WorldWideScience

Sample records for kaiser permanente kp

  1. A retrospective analysis of health systems in Denmark and Kaiser Permanente

    DEFF Research Database (Denmark)

    Frølich, Anne; Schiøtz, Michaela L; Strandberg-Larsen, Martin

    2008-01-01

    ABSTRACT: BACKGROUND: To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. METHODS: Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million...... citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase...... comparability. RESULTS: A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100...

  2. Achieving Kaiser Permanente quality.

    Science.gov (United States)

    McHugh, Matthew D; Aiken, Linda H; Eckenhoff, Myra E; Burns, Lawton R

    2016-01-01

    The Kaiser Permanente model of integrated health delivery is highly regarded for high-quality and efficient health care. Efforts to reproduce Kaiser's success have mostly failed. One factor that has received little attention and that could explain Kaiser's advantage is its commitment to and investment in nursing as a key component of organizational culture and patient-centered care. The aim of this study was to investigate the role of Kaiser's nursing organization in promoting quality of care. This was a cross-sectional analysis of linked secondary data from multiple sources, including a detailed survey of nurses, for 564 adult, general acute care hospitals from California, Florida, Pennsylvania, and New Jersey in 2006-2007. We used logistic regression models to examine whether patient (mortality and failure-to-rescue) and nurse (burnout, job satisfaction, and intent-to-leave) outcomes in Kaiser hospitals were better than in non-Kaiser hospitals. We then assessed whether differences in nursing explained outcomes differences between Kaiser and other hospitals. Finally, we examined whether Kaiser hospitals compared favorably with hospitals known for having excellent nurse work environments-Magnet hospitals. Patient and nurse outcomes in Kaiser hospitals were significantly better compared with non-Magnet hospitals. Kaiser hospitals had significantly better nurse work environments, staffing levels, and more nurses with bachelor's degrees. Differences in nursing explained a significant proportion of the Kaiser outcomes advantage. Kaiser hospital outcomes were comparable with Magnet hospitals, where better outcomes have been largely explained by differences in nursing. An important element in Kaiser's success is its investment in professional nursing, which may not be evident to systems seeking to achieve Kaiser's advantage. Our results suggest that a possible strategy for achieving outcomes like Kaiser may be for hospitals to consider Magnet designation, a proven and

  3. Breaching the security of the Kaiser Permanente Internet patient portal: the organizational foundations of information security.

    Science.gov (United States)

    Collmann, Jeff; Cooper, Ted

    2007-01-01

    This case study describes and analyzes a breach of the confidentiality and integrity of personally identified health information (e.g. appointment details, answers to patients' questions, medical advice) for over 800 Kaiser Permanente (KP) members through KP Online, a web-enabled health care portal. The authors obtained and analyzed multiple types of qualitative data about this incident including interviews with KP staff, incident reports, root cause analyses, and media reports. Reasons at multiple levels account for the breach, including the architecture of the information system, the motivations of individual staff members, and differences among the subcultures of individual groups within as well as technical and social relations across the Kaiser IT program. None of these reasons could be classified, strictly speaking, as "security violations." This case study, thus, suggests that, to protect sensitive patient information, health care organizations should build safe organizational contexts for complex health information systems in addition to complying with good information security practice and regulations such as the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

  4. The Kaiser Permanente Northwest Cardiovascular Risk Factor Management Program: A Model for All

    Science.gov (United States)

    Joyce, Jodi S; Fetter, Martina M; Klopfenstein, Dean H; Nash, Michael K

    2005-01-01

    Proof of the effectiveness of preventive measures that reduce established risk traits for atherothrombotic disorders has spurred attempts to systematically apply these interventions among susceptible populations. One such attempt is the Cardiovascular Risk Factor Management (CVRFM) Program, launched in 2003 to optimize clinical management and outcomes for 75,000 Kaiser Permanente Northwest Region (KPNW) members with atherosclerotic cardiovascular disease (CVD) or hypertension. The CVRFM Program is a centralized, multidisciplinary, proactive telephone-based clinical management intervention consisting of an “outreach” call, an interview, a mailed individualized care plan and information packet, regular follow-up (including protocolized medication management) and—when “goal status” is achieved—transfer of the patient to a maintenance plan. Quarterly evaluation of effectiveness entailed measurement of a range of clinical, utilization, and member satisfaction outcomes. Results by the fourth quarter were outstanding: For example, >98% of participants with coronary disease or diabetes had LDL cholesterol testing, >90% of coronary patients received aspirin or statin treatment, 99% were “extremely” or “very” satisfied with the program, and reductions were observed in the number of hospitalizations and visits to the emergency department and clinic. Mathematical models predict a decrease in myocardial infarctions and cardiovascular mortality within two years after implementing the program, the underlying principles of which should yield similar improvement in other Kaiser Permanente (KP) Regions and in other health care organizations. PMID:21660155

  5. Investing in Obesity Treatment: Kaiser Permanente's Approach to Chronic Disease Management.

    Science.gov (United States)

    Tsai, Adam G; Histon, Trina; Donahoo, W Troy; Hashmi, Shahid; Murali, Sameer; Latare, Peggy; Oliver, Lajune; Slovis, Jennifer; Grall, Sarah; Fisher, David; Solomon, Loel

    2016-09-01

    Kaiser Permanente, an integrated health care delivery system in the USA, takes a "whole systems" approach to the chronic disease of obesity that begins with efforts to prevent it by modifying the environment in communities and schools. Aggressive case-finding and substantial investment in intensive lifestyle modification programs target individuals at high risk of diabetes and other weight-related conditions. Kaiser Permanente regions are increasingly standardizing their approach when patients with obesity require treatment intensification using medically supervised diets, prescription medication to treat obesity, or weight loss surgery.

  6. Kaiser Permanente's performance improvement system, part 2: developing a value framework.

    Science.gov (United States)

    Schilling, Lisa; Deas, Dennis; Jedlinsky, Maile; Aronoff, Deborah; Fershtman, Juliette; Wali, Abdul

    2010-12-01

    In 2008, Kaiser Permanente began phased implementation of a nationwide performance improvement (PI) system. The aim was to improve performance by providing consistent, highly meaningful performance measurement, increase PI skills in staff at all levels, develop organizational capabilities, and provide support for making improvements in medical centers and across regions. Evaluating the PI System: The intermediate results of the PI system were assessed in the 22 medical centers in four of the eight Kaiser Permanente regions. Implementation for 3 of these medical centers occurred in January 2008 through November 2008, with implementation for the remaining 19 medical centers occurring from September 2008 through September 2009. The 22 medical centers that were evaluated achieved a 61% improvement in selected capabilities, and improvement advisors (IAs) successfully completed 84% of initial PI projects. For each dollar invested, estimates suggested an average return on investment of $2.36. Critical factors include adequate dedicated time for PI activities by staff with necessary expertise, expert support to operations, alignment of projects with regional and national strategic priorities, and close working relationships between PI staff and operational management. Involving finance leaders in improvement planning, prioritization, and oversight is important. These elements can be adapted to smaller systems and single hospitals. The initial evaluation of the Kaiser Permanente PI system indicated that (1) IAs successfully led projects in conjunction with frontline teams, (2) organizational capabilities increased, and (3) the investment in PI infrastructure and staff was sound. Expansion throughout the entire Kaiser Permanente system is under way.

  7. The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

    NARCIS (Netherlands)

    Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

    2010-01-01

    OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California,

  8. Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities.

    Science.gov (United States)

    Schilling, Lisa; Chase, Alide; Kehrli, Sommer; Liu, Amy Y; Stiefel, Matt; Brentari, Ruth

    2010-11-01

    By 2004, senior leaders at Kaiser Permanente, the largest not-for-profit health plan in the United States, recognizing variations across service areas in quality, safety, service, and efficiency, began developing a performance improvement (PI) system to realizing best-in-class quality performance across all 35 medical centers. MEASURING SYSTEMWIDE PERFORMANCE: In 2005, a Web-based data dashboard, "Big Q," which tracks the performance of each medical center and service area against external benchmarks and internal goals, was created. PLANNING FOR PI AND BENCHMARKING PERFORMANCE: In 2006, Kaiser Permanente national and regional continued planning the PI system, and in 2007, quality, medical group, operations, and information technology leaders benchmarked five high-performing organizations to identify capabilities required to achieve consistent best-in-class organizational performance. THE PI SYSTEM: The PI system addresses the six capabilities: leadership priority setting, a systems approach to improvement, measurement capability, a learning organization, improvement capacity, and a culture of improvement. PI "deep experts" (mentors) consult with national, regional, and local leaders, and more than 500 improvement advisors are trained to manage portfolios of 90-120 day improvement initiatives at medical centers. Between the second quarter of 2008 and the first quarter of 2009, performance across all Kaiser Permanente medical centers improved on the Big Q metrics. The lessons learned in implementing and sustaining PI as it becomes fully integrated into all levels of Kaiser Permanente can be generalized to other health care systems, hospitals, and other health care organizations.

  9. Kaiser Permanente's performance improvement system, Part 4: Creating a learning organization.

    Science.gov (United States)

    Schilling, Lisa; Dearing, James W; Staley, Paul; Harvey, Patti; Fahey, Linda; Kuruppu, Francesca

    2011-12-01

    In 2006, recognizing variations in performance in quality, safety, service, and efficiency, Kaiser Permanente leaders initiated the development of a performance improvement (PI) system. Kaiser Permanente has implemented a strategy for creating the systemic capacity for continuous improvement that characterizes a learning organization. Six "building blocks" were identified to enable Kaiser Permanente to make the transition to becoming a learning organization: real-time sharing of meaningful performance data; formal training in problem-solving methodology; workforce engagement and informal knowledge sharing; leadership structures, beliefs, and behaviors; internal and external benchmarking; and technical knowledge sharing. Putting each building block into place required multiple complex strategies combining top-down and bottom-up approaches. Although the strategies have largely been successful, challenges remain. The demand for real-time meaningful performance data can conflict with prioritized changes to health information systems. It is an ongoing challenge to teach PI, change management, innovation, and project management to all managers and staff without consuming too much training time. Challenges with workforce engagement include low initial use of tools intended to disseminate information through virtual social networking. Uptake of knowledge-sharing technologies is still primarily by innovators and early adopters. Leaders adopt new behaviors at varying speeds and have a range of abilities to foster an environment that is psychologically safe and stimulates inquiry. A learning organization has the capability to improve, and it develops structures and processes that facilitate the acquisition and sharing of knowledge.

  10. Kaiser Permanente/Sandia National health care model. Phase I prototype final report. Part 1 - model overview

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, D.; Yoshimura, A.; Butler, D.; Judson, R. [and others

    1996-11-01

    This report describes the results of a Cooperative Research and Development Agreement between Sandia National Laboratories and Kaiser Permanente Southern California to develop a prototype computer model of Kaiser Permanente`s health care delivery system. As a discrete event simulation, SimHCO models for each of 100,000 patients the progression of disease, individual resource usage, and patient choices in a competitive environment. SimHCO is implemented in the object-oriented programming language C++, stressing reusable knowledge and reusable software components. The versioned implementation of SimHCO showed that the object-oriented framework allows the program to grow in complexity in an incremental way. Furthermore, timing calculations showed that SimHCO runs in a reasonable time on typical workstations, and that a second phase model will scale proportionally and run within the system constraints of contemporary computer technology. This report is published as two documents: Model Overview and Domain Analysis. A separate Kaiser-proprietary report contains the Disease and Health Care Organization Selection Models.

