Messenger. The control group used lecture method without social media integration. The collecting data used observation, documentation, interview, questionnaire, and test. The researcher used a t-test for compared the control group and the experimental group’s learning outcomes at an alpha level of 0,05. The results showed differences between the experiment group and the control group. The study result of the experimental higher than the control groups. This learning was designed with start, grouping, planning, presenting, organizing, investigating, evaluating, ending’s stage. Integration of WhatsApp with group investigation method could cause the positive communication between student and lecturer. Discussion in this learning was well done, the student’s knowledge could appear in a group and the information could spread evenly and quickly.

  3. The use of "vertical integration groups" to help define and update course/clerkship content.

    Science.gov (United States)

    Nierenberg, D W

    1998-10-01

    Faculty at many medical schools are working hard to improve the quality of their curricula. While the world "curriculum" means different things to different people, curricular change often includes improving the structure of the teaching/learning environment (e.g., seminars or problem-based learning groups vs lectures), the content of courses and clerkships (the core set of knowledge, skills, and attitudes that should be learned), and the manner in which student learning of knowledge and skills is evaluated (the sense that evaluation can help "drive" the curriculum). The author describes how "vertical integration groups" have been used over four years at Dartmouth Medical School to improve and modernize the content of courses and clerkships. In this approach, students and faculty work together to address and improve content areas that normally are not associated with traditional, discipline-centered courses or clerkships. The author discusses the advantages of this approach, the challenges encountered during implementation, and examples of how the approach has been put into action.

  4. Integration of two RAB5 groups during endosomal transport in plants

    Science.gov (United States)

    Ebine, Kazuo; Choi, Seung-won; Ichinose, Sakura; Uemura, Tomohiro; Nakano, Akihiko

    2018-01-01

    RAB5 is a key regulator of endosomal functions in eukaryotic cells. Plants possess two different RAB5 groups, canonical and plant-unique types, which act via unknown counteracting mechanisms. Here, we identified an effector molecule of the plant-unique RAB5 in Arabidopsis thaliana, ARA6, which we designated PLANT-UNIQUE RAB5 EFFECTOR 2 (PUF2). Preferential colocalization with canonical RAB5 on endosomes and genetic interaction analysis indicated that PUF2 coordinates vacuolar transport with canonical RAB5, although PUF2 was identified as an effector of ARA6. Competitive binding of PUF2 with GTP-bound ARA6 and GDP-bound canonical RAB5, together interacting with the shared activating factor VPS9a, showed that ARA6 negatively regulates canonical RAB5-mediated vacuolar transport by titrating PUF2 and VPS9a. These results suggest a unique and unprecedented function for a RAB effector involving the integration of two RAB groups to orchestrate endosomal trafficking in plant cells. PMID:29749929

  5. Leveraging Web Services in Providing Efficient Discovery, Retrieval, and Integration of NASA-Sponsored Observations and Predictions

    Science.gov (United States)

    Bambacus, M.; Alameh, N.; Cole, M.

    2006-12-01

    The Applied Sciences Program at NASA focuses on extending the results of NASA's Earth-Sun system science research beyond the science and research communities to contribute to national priority applications with societal benefits. By employing a systems engineering approach, supporting interoperable data discovery and access, and developing partnerships with federal agencies and national organizations, the Applied Sciences Program facilitates the transition from research to operations in national applications. In particular, the Applied Sciences Program identifies twelve national applications, listed at http://science.hq.nasa.gov/earth-sun/applications/, which can be best served by the results of NASA aerospace research and development of science and technologies. The ability to use and integrate NASA data and science results into these national applications results in enhanced decision support and significant socio-economic benefits for each of the applications. This paper focuses on leveraging the power of interoperability and specifically open standard interfaces in providing efficient discovery, retrieval, and integration of NASA's science research results. Interoperability (the ability to access multiple, heterogeneous geoprocessing environments, either local or remote by means of open and standard software interfaces) can significantly increase the value of NASA-related data by increasing the opportunities to discover, access and integrate that data in the twelve identified national applications (particularly in non-traditional settings). Furthermore, access to data, observations, and analytical models from diverse sources can facilitate interdisciplinary and exploratory research and analysis. To streamline this process, the NASA GeoSciences Interoperability Office (GIO) is developing the NASA Earth-Sun System Gateway (ESG) to enable access to remote geospatial data, imagery, models, and visualizations through open, standard web protocols. The gateway (online

  6. Explosive Technology Group

    Data.gov (United States)

    Federal Laboratory Consortium — The Explosive Technology Group (ETG) provides diverse technical expertise and an agile, integrated approach to solve complex challenges for all classes of energetic...

  7. Coalescent-Based Analyses of Genomic Sequence Data Provide a Robust Resolution of Phylogenetic Relationships among Major Groups of Gibbons

    Science.gov (United States)

    Shi, Cheng-Min; Yang, Ziheng

    2018-01-01

    Abstract The phylogenetic relationships among extant gibbon species remain unresolved despite numerous efforts using morphological, behavorial, and genetic data and the sequencing of whole genomes. A major challenge in reconstructing the gibbon phylogeny is the radiative speciation process, which resulted in extremely short internal branches in the species phylogeny and extensive incomplete lineage sorting with extensive gene-tree heterogeneity across the genome. Here, we analyze two genomic-scale data sets, with ∼10,000 putative noncoding and exonic loci, respectively, to estimate the species tree for the major groups of gibbons. We used the Bayesian full-likelihood method bpp under the multispecies coalescent model, which naturally accommodates incomplete lineage sorting and uncertainties in the gene trees. For comparison, we included three heuristic coalescent-based methods (mp-est, SVDQuartets, and astral) as well as concatenation. From both data sets, we infer the phylogeny for the four extant gibbon genera to be (Hylobates, (Nomascus, (Hoolock, Symphalangus))). We used simulation guided by the real data to evaluate the accuracy of the methods used. Astral, while not as efficient as bpp, performed well in estimation of the species tree even in presence of excessive incomplete lineage sorting. Concatenation, mp-est and SVDQuartets were unreliable when the species tree contains very short internal branches. Likelihood ratio test of gene flow suggests a small amount of migration from Hylobates moloch to H. pileatus, while cross-genera migration is absent or rare. Our results highlight the utility of coalescent-based methods in addressing challenging species tree problems characterized by short internal branches and rampant gene tree-species tree discordance. PMID:29087487

  8. "With a Touch of a Button": Staff perceptions on integrating technology in an Irish service provider for people with intellectual disabilities.

    Science.gov (United States)

    Clifford Simplican, Stacy; Shivers, Carolyn; Chen, June; Leader, Geraldine

    2018-01-01

    People with intellectual disabilities continue to underutilize technology, in part due to insufficient training. Because support staff professionals provide instructional support, how they perceive integrating new technologies is important for people with intellectual disabilities. The authors conducted a sequential mixed-methods exploratory study (quan→QUAL) including quantitative data from online surveys completed by 46 staff members and qualitative data from five focus groups attended by 39 staff members. Quantitative results show strong support for diverse technologies. In contrast, qualitative results suggest that staff members' support of technology decreases when they perceive that technology may jeopardize service users' safety or independence. Although staff members identified increasing independence as the main reason to use new technologies with service users, they also worried that technologies used to increase the social inclusion of service users may pose undue risk and thus may limit their embrace of technology. © 2017 John Wiley & Sons Ltd.

  9. Path integral for coherent states of the dynamical U2 group and U2/1 supergroup

    International Nuclear Information System (INIS)

    Kochetov, E.A.

    1992-01-01

    A part-integral formulation in the representation of coherent states for the unitary U 2 group and U 2/1 supergroup is introduced. U 2 and U 2/1 path integrals are shown to be defined on the coset spaces U 2 /U 1 xU 1 and U 2/1 /U 1/1 xU 1 , respectively. These coset appears as curved classical phase spaces. Partition functions are expressed as path integrals over these spaces. In the case when U 2 and U 2/1 are the dynamical groups, the corresponding path integrals are evaluated with the help of linear fractional transformations that appear as the group (supergroup) action in the coset space (superspace). Possible applications for quantum models are discussed. 9 refs

  10. Understanding the motivations of health-care providers in performing female genital mutilation: an integrative review of the literature.

    Science.gov (United States)

    Doucet, Marie-Hélène; Pallitto, Christina; Groleau, Danielle

    2017-03-23

    Female genital mutilation (FGM) is a traditional harmful practice that can cause severe physical and psychological damages to girls and women. Increasingly, trained health-care providers carry out the practice at the request of families. It is important to understand the motivations of providers in order to reduce the medicalization of FGM. This integrative review identifies, appraises and summarizes qualitative and quantitative literature exploring the factors that are associated with the medicalization of FGM and/or re-infibulation. Literature searches were conducted in PubMed, CINAHL and grey literature databases. Hand searches of identified studies were also examined. The "CASP Qualitative Research Checklist" and the "STROBE Statement" were used to assess the methodological quality of the qualitative and quantitative studies respectively. A total of 354 articles were reviewed for inclusion. Fourteen (14) studies, conducted in countries where FGM is largely practiced as well as in countries hosting migrants from these regions, were included. The main findings about the motivations of health-care providers to practice FGM were: (1) the belief that performing FGM would be less harmful for girls or women than the procedure being performed by a traditional practitioner (the so-called "harm reduction" perspective); (2) the belief that the practice was justified for cultural reasons; (3) the financial gains of performing the procedure; (4) responding to requests of the community or feeling pressured by the community to perform FGM. The main reasons given by health-care providers for not performing FGM were that they (1) are concerned about the risks that FGM can cause for girls' and women's health; (2) are preoccupied by the legal sanctions that might result from performing FGM; and (3) consider FGM to be a "bad practice". The findings of this review can inform public health program planners, policy makers and researchers to adapt or create strategies to end

  11. Substrate-Integrated Waveguide PCB Leaky-Wave Antenna Design Providing Multiple Steerable Beams in the V-Band

    Directory of Open Access Journals (Sweden)

    Matthias Steeg

    2017-12-01

    Full Text Available A periodic leaky-wave antenna (LWA design based on low loss substrate-integrated waveguide (SIW technology with inset half-wave microstrip antennas is presented. The developed LWA operates in the V-band between 50 and 70 GHz and has been fabricated using standard printed circuit board (PCB technology. The presented LWA is highly functional and very compact supporting 1D beam steering and multibeam operation with only a single radio frequency (RF feeding port. Within the operational 50–70 GHz bandwidth, the LWA scans through broadside, providing over 40° H-plane beam steering. When operated within the 57–66 GHz band, the maximum steering angle is 18.2°. The maximum gain of the fabricated LWAs is 15.4 dBi with only a small gain variation of +/−1.5 dB across the operational bandwidth. The beam steering and multibeam capability of the fabricated LWA is further utilized to support mobile users in a 60 GHz hot-spot. For a single user, a maximum wireless on-off keying (OOK data rate of 2.5 Gbit/s is demonstrated. Multibeam operation is achieved using the LWA in combination with multiple dense wavelength division multiplexing (WDM channels and remote optical heterodyning. Experimentally, multibeam operation supporting three users within a 57–66 GHz hot-spot with a total wireless cell capacity of 3 Gbit/s is achieved.

  12. Social Integration and Religious Identity Expression among Dutch Muslims: The Role of Minority and Majority Group Contact

    Science.gov (United States)

    Maliepaard, Mieke; Phalet, Karen

    2012-01-01

    Against the background of contrasting religious versus secular norms in immigrant communities and in Dutch society, this study examines how religious identity expression is related to the social integration of Dutch Muslims within (a) Turkish or Moroccan minority groups and (b) Dutch majority groups. Using nationally representative survey data (N…

  13. Molecules, morphometrics and new fossils provide an integrated view of the evolutionary history of Rhinopomatidae (Mammalia: Chiroptera).

    Science.gov (United States)

    Hulva, Pavel; Horácek, Ivan; Benda, Petr

    2007-09-14

    The Rhinopomatidae, traditionally considered to be one of the most ancient chiropteran clades, remains one of the least known groups of Rhinolophoidea. No relevant fossil record is available for this family. Whereas there have been extensive radiations in related families Rhinolophidae and Hipposideridae, there are only a few species in the Rhinopomatidae and their phylogenetic relationship and status are not fully understood. Here we present (a) a phylogenetic analysis based on a partial cytochrome b sequence, (b) new fossils from the Upper Miocene site Elaiochoria 2 (Chalkidiki, Greece), which represents the first appearance datum of the family based on the fossil record, and (c) discussion of the phylogeographic patterns in both molecular and morphological traits. We found deep divergences in the Rhinopoma hardwickii lineage, suggesting that the allopatric populations in (i) Iran and (ii) North Africa and the Middle East should have separate species status. The latter species (R. cystops) exhibits a shallow pattern of isolation by distance (separating the Middle East and the African populations) that contrasts with the pattern of geographic variation in the morphometrical traits. A deep genetic gap was also found in Rhinopoma muscatellum (Iran vs. Yemen). We found only minute genetic distance between R. microphyllum from the Levant and India, which fails to support the sub/species distinctness of the Indian form (R. microphyllum kinneari). The mtDNA survey provided phylogenetic tree of the family Rhinopomatidae for the first time and revealed an unexpected diversification of the group both within R. hardwickii and R. muscatellum morphospecies. The paleobiogeographic scenario compiled in respect to molecular clock data suggests that the family originated in the region south of the Eocene Western Tethyan seaway or in India, and extended its range during the Early Miocene. The fossil record suggests a Miocene spread into the Mediterranean region, followed by a post

  14. Molecules, morphometrics and new fossils provide an integrated view of the evolutionary history of Rhinopomatidae (Mammalia: Chiroptera

    Directory of Open Access Journals (Sweden)

    Benda Petr

    2007-09-01

    Full Text Available Abstract Background The Rhinopomatidae, traditionally considered to be one of the most ancient chiropteran clades, remains one of the least known groups of Rhinolophoidea. No relevant fossil record is available for this family. Whereas there have been extensive radiations in related families Rhinolophidae and Hipposideridae, there are only a few species in the Rhinopomatidae and their phylogenetic relationship and status are not fully understood. Results Here we present (a a phylogenetic analysis based on a partial cytochrome b sequence, (b new fossils from the Upper Miocene site Elaiochoria 2 (Chalkidiki, Greece, which represents the first appearance datum of the family based on the fossil record, and (c discussion of the phylogeographic patterns in both molecular and morphological traits. We found deep divergences in the Rhinopoma hardwickii lineage, suggesting that the allopatric populations in (i Iran and (ii North Africa and the Middle East should have separate species status. The latter species (R. cystops exhibits a shallow pattern of isolation by distance (separating the Middle East and the African populations that contrasts with the pattern of geographic variation in the morphometrical traits. A deep genetic gap was also found in Rhinopoma muscatellum (Iran vs. Yemen. We found only minute genetic distance between R. microphyllum from the Levant and India, which fails to support the sub/species distinctness of the Indian form (R. microphyllum kinneari. Conclusion The mtDNA survey provided phylogenetic tree of the family Rhinopomatidae for the first time and revealed an unexpected diversification of the group both within R. hardwickii and R. muscatellum morphospecies. The paleobiogeographic scenario compiled in respect to molecular clock data suggests that the family originated in the region south of the Eocene Western Tethyan seaway or in India, and extended its range during the Early Miocene. The fossil record suggests a Miocene spread

  15. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S

    2015-01-01

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  16. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S [UC Davis Cancer Center, Sacramento, CA (United States)

    2015-06-15

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  17. The Second International Piping Integrity Research Group (IPIRG-2) program. Final report, October 1991--April 1996

    International Nuclear Information System (INIS)

    Hopper, A.; Wilowski, G.; Scott, P.; Olson, R.

    1997-03-01

    The IPIRG-2 program was an international group program managed by the US NRC and funded by organizations from 15 nations. The emphasis of the IPIRG-2 program was the development of data to verify fracture analyses for cracked pipes and fittings subjected to dynamic/cyclic load histories typical of seismic events. The scope included: (1) the study of more complex dynamic/cyclic load histories, i.e., multi-frequency, variable amplitude, simulated seismic excitations, than those considered in the IPIRG-1 program, (2) crack sizes more typical of those considered in Leak-Before-Break (LBB) and in-service flaw evaluations, (3) through-wall-cracked pipe experiments which can be used to validate LBB-type fracture analyses, (4) cracks in and around pipe fittings, such as elbows, and (5) laboratory specimen and separate effect pipe experiments to provide better insight into the effects of dynamic and cyclic load histories. Also undertaken were an uncertainty analysis to identify the issues most important for LBB or in-service flaw evaluations, updating computer codes and databases, the development and conduct of a series of round-robin analyses, and analyst's group meetings to provide a forum for nuclear piping experts from around the world to exchange information on the subject of pipe fracture technology. 17 refs., 104 figs., 41 tabs

  18. Final Report. An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group

    Energy Technology Data Exchange (ETDEWEB)

    Rosenthal, Andrew [New Mexico State Univ., Las Cruces, NM (United States)

    2013-12-30

    The DOE grant, “An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group,” to New Mexico State University created the Solar America Board for Codes and Standards (Solar ABCs). From 2007 – 2013 with funding from this grant, Solar ABCs identified current issues, established a dialogue among key stakeholders, and catalyzed appropriate activities to support the development of codes and standards that facilitated the installation of high quality, safe photovoltaic systems. Solar ABCs brought the following resources to the PV stakeholder community; Formal coordination in the planning or revision of interrelated codes and standards removing “stove pipes” that have only roofing experts working on roofing codes, PV experts on PV codes, fire enforcement experts working on fire codes, etc.; A conduit through which all interested stakeholders were able to see the steps being taken in the development or modification of codes and standards and participate directly in the processes; A central clearing house for new documents, standards, proposed standards, analytical studies, and recommendations of best practices available to the PV community; A forum of experts that invites and welcomes all interested parties into the process of performing studies, evaluating results, and building consensus on standards and code-related topics that affect all aspects of the market; and A biennial gap analysis to formally survey the PV community to identify needs that are unmet and inhibiting the market and necessary technical developments.

  19. Dynamical mean-field theory and path integral renormalisation group calculations of strongly correlated electronic states

    Energy Technology Data Exchange (ETDEWEB)

    Heilmann, D.B.

    2007-02-15

    The two-plane HUBBARD model, which is a model for some electronic properties of undoped YBCO superconductors as well as displays a MOTT metal-to-insulator transition and a metal-to-band insulator transition, is studied within Dynamical Mean-Field Theory using HIRSCH-FYE Monte Carlo. In order to find the different transitions and distinguish the types of insulator, we calculate the single-particle spectral densities, the self-energies and the optical conductivities. We conclude that there is a continuous transition from MOTT to band insulator. In the second part, ground state properties of a diagonally disordered HUBBARD model is studied using a generalisation of Path Integral Renormalisation Group, a variational method which can also determine low-lying excitations. In particular, the distribution of antiferromagnetic properties is investigated. We conclude that antiferromagnetism breaks down in a percolation-type transition at a critical disorder, which is not changed appreciably by the inclusion of correlation effects, when compared to earlier studies. Electronic and excitation properties at the system sizes considered turn out to primarily depend on the geometry. (orig.)

  20. Dynamical mean-field theory and path integral renormalisation group calculations of strongly correlated electronic states

    International Nuclear Information System (INIS)

    Heilmann, D.B.

    2007-02-01

    The two-plane HUBBARD model, which is a model for some electronic properties of undoped YBCO superconductors as well as displays a MOTT metal-to-insulator transition and a metal-to-band insulator transition, is studied within Dynamical Mean-Field Theory using HIRSCH-FYE Monte Carlo. In order to find the different transitions and distinguish the types of insulator, we calculate the single-particle spectral densities, the self-energies and the optical conductivities. We conclude that there is a continuous transition from MOTT to band insulator. In the second part, ground state properties of a diagonally disordered HUBBARD model is studied using a generalisation of Path Integral Renormalisation Group, a variational method which can also determine low-lying excitations. In particular, the distribution of antiferromagnetic properties is investigated. We conclude that antiferromagnetism breaks down in a percolation-type transition at a critical disorder, which is not changed appreciably by the inclusion of correlation effects, when compared to earlier studies. Electronic and excitation properties at the system sizes considered turn out to primarily depend on the geometry. (orig.)

  1. [Tailored Care for Functional Vertigo/Dizziness - An Integrative Group Psychotherapy Approach].

    Science.gov (United States)

    Radziej, Katharina; Schmid-Mühlbauer, Gabriele; Limburg, Karina; Lahmann, Claas

    2017-06-01

    Functional vertigo and dizziness (VD) symptoms are highly prevalent and usually accompanied by a strong impairment of quality in everyday and working life. The complaints are often associated with various psychiatric disorders, particularly phobic and other anxiety disorders, depressive or somatoform disorders. Despite this clinical relevance of VD symptoms, studies towards psychotherapeutic treatment options for patients with functional VD are still rare. Thus, the present study outlines a manual for outpatient group therapy for patients with functional VD symptoms. Our approach aims to assist patients in developing an understanding of the interaction between bodily complaints and psychosocial factors while detracting from a purely symptom based focus. The integrative-psychotherapeutic treatment program consists of 16 weekly sessions and includes a regular vestibular rehabilitation training as well as disorder-oriented modules towards anxiety and panic disorder, depression, and somatisation. We are currently conducting a randomised controlled trial in order to evaluate the short- and long-term effectiveness of the program in reducing VD and further bodily symptoms, vertigo-related social and physical handicap as well as anxiety and depressive complaints. A previously completed pilot trial has led to small to large pre-follow-up-effects on primary and secondary outcome measures. Conclusions regarding acceptance and feasibility of the therapy concept are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  2. A 10-year follow-up study of completers versus dropouts following treatment with an integrated cognitive-behavioral group therapy for eating disorders.

    Science.gov (United States)

    Okamoto, Yuri; Miyake, Yoshie; Nagasawa, Ichie; Shishida, Kazuhiro

    2017-01-01

    Cognitive-behavioral therapy (CBT) has been recommended for the treatment of eating disorders, and group therapy is known to have certain advantages over individual therapy. The aim of the current study was to compare the 10-year prognosis of patients who completed integrated group CBT with those who dropped out and to examine the effect of completion of group CBT on the prognosis. The participants were 65 adult patients with eating disorders. All patients were women and Japanese. The average age (19-37) of the patients was 25.1 ± 3.8 years, and the average body mass index (BMI) was 17.7 ± 2.0. We conducted integrated group CBT with the patients and compared eating disorder symptoms, mood states, coping styles, and self-esteem before and after therapy. Furthermore, we compared clinical features and the 10-year prognosis of patients who completed the treatment and those who dropped out. After 10 sessions of group therapy, Eating Attitudes Test scores, Profile of Mood States depression scores, and Coping Inventory for Stressful Situations emotion-oriented scores decreased, while Rosenberg's Self-Esteem Scale scores increased. Regarding the results of the 10-year follow up, the completer group had more patients with a good prognosis. In contrast, the dropout group had more patients with a poor prognosis. Those who completed the integrated group CBT had a good prognosis. Group therapy gives the patients an opportunity to form peer relationships, and helps them to develop communication and socialization skills. Furthermore, in the group therapy sessions, the patients develop self-awareness by listening to other members of the group and they also develop interpersonal relationships. This effect may be temporary, but experience of group therapy may provide hope for the patient and increase the chance of the patient continuing treatment. Retrospectively registered in University Hospital Medical Information Network in Japan: No. 000028868 (May 19th, 2017).

  3. Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers.

    Science.gov (United States)

    Lau, Janice Ying-Chui; Wong, Eliza Lai-Yi; Chung, Roger Y; Law, Stephen C K; Threapleton, Diane; Kiang, Nicole; Chau, Patsy; Wong, Samuel Y S; Woo, Jean; Yeoh, Eng-Kiong

    2018-04-27

    To examine the barriers that hinder collaboration between health care and social care services and to report recommendations for effective collaboration to meet the growing support and care needs of our ageing population. Data for this qualitative study were obtained from interviews with 7 key informants (n = 42) and 22 focus groups (n = 117) consisting of service providers who were from the health care or social care sectors and supporting elderly patients with multiple chronic diseases or long-term care needs. Data collection was conducted from 2015 to 2016. The data were analysed using an inductive approach on the basis of thematic analysis. Qualitative analysis reviewed a number of factors that play a significant role in setting up barriers at the operational level, including fragmentation and lack of sustainability of discharge programmes provided by non-governmental organisations, lack of capacity of homes for the elderly, limitation of time and resources, and variation of roles in supporting end-of-life care decisions between the medical and social sectors. Other barriers are those of communication to be found at the structural level and perceptual ones that exist between professionals. Of these, perceptual barriers affect attitudes and create mistrust and interprofessional stereotypes and a hierarchy between the health care and social care sectors. Health care and social care service providers recognise the need for collaborative work to enhance continuity of care and ageing in place; however, their efforts are hindered by the identified barriers that need to be dealt with in practical terms and by a change of policy. Copyright © 2018 John Wiley & Sons, Ltd.

  4. An Integral Model to Provide Reactive and Proactive Services in an Academic CSIRT Based on Business Intelligence

    Directory of Open Access Journals (Sweden)

    Walter Fuertes

    2017-11-01

    Full Text Available Cyber-attacks have increased in severity and complexity. That requires, that the CERT/CSIRT research and develops new security tools. Therefore, our study focuses on the design of an integral model based on Business Intelligence (BI, which provides reactive and proactive services in a CSIRT, in order to alert and reduce any suspicious or malicious activity on information systems and data networks. To achieve this purpose, a solution has been assembled, that generates information stores, being compiled from a continuous network transmission of several internal and external sources of an organization. However, it contemplates a data warehouse, which is focused like a correlator of logs, being formed by the information of feeds with diverse formats. Furthermore, it analyzed attack detection and port scanning, obtained from sensors such as Snort and Passive Vulnerability Scanner, which are stored in a database, where the logs have been generated by the systems. With such inputs, we designed and implemented BI systems using the phases of the Ralph Kimball methodology, ETL and OLAP processes. In addition, a software application has been implemented using the SCRUM methodology, which allowed to link the obtained logs to the BI system for visualization in dynamic dashboards, with the purpose of generating early alerts and constructing complex queries using the user interface through objects structures. The results demonstrate, that this solution has generated early warnings based on the level of criticality and level of sensitivity of malware and vulnerabilities as well as monitoring efficiency, increasing the level of security of member institutions.

  5. Efficacy of hospital in the home services providing care for patients admitted from emergency departments: an integrative review.

    Science.gov (United States)

    Varney, Jane; Weiland, Tracey J; Jelinek, George

    2014-06-01

    Increases in emergency department (ED) demand may compromise patient outcomes, leading not only to overcrowding in the ED, increased ED waiting times and increased ED length of stay, but also compromising patient safety; the risk of adverse events is known to rise in the presence of overcrowding. Hospital in the home (HiTH) services may offer one means of reducing ED demand. This integrative review sought to assess the efficacy of admission-avoidance HiTH services that admit patients directly from the ED. Papers published between 1995 and 2013 were identified through searches of Medline, CINAHL and Google. English-language studies that assessed the efficacy of a HiTH service and that recruited at least one-third of the participants directly from the ED were included in the review. A HiTH service was considered one that provided health professional support to patients at home for a time-limited period, thus avoiding the need for hospitalization. Twenty-two articles met the inclusion criteria for this review. The interventions were diverse in terms of the clinical interventions delivered, the range and intensity of health professional input and the conditions treated. The studies included in the review found no effect on clinical outcomes, rates of adverse events or complications, although patient satisfaction and costs were consistently and favourably affected by HiTH treatment. Given evidence suggesting that HiTH services which recruit patients directly from the ED contribute to cost-savings, greater patient satisfaction and safety and efficacy outcomes that are at least equivalent to those associated with hospital-based care, the expansion of such programmes might therefore be considered a priority for policy makers.

  6. Integrated application of transcriptomics and metabolomics provides insights into glycogen content regulation in the Pacific oyster Crassostrea gigas.

    Science.gov (United States)

    Li, Busu; Song, Kai; Meng, Jie; Li, Li; Zhang, Guofan

    2017-09-11

    The Pacific oyster Crassostrea gigas is an important marine fishery resource, which contains high levels of glycogen that contributes to the flavor and the quality of the oyster. However, little is known about the molecular and chemical mechanisms underlying glycogen content differences in Pacific oysters. Using a homogeneous cultured Pacific oyster family, we explored these regulatory networks at the level of the metabolome and the transcriptome. Oysters with the highest and lowest natural glycogen content were selected for differential transcriptome and metabolome analysis. We identified 1888 differentially-expressed genes, seventy-five differentially-abundant metabolites, which are part of twenty-seven signaling pathways that were enriched using an integrated analysis of the interaction between the differentially-expressed genes and the differentially-abundant metabolites. Based on these results, we found that a high expression of carnitine O-palmitoyltransferase 2 (CPT2), indicative of increased fatty acid degradation, is associated with a lower glycogen content. Together, a high level of expression of phosphoenolpyruvate carboxykinase (PEPCK), and high levels of glucogenic amino acids likely underlie the increased glycogen production in high-glycogen oysters. In addition, the higher levels of the glycolytic enzymes hexokinase (HK) and pyruvate kinase (PK), as well as of the TCA cycle enzymes malate dehydrogenase (MDH) and pyruvate carboxylase (PYC), imply that there is a concomitant up-regulation of energy metabolism in high-glycogen oysters. High-glycogen oysters also appeared to have an increased ability to cope with stress, since the levels of the antioxidant glutathione peroxidase enzyme 5 (GPX5) gene were also increased. Our results suggest that amino acids and free fatty acids are closely related to glycogen content in oysters. In addition, oysters with a high glycogen content have a greater energy production capacity and a greater ability to cope with

  7. Integrated Qs Al Mudatsir in the reality group counseling to grow the character of students academic responsibility

    Directory of Open Access Journals (Sweden)

    Asroful Kadafi

    2017-11-01

    The emotional development of students in early teens showed a sensitive and recreative nature (critical, emotions are often negative and temperamental. This negative passion is evidenced by the findings in the field of Indonesian teenagers, such as Tawuran, promiscuity, students who dare to do nasty with school friends (Tirto, 2013. Many factors are the cause, one of which is still the weak character of academic responsibility that students have. This problem becomes a serious problem in the world of education Indonesia. Therefore, it is natural for educational practitioners to take solutive steps to overcome the problem. One education practitioner who has a strategic position to handle the case is Counselor. Counselors are deemed able to provide practical solutions through Reality Group Counseling services by integrating spiritual values (Islam to foster student academic responsibilities. Reality group counseling emphasizes the growth of personal responsibility. This advice is also in line with Islamic values that encourage individuals always to be responsible for every action as reflected in the QS. Al Muddassir: 38.

  8. Integration of Density Dependence and Concentration Response Models Provides an Ecologically Relevant Assessment of Populations Exposed to Toxicants

    Science.gov (United States)

    The assessment of toxic exposure on wildlife populations involves the integration of organism level effects measured in toxicity tests (e.g., chronic life cycle) and population models. These modeling exercises typically ignore density dependence, primarily because information on ...

  9. The benefits of Outsourcing facility services when selecting right service provider for a hotel:Case Kämp Group Oy

    OpenAIRE

    Paudyal, Manoj; Acharya, Saroj

    2015-01-01

    This research paper examines about the outsourcing of facility services in the Kämp group of hotels. The scope of the study includes Facility Management, outsourcing facilities services, and the selection process of the service providers for a hotel. The research was carried at the hotels of Kämp group Oy in the Metropolitan Area of Helsinki. Facility management includes wide ranges of non-core functions such as Property management, real estates, design and technology. Activities such as secu...

  10. Provider and Staff Perceptions and Experiences Implementing Behavioral Health Integration in Six Low-Income Health Care Organizations.

    Science.gov (United States)

    Farb, Heather; Sacca, Katie; Variano, Margaret; Gentry, Lisa; Relle, Meagan; Bertrand, Jane

    2018-01-01

    Behavioral health integration (BHI) is a proven, effective practice for addressing the joint behavioral health and medical health needs of vulnerable populations. As part of the New Orleans Charitable Health Fund (NOCHF) program, this study addressed a gap in literature to better understand factors that impact the implementation of BHI by analyzing perceptions and practices among staff at integrating organizations. Using a mixed-method design, quantitative results from the Levels of Integration Measure (LIM), a survey tool for assessing staff perceptions of BHI in primary care settings (n=86), were analyzed alongside qualitative results from in-depth interviews with staff (n=27). Findings highlighted the roles of strong leadership, training, and process changes on staff collaboration, relationships, and commitment to BHI. This study demonstrates the usefulness of the LIM in conjunction with in-depth interviews as an assessment tool for understanding perceptions and organizational readiness for BHI implementation.

  11. Providing an integrated waste management strategy and operation focused on project end states at the Hanford site

    International Nuclear Information System (INIS)

    Blackford, L.

    2009-01-01

    responsibilities; 3) provides a basis for budgeting; and 4) reflects a concerted goal of achieving full regulatory compliance and remediation (with enforceable milestones) in an aggressive manner. CHPRC's approach to safely accelerate and accomplish solid waste stabilization and disposition provides an integrated waste management (WM) strategy and operation focused on project end states. CHPRC will present planned approaches for waste stabilization and disposition based on lessons learned at other DOE sites and discuss optimizing solutions to accelerating TPA milestone M-91 TRU waste retrieval activities through innovation and increased production, Point of Generation waste management, unique transport and packaging systems that are re-usable, and in-field waste handling and treatment processes that have generated cost saving and are generating early-completion cost savings of $66 million on the PRC that can be redirected to other pressing Hanford Plateau Remediation Contract (PRC) projects. (authors)

  12. Social facilitation of eating novel food in tufted capuchin monkeys (Cebus apella): input provided by group members and responses affected in the observer.

    Science.gov (United States)

    Addessi, E; Visalberghi, E

    2001-11-01

    Learning about food palatability from watching what conspecifics eat might be one of the advantages of group living. A previous study investigated whether group members' presence or eating activity account for social facilitation of eating of foods never previously tasted. Capuchins encountered novel colored foods when (1) alone (Alone condition) or (2) with group members visible in the nearby cage (Group-present condition) or (3) with group members present and eating a familiar food that had not been colored (Group+food condition). Social facilitation of eating occurred when group members were eating, despite the difference in color between the familiar food eaten by them and the novel food presented to the experimental subject. To clarify what subjects learnt from group members when social facilitation occurred, we further analyze here the data from the previous study. The number of visual exposures to the colored novel food (as a group member) correlated with increased consumption of that novel food when encountered later (as experimental subject). In contrast, the number of times that an individual fed on the familiar food (as a group member) did not decrease its consumption of novel food (as experimental subject). Therefore, capuchins (1) habituated to the colors of the novel foods, and (2) did not take into account that seeing group members eating a food does not provide information about the palatability of a differently colored food. Since social facilitation of eating occurs when foods do not match in color, at least in capuchins, social facilitation of eating should not be considered as a way of learning about a safe diet, but rather as a way of overcoming neophobia.

  13. The Hydrograph Analyst, an Arcview GIS Extension That Integrates Point, Spatial, and Temporal Data Provides A Graphical User Interface for Hydrograph Analysis

    International Nuclear Information System (INIS)

    Jones, M.L.; O'Brien, G.M.; Jones, M.L.

    2000-01-01

    The Hydrograph Analyst (HA) is an ArcView GIS 3.2 extension developed by the authors to analyze hydrographs from a network of ground-water wells and springs in a regional ground-water flow model. ArcView GIS integrates geographic, hydrologic, and descriptive information and provides the base functionality needed for hydrograph analysis. The HA extends ArcView's base functionality by automating data integration procedures and by adding capabilities to visualize and analyze hydrologic data. Data integration procedures were automated by adding functionality to the View document's Document Graphical User Interface (DocGUI). A menu allows the user to query a relational database and select sites which are displayed as a point theme in a View document. An ''Identify One to Many'' tool is provided within the View DocGUI to retrieve all hydrologic information for a selected site and display it in a simple and concise tabular format. For example, the display could contain various records from many tables storing data for one site. Another HA menu allows the user to generate a hydrograph for sites selected from the point theme. Hydrographs generated by the HA are added as hydrograph documents and accessed by the user with the Hydrograph DocGUI, which contains tools and buttons for hydrograph analysis. The Hydrograph DocGUI has a ''Select By Polygon'' tool used for isolating particular points on the hydrograph inside a user-drawn polygon or the user could isolate the same points by constructing a logical expression with the ArcView GIS ''Query Builder'' dialog that is also accessible in the Hydrograph DocGUI. Other buttons can be selected to alter the query applied to the active hydrograph. The selected points on the active hydrograph can be attributed (or flagged) individually or as a group using the ''Flag'' tool found on the Hydrograph DocGUI. The ''Flag'' tool activates a dialog box that prompts the user to select an attribute and ''methods'' or ''conditions'' that qualify

  14. 49 CFR 214.353 - Training and qualification of roadway workers who provide on-track safety for roadway work groups.

    Science.gov (United States)

    2010-10-01

    ... RAILROAD WORKPLACE SAFETY Roadway Worker Protection § 214.353 Training and qualification of roadway workers who provide on-track safety for roadway work groups. (a) The training and qualification of roadway... 49 Transportation 4 2010-10-01 2010-10-01 false Training and qualification of roadway workers who...

  15. The Turn the Tables Technique (T[cube]): A Program Activity to Provide Group Facilitators Insight into Teen Sexual Behaviors and Beliefs

    Science.gov (United States)

    Sclafane, Jamie Heather; Merves, Marni Loiacono; Rivera, Angelic; Long, Laura; Wilson, Ken; Bauman, Laurie J.

    2012-01-01

    The Turn the Tables Technique (T[cube]) is an activity designed to provide group facilitators who lead HIV/STI prevention and sexual health promotion programs with detailed and current information on teenagers' sexual behaviors and beliefs. This information can be used throughout a program to tailor content. Included is a detailed lesson plan of…

  16. ADVANCED VOCATIONAL TRAINING OF ENVIRONMENTAL PROFESSIONALS FOR PROVIDING SUSTAINABLE DEVELOPMENT OF RAILWAYS OF UKRAINE ON THE WAY TO EUROPEAN INTEGRATION

    Directory of Open Access Journals (Sweden)

    Zoriana Dvulit

    2017-12-01

    Full Text Available The subject of the research is to study the state of issue of advanced training of environmental professionals and specialists on six railways of Ukrzaliznytsia PJSC: Donetsk, Lviv, Odesa, Pivdenna (Southern, Pivdenno-Zakhidna (Southwestern and Pridniprovska Railways. The purpose of the article is to study the issue of providing the necessary qualification level of postgraduate education (advanced training of environmental professionals and specialists at six Ukrainian railways. The methodology of the research: In order to achieve the goal, the following methods are used in the article: 1 statistical methods and methods of comparative analysis; 2 questionnaires and expert surveys of environmental professionals and specialists; 3 taxonomic methods. The novelty of the research. The state of the issue of ensuring the necessary level of professional development of environmental professionals and specialists at six railways of Ukrzaliznytsia PJSC is investigated. Namely: 1. the state of the level of professional development of environmental professionals and specialists of 6 railways of Ukrzaliznytsia PJSC for the period from 2012 to 2016 is researched and evaluated; its structural and dynamic analysis is carried out; 2. calculations of taxonomic indicators of the level of development of career development system for environmental professionals and specialists as distribution of expenses for advanced training for 6 railways for 2012–2016 are made; 3. carried out a questionnaire of environmental professionals and specialists, whose list of functional responsibilities, in accordance with the job description (both staffed and part-time workers, includes issues of the use of natural resources and environmental protection – in order to clarify the availability of environmental education, the length of work in the railway, the length of work in positions associated with environmental activities, the level of satisfaction with the content of their work

  17. Integrating spirituality into a group psychological therapy program for cancer patients.

    Science.gov (United States)

    Cunningham, Alastair J

    2005-06-01

    Although the importance of spiritual issues to people with cancer is by now widely acknowledged, there has been almost no research on the value of interventions specifically designed to enhance the spiritual experience of these patients. The present report describes an exploratory study on the effects of a brief psychoeducational course emphasizing spiritual aspects of coping and healing. Ninety-seven patients with various types and stages of cancer took part in the 8-session course as the third stage in a progressive, stepwise program of support and psychological education. Standard psychometric tests were administered at entry, 8 weeks, and 6 months. Written home assignments, returned by participants, provided an insight into their experience. Significant improvements in scores were found immediately following the intervention; by 6 months, however, these improvements above entry level had declined to about half the 8-week value. In their written homework, patients grappled with such issues as doubts about the existence of a god, judgment and forgiveness, guilt, projection, self-importance, and the meaning of love. As the course progressed, many claimed to be better able to accept their condition and to experience an enhanced sense of meaning in their lives, coupled with a heightened appreciation for the events of everyday life and less tendency to conflict with others. These preliminary findings indicate that further, more rigorous investigation would be worthwhile and support the growing view that addressing spiritual issues within the framework of group therapy can be of great benefit to people with cancer.

  18. On the use of the Lie group technique for differential equations with a small parameter: Approximate solutions and integrable equations

    International Nuclear Information System (INIS)

    Burde, G.I.

    2002-01-01

    A new approach to the use of the Lie group technique for partial and ordinary differential equations dependent on a small parameter is developed. In addition to determining approximate solutions to the perturbed equation, the approach allows constructing integrable equations that have solutions with (partially) prescribed features. Examples of application of the approach to partial differential equations are given

  19. 76 FR 19174 - In the Matter of Circuit Systems, Inc., Global Energy Group, Inc., Integrated Medical Resources...

    Science.gov (United States)

    2011-04-06

    ... SECURITIES AND EXCHANGE COMMISSION File No. 500-1 In the Matter of Circuit Systems, Inc., Global Energy Group, Inc., Integrated Medical Resources, Inc., iNTELEFILM Corp., and Lot$off Corp.; Order of... lack of current and accurate information concerning the securities of Circuit Systems, Inc. because it...

  20. 78 FR 14798 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-03-07

    ... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information about...

  1. The integrable quantum group invariant A2n-1(2) and Dn+1(2) open spin chains

    Science.gov (United States)

    Nepomechie, Rafael I.; Pimenta, Rodrigo A.; Retore, Ana L.

    2017-11-01

    A family of A2n(2) integrable open spin chains with Uq (Cn) symmetry was recently identified in arxiv:arXiv:1702.01482. We identify here in a similar way a family of A2n-1(2) integrable open spin chains with Uq (Dn) symmetry, and two families of Dn+1(2) integrable open spin chains with Uq (Bn) symmetry. We discuss the consequences of these symmetries for the degeneracies and multiplicities of the spectrum. We propose Bethe ansatz solutions for two of these models, whose completeness we check numerically for small values of n and chain length N. We find formulas for the Dynkin labels in terms of the numbers of Bethe roots of each type, which are useful for determining the corresponding degeneracies. In an appendix, we briefly consider Dn+1(2) chains with other integrable boundary conditions, which do not have quantum group symmetry.

  2. The integrable quantum group invariant A2n−1(2 and Dn+1(2 open spin chains

    Directory of Open Access Journals (Sweden)

    Rafael I. Nepomechie

    2017-11-01

    Full Text Available A family of A2n(2 integrable open spin chains with Uq(Cn symmetry was recently identified in arXiv:1702.01482. We identify here in a similar way a family of A2n−1(2 integrable open spin chains with Uq(Dn symmetry, and two families of Dn+1(2 integrable open spin chains with Uq(Bn symmetry. We discuss the consequences of these symmetries for the degeneracies and multiplicities of the spectrum. We propose Bethe ansatz solutions for two of these models, whose completeness we check numerically for small values of n and chain length N. We find formulas for the Dynkin labels in terms of the numbers of Bethe roots of each type, which are useful for determining the corresponding degeneracies. In an appendix, we briefly consider Dn+1(2 chains with other integrable boundary conditions, which do not have quantum group symmetry.

  3. Integrative and distributive negotiation in small groups : Effects of task structure, decision rule, and social motive

    NARCIS (Netherlands)

    Beersma, Bianca; De Dreu, Carsten K W

    2002-01-01

    This study examined the interactive effects of task structure, decision rule, and social motive on small-group negotiation processes and outcomes. Three-person groups negotiated either within an asymmetrical task structure (in which a majority of group members have compatible interests) or within a

  4. An evaluation of the performance of an integrated solar combined cycle plant provided with air-linear parabolic collectors

    International Nuclear Information System (INIS)

    Amelio, Mario; Ferraro, Vittorio; Marinelli, Valerio; Summaria, Antonio

    2014-01-01

    An evaluation of the performance of an innovative solar system integrated in a combined cycle plant is presented, in which the heat transfer fluid flowing in linear parabolic collectors is the same oxidant air that is introduced into the combustion chamber of the plant. This peculiarity allows a great simplification of the plant. There is a 22% saving of fossil fuel results in design conditions and 15.5% on an annual basis, when the plant works at nominal volumetric flow rate in the daily hours. The net average year efficiency is 60.9% against the value of 51.4% of a reference combined cycle plant without solar integration. Moreover, an economic evaluation of the plant is carried out, which shows that the extra-cost of the solar part is recovered in about 5 years. - Highlights: • A model to calculate an innovative ISCCS (Integrated solar Combined Cycle Systems) solar plant is presented. • The plant uses air as heat transfer fluid as well as oxidant in the combustor. • The plant presents a very high thermodynamic efficiency. • The plant is very simple in comparison with existing ISCCS

  5. Development and application of knowledge-based subject group integration platforms:A case study of Shanghai Institute of Ceramics,CAS

    Institute of Scientific and Technical Information of China (English)

    Yu; LIU; Jian; FU; Huijun; ZHENG; Hao; CHEN; Zhiping; YANG

    2014-01-01

    Purpose:According to the different requirements of research group users,we established the knowledge-based subject group integration platforms of Shanghai Institute of Ceramics,the Chinese Academy of Sciences(abbreviated as SIC CAS hereinafter),which were designed and constructed to better meet the needs of CAS research groups for their development,collaboration and communication.Design/methodology/approach:We first identified the requirements of users via preliminary investigation,and then chose CASI1 P,iLibrary and XKE technology,respectively as the building tools compatible with the major demands of users.These steps helped us complete the layout design of SIC CAS integration platforms,as well as its knowledge organization and integration.Findings:According to the need of users,we applied three types of platform construction technologies to five SIC integration platforms,and formulated standard norms for the further construction process,which could provide useful reference for a sustainable development for the extensive construction in CAS institutes.Research limitations:In order to make the SIC integration platforms more intelligent and have more functions,we need to enlarge the scale of the Platforms and upgrade the building tools for the platform construction.Practical implications:The nature of SIC sub-project integration platforms is to construct a content-sensitive environment which can embed knowledge services and knowledge applications seamlessly into scientific activities,so the Platform is expected to be a useful tool to help researchers better understand the recent development of the research field and form collaborations with their peers.Originality/value:SIC integration platforms are the only pilot construction that used 3different platform technologies in the first batch of knowledge-based subject group integration platforms of the Chinese Academy of Sciences.The construction is user-centered throughout the whole process,namely,from the technology

  6. Integrating DNA barcodes and morphology for species delimitation in the Corynoneura group (Diptera: Chironomidae: Orthocladiinae).

    Science.gov (United States)

    Silva, F L; Wiedenbrug, S

    2014-02-01

    In this study, we use DNA barcodes for species delimitation to solve taxonomic conflicts in 86 specimens of 14 species belonging to the Corynoneura group (Diptera: Chironomidae: Orthocladiinae), from the Atlantic Forest, Brazil. Molecular analysis of cytochrome c-oxidase subunit I (COI) gene sequences supported 14 cohesive species groups, of which two similar groups were subsequently associated with morphological variation at the pupal stage. Eleven species previously described based on morphological criteria were linked to DNA markers. Furthermore, there is the possibility that there may be cryptic species within the Corynoneura group, since one group of species presented internal grouping, although no morphological divergence was observed. Our results support DNA-barcoding as an excellent tool for species delimitation in groups where taxonomy by means of morphology is difficult or even impossible.

  7. Group integration for lattice gauge theory at large and at small coupling

    International Nuclear Information System (INIS)

    Brower, R.C.; Nauenberg, M.

    1981-01-01

    We consider the fundamental SU(N) invariant integrals encountered in Wilson's lattice QCD with an eye to analytical results for N → infinite and approximations for small g 2 at fixed N. We develop a new semiclassical technique starting from the Schwinger-Dyson equations cast in differential form to give an exact solution to the single-link integral for N → infinite. The third-order phase transition discovered by Gross and Witten for two-dimensional QCD occurs here for any dimension. Alternatively we parametrize directly the integral over the Haar measure and obtain approximate results for SU(N) using stationary phase at small g 2 . Remarkably the single-loop correction gives the exact answer at N = infinite. We show that the naive lattice string of Weingarten is obtained from N → infinite QCD in the limit of dimensions d → infinite. We discuss applications of our techniques to the 1/N expansion. (orig.)

  8. Integrated social facility location planning for decision support: Accessibility studies provide support to facility location and integration of social service provision

    CSIR Research Space (South Africa)

    Green, Cheri A

    2012-09-01

    Full Text Available for two or more facilities to create an integrated plan for development Step 6 Costing of development plan Case Study Access norms and thresholds guidelines in accessibility analysis Appropriate norms/provision guidelines facilitate both service... access norms and threshold standards ?Test the relationship between service demand and the supply (service capacity) of the facility provision points within a defined catchment area ?Promote the ?right?sizing? of facilities relative to the demand...

  9. The Role of Adolescent Friendship Group Integration and Cohesion in Weapon-Related Violent Crime as a Young Adult.

    Science.gov (United States)

    Mundt, Marlon P; Antonaccio, Olena P; French, Michael T; Zakletskaia, Larissa I

    2017-08-01

    Weapon-related violent crime is a serious, complex, and multifaceted public health problem. The present study uses data from Waves I and III of Add Health (n = 10,482, 54% female) to examine how friendship group integration and cohesion in adolescence (ages 12-19) is associated with weapon-related criminal activity as a young adult (ages 18-26). Results indicate that greater cohesion in friendship groups is associated with significantly lower weapon-related criminal activity in young adulthood. In addition, for adolescent girls, a greater number of close friendship ties-an indicator of friendship group integration-is associated with less weapon-related criminal activity in young adulthood. These findings suggest that school-based initiatives to facilitate inclusive and cohesive adolescent peer communities may be an effective strategy to curb weapon-related criminal activity in young adulthood.

  10. Integrating cell-free biosyntheses of heme prosthetic group and apoenzyme for the synthesis of functional P450 monooxygenase.

    Science.gov (United States)

    Kwon, Yong-Chan; Oh, In-Seok; Lee, Nahum; Lee, Kyung-Ho; Yoon, Yeo Joon; Lee, Eun Yeol; Kim, Byung-Gee; Kim, Dong-Myung

    2013-04-01

    Harnessing the isolated protein synthesis machinery, cell-free protein synthesis reproduces the cellular process of decoding genetic information in artificially controlled environments. More often than not, however, generation of functional proteins requires more than simple translation of genetic sequences. For instance, many of the industrially important enzymes require non-protein prosthetic groups for biological activity. Herein, we report the complete cell-free biogenesis of a heme prosthetic group and its integration with concurrent apoenzyme synthesis for the production of functional P450 monooxygenase. Step reactions required for the syntheses of apoenzyme and the prosthetic group have been designed so that these two separate pathways take place in the same reaction mixture, being insulated from each other. Combined pathways for the synthesis of functional P450 monooxygenase were then further integrated with in situ assay reactions to enable real-time measurement of enzymatic activity during its synthesis. Copyright © 2012 Wiley Periodicals, Inc.

  11. Providing patients with information about disease-modifying anti-rheumatic drugs: Individually or in groups? A pilot randomized controlled trial comparing adherence and satisfaction.

    Science.gov (United States)

    Homer, Dawn; Nightingale, Peter; Jobanputra, Paresh

    2009-06-01

    Communicating information about disease-modifying anti-rheumatic drugs (DMARDs) before patients start treatment is a key role for some rheumatology clinical nurse specialists. This is done in our unit to promote understanding of the risks and benefits of drug therapy and encourage timely and reliable use of DMARDs. Information is routinely provided individually but this can lead to delays in starting treatment because of limited nursing resources. In this randomized trial we tested the feasibility of giving patients, who were about to start on a DMARD, information about the drug in groups and compared this with information given individually. Adults with a clinical diagnosis of rheumatoid arthritis or psoriatic arthritis who were referred to the nursing team for counselling about starting on methotrexate, sulfasalazine or leflunomide were included. Patients who had previously taken a DMARD were not excluded and those consenting were randomized to receive drug information individually or in groups (of three to six patients). We provided all patients with written materials about the relevant drug and discussed the risks and benefits of drug use verbally. Patients allocated to group counselling received this intervention in a teaching room, with a slide presentation. The primary outcome was adherence with medication use, ascertained by pill counts, self-report diaries and prescription dispensation. Secondary outcomes included satisfaction with information about medicines (SIMS) by questionnaire; time taken to provide information; adherence to scheduled hospital appointments and blood monitoring schedules; and DMARD continuation rates at four and twelve months. Of 127 eligible patients referred for counselling about DMARDs, 62 consented to take part: 32 were randomized to receive drug information individually and 30 to receiving it in groups. Patients allocated to the two different interventions were comparable for age and diagnoses at baseline but more patients

  12. Thermal cycling in LWR components in OECD-NEA member countries - CSNI integrity and ageing working group

    International Nuclear Information System (INIS)

    Faidy, Claude; Chapuliot, Stephane; Mathet, Eric

    2005-01-01

    Thermal cycling is a widespread and recurring problem in nuclear power plants worldwide. Several incidents with leakage of primary water inside the containment challenged the integrity of NPPs although no release outside of containment occurred. Thermal cycling was not taken into account at the design stage. Regulatory bodies, utilities and researchers have to address it for their operating plants. It is a complex phenomenon that involves and links thermal hydraulic, fracture mechanic, materials and plant operation. Thermal cycling is connected either to operating transients (low cycle fatigue) or to complex phenomenon like stratification, vortex and mixing (low and high cycle fatigue). The former is covered by existing rules and codes. The latter is partially addressed by national rules and constitutes the subject of this report. In 2002, the Committee on the Safety of Nuclear Installations (CSNI) requested the working group on the integrity of reactor components and structures (IAGE WG) to prepare a program of work on thermal cycling to provide information to NEA member countries on operational experience, regulatory policies, countermeasures in place, current status of research and development, and to identify areas where research is needed both at national and international levels. The working group proposed a 3 fold program that covered: - Review of operating experience, regulatory framework, countermeasures and current research; - Benchmark to assess calculation capabilities in NEA member countries for crack initiation and propagation under a cyclic thermal loading, and ultimately to develop screening criteria to identify susceptible components; results of the benchmark were published in 2005; - Organisation of an international conference in cooperation with the EPRI and the USNRC on fatigue of reactor components. This conference reviews progress in the areas and provides a forum for discussion and exchange of information between high level experts. The

  13. Leader Responses to Collective Failure, and Maintenance of Group Integration, Task Motivation, Compliance, and Leader Endorsement

    Science.gov (United States)

    1980-11-01

    be found in Kolb , D. A., Rubin, 1. M., and McIntyre, J. M., Organizational Psychology: An Experiential * Avyroach (Englewood Cliffs, N.J.: Prentice...group member would have 10 minutes to examine and learn the steps involved in building the second model. During this 10 minute period, group members...necessarily yield increased compliance. -57- REFERENCES Cartwright, D., & Zander, A. (Eds.). Group dynamics: Research and theory (3rd ed.). Evanston, Ill

  14. Project of an information integrated system to provide support to the regulatory control of the radioactive waste inventory

    International Nuclear Information System (INIS)

    Christovao, Marilia Tavares

    2005-05-01

    Sources and radioactive waste deriving from industry activities, medical practice and other areas are collected, received, and stored as waste on Brazilian Nuclear Energy Commission (CNEN) Institutes, that also generate, treat and store their own radioactive waste. The object of this project is to present an Integrated Information System named SICORR, having as guidelines, the referred processes to the radioactive waste regulatory control, under the responsibility of the Radioactive Waste Division (DIREJ), the General Coordination of Licensing and Control (CGLC), the Directorate of Safety and Radiation Protection (DRS) and the CNEN. The main objective of the work was reached, once the project SICORR modeling considers the radioactive waste control inventory, enclosing the treatment and integration of the radioactive waste and the radionuclides data and processes; the installations that produce, use, transport or store radiation sources data; and, CNEN Institutes responsible for the radioactive waste management data. The SICORR functions or essential modules involve the data treatment, integration, standardization and consistency between the processes. The SICORR specification and the analysis results are registered in documents, Software Specification Proposal (PESw) and Software Requirements Specification (ERSw), and are presented in text, in diagrams and user interfaces. Use cases have been used in the SICORR context diagram. The user interfaces for each use case have been detailed, defining the graphical layout, the relationships description with other interfaces, the interface details properties and the commands and the product entrances and exits. For objects radioactive waste and radionuclides, states diagrams have been drawn. The activities diagram represents the business model process. The class diagram represents the static objects and relationships that exist between them, under the specification point of view. The class diagram have been determined

  15. Factores, grupos de riesgo y atención integral a la conducta violenta Factors, risk groups and integral care to violent behavior

    Directory of Open Access Journals (Sweden)

    Anais Marta Valladares González

    2010-09-01

    Full Text Available La violencia es la acción ejercida por una o varias personas, en la que se somete de manera intencional al maltrato, presión, sufrimiento, manipulación u otra acción que atente contra la integridad física, psicológica y moral de cualquier persona o grupo de personas. Los factores de riesgo de la conducta violenta se pueden agrupar en macrosociales, microsociales e individuales. El enfoque integral de intervención hacia la conducta violenta, debe tener en cuenta, no solo los componentes biológicos, psicológicos y sociales, sino también las peculiaridades sociales, grupales e individuales de su determinación.Violence is the action exerted by one or a certain number of persons practicing in an intentional way the ill-treatment, the pressure, suffering, manipulation or another action attempting on physical, psychological or moral integrity of any person of group of persons. The risk factors of violent behavior may be grouped into macrosocial, microsocial and individual. The integral approach of the intervention to violent behavior must to be into account not only the biological, psychological and social components but also the social, group and individual particular features of its determination.

  16. Integration of copy number and transcriptomics provides risk stratification in prostate cancer: A discovery and validation cohort study

    Science.gov (United States)

    Ross-Adams, H.; Lamb, A.D.; Dunning, M.J.; Halim, S.; Lindberg, J.; Massie, C.M.; Egevad, L.A.; Russell, R.; Ramos-Montoya, A.; Vowler, S.L.; Sharma, N.L.; Kay, J.; Whitaker, H.; Clark, J.; Hurst, R.; Gnanapragasam, V.J.; Shah, N.C.; Warren, A.Y.; Cooper, C.S.; Lynch, A.G.; Stark, R.; Mills, I.G.; Grönberg, H.; Neal, D.E.

    2015-01-01

    Background Understanding the heterogeneous genotypes and phenotypes of prostate cancer is fundamental to improving the way we treat this disease. As yet, there are no validated descriptions of prostate cancer subgroups derived from integrated genomics linked with clinical outcome. Methods In a study of 482 tumour, benign and germline samples from 259 men with primary prostate cancer, we used integrative analysis of copy number alterations (CNA) and array transcriptomics to identify genomic loci that affect expression levels of mRNA in an expression quantitative trait loci (eQTL) approach, to stratify patients into subgroups that we then associated with future clinical behaviour, and compared with either CNA or transcriptomics alone. Findings We identified five separate patient subgroups with distinct genomic alterations and expression profiles based on 100 discriminating genes in our separate discovery and validation sets of 125 and 103 men. These subgroups were able to consistently predict biochemical relapse (p = 0.0017 and p = 0.016 respectively) and were further validated in a third cohort with long-term follow-up (p = 0.027). We show the relative contributions of gene expression and copy number data on phenotype, and demonstrate the improved power gained from integrative analyses. We confirm alterations in six genes previously associated with prostate cancer (MAP3K7, MELK, RCBTB2, ELAC2, TPD52, ZBTB4), and also identify 94 genes not previously linked to prostate cancer progression that would not have been detected using either transcript or copy number data alone. We confirm a number of previously published molecular changes associated with high risk disease, including MYC amplification, and NKX3-1, RB1 and PTEN deletions, as well as over-expression of PCA3 and AMACR, and loss of MSMB in tumour tissue. A subset of the 100 genes outperforms established clinical predictors of poor prognosis (PSA, Gleason score), as well as previously published gene

  17. Raising awareness of carrier testing for hereditary haemoglobinopathies in high-risk ethnic groups in the Netherlands: a pilot study among the general public and primary care providers.

    Science.gov (United States)

    Weinreich, Stephanie S; de Lange-de Klerk, Elly Sm; Rijmen, Frank; Cornel, Martina C; de Kinderen, Marja; Plass, Anne Marie C

    2009-09-15

    In the Netherlands no formal recommendations exist concerning preconceptional or antenatal testing for carriership of hereditary haemoglobinopathies. Those at highest risk may be unaware of the possibility of carrier screening. While universal newborn screening has recently been introduced, neither preconceptional nor antenatal carrier testing is routinely offered by health care services to the general public. A municipal health service and a foundation for public information on medical genetics undertook a pilot project with the aim of increasing knowledge and encouraging informed choice. Two groups were targeted: members of the public from ethnic groups at increased risk, and primary health care providers. This study examines the effectiveness of culturally specific 'infotainment' to inform high-risk ethnic groups about their increased risk for haemoglobinopathies. In addition, the study explores attitudes and intentions of primary care providers towards haemoglobinopathy carrier testing of their patients from high-risk ethnic groups. Informational sessions tailored to the public or professionals were organised in Amsterdam, and evaluated for their effect. Psychological parameters were measured using structured questionnaires based on the Theory of Planned Behaviour. The pre-test/post-test questionnaire showed that members of the public gained understanding of inheritance and carriership of haemoglobinopathies from the "infotainment" session (p Perceived behavioural control, i.e. the feeling that they could actually get tested if they wanted to, increased in the targeted age group of 18-45 years (N = 41; p ethnic groups was positive, yet they did not show strong intention to effectuate carrier testing of their patients on the basis of ethnicity. The main factor which explained their (lack of) intention was social norm, i.e. their perception of negative peer opinion (41% variance explained). The majority of primary health care providers felt that policy change was

  18. Raising awareness of carrier testing for hereditary haemoglobinopathies in high-risk ethnic groups in the Netherlands: a pilot study among the general public and primary care providers

    Directory of Open Access Journals (Sweden)

    Cornel Martina C

    2009-09-01

    Full Text Available Abstract Background In the Netherlands no formal recommendations exist concerning preconceptional or antenatal testing for carriership of hereditary haemoglobinopathies. Those at highest risk may be unaware of the possibility of carrier screening. While universal newborn screening has recently been introduced, neither preconceptional nor antenatal carrier testing is routinely offered by health care services to the general public. A municipal health service and a foundation for public information on medical genetics undertook a pilot project with the aim of increasing knowledge and encouraging informed choice. Two groups were targeted: members of the public from ethnic groups at increased risk, and primary health care providers. This study examines the effectiveness of culturally specific 'infotainment' to inform high-risk ethnic groups about their increased risk for haemoglobinopathies. In addition, the study explores attitudes and intentions of primary care providers towards haemoglobinopathy carrier testing of their patients from high-risk ethnic groups. Methods Informational sessions tailored to the public or professionals were organised in Amsterdam, and evaluated for their effect. Psychological parameters were measured using structured questionnaires based on the Theory of Planned Behaviour. Results The pre-test/post-test questionnaire showed that members of the public gained understanding of inheritance and carriership of haemoglobinopathies from the "infotainment" session (p Conclusion The "infotainment" programme may have a positive effect on people from high-risk groups, but informed general practitioners and midwives were reluctant to facilitate their patients' getting tested. Additional initiatives are needed to motivate primary care providers to facilitate haemoglobinopathy carrier testing for their patients from high-risk backgrounds.

  19. HIV/TB co-infection:perspectives of TB patients and providers on the integrated HIV/TB pilot program in Tamilnadu, India

    OpenAIRE

    Lakshminarayanan, Mahalakshmi

    2009-01-01

    The WHO recommends routine HIV testing among TB patients as a key strategy to combat the dual HIV/TB epidemic. India has integrated its HIV and TB control programs and is offering provider initiated HIV testing for all TB patients since 2007. Using a mixed methods approach, this study aims to understand the perspectives of TB patients and providers on the integrated HIV/TB pilot program in Tamilnadu, India. A survey conducted by the Tuberculosis Research Center, India on 300 TB patients is th...

  20. Integrating the Beliefs of Dewey, Lewin, and Rogers into a Rationale for Effective Group Leadership.

    Science.gov (United States)

    Grove, Richard W.

    1992-01-01

    Presents a rationale for effective group leadership grounded in John Withall's articulation of selected beliefs of John Dewey, Kurt Lewin, and Carl Rogers. Teachers and administrators need more and better preparation in collaborative inquiry. Knowledge and skills in collaborative inquiry should undergird the successful functioning of groups of…

  1. Group Investigation as a Cooperative Learning Strategy: An Integrated Analysis of the Literature

    Science.gov (United States)

    Mitchell, Mitzi G.; Montgomery, Hilary; Holder, Michelle; Stuart, Dan

    2008-01-01

    The cooperative learning strategy of group investigation has been used extensively in elementary and high school classrooms. Whereas this learning strategy seems to benefit low- and middle-achieving students, the performance of high-achieving students seems to change little. This article examines the literature on group investigation as a…

  2. The Process Model of Group-Based Emotion : Integrating Intergroup Emotion and Emotion Regulation Perspectives

    NARCIS (Netherlands)

    Goldenberg, Amit; Halperin, Eran; van Zomeren, Martijn; Gross, James J.

    Scholars interested in emotion regulation have documented the different goals and strategies individuals have for regulating their emotions. However, little attention has been paid to the regulation of group-based emotions, which are based on individuals' self-categorization as a group member and

  3. Group Trust, Communication Media, and Interactivity: Toward an Integrated Model of Online Collaborative Learning

    Science.gov (United States)

    Du, Jianxia; Wang, Chuang; Zhou, Mingming; Xu, Jianzhong; Fan, Xitao; Lei, Saosan

    2018-01-01

    The present investigation examines the multidimensional relationships among several critical components in online collaborative learning, including group trust, communication media, and interactivity. Four hundred eleven university students from 103 groups in the United States responded survey items on online collaboration, interactivity,…

  4. An integrated approach for determining the size of hardwood group-selection openings

    Science.gov (United States)

    Chris B. LeDoux

    1999-01-01

    The use of group-selection methods is becoming more widespread as landowners and forest managers attempt to respond to public pressure to reduce the size of clearcut blocks. Several studies have shown that harvesting timber in smaller groups or clumps increases the cost of operations for both cable and ground-based logging systems. Recent regeneration studies have...