  11. Kaiser Permanente-Sandia National Health Care Model: Phase 1 prototype final report. Part 2 -- Domain analysis

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, D.; Yoshimura, A.; Butler, D.; Judson, R.; Mason, W.; Napolitano, L.; Mariano, R. [Sandia National Labs., Livermore, CA (United States); Eddy, D.; Schlessinger, L. [Kaiser Permanente, Pasadena, CA (United States)

    1996-11-01

    This report describes the results of a Cooperative Research and Development Agreement between Sandia National Laboratories and Kaiser Permanente Southern California to develop a prototype computer model of Kaiser Permanente`s health care delivery system. As a discrete event simulation, SimHCO models for each of 100,000 patients the progression of disease, individual resource usage, and patient choices in a competitive environment. SimHCO is implemented in the object-oriented programming language C{sup 2}, stressing reusable knowledge and reusable software components. The versioned implementation of SimHCO showed that the object-oriented framework allows the program to grow in complexity in an incremental way. Furthermore, timing calculations showed that SimHCO runs in a reasonable time on typical workstations, and that a second phase model will scale proportionally and run within the system constraints of contemporary computer technology.

  12. The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

    Science.gov (United States)

    Lester, Helen; Schmittdiel, Julie; Selby, Joe; Fireman, Bruce; Campbell, Stephen; Lee, Janelle; Whippy, Alan; Madvig, Philip

    2010-05-11

    To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. Longitudinal analysis. 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. 2 523 659 adult members of Kaiser Permanente Northern California. Main outcomes measures Yearly assessment of patient level glycaemic control (HbA(1c) financial incentives were attached to screening for diabetic retinopathy (1999-2003), the rate rose from 84.9% to 88.1%. This was followed by four years without incentives when the rate fell year on year to 80.5%. During the two initial years when financial incentives were attached to cervical cancer screening (1999-2000), the screening rate rose slightly, from 77.4% to 78.0%. During the next five years when financial incentives were removed, screening rates fell year on year to 74.3%. Incentives were then reattached for two years (2006-7) and screening rates began to increase. Across the 35 facilities, the removal of incentives was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening. Policy makers and clinicians should be aware that removing facility directed financial incentives from clinical indicators may mean that performance levels decline.

  13. Making the business case for hospital information systems--a Kaiser Permanente investment decision.

    Science.gov (United States)

    Garrido, Terhilda; Raymond, Brian; Jamieson, Laura; Liang, Louise; Wiesenthal, Andrew

    2004-01-01

    Further evidence in favor of the clinical IT business case is set forth in Kaiser Permanente's cost/benefit analysis for an electronic hospital information system. This article reviews the business case for an inpatient electronic medical record system, including 36 categories of quantifiable benefits that contribute to a positive cumulative net cash flow within an 8.5 year period. However, the business case hinges on several contingent success factors: leadership commitment, timely implementation, partnership with labor, coding compliance, and workflow redesign. The issues and constraints that impact the potential transferability of this business case across delivery systems raise questions that merit further attention.

  14. A Community-Level Initiative to Prevent Obesity: Results From Kaiser Permanente's Healthy Eating Active Living Zones Initiative in California.

    Science.gov (United States)

    Cheadle, Allen; Atiedu, Akpene; Rauzon, Suzanne; Schwartz, Pamela M; Keene, Laura; Davoudi, Mehrnaz; Spring, Rebecca; Molina, Michelle; Lee, Lynda; Boyle, Kathryn; Williamson, Dana; Steimberg, Clara; Tinajero, Roberta; Ravel, Jodi; Nudelman, Jean; Azuma, Andrea Misako; Kuo, Elena S; Solomon, Loel

    2018-05-01

    A growing number of health systems are leading health promotion efforts in their wider communities. What impact are these efforts having on health behaviors and ultimately health status? This paper presents evaluation results from the place-based Kaiser Permanente Healthy Eating Active Living Zones obesity prevention initiative, implemented in 2011-2015 in 12 low-income communities in Kaiser Permanente's Northern and Southern California Regions. The Healthy Eating Active Living Zones design targeted places and people through policy, environmental, and programmatic strategies. Each Healthy Eating Active Living Zone is a small, low-income community of 10,000 to 20,000 residents with high obesity rates and other health disparities. Community coalitions planned and implemented strategies in each community. A population-dose approach and pre and post surveys were used to assess impact of policy, program, and environmental change strategies; the analysis was conducted in 2016. Population dose is the product of reach (number of people affected by a strategy divided by target population size) and strength (the effect size or relative change in behavior for each person exposed to the strategy). More than 230 community change strategies were implemented over 3 years, encompassing policy, environmental, and programmatic changes as well as efforts to build community capacity to sustain strategies and make changes in the future. Positive population-level results were seen for higher-dose strategies, particularly those targeting youth physical activity. Higher-dose strategies were more likely to be found in communities with the longest duration of investment. These results demonstrate that strong (high-dose), community-based obesity prevention strategies can lead to improved health behaviors, particularly among youth in school settings. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is

  15. Which is the real Kaiser?

    Science.gov (United States)

    Kertesz, L

    1997-08-25

    Fans of Kaiser Permanente, the nation's oldest and largest HMO, consider the company a cost-effective healthcare delivery system that supports its patients, caregivers and the practice of high-quality medicine. Its detractors see Kaiser as an evil HMO empire that hoards money, mistreats doctors and skimps on care. The dichotomy shows that Kaiser is like a giant mirror, reflecting the struggles and uncertainties of the evolving U.S. healthcare system.

  16. Kaiser Permanente Creatinine Safety Program: A Mechanism to Ensure Widespread Detection and Care for Chronic Kidney Disease.

    Science.gov (United States)

    Sim, John J; Rutkowski, Mark P; Selevan, David C; Batech, Michael; Timmins, Royann; Slezak, Jeff M; Jacobsen, Steven J; Kanter, Michael H

    2015-11-01

    Chronic kidney disease is highly prevalent but is challenging to diagnose because of the need to establish chronicity. Within the current healthcare environment, a single abnormal creatinine measurement often can go without a follow-up, which can lead to missed diagnoses or diagnostic errors. The Kaiser Permanente Southern California creatinine safety program (the Creatinine SureNet) was created to help ensure that all single abnormal creatinine results had a follow-up evaluation. In the period February 1, 2010, to March 1, 2014, the electronic health records were used to capture individuals with single abnormal creatinine results that went >90 days without a repeat measurement. A coordinated effort among a centralized regional nurse and providers was used to communicate with patients and order a repeat creatinine measurement. A total of 12,396 individuals were identified (84% ambulatory care encounters). A total of 6981 individuals (52%) followed up with a repeat measurement. Female patients, non-Hispanic whites, and older individuals were more likely to obtain a repeat measurement. Subsequently, 3668 individuals had chronic kidney disease confirmed. Within 6 months, 1550 patients had chart documentation of their chronic kidney disease and 336 patients had a nephrology consultation. The ambulatory care environment, given its high volume and various prioritizations, is an under-recognized area where diagnostic errors are not uncommon and failure to follow up on abnormal test results can occur routinely. The Kaiser Permanente Southern California Creatinine SureNet program leverages the electronic health records and its multidisciplinary resources in an effort to ensure that patients with potential chronic kidney disease are identified and managed properly. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Internet infrastructures and health care systems: a qualitative comparative analysis on networks and markets in the British National Health Service and Kaiser Permanente.

    Science.gov (United States)

    Séror, Ann C

    2002-12-01

    The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. to identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.

  18. Kaiser captures spirit of games.

    Science.gov (United States)

    Herreria, J

    1998-01-01

    With a multi-media campaign, Kaiser Permanente blitzed its market area by becoming a sponsor of the Nike World Masters Games. The advertising campaign promoted Kaiser as the exclusive health care sponsor. Company officials are counting on this campaign to leverage the health care institution's commitment to the community. In addition to the advertising, Kaiser searched for local athletes to represent its "play the sports for life" theme. As part of a promotion to award 200 athlete sponsorships to the Games, Kaiser's own master athletes were invited to tell their stories. Some of the members shared stories about such topics as experiencing an accident, receiving assistance from a Kaiser physician and incorporating a lifestyle of sport for rehabilitation. From the hundreds of letters received, two members and one employee were selected for the television spots. The sporting event reinforces Kaiser's philosophy of fitness-oriented lifestyles among its members. The Nike World Masters Games are the largest participatory multi-sport competition in the world, gathering together more than 25,000 men and women from more than 100 countries.

  19. Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system.

    Science.gov (United States)

    Strandberg-Larsen, Martin; Schiøtz, Michaela L; Silver, Jeremy D; Frølich, Anne; Andersen, John S; Graetz, Ilana; Reed, Mary; Bellows, Jim; Krasnik, Allan; Rundall, Thomas; Hsu, John

    2010-04-08

    Integration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in practice. Our objective was to compare primary care clinicians' perceptions of clinical integration and three sub-aspects in two healthcare systems: Kaiser Permanente, Northern California (KPNC) and the Danish healthcare system (DHS). Further, we examined the associations between specific organizational factors and clinical integration within each system. Comparable questionnaires were sent to a random sample of primary care clinicians in KPNC (n = 1103) and general practitioners in DHS (n = 700). Data were analysed using multiple logistic regression models. More clinicians in KPNC perceived to be part of a clinical integrated environment than did general practitioners in the DHS (OR = 3.06, 95% CI: 2.28, 4.12). Further, more KPNC clinicians reported timeliness of information transfer (OR = 2.25, 95% CI: 1.62, 3.13), agreement on roles and responsibilities (OR = 1.79, 95% CI: 1.30, 2.47) and established coordination mechanisms in place to ensure effective handoffs (OR = 6.80, 95% CI: 4.60, 10.06). None of the considered organizational factors in the sub-country analysis explained a substantial proportion of the variation in clinical integration. More primary care clinicians in KPNC reported clinical integration than did general practitioners in the DHS. Focused measures of clinical integration are needed to develop the field of clinical integration and to create the scientific foundation to guide managers searching for evidence based approaches.

  20. Questioning the claims from Kaiser.

    Science.gov (United States)

    Talbot-Smith, Alison; Gnani, Shamini; Pollock, Allyson M; Gray, Denis Pereira

    2004-06-01

    The article by Feachem et al, published in the BMJ in 2002, claimed to show that, compared with the United Kingdom (UK) National Health Service (NHS), the Kaiser Permanente healthcare system in the United States (US) has similar healthcare costs per capita, and performance that is considerably better in certain respects. To assess the accuracy of Feachem et al's comparison and conclusions. Detailed re-examination of the data and methods used and consideration of the 82 letters responding to the article. Analyses revealed four main areas in which Feachem et al's methodology was flawed. Firstly, the populations of patients served by Kaiser Permanente and by the NHS are fundamentally different. Kaiser's patients are mainly employed, significantly younger, and significantly less socially deprived and so are healthier. Feachem et al fail to adjust adequately for these factors. Secondly, Feachem et al have wrongly inflated NHS costs by omitting substantial user charges payable by Kaiser members for care, excluding the costs of marketing and administration, and deducting the surplus from Kaiser's costs while underestimating the capital charge element of the NHS budget and other costs. They also used two methods of converting currency, the currency rate and a health purchasing power parity conversion. This is double counting. Feachem et al reported that NHS costs were 10% less per head than Kaiser. Correcting for the double currency conversion gives the NHS a 40% cost advantage such that per capita costs are 1161 dollars and 1951 dollars for the NHS and Kaiser, respectively. Thirdly, Feachem et al use non-standardised data for NHS bed days from the Organisation for Economic Cooperation and Development, rather than official Department of Health bed availability and activity statistics for England. Leaving aside the non-comparability of the population and lack of standardisation of the data, the result is to inflate NHS acute bed use and underestimate the efficiency of

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

    Science.gov (United States)

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

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

  2. The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: a qualitative study of Kaiser Permanente.

    Science.gov (United States)

    Otte-Trojel, Terese; Rundall, Thomas G; de Bont, Antoinette; van de Klundert, Joris; Reed, Mary E

    2015-12-16

    Patient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However, despite growing research on patient portals and their effects, our understanding of the organizational dynamics that explain how effects come about is limited. This paper uses qualitative methods to advance our understanding of the organizational dynamics that influence the impact of a patient portal on organizational performance and patient health. The study setting is Kaiser Permanente, the world's largest not-for-profit integrated delivery system, which has been using a portal for over ten years. We interviewed eighteen physician leaders and executives particularly knowledgeable about the portal to learn about how they believe the patient portal works and what organizational factors affect its workings. Our analytical framework centered on two research questions. (1) How does the patient portal impact care delivery to produce the documented effects?; and (2) What are the important organizational factors that influence the patient portal's development? We identify five ways in which the patient portal may impact care delivery to produce reported effects. First, the portal's ability to ease access to services improves some patients' satisfaction as well as changes the way patients seek care. Second, the transparency and activation of information enable some patients to better manage their care. Third, care management may also be improved through augmented patient-physician interaction. This augmented interaction may also increase the 'stickiness' of some patients to their providers. Forth, a similar effect may be triggered by a closer connection between Kaiser Permanente and patients, which may reduce the likelihood that patients will switch health plans. Finally, the portal may induce efficiencies in physician workflow and administrative tasks, stimulating certain operational savings and deeper involvement of

  3. Incidence of Norovirus and Other Viral Pathogens That Cause Acute Gastroenteritis (AGE) among Kaiser Permanente Member Populations in the United States, 2012-2013.