  5. Web-based management of research groups - using the right tools and an adequate integration strategy

    Energy Technology Data Exchange (ETDEWEB)

    Barroso, Antonio Carlos de Oliveira; Menezes, Mario Olimpio de, E-mail: barroso@ipen.b, E-mail: mario@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Grupo de Pesquisa em Gestao do Conhecimento Aplicada a Area Nuclear

    2011-07-01

    Nowadays broad interest in a couple of inter linked subject areas can make the configuration of a research group to be much diversified both in terms of its components and of the binding relationships that glues the group together. That is the case of the research group for knowledge management and its applications to nuclear technology - KMANT at IPEN, a living entity born 7 years ago and that has sustainably attracted new collaborators. This paper describes the strategic planning of the group, its charter and credo, the present components of the group and the diversified nature of their relations with the group and with IPEN. Then the technical competencies and currently research lines (or programs) are described as well as the research projects, and the management scheme of the group. In the sequence the web-based management and collaboration tools are described as well our experience with their use. KMANT have experiment with over 20 systems and software in this area, but we will focus on those aimed at: (a) web-based project management (RedMine, ClockinIT, Who does, PhProjekt and Dotproject); (b) teaching platform (Moodle); (c) mapping and knowledge representation tools (Cmap, Freemind and VUE); (d) Simulation tools (Matlab, Vensim and NetLogo); (e) social network analysis tools (ORA, MultiNet and UciNet); (f) statistical analysis and modeling tools (R and SmartPLS). Special emphasis is given to the coupling of the group permanent activities like graduate courses and regular seminars and how newcomers are selected and trained to be able to enroll the group. A global assessment of the role the management strategy and available tool set for the group performance is presented. (author)

  6. Web-based management of research groups - using the right tools and an adequate integration strategy

    International Nuclear Information System (INIS)

    Barroso, Antonio Carlos de Oliveira; Menezes, Mario Olimpio de

    2011-01-01

    Nowadays broad interest in a couple of inter linked subject areas can make the configuration of a research group to be much diversified both in terms of its components and of the binding relationships that glues the group together. That is the case of the research group for knowledge management and its applications to nuclear technology - KMANT at IPEN, a living entity born 7 years ago and that has sustainably attracted new collaborators. This paper describes the strategic planning of the group, its charter and credo, the present components of the group and the diversified nature of their relations with the group and with IPEN. Then the technical competencies and currently research lines (or programs) are described as well as the research projects, and the management scheme of the group. In the sequence the web-based management and collaboration tools are described as well our experience with their use. KMANT have experiment with over 20 systems and software in this area, but we will focus on those aimed at: (a) web-based project management (RedMine, ClockinIT, Who does, PhProjekt and Dotproject); (b) teaching platform (Moodle); (c) mapping and knowledge representation tools (Cmap, Freemind and VUE); (d) Simulation tools (Matlab, Vensim and NetLogo); (e) social network analysis tools (ORA, MultiNet and UciNet); (f) statistical analysis and modeling tools (R and SmartPLS). Special emphasis is given to the coupling of the group permanent activities like graduate courses and regular seminars and how newcomers are selected and trained to be able to enroll the group. A global assessment of the role the management strategy and available tool set for the group performance is presented. (author)

  7. WEB Services Networks and Technological Hybrids — The Integration Challenges of WAN Distributed Computing for ASP Providers

    Science.gov (United States)

    Mroczkiewicz, Pawel

    A necessity of integration of both information systems and office software existing in organizations has had a long history. The beginning of this kind of solutions reaches back to the old generation of network protocols called EDI (Electronic Data Interchange) and EDIFACT standard, which was initiated in 1988 and has dynamically evolved ever since (S. Michalski, M. Suskiewicz, 1995). The mentioned protocol was usually used for converting documents into natural formats processed by applications. It caused problems with binary files and, furthermore, the communication mechanisms had to be modified each time new documents or applications were added. When we compare EDI with the previously used communication mechanisms, EDI was a great step forward as it was the first, big scale attempt to define standards of data interchange between the applications in business transactions (V. Leyland, 1995, p. 47).

  8. Using group learning to promote integration and cooperative learning between Asian and Australian second-year veterinary science students.

    Science.gov (United States)

    Mills, Paul C; Woodall, Peter F; Bellingham, Mark; Noad, Michael; Lloyd, Shan

    2007-01-01

    There is a tendency for students from different nationalities to remain within groups of similar cultural backgrounds. The study reported here used group project work to encourage integration and cooperative learning between Australian students and Asian (Southeast Asian) international students in the second year of a veterinary science program. The group project involved an oral presentation during a second-year course (Structure and Function), with group formation engineered to include very high, high, moderate, and low achievers (based on previous grades). One Asian student and three Australian students were placed in each group. Student perceptions of group dynamics were analyzed through a self-report survey completed at the end of the presentations and through group student interviews. Results from the survey were analyzed by chi-square to compare the responses between Asian and Australian students, with statistical significance accepted at p learning experience. Asian students expressed a greater preference for working in a group than for working alone (p = 0.001) and reported more frequently than Australian students that teamwork produces better results (p = 0.01). Australian students were more likely than Asian students to voice their opinion in a team setting (p = 0.001), while Asian students were more likely to depend on the lecturer for directions (p = 0.001). The results also showed that group project work appeared to create an environment that supported learning and was a successful strategy to achieve acceptance of cultural differences.

  9. Integral dimension in the string theory based on a group manifold

    International Nuclear Information System (INIS)

    Toyota, N.

    1990-01-01

    We study string models on a group manifold with Kac-Moody symmetry where the critical dimension d is integer. In particular the possibility of four-dimensional models is investigated. We find that only nine group manifolds with a relevant k level can have four as the critical dimension among an infinite number of compact Lie groups. They are all listed. The models with minimal conformal sectors adding to the Kac-Moody sector are investigated. In the cases with minimal conformal sector, there are only two groups, SU(5) and SO(43), that can give d=4. Among the cases with some tensoring products of minimal conformal sectors we discuss a few special cases with k=0 and k=1. The cases based on N=1 super Kac-Moody algebra are also studied. Finally we discuss the possibility of the enlargement of gauge symmetry. (orig.)

  10. Group theoretical and Hamiltonian structures of integrable evolution equations in 1x1 and 2x1 dimensions

    International Nuclear Information System (INIS)

    Konopel'chenko, B.G.

    1983-01-01

    New results in investigation of the group-theoretical and hamiltonian structure of the integrable evolution equations in 1+1 and 2+1 dimensions are briefly reviewed. Main general results, such as the form of integrable equations, Baecklund transfomations, symmetry groups, are turned out to have the same form for different spectral problems. The used generalized AKNS-method (the Ablowitz Kaup, Newell and Segur method) permits to prove that all nonlinear evolution equations considered are hamiltonians. The general condition of effective application of the ACNS mehtod to the concrete spectral problem is the possibility to calculate a recursion operator explicitly. The embedded representation is shown to be a fundamental object connected with different aspects of the inverse scattering problem

  11. Integrating field plots, lidar, and landsat time series to provide temporally consistent annual estimates of biomass from 1990 to present

    Science.gov (United States)

    Warren B. Cohen; Hans-Erik Andersen; Sean P. Healey; Gretchen G. Moisen; Todd A. Schroeder; Christopher W. Woodall; Grant M. Domke; Zhiqiang Yang; Robert E. Kennedy; Stephen V. Stehman; Curtis Woodcock; Jim Vogelmann; Zhe Zhu; Chengquan. Huang

    2015-01-01

    We are developing a system that provides temporally consistent biomass estimates for national greenhouse gas inventory reporting to the United Nations Framework Convention on Climate Change. Our model-assisted estimation framework relies on remote sensing to scale from plot measurements to lidar strip samples, to Landsat time series-based maps. As a demonstration, new...

  12. Integrative analysis of kinase networks in TRAIL-induced apoptosis provides a source of potential targets for combination therapy

    DEFF Research Database (Denmark)

    So, Jonathan; Pasculescu, Adrian; Dai, Anna Y.

    2015-01-01

    phosphoproteomics. With these protein interaction maps, we modeled information flow through the networks and identified apoptosis-modifying kinases that are highly connected to regulated substrates downstream of TRAIL. The results of this analysis provide a resource of potential targets for the development of TRAIL...

  13. Integrated analysis of epigenomic and genomic changes by DNA methylation dependent mechanisms provides potential novel biomarkers for prostate cancer.

    Science.gov (United States)

    White-Al Habeeb, Nicole M A; Ho, Linh T; Olkhov-Mitsel, Ekaterina; Kron, Ken; Pethe, Vaijayanti; Lehman, Melanie; Jovanovic, Lidija; Fleshner, Neil; van der Kwast, Theodorus; Nelson, Colleen C; Bapat, Bharati

    2014-09-15

    Epigenetic silencing mediated by CpG methylation is a common feature of many cancers. Characterizing aberrant DNA methylation changes associated with tumor progression may identify potential prognostic markers for prostate cancer (PCa). We treated two PCa cell lines, 22Rv1 and DU-145 with the demethylating agent 5-Aza 2'-deoxycitidine (DAC) and global methylation status was analyzed by performing methylation-sensitive restriction enzyme based differential methylation hybridization strategy followed by genome-wide CpG methylation array profiling. In addition, we examined gene expression changes using a custom microarray. Gene Set Enrichment Analysis (GSEA) identified the most significantly dysregulated pathways. In addition, we assessed methylation status of candidate genes that showed reduced CpG methylation and increased gene expression after DAC treatment, in Gleason score (GS) 8 vs. GS6 patients using three independent cohorts of patients; the publically available The Cancer Genome Atlas (TCGA) dataset, and two separate patient cohorts. Our analysis, by integrating methylation and gene expression in PCa cell lines, combined with patient tumor data, identified novel potential biomarkers for PCa patients. These markers may help elucidate the pathogenesis of PCa and represent potential prognostic markers for PCa patients.

  14. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care.

    Science.gov (United States)

    Goodwin, N

    2001-01-01

    This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital) services and also, potentially, social care. This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  15. The role of individualist and collectivist orientations on self-determined motivation: integrating self-determination theory and group processes

    OpenAIRE

    Rentzelas, Panagiotis

    2009-01-01

    The main aim of this thesis was to examine the role of individualism and collectivism as situational group norms on intrinsic motivation. A further aim was to examine the effect of individual differences in individualist and collectivist orientations on the effect of autonomous motivation on intention and behaviour. This research integrated the concept of self-determined and intrinsic motivation as postulated in Self-Determination Theory (Deci & Ryan, 1985a, 2000,2002), individualism and coll...

  16. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care

    Directory of Open Access Journals (Sweden)

    Nick Goodwin

    2001-03-01

    Full Text Available Purpose: This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Theory: Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital services and also, potentially, social care. Method: This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Results: Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. Conclusions: The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  17. The Effectiveness of Eye Movement Desensitization and Reprocessing Integrative Group Protocol with Adolescent Survivors of the Central Italy Earthquake

    OpenAIRE

    Maslovaric, Giada; Zaccagnino, Maria; Mezzaluna, Clarice; Perilli, Sava; Trivellato, Denis; Longo, Vittorio; Civilotti, Cristina

    2017-01-01

    Earthquakes, which can cause widespread territorial and socio-economic destruction, are life-threatening, unexpected, unpredictable, and uncontrollable events caused by the shaking of the surface of the earth. The psychological consequences, such as PTSD, anxiety, depression, and suicidal ideation, are well-known to clinicians and researchers. This study was conducted with the aim of evaluating the use of the Eye Movement Desensitization and Reprocessing (EMDR) Integrative Group Treatment Pro...

  18. Formation of Escherichia coli Hfr strains by integrative suppression with the P group plasmid RP1.

    OpenAIRE

    Martin, R R; Thorlton, C L; Unger, L

    1981-01-01

    Hfr strains of Escherichia coli were obtained by integrative suppression of a dnaA(Ts) mutation by the Inc P-1 plasmid RP1 without prior creation of an unnatural homology between the plasmid and the E. coli chromosome. Unmodified RP1 mobilized the polarized transfer of the chromosome in a counterclock-wise direction from a distinct origin between 81 min (pyrE) and 82 min (dnaA) with pyrE as a leading marker. Inheritance of RP1-Hfr chromosomal and antibiotic resistance genes was due to recombi...

  19. Palliative sedation challenging the professional competency of health care providers and staff: a qualitative focus group and personal written narrative study.

    Science.gov (United States)

    Leboul, Danièle; Aubry, Régis; Peter, Jean-Michel; Royer, Victor; Richard, Jean-François; Guirimand, Frédéric

    2017-04-11

    Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation. Data were collected using a qualitative study involving multi-professional focus groups with health care providers and staff as well as personal narratives written by physicians and paramedical staff. A total of 35 medical and paramedical providers volunteered to participate in focus group discussions in three Palliative Care Units in two French hospitals and to write personal narratives. Health care provider and staff opinions had to do with their professional stance and competencies when using midazolam and practicing sedation in palliative care. They expressed uncertainty regarding three aspects of the comprehensive care: biomedical rigour of diagnosis and therapeutics, quality of the patient/provider relationship and care to be provided. Focusing on the sedative effect of midazolam and continuous sedation until death, the interviewed health care providers examined the basics of their professional competency as well as the key role played by the health care team in terms of providing support and minimizing workplace suffering. Nurses were subject to the greatest misgivings about their work when they were called upon to sedate patients. The uncertainty experienced by the carers with regard to the medical, psychosocial and ethical justification for sedation is a source of psychological burden and moral distress

  20. Exploring Parental and Staff Perceptions of the Family-Integrated Care Model: A Qualitative Focus Group Study.

    Science.gov (United States)

    Broom, Margaret; Parsons, Georgia; Carlisle, Hazel; Kecskes, Zsuzsoka; Thibeau, Shelley

    2017-12-01

    Family-integrated care (FICare) is an innovative model of care developed at Mount Sinai Hospital, Canada, to better integrate parents into the team caring for their infant in the neonatal intensive care unit (NICU). The effects of FICare on neonatal outcomes and parental anxiety were assessed in an international multicenter randomized trial. As an Australian regional level 3 NICU that was randomized to the intervention group, we aimed to explore parent and staff perceptions of the FICare program in our dual occupancy NICU. This qualitative study took place in a level 3 NICU with 5 parent participants and 8 staff participants, using a post implementation review design. Parents and staff perceptions of FICare were explored through focus group methodology. Thematic content analysis was done on focus group transcripts. Parents and staff perceived the FICare program to have had a positive impact on parental confidence and role attainment and thought that FICare improved parent-to-parent and parent-to-staff communication. Staff reported that nurses working with families in the program performed less hands-on care and spent more time educating and supporting parents. FICare may change current NICU practice through integrating and accepting parents as active members of the infant's care team. In addition, nurse's roles may transition from bedside carer to care coordinator, educating and supporting parents during their journey through the NICU. Further research is needed to assess the long-term impact of FICare on neonates, parents, and staff.

  1. Research on Cooperative Combat for Integrated Reconnaissance-Attack-BDA of Group LAVs

    Directory of Open Access Journals (Sweden)

    Li Bing

    2014-01-01

    Full Text Available LAVs (loitering air vehicles are advanced weapon systems that can loiter autonomously over a target area, detect and acquire the targets, and then attack them. In this paper, by the theory of Itô stochastic differential, a group system was analyzed. The uniqueness and continuity of the solution of the system was discussed. Afterwards the model of the system based on the state transition was established with the finite state machine automatically. At last, a search algorithm was proposed for obtaining good feasible solutions for problems. And simulation results show that model and method are effective for dealing with cooperative combat of group LAVs.

  2. The Allolobophora sturanyi species group revisited: Integrated taxonomy and new taxa (Clitellata: Megadrili

    Directory of Open Access Journals (Sweden)

    Szederjesi, T.

    2016-04-01

    Full Text Available The Allolobophora sturanyi Rosa, 1895 species group is revisited using DNA barcoding and morphology. Barcoding results corroborated the previous treatment of the Allolobophora sturanyi subspecies and furthermore proved that the morphologically similar Allolobophora gestroides Zicsi, 1970 species belong to this species group. Elaboration of new samples from the Apuseni Mts resulted in discovery of a new subspecies A. sturanyi biharica ssp. nov. from the summit of the Bihor range, and a new species A. zicsica from the Vladeasa range similar to A. gestroides described from Northern Hungary.

  3. Data And Informatics Working Group On Virtual Data Integration Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Williams, D. N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Palanisamy, G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Dam, K. K. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-10-13

    This report is the outcome of a workshop that was commissioned by the Department of Energy’s Climate and Environmental Sciences Division (CESD) to examine current and future data infrastructure requirements that would be foundational to achieving CESD’s scientific mission goals. Over the past several years, data volumes in CESD disciplines have risen sharply to unprecedented levels (tens of petabytes). So too has the complexity and diversity of the research data (simulation, observation, and reanalysis) needing to be captured, stored, verified, analyzed, and integrated. With the trends of increased data volume (in the hundreds of petabytes), more complex analysis processes, and growing crossdisciplinary collaborations, it is timely to investigate whether the CESD community has the right computational and data support to realize the full scientific potential from its data collections. In recognition of the challenges, a partnership is forming across CESD and with national and international agencies to investigate the viability of creating an integrated, collaborative data infrastructure: a virtual laboratory. The overarching goal of this report is to identify the community’s key data technology requirements and high-priority development needs for sustaining and growing their scientific discovery potential. The report also aims to map these requirements to existing solutions and to identify gaps in current services, tools, and infrastructure that will need to be addressed in the short, medium, and long term so as not to impede scientific progress

  4. A METHOD AND AN APPARATUS FOR PROVIDING TIMING SIGNALS TO A NUMBER OF CIRCUITS, AN INTEGRATED CIRCUIT AND A NODE

    DEFF Research Database (Denmark)

    2006-01-01

    A method of providing or transporting a timing signal between a number of circuits, electrical or optical, where each circuit is fed by a node. The nodes forward timing signals between each other, and at least one node is adapted to not transmit a timing signal before having received a timing...... signal from at least two nodes. In this manner, the direction of the timing skew between nodes and circuits is known and data transport between the circuits made easier....

  5. Integrated geomechanical, petrographical and petrophysical study of the sandstones of the Wajid Group, SW Saudi Arabia

    Science.gov (United States)

    Benaafi, Mohammed; Hariri, Mustafa; Al-Shaibani, Abdulaziz; Abdullatif, Osman; Makkawi, Mohammed

    2018-07-01

    The Cambro-Permian siliciclastic succession in southwestern Saudi Arabia is represented by the Wajid Group, which consists mainly of fluvial, shallow marine, aeolian, and glacial sandstones. The Wajid Group comprises the Dibsiyah, Sanamah, Qalibah, Khusayyayn, and Juwayl Formations. It is exposed in the Wadi Al-Dawasir area and extends to Najran City. The sandstones of the Wajid Group serve as groundwater aquifers in the Wadi Al-Dawasir and Najran areas and host hydrocarbon (mainly gas) reservoirs in the Rub' Al-Khali Basin. This study aims to characterize the geomechanical properties (rock strength and Young's modulus) of the sandstones of the Wajid Group using field and experimental techniques. A further objective is to investigate the relationships between the geomechanical properties and the petrographical and petrophysical properties of the studied sandstones. The geomechanical properties of the studied sandstones vary from glacial to non-glacial sandstones, as the glacial sandstones display high values of the geomechanical properties with high variability indices. Four geological factors including grain size, cement content, porosity and permeability were observed as the main controls on the geomechanical behaviour of the studied sandstones except for the Khusayyayn sandstone, where the mineral composition was also important. Significant correlations were observed between the petrographical and petrophysical properties and the geomechanical properties of the glacial sandstones. Predictive models of the geomechanical properties (RN, UCS, and E) were generated using regression analysis to account for the glacial sandstones.

  6. Integration of noninvasive prenatal prediction of fetal blood group into clinical prenatal care

    DEFF Research Database (Denmark)

    Clausen, Frederik Banch

    2014-01-01

    Incompatibility of red blood cell blood group antigens between a pregnant woman and her fetus can cause maternal immunization and, consequently, hemolytic disease of the fetus and newborn. Noninvasive prenatal testing of cell-free fetal DNA can be used to assess the risk of hemolytic disease...

  7. Integrating Identities: Facilitating a Support Group for LGBTQ Students on a Christian College Campus

    Science.gov (United States)

    Vespone, Brianna M.

    2016-01-01

    College can be a challenging time for young adults, as many are experiencing life on their own for the first time, adjusting to new lifestyles, new social groups, and new ways to express themselves. For lesbian, gay, bisexual, transgender, and queer (LGBTQ) college students, the challenges are increased as they face harassment, discrimination, and…

  8. “Partners rather than just providers…”: A qualitative study on health care professionals’ views on implementation of multidisciplinary group meetings in the North West London Integrated Care Pilot

    Directory of Open Access Journals (Sweden)

    Angelos P Kassianos

    2015-09-01

    Full Text Available Introduction: Multidisciplinary group meetings are one of the key drivers of facilitating integrated care. Health care professionals attending such groups have a key role in the success of these discussions and hence, in the forming of multi-professional integrated care. The study aimed to explore the professionals’ experiences and views of participating and implementing the groups in integrated care context. Methods: A qualitative study including 25 semi-structured interviews with professionals participating in the Northwest London Integrated Care Pilot analysed using thematic content analysis. Results: Participants mentioned a number of benefits of participating in the meetings, including shared learning and shared decision-making between different services and specialties. Yet, they perceived barriers that diminish the efficiency of the groups, such as time constraints, group dynamics and technicalities. The participants felt that the quality of discussions and facilitation could be improved, as well as technical arrangements that would make them easier to participate. Most of the participants perceived the groups to be beneficial for providers mostly questioning the benefits for patient care. Conclusion: Findings provide an insight into how health professionals’ views of their participation to the multidisciplinary group meetings can be more effectively translated into more tangible benefits to the patients. To benefit patient care, the multidisciplinary groups need to be more patient-oriented rather than provider-oriented, while overcoming professional boundaries for participating.

  9. Immunization with Hexon modified adenoviral vectors integrated with gp83 epitope provides protection against Trypanosoma cruzi infection.

    Directory of Open Access Journals (Sweden)

    Anitra L Farrow

    2014-08-01

    Full Text Available Trypanosoma cruzi is the causative agent of Chagas disease. Chagas disease is an endemic infection that affects over 8 million people throughout Latin America and now has become a global challenge. The current pharmacological treatment of patients is unsuccessful in most cases, highly toxic, and no vaccines are available. The results of inadequate treatment could lead to heart failure resulting in death. Therefore, a vaccine that elicits neutralizing antibodies mediated by cell-mediated immune responses and protection against Chagas disease is necessary.The "antigen capsid-incorporation" strategy is based upon the display of the T. cruzi epitope as an integral component of the adenovirus' capsid rather than an encoded transgene. This strategy is predicted to induce a robust humoral immune response to the presented antigen, similar to the response provoked by native Ad capsid proteins. The antigen chosen was T. cruzi gp83, a ligand that is used by T. cruzi to attach to host cells to initiate infection. The gp83 epitope, recognized by the neutralizing MAb 4A4, along with His6 were incorporated into the Ad serotype 5 (Ad5 vector to generate the vector Ad5-HVR1-gp83-18 (Ad5-gp83. This vector was evaluated by molecular and immunological analyses. Vectors were injected to elicit immune responses against gp83 in mouse models. Our findings indicate that mice immunized with the vector Ad5-gp83 and challenged with a lethal dose of T. cruzi trypomastigotes confer strong immunoprotection with significant reduction in parasitemia levels, increased survival rate and induction of neutralizing antibodies.This data demonstrates that immunization with adenovirus containing capsid-incorporated T. cruzi antigen elicits a significant anti-gp83-specific response in two different mouse models, and protection against T. cruzi infection by eliciting neutralizing antibodies mediated by cell-mediated immune responses, as evidenced by the production of several Ig isotypes

  10. The experience of providing end-of-life care to a relative with advanced dementia: an integrative literature review.

    Science.gov (United States)

    Peacock, Shelley C

    2013-04-01

    The number of people with dementia is growing at an alarming rate. An abundance of research over the past two decades has examined the complex aspects of caring for a relative with dementia. However, far less research has been conducted specific to the experiences of family caregivers providing end-of-life care, which is perplexing, as dementia is a terminal illness. This article presents what is known and highlights the gaps in the literature relevant to the experiences of family caregivers of persons with dementia at the end of life. A thorough search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases from 1960 to 2011 was conducted. Ten studies were identified that specifically addressed the experience of family caregivers providing end-of-life care to a relative with advanced dementia. Common themes of these studies included: 1) the experience of grief, 2) guilt and burden with decision making, 3) how symptoms of depression may or may not be resolved with death of the care receiver, 4) how caregivers respond to the end-stage of dementia, and 5) expressed needs of family caregivers. It is evident from this literature review that much remains to be done to conceptualize the experience of end-of-life caregiving in dementia.

  11. Integration Between Mental Health-Care Providers and Traditional Spiritual Healers: Contextualising Islam in the Twenty-First Century.

    Science.gov (United States)

    Chowdhury, Nayeefa

    2016-10-01

    In the United Arab Emirates, neuropsychiatric disorders are estimated to contribute to one-fifth of the global burden of disease. Studies show that the UAE citizens' apathy towards seeking professional mental health services is associated with the 'religious viewpoints' on the issue, societal stigma, lack of awareness of mental health and lack of confidence in mental health-care providers. Mental health expenditures by the UAE government health ministry are not available exclusively. The majority of primary health-care doctors and nurses have not received official in-service training on mental health within the last 5 years. Efforts are to be made at deconstructing the position of mental illness and its treatments in the light of Islamic Jurisprudence; drafting culturally sensitive and relevant models of mental health care for Emirati citizens; liaising between Imams of mosques and professional mental health service providers; launching small-scale pilot programs in collaboration with specialist institutions; facilitating mentoring in line with Science, Technology, Engineering and Math (STEM) outreach programmes for senior school Emirati students concerning mental health; and promoting mental health awareness in the wider community through participation in events open to public.

  12. An Integrated Approach with Group Decision-Making for Strategy Selection in SWOT Analysis

    OpenAIRE

    İhsan Yüksel

    2012-01-01

    The main aim of this study was to improve the analytical dimension of SWOT (strengths, weaknesses, opportunities and threats) analysis with group decision-making, which underlines the analysis of internal and external environments that in turn, will improve the definition of corporate strategy within the strategic planning process. The main issue of the study was how to select the most appropriate strategy by taking into consideration different effects of each factor of SWOT analysis on strat...

  13. Example-based learning: comparing the effects of additionally providing three different integrative learning activities on physiotherapy intervention knowledge.

    Science.gov (United States)

    Dyer, Joseph-Omer; Hudon, Anne; Montpetit-Tourangeau, Katherine; Charlin, Bernard; Mamede, Sílvia; van Gog, Tamara

    2015-03-07

    Example-based learning using worked examples can foster clinical reasoning. Worked examples are instructional tools that learners can use to study the steps needed to solve a problem. Studying worked examples paired with completion examples promotes acquisition of problem-solving skills more than studying worked examples alone. Completion examples are worked examples in which some of the solution steps remain unsolved for learners to complete. Providing learners engaged in example-based learning with self-explanation prompts has been shown to foster increased meaningful learning compared to providing no self-explanation prompts. Concept mapping and concept map study are other instructional activities known to promote meaningful learning. This study compares the effects of self-explaining, completing a concept map and studying a concept map on conceptual knowledge and problem-solving skills among novice learners engaged in example-based learning. Ninety-one physiotherapy students were randomized into three conditions. They performed a pre-test and a post-test to evaluate their gains in conceptual knowledge and problem-solving skills (transfer performance) in intervention selection. They studied three pairs of worked/completion examples in a digital learning environment. Worked examples consisted of a written reasoning process for selecting an optimal physiotherapy intervention for a patient. The completion examples were partially worked out, with the last few problem-solving steps left blank for students to complete. The students then had to engage in additional self-explanation, concept map completion or model concept map study in order to synthesize and deepen their knowledge of the key concepts and problem-solving steps. Pre-test performance did not differ among conditions. Post-test conceptual knowledge was higher (P example and completion example strategies to foster intervention selection.

  14. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

    Science.gov (United States)

    Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

    2015-10-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

  15. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges

    Science.gov (United States)

    Johnson, Jennifer E.; Schonbrun, Yael Chatav; Peabody, Marlanea E.; Shefner, Ruth T.; Fernandes, Karen M.; Rosen, Rochelle K.; Zlotnick, Caron

    2014-01-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24–72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

  16. Simulator with integrated HW and SW for prediction of thermal comfort to provide feedback to the climate control system

    Science.gov (United States)

    Pokorný, Jan; Kopečková, Barbora; Fišer, Jan; JÍcha, Miroslav

    2018-06-01

    The aim of the paper is to assemble a simulator for evaluation of thermal comfort in car cabins in order to give a feedback to the HVAC (heating, ventilation and air conditioning) system. The HW (hardware) part of simulator is formed by thermal manikin Newton and RH (relative humidity), velocity and temperature probes. The SW (software) part consists of the Thermal Comfort Analyser (using ISO 14505-2) and Virtual Testing Stand of Car Cabin defining the heat loads of car cabin. Simulator can provide recommendation for the climate control how to improve thermal comfort in cabin by distribution and directing of air flow, and also by amount of ventilation power to keep optimal temperature inside a cabin. The methods of evaluation of thermal comfort were verified by tests with 10 test subjects for summer (summer clothing, ambient air temperature 30 °C, HVAC setup: +24 °C auto) and winter conditions (winter clothing, ambient air temperature -5 °C, HVAC setup: +18 °C auto). The tests confirmed the validity of the thermal comfort evaluation using the thermal manikin and ISO 14505-2.

  17. Simulator with integrated HW and SW for prediction of thermal comfort to provide feedback to the climate control system

    Directory of Open Access Journals (Sweden)

    Pokorný Jan

    2018-01-01

    Full Text Available The aim of the paper is to assemble a simulator for evaluation of thermal comfort in car cabins in order to give a feedback to the HVAC (heating, ventilation and air conditioning system. The HW (hardware part of simulator is formed by thermal manikin Newton and RH (relative humidity, velocity and temperature probes. The SW (software part consists of the Thermal Comfort Analyser (using ISO 14505-2 and Virtual Testing Stand of Car Cabin defining the heat loads of car cabin. Simulator can provide recommendation for the climate control how to improve thermal comfort in cabin by distribution and directing of air flow, and also by amount of ventilation power to keep optimal temperature inside a cabin. The methods of evaluation of thermal comfort were verified by tests with 10 test subjects for summer (summer clothing, ambient air temperature 30 °C, HVAC setup: +24 °C auto and winter conditions (winter clothing, ambient air temperature -5 °C, HVAC setup: +18 °C auto. The tests confirmed the validity of the thermal comfort evaluation using the thermal manikin and ISO 14505-2.

  18. Management and presentation of grouped procedures: has the IHE integration profile cracked the toughest radiology workflow nut?

    Science.gov (United States)

    Parisot, Charles R.; Channin, David S.; Avrin, David E.; Lindop, Christopher

    2001-08-01

    In a simple, typical radiology workflow process, an order generates a single procedure, which in turn generates a single data set, from which, one radiology report is generated. There are, however, occasions when a single order consists of more than one procedure each with a separate report, yet the procedures are accomplished by one physical acquisition of data. The prototypical example of this is the request for computed tomographic evaluation of the chest, abdomen and pelvis. The study is accomplished, with modern day scanners, by a single helical acquisition, yet there are typically three codable and billable procedures involved, and these may be reported independently either for administrative or academic reasons. This grouping of procedures remained up to now a challenge to automate across integrated modalities, PACS and RIS. This paper discusses a number of other practical cases where this situation occurs and reviews the capabilities of the Presentation of Grouped Procedures IHE Integration Profile in solving this problem. The DICOM services used are evaluated as well as the strengths and weaknesses of this IHE Integration Profile. The implementation experience gained on both a CT and an MR for the IHE Demonstration at RSNA 2000 and HIMSS 2001 is also reviewed. In conclusion, the resulting clinical and operational benefits are discussed.

  19. The mixed waste focus area mercury working group: an integrated approach for mercury treatment and disposal

    International Nuclear Information System (INIS)

    Conley, T.B.; Morris, M.I.; Holmes-Burns, H.; Petersell, J.; Schwendiman, L.

    1997-01-01

    In May 1996, the U.S. Department of Energy (DOE) Mixed Waste Focus Area (MWFA) initiated the Mercury Work Group (HgWG), which was established to address and resolve the issues associated with mercury- contaminated mixed wastes. Three of the first four technology deficiencies identified during the MWFA technical baseline development process were related to mercury amalgamation, stabilization, and separation/removal. The HgWG will assist the MWFA in soliciting, identifying, initiating, and managing all the efforts required to address these deficiencies. The focus of the HgWG is to better establish the mercury-related treatment needs at the DOE sites, refine the MWFA technical baseline as it relates to mercury treatment, and make recommendations to the MWFA on how to most effectively address these needs. The team will initially focus on the sites with the most mercury-contaminated mixed wastes, whose representatives comprise the HgWG. However, the group will also work with the sites with less inventory to maximize the effectiveness of these efforts in addressing the mercury- related needs throughout the entire complex

  20. Integrating GPS, GYRO, vehicle speed sensor, and digital map to provide accurate and real-time position in an intelligent navigation system

    Science.gov (United States)

    Li, Qingquan; Fang, Zhixiang; Li, Hanwu; Xiao, Hui

    2005-10-01

    The global positioning system (GPS) has become the most extensively used positioning and navigation tool in the world. Applications of GPS abound in surveying, mapping, transportation, agriculture, military planning, GIS, and the geosciences. However, the positional and elevation accuracy of any given GPS location is prone to error, due to a number of factors. The applications of Global Positioning System (GPS) positioning is more and more popular, especially the intelligent navigation system which relies on GPS and Dead Reckoning technology is developing quickly for future huge market in China. In this paper a practical combined positioning model of GPS/DR/MM is put forward, which integrates GPS, Gyro, Vehicle Speed Sensor (VSS) and digital navigation maps to provide accurate and real-time position for intelligent navigation system. This model is designed for automotive navigation system making use of Kalman filter to improve position and map matching veracity by means of filtering raw GPS and DR signals, and then map-matching technology is used to provide map coordinates for map displaying. In practical examples, for illustrating the validity of the model, several experiments and their results of integrated GPS/DR positioning in intelligent navigation system will be shown for the conclusion that Kalman Filter based GPS/DR integrating position approach is necessary, feasible and efficient for intelligent navigation application. Certainly, this combined positioning model, similar to other model, can not resolve all situation issues. Finally, some suggestions are given for further improving integrated GPS/DR/MM application.

  1. An interval-valued 2-tuple linguistic group decision-making model based on the Choquet integral operator

    Science.gov (United States)

    Liu, Bingsheng; Fu, Meiqing; Zhang, Shuibo; Xue, Bin; Zhou, Qi; Zhang, Shiruo

    2018-01-01

    The Choquet integral (IL) operator is an effective approach for handling interdependence among decision attributes in complex decision-making problems. However, the fuzzy measures of attributes and attribute sets required by IL are difficult to achieve directly, which limits the application of IL. This paper proposes a new method for determining fuzzy measures of attributes by extending Marichal's concept of entropy for fuzzy measure. To well represent the assessment information, interval-valued 2-tuple linguistic context is utilised to represent information. Then, we propose a Choquet integral operator in an interval-valued 2-tuple linguistic environment, which can effectively handle the correlation between attributes. In addition, we apply these methods to solve multi-attribute group decision-making problems. The feasibility and validity of the proposed operator is demonstrated by comparisons with other models in illustrative example part.

  2. Discussion group networks in occupational medicine: A tool for continuing education to promote the integration of workers with disabilities.

    Science.gov (United States)

    Rinsky-Halivni, Lilah; Lerman, Yehuda

    2018-04-01

    Despite their legal rights, individuals with disabilities face numerous obstacles to integration in the workplace which can result in their discharge from the labor force. Currently occupational physicians have few resources to help decide whether to integrate disabled workers in pre-placement, or in cases of return-to-work. A network of 13 discussion groups comprised of the occupational physicians of each regional clinic of a large Health Maintenance Organization (HMO) in Israel was created to deal with disability management dilemmas. A moderator compiles and shares the physicians' opinions and experiences with all network members thus assisting the consulting physician in decision-making. Successful management of three representative cases is described to illustrate real-life implementations of this network. The network enables both the consulting and other physicians to tap a large knowledge base and decision-making experience concerning cases of occupational disability management, contributing to professional development and improved service delivery. © 2018 Wiley Periodicals, Inc.

  3. Groups of integral transforms generated by Lie algebras of second-and higher-order differential operators

    International Nuclear Information System (INIS)

    Steinberg, S.; Wolf, K.B.

    1979-01-01

    The authors study the construction and action of certain Lie algebras of second- and higher-order differential operators on spaces of solutions of well-known parabolic, hyperbolic and elliptic linear differential equations. The latter include the N-dimensional quadratic quantum Hamiltonian Schroedinger equations, the one-dimensional heat and wave equations and the two-dimensional Helmholtz equation. In one approach, the usual similarity first-order differential operator algebra of the equation is embedded in the larger one, which appears as a quantum-mechanical dynamic algebra. In a second approach, the new algebra is built as the time evolution of a finite-transformation algebra on the initial conditions. In a third approach, the algebra to inhomogeneous similarity algebra is deformed to a noncompact classical one. In every case, we can integrate the algebra to a Lie group of integral transforms acting effectively on the solution space of the differential equation. (author)

  4. Introducing perennial biomass crops into agricultural landscapes to address water quality challenges and provide other environmental services: Integrating perennial bioenergy crops into agricultural landscapes

    Energy Technology Data Exchange (ETDEWEB)

    Cacho, J. F. [Environmental Science Division, Argonne National Laboratory, Lemont IL USA; Negri, M. C. [Environmental Science Division, Argonne National Laboratory, Lemont IL USA; Zumpf, C. R. [Environmental Science Division, Argonne National Laboratory, Lemont IL USA; Campbell, P. [Environmental Science Division, Argonne National Laboratory, Lemont IL USA

    2017-11-29

    The world is faced with a difficult multiple challenge of meeting nutritional, energy, and other basic needs, under a limited land and water budget, of between 9 and 10 billion people in the next three decades, mitigating impacts of climate change, and making agricultural production resilient. More productivity is expected from agricultural lands, but intensification of production could further impact the integrity of our finite surface water and groundwater resources. Integrating perennial bioenergy crops in agricultural lands could provide biomass for biofuel and potential improvements on the sustainability of commodity crop production. This article provides an overview of ways in which research has shown that perennial bioenergy grasses and short rotation woody crops can be incorporated into agricultural production systems with reduced indirect land use change, while increasing water quality benefits. Current challenges and opportunities as well as future directions are also highlighted.

  5. [An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group].

    Science.gov (United States)

    Kim, Dasom; Lee, Insook

    2017-10-01

    This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements. © 2017 Korean Society of Nursing Science

  6. Evaluation of the performances of wastewater treatment services provided by the metropolitan municipalities in Turkey using Entropy integrated SAW, MOORA and TOPSIS

    OpenAIRE

    Ayyıldız, Ertuğrul; Özçelik, Gökhan

    2018-01-01

    Reusingof the wastewater has a vital importance because of limited natural waterresources all around the world. Recycled wastewater can be used in many areassuch as agriculture, industry, cleaning etc. Treatment of wastewater is one ofthe important tasks of metropolitan municipalities. The aim of this study is toevaluate the performances of wastewater treatment services provided by themetropolitan municipalities in Turkey using Entropy integrated SAW, MOORA andTOPSIS methods. In the scope of ...

  7. Providing full point-to-point communications among compute nodes of an operational group in a global combining network of a parallel computer

    Energy Technology Data Exchange (ETDEWEB)

    Archer, Charles J.; Faraj, Daniel A.; Inglett, Todd A.; Ratterman, Joseph D.

    2018-01-30

    Methods, apparatus, and products are disclosed for providing full point-to-point communications among compute nodes of an operational group in a global combining network of a parallel computer, each compute node connected to each adjacent compute node in the global combining network through a link, that include: receiving a network packet in a compute node, the network packet specifying a destination compute node; selecting, in dependence upon the destination compute node, at least one of the links for the compute node along which to forward the network packet toward the destination compute node; and forwarding the network packet along the selected link to the adjacent compute node connected to the compute node through the selected link.

  8. Integration of social aspects in radiation protection. The AIRP Work group on communication

    International Nuclear Information System (INIS)

    Cantone, Marie C.; Magnoni, Mauro; Sturloni, Giancarlo

    2008-01-01

    Radiation protection has never been confined just to its scientific and quantitative aspects as it also incorporates a real and proper social factor. In most developed countries, considerations on the social and ethical issues of radiation protection and discussions on the approaches to stakeholder involvement are in a state of positive turmoil. Scientific and practical experts are identifying and promoting dialogue procedures, embracing ethical and social aspects, and are moving together to add to their experience in new and improved practices for the decision-making process. In early 2006, the Italian Radiation Protection Association (AIRP) set up a workgroup for the purpose of: 1-) Promoting dialogue among RP experts, experts in other disciplines, national and local authorities and the public, in relation to social awareness issues in the fields of ionising and non-ionising radiation protection; 2-) Promoting reflection on the mutual interactions between radiation protection and society; 3-) Contributing to the development and diffusion in the RP community of the culture of stakeholder engagement in the decision-making process. Aiming at promoting continual dialogue between the radiation protection community and society, an initial meeting was held in June 2006 on the fundamentals and objectives of RP communication, by focusing on issues such as: the credibility of information sources, the role of the mass media and institutions in risk communication. A workshop was held in November 2006 on the social aspects of radiation protection: experts in scientific journalism, sociology and medical physics, representatives of consumer associations, participants in a Government task commission, local authorities and representatives of the leading local and national institutions involved in RP, were given the opportunity of communicating and discussing the main socially-sensitive aspects of RP. The work of the AIRP group continued in 2007 with two events related on the

  9. From myth to the individual: The dynamic process of cultural integration in groups of psychodrama in childhood

    Directory of Open Access Journals (Sweden)

    Angela Sordano

    2014-09-01

    Full Text Available This paper describes how the work methodology through the tale and psychodrama with children and adolescents focuses on the development of symbolic constructions figuratively organized which draw directly from the unconscious world of the participants and the mythic dimensions that organize their story. The psychodramatic group in childhood and adolescence may promote the social integration of people ethnically and culturally diverse through the recovery of those mythical and deep aspects that play a role in the unconscious of the individual.Keywords: Psychodrama; Adolescents; Mith

  10. Integration of Monetary and Fiscal Policy of the Countries of the Visegrad Group

    Directory of Open Access Journals (Sweden)

    Kappel Stanislav

    2014-09-01

    Full Text Available The aim of this paper is to evaluate mutual interaction of monetary and fiscal policies in the countries of the Visegrad group, i.e. in the Czech Republic, Slovakia, Poland and Hungary. The relationship of monetary and fiscal policy - their coordination, cooperation or mutual antagonism - are basic determinants of successful implementation for economic policy of the state. Fiscal and monetary policies usually have different aims, and some conflict situations may arise in practical economic and political decision- making. Each policy has to make its decision with regard to the other one. Methodical approaches of this contribution are based on the game theory, which deals with the analysis of a wide range of decision situations with more participants (players and it is primarily focused on the conflict situations. This game-theoretical approach is responsible for creating the theoretical model which is then dealt with in the empirical analysis. We find a distinctly stabilizing role of monetary policy and relatively problematic stabilizing role of fiscal policy in the analyzed countries. The dominant role of monetary policy is statistically confirmed in the case of the Czech Republic and Hungary.

  11. Mixed Waste Focus Area Mercury Working Group: An integrated approach to mercury waste treatment and disposal

    International Nuclear Information System (INIS)

    Conley, T.B.; Morris, M.I.; Osborne-Lee, I.W.

    1998-03-01

    In May 1996, the US Department of Energy (DOE) Mixed Waste Focus Area (MWFA) initiated the Mercury Working Group (HgWG). The HgWG was established to address and resolve the issues associated with mercury contaminated mixed wastes. During the MWFA's initial technical baseline development process, three of the top four technology deficiencies identified were related to the need for amalgamation, stabilization, and separation removal technologies for the treatment of mercury and mercury contaminated mixed waste. The HgWG is assisting the MWFA in soliciting, identifying, initiating, and managing efforts to address these areas. The focus of the HgWG is to better establish the mercury related treatment technologies at the DOE sites, refine the MWFA technical baseline as it relates to mercury treatment, and make recommendations to the MWFA on how to most effectively address these needs. Based on the scope and magnitude of the mercury mixed waste problem, as defined by HgWG, solicitations and contract awards have been made to the private sector to demonstrate both the amalgamation and stabilization processes using actual mixed wastes. Development efforts are currently being funded that will address DOE's needs for separation removal processes. This paper discusses the technology selection process, development activities, and the accomplishments of the HgWG to date through these various activities

  12. An infrastructure with a unified control plane to integrate IP into optical metro networks to provide flexible and intelligent bandwidth on demand for cloud computing

    Science.gov (United States)

    Yang, Wei; Hall, Trevor

    2012-12-01

    The Internet is entering an era of cloud computing to provide more cost effective, eco-friendly and reliable services to consumer and business users and the nature of the Internet traffic will undertake a fundamental transformation. Consequently, the current Internet will no longer suffice for serving cloud traffic in metro areas. This work proposes an infrastructure with a unified control plane that integrates simple packet aggregation technology with optical express through the interoperation between IP routers and electrical traffic controllers in optical metro networks. The proposed infrastructure provides flexible, intelligent, and eco-friendly bandwidth on demand for cloud computing in metro areas.

  13. Solid-state NMR detection of 14N-13C dipolar couplings between amino acid side groups provides constraints on amyloid fibril architecture.

    Science.gov (United States)

    Middleton, David A

    2011-02-01

    Solid-state nuclear magnetic resonance (SSNMR) is a powerful technique for the structural analysis of amyloid fibrils. With suitable isotope labelling patterns, SSNMR can provide constraints on the secondary structure, alignment and registration of β-strands within amyloid fibrils and identify the tertiary and quaternary contacts defining the packing of the β-sheet layers. Detection of (14)N-(13)C dipolar couplings may provide potentially useful additional structural constraints on β-sheet packing within amyloid fibrils but has not until now been exploited for this purpose. Here a frequency-selective, transfer of population in double resonance SSNMR experiment is used to detect a weak (14)N-(13)C dipolar coupling in amyloid-like fibrils of the peptide H(2)N-SNNFGAILSS-COOH, which was uniformly (13)C and (15)N labelled across the four C-terminal amino acids. The (14)N-(13)C interatomic distance between leucine and asparagine side groups is constrained between 2.4 and 3.8 Å, which allows current structural models of the β-spine arrangement within the fibrils to be refined. This procedure could be useful for the general structural analysis of other proteins in condensed phases and environments, such as biological membranes. Copyright © 2011 John Wiley & Sons, Ltd.

  14. Integration

    DEFF Research Database (Denmark)

    Emerek, Ruth

    2004-01-01

    Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration......Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration...

  15. Integrating Research, Theory-Building, Training, and Practice in CBT Group Therapy for Children and Adolescents with anxiety

    DEFF Research Database (Denmark)

    Thastum, Mikael

    This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents. The res......This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents....... The resulting Youth CBT Therapy Program at Aarhus is organized around a short-term, 10-session, evidence-based, manualized, family-based, cognitive behavioral therapy (CBT) group program, called "Cool Kids" for children and "Chilled Adolescents" for adolescents, and derived from Ronald Rapee's work in Australia....... A distinctive aspect of the work of the Youth CBT Therapy Program is their incorporation of a case-study perspective into a series of group designs, including:(a) a randomized treatment vs. waitlist-control efficacy study (n=120); (b) an open, naturalistic effectiveness study of the program in two mental health...

  16. Perceived effective and feasible strategies to promote healthy eating in young children: focus groups with parents, family child care providers and daycare assistants.

    Science.gov (United States)

    Vandeweghe, Laura; Moens, Ellen; Braet, Caroline; Van Lippevelde, Wendy; Vervoort, Leentje; Verbeken, Sandra

    2016-10-04

    The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children's eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14), family child care providers (n = 9), and daycare assistants (n = 10). The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy). Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.

  17. Perceived effective and feasible strategies to promote healthy eating in young children: focus groups with parents, family child care providers and daycare assistants

    Directory of Open Access Journals (Sweden)

    Laura Vandeweghe

    2016-10-01

    Full Text Available Abstract Background The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children’s eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Methods Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14, family child care providers (n = 9, and daycare assistants (n = 10. The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Results Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy. Conclusions Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.

  18. [Integrity].

    Science.gov (United States)

    Gómez Rodríguez, Rafael Ángel

    2014-01-01

    To say that someone possesses integrity is to claim that that person is almost predictable about responses to specific situations, that he or she can prudentially judge and to act correctly. There is a closed interrelationship between integrity and autonomy, and the autonomy rests on the deeper moral claim of all humans to integrity of the person. Integrity has two senses of significance for medical ethic: one sense refers to the integrity of the person in the bodily, psychosocial and intellectual elements; and in the second sense, the integrity is the virtue. Another facet of integrity of the person is la integrity of values we cherish and espouse. The physician must be a person of integrity if the integrity of the patient is to be safeguarded. The autonomy has reduced the violations in the past, but the character and virtues of the physician are the ultimate safeguard of autonomy of patient. A field very important in medicine is the scientific research. It is the character of the investigator that determines the moral quality of research. The problem arises when legitimate self-interests are replaced by selfish, particularly when human subjects are involved. The final safeguard of moral quality of research is the character and conscience of the investigator. Teaching must be relevant in the scientific field, but the most effective way to teach virtue ethics is through the example of the a respected scientist.

  19. Integration of borehole and seismic data to unravel complex stratigraphy: Case studies from the Mannville Group, Western Canada

    Science.gov (United States)

    Sarzalejo Silva, Sabrina Ester

    Understanding the stratigraphic architecture of geologically complex reservoirs, such as the heavy oil deposits of Western Canada, is essential to achieve an efficient hydrocarbon recovery. Borehole and 3-D seismic data were integrated to define the stratigraphic architecture and generate 3-dimensional geological models of the Mannville Group in Saskatchewan. The Mannville is a stratigraphically complex unit formed of fluvial to marine deposits. Two areas in west-central and southern Saskatchewan were examined in this study. In west-central Saskatchewan, the area corresponds to a stratigraphically controlled heavy oil reservoir with production from the undifferentiated Dina-Cummings Members of the Lower Cretaceous Mannville Group. The southern area, although non-prospective for hydrocarbons, shares many similarities with time-equivalent strata in areas of heavy oil production. Seismic sequence stratigraphic principles together with log signatures permitted the subdivision of the Mannville into different packages. An initial geological model was generated integrating seismic and well-log data Multiattribute analysis and neural networks were used to generate a pseudo-lithology or gamma-ray volume. The incorporation of borehole core data to the model and the subsequent integration with the lithological prediction were crucial to capture the distribution of reservoir and non-reservoir deposits in the study area. The ability to visualize the 3-D seismic data in a variety of ways, including arbitrary lines and stratal or horizon slicing techniques helped the definition of stratigraphic features such as channels and scroll bars that affect fluid flow in hydrocarbon producing areas. Small-scale heterogeneities in the reservoir were not resolved due to the resolution of the seismic data. Although not undertaken in this study, the resulting stratigraphic framework could be used to help construct a static reservoir model. Because of the small size of the 3-D seismic surveys

  20. A Framework for an Integrated Risk Informed Decision Making Process. INSAG-25. A Report by the International Nuclear Safety Group

    International Nuclear Information System (INIS)

    2011-01-01

    There is general international agreement, as reflected in various IAEA Safety Standards on nuclear reactor design and operation, that both deterministic and probabilistic analyses contribute to reactor safety by providing insights, perspective, comprehension and balance. Accordingly, the integration of deterministic and probabilistic analyses is increasing to support design, safety evaluation and operations. Additionally, application of these approaches to physical security is now being considered by several Member States. Deterministic and probabilistic analyses yield outputs that are complementary to each other. There is thus a need to use a structured framework for consideration of deterministic and probabilistic techniques and findings. In this process, it is appropriate to encourage a balance between deterministic approaches, probabilistic analyses and other factors (see Section 3) in order to achieve an integrated decision making process that serves in an optimal fashion to ensure nuclear reactor safety. This report presents such a framework - a framework that is termed 'integrated risk informed decision making' (IRIDM). While the details of IRIDM methods may change with better understanding of the subject, the framework presented in this report is expected to apply for the foreseeable future. IRIDM depends on the integration of a wide variety of information, insights and perspectives, as well as the commitment of designers, operators and regulatory authorities to use risk information in their decisions. This report thus focuses on key IRIDM aspects, as well considerations that bear on their application which should be taken into account in order to arrive at sound risk informed decisions. This report is intended to be in harmony with the IAEA Safety Standards and various INSAG reports relating to safety assessment and verification, and seeks to convey an appropriate approach to enhance nuclear reactor safety

  1. A Framework for an Integrated Risk Informed Decision Making Process. INSAG-25. A Report by the International Nuclear Safety Group

    International Nuclear Information System (INIS)

    2014-01-01

    There is general international agreement, as reflected in various IAEA Safety Standards on nuclear reactor design and operation, that both deterministic and probabilistic analyses contribute to reactor safety by providing insights, perspective, comprehension and balance. Accordingly, the integration of deterministic and probabilistic analyses is increasing to support design, safety evaluation and operations. Additionally, application of these approaches to physical security is now being considered by several Member States. Deterministic and probabilistic analyses yield outputs that are complementary to each other. There is thus a need to use a structured framework for consideration of deterministic and probabilistic techniques and findings. In this process, it is appropriate to encourage a balance between deterministic approaches, probabilistic analyses and other factors (see Section 3) in order to achieve an integrated decision making process that serves in an optimal fashion to ensure nuclear reactor safety. This report presents such a framework - a framework that is termed 'integrated risk informed decision making' (IRIDM). While the details of IRIDM methods may change with better understanding of the subject, the framework presented in this report is expected to apply for the foreseeable future. IRIDM depends on the integration of a wide variety of information, insights and perspectives, as well as the commitment of designers, operators and regulatory authorities ers, operators and regulatory authorities to use risk information in their decisions. This report thus focuses on key IRIDM aspects, as well considerations that bear on their application which should be taken into account in order to arrive at sound risk informed decisions. This report is intended to be in harmony with the IAEA Safety Standards and various INSAG reports relating to safety assessment and verification, and seeks to convey an appropriate approach to enhance nuclear reactor safety

  2. Integrating Group Counseling, Cell Phone Messaging, and Participant-Generated Songs and Dramas into a Microcredit Program Increases Nigerian Women’s Adherence to International Breastfeeding Recommendations123

    Science.gov (United States)

    Flax, Valerie L.; Negerie, Mekebeb; Ibrahim, Alawiyatu Usman; Leatherman, Sheila; Daza, Eric J.; Bentley, Margaret E.

    2014-01-01

    In northern Nigeria, interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practices. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled designs. We conducted a cluster-randomized controlled trial in Bauchi State, Nigeria, with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients. The intervention had 3 components. Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo. Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients (5–7 women). The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings. The control arm continued with the regular microcredit program. Randomization occurred at the level of the monthly meeting groups. Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo. Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors. Among the clients who completed the final survey (n = 390), the odds of exclusive breastfeeding to 6 mo (OR: 2.4; 95% CI: 1.4, 4.0) and timely breastfeeding initiation (OR: 2.6; 95% CI: 1.6, 4.1) were increased in the intervention vs. control arm. Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention. In conclusion, a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practices. This intervention could be scaled up in Nigeria, where local organizations provide microcredit to >500,000 clients. Furthermore, the intervention could be adopted more widely

  3. Integrating group counseling, cell phone messaging, and participant-generated songs and dramas into a microcredit program increases Nigerian women's adherence to international breastfeeding recommendations.

    Science.gov (United States)

    Flax, Valerie L; Negerie, Mekebeb; Ibrahim, Alawiyatu Usman; Leatherman, Sheila; Daza, Eric J; Bentley, Margaret E

    2014-07-01

    In northern Nigeria, interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practices. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled designs. We conducted a cluster-randomized controlled trial in Bauchi State, Nigeria, with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients. The intervention had 3 components. Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo. Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients (5-7 women). The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings. The control arm continued with the regular microcredit program. Randomization occurred at the level of the monthly meeting groups. Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo. Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors. Among the clients who completed the final survey (n = 390), the odds of exclusive breastfeeding to 6 mo (OR: 2.4; 95% CI: 1.4, 4.0) and timely breastfeeding initiation (OR: 2.6; 95% CI: 1.6, 4.1) were increased in the intervention vs. control arm. Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention. In conclusion, a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practices. This intervention could be scaled up in Nigeria, where local organizations provide microcredit to >500,000 clients. Furthermore, the intervention could be adopted more widely

  4. Fanconi anemia complementation group A (FANCA) localizes to centrosomes and functions in the maintenance of centrosome integrity.

    Science.gov (United States)

    Kim, Sunshin; Hwang, Soo Kyung; Lee, Mihee; Kwak, Heejin; Son, Kook; Yang, Jiha; Kim, Sung Hak; Lee, Chang-Hun

    2013-09-01

    Fanconi anemia (FA) proteins are known to play roles in the cellular response to DNA interstrand cross-linking lesions; however, several reports have suggested that FA proteins play additional roles. To elucidate novel functions of FA proteins, we used yeast two-hybrid screening to identify binding partners of the Fanconi anemia complementation group A (FANCA) protein. The candidate proteins included never-in-mitosis-gene A (NIMA)-related kinase 2 (Nek2), which functions in the maintenance of centrosome integrity. The interaction of FANCA and Nek2 was confirmed in human embryonic kidney (HEK) 293T cells. Furthermore, FANCA interacted with γ-tubulin and localized to centrosomes, most notably during the mitotic phase, confirming that FANCA is a centrosomal protein. Knockdown of FANCA increased the frequency of centrosomal abnormalities and enhanced the sensitivity of U2OS osteosarcoma cells to nocodazole, a microtubule-interfering agent. In vitro kinase assays indicated that Nek2 can phosphorylate FANCA at threonine-351 (T351), and analysis with a phospho-specific antibody confirmed that this phosphorylation occurred in response to nocodazole treatment. Furthermore, U2OS cells overexpressing the phosphorylation-defective T351A FANCA mutant showed numerical centrosomal abnormalities, aberrant mitotic arrest, and enhanced nocodazole sensitivity, implying that the Nek2-mediated T351 phosphorylation of FANCA is important for the maintenance of centrosomal integrity. Taken together, this study revealed that FANCA localizes to centrosomes and is required for the maintenance of centrosome integrity, possibly through its phosphorylation at T351 by Nek2. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Analysis of DNA binding by human factor xeroderma pigmentosum complementation group A (XPA) provides insight into its interactions with nucleotide excision repair substrates.

    Science.gov (United States)

    Sugitani, Norie; Voehler, Markus W; Roh, Michelle S; Topolska-Woś, Agnieszka M; Chazin, Walter J

    2017-10-13

    Xeroderma pigmentosum (XP) complementation group A (XPA) is an essential scaffolding protein in the multiprotein nucleotide excision repair (NER) machinery. The interaction of XPA with DNA is a core function of this protein; a number of mutations in the DNA-binding domain (DBD) are associated with XP disease. Although structures of the central globular domain of human XPA and data on binding of DNA substrates have been reported, the structural basis for XPA's DNA-binding activity remains unknown. X-ray crystal structures of the central globular domain of yeast XPA (Rad14) with lesion-containing DNA duplexes have provided valuable insights, but the DNA substrates used for this study do not correspond to the substrates of XPA as it functions within the NER machinery. To better understand the DNA-binding activity of human XPA in NER, we used NMR to investigate the interaction of its DBD with a range of DNA substrates. We found that XPA binds different single-stranded/double-stranded junction DNA substrates with a common surface. Comparisons of our NMR-based mapping of binding residues with the previously reported Rad14-DNA crystal structures revealed similarities and differences in substrate binding between XPA and Rad14. This includes direct evidence for DNA contacts to the residues extending C-terminally from the globular core, which are lacking in the Rad14 construct. Moreover, mutation of the XPA residue corresponding to Phe-262 in Rad14, previously reported as being critical for DNA binding, had only a moderate effect on the DNA-binding activity of XPA. The DNA-binding properties of several disease-associated mutations in the DBD were investigated. These results suggest that for XPA mutants exhibiting altered DNA-binding properties, a correlation exists between the extent of reduction in DNA-binding affinity and the severity of symptoms in XP patients. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

  6. Intuitionistic Trapezoidal Fuzzy Group Decision-Making Based on Prospect Choquet Integral Operator and Grey Projection Pursuit Dynamic Cluster

    Directory of Open Access Journals (Sweden)

    Jiahang Yuan

    2017-01-01

    Full Text Available In consideration of the interaction among attributes and the influence of decision makers’ risk attitude, this paper proposes an intuitionistic trapezoidal fuzzy aggregation operator based on Choquet integral and prospect theory. With respect to a multiattribute group decision-making problem, the prospect value functions of intuitionistic trapezoidal fuzzy numbers are aggregated by the proposed operator; then a grey relation-projection pursuit dynamic cluster method is developed to obtain the ranking of alternatives; the firefly algorithm is used to optimize the objective function of projection for obtaining the best projection direction of grey correlation projection values, and the grey correlation projection values are evaluated, which are applied to classify, rank, and prefer the alternatives. Finally, an illustrative example is taken in the present study to make the proposed method comprehensible.

  7. The programme of OECD-Nuclear Energy Agency Committee on the safety of nuclear installations principal working group no. 3 on reactor component integrity

    International Nuclear Information System (INIS)

    Schulz, H.; Miller, A.

    1995-01-01

    The programme of the OECD-NEA Principal Working Group No.3 on reactor component integrity is described including the following issues: regular Committee meetings; non-destructive testing; fracture analysis; aging; related activities

  8. Pedagogical Work, Stress Regulation and Work-Related Well-Being among Early Childhood Professionals in Integrated Special Day-Care Groups

    Science.gov (United States)

    Nislin, Mari A.; Sajaniemi, Nina K.; Sims, Margaret; Suhonen, Eira; Maldonado Montero, Enrique F.; Hirvonen, Ari; Hyttinen, Sirpa

    2016-01-01

    The aim of this study was to investigate the relationship between early childhood professionals' (ECPs) stress regulation (using salivary cortisol and alpha-amylase [AA] measurements), work engagement and the quality of their pedagogical work in integrated special day-care groups. Participants were 89 ECPs from 21 integrated special day-care…

  9. Results and synthesis of integrated geologic studies of the carboniferous Lisburne Group of Northeastern Alaska. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Watts, K.F.

    1995-05-01

    The primary objective of this project was to develop an integrated database to characterize reservoir heterogeneities resulting from numerous small-scale shallowing-upward cycles (parasequences) comprising the Pennsylvanian Wahoo 1imestone. The Wahoo Limestone is the upper part of an extensive carbonate platform sequence of the Carboniferous Lisburne Group which is widely exposed in the Brooks Range and is a widespread hydrocarbon reservoir unit in the subsurface of the North Slope of Alaska. A leading goal is to determine lateral and vertical variations in the complex mosaic of carbonate facies comprising the Wahoo. Aspects of rock units adjacent to the Wahoo, the underlying Endicott Group and Alapah Limestone and overlying Echooka Formation are also discussed. This report includes an overview of the regional geological framework; a discussion of biostratigraphic results; a summary of diagenetic studies; and preliminary results of comparative studies of a cored well in the Lisburne oil field. A computerized database system (the Wahoo database) was developed and is explained in a users manual. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  10. Tailored care for somatoform vertigo/dizziness: study protocol for a randomised controlled trial evaluating integrative group psychotherapy.

    Science.gov (United States)

    Lahmann, Claas; Henningsen, P; Dieterich, M; Radziej, K; Schmid, G

    2015-08-01

    Vertigo/dizziness (VD) ranks high in lifetime prevalence and clinical relevance. Nearly half of the complex VD disorders presenting at specialised units for vertigo or otoneurological disorders are not fully explained by an identifiable medical illness, but instead are related to anxiety, depressive, or somatoform disorders. Although there is some evidence that psychotherapy may be effective for these patients, therapeutic options remain unsatisfactory. This report describes the objectives, design and methods of a randomised, controlled clinical trial, evaluating the efficacy of manualised, multimodal group psychotherapy, based on integrative psychotherapy (IPT) and tailored to subgroups of mental disorders in medically unexplained VD. This psychotherapeutic approach will be compared to self-help groups (n = 172; n = 86 per study arm). Improvements with regard to handicap due to VD at 12 months follow-up will serve as primary outcome. Additionally, measures of generic quality of life, severity of vertigo, depression, anxiety, somatisation as well as Head Impulse Test and Computerized Static Posturography will be applied. We will also analyse the cost-effectiveness of this trial. The study aims to improve treatment of this therapeutically underserved population who are often severely impaired in their working and daily lives. ClinicalTrials.gov Identifier: NCT02320851. This is an on-going study; recruitment for the study is about to start.

  11. Integrating the health and mental health needs of the chronically ill: a group for individuals with depression and sickle cell disease.

    Science.gov (United States)

    Comer, Edna W

    2004-01-01

    Concerns about high rates of depression among persons with sickle cell disease and no effective interventions for treatment of this condition were the impetuses for the study described in this paper. A groupwork service using cognitive-behavioral and self-management techniques were integrated into health care services at a Comprehensive Sickle Cell Center to treat depression in a small group of patients. An interdisciplinary team that included health care and mental health providers from the Center and a social work researcher guided the endeavor. Principles of Intervention Research were applied in the development of the service and to evaluate its effectiveness. Among the findings were that study participants realized a decrease in depressive symptoms.

  12. Integration of ethnic minorities during group-work for vocational teachers-in-training in health studies.

    Science.gov (United States)

    Goth, Ursula Småland; Bergsli, Oddhild; Johanesen, Else Marie

    2017-01-28

    To determine how to enhance integration of minority students in health education, and thereby improve intercultural communication skills and cultural sensitivity in a sample of health teacher students in Norway. After a group-work intervention and for a period of six months afterwards we followed an "action research" approach and observed 47 health teachers-in-training in their first year at the Oslo and Akershus University College during classroom interactions. Data were qualitative and comprised student self-reports and survey results along with observations from three teachers, the authors of the study. Data were analyzed using a constant comparative approach with opinion categorization and an open coding procedure, with separate analyses performed on observations from minority students, majority students, and teachers. Both ethnic majority and minority students experienced an increase in intercultural knowledge and problem-solving ability after the experience of an early intervention in their first academic year of tertiary education. Students reacted favorably to the intervention and noted in class assessments both the challenges and rewards of overcoming cultural barriers. Teacher observation notes confirmed that early intervention led to an increase in interaction and cross-cultural engagement between minority and majority students compared to previous years' classes without the intervention. Early classroom intervention to promote intercultural engagement can prevent clique formation along majority/minority lines. The method used here, tailored group assignments in ethnically diverse working groups at the very beginning of students' tertiary academic career, can be an effective approach to cultivating attitudes and skills fostering intercultural awareness and sensitivity.

  13. A group randomized controlled trial integrating obesity prevention and control for postpartum adolescents in a home visiting program.

    Science.gov (United States)

    Haire-Joshu, Debra L; Schwarz, Cynthia D; Peskoe, Sarah B; Budd, Elizabeth L; Brownson, Ross C; Joshu, Corinne E

    2015-06-26

    Adolescence represents a critical period for the development of overweight that tracks into adulthood. This risk is significantly heightened for adolescents that become pregnant, many of whom experience postpartum weight retention. The aim of this study was to evaluate Balance Adolescent Lifestyle Activities and Nutrition Choices for Energy (BALANCE), a multicomponent obesity prevention intervention targeting postpartum adolescents participating in a national home visiting child development-parent education program. A group randomized, nested cohort design was used with 1325 adolescents, 694 intervention and 490 control, (mean age = 17.8 years, 52 % underrepresented minorities) located across 30 states. Participatory methods were used to integrate lifestyle behavior change strategies within standard parent education practice. Content targeted replacement of high-risk obesogenic patterns (e.g. sweetened drink and high fat snack consumption, sedentary activity) with positive behaviors (e.g. water intake, fruit and vegetables, increased walking). Parent educators delivered BALANCE through home visits, school based classroom-group meetings, and website activities. Control adolescents received standard child development information. Phase I included baseline to posttest (12 months); Phase II included baseline to follow-up (24 months). When compared to the control group, BALANCE adolescents who were ≥12 weeks postpartum were 89 % more likely (p = 0.02) to maintain a normal BMI or improve an overweight/obese BMI by 12 months; this change was not sustained at 24 months. When compared to the control group, BALANCE adolescents significantly improved fruit and vegetable intake (p = .03). In stratified analyses, water intake improved among younger BALANCE teens (p = .001) and overweight/obese BALANCE teens (p = .05) when compared to control counterparts. There were no significant differences between groups in sweetened drink and snack consumption

  14. A hybrid optical switch architecture to integrate IP into optical networks to provide flexible and intelligent bandwidth on demand for cloud computing

    Science.gov (United States)

    Yang, Wei; Hall, Trevor J.

    2013-12-01

    The Internet is entering an era of cloud computing to provide more cost effective, eco-friendly and reliable services to consumer and business users. As a consequence, the nature of the Internet traffic has been fundamentally transformed from a pure packet-based pattern to today's predominantly flow-based pattern. Cloud computing has also brought about an unprecedented growth in the Internet traffic. In this paper, a hybrid optical switch architecture is presented to deal with the flow-based Internet traffic, aiming to offer flexible and intelligent bandwidth on demand to improve fiber capacity utilization. The hybrid optical switch is capable of integrating IP into optical networks for cloud-based traffic with predictable performance, for which the delay performance of the electronic module in the hybrid optical switch architecture is evaluated through simulation.

  15. Cochrane Qualitative and Implementation Methods Group guidance series-paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews.