    Science.gov (United States)

    Grytdal, Scott P; DeBess, Emilio; Lee, Lore E; Blythe, David; Ryan, Patricia; Biggs, Christianne; Cameron, Miriam; Schmidt, Mark; Parashar, Umesh D; Hall, Aron J

    2016-01-01

    Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE). However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP) health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations. Over a one-year study period, participating laboratories randomly selected stools submitted for routine clinical diagnostics for inclusion in the study along with accompanying demographic and clinical data. Selected stools were tested for norovirus, rotavirus, sapovirus, and astrovirus using standardized real-time RT-PCR protocols. Each KP site provided administrative data which were used in conjunction with previously published data on healthcare utilization to extrapolate pathogen detection rates into population-based incidence rates. A total of 1,099 specimens collected during August 2012 to September 2013 were included. Mean age of patients providing stool specimens was 46 years (range: 0-98 years). Noroviruses were the most common viral pathogen identified among patients with AGE (n = 63 specimens, 6% of specimens tested). In addition, 22 (2%) of specimens were positive for rotavirus; 19 (2%) were positive for sapovirus; and 7 (1%) were positive for astrovirus. Incidence of norovirus-associated outpatient visits was 5.6 per 1,000 person-years; incidence of norovirus disease in the community was estimated to be 69.5 per 1,000 person-years. Norovirus incidence was highest among children age (outpatient incidence = 25.6 per 1,000 person-years; community incidence = 152.2 per 1,000 person-years), followed by older adults aged >65 years (outpatient incidence = 7.8 per 1,000 person-years; community incidence = 75.8 per 1,000 person

  4. Incidence of Norovirus and Other Viral Pathogens That Cause Acute Gastroenteritis (AGE among Kaiser Permanente Member Populations in the United States, 2012-2013.

    Directory of Open Access Journals (Sweden)

    Scott P Grytdal

    Full Text Available Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE. However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations. Over a one-year study period, participating laboratories randomly selected stools submitted for routine clinical diagnostics for inclusion in the study along with accompanying demographic and clinical data. Selected stools were tested for norovirus, rotavirus, sapovirus, and astrovirus using standardized real-time RT-PCR protocols. Each KP site provided administrative data which were used in conjunction with previously published data on healthcare utilization to extrapolate pathogen detection rates into population-based incidence rates. A total of 1,099 specimens collected during August 2012 to September 2013 were included. Mean age of patients providing stool specimens was 46 years (range: 0-98 years. Noroviruses were the most common viral pathogen identified among patients with AGE (n = 63 specimens, 6% of specimens tested. In addition, 22 (2% of specimens were positive for rotavirus; 19 (2% were positive for sapovirus; and 7 (1% were positive for astrovirus. Incidence of norovirus-associated outpatient visits was 5.6 per 1,000 person-years; incidence of norovirus disease in the community was estimated to be 69.5 per 1,000 person-years. Norovirus incidence was highest among children 65 years (outpatient incidence = 7.8 per 1,000 person-years; community incidence = 75.8 per 1,000 person-years. Outpatient incidence rates of rotavirus, sapovirus, and astrovirus were 2.0, 1.6, 0.6 per 1,000 person

  5. TPMG Northern California appointments and advice call center.

    Science.gov (United States)

    Conolly, Patricia; Levine, Leslie; Amaral, Debra J; Fireman, Bruce H; Driscoll, Tom

    2005-08-01

    Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of healthcare services to KP members efficiently and cost effectively. Since 1995, when The Permanente Medical Group (TPMG) began to consolidate primary care phone services into three physical call centers, the TPMG Appointments and Advice Call Center (AACC) has become the "front office" for primary care services across approximately 89% of Northern California. The AACC provides primary care phone service for approximately 3 million Kaiser Foundation Health Plan members in Northern California and responds to approximately 1 million calls per month across the three AACC sites. A database records each caller's identity as well as the day, time, and duration of each call; reason for calling; services provided to callers as a result of calls; and clinical outcomes of calls. We here summarize this information for the period 2000 through 2003.

  6. Incidence of Norovirus and Other Viral Pathogens That Cause Acute Gastroenteritis (AGE) among Kaiser Permanente Member Populations in the United States, 2012–2013

    Science.gov (United States)

    Grytdal, Scott P.; Biggs, Christianne; Cameron, Miriam; Schmidt, Mark; Parashar, Umesh D.; Hall, Aron J.

    2016-01-01

    Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE). However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP) health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations. Over a one-year study period, participating laboratories randomly selected stools submitted for routine clinical diagnostics for inclusion in the study along with accompanying demographic and clinical data. Selected stools were tested for norovirus, rotavirus, sapovirus, and astrovirus using standardized real-time RT-PCR protocols. Each KP site provided administrative data which were used in conjunction with previously published data on healthcare utilization to extrapolate pathogen detection rates into population-based incidence rates. A total of 1,099 specimens collected during August 2012 to September 2013 were included. Mean age of patients providing stool specimens was 46 years (range: 0–98 years). Noroviruses were the most common viral pathogen identified among patients with AGE (n = 63 specimens, 6% of specimens tested). In addition, 22 (2%) of specimens were positive for rotavirus; 19 (2%) were positive for sapovirus; and 7 (1%) were positive for astrovirus. Incidence of norovirus-associated outpatient visits was 5.6 per 1,000 person-years; incidence of norovirus disease in the community was estimated to be 69.5 per 1,000 person-years. Norovirus incidence was highest among children incidence = 25.6 per 1,000 person-years; community incidence = 152.2 per 1,000 person-years), followed by older adults aged >65 years (outpatient incidence = 7.8 per 1,000 person-years; community incidence = 75.8 per 1,000 person

  7. Association between personal health record enrollment and patient loyalty.

    Science.gov (United States)

    Turley, Marianne; Garrido, Terhilda; Lowenthal, Alex; Zhou, Yi Yvonne

    2012-07-01

    To examine the association between patient loyalty, as measured by member retention in the health plan, and access to My Health Manager (MHM), Kaiser Permanente's PHR, which is linked to its electronic health record, KP HealthConnect. We conducted a retrospective cohort observational quality improvement project from the third quarter of 2005 to the fourth quarter of 2008 for approximately 394,000 Kaiser Permanente Northwest members. To control for self-selection bias, we used propensity scores to perform exact 1-to-1 matching without replacement between MHM users and nonusers. We estimated retention rates of the matched data and assessed the association between MHM use and retention versus voluntary termination. We also estimated odds ratios of significant variables impacting member retention. The probability of remaining a member or being involuntarily terminated versus voluntary termination was 96.7% for users (95% confidence interval [CI], 96.6%-96.7%) and 92.2% for nonusers (95% CI, 92.1%-92.4%; P loyalty, retention is critical to healthcare organizations.

  8. Personal health record use and association with immunizations and well-child care visits recommendations.

    Science.gov (United States)

    Tom, Jeffrey O; Chen, Chuhe; Zhou, Yi Yvonne

    2014-01-01

    To determine the association of parental use of integrated personal health records (PHRs) with children's adherence to immunization and well-child care (WCC) visit recommendations. For the immunization and WCC visit measures, we retrospectively analyzed, respectively, 766 and 639 matched pairs at Kaiser Permanente (KP) Hawaii and 2795 and 2448 pairs at KP Northwest who were ≤ 31 days old at enrollment and continuously enrolled for 2 years between January 2007 and July 2011. The independent variable (≥ 1 PHR feature used vs none) was matched using propensity scores on parental and children characteristics. The dependent variables were 2 measures from the 2010 Healthcare Effectiveness Data and Information Set: combination 2 immunization (all immunizations vs immunizations only at KP Northwest (KP Hawaii: OR 1.1, 95% CI 0.8-1.4, P > .05; KP Northwest OR 1.2, 95% CI 1.0-1.3, P immunizations in only 1 region. Copyright © 2014 Mosby, Inc. All rights reserved.

  9. End-Stage Renal Disease Outcomes among the Kaiser Permanente Southern California Creatinine Safety Program (Creatinine SureNet): Opportunities to Reflect and Improve.

    Science.gov (United States)

    Sim, John J; Batech, Michael; Danforth, Kim N; Rutkowski, Mark P; Jacobsen, Steven J; Kanter, Michael H

    2017-01-01

    The Kaiser Permanente Southern California (KPSC) creatinine safety program (Creatinine SureNet) identifies and outreaches to thousands of people annually who may have had a missed diagnosis for chronic kidney disease (CKD). We sought to determine the value of this outpatient program and evaluate opportunities for improvement. Longitudinal cohort study (February 2010 through December 2015) of KPSC members captured into the creatinine safety program who were characterized using demographics, laboratory results, and different estimations of glomerular filtration rate. Age- and sex-adjusted rates of end-stage renal disease (ESRD) were compared with those in the overall KPSC population. Among 12,394 individuals, 83 (0.7%) reached ESRD. The age- and sex-adjusted relative risk of ESRD was 2.7 times higher compared with the KPSC general population during the same period (94.7 vs 35.4 per 100,000 person-years; p creatinine measurements, only 13% had a urine study performed (32% among patients with confirmed CKD). Our study found a higher incidence of ESRD among individuals captured into the KPSC creatinine safety program. If the Chronic Kidney Disease Epidemiology Collaboration equation were used, fewer people would have been captured while improving the accuracy for diagnosing CKD. Urine testing was low even among patients with confirmed CKD. Our findings demonstrate the importance of a creatinine safety net program in an integrated health system but also suggest opportunities to improve CKD care and screening.

  10. 75 FR 70689 - Kaiser Aluminum Fabricated Products, LLC; Kaiser Aluminum-Greenwood Forge Division; Currently...

    Science.gov (United States)

    2010-11-18

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-70,376] Kaiser Aluminum Fabricated Products, LLC; Kaiser Aluminum- Greenwood Forge Division; Currently Known As Contech Forgings, LLC..., applicable to workers of Kaiser Aluminum Fabricated Products, LLC, Kaiser Aluminum-Greenwood Forge Division...