    Science.gov (United States)

    Harden, Angela; Thomas, James; Cargo, Margaret; Harris, Janet; Pantoja, Tomas; Flemming, Kate; Booth, Andrew; Garside, Ruth; Hannes, Karin; Noyes, Jane

    2018-05-01

    The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Differences in Approach between Nuclear and Conventional Seismic Standards with regard to Hazard Definition - CSNI Integrity And Ageing Working Group

    International Nuclear Information System (INIS)

    Djaoudi, Ali; Labbe, Pierre; Murphy, Andrew; Kitada, Yoshio

    2008-01-01

    The Committee on the safety of Nuclear Installations (CSNI) of the OECD-NEA co-ordinates the NEA activities related to maintaining and advancing the scientific and technological knowledge base of the safety of nuclear installations. The Integrity and Ageing of Components and Structures Working Group of the CSNI is responsible for work related to the development and use of methods, data and information to assess the behaviour of materials and structures. It has three sub-groups, dealing with the integrity of metal components and structures, ageing of concrete structures, and the seismic behaviour of structures. The CSNI, at its meeting in June 2003, agreed to initiate an activity aimed to identify any difference between nuclear and non-nuclear conventional standards and their potential significance with regard to seismic hazards and design methods. There was a perception, mainly in some of the European countries that nuclear seismic hazard and design standards may be lagging behind developments in similar standards for conventional facilities. Adequate answer to such perception, need the examination of the following aspects and their significance on the seismic assessment of structures and components: - The safety philosophy behind the seismic nuclear and conventional standards. - The differences in approach regarding the seismic hazard definition. - The difference in approach regarding the design and the methods of analysis. These topics are examined in this report. Appendices A to H of this report contain a brief description of the conventional and the nuclear approaches in the NEA member countries: Belgium, Canada, Czech Republic, Germany, Japan, South Korea, Spain,and USA. The following general conclusions can be drawn: - The approach adopted by the nuclear seismic standards is more conservative and more reliable (in particular for meeting the continued operation criteria) than the recommended by the currently applicable force based conventional seismic codes

  17. The integration of the treatment for common mental disorders in primary care: experiences of health care providers in the MANAS trial in Goa, India

    Directory of Open Access Journals (Sweden)

    Kirkwood Betty R

    2011-10-01

    Full Text Available Abstract Background The MANAS trial reported that a Lay Health Counsellor (LHC led collaborative stepped care intervention (the "MANAS intervention" for Common Mental Disorders (CMD was effective in public sector primary care clinics but private sector General Practitioners (GPs did as well with or without the additional counsellor. This paper aims to describe the experiences of integrating the MANAS intervention in primary care. Methods Qualitative semi-structured interviews with key members (n = 119 of the primary health care teams upon completion of the trial and additional interviews with control arm GPs upon completion of the outcome analyses which revealed non-inferiority of this arm. Results Several components of the MANAS intervention were reported to have been critically important for facilitating integration, notably: screening and the categorization of the severity of CMD; provision of psychosocial treatments and adherence management; and the support of the visiting psychiatrist. Non-adherence was common, often because symptoms had been controlled or because of doubt that health care interventions could address one's 'life difficulties'. Interpersonal therapy was intended to be provided face to face by the LHC; however it could not be delivered for most eligible patients due to the cost implications related to travel to the clinic and the time lost from work. The LHCs had particular difficulty in working with patients with extreme social difficulties or alcohol related problems, and elderly patients, as the intervention seemed unable to address their specific needs. The control arm GPs adopted practices similar to the principles of the MANAS intervention; GPs routinely diagnosed CMD and provided psychoeducation, advice on life style changes and problem solving, prescribed antidepressants, and referred to specialists as appropriate. Conclusion The key factors which enhance the acceptability and integration of a LHC in primary care are

  18. Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups : A case study

    NARCIS (Netherlands)

    Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, H.J.M.

    2015-01-01

    Background Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two

  19. Transition to Kindergarten for Children with Autism Spectrum Disorder: A Focus Group Study With Ethnically Diverse Parents, Teachers, and Early Intervention Service Providers

    Science.gov (United States)

    Starr, Elizabeth M.; Martini, Tanya S.; Kuo, Ben C. H.

    2016-01-01

    Despite the stated importance of a successful kindergarten transition (TTK) for future school success, no research has addressed this transition for culturally/ethnically diverse families having children with autism spectrum disorders (ASD). To address this gap, six focus groups (three with ethnically diverse parents, one with kindergarten…

  20. Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP Applied to Caregivers of Patients With Dementia

    Directory of Open Access Journals (Sweden)

    Serena Passoni

    2018-06-01

    Full Text Available Caregivers of patients with dementia experience high levels of stress and burden, with effects comparable to those of a traumatic event. Eye Movement Desensitization and Reprocessing (EMDR appear to be effective in recovering post-traumatic stress disorder (PTSD. We aimed at investigating the effectiveness of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP on the “caregiver syndrome”. Forty-four primary caregivers entered the study. They were randomly assigned to either the “immediate” branch, who received the treatment soon after recruitment, or to the “delayed” branch, who received it two months after recruitment. The treatment consisted of eight group sessions (one per week spanning over two months. Emotional distress was measured before the treatment, immediately after the end of it, and two months later (follow-up, by means of several clinical scales (Impact of Event Scale-Revised, IES-R; Caregiver Needs Assessment, CNA; Caregiver Burden Inventory, CBI; Anxiety and Depression Scale-Reduced Form, AD-R. The “immediate” branch improved significantly more than the “delayed” (control branch on The Impact of Event Scale-Revised, the Anxiety, and the Depression scales; however, after treatment such an improvement was maintained only in the first scale. The “delayed” branch took less advantage of the treatment, showing significant reduction only on the Depression scale, an effect which disappeared at follow-up. These preliminary results show for the first time that EMDR-IGTP reduces stress-related symptoms, anxiety, and depression in caregivers of patients with dementia. Interestingly, caregivers who were inserted in a waiting list after recruitment showed smaller treatment effects. Larger samples are needed to better interpret such differential clinical profiles.

  1. Integrated ground-based hyperspectral imaging and geochemical study of the Eagle Ford Group in West Texas

    Science.gov (United States)

    Sun, Lei; Khan, Shuhab; Godet, Alexis

    2018-01-01

    This study used ground-based hyperspectral imaging to map an outcrop of the Eagle Ford Group in west Texas. The Eagle Ford Group consists of alternating layers of mudstone - wackestone, grainstone - packstone facies and volcanic ash deposits with high total organic content deposited during the Cenomanian - Turonian time period. It is one of the few unconventional source rock and reservoirs that have surface representations. Ground-based hyperspectral imaging scanned an outcrop and hand samples at close ranges with very fine spatial resolution (centimeter to sub-millimeter). Spectral absorption modeling of clay minerals and calcite with the modified Gaussian model (MGM) allowed quantification of variations of mineral abundances. Petrographic analysis confirmed mineral identifications and shed light on sedimentary textures, and major element geochemistry supported the mineral quantification. Mineral quantification resulted in mapping of mudstone - wackestone, grainstone - packstone facies and bentonites (volcanic ash beds). The lack of spatial associations between the grainstones and bentonites on the outcrop calls into question the hypothesis that the primary productivity is controlled by iron availability from volcanic ash beds. Enrichment of molybdenum (Mo) and uranium (U) indicated "unrestricted marine" paleo-hydrogeology and anoxic to euxinic paleo-redox bottom water conditions. Hyperspectral remote sensing data also helped in creating a virtual outcrop model with detailed mineralogical compositions, and provided reservoir analog to extract compositional and geo-mechanical characteristics and variations. The utilization of these new techniques in geo-statistical analysis provides a workflow for employing remote sensing in resource exploration and exploitation.

  2. Handling equipment Selection in open pit mines by using an integrated model based on group decision making

    Directory of Open Access Journals (Sweden)

    Abdolreza Yazdani-Chamzini

    2012-10-01

    Full Text Available Process of handling equipment selection is one of the most important and basic parts in the project planning, particularly mining projects due to holding a high charge of the total project's cost. Different criteria impact on the handling equipment selection, while these criteria often are in conflicting with each other. Therefore, the process of handling equipment selection is a complex and multi criteria decision making problem. There are a variety of methods for selecting the most appropriate equipment among a set of alternatives. Likewise, according to the sophisticated structure of the problem, imprecise data, less of information, and inherent uncertainty, the usage of the fuzzy sets can be useful. In this study a new integrated model based on fuzzy analytic hierarchy process (FAHP and fuzzy technique for order preference by similarity to ideal solution (FTOPSIS is proposed, which uses group decision making to reduce individual errors. In order to calculate the weights of the evaluation criteria, FAHP is utilized in the process of handling equipment selection, and then these weights are inserted to the FTOPSIS computations to select the most appropriate handling system among a pool of alternatives. The results of this study demonstrate the potential application and effectiveness of the proposed model, which can be applied to different types of sophisticated problems in real problems.

  3. The Effectiveness of Eye Movement Desensitization and Reprocessing Integrative Group Protocol with Adolescent Survivors of the Central Italy Earthquake

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    Giada Maslovaric

    2017-10-01

    Full Text Available Earthquakes, which can cause widespread territorial and socio-economic destruction, are life-threatening, unexpected, unpredictable, and uncontrollable events caused by the shaking of the surface of the earth. The psychological consequences, such as PTSD, anxiety, depression, and suicidal ideation, are well-known to clinicians and researchers. This study was conducted with the aim of evaluating the use of the Eye Movement Desensitization and Reprocessing (EMDR Integrative Group Treatment Protocol on a sample of adolescents, after the earthquake in Central Italy on 24 August 2016. The objective of the EMDR intervention was to reduce PTSD symptoms. Before and after EMDR, specific assessment to find changes in PTSD symptoms was made using the Impact of Event Scale-Revised and through the analyses of the Subjective Units of Disturbance. The EMDR treatment was given in three sessions (T1, T2, and T3, each lasting 90 min, and the results at follow-up phase (T4 were also monitored. The results are very encouraging, showing significantly reduced PTSD symptoms in the majority of the subjects. The clinical implications and limitations will be discussed.

  4. The Effectiveness of Eye Movement Desensitization and Reprocessing Integrative Group Protocol with Adolescent Survivors of the Central Italy Earthquake.

    Science.gov (United States)

    Maslovaric, Giada; Zaccagnino, Maria; Mezzaluna, Clarice; Perilli, Sava; Trivellato, Denis; Longo, Vittorio; Civilotti, Cristina

    2017-01-01

    Earthquakes, which can cause widespread territorial and socio-economic destruction, are life-threatening, unexpected, unpredictable, and uncontrollable events caused by the shaking of the surface of the earth. The psychological consequences, such as PTSD, anxiety, depression, and suicidal ideation, are well-known to clinicians and researchers. This study was conducted with the aim of evaluating the use of the Eye Movement Desensitization and Reprocessing (EMDR) Integrative Group Treatment Protocol on a sample of adolescents, after the earthquake in Central Italy on 24 August 2016. The objective of the EMDR intervention was to reduce PTSD symptoms. Before and after EMDR, specific assessment to find changes in PTSD symptoms was made using the Impact of Event Scale-Revised and through the analyses of the Subjective Units of Disturbance. The EMDR treatment was given in three sessions (T1, T2, and T3), each lasting 90 min, and the results at follow-up phase (T4) were also monitored. The results are very encouraging, showing significantly reduced PTSD symptoms in the majority of the subjects. The clinical implications and limitations will be discussed.

  5. Art therapy, psychodrama, and verbal therapy. An integrative model of group therapy in the treatment of adolescents with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Diamond-Raab, Lisa; Orrell-Valente, Joan K

    2002-04-01

    Anorexia nervosa and bulimia nervosa typically afflict individuals in adolescence. Given the intractability of these diseases in combination with the natural recalcitrance of adolescence, treatment with this population presents a daunting challenge. Traditional group therapy that focuses on verbal therapy is often not effective with this population, particularly in the acute stages of the diseases. A group therapy approach that integrates art therapy, psychodrama, and verbal therapy offers an innovative alternative to traditional group therapy.

  6. Investigating the Effects of Group Investigation (GI and Cooperative Integrated Reading and Comprehension (CIRC as the Cooperative Learning Techniques on Learner's Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Mohammad Amin Karafkan

    2015-11-01

    Full Text Available Cooperative learning consists of some techniques for helping students work together more effectively. This study investigated the effects of Group Investigation (GI and Cooperative Integrated Reading and Composition (CIRC as cooperative learning techniques on Iranian EFL learners’ reading comprehension at an intermediate level. The participants of the study were 207 male students who studied at an intermediate level at ILI. The participants were randomly assigned into three equal groups: one control group and two experimental groups. The control group was instructed via conventional technique following an individualistic instructional approach. One experimental group received GI technique. The other experimental group received CIRC technique. The findings showed that there was a meaningful difference between the mean of the reading comprehension score of GI experimental group and CRIC experimental group. CRIC technique is more effective than GI technique in enhancing the reading comprehension test scores of students.

  7. Left alone--Swedish nurses' and mental health workers' experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era. A focus-group interview study.

    Science.gov (United States)

    Kristiansen, Lisbeth; Hellzén, Ove; Asplund, Kenneth

    2010-09-01

    The professional role of nurses and mental health workers in social psychiatry is being re-defined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses' and mental health workers' views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly 'strangled' situation', and 'Feeling overwhelming frustration'. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general. © 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.

  8. Group 12: Related Service Providers. IMPACT: The District of Columbia Public Schools Effectiveness Assessment System for School-Based Personnel, 2012-2013

    Science.gov (United States)

    District of Columbia Public Schools, 2012

    2012-01-01

    The 2012-2013 school year represents a pivotal juncture for DC Public Schools. Last spring, Mayor Gray and Chancellor Kaya Henderson introduced "A Capital Commitment," their ambitious plan to dramatically accelerate student achievement in the district over the next five years by providing all of their students with a safe, academically…

  9. Using In-class Group Exercises to Enhance Lectures and Provide Introductory Physics Students an Opportunity to Perfect Problem Solving Skills through Interactions with Fellow Students

    Science.gov (United States)

    Trout, Joseph; Bland, Jared

    2013-03-01

    In this pilot project, one hour of lecture time was replaced with one hour of in-class assignments, which groups of students collaborated on. These in-class assignments consisted of problems or projects selected for the calculus-based introductory physics students The first problem was at a level of difficulty that the majority of the students could complete with a small to moderate amount of difficulty. Each successive problem was increasingly more difficult, the last problem being having a level of difficulty that was beyond the capabilities of the majority of the students and required some instructor intervention. The students were free to choose their own groups. Students were encouraged to interact and help each other understand. The success of the in-class exercises were measured using pre-tests and post-tests. The pre-test and post-test were completed by each student independently. Statistics were also compiled on each student's attendance record and the amount of time spent reading and studying, as reported by the student. Statistics were also completed on the student responses when asked if they had sufficient time to complete the pre-test and post-test and if they would have completed the test with the correct answers if they had more time. The pre-tests and post-tests were not used in the computation of the grades of the students.

  10. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    Directory of Open Access Journals (Sweden)

    Esbensen Bente

    2011-06-01

    Full Text Available Abstract Background Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus a barrier for health care providers (HCPs to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs and are integrated into routine outpatient clinic visits are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic visits will reduce haemoglobin A1c (HbA1c concentrations and improve adolescents' life skills compared with a control group. Methods/Design Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1 diabetes (HbA1c > 8.0% and their parents from 2 Danish hospitals and randomise into GSD-Y or control groups. During an 8-12 month period, the GSD-Y group will complete 8 outpatient GSD-Y visits, and the control group will completes an equal number of standard visits. The primary outcome is HbA1c. Secondary outcomes include the following: number of self-monitored blood glucose values and levels of autonomous motivation, involvement and autonomy support from parents, autonomy support from HCPs, perceived competence in managing diabetes, well-being, and diabetes-related problems. Primary and secondary outcomes will be evaluated within and between groups by comparing data from baseline, after completion of the visits, and again after a 6-month follow-up. To

  11. The ClaudicatioNet concept: design of a national integrated care network providing active and healthy aging for patients with intermittent claudication

    Directory of Open Access Journals (Sweden)

    Lauret GJ

    2012-08-01

    Full Text Available Gert-Jan Lauret,1,2 Harm JH Gijsbers,3 Erik JM Hendriks,2 Marie-Louise Bartelink,4 Rob A de Bie,2 Joep AW Teijink1,2 On behalf of the ClaudicatioNet Study Group members1Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; 2Caphri Research Institute, Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; 3Dutch Society for Heart, Vascular and Lung Physiotherapy, Meijerslaan PG Heemstede, The Netherlands; 4Julius Center Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The NetherlandsIntroduction: Intermittent claudication (IC is a manifestation of peripheral arterial occlusive disease (PAOD. Besides cardiovascular risk management, supervised exercise therapy (SET should be offered to all patients with IC. Outdated guidelines, an insufficient number of specialized physiotherapists (PTs, lack of awareness of the importance of SET by referring physicians, and misguided financial incentives all seriously impede the availability of a structured SET program in The Netherlands.Description of care practice: By initiating regional care networks, ClaudicatioNet aims to improve the quality of care for patients with IC. Based on the chronic care model as a conceptual framework, these networks should enhance the access, continuity, and (cost efficiency of the health care system. With the aid of a national database, health care professionals will be able to benchmark patient results while ClaudicatioNet will be able to monitor quality of care by way of functional and patient reported outcome measures.Discussion: The success of ClaudicatioNet is dependent on several factors. Vascular surgeons, general practitioners and coordinating central caregivers will need to team up and work in close collaboration with specialized PTs. A substantial task in the upcoming years will be to monitor the quality, volume, and distribution of ClaudicatioNet PTs. Finally, misguided financial incentives

  12. High prevalence of alpha- and beta-thalassemia in the Kadazandusuns in East Malaysia: challenges in providing effective health care for an indigenous group.

    Science.gov (United States)

    Tan, Jin-Ai Mary Anne; Lee, Ping-Chin; Wee, Yong-Chui; Tan, Kim-Lian; Mahali, Noor Fadzlin; George, Elizabeth; Chua, Kek-Heng

    2010-01-01

    Thalassemia can lead to severe transfusion-dependent anemia, and it is the most common genetic disorder in Malaysia. This paper aims to determine the prevalence of thalassemia in the Kadazandusuns, the largest indigenous group in Sabah, East Malaysia. α- and β-thalassemia were confirmed in 33.6% and 12.8%, of the individuals studied respectively. The high prevalence of α- and β-thalassemia in the Kadazandusuns indicates that thalassemia screening, genetic counseling, and prenatal diagnosis should be included as part of their healthcare system. This preliminary paper serves as a baseline for further investigations into the health and genetic defects of the major indigenous population in Sabah, East Malaysia.

  13. Learning to provide children with a secure base and a safe haven: The Circle of Security-Parenting (COS-P) group intervention.

    Science.gov (United States)

    Kim, Monica; Woodhouse, Susan S; Dai, Chenchen

    2018-05-21

    Insecure attachment is linked to a host of negative child outcomes, including internalizing and externalizing behavior problems. Circle of Security-Parenting (COS-P) is a manualized, video-based, eight unit, group parenting intervention to promote children's attachment security. COS-P was designed to be easily implemented, so as to make attachment interventions more widely available to families. We present the theoretical background of COS-P, research evidence supporting the COS approach, as well as a description of the COS-P intervention protocol. The case example of "Alexa," mother of three children (aged 7, 6, and 4 years), illustrates how parents can make use of the COS-P intervention to better understand children's needs, build skills in observing and interpreting children's signals, learn to recognize and regulate their own responses to their children, and learn new ways of responding to children's needs. © 2018 Wiley Periodicals, Inc.

  14. "I think we've got too many tests!": Prenatal providers' reflections on ethical and clinical challenges in the practice integration of cell-free DNA screening.

    Science.gov (United States)

    Gammon, B L; Kraft, S A; Michie, M; Allyse, M

    2016-01-01

    on prenatal practice, and potential future of cfDNA screening in clinical practice. Given the likelihood that the scope and uptake of cfDNA screening will continue to increase, it is essential to consider how these changes will affect frontline prenatal care providers and, in turn, patients. Providers' requests for additional guidance and data as well as their concerns with the lack of time available to explain screening and testing options indicate significant potential issues with patient care. It is important to ensure that the clinical integration of cfDNA screening is managed responsibly and ethically before it expands further, exacerbating pre-existing issues. As prenatal screening evolves, so should informed consent and the resources available to women making decisions. The field must take steps to maximize the advantages of cfDNA screening and responsibly manage its ethical issues.

  15. Changing Names with Changed Address: Integrated Taxonomy and Species Delimitation in the Holarctic Colymbetes paykulli Group (Coleoptera: Dytiscidae.

    Directory of Open Access Journals (Sweden)

    Marcus K Drotz

    Full Text Available Species delimitation of geographically isolated forms is a long-standing problem in less studied insect groups. Often taxonomic decisions are based directly on morphologic variation, and lack a discussion regarding sample size and the efficiency of migration barriers or dispersal/migration capacity of the studied species. These problems are here exemplified in a water beetle complex from the Bering Sea region that separates North America from Eurasia. Only a few sampled specimens occur from this particular area and they are mostly found in museum and private collections. Here we utilize the theory of integrated taxonomy to discuss the speciation of the Holarctic Colymbetes paykulli water beetle complex, which historically has included up to five species of which today only two are recognized. Three delimitation methods are used; landmark based morphometry of body shape, variation in reticulation patterns of the pronotum exo-skeleton and sequence variation of the partial mitochondrial gene Cyt b. Our conclusion is that the Palearctic and Nearctic populations of C. paykulli are given the status of separate species, based on the fact that all methods showed significant separation between populations. As a consequence the name of the Palearctic species is C. paykulli Erichson and the Nearctic species should be known as C. longulus LeConte. There is no clear support for delineation between Palearctic and Nearctic populations of C. dahuricus based on mtDNA. However, significant difference in size and reticulation patterns from the two regions is shown. The combined conclusion is that the C. dahuricus complex needs a more thorough investigation to fully disentangle its taxonomic status. Therefore it is here still regarded as a Holarctic species. This study highlights the importance to study several diagnosable characters that has the potential to discriminate evolutionary lineage during speciation.

  16. Effectiveness of integrated body-mind-spirit group intervention on the well-being of Indian patients with depression: a pilot study.

    Science.gov (United States)

    Sreevani, Rentala; Reddemma, Konduru; Chan, Cecilia L W; Leung, Pamela Pui Yu; Wong, Venus; Chan, Celia Hoi Yan

    2013-09-01

    Depression is a leading cause of disability worldwide. There is a need to develop effective strategies to treat depression and prevent recurrence. Treatments that combine pharmacological and psychotherapeutic approaches are preferred for treating severe forms of depression. The study assesses the effect of an integrated body-mind-spirit group intervention in patients with depression. This pilot study was a pretest-posttest design study. Thirty adult patients diagnosed with depression attending the psychiatric outpatient department at a district hospital were randomly assigned to either the intervention group or comparison group. Each group had 15 patients. The intervention group received both the intervention and routine hospital treatment and underwent four group integrated body-mind-spirit group intervention therapy sessions. These sessions were held once per week on either Saturday or Sunday, with each session lasting more than 3 hours. Comparison group participants received routine hospital treatment only. Outcome measures, including level of depression, well-being, and work and social adjustment, were measured using the Beck Depression Inventory-II, body-mind-spirit well-being scale, and work and social adjustment scale. Both groups were evaluated at baseline, 1 month, 2 months, and 3 months. Results showed that both groups had significant reductions in the level of depression, improvements in well-being, and work and social adjustment at 3-month follow-up compared with baseline. In addition, the intervention group showed significant mean differences in levels of depression, well-being, and work and social adjustment compared with the comparison group. The integrated body-mind-spirit group intervention model appears to reduce depressive symptoms and improve well-being in patients with depression.

  17. Preliminary Results from Powell Research Group on Integrating GRACE Satellite and Ground-based Estimates of Groundwater Storage Changes

    Science.gov (United States)

    Scanlon, B. R.; Zhang, Z.; Reitz, M.; Rodell, M.; Sanford, W. E.; Save, H.; Wiese, D. N.; Croteau, M. J.; McGuire, V. L.; Pool, D. R.; Faunt, C. C.; Zell, W.

    2017-12-01

    Groundwater storage depletion is a critical issue for many of the major aquifers in the U.S., particularly during intense droughts. GRACE (Gravity Recovery and Climate Experiment) satellite-based estimates of groundwater storage changes have attracted considerable media attention in the U.S. and globally and interest in GRACE products continues to increase. For this reason, a Powell Research Group was formed to: (1) Assess variations in groundwater storage using a variety of GRACE products and other storage components (snow, surface water, and soil moisture) for major aquifers in the U.S., (2) Quantify long-term trends in groundwater storage from ground-based monitoring and regional and national modeling, and (3) Use ground-based monitoring and modeling to interpret GRACE water storage changes within the context of extreme droughts and over-exploitation of groundwater. The group now has preliminary estimates from long-term trends and seasonal fluctuations in water storage using different GRACE solutions, including CSR, JPL and GSFC. Approaches to quantifying uncertainties in GRACE data are included. This work also shows how GRACE sees groundwater depletion in unconfined versus confined aquifers, and plans for future work will link GRACE data to regional groundwater models. The wealth of ground-based observations for the U.S. provides a unique opportunity to assess the reliability of GRACE-based estimates of groundwater storage changes.

  18. A comparison of case volumes among urologic surgeons identified on an industry-sponsored website to an all provider peer group.

    Science.gov (United States)

    See, William A; Jacobson, Kenneth; Derus, Sue; Langenstroer, Peter

    2014-11-01

    Industry-sponsored websites for robotic surgery direct to surgeons listed as performing specific robotic surgical procedures. The purpose of this study was to compare average annual, surgeon-specific, case volumes for those procedures for which they were listed as performing on the commercial website with the volumes of all providers performing these same procedures across a defined geographic region. A list of providers within the state of Wisconsin cited as performing specific urologic procedures was obtained through the Intuitive Surgical website 〈http://www.davincisurgery.com/da-vinci-urology/〉. Surgeon-specific annual case volumes from 2009 to 2013 for these same cases were obtained for all Wisconsin providers through DataBay Resources (Warrendale, PA) based on International classification of diseases-9 codes. Procedural activity was rank ordered, and surgeons were placed in "volume deciles" derived from the total annual number of cases performed by all surgeons. The distribution of commercially listed surgeon volumes, both 5-year average and most recent year, was compared with the average and 2013 volumes of all surgeons performing a specific procedure. A total of 35 individual urologic surgeons listed as performing robotic surgery in Wisconsin were identified through a "search" using the Intuitive Surgical website. Specific procedure analysis returned 5, 12, 9, and 15 surgeon names for cystectomy, partial nephrectomy, radical nephrectomy, and prostatectomy, respectively. This compared with the total number of surgeons who had performed the listed procedure in Wisconsin at least 1 time during the prior 5 years of 123, 153, 242, and 165, respectively. When distributed by surgeon-volume deciles, surgeons listed on industry-sponsored sites varied widely in their respective volume decile. More than half of site-listed, procedure-specific surgeons fell below the fifth decile for surgeon volume. Data analysis based solely on 2013 case volumes had no effect on

  19. MARKETING RELATIONSHIP AND TRADING IN THE RELATIONSHIP BETWEEN SERVICE PROVIDERS, HEALTH OPERATORS AND FINAL CUSTOMER: THE SEARCH FOR AN INTEGRATING MODEL

    Directory of Open Access Journals (Sweden)

    Nilda Catalina, Tañski

    2012-01-01

    Full Text Available The marketing relationship finds similarities with the concept of cooperative bargaining, the purpose of this is to find solutions to mutual gains with long-term vision. Within this approach, we sought to build an integrative model of relationship marketing and negotiation in the relationship between service providers, health operators and final customers in the health plan market in Brazil, this relationship is complex, full of conflicts and stagnation. It was first used, first, as an exploratory research of direct observation of the phenomenon referred to relationship marketing, trading and health insurance to increase employment opportunities. Then, the method of data collection was in that environment through online questionnaires using the survey method, in the representative sector. The type of sample used, where n = 217 and the confidence level was 95%, not intentional probabilistic. In the final, it was concluded that the initially proposed model was fully accepted, taking into account the choice of methodology, then achieving the main objective of this study.

  20. The Feasibility of Creating Partnerships Between Palliative Care Volunteers and Healthcare Providers to Support Rural Frail Older Adults and Their Families: An Integrative Review.

    Science.gov (United States)

    Connell, Braydon; Warner, Grace; Weeks, Lori E

    2017-09-01

    Background/Question: Volunteers are important in the support of frail older adults requiring palliative care, especially in rural areas. However, there are challenges associated with volunteer supports related to training, management and capacity to work in partnership with healthcare providers (HCP). This review addresses the question: What is the feasibility of a volunteer-HCP partnership to support frail older adults residing in rural areas, as they require palliative care? This integrative review identified ten articles that met the identified search criteria. Articles were appraised using the Critical Appraisal Skills Programme (CASP) checklists, designed for use across a range of quantitative and qualitative studies. Studies were drawn from international sources to understand how volunteer roles vary by culture and organization; the majority of studies were conducted in North America. Studies varied in methodology, including quantitative, qualitative and educational commentary. Identified factors that were crucial to the feasibility of volunteer-HCP partnerships in rural areas included volunteer training dynamics, relationships between volunteers and HCP, and rural environmental factors. Preliminary evidence indicates that a volunteer-HCP palliative partnership is feasible. However, training policies/procedures, volunteer-HCP relationships, and rural specific designs impact the feasibility of this partnership. Additional research is needed to further establish the feasibility of implementing these partnerships in rural settings.

  1. Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings.

    Science.gov (United States)

    Alvarez, Carmen; Debnam, Katrina; Clough, Amber; Alexander, Kamila; Glass, Nancy E

    2018-04-01

    Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting. Despite recognition of IPV as a problem, none of the clinical sites had a protocol to guide screening and response to IPV disclosure. Screening practices varied across the sites, sometimes conducted by medical assistants prior to the provider visit and other times by the physician or nurse provider. When IPV was disclosed, it was often during assessment for a presenting problem such as poor sleep or anxiety. Most healthcare workers felt that clinical and community resources were limited for their patients experiencing IPV. The "warm hand-off" to a social worker was the most common response strategy when possible; otherwise, women were given information about available resources such as hotlines and safe houses. We discuss structural, family, and individual barriers to accessing safety resources for underserved women and review how an easily accessible safety decision app, such as myPlan, could be a resource for women to safely tailor an action plan for her situation. © 2018 Wiley Periodicals, Inc.

  2. eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients' and Health Care Providers' Use of Health-Related Internet Information.

    Science.gov (United States)

    Townsend, Anne; Leese, Jenny; Adam, Paul; McDonald, Michael; Li, Linda C; Kerr, Sheila; Backman, Catherine L

    2015-06-22

    The rapid explosion in online digital health resources is seen as transformational, accelerating the shift from traditionally passive patients to patients as partners and altering the patient-health care professional (HCP) relationship. Patients with chronic conditions are increasingly engaged, enabled, and empowered to be partners in their care and encouraged to take responsibility for managing their conditions with HCP support. In this paper, we focus on patients' and HCPs' use of health-related Internet information and how it influences the patient-HCP relationship. In particular, we examine the challenges emerging in medical encounters as roles and relationships shift and apply a conceptual framework of relational ethics to examine explicit and nuanced ethical dimensions emerging in patient-HCP interactions as both parties make increased use of health-related Internet information. We purposively sampled patients and HCPs in British Columbia, Canada, to participate in focus groups. To be eligible, patients self-reported a diagnosis of arthritis and at least one other chronic health condition; HCPs reported a caseload with >25% of patients with arthritis and multimorbidity. We used a semistructured, but flexible, discussion guide. All discussions were audiotaped and transcribed verbatim. Elements of grounded theory guided our constant comparison thematic analytic approach. Analysis was iterative. A relational ethics conceptual lens was applied to the data. We recruited 32 participants (18 patients, 14 HCPs). They attended seven focus groups: four with patients and three with rehabilitation professionals and physicians. Predominant themes to emerge were how use of health-related Internet information fostered (1) changing roles, (2) patient-HCP partnerships, and (3) tensions and burdens for patients and HCPs. Relational aspects such as mutual trust, uncertainty, and vulnerability are illuminated in patient-HCP interactions around health-related Internet information

  3. 'Integration'

    DEFF Research Database (Denmark)

    Olwig, Karen Fog

    2011-01-01

    , while the countries have adopted disparate policies and ideologies, differences in the actual treatment and attitudes towards immigrants and refugees in everyday life are less clear, due to parallel integration programmes based on strong similarities in the welfare systems and in cultural notions...... of equality in the three societies. Finally, it shows that family relations play a central role in immigrants’ and refugees’ establishment of a new life in the receiving societies, even though the welfare society takes on many of the social and economic functions of the family....

  4. Clinical practice guidelines for the utilization of positron emission tomography/computed tomography imaging in selected oncologic applications: suggestions from a provider group.

    Science.gov (United States)

    Manning, Ken; Tepfer, Beth; Goldklang, Gerald; Loyd, Richard; Garimella, Prasad; Halkar, Raghuveer

    2007-01-01

    Positron emission tomography, combined with computed tomography (PET/CT) has provided clinicians with useful information regarding the diagnosis, initial staging, restaging, and therapy monitoring of malignancies since the beginning of the current century. Our intent here is to identify the critical steps in clinical workups and follow-up, in the true outpatient clinical setting of a freestanding imaging center, for utilization of PET/CT in four different cancer types. The four most common reasons for referrals to our facility were identified by reviewing two years of referral data. They were lung cancer (including solitary pulmonary nodule), lymphomas, breast cancer, and colorectal cancer. A review of published literature from 1996 and later was accepted as evidence of appropriateness for utilizing PET/CT in various clinical scenarios. In addition, a medical advisory board consisting of 15 referring physicians representing various specialties was established to provide practical advice regarding the appropriate use of PET/CT in clinical situations. National Comprehensive Cancer Network (NCCN) guidelines were also referenced to establish a baseline for clinical workups at various stages of disease. Several inconsistencies were identified among the three primary sources of information leading to the establishment of a standardized algorithm for each cancer type. NCCN data did not always agree with published literature, which was also often different from actual clinical practices of referring physicians. The most common inconsistencies included differing opinions from the referrers vs what was published in the NCCN guidelines, especially with regard to the utilization of PET/CT for applications not yet covered by insurance companies. After a reconciliation of the medical advisory board's clinical practices and several published articles, a consensus was established by the medical advisory board for the use of PET/CT imaging for the four cancer types, enabling us to

  5. Enzyme-polyelectrolyte complexes in water-ethanol mixtures: negatively charged groups artificially introduced into alpha-chymotrypsin provide additional activation and stabilization effects.