  11. q-Deformed KP Hierarchy and q-Deformed Constrained KP Hierarchy

    OpenAIRE

    He, Jingsong; Li, Yinghua; Cheng, Yi

    2006-01-01

    Using the determinant representation of gauge transformation operator, we have shown that the general form of $au$ function of the $q$-KP hierarchy is a $q$-deformed generalized Wronskian, which includes the $q$-deformed Wronskian as a special case. On the basis of these, we study the $q$-deformed constrained KP ($q$-cKP) hierarchy, i.e. $l$-constraints of $q$-KP hierarchy. Similar to the ordinary constrained KP (cKP) hierarchy, a large class of solutions of $q$-cKP hierarchy can be represent...

  12. Genetic Ancestry Is not Associated with Breast Cancer Recurrence or Survival in U.S. Latina Women Enrolled in the Kaiser Permanente Pathways Study.

    Science.gov (United States)

    Engmann, Natalie J; Ergas, Isaac J; Yao, Song; Kwan, Marilyn L; Roh, Janise M; Ambrosone, Christine B; Kushi, Lawrence H; Fejerman, Laura

    2017-09-01

    Background: The U.S. Hispanic/Latino population is heterogeneous both socioculturally and by the proportion of European, Indigenous American, and African ancestry of the regions from which individuals originate. A previous study reported that genetic ancestry was associated with breast cancer survival among Latinas, independent of sociodemographic and tumor characteristics, suggesting that a genetic factor associated with ancestry may affect breast cancer survival. Methods: We evaluated the association of genetic ancestry with breast cancer outcomes among 506 Latina women with invasive breast cancer in the Pathways Study, a cohort study within Kaiser Permanente, an integrated health care delivery system. Proportional hazards models were used to assess the effect of ancestry on breast cancer recurrence (53 events), breast cancer-specific mortality (31 events) and all-cause mortality (54 events), with a mean follow-up time of 6 years. Results: Indigenous American ancestry was not associated with breast cancer recurrence [HR = 1.00 per 10% increase; 95% confidence interval (CI), 0.86-1.16], breast cancer mortality (HR = 0.95; 95% CI, 0.77-1.17), or all-cause mortality (HR = 0.93; 95% CI, 0.80-1.08). Adjustment for sociodemographic variables, tumor characteristics, and treatment did not alter the associations. Conclusions: Our results suggest that previously reported differences in breast cancer survival by genetic ancestry may be overcome by improving health care access and/or quality. Impact: Improving health care access and quality may reduce breast cancer disparities among U.S. Latinas. Cancer Epidemiol Biomarkers Prev; 26(9); 1466-9. ©2017 AACR . ©2017 American Association for Cancer Research.

  13. Identifying organisational principles and management practices important to the quality of health care services for chronic conditions

    DEFF Research Database (Denmark)

    Frølich, Anne

    2012-01-01

    are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system...... in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear...... which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved....

  14. Recursion Operators for Dispersionless KP Hierarchy

    International Nuclear Information System (INIS)

    Cheng Qiusheng; He Jingsong

    2012-01-01

    Based on the corresponding theorem between dispersionless KP (dKP) hierarchy and ħ-dependent KPKP) hierarchy, a general formal representation of the recursion operators for dKP hierarchy under n-reduction is given in a systematical way from the corresponding ħKP hierarchy. To illustrate this method, the recursion operators for dKP hierarchy under 2-reduction and 3-reduction are calculated in detail.

  15. Innovative partnerships to advance public health training in community-based academic residency programs

    Directory of Open Access Journals (Sweden)

    Lo JC

    2017-10-01

    Full Text Available Joan C Lo,1–3 Thomas E Baudendistel,2,3 Abhay Dandekar,3,4 Phuoc V Le,5 Stanton Siu,2,3 Bruce Blumberg6 1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; 2Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 3Graduate Medical Education, Kaiser Permanente East Bay, Oakland, CA, USA; 4Department of Pediatrics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 5School of Public Health, University of California Berkeley, Berkeley, CA, USA; 6Graduate Medical Education, Kaiser Permanente Northern California, Oakland, CA, USA Abstract: Collaborative partnerships between community-based academic residency ­training programs and schools of public health, represent an innovative approach to training future physician leaders in population management and public health. In Kaiser Permanente Northern California, development of residency-Masters in Public Health (MPH tracks in the Internal Medicine Residency and the Pediatrics Residency programs, with MPH graduate studies completed at the University of California Berkeley School of Public Health, enables physicians to integrate clinical training with formal education in epidemiology, biostatistics, health policy, and disease prevention. These residency-MPH programs draw on more than 50 years of clinical education, public health training, and health services research – creating an environment that sparks inquiry and added value by developing skills in patient-centered care through the lens of population-based outcomes. Keywords: graduate medical education, public health, master’s degree, internal medicine, pediatrics, residency training

  16. Gauge equivalence between two-boson KP hierarchies

    International Nuclear Information System (INIS)

    Aratyn, H.

    1994-01-01

    In this paper it is explained the status of the two-boson KP hierarchy, which appears in this setting as an invariant subspace of the coadjoint orbit within the KP l=1 hierarchy. We will work with two main cases of two-boson KP hierarchies, one defined within KP l=1 hierarchy will be called Faa di Bruno KP hierarchy, while the second defined within KP hierarchy for a quadratic two-boson KP hierarchy. It will be established for them the gauge invariance playing the role of generalized Miura transformations. It is emphasized the symplectic character of equivalence of KP l=1 and KP. It is also made a point that the gauge equivalence established for two-boson systems is valid for an arbitrary n-th Poisson bracket structure and not only the first Poisson bracket structure. (author). 7 refs

  17. Explorations of the extended ncKP hierarchy

    International Nuclear Information System (INIS)

    Dimakis, Aristophanes; Mueller-Hoissen, Folkert

    2004-01-01

    A recently obtained extension (xncKP) of the Moyal-deformed KP hierarchy (ncKP hierarchy) by a set of evolution equations in the Moyal-deformation parameters is further explored. Formulae are derived to compute these equations efficiently. Reductions of the xncKP hierarchy are treated, in particular to the extended ncKdV and ncBoussinesq hierarchies. Furthermore, a good part of the Sato formalism for the KP hierarchy is carried over to the generalized framework. In particular, the well-known bilinear identity theorem for the KP hierarchy, expressed in terms of the (formal) Baker-Akhiezer function, extends to the xncKP hierarchy. Moreover, it is demonstrated that N-soliton solutions of the ncKP equation are also solutions of the first few deformation equations. This is shown to be related to the existence of certain families of algebraic identities

  18. Measuring integrated care

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Martin

    2011-01-01

    respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser...... differences were found in the perception of clinical integration in the two settings. More primary care clinicians in the Northern California region of Kaiser Permanente reported being part of a clinical integrated environment than did Danish general practitioners. By measuring the level of clinical...... and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine...

  19. A note on the KP hierarchy

    International Nuclear Information System (INIS)

    Depireux, D.A.

    1992-01-01

    In this paper, given the two boson representation of the conformal algebra W ∞ , the second Hamiltonian structure of the KP hierarchy, the author constructs a bi-Hamiltonian hierarchy for the two associated currents. The KP hierarchy appears as a composite of this new and simpler system. The bi-Hamiltonian structure of the new hierarchy gives naturally all the Hamiltonian structures of the KP system

  20. An extended integrable fractional-order KP soliton hierarchy

    International Nuclear Information System (INIS)

    Li Li

    2011-01-01

    In this Letter, we consider the modified derivatives and integrals of fractional-order pseudo-differential operators. A sequence of Lax KP equations hierarchy and extended fractional KP (fKP) hierarchy are introduced, and the fKP hierarchy has Lax presentations with the extended Lax operators. In the case of the extension with the half-order pseudo-differential operators, a new integrable fKP hierarchy is obtained. A few particular examples of fractional order will be listed, together with their Lax pairs.

  1. An extended integrable fractional-order KP soliton hierarchy

    Energy Technology Data Exchange (ETDEWEB)

    Li Li, E-mail: li07099@163.co [College of Maths and Systematic Science, Shenyang Normal University, Shenyang 110034 (China)

    2011-01-17

    In this Letter, we consider the modified derivatives and integrals of fractional-order pseudo-differential operators. A sequence of Lax KP equations hierarchy and extended fractional KP (fKP) hierarchy are introduced, and the fKP hierarchy has Lax presentations with the extended Lax operators. In the case of the extension with the half-order pseudo-differential operators, a new integrable fKP hierarchy is obtained. A few particular examples of fractional order will be listed, together with their Lax pairs.

  2. The permanental process

    DEFF Research Database (Denmark)

    McCullagh, Peter; Møller, Jesper

    2006-01-01

    We extend the boson process first to a large class of Cox processes and second to an even larger class of infinitely divisible point processes. Density and moment results are studied in detail. These results are obtained in closed form as weighted permanents, so the extension i called a permanental...... process. Temporal extensions and a particularly tractable case of the permanental process are also studied. Extensions of the fermion process along similar lines, leading to so-called determinantal processes, are discussed....

  3. BKP and CKP revisited: the odd KP system

    International Nuclear Information System (INIS)

    Dimakis, Aristophanes; Müller-Hoissen, Folkert

    2009-01-01

    By restricting a linear system for the KP hierarchy to those independent variables t n with odd n, its compatibility (Zakharov-Shabat conditions) leads to the 'odd KP hierarchy'. The latter consists of pairs of equations for two dependent variables, taking values in an (typically noncommutative) associative algebra. If the algebra is commutative, the odd KP hierarchy is known to admit reductions to the BKP and the CKP hierarchy. We approach the odd KP hierarchy and its relation to BKP and CKP in different ways, and address the question of whether noncommutative versions of the BKP and the CKP equation (and some of their reductions) exist. In particular, we derive a functional representation of a linear system for the odd KP hierarchy, which in the commutative case produces functional representations of the BKP and CKP hierarchies in terms of a tau function. Furthermore, we consider a functional representation of the KP hierarchy that involves a second (auxiliary) dependent variable and features the odd KP hierarchy directly as a subhierarchy. A method to generate large classes of exact solutions to the KP hierarchy from solutions to a linear matrix ODE system, via a hierarchy of matrix Riccati equations, then also applies to the odd KP hierarchy, and this in turn can be exploited, in particular, to obtain solutions to the BKP and CKP hierarchies

  4. Frederik Kaiser (1808-1872) and the Modernisation of Dutch Astronomy

    Science.gov (United States)

    van der Heijden, Petra

    Frederik Kaiser was the director of Leiden Observatory from 1837 until his death in 1872. Educated by his German-born uncle Johan Frederik Keyser (1766-1823), who was a proficient amateur astronomer, Kaiser proved to be a real observational talent. Despite the poor conditions in which he worked, his observations soon rivalled with the best in the world. Kaiser's contributions to astronomical practice include the foundation of a new, completely up-to-date observatory building in Leiden, and the introduction of statistics and precision measurements in daily practice at the observatory. Moreover he was the author of several bestselling books on popular astronomy. Kaiser had an extensive correspondence with colleagues all over Europe, mostly in Germany. Correpondents include Airy, Argelander, Von Auwers, Bessel, Encke, John Herschel, LeVerrier, Von Littrow, Schumacher, Otto W. Struve, as well as several geodesists and instrument makers. Preliminary research indicates that Frederik Kaiser played a crucial role in the revival of Dutch astronomy in the second half of the 19th century. This project aims at analysing and explaining Kaiser's activities in science, institutionalisation and popularisation, in the context of national and international developments in 19th-century astronomy and scientific culture.