    Science.gov (United States)

    Kudryashova, E V; Gladilin, A K; Vakurov, A V; Heitz, F; Levashov, A V; Mozhaev, V V

    1997-07-20

    Formation of noncovalent complexes between alpha-chymotrypsin (CT) and a polyelectrolyte, polybrene (PB), has been shown to produce two major effects on enzymatic reactions in binary mixtures of polar organic cosolvents with water. (i) At moderate concentrations of organic cosolvents (10% to 30% v/v), enzymatic activity of CT is higher than in aqueous solutions, and this activation effect is more significant for CT in complex with PB (5- to 7-fold) than for free enzyme (1.5- to 2.5-fold). (ii) The range of cosolvent concentrations that the enzyme tolerates without complete loss of catalytic activity is much broader. For enhancement of enzyme stability in the complex with the polycation, the number of negatively charged groups in the protein has been artificially increased by using chemical modification with pyromellitic and succinic anhydrides. Additional activation effect at moderate concentrations of ethanol and enhanced resistance of the enzyme toward inactivation at high concentrations of the organic solvent have been observed for the modified preparations of CT in the complex with PB as compared with an analogous complex of the native enzyme. Structural changes behind alterations in enzyme activity in water-ethanol mixtures have been studied by the method of circular dichroism (CD). Protein conformation of all CT preparations has not changed significantly up to 30% v/v of ethanol where activation effects in enzymatic catalysis were most pronounced. At higher concentrations of ethanol, structural changes in the protein have been observed for different forms of CT that were well correlated with a decrease in enzymatic activity. (c) 1997 John Wiley & Sons, Inc. Biotechnol Bioeng 55: 267-277, 1997.

  6. Report of study group 4.3 ''pipeline integrity management and safety''

    Energy Technology Data Exchange (ETDEWEB)

    Clavel, P.

    2000-07-01

    This report highlights the Pipeline integrity Management methods being implemented by gas companies. These aim at maintaining the current high safety level, prevent major hazards, ensure the integrity of the pipeline and protect people and environment in the vicinity of the pipeline in the most cost effective way. It should be noticed that Pipeline Integrity Management aspects, technical and organisational, are included in the more general framework of the Safety Management System. Currently, more and more gas companies implement such a system on the basis of standards like ISO 9000 and so on. In this way, the report shows how practices of Pipeline Integrity Management are continually developing in order to adapt to their environment, and to improve performance. Past experience and imminent developments show that Pipeline Integrity Management is a flexible and efficient approach to improve safety in the long term. Consequently, Pipeline Integrity Management Systems are, under the control of authorities, the best alternative to additional safety regulations. Within the context of deregulation of the European markets and globalization Pipeline Integrity Management appears to be a tool to promote the gas industry in the eyes of the authorities, the market regulators and the customers (industrialists,...). (author)

  7. Integrated RNA- and protein profiling of fermentation and respiration in diploid budding yeast provides insight into nutrient control of cell growth and development.

    Science.gov (United States)

    Becker, Emmanuelle; Liu, Yuchen; Lardenois, Aurélie; Walther, Thomas; Horecka, Joe; Stuparevic, Igor; Law, Michael J; Lavigne, Régis; Evrard, Bertrand; Demougin, Philippe; Riffle, Michael; Strich, Randy; Davis, Ronald W; Pineau, Charles; Primig, Michael

    2015-04-24

    Diploid budding yeast undergoes rapid mitosis when it ferments glucose, and in the presence of a non-fermentable carbon source and the absence of a nitrogen source it triggers sporulation. Rich medium with acetate is a commonly used pre-sporulation medium, but our understanding of the molecular events underlying the acetate-driven transition from mitosis to meiosis is still incomplete. We identified 263 proteins for which mRNA and protein synthesis are linked or uncoupled in fermenting and respiring cells. Using motif predictions, interaction data and RNA profiling we find among them 28 likely targets for Ume6, a subunit of the conserved Rpd3/Sin3 histone deacetylase-complex regulating genes involved in metabolism, stress response and meiosis. Finally, we identify 14 genes for which both RNA and proteins are detected exclusively in respiring cells but not in fermenting cells in our sample set, including CSM4, SPR1, SPS4 and RIM4, which were thought to be meiosis-specific. Our work reveals intertwined transcriptional and post-transcriptional control mechanisms acting when a MATa/α strain responds to nutritional signals, and provides molecular clues how the carbon source primes yeast cells for entering meiosis. Our integrated genomics study provides insight into the interplay between the transcriptome and the proteome in diploid yeast cells undergoing vegetative growth in the presence of glucose (fermentation) or acetate (respiration). Furthermore, it reveals novel target genes involved in these processes for Ume6, the DNA binding subunit of the conserved histone deacetylase Rpd3 and the co-repressor Sin3. We have combined data from an RNA profiling experiment using tiling arrays that cover the entire yeast genome, and a large-scale protein detection analysis based on mass spectrometry in diploid MATa/α cells. This distinguishes our study from most others in the field-which investigate haploid yeast strains-because only diploid cells can undergo meiotic development

  8. A Critical Assessment of a Eurosceptic Party Group on European Integration: A Case Study of the European Conservatives and Reformists Group

    Directory of Open Access Journals (Sweden)

    Akbaba Sertan

    2014-06-01

    Full Text Available The article explores Euroscepticism and the way it is utilized within the politics of Europe, analyzed upon evidence from a Eurosceptic Euro-party located in the European Parliament, namely the European Conservatives and Reformists Group (ECR. The aim of this article is to clarify that the selected party> disproves the argument of EU- criticism being an unfavourable condition, and, more importantly, its contribution to the political contestation in the EU. For such an assessment, a survey of the party> manifesto, party working documents, as well as the discourses of the Member of the European Parliament (MEPs will be analyzed, and the concept of Euroscepticism will be once again in the centre of this analysis. This argument is evaluated based on the transnational-level analysis of the aforementioned party, focusing primarily on three specific issues-the democratic deficit, the issue of sovereignty! and anti-immigration rhetoric.

  9. National platform electromobility. Interim report of the working group 3 Load infrastructure and rid integration; Nationale Plattform Elektromobilitaet. Zwischenbericht der Arbeitsgruppe 3 Lade-Infrastruktur und Netzintegration

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Stefan [E.ON AG, Duesseldorf (Germany). Political Affairs and Communications Energy Mix, Environment, Efficiency; Ledwon, Martin [Siemens AG, Berlin (Germany). Government Affairs

    2010-07-01

    The contribution under consideration reports on the first intermediate results of the working group 3 ''Load infrastructure and grid integration'' of the national platform electromobility. Next to the representation of the general objective of this working group, the following aspects are considered: (a) Electromobility in the field of tension between the power supply system and renewable production; (b) Possible network loads due to the integration of electrically powered vehicles; (c) Requirements concerning the load infrastructure; (d) Technology development of the load point; (e) Potentials by the integration of electrical mobiles into the Smart Grid; (f) Research and Development roadmap. This contribution finishes with a presentation of a concrete conversion plan for the demand of infrastructure.

  10. An integrative description of Mesobiotus ethiopicus sp. nov. (Tardigrada: Eutardigrada: Parachela: Macrobiotidae: harmsworthi group) from the northern Afrotropic region

    DEFF Research Database (Denmark)

    Stec, Daniel; Kristensen, Reinhardt Møbjerg

    2017-01-01

    A new species of the Mesobiotus harmsworthi group is described from Ethiopia. An integrative taxonomy approach was applied by combining morphological and morphometric analyses—imaging under phase contrast and scanning electron microscopy with molecular analysis (18S rRNA, 28S rRNA and COI markers...

  11. Decree 302/013. It amend Art. 5 of Decree 202/005 on the integration of the National Oncology Committee and it create a Standing Advisory Group

    International Nuclear Information System (INIS)

    2013-01-01

    The decree is about an adaptation of the integration of the national committee on oncologic o including representatives of the Faculty of Medicine of the University of the Republic and representatives of the National Board of Health and Honorary Commission to Fight Cancer that is proposed.Creating a Standing Advisory Group is also suggested

  12. Integrating Multiple Intelligences and Learning Styles on Solving Problems, Achievement in, and Attitudes towards Math in Six Graders with Learning Disabilities in Cooperative Groups

    Science.gov (United States)

    Eissa, Mourad Ali; Mostafa, Amaal Ahmed

    2013-01-01

    This study investigated the effect of using differentiated instruction by integrating multiple intelligences and learning styles on solving problems, achievement in, and attitudes towards math in six graders with learning disabilities in cooperative groups. A total of 60 students identified with LD were invited to participate. The sample was…

  13. Renewable Electricity Grid Integration Roadmap for Mexico. Supplement to the IEA Expert Group Report on Recommended Practices for Wind Integration Studies

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, Brian [Evergreen Renewable Consulting, Evergreen, CO (United States); Cochran, Jaquelin [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Watson, Andrea [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Katz, Jessica [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bracho, Ricardo [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2015-08-19

    As a recognized leader in efforts to mitigate global climate change, the Government of Mexico (GOM) works proactively to reduce emissions, demonstrating strong political will and capacity to comprehensively address climate change. Since 2010, the U.S. government (USG) has supported these efforts by partnering with Mexico under the Enhancing Capacity for Low Emission Development Strategies (EC-LEDS) program. Through the program, the USG has partnered with Mexico’s Ministry of Energy (SENER), as well as other government agencies, to support GOM in reaching its clean energy and climate change goals. Specifically, the EC-LEDS program is supporting GOM’s clean energy goal of generating 35% of its electricity from renewable energy (RE) by 2024. EC-LEDS, through the U.S. Agency for International Development (USAID) and the U.S Department of Energy’s (DOE’s) National Renewable Energy Laboratory (NREL), has been collaborating with SENER and GOM interagency working group—the Consejo Consultivo para las Energías Renovables (Consultative Council on Renewable Energy)—to create a grid integration roadmap for variable RE. 1 A key objective in creating a grid integration roadmap is assessing likely impacts of wind and solar energy on the power system and modifying planning and operations accordingly. This paper applies best practices in conducting a grid integration study to the Mexican context.

  14. Integrating a Career Planning and Development Program into the Baccalaureate Nursing Curriculum: Part III. Impact on Faculty's Career Satisfaction and Confidence in Providing Student Career Coaching.

    Science.gov (United States)

    Waddell, Janice; Spalding, Karen; Navarro, Justine; Gaitana, Gianina

    2015-11-25

    As career satisfaction has been identified as a predictor of retention of nurses across all sectors, it is important that career satisfaction of both new and experienced nursing faculty is recognized in academic settings. A study of a curriculum-based career planning and development (CPD) program was conducted to determine the program's effects on participating students, new graduate nurses, and faculty. This third in a series of three papers reports on how the CPD intervention affected faculty participants' sense of career satisfaction and confidence in their role as career educators and coaches. Faculty who participated in the intervention CPD intervention group reported an increase in confidence in their ability to provide career coaching and education to students. They further indicated that their own career development served to enhance career satisfaction; an outcome identified as a predictor of faculty career satisfaction. Study results suggest that interventions such as the one described in this paper can have a potentially positive impact in other settings as well.

  15. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  16. Measuring horizontal integration among health care providers in the community: an examination of a collaborative process within a palliative care network.

    Science.gov (United States)

    Bainbridge, Daryl; Brazil, Kevin; Krueger, Paul; Ploeg, Jenny; Taniguchi, Alan; Darnay, Julie

    2015-05-01

    In many countries formal or informal palliative care networks (PCNs) have evolved to better integrate community-based services for individuals with a life-limiting illness. We conducted a cross-sectional survey using a customized tool to determine the perceptions of the processes of palliative care delivery reflective of horizontal integration from the perspective of nurses, physicians and allied health professionals working in a PCN, as well as to assess the utility of this tool. The process elements examined were part of a conceptual framework for evaluating integration of a system of care and centred on interprofessional collaboration. We used the Index of Interdisciplinary Collaboration (IIC) as a basis of measurement. The 86 respondents (85% response rate) placed high value on working collaboratively and most reported being part of an interprofessional team. The survey tool showed utility in identifying strengths and gaps in integration across the network and in detecting variability in some factors according to respondent agency affiliation and profession. Specifically, support for interprofessional communication and evaluative activities were viewed as insufficient. Impediments to these aspects of horizontal integration may be reflective of workload constraints, differences in agency operations or an absence of key structural features.

  17. Silicon-Based Integration of Groups III, IV, V Chemical Vapor Depositions in High-Quality Photodiodes

    NARCIS (Netherlands)

    Sammak, A.

    2012-01-01

    Heterogeneous integration of III-V semiconductors with silicon (Si) technology is an interesting approach to utilize the advantages of both high-speed photonic and electronic properties. The work presented in this thesis is initiated by this major goal of merging III-V semiconductor technology with

  18. What's New is What's Old: Use of Bode's Integral Theorem (circa 1945) to Provide Insight for 21st Century Spacecraft Attitude Control System Design Tuning

    Science.gov (United States)

    Ruth, Mike; Lebsock, Ken; Dennehy, Neil

    2010-01-01

    This paper revisits the Bode integral theorem, first described in 1945 for feedback amplifier design, in the context of modern satellite Attitude Control System (ACS) design tasks. Use of Bode's Integral clarifies in an elegant way the connection between open-loop stability margins and closed-loop bandwidth. More importantly it shows that there is a very strong tradeoff between disturbance rejection below the satellite controller design bandwidth, and disturbance amplification in the 'penalty region' just above the design bandwidth. This information has been successfully used to re-tune the control designs for several NASA science-mission satellites. The Appendix of this paper contains a complete summary of the relevant integral conservation theorems for stable, unstable, and non-minimum- phase plants.

  19. 76 FR 16776 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2011-03-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and... a meeting is scheduled to be held for the Advisory Group on Prevention, Health Promotion, and... advice to the National Prevention, Health Promotion and Public Health (the ``Council''). The Advisory...

  20. Integrating the ACR Appropriateness Criteria Into the Radiology Clerkship: Comparison of Didactic Format and Group-Based Learning.

    Science.gov (United States)

    Stein, Marjorie W; Frank, Susan J; Roberts, Jeffrey H; Finkelstein, Malka; Heo, Moonseong

    2016-05-01

    The aim of this study was to determine whether group-based or didactic teaching is more effective to teach ACR Appropriateness Criteria to medical students. An identical pretest, posttest, and delayed multiple-choice test was used to evaluate the efficacy of the two teaching methods. Descriptive statistics comparing test scores were obtained. On the posttest, the didactic group gained 12.5 points (P didactic group gained 14.4 points (P didactic lectures, group-based learning is more enjoyable, time efficient, and equally efficacious. The choice of educational method can be individualized for each institution on the basis of group size, time constraints, and faculty availability. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Integration of naturopathic medicine into acute inpatient care: An approach for patient-centred medicine under diagnosis-related groups.

    Science.gov (United States)

    Romeyke, Tobias; Nöhammer, Elisabeth; Scheuer, Hans Christoph; Stummer, Harald

    2017-08-01

    The integration of naturopathic methods into acute inpatient care has been the subject of very few scientific studies. Patient expectations of the service received in hospital are increasing, and the integration of naturopathy into clinical practice can serve as Unique Selling Proposition. The present study was conducted over a period of two years. In total, over 1700 patients were included in the study. The setting is an acute hospital specialising in a multimodal, patient-centred approach to treatment. Patient satisfaction with the use of holistic care, patient perception of adherence to treatment and the amount of time care staff spend with patients were all investigated. The patients' principal diagnoses were also recorded using the DRG classification system, as were the number of concomitant diseases and the length of their stay in hospital. The majority of patients rate the integration of complementary care in the acute hospital very positively. The effects on patient perception of adherence to treatment and the amount of time care staff spend with patients are also assessed positively. At the same time, we can see that patients who receive patient-centred care in this study predominantly suffer from diseases and disorders of the musculoskeletal system and connective tissue, diseases of the nervous system and mental diseases and disorders. They also have numerous concomitant diseases. It could be shown that patients are very satisfied with the combination of naturopathy and academic medicine and with approaches that take patient preferences into account. Integrating naturopathy can be considered for multimorbid patients, in particular. Moreover, patient-centred care can improve staff satisfaction levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Pastoral Group Counselling at a High Security Prison in Israel: Integrating Pierre Janet's Psychological Analysis with Fritz Perls' Gestalt Therapy.

    Science.gov (United States)

    Brown, Paul; Brown, Marta

    2015-03-01

    This is a report of a short-term, pastoral counselling group conducted with Jewish internees in a high security prison in Israel. It was held as an adjunct to daily secular individual and group counselling and rehabilitation run by the Department of Social Work. Pastoral counselling employed spiritual and psychosocial methodologies to reduce anger, improve prisoner frustration tolerance, and develop a sense of self-efficacy and communal identity. It combined semi-didactic scriptural input with Pierre Janet's personality model, Fritz Perls' gestalt therapy, and analysis of the group process. © The Author(s) 2015 Reprints and permissions:sagepub.co.uk/journalsPermissions.nav.

  3. Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group.

    Science.gov (United States)

    Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

    2016-03-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a group of peers who also have a sibling with an intellectual disability, though no specific method for running this type of group has yet been fully explored. This article reports the views of 39 children taking part in such a group, analysing their perspective through a proposed model for the operation of sibling groups: social pedagogy. It was found that the closer the group's activities were to social pedagogy, the more supported the children and young people felt. © The Author(s) 2015.

  4. National platform electromobility. Interims report of the working group 1 propulsion technology and vehicle integration; Nationale Plattform Elektromobilitaet. Zwischenbericht der Arbeitsgruppe 1 Antriebstechnologie und Fahrzeugintegration

    Energy Technology Data Exchange (ETDEWEB)

    Meusinger, Josefin [Koordinierungsstelle der Industrie fuer die Nationale Plattform Elektromobilitaet, Berlin (Germany)

    2010-07-01

    The working group ''Propulsion technology and vehicle integration'' investigates electrical and electrified powertrains for the employment in passenger cars and commercial vehicles regarding to the goals of the national platform electrical mobility. Apart from the optimization of the architecture and the gradual physical integration of the components into drive modules the material research for new magnetic materials, for the surface refinement and basic research for the semiconductor technology/physics is a further compelling condition for long-term successes in the area of electric drives. Parallel to the increase of unit productions the degree of automation has to be improved significantly. The costs are to be affected positively by large numbers of unit productions. A bundling, acceleration and promotion of the activities from the research to the development in competence centres and landmark projects for the propulsion technology and vehicle integration are recommended. This is to be used by means of the existing instruments of the industrial community research.

  5. Deciphering the genomes of 16 Acanthamoeba species does not provide evidence of integration of known giant virus-associated mobile genetic elements.

    Science.gov (United States)

    Chelkha, Nisrine; Colson, Philippe; Levasseur, Anthony; La Scola, Bernard

    2018-06-02

    Giant viruses infect protozoa, especially amoebae of the genus Acanthamoeba. These viruses possess genetic elements named Mobilome. So far, this mobilome comprises provirophages which are integrated into the genome of their hosts, transpovirons, and Maverick/Polintons. Virophages replicate inside virus factories within Acanthamoeba and can decrease the infectivity of giant viruses. The virophage infecting CroV was found to be integrated in the host of CroV, Cafeteria roenbergensis, thus protecting C. roenbergensis by reduction of CroV multiplication. Because of this unique property, assessment of the mechanisms of replication of virophages and their relationship with giant viruses is a key element of this investigation. This work aimed at evaluating the presence and the dynamic of these mobile elements in sixteen Acanthamoeba genomes. No significant traces of the integration of genomes or sequences from known virophages were identified in all the available Acanthamoeba genomes. These results brought us to hypothesize that the interactions between mimiviruses and their virophages might occur through different mechanisms, or at low frequency. An additional explanation could be that our knowledge of the diversity of virophages is still very limited. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. The Integration of Family and Group Therapy as an Alternative to Juvenile Incarceration: A Quasi-Experimental Evaluation Using Parenting with Love and Limits.

    Science.gov (United States)

    Karam, Eli A; Sterrett, Emma M; Kiaer, Lynn

    2017-06-01

    The current study employed a quasi-experimental design using both intent-to-treat and protocol adherence analysis of 155 moderate- to high-risk juvenile offenders to evaluate the effectiveness of Parenting with Love and Limits® (PLL), an integrative group and family therapy approach. Youth completing PLL had significantly lower rates of recidivism than the comparison group. Parents also reported statistically significant improvements in youth behavior. Lengths of service were also significantly shorter for the treatment sample than the matched comparison group by an average of 4 months. This study contributes to the literature by suggesting that intensive community-based combined family and group treatment is effective in curbing recidivism among high-risk juveniles. © 2015 Family Process Institute.

  7. Effectiveness of the Lunch is in the Bag program on communication between the parent, child and child-care provider around fruits, vegetables and whole grain foods: A group-randomized controlled trial.

    Science.gov (United States)

    Sharma, Shreela V; Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cynthia; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M

    2015-12-01

    To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011 to 2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at pparent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β=0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β=0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Calculation of thermodynamic properties of sodium and potassium vapors on the base of semiempirical state equation. Group integrals and virial coefficients

    International Nuclear Information System (INIS)

    Reva, T.D.; Semenov, A.M.

    1984-01-01

    Statistically significant estimations of the second, third and fourth group integrals of sodium and potassium vapors were obtained in the framework of the initial atom method on the basis of semiempirical equation of state derived by the authors. Possibility is duscussed of estimating dimer, trimer and tetramer concentrations from these data with account of unideality of vapors. High rate of convergence of density and pressure group expansion is demonstrated. Virial coefficients were calculated. It is shown that virial expansions of thermodynamic functions diverge at elevated densities of the gases under study. The estimations of senior virial coefficients of sodium and potassium vapors available in literature were proved to be faulty

  9. A Mathematical Framework for the Complex System Approach to Group Dynamics: The Case of Recovery House Social Integration.

    Science.gov (United States)

    Light, John M; Jason, Leonard A; Stevens, Edward B; Callahan, Sarah; Stone, Ariel

    2016-03-01

    The complex system conception of group social dynamics often involves not only changing individual characteristics, but also changing within-group relationships. Recent advances in stochastic dynamic network modeling allow these interdependencies to be modeled from data. This methodology is discussed within a context of other mathematical and statistical approaches that have been or could be applied to study the temporal evolution of relationships and behaviors within small- to medium-sized groups. An example model is presented, based on a pilot study of five Oxford House recovery homes, sober living environments for individuals following release from acute substance abuse treatment. This model demonstrates how dynamic network modeling can be applied to such systems, examines and discusses several options for pooling, and shows how results are interpreted in line with complex system concepts. Results suggest that this approach (a) is a credible modeling framework for studying group dynamics even with limited data, (b) improves upon the most common alternatives, and (c) is especially well-suited to complex system conceptions. Continuing improvements in stochastic models and associated software may finally lead to mainstream use of these techniques for the study of group dynamics, a shift already occurring in related fields of behavioral science.

  10. Deep intraspecific DNA barcode splits and hybridisation in the Udea alpinalis group (Insecta, Lepidoptera, Crambidae – an integrative revision

    Directory of Open Access Journals (Sweden)

    Richard Mally

    2018-04-01

    Full Text Available The analysis of mitochondrial COI data for the European-Centroasian montane Udea alpinalis species group finds deep intraspecific splits. Specimens of U. austriacalis and U. rhododendronalis separate into several biogeographical groups. These allopatric groups are not recovered in the analyses of the two nuclear markers wingless and Elongation factor 1-alpha, except for U. austriacalis from the Pyrenees and the French Massif Central. The latter populations are also morphologically distinct and conspecific with Scopula donzelalis Guenée, 1854, which is removed from synonymy and reinstated as Udea donzelalis (Guenée, 1854 stat. rev. Furthermore, Udea altaica (Zerny, 1914, stat. n. from the Mongolian central Altai mountains, U. juldusalis (Zerny, 1914, stat. n. from the Tian Shan mountains of Kazakhstan, Kyrgyzstan and NW China, and U. plumbalis (Zerny, 1914, stat. n. from the Sayan Mountains of Northern Mongolia are raised to species level, and lectotypes are designated. Evidence of introgression of U. alpinalis into U. uliginosalis at three localities in the Central Alps is presented. A screening for Wolbachia using the markers wsp, gatB and ftsZ was negative for the U. alpinalis species group, but Wolbachia was found in single specimens of U. fulvalis and U. olivalis (both in the U. numeralis species group. We do not find evidence for the conjecture of several authors of additional subspecies in U. rhododendronalis, and synonymise U. rhododendronalis luquetalis Leraut, 1996, syn. n. and U. r. ventosalis Leraut, 1996, syn. n. with the nominal U. rhododendronalis (Duponchel, 1834.

  11. Integrated Analysis and Visualization of Group Differences in Structural and Functional Brain Connectivity: Applications in Typical Ageing and Schizophrenia.

    Directory of Open Access Journals (Sweden)

    Carolyn D Langen

    Full Text Available Structural and functional brain connectivity are increasingly used to identify and analyze group differences in studies of brain disease. This study presents methods to analyze uni- and bi-modal brain connectivity and evaluate their ability to identify differences. Novel visualizations of significantly different connections comparing multiple metrics are presented. On the global level, "bi-modal comparison plots" show the distribution of uni- and bi-modal group differences and the relationship between structure and function. Differences between brain lobes are visualized using "worm plots". Group differences in connections are examined with an existing visualization, the "connectogram". These visualizations were evaluated in two proof-of-concept studies: (1 middle-aged versus elderly subjects; and (2 patients with schizophrenia versus controls. Each included two measures derived from diffusion weighted images and two from functional magnetic resonance images. The structural measures were minimum cost path between two anatomical regions according to the "Statistical Analysis of Minimum cost path based Structural Connectivity" method and the average fractional anisotropy along the fiber. The functional measures were Pearson's correlation and partial correlation of mean regional time series. The relationship between structure and function was similar in both studies. Uni-modal group differences varied greatly between connectivity types. Group differences were identified in both studies globally, within brain lobes and between regions. In the aging study, minimum cost path was highly effective in identifying group differences on all levels; fractional anisotropy and mean correlation showed smaller differences on the brain lobe and regional levels. In the schizophrenia study, minimum cost path and fractional anisotropy showed differences on the global level and within brain lobes; mean correlation showed small differences on the lobe level. Only

  12. Integrated DNA methylation and copy-number profiling identify three clinically and biologically relevant groups of anaplastic glioma.

    Science.gov (United States)

    Wiestler, Benedikt; Capper, David; Sill, Martin; Jones, David T W; Hovestadt, Volker; Sturm, Dominik; Koelsche, Christian; Bertoni, Anna; Schweizer, Leonille; Korshunov, Andrey; Weiß, Elisa K; Schliesser, Maximilian G; Radbruch, Alexander; Herold-Mende, Christel; Roth, Patrick; Unterberg, Andreas; Hartmann, Christian; Pietsch, Torsten; Reifenberger, Guido; Lichter, Peter; Radlwimmer, Bernhard; Platten, Michael; Pfister, Stefan M; von Deimling, Andreas; Weller, Michael; Wick, Wolfgang

    2014-10-01

    The outcome of patients with anaplastic gliomas varies considerably. Whether a molecular classification of anaplastic gliomas based on large-scale genomic or epigenomic analyses is superior to histopathology for reflecting distinct biological groups, predicting outcomes and guiding therapy decisions has yet to be determined. Epigenome-wide DNA methylation analysis, using a platform which also allows the detection of copy-number aberrations, was performed in a cohort of 228 patients with anaplastic gliomas (astrocytomas, oligoastrocytomas, and oligodendrogliomas), including 115 patients of the NOA-04 trial. We further compared these tumors with a group of 55 glioblastomas. Unsupervised clustering of DNA methylation patterns revealed two main groups correlated with IDH status: CpG island methylator phenotype (CIMP) positive (77.5 %) or negative (22.5 %). CIMP(pos) (IDH mutant) tumors showed a further separation based on copy-number status of chromosome arms 1p and 19q. CIMP(neg) (IDH wild type) tumors showed hallmark copy-number alterations of glioblastomas, and clustered together with CIMP(neg) glioblastomas without forming separate groups based on WHO grade. Notably, there was no molecular evidence for a distinct biological entity representing anaplastic oligoastrocytoma. Tumor classification based on CIMP and 1p/19q status was significantly associated with survival, allowing a better prediction of outcome than the current histopathological classification: patients with CIMP(pos) tumors with 1p/19q codeletion (CIMP-codel) had the best prognosis, followed by patients with CIMP(pos) tumors but intact 1p/19q status (CIMP-non-codel). Patients with CIMP(neg) anaplastic gliomas (GBM-like) had the worst prognosis. Collectively, our data suggest that anaplastic gliomas can be grouped by IDH and 1p/19q status into three molecular groups that show clear links to underlying biology and a significant association with clinical outcome in a prospective trial cohort.

  13. The business end of health information technology. Can a fully integrated electronic health record increase provider productivity in a large community practice?

    Science.gov (United States)

    De Leon, Samantha; Connelly-Flores, Alison; Mostashari, Farzad; Shih, Sarah C

    2010-01-01

    Electronic health records (EHRs) are expected to transform and improve the way medicine is practiced. However, providers perceive many barriers toward implementing new health information technology. Specifically, they are most concerned about the potentially negative impact on their practice finances and productivity. This study compares the productivity of 75 providers at a large urban primary care practice from January 2005 to February 2009, before and after implementing an EHR system, using longitudinal mixed model analyses. While decreases in productivity were observed at the time the EHR system was implemented, most providers quickly recovered, showing increases in productivity per month shortly after EHR implementation. Overall, providers had significant productivity increases of 1.7% per month per provider from pre- to post-EHR adoption. The majority of the productivity gains occurred after the practice instituted a pay-for-performance program, enabled by the data capture of the EHRs. Coupled with pay-for-performance, EHRs can spur rapid gains in provider productivity.

  14. Integrated analysis and visualization of group differences in structural and functional brain connectivity: Applications in typical ageing and schizophrenia

    NARCIS (Netherlands)

    C.D. Langen (Carolyn); T.J.H. White (Tonya); M.A. Ikram (Arfan); M.W. Vernooij (Meike); W.J. Niessen (Wiro)

    2015-01-01

    textabstractStructural and functional brain connectivity are increasingly used to identify and analyze group differences in studies of brain disease. This study presents methods to analyze uniand bi-modal brain connectivity and evaluate their ability to identify differences. Novel visualizations of

  15. Integrated Analysis and Visualization of Group Differences in Structural and Functional Brain Connectivity : Applications in Typical Ageing and Schizophrenia

    NARCIS (Netherlands)

    Langen, C.D.; White, T.; Ikram, M.A.; Vernooij, M.W.; Niessen, W.J.

    2015-01-01

    Structural and functional brain connectivity are increasingly used to identify and analyze group differences in studies of brain disease. This study presents methods to analyze uni- and bi-modal brain connectivity and evaluate their ability to identify differences. Novel visualizations of

  16. Participative approach to elicit water quality monitoring needs from stakeholder groups - An application of integrated watershed management.

    Science.gov (United States)

    Behmel, S; Damour, M; Ludwig, R; Rodriguez, M J

    2018-07-15

    Water quality monitoring programs (WQMPs) must be based on monitoring objectives originating from the real knowledge needs of all stakeholders in a watershed and users of the resource. This paper proposes a participative approach to elicit knowledge needs and preferred modes of communication from citizens and representatives of organized stakeholders (ROS) on water quality and quantity issues. The participative approach includes six steps and is adaptable and transferable to different types of watersheds. These steps are: (1) perform a stakeholder analysis; (2) conduct an adaptable survey accompanied by a user-friendly public participation geographical information system (PPGIS); (3) hold workshops to meet with ROS to inform them of the results of the survey and PPGIS; discuss attainment of past monitoring objectives; exchange views on new knowledge needs and concerns on water quality and quantity; (4) meet with citizens to obtain the same type of input (as from ROS); (5) analyze the data and information collected to identify new knowledge needs and modes of communication and (6) identify, in collaboration with the individuals in charge of the WQMPs, the short-, medium- and long-term monitoring objectives and communication strategies to be pursued. The participative approach was tested on two distinct watersheds in the province of Quebec, Canada. It resulted in a series of optimization objectives of the existing WQMPs, new monitoring objectives and recommendations regarding communication strategies of the WQMPs' results. The results of this study show that the proposed methodology is appreciated by all parties and that the outcomes and monitoring objectives are acceptable. We also conclude that successful integrated watershed management is a question of scale, and that every aspect of integrated watershed management needs to be adapted to the surface watershed, the groundwater watershed (aquifers) and the human catchment area. Copyright © 2018 Elsevier Ltd. All

  17. Harmonisation (legal, dosimetric, quality aspects) of individual monitoring, and integration of monitoring for external and internal exposures (EURADOS working group)

    International Nuclear Information System (INIS)

    Lopez, M.A.; Currivan, L.; Falk, R.; Olko, P.; Wernli, C.; Castellani, C.M.; Dijk, J.W.E. van

    2003-01-01

    The EURADOS Working Group II on 'Harmonisation of individual monitoring' consists of experts from almost all EU Member States and Newly Associated States (NAS), involved in tasks related to the assessment of doses for internal and external radiation. The final objective is to achieve harmonisation in individual monitoring for occupational exposures. Sub-group 2 activities are focused on investigating how the results from personal dosemeters for external radiation and workplace monitoring and from monitoring for internal exposure can be combined into a complete and consistent system of individual monitoring. Three questionnaires were prepared, covering Individual monitoring of external radiation (Questionnaire 1), 'Internal exposure' (Questionnaire 2) and 'Natural sources of radiation at workplace' (Questionnaire 3). With the agreement of a 'contact-person' selected in each country, the distribution of the three EURADOS 2002 questionnaires was carried out by e-mail among the dosimetry facilities of 28 European countries. The preliminary results of these actions are presented here. (author)

  18. Combining Modeling and Monitoring to Produce a New Paradigm of an Integrated Approach to Providing Long-Term Control of Contaminants

    Science.gov (United States)

    Fogwell, T. W.