  5. Affine Lie algebraic origin of constrained KP hierarchies

    International Nuclear Information System (INIS)

    Aratyn, H.; Gomes, J.F.; Zimerman, A.H.

    1994-07-01

    It is presented an affine sl(n+1) algebraic construction of the basic constrained KP hierarchy. This hierarchy is analyzed using two approaches, namely linear matrix eigenvalue problem on hermitian symmetric space and constrained KP Lax formulation and we show that these approaches are equivalent. The model is recognized to be generalized non-linear Schroedinger (GNLS) hierarchy and it is used as a building block for a new class of constrained KP hierarchies. These constrained KP hierarchies are connected via similarity-Backlund transformations and interpolate between GNLS and multi-boson KP-Toda hierarchies. The construction uncovers origin of the Toda lattice structure behind the latter hierarchy. (author). 23 refs

  6. Kaiser Family Foundation - Content Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — Chartpacks, chartbooks, factsheets, reports, and slide presentations bring Kaiser Family Foundation information to life, and can be easily incorporated into your...

  7. Two-reduction of the super-KP hierarchy

    International Nuclear Information System (INIS)

    McArthur, I.N.

    1994-01-01

    Recursion relations are established for the residues of fractional powers of a two-reduced super-KP operator making use of the Baker-Akhiezer function. These show the integrability of the two-reduced even (or bosonic) flows of the super-KP hierarchy. Similar recursion relations are also proven for the residues of operators associated with the odd (or fermionic) flows of the Mulase-Rabin super-KP hierarchy. Due to the presence of a spectral parameter and itts fermionic partner in the Baker-Akhiezer function, these recursion relations should be relevant to any attempt to prove or disprove a recent proposal that the integrable hierarchy underlying two-dimensional quantum supergravity is the Mulase-Rabin super-KP hierarchy. (orig.)

  8. On Recursion Operator of the q -KP Hierarchy

    International Nuclear Information System (INIS)

    Tian Ke-Lei; Zhu Xiao-Ming; He Jing-Song

    2016-01-01

    It is the aim of the present article to give a general expression of flow equations of the q-KP hierarchy. The distinct difference between the q-KP hierarchy and the KP hierarchy is due to q-binomial and the action of q-shift operator θ, which originates from the Leibnitz rule of the quantum calculus. We further show that the n-reduction leads to a recursive scheme for these flow equations. The recursion operator for the flow equations of the q-KP hierarchy under the n-reduction is also derived. (paper)

  9. Frederik Kaiser (1808-1872, een gekweld man met een missie

    Directory of Open Access Journals (Sweden)

    Huib Zuidervaart

    2011-06-01

    Full Text Available Frederik Kaiser (1808-1872, a tormented man with a missionThe Leiden astronomer Kaiser has been instrumental for the rise of Dutch astronomy in the late nineteenth-century. His career was impressive. In 1826, without any formal university education, he began at the Leiden Astronomical Observatory as an ordinary observer. Through his work in astronomy he obtained an honorary doctorate, which enabled him in 1838 to become director of the observatory. In 1844 he was appointed full professor and in the academic year 1857/1858 he even became Rector Magnificus of Leiden University. In 1860 he even saw the fulfillmentof his life-long dream: the opening of a brand new astronomical observatory. However, in spite of these obvious professional successes, Kaiser's personal life was full of melancholy. This paper investigates Kaiser's personality, using correspondence with his family, as well as testimonies written down by his students and other contemporaries. Among others, we demonstrate the way in which Kaiser used his personal network, as well as his fierce continuous – and often publicly expressed – complaining, as a successful strategy in establishing his new astronomical observatory.

  10. Transforming and Sustaining the Care Environment

    OpenAIRE

    Goldfisher, Anne M.; Hounslow, Barbara; Blank, Judi

    2014-01-01

    Background: Caring Science Theory and Practices have been part of the Kaiser Permanente's Strategic Priority for Kaiser Permanente Northern Region since 2010. Their goal is to ensure the continued spread across the medical center of practices guided by the Caring Sciences framework that fosters caring-healing environments and that reinforce helping-trusting relationships between caregivers and between caregivers and patients. Methods: Gaining senior-level leader sponsorship is an essential el...

  11. Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System

    Science.gov (United States)

    Durant, Anne Foss; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

    2015-01-01

    In early 2010, leaders within Kaiser Permanente (KP) Northern California’s Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes. PMID:26828076

  12. Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

    Science.gov (United States)

    Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

    2015-01-01

    In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

  13. Self-Consistent Sources Extensions of Modified Differential-Difference KP Equation

    Science.gov (United States)

    Gegenhasi; Li, Ya-Qian; Zhang, Duo-Duo

    2018-04-01

    In this paper, we investigate a modified differential-difference KP equation which is shown to have a continuum limit into the mKP equation. It is also shown that the solution of the modified differential-difference KP equation is related to the solution of the differential-difference KP equation through a Miura transformation. We first present the Grammian solution to the modified differential-difference KP equation, and then produce a coupled modified differential-difference KP system by applying the source generation procedure. The explicit N-soliton solution of the resulting coupled modified differential-difference system is expressed in compact forms by using the Grammian determinant and Casorati determinant. We also construct and solve another form of the self-consistent sources extension of the modified differential-difference KP equation, which constitutes a Bäcklund transformation for the differential-difference KP equation with self-consistent sources. Supported by the National Natural Science Foundation of China under Grant Nos. 11601247 and 11605096, the Natural Science Foundation of Inner Mongolia Autonomous Region under Grant Nos. 2016MS0115 and 2015MS0116 and the Innovation Fund Programme of Inner Mongolia University No. 20161115

  14. Hierarchies of multi-component mKP equations and theirs integrable couplings

    International Nuclear Information System (INIS)

    Ji Jie; Yao Yuqin; Zhu Fubo; Chen Dengyuan

    2008-01-01

    First, a new multi-component modified Kadomtsev-Petviashvill (mKP) spectral problem is constructed by k-constraint imposed on a general pseudo-differential operator. Then, two hierarchies of multi-component mKP equations are derived, including positive non-isospectral mKP hierarchy and negative non-isospectral mKP hierarchy. Moreover, new integrable couplings of the resulting mKP soliton hierarchies are constructed by enlarging the associated matrix spectral problem

  15. Digital Design with KP-Lab

    Directory of Open Access Journals (Sweden)

    D. Ponta

    2007-08-01

    Full Text Available KP-Lab is an EU Integrated Project envisioning a learning system that facilitates innovative practices of sharing, creating and working with knowledge in education and workplaces. The project exploits a novel pedagogical view, the knowledge-creation metaphor of learning. According to such “trialogical” approach, cognition arises through collaborative work in systematically developing shared “knowledge artefacts”, such as concepts, plans, material products, or social practices. The paper presents the plan of a pilot course to test the KP-Lab methodologies and tools in the field of Digital Design.

  16. Antimicrobial Activity and Chemical Composition of "Kpètè-Kpètè": A Starter of Benin Traditional Beer Tchoukoutou.

    Science.gov (United States)

    N'tcha, Christine; Sina, Haziz; Kayodé, Adéchola Pierre Polycarpe; Gbenou, Joachim D; Baba-Moussa, Lamine

    2017-01-01

    The aim of this study was to investigate the antibacterial effect of the crude starter " kpètè-kpètè " and lactic acid bacteria used during the production of "tchoukoutou." To achieve this, a total of 11 lactic acid bacteria and 40 starter samples were collected from four communes. The samples were tested on 29 gram + and - strains by disk diffusion method. The minimum inhibitory and bactericidal concentrations of starter and lactic acid bacteria were determined by conventional methods. Organic acids, sugar, and volatile compounds were determined using the HPLC method. The "kpètè-kpètè" displays a high antibacterial activity against the tested strains. The most sensitive strain was S. epidermidis (12.5 mm) whereas the resistance strain was Proteus mirabilis (8 mm). All the tested ferment has not any inhibitory effect on Enterococcus faecalis . The lactic acid bacteria isolates of Parakou showed the highest (17.48 mm) antibacterial activity whereas the smallest diameter was obtained with the ferment collected from Boukoumbé (9.80 mm). The starters' chemical screening revealed the presence of tannins, anthocyanin flavonoids, triterpenes, steroids, reducing compounds, and mucilage O-glycosides. These compounds are probably the source of recorded inhibition effect. The lactic acid bacteria of the "kpètè-kpètè" could be used to develop a food ingredient with probiotic property.

  17. Biodegradation of naphthalene and phenanthren by Bacillus subtilis 3KP

    Science.gov (United States)

    Ni'matuzahroh, Trikurniadewi, N.; Pramadita, A. R. A.; Pratiwi, I. A.; Salamun, Fatimah, Sumarsih, Sri

    2017-06-01

    The purposes of this research were to know growth response, degradation ability, and uptake mechanism of naphthalene and phenanthrene by Bacillus subtilis 3KP. Bacillus subtilis 3KP was grown on Mineral Synthetic (MS) medium with addition of 1% yeast extract and naphthalene and phenanthrene respectively 200 ppm in different cultures. Bacillus subtilis 3KP growth response was monitored by Total Plate Count (TPC) method, the degradation ability was monitored by UV-Vis spectrophotometer, and the uptake mechanism of hydrocarbon was monitored by emulsification activity, decrease of surface tension, and activity of Bacterial Adherence to Hydrocarbon (BATH). Bacillus subtilis 3KP was able to grow and show biphasic growth pattern on both of substrates. Naphthalene and phenanthrene were used as a carbon source for Bacillus subtilis 3KP growth that indicated by the reduction of substrate concomitant with the growth. At room temperature conditions (± 30°C) and 90 rpm of agitation for 7 days, Bacillus subtilis 3KP could degrade naphthalene in the amount of 70.5% and phenanthrene in the amount of 24.8%. Based on the analysis of UV-Vis spectrophotometer, three metabolites, 1-hydroxy-2-naphthoic acid, salicylic acid, and pyrocatechol were found in both cultures. The metabolite identification became basis of propose degradation pathway of naphthalene and phenanthrene by Bacillus subtilis 3KP. The results of hydrocarbon uptake mechanism test show that Bacillus subtilis 3KP used all of the mechanism to degrade naphthalene and phenanthrene.

  18. Educação Permanente em Saúde no Brasil: educação ou gerenciamento permanente?

    Directory of Open Access Journals (Sweden)

    Cristiane Lopes Simão Lemos

    2016-03-01

    Full Text Available Resumo O objetivo do estudo foi analisar a concepção e os fundamentos da Educação Permanente em Saúde (EPS constante da Política Nacional de Educação Permanente em Saúde (PNEPS no Brasil. A metodologia baseou-se na análise de documentos do Ministério da Saúde e de artigos científicos relacionados. Constatou-se que a concepção da EPS na PNEPS transcende um significado pedagógico, respondendo a um processo de reestruturação dos serviços diante das novas demandas do modelo. Justamente no momento em que o trabalho se encontra cada vez mais instável e precarizado, o Ministério da Saúde apresenta um discurso sobre uma gestão inovadora, dando centralidade à questão da EPS. A ideia não é de educação permanente, mas de gerenciamento permanente. Ao contrário de um instrumento de transformação radical, a EPS converte-se em uma ideologia que seduz pela sua aparência de novidade pedagógica.

  19. Wronskian type solutions for the vector k-constrained KP hierarchy

    International Nuclear Information System (INIS)

    Zhang Youjin.