    2009-12-01

    Sir David King, Chief Science Advisor to the British government and Cambridge University Professor, stated in October 2005, "The scientific community is considerably more capable than it has been in the past to assist governments to avoid and reduce risk to their own populations. Prime ministers and presidents ignore the advice from the science community at the peril of their own populations." Some of these greater capabilities can be found in better monitoring techniques applied to better modeling methods. These modeling methods can be combined with the information derived from monitoring data in order to decrease the risk of population exposure to dangerous substances and to promote efficient control or cleanup of the contaminants. An introduction is presented of the types of problems that exist for long-term control of radionuclides at DOE sites. A breakdown of the distributions at specific sites is given, together with the associated difficulties. A paradigm for remediation showing the integration of monitoring with modeling is presented. It is based on a feedback system that allows for the monitoring to act as principal sensors in a control system. The resulting system can be optimized to improve performance. Optimizing monitoring automatically entails linking the monitoring with modeling. If monitoring designs were required to be more efficient, thus requiring optimization, then the monitoring automatically becomes linked to modeling. Records of decision could be written to accommodate revisions in monitoring as better modeling evolves. Currently the establishment of a very prescriptive monitoring program fails to have a mechanism for improving models and improving control of the contaminants. The technical pieces of the required paradigm are already available; they just need to be implemented and applied to solve the long-term control of the contaminants. An integration of the various parts of the system is presented. Each part is described, and examples are

  19. Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation

    Science.gov (United States)

    Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric

    2014-01-01

    ABSTRACT Background: The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. Methods: The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. Results: While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. Conclusions: The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of i

  20. Attention Is Required for Knowledge-Based Sequential Grouping: Insights from the Integration of Syllables into Words.

    Science.gov (United States)

    Ding, Nai; Pan, Xunyi; Luo, Cheng; Su, Naifei; Zhang, Wen; Zhang, Jianfeng

    2018-01-31

    How the brain groups sequential sensory events into chunks is a fundamental question in cognitive neuroscience. This study investigates whether top-down attention or specific tasks are required for the brain to apply lexical knowledge to group syllables into words. Neural responses tracking the syllabic and word rhythms of a rhythmic speech sequence were concurrently monitored using electroencephalography (EEG). The participants performed different tasks, attending to either the rhythmic speech sequence or a distractor, which was another speech stream or a nonlinguistic auditory/visual stimulus. Attention to speech, but not a lexical-meaning-related task, was required for reliable neural tracking of words, even when the distractor was a nonlinguistic stimulus presented cross-modally. Neural tracking of syllables, however, was reliably observed in all tested conditions. These results strongly suggest that neural encoding of individual auditory events (i.e., syllables) is automatic, while knowledge-based construction of temporal chunks (i.e., words) crucially relies on top-down attention. SIGNIFICANCE STATEMENT Why we cannot understand speech when not paying attention is an old question in psychology and cognitive neuroscience. Speech processing is a complex process that involves multiple stages, e.g., hearing and analyzing the speech sound, recognizing words, and combining words into phrases and sentences. The current study investigates which speech-processing stage is blocked when we do not listen carefully. We show that the brain can reliably encode syllables, basic units of speech sounds, even when we do not pay attention. Nevertheless, when distracted, the brain cannot group syllables into multisyllabic words, which are basic units for speech meaning. Therefore, the process of converting speech sound into meaning crucially relies on attention. Copyright © 2018 the authors 0270-6474/18/381178-11$15.00/0.

  1. Mixed Waste Focus Area Working Group: An Integrated Approach to Mercury Waste Treatment and Disposal. Revision 1

    International Nuclear Information System (INIS)

    Morris, M.I.; Conley, T.B.; Osborne-Lee, I.W.

    1997-01-01

    May 1996, the U.S. Department of Energy (DOE) Mixed Waste Focus Area (MWFA) initiated the Mercury Work Group (HgWG). The HgWG was established to address and resolve the issues associated with Mercury- contaminated mixed wastes (MWs). During the initial technical baseline development process of the MWFA, three of the top four technology deficiencies identified were related to (1) amalgamation, (2) stabilization, and (3) separation and removal for the treatment of mercury and mercury-contaminated mixed waste (MW). The HgWG is assisting the MWFA in soliciting, identifying, initiating, and managing efforts to address these needs

  2. Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals.

    Science.gov (United States)

    Bjerså, Kristofer; Stener Victorin, Elisabet; Fagevik Olsén, Monika

    2012-04-12

    Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were

  3. Knowledge about complementary, alternative and integrative medicine (CAM among registered health care providers in Swedish surgical care: a national survey among university hospitals

    Directory of Open Access Journals (Sweden)

    Bjerså Kristofer

    2012-04-01

    Full Text Available Abstract Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0% questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in

  4. The Functional Segregation and Integration Model: Mixture Model Representations of Consistent and Variable Group-Level Connectivity in fMRI

    DEFF Research Database (Denmark)

    Churchill, Nathan William; Madsen, Kristoffer Hougaard; Mørup, Morten

    2016-01-01

    flexibility: they only estimate segregated structure and do not model interregional functional connectivity, nor do they account for network variability across voxels or between subjects. To address these issues, this letter develops the functional segregation and integration model (FSIM). This extension......The brain consists of specialized cortical regions that exchange information between each other, reflecting a combination of segregated (local) and integrated (distributed) processes that define brain function. Functional magnetic resonance imaging (fMRI) is widely used to characterize...... brain regions where network expression predicts subject age in the experimental data. Thus, the FSIM is effective at summarizing functional connectivity structure in group-level fMRI, with applications in modeling the relationships between network variability and behavioral/demographic variables....

  5. New quality assurance program integrating ''modern radiotherapy'' within the German Hodgkin Study Group

    Energy Technology Data Exchange (ETDEWEB)

    Kriz, J.; Haverkamp, U.; Eich, H.T. [University of Muenster, Department of Radiation Oncology, Muenster (Germany); Baues, C.; Marnitz-Schulze, S. [University of Cologne, Department of Radiation Oncology, Koeln (Germany); Engenhart-Cabillic, R. [University of Marburg, Department of Radiation Oncology, Marburg (Germany); Herfarth, K. [University of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Lukas, P. [University of Innsbruck, Department of Radiation Oncology, Innsbruck (Austria); Schmidberger, H. [University of Mainz, Department of Radiation Oncology, Mainz (Germany); Fuchs, M.; Engert, A. [University of Cologne, Department of Internal Medicine, Koeln (Germany)

    2017-02-15

    Field design changed substantially from extended-field RT (EF-RT) to involved-field RT (IF-RT) and now to involved-node RT (IN-RT) and involved-site RT (IS-RT) as well as treatment techniques in radiotherapy (RT) of Hodgkin's lymphoma (HL). The purpose of this article is to demonstrate the establishment of a quality assurance program (QAP) including modern RT techniques and field designs within the German Hodgkin Study Group (GHSG). In the era of modern conformal RT, this QAP had to be fundamentally adapted and a new evaluation process has been intensively discussed by the radiotherapeutic expert panel of the GHSG. The expert panel developed guidelines and criteria to analyse ''modern'' field designs and treatment techniques. This work is based on a dataset of 11 patients treated within the sixth study generation (HD16-17). To develop a QAP of ''modern RT'', the expert panel defined criteria for analysing current RT procedures. The consensus of a modified QAP in ongoing and future trials is presented. With this schedule, the QAP of the GHSG could serve as a model for other study groups. (orig.) [German] Nicht nur die Zielvolumendefinitionen haben sich von der Extended-Field- (EF-RT) ueber die Involved-Field- (IF-RT) bis zur Involved-Node- (IN-RT) und Involved-Site-Radiotherapie (IS-RT) weiterentwickelt. Auch die Radiotherapie(RT)-Techniken in der Behandlung von Patienten mit Hodgkin-Lymphom haben Aenderungen erfahren. Wir moechten aufzeigen, wie die Arbeit des Qualitaetssicherungsprogramms (QAP) innerhalb der Deutschen Hodgkin Studiengruppe (German Hodgkin Study Group [GHSG]) in der Aera der ''modernen RT'' hinsichtlich intensitaetsmodulierter RT (IMRT) und bildgefuehrter RT (IGRT), aber auch hinsichtlich moderner Felddefinitionen wie bei der IN-RT angepasst wurde. In der Aera der ''modernen RT'' wurde das QAP vom radiotherapeutischen Expertenpanel der GHSG im Rahmen einiger

  6. The ClaudicatioNet concept: design of a national integrated care network providing active and healthy aging for patients with intermittent claudication.

    Science.gov (United States)

    Lauret, Gert-Jan; Gijsbers, Harm J H; Hendriks, Erik J M; Bartelink, Marie-Louise; de Bie, Rob A; Teijink, Joep A W

    2012-01-01

    Intermittent claudication (IC) is a manifestation of peripheral arterial occlusive disease (PAOD). Besides cardiovascular risk management, supervised exercise therapy (SET) should be offered to all patients with IC. Outdated guidelines, an insufficient number of specialized physiotherapists (PTs), lack of awareness of the importance of SET by referring physicians, and misguided financial incentives all seriously impede the availability of a structured SET program in The Netherlands. By initiating regional care networks, ClaudicatioNet aims to improve the quality of care for patients with IC. Based on the chronic care model as a conceptual framework, these networks should enhance the access, continuity, and (cost) efficiency of the health care system. With the aid of a national database, health care professionals will be able to benchmark patient results while ClaudicatioNet will be able to monitor quality of care by way of functional and patient reported outcome measures. The success of ClaudicatioNet is dependent on several factors. Vascular surgeons, general practitioners and coordinating central caregivers will need to team up and work in close collaboration with specialized PTs. A substantial task in the upcoming years will be to monitor the quality, volume, and distribution of ClaudicatioNet PTs. Finally, misguided financial incentives within the Dutch health care system need to be tackled. With ClaudicatioNet, integrated care pathways are likely to improve in the upcoming years. This should result in the achievement of optimal quality of care for all patients with IC.

  7. Leadership emergence over time in short-lived groups: Integrating expectations states theory with temporal person-perception and self-serving bias.

    Science.gov (United States)

    Kalish, Yuval; Luria, Gil

    2016-10-01

    Research into leadership emergence typically focuses on the attributes of the emergent leader. By considering also the attributes of perceivers and the passage of time, we develop a more complete theory of leadership emergence in short-lived groups. Using expectation states theory as an overarching theoretical framework, and integrating it with the surface- and deep-level diversity literature and with theories of self-serving biases, we examine the predictors of leadership emergence in short timeframes. We conduct a field study in a military assessment boot camp (a pilot study, n = 60; and a main study, n = 89). We use cross-sectional and longitudinal exponential random graph models to analyze data on participants' abilities and on their perceptions of who, in their respective groups, were "leaders." We find that the criteria by which people perceive leadership in others change over time, from easily noticeable attributes to covert leadership-relevant attributes, and that people also rely on leadership-relevant attributes that they possess at high levels to inform their perceptions of leadership in others. The integration of expectation states theory, attribute salience over time and theories of self-serving bias is needed for a full understanding of leadership emergence in groups, because perceivers' own abilities are instrumental in shaping their perceptions of emergent leadership over time. Theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. The Genomics Education Partnership: Successful Integration of Research into Laboratory Classes at a Diverse Group of Undergraduate Institutions

    Science.gov (United States)

    Shaffer, Christopher D.; Alvarez, Consuelo; Bailey, Cheryl; Barnard, Daron; Bhalla, Satish; Chandrasekaran, Chitra; Chandrasekaran, Vidya; Chung, Hui-Min; Dorer, Douglas R.; Du, Chunguang; Eckdahl, Todd T.; Poet, Jeff L.; Frohlich, Donald; Goodman, Anya L.; Gosser, Yuying; Hauser, Charles; Hoopes, Laura L.M.; Johnson, Diana; Jones, Christopher J.; Kaehler, Marian; Kokan, Nighat; Kopp, Olga R.; Kuleck, Gary A.; McNeil, Gerard; Moss, Robert; Myka, Jennifer L.; Nagengast, Alexis; Morris, Robert; Overvoorde, Paul J.; Shoop, Elizabeth; Parrish, Susan; Reed, Kelynne; Regisford, E. Gloria; Revie, Dennis; Rosenwald, Anne G.; Saville, Ken; Schroeder, Stephanie; Shaw, Mary; Skuse, Gary; Smith, Christopher; Smith, Mary; Spana, Eric P.; Spratt, Mary; Stamm, Joyce; Thompson, Jeff S.; Wawersik, Matthew; Wilson, Barbara A.; Youngblom, Jim; Leung, Wilson; Buhler, Jeremy; Mardis, Elaine R.; Lopatto, David

    2010-01-01

    Genomics is not only essential for students to understand biology but also provides unprecedented opportunities for undergraduate research. The goal of the Genomics Education Partnership (GEP), a collaboration between a growing number of colleges and universities around the country and the Department of Biology and Genome Center of Washington University in St. Louis, is to provide such research opportunities. Using a versatile curriculum that has been adapted to many different class settings, GEP undergraduates undertake projects to bring draft-quality genomic sequence up to high quality and/or participate in the annotation of these sequences. GEP undergraduates have improved more than 2 million bases of draft genomic sequence from several species of Drosophila and have produced hundreds of gene models using evidence-based manual annotation. Students appreciate their ability to make a contribution to ongoing research, and report increased independence and a more active learning approach after participation in GEP projects. They show knowledge gains on pre- and postcourse quizzes about genes and genomes and in bioinformatic analysis. Participating faculty also report professional gains, increased access to genomics-related technology, and an overall positive experience. We have found that using a genomics research project as the core of a laboratory course is rewarding for both faculty and students. PMID:20194808

  9. NutriLive: An Integrated Nutritional Approach as a Sustainable Tool to Prevent Malnutrition in Older People and Promote Active and Healthy Ageing—The EIP-AHA Nutrition Action Group

    Directory of Open Access Journals (Sweden)

    Maddalena Illario

    2016-01-01

    Full Text Available The present document describes a nutritional approach that is nested in the European Innovation Partnership for Active and Healthy Aging (EIP-AHA and aims to provide the first common European program translating an integrated approach to nutritional frailty in terms of a multidimensional and transnational methodology. The document has been developed by the A3 Nutrition Action Area of the EIP-AHA and aims at providing a stepwise approach to malnutrition in older citizens, identifying adequate interventions based on a unified assessment and ICT-supported solutions. “NutriLive” is an integrated nutritional approach, represented by a structured Screening-Assessment-Monitoring-Action-Pyramid-Model (SAM-AP. Its core concept is the stratification of the nutritional needs, considered by the working group as the key for targeted, effective, and sustainable interventions. “NutriLive” tries to close gaps in epidemiological data within an aging population, creating a unified language to deal with the topic of nutrition and malnutrition in Europe. By assembling all the validated screening, assessment, and monitoring tools on malnutrition in a first pyramid, which is interrelated to a second intervention pyramid, the A3 Nutrition WG identifies a common, integrated vision on the nutritional approach to frailty, which applies to the various health care settings.

  10. Structured approaches to large-scale systems: Variational integrators for interconnected Lagrange-Dirac systems and structured model reduction on Lie groups

    Science.gov (United States)

    Parks, Helen Frances

    This dissertation presents two projects related to the structured integration of large-scale mechanical systems. Structured integration uses the considerable differential geometric structure inherent in mechanical motion to inform the design of numerical integration schemes. This process improves the qualitative properties of simulations and becomes especially valuable as a measure of accuracy over long time simulations in which traditional Gronwall accuracy estimates lose their meaning. Often, structured integration schemes replicate continuous symmetries and their associated conservation laws at the discrete level. Such is the case for variational integrators, which discretely replicate the process of deriving equations of motion from variational principles. This results in the conservation of momenta associated to symmetries in the discrete system and conservation of a symplectic form when applicable. In the case of Lagrange-Dirac systems, variational integrators preserve a discrete analogue of the Dirac structure preserved in the continuous flow. In the first project of this thesis, we extend Dirac variational integrators to accommodate interconnected systems. We hope this work will find use in the fields of control, where a controlled system can be thought of as a "plant" system joined to its controller, and in the approach of very large systems, where modular modeling may prove easier than monolithically modeling the entire system. The second project of the thesis considers a different approach to large systems. Given a detailed model of the full system, can we reduce it to a more computationally efficient model without losing essential geometric structures in the system? Asked without the reference to structure, this is the essential question of the field of model reduction. The answer there has been a resounding yes, with Principal Orthogonal Decomposition (POD) with snapshots rising as one of the most successful methods. Our project builds on previous work

  11. Introduction to quantum groups

    CERN Document Server

    Chaichian, Masud

    1996-01-01

    In the past decade there has been an extemely rapid growth in the interest and development of quantum group theory.This book provides students and researchers with a practical introduction to the principal ideas of quantum groups theory and its applications to quantum mechanical and modern field theory problems. It begins with a review of, and introduction to, the mathematical aspects of quantum deformation of classical groups, Lie algebras and related objects (algebras of functions on spaces, differential and integral calculi). In the subsequent chapters the richness of mathematical structure

  12. Revision of the Malagasy Camponotus edmondi species group (Hymenoptera, Formicidae, Formicinae): integrating qualitative morphology and multivariate morphometric analysis.

    Science.gov (United States)

    Rakotonirina, Jean Claude; Csősz, Sándor; Fisher, Brian L

    2016-01-01

    The Malagasy Camponotus edmondi species group is revised based on both qualitative morphological traits and multivariate analysis of continuous morphometric data. To minimize the effect of the scaling properties of diverse traits due to worker caste polymorphism, and to achieve the desired near-linearity of data, morphometric analyses were done only on minor workers. The majority of traits exhibit broken scaling on head size, dividing Camponotus workers into two discrete subcastes, minors and majors. This broken scaling prevents the application of algorithms that uses linear combination of data to the entire dataset, hence only minor workers were analyzed statistically. The elimination of major workers resulted in linearity and the data meet required assumptions. However, morphometric ratios for the subsets of minor and major workers were used in species descriptions and redefinitions. Prior species hypotheses and the goodness of clusters were tested on raw data by confirmatory linear discriminant analysis. Due to the small sample size available for some species, a factor known to reduce statistical reliability, hypotheses generated by exploratory analyses were tested with extreme care and species delimitations were inferred via the combined evidence of both qualitative (morphology and biology) and quantitative data. Altogether, fifteen species are recognized, of which 11 are new to science: Camponotus alamaina sp. n. , Camponotus androy sp. n. , Camponotus bevohitra sp. n. , Camponotus galoko sp. n. , Camponotus matsilo sp. n. , Camponotus mifaka sp. n. , Camponotus orombe sp. n. , Camponotus tafo sp. n. , Camponotus tratra sp. n. , Camponotus varatra sp. n. , and Camponotus zavo sp. n. Four species are redescribed: Camponotus echinoploides Forel, Camponotus edmondi André, Camponotus ethicus Forel, and Camponotus robustus Roger. Camponotus edmondi ernesti Forel, syn. n. is synonymized under Camponotus edmondi . This revision also includes an identification key to

  13. Integrated real-time information to use in commercial, logistics and operational activities provide by the national control center operation of Transpetro

    Energy Technology Data Exchange (ETDEWEB)

    Aniceto, Hello A. R. [National Control Center Operation Transpetro, Rio de Janeiro, (Brazil)

    2010-07-01

    TRANSPETRO needed real time computational tools to manage its commercial, logistics and operational activities more efficiently. TRANSPETRO's National Control Center Operation developed an information site that provides information in real time on the process plans involved in each operation, using a Plant Information Management System (PIMS). SCADA systems were introduced during 2009 and 2010. This paper reports on the global introduction of the site and its basic architecture. Every screen displays the overall data in real time on movement in volume in pipeline operated by TRANSPETRO. The products transported are tracked for each infrastructure and are shown on dynamic geographic maps. Applications have been developed to improve the quality of information available to customers. It was found that the development of this site using PIMS technology brought gains in support to decision-making at the strategic and tactical levels for TRANSPETRO.

  14. Group theory and lattice gauge fields

    International Nuclear Information System (INIS)

    Creutz, M.

    1988-09-01

    Lattice gauge theory, formulated in terms of invariant integrals over group elements on lattice bonds, benefits from many group theoretical notions. Gauge invariance provides an enormous symmetry and powerful constraints on expectation values. Strong coupling expansions require invariant integrals over polynomials in group elements, all of which can be evaluated by symmetry considerations. Numerical simulations involve random walks over the group. These walks automatically generate the invariant group measure, avoiding explicit parameterization. A recently proposed overrelaxation algorithm is particularly efficient at exploring the group manifold. These and other applications of group theory to lattice gauge fields are reviewed in this talk. 17 refs

  15. Accuracy and calibration of integrated radiation output indicators in diagnostic radiology: A report of the AAPM Imaging Physics Committee Task Group 190

    International Nuclear Information System (INIS)

    Lin, Pei-Jan P.; Schueler, Beth A.; Balter, Stephen; Strauss, Keith J.; Wunderle, Kevin A.; LaFrance, M. Terry; Kim, Don-Soo; Behrman, Richard H.; Shepard, S. Jeff; Bercha, Ishtiaq H.

    2015-01-01

    Due to the proliferation of disciplines employing fluoroscopy as their primary imaging tool and the prolonged extensive use of fluoroscopy in interventional and cardiovascular angiography procedures, “dose-area-product” (DAP) meters were installed to monitor and record the radiation dose delivered to patients. In some cases, the radiation dose or the output value is calculated, rather than measured, using the pertinent radiological parameters and geometrical information. The AAPM Task Group 190 (TG-190) was established to evaluate the accuracy of the DAP meter in 2008. Since then, the term “DAP-meter” has been revised to air kerma-area product (KAP) meter. The charge of TG 190 (Accuracy and Calibration of Integrated Radiation Output Indicators in Diagnostic Radiology) has also been realigned to investigate the “Accuracy and Calibration of Integrated Radiation Output Indicators” which is reflected in the title of the task group, to include situations where the KAP may be acquired with or without the presence of a physical “meter.” To accomplish this goal, validation test protocols were developed to compare the displayed radiation output value to an external measurement. These test protocols were applied to a number of clinical systems to collect information on the accuracy of dose display values in the field

  16. Accuracy and calibration of integrated radiation output indicators in diagnostic radiology: A report of the AAPM Imaging Physics Committee Task Group 190

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Pei-Jan P., E-mail: Pei-Jan.Lin@vcuhealth.org [Virginia Commonwealth University Medical Center, Richmond, Virginia 23298 (United States); Schueler, Beth A. [Mayo Clinic, Rochester, Minnesota 55905 (United States); Balter, Stephen [Columbia University Medical Center, New York, New York 10032 (United States); Strauss, Keith J. [Children’s Hospital Medical Center, Cincinnati, Ohio 45229 (United States); Wunderle, Kevin A. [Cleveland Clinic Foundation, Cleveland, Ohio 44195 (United States); LaFrance, M. Terry [Baystate Health Systems, Inc., Springfield, Massachusetts 01199 (United States); Kim, Don-Soo [Children’s Hospital Boston, Boston, Massachusetts 02115 (United States); Behrman, Richard H. [Boston University Medical Center, Boston, Massachusetts 02118 (United States); Shepard, S. Jeff [University of Texas MD Anderson Cancer Center, Houston, Texas 77096 (United States); Bercha, Ishtiaq H. [Children’s Hospital Colorado, Aurora, Colorado 80045 (United States)

    2015-12-15

    Due to the proliferation of disciplines employing fluoroscopy as their primary imaging tool and the prolonged extensive use of fluoroscopy in interventional and cardiovascular angiography procedures, “dose-area-product” (DAP) meters were installed to monitor and record the radiation dose delivered to patients. In some cases, the radiation dose or the output value is calculated, rather than measured, using the pertinent radiological parameters and geometrical information. The AAPM Task Group 190 (TG-190) was established to evaluate the accuracy of the DAP meter in 2008. Since then, the term “DAP-meter” has been revised to air kerma-area product (KAP) meter. The charge of TG 190 (Accuracy and Calibration of Integrated Radiation Output Indicators in Diagnostic Radiology) has also been realigned to investigate the “Accuracy and Calibration of Integrated Radiation Output Indicators” which is reflected in the title of the task group, to include situations where the KAP may be acquired with or without the presence of a physical “meter.” To accomplish this goal, validation test protocols were developed to compare the displayed radiation output value to an external measurement. These test protocols were applied to a number of clinical systems to collect information on the accuracy of dose display values in the field.

  17. Improved evaluations and integral data testing for FENDL. Summary report of the IAEA advisory group meeting held in Garching, Germany, 12 to 16 September 1994

    International Nuclear Information System (INIS)

    Ganesan, S.

    1994-12-01

    The IAEA Nuclear Data Section, in co-operation with several national nuclear data centres and research groups, has created the first version of an internationally available Fusion Evaluated Nuclear Data Library (FENDL-1). The FENDL library has been selected to serve as a comprehensive source of processed and tested nuclear data tailored to the requirements of the Engineering and Development Activities (EDA) of the International Thermonuclear Experimental Reactor (ITER) Project and other fusion-related development projects. Within the scope of the FENDL project, the International Atomic Energy Agency performs the task of coordinating the assembling, processing and testing of a comprehensive, fusion-relevant Fusion Evaluated Nuclear Data Library with unrestricted international distribution. The present report contains the summary of the IAEA Advisory Group Meeting on ''Improved Evaluations and Integral Data Testing for FENDL'', 12-16 September 1994 hosted by the Max-Planck-Institut fuer Plasmaphysik, Garching, Germany. The report presents the current status of the FENDL activity and the future work plans in the form of conclusions and recommendations of the four Working Groups of the Advisory Group Meeting on (1) Basic Evaluations towards FENDL/E-2.0 for ITER Design, (2) Experimental and Calculational Benchmarks on Fusion Neutronics for FENDL Validation, (3) Production and Interfacing of FENDL Libraries to ITER Design, and, (4) Activation. (author)

  18. Integrative Scenario Development

    Directory of Open Access Journals (Sweden)

    Joerg A. Priess

    2014-03-01

    Full Text Available Scenarios are employed to address a large number of future environmental and socioeconomic challenges. We present a conceptual framework for the development of scenarios to integrate the objectives of different stakeholder groups. Based on the framework, land-use scenarios were developed to provide a common base for further research. At the same time, these scenarios assisted regional stakeholders to bring forward their concerns and arrive at a shared understanding of challenges between scientific and regional stakeholders, which allowed them to eventually support regional decision making. The focus on the integration of views and knowledge domains of different stakeholder groups, such as scientists and practitioners, required rigorous and repeated measures of quality control. The application of the integrative concept provided products for both stakeholder groups, and the process of scenario development facilitated cooperation and learning within both the scientist and practitioner groups as well as between the two groups.

  19. Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness.

    Science.gov (United States)

    Cabassa, Leopoldo J; Gomes, Arminda P; Meyreles, Quisqueya; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Manrique, Yamira; Lewis-Fernández, Roberto

    2014-11-30

    Health-care manager interventions improve the physical health of people with serious mental illness (SMI) and could be widely implemented in public mental health clinics. Local adaptations and customization may be needed to increase the reach of these interventions in the public mental health system and across different racial and ethnic communities. In this study, we describe how we used the collaborative intervention planning framework to customize an existing health-care manager intervention to a new patient population (Hispanics with SMI) and provider group (social workers) to increase its fit with our local community. The study was conducted in partnership with a public mental health clinic that serves predominantly Hispanic clients. A community advisory board (CAB) composed of researchers and potential implementers (e.g., social workers, primary care physicians) used the collaborative intervention planning framework, an approach that combines community-based participatory research principles and intervention mapping (IM) procedures, to inform intervention adaptations. The adaptation process included four steps: fostering collaborations between CAB members; understanding the needs of the local population through a mixed-methods needs assessment, literature reviews, and group discussions; reviewing intervention objectives to identify targets for adaptation; and developing the adapted intervention. The application of this approach enabled the CAB to identify a series of cultural and provider level-adaptations without compromising the core elements of the original health-care manager intervention. Reducing health disparities in people with SMI requires community engagement, particularly when preparing existing interventions to be used with new communities, provider groups, and practice settings. Our study illustrates one approach that can be used to involve community stakeholders in the intervention adaptation process from the very beginning to enhance the

  20. Transcriptional and Bioinformatic Analysis Provide a Relationship between Host Response Changes to Marek’s Disease Viruses Infection and an Integrated Long Terminal Repeat

    Directory of Open Access Journals (Sweden)

    Ning eCui

    2016-04-01

    Full Text Available GX0101, Marek’s disease virus (MDV strain with a long terminal repeat (LTR insert of reticuloendotheliosis virus (REV, was isolated from CVI988/Rispens vaccinated birds showing tumors. We have constructed a LTR deleted strain GX0101∆LTR in our previous study. To compare the host responses to GX0101 and GX0101∆LTR, chicken embryo fibroblasts (CEF cells were infected with two MDV strains and a gene-chip containing chicken genome was employed to examine gene transcription changes in host cells in the present study. Of the 42 368 chicken transcripts on the chip, there were 2199 genes that differentially expressed in CEF infected with GX0101 compared to GX0101∆LTR significantly. Differentially expressed genes were distributed to 25 possible gene networks according to their intermolecular connections and were annotated to 56 pathways. The insertion of REV LTR showed the greatest influence on cancer formation and metastasis, followed with immune changes, atherosclerosis and nervous system disorders in MDV-infected CEF cells. Based on these bio functions, GX0101 infection was predicated with a greater growth and survival inhibition but lower oncogenicity in chickens than GX0101∆LTR, at least in the acute phase of infection. In summary, the insertion of REV LTR altered the expression of host genes in response to MDV infection, possibly resulting in novel phenotypic properties in chickens. Our study has provided the evidence of retroviral insertional changes of host responses to herpesvirus infection for the first time, which will promote to elucidation of the possible relationship between the LTR insertion and the observed phenotypes.

  1. Integrated seismic analysis of the Chalk Group in eastern Denmark—Implications for estimates of maximum palaeo-burial in southwest Scandinavia

    DEFF Research Database (Denmark)

    Nielsen, Lars; Boldreel, Lars Ole; Hansen, Thomas Mejer

    2011-01-01

    Group. The sonic velocities are consistent with the overall seismic layering, although they show additional fine-scale layering. Integration of gamma and sonic log with porosity data shows that seismic velocity is sensitive to clay content. In intervals near boundaries of the refraction model, moderate......The origin of the topography of southwest Scandinavia is subject to discussion. Analysis of borehole seismic velocity has formed the basis for interpretation of several hundred metres of Neogene uplift in parts of Denmark.Here, refraction seismic data constrain a 7.5km long P-wave velocity model...... of the Chalk Group below the Stevns peninsula, eastern part of the Danish Basin. The model contains four layers in the ~860m thick Chalk Group with mean velocities of 2.2km/s, 2.4km/s, 3.1km/s, and 3.9–4.3km/s. Sonic and gamma wireline log data from two cored boreholes represent the upper ~450m of the Chalk...

  2. Using an Integrated Group Decision Method Based on SVM, TFN-RS-AHP, and TOPSIS-CD for Cloud Service Supplier Selection

    Directory of Open Access Journals (Sweden)

    Lian-hui Li

    2017-01-01

    Full Text Available To solve the cloud service supplier selection problem under the background of cloud computing emergence, an integrated group decision method is proposed. The cloud service supplier selection index framework is built from two perspectives of technology and technology management. Support vector machine- (SVM- based classification model is applied for the preliminary screening to reduce the number of candidate suppliers. A triangular fuzzy number-rough sets-analytic hierarchy process (TFN-RS-AHP method is designed to calculate supplier’s index value by expert’s wisdom and experience. The index weight is determined by criteria importance through intercriteria correlation (CRITIC. The suppliers are evaluated by the improved TOPSIS replacing Euclidean distance with connection distance (TOPSIS-CD. An electric power enterprise’s case is given to illustrate the correctness and feasibility of the proposed method.

  3. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care.

    Science.gov (United States)

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B

    2017-01-01

    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  4. Racial differences in sensitivity to behavioral integrity: attitudinal consequences, in-group effects, and "trickle down" among Black and non-Black employees.

    Science.gov (United States)

    Simons, Tony; Friedman, Ray; Liu, Leigh Anne; McLean Parks, Judi

    2007-05-01

    Recent research has suggested that employees are highly affected by perceptions of their managers' pattern of word-action consistency, which T. Simons (2002) called behavioral integrity (BI). The authors of the present study suggest that some employee racial groups may be more attentive to BI than others. They tested this notion using data from 1,944 employees working at 107 different hotels and found that Black employees rated their managers as demonstrating lower BI than did non-Black employees. Mediation analyses were consistent with the notion that these differences in perceived BI in turn account for cross-race differences in trust in management, interpersonal justice, commitment, satisfaction, and intent to stay. Results of hierarchical linear modeling were consistent with the idea that middle managers' perceptions of their senior managers' BI "trickle down" to affect line employee perceptions of the middle managers and that this trickle-down effect is stronger for Black employees. The authors interpret these results as indicative of heightened sensitivity to managers' BI on the part of Black employees. They also found a reverse in-group effect, in that Black employees were substantially more critical of Black managers than were non-Black employees. 2007 APA, all rights reserved

  5. Preliminary Assessment of ATR-C Capabilities to Provide Integral Benchmark Data for Key Structural/Matrix Materials that May be Used for Nuclear Data Testing and Analytical Methods Validation

    Energy Technology Data Exchange (ETDEWEB)

    John D. Bess

    2009-03-01

    The purpose of this research is to provide a fundamental computational investigation into the possible integration of experimental activities with the Advanced Test Reactor Critical (ATR-C) facility with the development of benchmark experiments. Criticality benchmarks performed in the ATR-C could provide integral data for key matrix and structural materials used in nuclear systems. Results would then be utilized in the improvement of nuclear data libraries and as a means for analytical methods validation. It is proposed that experiments consisting of well-characterized quantities of materials be placed in the Northwest flux trap position of the ATR-C. The reactivity worth of the material could be determined and computationally analyzed through comprehensive benchmark activities including uncertainty analyses. Experiments were modeled in the available benchmark model of the ATR using MCNP5 with the ENDF/B-VII.0 cross section library. A single bar (9.5 cm long, 0.5 cm wide, and 121.92 cm high) of each material could provide sufficient reactivity difference in the core geometry for computational modeling and analysis. However, to provide increased opportunity for the validation of computational models, additional bars of material placed in the flux trap would increase the effective reactivity up to a limit of 1$ insertion. For simplicity in assembly manufacture, approximately four bars of material could provide a means for additional experimental benchmark configurations, except in the case of strong neutron absorbers and many materials providing positive reactivity. Future tasks include the cost analysis and development of the experimental assemblies, including means for the characterization of the neutron flux and spectral indices. Oscillation techniques may also serve to provide additional means for experimentation and validation of computational methods and acquisition of integral data for improving neutron cross sections. Further assessment of oscillation

  6. Preliminary Assessment of ATR-C Capabilities to Provide Integral Benchmark Data for Key Structural/Matrix Materials that May be Used for Nuclear Data Testing and Analytical Methods Validation

    Energy Technology Data Exchange (ETDEWEB)

    John D. Bess

    2009-07-01

    The purpose of this document is to identify some suggested types of experiments that can be performed in the Advanced Test Reactor Critical (ATR-C) facility. A fundamental computational investigation is provided to demonstrate possible integration of experimental activities in the ATR-C with the development of benchmark experiments. Criticality benchmarks performed in the ATR-C could provide integral data for key matrix and structural materials used in nuclear systems. Results would then be utilized in the improvement of nuclear data libraries and as a means for analytical methods validation. It is proposed that experiments consisting of well-characterized quantities of materials be placed in the Northwest flux trap position of the ATR-C. The reactivity worth of the material could be determined and computationally analyzed through comprehensive benchmark activities including uncertainty analyses. Experiments were modeled in the available benchmark model of the ATR using MCNP5 with the ENDF/B-VII.0 cross section library. A single bar (9.5 cm long, 0.5 cm wide, and 121.92 cm high) of each material could provide sufficient reactivity difference in the core geometry for computational modeling and analysis. However, to provide increased opportunity for the validation of computational models, additional bars of material placed in the flux trap would increase the effective reactivity up to a limit of 1$ insertion. For simplicity in assembly manufacture, approximately four bars of material could provide a means for additional experimental benchmark configurations, except in the case of strong neutron absorbers and many materials providing positive reactivity. Future tasks include the cost analysis and development of the experimental assemblies, including means for the characterization of the neutron flux and spectral indices. Oscillation techniques may also serve to provide additional means for experimentation and validation of computational methods and acquisition of

  7. Permutation groups

    CERN Document Server

    Passman, Donald S

    2012-01-01

    This volume by a prominent authority on permutation groups consists of lecture notes that provide a self-contained account of distinct classification theorems. A ready source of frequently quoted but usually inaccessible theorems, it is ideally suited for professional group theorists as well as students with a solid background in modern algebra.The three-part treatment begins with an introductory chapter and advances to an economical development of the tools of basic group theory, including group extensions, transfer theorems, and group representations and characters. The final chapter feature

  8. Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes.