    1995-07-01

    Motivated by a relation of the 1-constrained Kadomtsev-Petviashvili (KP) hierarchy with the 2 component KP hierarchy, the tau-conditions of the vector k-constrained KP hierarchy are constructed by using an analogue of the Baker-Akhiezer (m + 1)-point function. These tau functions are expressed in terms of Wronskian type determinants. (author). 20 refs

  20. Biotransformation and oxidative stress responses in rat hepatic cell-line (H4IIE) exposed to racemic ketoprofen (RS-KP) and its enantiomer, dexketoprofen (S(+)-KP).

    Science.gov (United States)

    Mennillo, Elvira; Krøkje, Åse; Pretti, Carlo; Meucci, Valentina; Arukwe, Augustine

    2018-03-30

    Pharmaceuticals such as racemate ketoprofen (RS-KP) and its enantiomer, dexketoprofen (S(+)-KP) are highly detectable non-steroidal anti-inflammatory drugs (NSAIDs) in the aquatic environment and therefore are designated as one of the most emerging groups of pollutants that can affect environmental and human health. The potential impact of these pharmaceuticals was assessed for the first time in vitro using a rat hepatocellular carcinoma cell line (H4IIE). Cells were exposed to low and high concentrations of these drugs. Cytotoxicity was determined by MTT reduction assay; CYP1A1 transcriptional and enzymatic levels together with canonical oxidative stress responsive markers (GPx, GR, GST and CAT) were also investigated. Cells exposed to RS-KP and S(+)-KP did not show cytotoxicity effect at the concentrations tested. However, this study highlighted differences between RS-KP and S(+)-KP in most of the evaluated markers, showing compound-, concentration- and time-specific effect patterns which suggest a potential stereo-selective toxicity of these drugs. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Red wine consumption not associated with reduced risk of colorectal cancer.

    Science.gov (United States)

    Chao, Chun; Haque, Reina; Caan, Bette J; Poon, Kwun-Yee T; Tseng, Hung-Fu; Quinn, Virginia P

    2010-01-01

    Red wine contains polyphenol antioxidants that inhibit colorectal cancer (CRC) development in animal studies. We investigated the effect of red wine intake on risk of CRC in the California Men's Health Study (CMHS). CMHS is a prospective, multiethnic cohort of middle-aged men who were members of the Kaiser Permanente (KP) California Health Plans and completed study questionnaires between 2002-2003. Incident CRC were identified from the health plan cancer registries through the end of 2007 (n = 287). To properly account for potential confounding by previous endoscopy screening, we restricted the primary analyses to CMHS men continuously enrolled in KP between 1998-2002 (n = 43,483 and CRC = 176). We used multivariable Cox regression to adjust for important confounders. We did not find an inverse association between moderate red wine intake and risk of CRC. The hazard ratio for consuming >/=1 drink/day (average = 2 drinks/day) was 1.16, 95% confidence intervals 0.56-2.40. There was no linear dose-response. The lack of clear association for red wine intake was consistently observed when we stratified the analyses by CRC stage at diagnosis and cancer site (colon or rectum). Moderate red wine consumption was not associated with reduced risk of colorectal cancer in this population of middle-aged men.

  2. A new class of weight and WA systems of the Kravchenko-Kaiser functions

    Science.gov (United States)

    Kravchenko, V. F.; Pustovoit, V. I.; Churikov, D. V.

    2014-05-01

    A new class of weight and WA-systems of the Kravchenko-Kaiser functions which showed its efficiency in various physical applications is proposed and substantiated. This publication consists of three parts. In the first the Kravchenko-Kaiser weight functions are constructed on basis of the theory of atomic functions (AFs) and the Kaiser windows for the first time. In the second part new constructions of analytic WA-systems of the Kravchenko-Kaiser functions are costructed. In the third part their applications to problems of weight averaging of the difference frequency signals are considered. The numerical experiment and the physical analysis of the results for concrete physical models confirmed their efficiency. This class of functions can find wide physical applications in problems of digital signal processing, restoration of images, radar, radiometry, radio astronomy, remote sensing, etc.

  3. 10KP: A phylodiverse genome sequencing plan.

    Science.gov (United States)

    Cheng, Shifeng; Melkonian, Michael; Smith, Stephen A; Brockington, Samuel; Archibald, John M; Delaux, Pierre-Marc; Li, Fay-Wei; Melkonian, Barbara; Mavrodiev, Evgeny V; Sun, Wenjing; Fu, Yuan; Yang, Huanming; Soltis, Douglas E; Graham, Sean W; Soltis, Pamela S; Liu, Xin; Xu, Xun; Wong, Gane Ka-Shu

    2018-03-01

    Understanding plant evolution and diversity in a phylogenomic context is an enormous challenge due, in part, to limited availability of genome-scale data across phylodiverse species. The 10KP (10,000 Plants) Genome Sequencing Project will sequence and characterize representative genomes from every major clade of embryophytes, green algae, and protists (excluding fungi) within the next 5 years. By implementing and continuously improving leading-edge sequencing technologies and bioinformatics tools, 10KP will catalogue the genome content of plant and protist diversity and make these data freely available as an enduring foundation for future scientific discoveries and applications. 10KP is structured as an international consortium, open to the global community, including botanical gardens, plant research institutes, universities, and private industry. Our immediate goal is to establish a policy framework for this endeavor, the principles of which are outlined here.

  4. 10KP: A phylodiverse genome sequencing plan

    Science.gov (United States)

    Cheng, Shifeng; Melkonian, Michael; Brockington, Samuel; Archibald, John M; Delaux, Pierre-Marc; Melkonian, Barbara; Mavrodiev, Evgeny V; Sun, Wenjing; Fu, Yuan; Yang, Huanming; Soltis, Douglas E; Graham, Sean W; Soltis, Pamela S; Liu, Xin; Xu, Xun

    2018-01-01

    Abstract Understanding plant evolution and diversity in a phylogenomic context is an enormous challenge due, in part, to limited availability of genome-scale data across phylodiverse species. The 10KP (10,000 Plants) Genome Sequencing Project will sequence and characterize representative genomes from every major clade of embryophytes, green algae, and protists (excluding fungi) within the next 5 years. By implementing and continuously improving leading-edge sequencing technologies and bioinformatics tools, 10KP will catalogue the genome content of plant and protist diversity and make these data freely available as an enduring foundation for future scientific discoveries and applications. 10KP is structured as an international consortium, open to the global community, including botanical gardens, plant research institutes, universities, and private industry. Our immediate goal is to establish a policy framework for this endeavor, the principles of which are outlined here. PMID:29618049

  5. Antimicrobial Activity and Chemical Composition of “Kpètè-Kpètè”: A Starter of Benin Traditional Beer Tchoukoutou

    Directory of Open Access Journals (Sweden)

    Christine N’tcha

    2017-01-01

    Full Text Available The aim of this study was to investigate the antibacterial effect of the crude starter “kpètè-kpètè” and lactic acid bacteria used during the production of “tchoukoutou.” To achieve this, a total of 11 lactic acid bacteria and 40 starter samples were collected from four communes. The samples were tested on 29 gram + and − strains by disk diffusion method. The minimum inhibitory and bactericidal concentrations of starter and lactic acid bacteria were determined by conventional methods. Organic acids, sugar, and volatile compounds were determined using the HPLC method. The “kpètè-kpètè” displays a high antibacterial activity against the tested strains. The most sensitive strain was S. epidermidis (12.5 mm whereas the resistance strain was Proteus mirabilis (8 mm. All the tested ferment has not any inhibitory effect on Enterococcus faecalis. The lactic acid bacteria isolates of Parakou showed the highest (17.48 mm antibacterial activity whereas the smallest diameter was obtained with the ferment collected from Boukoumbé (9.80 mm. The starters’ chemical screening revealed the presence of tannins, anthocyanin flavonoids, triterpenes, steroids, reducing compounds, and mucilage O-glycosides. These compounds are probably the source of recorded inhibition effect. The lactic acid bacteria of the “kpètè-kpètè” could be used to develop a food ingredient with probiotic property.

  6. Antimicrobial Activity and Chemical Composition of “Kpètè-Kpètè”: A Starter of Benin Traditional Beer Tchoukoutou

    Science.gov (United States)

    N'tcha, Christine; Sina, Haziz; Kayodé, Adéchola Pierre Polycarpe; Gbenou, Joachim D.

    2017-01-01

    The aim of this study was to investigate the antibacterial effect of the crude starter “kpètè-kpètè” and lactic acid bacteria used during the production of “tchoukoutou.” To achieve this, a total of 11 lactic acid bacteria and 40 starter samples were collected from four communes. The samples were tested on 29 gram + and − strains by disk diffusion method. The minimum inhibitory and bactericidal concentrations of starter and lactic acid bacteria were determined by conventional methods. Organic acids, sugar, and volatile compounds were determined using the HPLC method. The “kpètè-kpètè” displays a high antibacterial activity against the tested strains. The most sensitive strain was S. epidermidis (12.5 mm) whereas the resistance strain was Proteus mirabilis (8 mm). All the tested ferment has not any inhibitory effect on Enterococcus faecalis. The lactic acid bacteria isolates of Parakou showed the highest (17.48 mm) antibacterial activity whereas the smallest diameter was obtained with the ferment collected from Boukoumbé (9.80 mm). The starters' chemical screening revealed the presence of tannins, anthocyanin flavonoids, triterpenes, steroids, reducing compounds, and mucilage O-glycosides. These compounds are probably the source of recorded inhibition effect. The lactic acid bacteria of the “kpètè-kpètè” could be used to develop a food ingredient with probiotic property. PMID:28367445

  7. On two-current realization of KP hierarchy

    International Nuclear Information System (INIS)

    Aratyn, H.; Ferreira, L.A.; Gomes, J.F.; Zimerman, A.H.

    1992-06-01

    A simple description of the KP hierarchy and its multi-Hamiltonian structure is given in terms of two Bose currents. A deformation scheme connecting various W-infinity algebras and relation between two fundamental nonlinear structures are discussed. Properties of Faa di Bruno polynomials are extensively explored in this construction. Applications of our method are given for the Conformal Affine Toda model, WZNW models and discrete KP approach to Toda lattice chain. (author)

  8. Constrained KP models as integrable matrix hierarchies

    International Nuclear Information System (INIS)

    Aratyn, H.; Ferreira, L.A.; Gomes, J.F.; Zimerman, A.H.

    1997-01-01

    We formulate the constrained KP hierarchy (denoted by cKP K+1,M ) as an affine [cflx sl](M+K+1) matrix integrable hierarchy generalizing the Drinfeld endash Sokolov hierarchy. Using an algebraic approach, including the graded structure of the generalized Drinfeld endash Sokolov hierarchy, we are able to find several new universal results valid for the cKP hierarchy. In particular, our method yields a closed expression for the second bracket obtained through Dirac reduction of any untwisted affine Kac endash Moody current algebra. An explicit example is given for the case [cflx sl](M+K+1), for which a closed expression for the general recursion operator is also obtained. We show how isospectral flows are characterized and grouped according to the semisimple non-regular element E of sl(M+K+1) and the content of the center of the kernel of E. copyright 1997 American Institute of Physics

  9. Optimized Kaiser-Bessel Window Functions for Computed Tomography.

    Science.gov (United States)

    Nilchian, Masih; Ward, John Paul; Vonesch, Cedric; Unser, Michael

    2015-11-01

    Kaiser-Bessel window functions are frequently used to discretize tomographic problems because they have two desirable properties: 1) their short support leads to a low computational cost and 2) their rotational symmetry makes their imaging transform independent of the direction. In this paper, we aim at optimizing the parameters of these basis functions. We present a formalism based on the theory of approximation and point out the importance of the partition-of-unity condition. While we prove that, for compact-support functions, this condition is incompatible with isotropy, we show that minimizing the deviation from the partition of unity condition is highly beneficial. The numerical results confirm that the proposed tuning of the Kaiser-Bessel window functions yields the best performance.

  10. The Kaiser Wilhelm Society under National Socialism

    CERN Document Server

    Sachse, Carola; Walker, Mark

    2009-01-01

    During the first part of the twentieth century, German science led the world. The most important scientific institution in Germany was the Kaiser Wilhelm Society, including institutes devoted to different fields of scientific research. These researchers were not burdened by teaching obligations and enjoyed excellent financial and material support. When the National Socialists came to power in Germany, all of German society, including science, was affected. The picture that previously dominated our understanding of science under National Socialism from the end of the Second World War to the recent past - a picture of leading Nazis ignorant and unappreciative of modern science and of scientists struggling to resist the Nazis - needs to be revised. This book surveys the history of Kaiser Wilhelm Institutes under Hitler, illustrating definitively the cooperation, if not collaboration, between scientists and National Socialists in order to further the goals of autarky, racial hygiene, war, and genocide.

  11. The effect of patient satisfaction with pharmacist consultation on medication adherence: an instrumental variable approach

    Directory of Open Access Journals (Sweden)

    Gu NY

    2008-12-01

    Full Text Available There are limited studies on quantifying the impact of patient satisfaction with pharmacist consultation on patient medication adherence. Objectives: The objective of this study is to evaluate the effect of patient satisfaction with pharmacist consultation services on medication adherence in a large managed care organization. Methods: We analyzed data from a patient satisfaction survey of 6,916 patients who had used pharmacist consultation services in Kaiser Permanente Southern California from 1993 to 1996. We compared treating patient satisfaction as exogenous, in a single-equation probit model, with a bivariate probit model where patient satisfaction was treated as endogenous. Different sets of instrumental variables were employed, including measures of patients' emotional well-being and patients' propensity to fill their prescriptions at a non-Kaiser Permanente (KP pharmacy. The Smith-Blundell test was used to test whether patient satisfaction was endogenous. Over-identification tests were used to test the validity of the instrumental variables. The Staiger-Stock weak instrument test was used to evaluate the explanatory power of the instrumental variables. Results: All tests indicated that the instrumental variables method was valid and the instrumental variables used have significant explanatory power. The single equation probit model indicated that the effect of patient satisfaction with pharmacist consultation was significant (p<0.010. However, the bivariate probit models revealed that the marginal effect of pharmacist consultation on medication adherence was significantly greater than the single equation probit. The effect increased from 7% to 30% (p<0.010 after controlling for endogeneity bias. Conclusion: After appropriate adjustment for endogeneity bias, patients satisfied with their pharmacy services are substantially more likely to adhere to their medication. The results have important policy implications given the increasing focus

  12. Exposure to Mobile Source Air Pollution in Early-life and Childhood Asthma Incidence: The Kaiser Air Pollution and Pediatric Asthma Study.

    Science.gov (United States)

    Pennington, Audrey Flak; Strickland, Matthew J; Klein, Mitchel; Zhai, Xinxin; Bates, Josephine T; Drews-Botsch, Carolyn; Hansen, Craig; Russell, Armistead G; Tolbert, Paige E; Darrow, Lyndsey A

    2018-01-01

    Early-life exposure to traffic-related air pollution exacerbates childhood asthma, but it is unclear what role it plays in asthma development. The association between exposure to primary mobile source pollutants during pregnancy and during infancy and asthma incidence by ages 2 through 6 was examined in the Kaiser Air Pollution and Pediatric Asthma Study, a racially diverse birth cohort of 24,608 children born between 2000 and 2010 and insured by Kaiser Permanente Georgia. We estimated concentrations of mobile source fine particulate matter (PM2.5, µg/m), nitrogen oxides (NOX, ppb), and carbon monoxide (CO, ppm) at the maternal and child residence using a Research LINE source dispersion model for near-surface releases. Asthma was defined using diagnoses and medication dispensings from medical records. We used binomial generalized linear regression to model the impact of exposure continuously and by quintiles on asthma risk. Controlling for covariates and modeling log-transformed exposure, a 2.7-fold increase in first year of life PM2.5 was associated with an absolute 4.1% (95% confidence interval, 1.6%, 6.6%) increase in risk of asthma by age 5. Quintile analysis showed an increase in risk from the first to second quintile, but similar risk across quintiles 2-5. Risk differences increased with follow-up age. Results were similar for NOX and CO and for exposure during pregnancy and the first year of life owing to high correlation. Results provide limited evidence for an association of early-life mobile source air pollution with childhood asthma incidence with a steeper concentration-response relationship observed at lower levels of exposure.

  13. Third Order Reconstruction of the KP Scheme for Model of River Tinnelva

    Directory of Open Access Journals (Sweden)

    Susantha Dissanayake

    2017-01-01

    Full Text Available The Saint-Venant equation/Shallow Water Equation is used to simulate flow of river, flow of liquid in an open channel, tsunami etc. The Kurganov-Petrova (KP scheme which was developed based on the local speed of discontinuity propagation, can be used to solve hyperbolic type partial differential equations (PDEs, hence can be used to solve the Saint-Venant equation. The KP scheme is semi discrete: PDEs are discretized in the spatial domain, resulting in a set of Ordinary Differential Equations (ODEs. In this study, the common 2nd order KP scheme is extended into 3rd order scheme while following the Weighted Essentially Non-Oscillatory (WENO and Central WENO (CWENO reconstruction steps. Both the 2nd order and 3rd order schemes have been used in simulation in order to check the suitability of the KP schemes to solve hyperbolic type PDEs. The simulation results indicated that the 3rd order KP scheme shows some better stability compared to the 2nd order scheme. Computational time for the 3rd order KP scheme for variable step-length ode solvers in MATLAB is less compared to the computational time of the 2nd order KP scheme. In addition, it was confirmed that the order of the time integrators essentially should be lower compared to the order of the spatial discretization. However, for computation of abrupt step changes, the 2nd order KP scheme shows a more accurate solution.

  14. The zero curvature formulation of the KP and the sKP equations

    International Nuclear Information System (INIS)

    Barcelos Neto, J.; Das, A.; Panda, S.; Roy, S.

    1992-01-01

    The Kadomtsev-Petviashvili equation is derived from the zero curvature condition associated with the gauge group SL(2,R) in 2+1 dimensions. A fermionic extension of the KP equation is also obtained using the zero curvature condition of the super group OS p (2/1), which reduces upon appropriate restriction to the Kupershmidt equation. (author). 17 refs

  15. Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care

    Science.gov (United States)

    Lake, James; Turner, Mason Spain

    2017-01-01

    Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally. This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics. PMID:28898197

  16. Measuring integrated care.

    Science.gov (United States)

    Strandberg-Larsen, Martin

    2011-02-01

    The positive outcomes of coordination of healthcare services are to an increasing extent becoming clear. However the complexity of the field is an inhibiting factor for vigorously designed trial studies. Conceptual clarity and a consistent theoretical frame-work are thus needed. While researchers respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser Permanente has been put forward as an example for European healthcare systems to follow, although the evidence base is far from conclusive. The thesis has five objectives: 1) To contribute to the understanding of the concept of integration in healthcare systems and to identify measurement methods to capture the multi-dimensional aspects of integrated healthcare delivery. 2) To assess the level of integration of the Danish healthcare system. 3) To assess the use of joint health plans as a tool for coordination between the regional and local level in the Danish healthcare system. 4) To compare the inputs and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine the associations between specific organizational factors and clinical integration within each system. The literature was systematically searched to identify methods for measurement of integrated healthcare delivery. A national cross-sectional survey was conducted among major professional stake-holders at five different levels of the Danish healthcare system. The survey data were used to allow for analysis of the level of integration achieved. Data from the survey were

  17. KP4 to control Ustilago tritici in wheat: Enhanced greenhouse resistance to loose smut and changes in transcript abundance of pathogen related genes in infected KP4 plants.

    Science.gov (United States)

    Quijano, Carolina Diaz; Wichmann, Fabienne; Schlaich, Thomas; Fammartino, Alessandro; Huckauf, Jana; Schmidt, Kerstin; Unger, Christoph; Broer, Inge; Sautter, Christof

    2016-09-01

    Ustilago tritici causes loose smut, which is a seed-borne fungal disease of wheat, and responsible for yield losses up to 40%. Loose smut is a threat to seed production in developing countries where small scale farmers use their own harvest as seed material. The killer protein 4 (KP4) is a virally encoded toxin from Ustilago maydis and inhibits growth of susceptible races of fungi from the Ustilaginales. Enhanced resistance in KP4 wheat to stinking smut, which is caused by Tilletia caries, had been reported earlier. We show that KP4 in genetically engineered wheat increased resistance to loose smut up to 60% compared to the non-KP4 control under greenhouse conditions. This enhanced resistance is dose and race dependent. The overexpression of the transgene kp4 and its effect on fungal growth have indirect effects on the expression of endogenous pathogen defense genes.

  18. KP4 to control Ustilago tritici in wheat: Enhanced greenhouse resistance to loose smut and changes in transcript abundance of pathogen related genes in infected KP4 plants

    Directory of Open Access Journals (Sweden)

    Carolina Diaz Quijano

    2016-09-01

    Full Text Available Ustilago tritici causes loose smut, which is a seed-borne fungal disease of wheat, and responsible for yield losses up to 40%. Loose smut is a threat to seed production in developing countries where small scale farmers use their own harvest as seed material. The killer protein 4 (KP4 is a virally encoded toxin from Ustilago maydis and inhibits growth of susceptible races of fungi from the Ustilaginales. Enhanced resistance in KP4 wheat to stinking smut, which is caused by Tilletia caries, had been reported earlier. We show that KP4 in genetically engineered wheat increased resistance to loose smut up to 60% compared to the non-KP4 control under greenhouse conditions. This enhanced resistance is dose and race dependent. The overexpression of the transgene kp4 and its effect on fungal growth have indirect effects on the expression of endogenous pathogen defense genes.

  19. Properties and simulation of α-permanental random fields

    DEFF Research Database (Denmark)

    Møller, Jesper; Rubak, Ege Holger

    An α-permanental random field is briefly speaking a model for a collection of random variables with positive associations, where α is a positive number and the probability generating function is given in terms of a covariance or more general function so that density and moment expressions are given...... by certain α-permanents. Though such models possess many appealing probabilistic properties, many statisticians seem unaware of  α-permanental random fields and their potential applications. The purpose of this paper is first to summarize useful probabilistic results using the simplest possible setting......, and second to study stochastic constructions and simulation techniques, which should provide a useful basis for discussing the statistical aspects in future work. The paper also discusses some examples of  α-permanental random fields....

  20. The q-deformed mKP hierarchy with self-consistent sources, Wronskian solutions and solitons

    International Nuclear Information System (INIS)

    Lin Runliang; Peng Hua; Manas, Manuel

    2010-01-01

    Based on the eigenfunction symmetry constraint of the q-deformed modified KP hierarchy, a q-deformed mKP hierarchy with self-consistent sources (q-mKPHSCSs) is constructed. The q-mKPHSCSs contain two types of q-deformed mKP equation with self-consistent sources. By the combination of the dressing method and the method of variation of constants, a generalized dressing approach is proposed to solve the q-deformed KP hierarchy with self-consistent sources (q-KPHSCSs). Using the gauge transformation between the q-KPHSCSs and the q-mKPHSCSs, the q-deformed Wronskian solutions for the q-KPHSCSs and the q-mKPHSCSs are obtained. The one-soliton solutions for the q-deformed KP (mKP) equation with a source are given explicitly.

  1. Symmetries of supersymmetric integrable hierarchies of KP type

    International Nuclear Information System (INIS)

    Nissimov, E.; Pacheva, S.