    Science.gov (United States)

    Townsend, Anne; Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

    2013-10-17

    eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from traditional "passive patient" to an informed, engaged, and empowered "patient as partner," equipped to take part in shared decision-making, and take personal responsibility for self-managing their illness. The objective of our study is to examine how people with chronic illness use eHealth in their daily lives, how it affects patient-provider relationships, and the ethical and practical ramifications for patients, providers, and service delivery. This two-phase qualitative study is ongoing. We will purposively sample 60-70 participants in British Columbia, Canada. To be eligible, patient participants have to have arthritis and at least one other chronic health condition; health care providers (HCPs) need a caseload of patients with multi-morbidity (>25%). To date we have recruited 36 participants (18 patients, 18 HCPs). The participants attended 7 focus groups (FGs), 4 with patients and 3 with rehabilitation professionals and physicians. We interviewed 4 HCPs who were unable to attend a FG. In phase 2, we will build on FG findings and conduct 20-24 interviews with equal numbers of patients and HCPs (rehabilitation professionals and physicians). As in the FGs conducted in phase I, the interviews will use a semistructured, but flexible, discussion guide. All discussions are being audiotaped and transcribed verbatim. Constant comparisons and a narrative approach guides the analyses. A relational ethics conceptual lens is being applied to the data to identify emergent ethical issues. This study

  9. Provider software buyer's guide.

    Science.gov (United States)

    1994-03-01

    To help long term care providers find new ways to improve quality of care and efficiency, Provider magazine presents the fourth annual listing of software firms marketing computer programs for all areas of nursing facility operations. On the following five pages, more than 80 software firms display their wares, with programs such as minimum data set and care planning, dietary, accounting and financials, case mix, and medication administration records. The guide also charts compatible hardware, integration ability, telephone numbers, company contacts, and easy-to-use reader service numbers.

  10. ATLAS Detector Interface Group

    CERN Multimedia

    Mapelli, L

    Originally organised as a sub-system in the DAQ/EF-1 Prototype Project, the Detector Interface Group (DIG) was an information exchange channel between the Detector systems and the Data Acquisition to provide critical detector information for prototype design and detector integration. After the reorganisation of the Trigger/DAQ Project and of Technical Coordination, the necessity to provide an adequate context for integration of detectors with the Trigger and DAQ lead to organisation of the DIG as one of the activities of Technical Coordination. Such an organisation emphasises the ATLAS wide coordination of the Trigger and DAQ exploitation aspects, which go beyond the domain of the Trigger/DAQ project itself. As part of Technical Coordination, the DIG provides the natural environment for the common work of Trigger/DAQ and detector experts. A DIG forum for a wide discussion of all the detector and Trigger/DAQ integration issues. A more restricted DIG group for the practical organisation and implementation o...

  11. Is Pakistani Equity Market Integrated to the Equity Markets of Group of Eight (G8 Countries? An Empirical Analysis of Karachi Stock Exchange

    Directory of Open Access Journals (Sweden)

    Syed Muhammad Aamir Shah

    2012-09-01

    Full Text Available This study looks at the dynamic relationship between the Pakistani equity market and equity markets of Group of Eight countries (G8 which includes Canada, France, Germany, Italy, Japan, Russia, UK and USA by using weekly time series data starting from June 2004 to May 2009. Multivariate Co-integration approach by Johnson and Julius (1990 shows there exists no long-term relationship between the G8 and Pakistani equity market. Vector error correction (VECM model suggests that 100% of the lag periods disequilibrium has been corrected in the current period. Pairwise Granger Causality test shows that there exist a unidirectional causality between the equity market of Pakistan and the markets of France, Germany, Italy, Japan and United Kingdom. Impulse response analysis and variance decomposition analysis reveal that most of the shocks in Pakistani equity market are due to its own innovation and behave like exogenous. However, the markets of France, Japan, Germany and United Kingdom are exerting a little pressure on Pakistani equity markets. Therefore, by investing in Karachi Stock Exchange (KSE the fund manager of G8 countries especially Canada, Italy, Russia and USA is capable of getting the advantage of portfolio diversification.

  12. Approaches for the integration of human factors into the upgrading and refurbishment of control rooms - Summary and conclusions - Principal Working Group 1 on Operating Experience and Human Factors

    International Nuclear Information System (INIS)

    2002-01-01

    A modern approach to control room design, be it for upgrading or complete refurbishment, requires the integration of many disciplines and approaches. The integration of human factors into such a process continues to present challenges. How such a process should be conceived, planned, and carried out is of considerable interest to designers, operators and regulators. Many NPPs around the world have been, or will be faced with decisions concerning modernization of their control rooms. Such changes can be driven by a range of issues including; the need to replace outdated control and instrumentation systems; increasing regulatory concern about human performance; or the need to provide a better process control environment for NPPs whose life cycles extend beyond that originally intended. Considering the importance of operator performance for safe and profitable operations, a process for ensuring that human factors issues are properly addressed could be central to the success or failure of such a project. Human factors is of particular importance when a combination of existing and new systems are to be used, resulting in a so-called 'hybrid' control room. The workshop addressed this topical area by providing a forum where a number of important areas could be discussed and experiences and lessons shared. Topics identified before hand as important and worthy of discussion included: - Exploration of how human factors issues can be identified. - Consideration of those processes and techniques necessary to ensure that appropriate requirements are specified, and that suitable data is gathered and analysed. - Identification and discussion of issues related to the above topics together with lessons from utilities, vendors and regulators which have faced, or are currently facing, these challenges. The meeting itself focused on the state of knowledge and current best practices within these areas and provided a forum for the open discussion of the human factors issues, as seen by

  13. Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

    OpenAIRE

    Jennifer C. Reneker; Kyra Weems; Vincent Scaia

    2016-01-01

    This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at th...

  14. The integral form of supergravity

    Energy Technology Data Exchange (ETDEWEB)

    Castellani, L. [Dipartimento di Scienze e Innovazione Tecnologica, Università del Piemonte Orientale,Viale T. Michel, 11, 15121 Alessandria (Italy); INFN - Sezione di Torino,via P. Giuria 1, 10125 Torino (Italy); Catenacci, R. [Dipartimento di Scienze e Innovazione Tecnologica, Università del Piemonte Orientale,Viale T. Michel, 11, 15121 Alessandria (Italy); Gruppo Nazionale di Fisica Matematica, INdAM,P.le Aldo Moro 5, 00185 Roma (Italy); Grassi, P.A. [Dipartimento di Scienze e Innovazione Tecnologica, Università del Piemonte Orientale,Viale T. Michel, 11, 15121 Alessandria (Italy); INFN - Sezione di Torino,via P. Giuria 1, 10125 Torino (Italy)

    2016-10-11

    By using integral forms we derive the superspace action of D=3,N=1 supergravity as an integral on a supermanifold. The construction is based on target space picture changing operators, here playing the rôle of Poincaré duals to the lower-dimensional spacetime surfaces embedded into the supermanifold. We show how the group geometrical action based on the group manifold approach interpolates between the superspace and the component supergravity actions, thus providing another proof of their equivalence.

  15. A Quasi-Experimental Control Group Design Study to Determine the Effect of Integrating Character Education into a High School Social Studies Curriculum through Storytelling

    Science.gov (United States)

    Long, Russell L.

    2014-01-01

    The purpose of this study was to offer evidence for the development of student character through the integration of historical storytelling into a social studies classroom. A quasi-experimental study was conducted to determine the effect of character education through historical storytelling integrated into a United States history curriculum on…

  16. Muslims in their European societies of settlement : A comparative agenda for empirical research on socio-cultural integration across countries and groups

    NARCIS (Netherlands)

    Statham, P.; Tillie, J.

    2016-01-01

    Islam has become the key site for demarcating boundaries between majority populations and individuals of immigrant origin across Europe. This article outlines a research agenda on the socio-cultural integration of Muslims in their Western European societies of settlement. Integration issues with

  17. Information integration in control rooms and technical offices in nuclear power plants. Report prepared within the framework of the International Working Group on Nuclear Power Plant Control and Instrumentation

    International Nuclear Information System (INIS)

    2001-11-01

    The majority of the nuclear power plants in the world were designed 25 to 45 years ago. The information, instrumentation, safety, and control systems in these plant designs were based on analog, relay, and primitive digital technology. Computers that were available when most of the nuclear power plants were built were unsophisticated compared with those currently available. These less powerful machines with limited computational capabilities and memory were used to collect and store information. The main means for obtaining information from the plant were analog meters and strip chart recorders. In many cases these pieces of data had to be integrated and correlated with other data manually, in order to be usable. Procedures and plant information resided on paper only and were frequently hard to find and access in a timely manner. This report provides guidance to help with the integration of information in order to enhance the usability and usefulness of the information. It can also be used to help avoid the pitfalls that can occur when implementing new systems with respect to the information they need and produce. This reports philosophy is based on three important issues that allow the convenient structuring of the problem and to keep all of its important features. The first issue is the process of information systems integration and use. This is achieved by long term planning and the creation of the plant infrastructure plan. The second is to take care of the end users' needs in relation to their abilities. This is realized through analyses of user needs. Third is the design of the human-system interface (HSI), for example to distinguish between types of information for use in the plant control room and in technical offices. The development of this report was initiated by the IAEA International Working Group on Nuclear Power Plant Control and Instrumentation (IWG-NPPCI). It is a logical follow-up to IAEA-TECDOC-1016, Modernization of Instrumentation and Control

  18. Study protocol for a group randomized controlled trial of a classroom-based intervention aimed at preventing early risk factors for drug abuse: integrating effectiveness and implementation research.

    Science.gov (United States)

    Poduska, Jeanne; Kellam, Sheppard; Brown, C Hendricks; Ford, Carla; Windham, Amy; Keegan, Natalie; Wang, Wei

    2009-09-02

    While a number of preventive interventions delivered within schools have shown both short-term and long-term impact in epidemiologically based randomized field trials, programs are not often sustained with high-quality implementation over time. This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD), aimed at two early antecedents to drug abuse and other problem behaviors, namely, aggressive, disruptive behavior and poor academic achievement. The second purpose--the focus of this paper--was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. The WD intervention integrated three components, each previously tested separately: classroom behavior management; instruction, specifically reading; and family-classroom partnerships around behavior and learning. Teachers and students in 12 schools were randomly assigned to receive either the WD intervention or the standard first-grade program of the school system (SC). Three consecutive cohorts of first graders were randomized within schools to WD or SC classrooms and followed through the end of third grade to test the effectiveness of the WD intervention. Teacher practices were assessed over three years to examine the utility of the multilevel structure to support sustainability and scaling-up. The design employed in this trial appears to have considerable utility to provide data on WD effectiveness and to inform the field with regard to structures required to move evidence-based programs into practice. NCT00257088.

  19. Study protocol for a group randomized controlled trial of a classroom-based intervention aimed at preventing early risk factors for drug abuse: integrating effectiveness and implementation research

    Directory of Open Access Journals (Sweden)

    Keegan Natalie

    2009-09-01

    Full Text Available Abstract Background While a number of preventive interventions delivered within schools have shown both short-term and long-term impact in epidemiologically based randomized field trials, programs are not often sustained with high-quality implementation over time. This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD, aimed at two early antecedents to drug abuse and other problem behaviors, namely, aggressive, disruptive behavior and poor academic achievement. The second purpose--the focus of this paper--was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. Methods The WD intervention integrated three components, each previously tested separately: classroom behavior management; instruction, specifically reading; and family-classroom partnerships around behavior and learning. Teachers and students in 12 schools were randomly assigned to receive either the WD intervention or the standard first-grade program of the school system (SC. Three consecutive cohorts of first graders were randomized within schools to WD or SC classrooms and followed through the end of third grade to test the effectiveness of the WD intervention. Teacher practices were assessed over three years to examine the utility of the multilevel structure to support sustainability and scaling-up. Discussion The design employed in this trial appears to have considerable utility to provide data on WD effectiveness and to inform the field with regard to structures required to move evidence-based programs into practice. Trial Registration Clinical Trials Registration Number: NCT00257088

  20. 23 February 2010 - Polish Under Secretary of State, Ministry of Science and Higher Education, J. Szwed visiting CERN installations with sLHC Project Office T. Kurtyka and Machine Protection and Electrical Integrity Group Leader A. Siemko.

    CERN Multimedia

    Michel Blanc

    2010-01-01

    Tirage 1002023-01: In LHCb experimental area with Machine Protection and Electrical Integrity Group Leader A. Siemko; Mission Counselor M. Cichucka; Counselor to the Minister M. Klimkiewicz, Under Secretary of State J. Szwed; LHCb Collaboration, national group leader, Henryk Niewodniczanski Institut of Nuclear Physics G. Polok, Collaboration Spokesperson A. Golutvin and Delegate to CERN Council A. Zalewska. Tirage 28: Visiting the Computing Centre with IT Department Head F. Hemmer Tirage 49: In CMS Control centre, buiding 354 with Collaboration Spokesperson G. Tonelli and CMS Collaboration, national group leader, University of Warsaw J. Krolikowski. Tirage 62: visiting ALICE exhibition area and counting room with Collaboration Spokesperson J. Schukraft. Tirage 82-99: Under Secretary of State address to the Polish Community Tirage 82: Machine Protection and Electrical Integrity Group Leader A. Siemko Tirage 83: Polish Delegate to CERN Council A. Zalewska. Tirage 85: Directorate Office E. Rondio Tirage 86: ATLA...

  1. Revisão sobre alguns grupos de inseticidas utilizados no manejo integrado de pragas florestais / A review of some insecticide groups used in forest pest integrated management

    Directory of Open Access Journals (Sweden)

    Álvaro Boson de Castro Faria

    2009-08-01

    Full Text Available ResumoMuito embora os princípios, critérios e indicadores da certificação florestal exijam das empresas a valorização do controle biológico e a diminuição do uso de pesticidas, atualmente podemos nos valer de estratégias químicas que permitem minimizar os impactos sobre organismos não alvo, em que, respeitadas as devidas autorizações e disposições legais, são utilizadas como estratégias dos programas de controle e manejo integrados. Este trabalho tem como objetivo apresentar uma revisão bibliográfica a qual se estabeleceu um grau de evolução entre os inseticidas no controle de pragas florestais. O desenvolvimento classifica os grupos químicos de defensivos em quatro gerações: na primeira, os produtos inorgânicos; na segunda, os organoclorados, os organofosforados, os carbamatos e os piretróides; na terceira geração, os reguladores de crescimento e os fagos-inibidores; e na quarta, a biotecnologia e os produtos neonicotinóides, seu modo de ação e seus métodos de aplicação. As técnicas precisam ter como meta o aumento das produtividades ao ponto em que, simultaneamente, preservem o meio ambiente no seu sentido mais amplo, inclusive, considerando o ser humano como parte deste sistema.AbstractThe principles, criteria and forest certification indicators demand from companies more use of biological control and instead of esticides use. However, nowadays it’s common to see the use chemical strategies that allow minimizing impacts on non-target organisms. Respecting the due authorizations and legal dispositions, these strategies is used in the integrated pest management (IPM programs. This paper presents a revision of literature, establishing a degree of evolution amongst the insecticides used in forest pest control. The chemical groups are classified in four generations: in the first, the non-organics; in the second, the organochlorides, organophosphate, carbamates and piretroids; in the third, the insect growth

  2. Quantum Group U_q(sl(2 Symmetry and Explicit Evaluation of the One-Point Functions of the Integrable Spin-1 XXZ Chain

    Directory of Open Access Journals (Sweden)

    Tetsuo Deguchi

    2011-06-01

    Full Text Available We show some symmetry relations among the correlation functions of the integrable higher-spin XXX and XXZ spin chains, where we explicitly evaluate the multiple integrals representing the one-point functions in the spin-1 case. We review the multiple-integral representations of correlation functions for the integrable higher-spin XXZ chains derived in a region of the massless regime including the anti-ferromagnetic point. Here we make use of the gauge transformations between the symmetric and asymmetric R-matrices, which correspond to the principal and homogeneous gradings, respectively, and we send the inhomogeneous parameters to the set of complete 2s-strings. We also give a numerical support for the analytical expression of the one-point functions in the spin-1 case.

  3. Circular dichroism and fluorescence spectroscopy of cysteinyl-tRNA synthetase from Halobacterium salinarum ssp. NRC-1 demonstrates that group I cations are particularly effective in providing structure and stability to this halophilic protein.

    Directory of Open Access Journals (Sweden)

    Christopher J Reed

    Full Text Available Proteins from extremophiles have the ability to fold and remain stable in their extreme environment. Here, we investigate the presence of this effect in the cysteinyl-tRNA synthetase from Halobacterium salinarum ssp. NRC-1 (NRC-1, which was used as a model halophilic protein. The effects of salt on the structure and stability of NRC-1 and of E. coli CysRS were investigated through far-UV circular dichroism (CD spectroscopy, fluorescence spectroscopy, and thermal denaturation melts. The CD of NRC-1 CysRS was examined in different group I and group II chloride salts to examine the effects of the metal ions. Potassium was observed to have the strongest effect on NRC-1 CysRS structure, with the other group I salts having reduced strength. The group II salts had little effect on the protein. This suggests that the halophilic adaptations in this protein are mediated by potassium. CD and fluorescence spectra showed structural changes taking place in NRC-1 CysRS over the concentration range of 0-3 M KCl, while the structure of E. coli CysRS was relatively unaffected. Salt was also shown to increase the thermal stability of NRC-1 CysRS since the melt temperature of the CysRS from NRC-1 was increased in the presence of high salt, whereas the E. coli enzyme showed a decrease. By characterizing these interactions, this study not only explains the stability of halophilic proteins in extremes of salt, but also helps us to understand why and how group I salts stabilize proteins in general.

  4. Land use change and conversion effects on ground water quality trends: An integration of land change modeler in GIS and a new Ground Water Quality Index developed by fuzzy multi-criteria group decision-making models.

    Science.gov (United States)

    Shooshtarian, Mohammad Reza; Dehghani, Mansooreh; Margherita, Ferrante; Gea, Oliveri Conti; Mortezazadeh, Shima

    2018-04-01

    This study aggregated Land Change Modeller (LCM) as a useful model in GIS with an extended Groundwater Quality Index (GWQI) developed by fuzzy Multi-Criteria Group Decision-Making models to investigate the effect of land use change and conversion on groundwater quality being supplied for drinking. The model's performance was examined through an applied study in Shiraz, Iran, in a five year period (2011 to 2015). Four land use maps including urban, industrial, garden, and bare were employed in LCM model and the impact of change in area and their conversion to each other on GWQI changes was analysed. The correlation analysis indicated that increase in the urban land use area and conversion of bare to the residential/industrial land uses, had a relation with water quality decrease. Integration of LCM and GWQI can accurately and logically provide a numerical analysis of the possible impact of land use change and conversion, as one of the influencing factors, on the groundwater quality. Hence, the methodology could be used in urban development planning and management in macro level. Copyright © 2018. Published by Elsevier Ltd.

  5. Comparison of Provider-Assessed and Patient-Reported Outcome Measures of Acute Skin Toxicity During a Phase III Trial of Mometasone Cream Versus Placebo During Breast Radiotherapy: The North Central Cancer Treatment Group (N06C4)

    International Nuclear Information System (INIS)

    Neben-Wittich, Michelle A.; Atherton, Pamela J.; Schwartz, David J.; Sloan, Jeff A.; Griffin, Patricia C.; Deming, Richard L.; Anders, Jon C.; Loprinzi, Charles L.; Burger, Kelli N.; Martenson, James A.; Miller, Robert C.

    2011-01-01

    Purpose: Considerable interobserver variability exists among providers and between providers and patients when measuring subjective symptoms. In the recently published Phase III N06C4 trial of mometasone cream vs. placebo to prevent radiation dermatitis, the primary provider-assessed (PA) endpoint, using the Common Toxicity Criteria for Adverse Events (CTCAE), was negative. However, prospectively planned secondary analyses of patient-reported outcomes (PROs), using the Skindex-16 and Skin Toxicity Assessment Tool (STAT), were positive. This study assesses the relationship between PA outcomes and PROs. Methods and Materials: Pearson correlation coefficients were calculated to compare the three tools. Statistical correlations were defined as follows: 0.7, strong. Results: CTCAE dermatitis moderately correlated with STAT erythema, and CTCAE pruritus strongly correlated with STAT itching. CTCAE pruritus had a moderate correlation with Skindex-16 itching. Comparing the 2 PRO tools, Skindex-16 itching correlated moderately with STAT itching. Skindex-16 burning, hurting, irritation, and persistence all showed the strongest correlation with STAT burning; they showed moderate correlations with STAT itching and tenderness. Conclusions: The PRO Skindex-16 correlated well with the PRO portions of STAT, but neither tool correlated well with CTCAE. PROs delineated a wider spectrum of toxicity than PA measures and provided more information on rash, redness, pruritus, and annoyance measures compared with CTCAE findings of rash and pruritus. PROs may provide a more complete measure of patient experience than single-symptom, PA endpoints in clinical trials assessing radiation skin toxicity.

  6. Group dynamics.

    Science.gov (United States)

    Scandiffio, A L

    1990-12-01

    Group dynamics play a significant role within any organization, culture, or unit. The important thing to remember with any of these structures is that they are made up of people--people with different ideas, motivations, background, and sometimes different agendas. Most groups, formal or informal, look for a leader in an effort to maintain cohesiveness of the unit. At times, that cultural bond must be developed; once developed, it must be nurtured. There are also times that one of the group no longer finds the culture comfortable and begins to act out behaviorally. It is these times that become trying for the leader as she or he attempts to remain objective when that which was once in the building phase of group cohesiveness starts to fall apart. At all times, the manager must continue to view the employee creating the disturbance as an integral part of the group. It is at this time that it is beneficial to perceive the employee exhibiting problem behaviors as a special employee, as one who needs the benefit of your experience and skills, as one who is still part of the group. It is also during this time that the manager should focus upon her or his own views in the area of power, communication, and the corporate culture of the unit that one has established before attempting to understand another's point of view. Once we understand our own motivation and accept ourselves, it is then that we may move on to offer assistance to another. Once we understand our insecurities recognizing staff dysfunction as a symptom of system dysfunction will not be so threatening to the concept of the manager that we perceive ourselves to be. It takes a secure person to admit that she or he favors staff before deciding to do something to change things. The important thing to know is that it can be done. The favored staff can find a new way of relating to others, the special employee can find new modes of behavior (and even find self-esteem in the process), the group can find new ways

  7. Verkeersveiligheid in Nederland.Nationaal overzicht ten behoeve van de OECD-group S1 on Concepts and Methodologies for Integrated Safety Programmes.

    NARCIS (Netherlands)

    Paar, H.G.

    1983-01-01

    Since 1974 traffic safety policy in the Netherlands has been coordinated by one department of the national government. For research on traffic safety there is a central integrating institute, the Dutch institute for road safety research SWOV. In 1975 a management policy for traffic safety was

  8. Pedagogical Praxis Surrounding the Integration of Photography, Visual Literacy, Digital Literacy, and Educational Technology into Business Education Classrooms: A Focus Group Study

    Science.gov (United States)

    Schlosser, Peter Allen

    2010-01-01

    This paper reports on an investigation into how Marketing and Business Education Teachers utilize and integrate educational technology into curriculum through the use of photography. The ontology of this visual, technological, and language interface is explored with an eye toward visual literacy, digital literacy, and pedagogical praxis, focusing…

  9. Effect of provider-initiated testing and counselling and integration of ART services on access to HIV diagnosis and treatment for children in Lilongwe, Malawi: a pre- post comparison

    Directory of Open Access Journals (Sweden)

    Phiri Sam

    2009-12-01

    Full Text Available Abstract Background The HIV prevalence in Malawi is 12% and Kamuzu Central Hospital (KCH, in the capital Lilongwe, is the main provider of adult and paediatric HIV services in the central region. The Lighthouse at KCH offers opt-in HIV testing and counselling (HTC for adults and children. In June 2004, Lighthouse was the first clinic to provide free antiretroviral treatment (ART in the public sector, but few children accessed the services. In response, provider-initiated HIV testing and counselling (PITC and an ART clinic were introduced at the paediatric department at KCH in Quarter 4 (Q4 2004. Methods We analysed prospectively collected, aggregated data of quarterly reports from Q1 2003 to Q4 2006 from HTC centre registers, ART registers and clinic registrations at the ART clinics of both Lighthouse and the paediatric department. By comparing data of both facilities before (Q1 2003 to Q3 2004, and after the introduction of the services at the paediatric department (Q4 2004 to Q4 2006, we assessed the effect of this intervention on the uptake of HIV services for children at KCH. Results Overall, 3971 children were tested for HIV, 2428 HIV-infected children were registered for care and 1218 started ART. Between the two periods, the median (IQR number of children being tested, registered and starting ART per quarter rose from 101 (53-109 to 358 (318-440, 56 (50-82 to 226 (192-234 and 18 (8-23 to 139 (115-150, respectively. The median proportion of tested clients per quarter that were children rose from 3.8% (2.7-4.3 to 9.6% (8.8 to 10.0 (p = 0.0009 and the proportion of ART starters that were children rose from 6.9% (4.9-9.3 to 21.1% (19.2-24.2 (p = 0.0036. The proportion of registered children and adults starting ART each quarter increased similarly, from 26% to 53%, and 20% to 52%, respectively. Conclusions Implementation of PITC and integration of ART services within the paediatric ward are likely to be the main reasons for improved access to

  10. Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group.

    OpenAIRE

    Carter, Sid; Cook, J.; Sutton-Boulton, G.; Ward, V.; Clarke, S.

    2015-01-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a...

  11. Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes

    OpenAIRE

    Townsend, Anne; Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

    2013-01-01

    Background eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from tr...

  12. The quality and scope of information provided by medical laboratories to patients before laboratory testing: Survey of the Working Group for Patient Preparation of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    Science.gov (United States)

    Nikolac, Nora; Simundic, Ana-Maria; Kackov, Sanja; Serdar, Tihana; Dorotic, Adrijana; Fumic, Ksenija; Gudasic-Vrdoljak, Jelena; Klenkar, Kornelija; Sambunjak, Jadranka; Vidranski, Valentina

    2015-10-23

    The aim of this work was to evaluate to what extent the scope and content of information provided to patients is standardized across medical biochemistry laboratories in Croatia. Two on-line self-report surveys were sent out: Survey A regarding attitudes on importance of patient preparation and Survey B on the contents of patient preparation instructions. 13/118 laboratories (11%) do not provide written instructions to patients on how to prepare for laboratory testing, and 36 (40%) do not include information about water intake in their instructions. Only half of laboratories provide instructions for prostate-specific antigen (53.8%), female sex hormones (53.7%) and therapeutic drug monitoring (TDM) (52.5%). Inadequate information about fasting status (55.0%) and 24 hour urine collection (77.9%) were frequent errors with high severity and were associated with the greatest potential to cause patient harm. Laboratory professionals in Croatia have a positive attitude towards the importance of patient preparation for laboratory testing. However, the information for laboratory testing is not standardized and frequently lacks guidance for tests related to TDM, coagulation and endocrinology. This study highlights the need for standardized, updated and evidence-based recommendations for patient preparation in order to minimize the risk for patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Abelian groups

    CERN Document Server

    Fuchs, László

    2015-01-01

    Written by one of the subject’s foremost experts, this book focuses on the central developments and modern methods of the advanced theory of abelian groups, while remaining accessible, as an introduction and reference, to the non-specialist. It provides a coherent source for results scattered throughout the research literature with lots of new proofs. The presentation highlights major trends that have radically changed the modern character of the subject, in particular, the use of homological methods in the structure theory of various classes of abelian groups, and the use of advanced set-theoretical methods in the study of undecidability problems. The treatment of the latter trend includes Shelah’s seminal work on the undecidability in ZFC of Whitehead’s Problem; while the treatment of the former trend includes an extensive (but non-exhaustive) study of p-groups, torsion-free groups, mixed groups, and important classes of groups arising from ring theory. To prepare the reader to tackle these topics, th...

  14. Massachusetts State Police Special Tactical Operations Team User Focus Group Report - Law Enforcement Advanced Protection (LEAP) Duty Uniforms, Integrated Head Protection, Chemical/Biological Protection and Human Systems Integration

    National Research Council Canada - National Science Library

    Creighton, II, Thomas E; Hibbard, Bradley; Doherty, Stephen; McManus, Kelly

    2008-01-01

    ...) from representatives within the law enforcement community. This focus group consisted exclusively of personnel assigned to the Massachusetts State Police Special Tactical Operations (STOP) Team...

  15. NutriLive: An Integrated Nutritional Approach as a Sustainable Tool to Prevent Malnutrition in Older People and Promote Active and Healthy Ageing—The EIP-AHA Nutrition Action Group

    OpenAIRE

    Maddalena Illario; Angela Serena Maione; Maria Rosaria Rusciano; Edwig Goossens; Amelia Rauter; Nidia Braz; Harriet Jager-Wittenaar; Carolina Di Somma; Catherine Crola; Maria Soprano; Laura Vuolo; Pietro Campiglia; Guido Iaccarino; Helen Griffiths; Tobias Hartman

    2016-01-01

    The present document describes a nutritional approach that is nested in the European Innovation Partnership for Active and Healthy Aging (EIP-AHA) and aims to provide the first common European program translating an integrated approach to nutritional frailty in terms of a multidimensional and transnational methodology. The document has been developed by the A3 Nutrition Action Area of the EIP-AHA and aims at providing a stepwise approach to malnutrition in older citizens, identifying adequate...

  16. Transmission Integration | Grid Modernization | NREL

    Science.gov (United States)

    Transmission Integration Transmission Integration The goal of NREL's transmission integration integration issues and provide data, analysis, and models to enable the electric power system to more and finding solutions to address them to enable transmission grid integration. Capabilities Power

  17. Interorganisational Integration

    DEFF Research Database (Denmark)

    Lyngsø, Anne Marie; Godtfredsen, Nina Skavlan; Frølich, Anne

    2016-01-01

    INTRODUCTION: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration...... at a university hospital in the Capital Region of Denmark. RESULTS AND DISCUSSION: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner...... and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration...

  18. PROVIDING WOMEN, KEPT MEN

    Science.gov (United States)

    Mojola, Sanyu A

    2014-01-01

    This paper draws on ethnographic and interview based fieldwork to explore accounts of intimate relationships between widowed women and poor young men that emerged in the wake of economic crisis and a devastating HIV epidemic among the Luo ethnic group in Western Kenya. I show how the cooptation of widow inheritance practices in the wake of an overwhelming number of widows as well as economic crisis resulted in widows becoming providing women and poor young men becoming kept men. I illustrate how widows in this setting, by performing a set of practices central to what it meant to be a man in this society – pursuing and providing for their partners - were effectively doing masculinity. I will also show how young men, rather than being feminized by being kept, deployed other sets of practices to prove their masculinity and live in a manner congruent with cultural ideals. I argue that ultimately, women’s practice of masculinity in large part seemed to serve patriarchal ends. It not only facilitated the fulfillment of patriarchal expectations of femininity – to being inherited – but also served, in the end, to provide a material base for young men’s deployment of legitimizing and culturally valued sets of masculine practice. PMID:25489121

  19. Working Group 7 Summary

    Energy Technology Data Exchange (ETDEWEB)

    Nagaitsev S.; Berg J.

    2012-06-10

    The primary subject of working group 7 at the 2012 Advanced Accelerator Concepts Workshop was muon accelerators for a muon collider or neutrino factory. Additionally, this working group included topics that did not fit well into other working groups. Two subjects were discussed by more than one speaker: lattices to create a perfectly integrable nonlinear lattice, and a Penning trap to create antihydrogen.

  20. Group play

    DEFF Research Database (Denmark)

    Tychsen, Anders; Hitchens, Michael; Brolund, Thea

    2008-01-01

    Role-playing games (RPGs) are a well-known game form, existing in a number of formats, including tabletop, live action, and various digital forms. Despite their popularity, empirical studies of these games are relatively rare. In particular there have been few examinations of the effects of the v......Role-playing games (RPGs) are a well-known game form, existing in a number of formats, including tabletop, live action, and various digital forms. Despite their popularity, empirical studies of these games are relatively rare. In particular there have been few examinations of the effects...... of the various formats used by RPGs on the gaming experience. This article presents the results of an empirical study, examining how multi-player tabletop RPGs are affected as they are ported to the digital medium. Issues examined include the use of disposition assessments to predict play experience, the effect...... of group dynamics, the influence of the fictional game characters and the comparative play experience between the two formats. The results indicate that group dynamics and the relationship between the players and their digital characters, are integral to the quality of the gaming experience in multiplayer...