    2002-01-01

    This article is devoted to the systematic study of additional (non-isospectral) symmetries of constrained (reduced) supersymmetric integrable hierarchies of KP type--the so-called SKP (R;M B ,M F ) models. The latter are supersymmetric extensions of ordinary constrained KP hierarchies which contain as special cases basic integrable systems such as (m)KdV, AKNS, Fordy-Kulish, Yajima-Oikawa, etc. As a first main result it is shown that any SKP (R;M B ,M F ) hierarchy possesses two different mutually (anti-)commuting types of superloop superalgebra additional symmetries corresponding to the positive- and negative-grade parts of certain superloop superalgebras. The second main result is the systematic construction of the full algebra of additional Virasoro symmetries of SKP (R;M B ,M F ) hierarchies, which requires nontrivial modifications of the Virasoro flows known from the general case of unconstrained Manin-Radul super-KP hierarchies (the latter flows do not define symmetries for constrained SKP (R;M B ,M F ) hierarchies). As a third main result we provide systematic construction of the supersymmetric analogs of multi-component (matrix) KP hierarchies and show that the latter contain, among others, the supersymmetric version of the Davey-Stewartson system. Finally, we present an explicit derivation of the general Darboux-Baecklund solutions for the SKP (R;M B ,M F ) super-tau functions (supersymmetric 'soliton'-like solutions) which preserve the additional (non-isospectral) symmetries

  2. 75 FR 61246 - Kaiser Federal Financial Group, Inc., Covina, CA; Approval of Conversion Application

    Science.gov (United States)

    2010-10-04

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision [AC-51: OTS No. H-4729] Kaiser Federal... September 28, 2010, the Office of Thrift Supervision approved the application of K-Fed Mutual Holding Company and Kaiser Federal Bank, Covina, California, to convert to the stock form of organization. Copies...

  3. Riemann-Liouville integrals of fractional order and extended KP hierarchy

    International Nuclear Information System (INIS)

    Kamata, Masaru; Nakamula, Atsushi

    2002-01-01

    An attempt to formulate the extensions of the KP hierarchy by introducing fractional-order pseudo-differential operators is given. In the case of the extension with the half-order pseudo-differential operators, a system analogous to the supersymmetric extensions of the KP hierarchy is obtained. Unlike the supersymmetric extensions, no Grassmannian variable appears in the hierarchy considered here. More general hierarchies constructed by the 1/Nth-order pseudo-differential operators, their integrability and the reduction procedure are also investigated. In addition to finding the new extensions of the KP hierarchy, a brief introduction to the Riemann-Liouville integral is provided to yield a candidate for the fractional-order pseudo-differential operators

  4. The super W∞ symmetry of the Manin-Radul super KP hierarchy

    International Nuclear Information System (INIS)

    Das, A.; Sin, S.J.

    1991-11-01

    We show that the Manin-Radul super KP hierarchy is invariant under super W ∞ transformations. These transformations are characterized by time dependent flows which commute with the usual flows generated by the conserved quantities of the super KP hierarchy. (author). 16 refs

  5. On a direct approach to quasideterminant solutions of a noncommutative modified KP equation

    International Nuclear Information System (INIS)

    Gilson, C R; Nimmo, J J C; Sooman, C M

    2008-01-01

    A noncommutative version of the modified KP equation and a family of its solutions expressed as quasideterminants are discussed. The origin of these solutions is explained by means of Darboux transformations and the solutions are verified directly. We also verify directly an explicit connection between quasideterminant solutions of the noncommutative mKP equation and the noncommutative KP equation arising from the Miura transformation

  6. On Segal-Wilson's construction for the τ-functions of the constrained KP hierarchies

    International Nuclear Information System (INIS)

    Zhang You-jin.

    1994-06-01

    In this letter we study the constrained KP hierachies by employing Segal-Wilson's theory on the τ-functions of the KP hierarchy. We first describe the elements of the Grassmannian which correspond to solutions of the constrained KP hierarchy, and then we show how to construct its rational and soliton solutions from these elements of the Grassmannian. (author). 10 refs

  7. On the huge Lie superalgebra of pseudo superdifferential operators and super KP-hierarchies

    International Nuclear Information System (INIS)

    Sedra, M.B.

    1995-08-01

    Lie superalgebraic methods are used to establish a connection between the huge Lie superalgebra Ξ of super (pseudo) differential operators and various super KP-hierarchies. We show in particular that Ξ splits into 5 = 2 x 2 + 1 graded algebras expected to correspond to five classes of super KP-hierarchies generalizing the well-known Manin-Radul and Figueroa O'Farrill-Ramos supersymmetric KP-hierarchies. (author). 10 refs

  8. Medline Plus

    Full Text Available ... Merriam, KS, 05/04/2012) Colorectal Cancer Laparoscopic Right Colectomy ... Incontinence Advanced Procedures in Male Incontinence: The Male Sling (Kaiser Permanente San Diego ...

  9. Rational Degenerations of M-Curves, Totally Positive Grassmannians and KP2-Solitons

    Science.gov (United States)

    Abenda, Simonetta; Grinevich, Petr G.

    2018-03-01

    We establish a new connection between the theory of totally positive Grassmannians and the theory of M-curves using the finite-gap theory for solitons of the KP equation. Here and in the following KP equation denotes the Kadomtsev-Petviashvili 2 equation [see (1)], which is the first flow from the KP hierarchy. We also assume that all KP times are real. We associate to any point of the real totally positive Grassmannian Gr^{tp} (N,M) a reducible curve which is a rational degeneration of an M-curve of minimal genus {g=N(M-N)} , and we reconstruct the real algebraic-geometric data á la Krichever for the underlying real bounded multiline KP soliton solutions. From this construction, it follows that these multiline solitons can be explicitly obtained by degenerating regular real finite-gap solutions corresponding to smooth M-curves. In our approach, we rule the addition of each new rational component to the spectral curve via an elementary Darboux transformation which corresponds to a section of a specific projection Gr^{tp} (r+1,M-N+r+1)\\mapsto Gr^{tp} (r,M-N+r).

  10. Dependence of Energetic Electron Precipitation on the Geomagnetic Index Kp and Electron Energy

    Directory of Open Access Journals (Sweden)

    Mi-Young Park

    2013-12-01

    Full Text Available It has long been known that the magnetospheric particles can precipitate into the atmosphere of the Earth. In this paper we examine such precipitation of energetic electrons using the data obtained from low-altitude polar orbiting satellite observations. We analyze the precipitating electron flux data for many periods selected from a total of 84 storm events identified for 2001-2012. The analysis includes the dependence of precipitation on the Kp index and the electron energy, for which we use three energies E1 > 30 keV, E2 > 100 keV, E3 > 300 keV. We find that the precipitation is best correlated with Kp after a time delay of < 3 hours. Most importantly, the correlation with Kp is notably tighter for lower energy than for higher energy in the sense that the lower energy precipitation flux increases more rapidly with Kp than does the higher energy precipitation flux. Based on this we suggest that the Kp index reflects excitation of a wave that is responsible for scattering of preferably lower energy electrons. The role of waves of other types should become increasingly important for higher energy, for which we suggest to rely on other indicators than Kp if one can identify such an indicator.

  11. Soliton-like structures and the connection between the Bq and KP equations

    International Nuclear Information System (INIS)

    Bernal, J.; Agueero, Maximo A.; Flores-Romero, Erick

    2003-01-01

    We study the (2+1)-dimensional model proposed by Kadomtsev and Petviashvili (KP) to describe slowly varying nonlinear waves in a dispersive medium. Applying an appropriate Lie transformation and following the method introduced by Tajiri et al., the KP equation is reduced to a one-dimensional equation, that is, to a certain version of the Boussinesq equation (BqE). Then, we solve the BqE by the Hirota method, and finally we use the inverse transformation in order to obtain de KP solutions. We analyze some remarkable properties of the solutions found in this work

  12. Soliton-like structures and the connection between the Bq and KP equations

    CERN Document Server

    Bernal, J; Flores-Romero, E

    2003-01-01

    We study the (2+1)-dimensional model proposed by Kadomtsev and Petviashvili (KP) to describe slowly varying nonlinear waves in a dispersive medium. Applying an appropriate Lie transformation and following the method introduced by Tajiri et al., the KP equation is reduced to a one-dimensional equation, that is, to a certain version of the Boussinesq equation (BqE). Then, we solve the BqE by the Hirota method, and finally we use the inverse transformation in order to obtain de KP solutions. We analyze some remarkable properties of the solutions found in this work.

  13. Domain wall partition functions and KP

    International Nuclear Information System (INIS)

    Foda, O; Wheeler, M; Zuparic, M

    2009-01-01

    We observe that the partition function of the six-vertex model on a finite square lattice with domain wall boundary conditions is (a restriction of) a KP τ function and express it as an expectation value of charged free fermions (up to an overall normalization)

  14. Explicit flow equations and recursion operator of the ncKP hierarchy

    International Nuclear Information System (INIS)

    He, Jingsong; Wang, Lihong; Tu, Junyi; Li, Xiaodong

    2011-01-01

    The explicit expression of the flow equations of the noncommutative Kadomtsev–Petviashvili (ncKP) hierarchy is derived. Compared with the flow equations of the KP hierarchy, our result shows that the additional terms in the flow equations of the ncKP hierarchy indeed consist of commutators of dynamical coordinates {u i }. The recursion operator for the flow equations under n-reduction is presented. Further, under 2-reduction, we calculate a nonlocal recursion operator Φ(2) of the noncommutative Korteweg–de Vries(ncKdV) hierarchy, which generates a hierarchy of local, higher-order flows. Thus we solve the open problem proposed by Olver and Sokolov (1998 Commun. Math. Phys. 193 245–68)

  15. Integrable KP Coupling and Its Exact Solution

    International Nuclear Information System (INIS)

    Peng Ling; Yang Xuxong; Lou Senyue

    2012-01-01

    The integrable coupling is one of the most important topics in the nonlinear physics. This paper creates a novel integrable KP coupling and solves it via a recently-developed dark parameterization procedure. (general)

  16. Sato's Baecklund transformations, additional symmetries and ASvM formula for the discrete KP hierarchy

    International Nuclear Information System (INIS)

    Liu Shaowei; Cheng Yi

    2010-01-01

    Two kinds of symmetries, Sato's Baecklund transformations and additional symmetries, for the discrete KP (dKP) hierarchy are introduced, and the ASvM formula which demonstrates the equivalence of these two kinds of symmetries is obtained. In this process the Fay identity and the difference Fay identity of the dKP hierarchy are introduced and the ASvM formula in the form of tau function is calculated.

  17. Grassmannian approach to super-KP hierarchies

    International Nuclear Information System (INIS)

    Takama, Michiaki.

    1995-06-01

    We present a theory of 'maximal' super-KP (SKP) hierarchy whose flows are maximally extended to include all those of known SKP hierarchies, including, for example, the MRSKP hierarchy of Manin and Radul and the Jacobian SKP (JSKP) introduced by Mulase and Rabin. It is shown that SKP hierarchies has a natural field theoretic description in terms of the B-C system, in analogous way as the ordinary KP hierarchy. For this SKP hierarchy, we construct the vertex operators by using Kac-van de Leur superbosonization. The vertex operators act on the τ-function and then produce the wave function and the dual wave function of the hierarchy. Thereby we achieve the description of the 'maximal' SKP hierarchy in terms of the τ-function, which seemed to be lacking till now. Mutual relations among the SKP hierarchies are clarified. The MRSKP and the JSKP hierarchies are obtained as special cases when the time variables are appropriately restricted. (author)

  18. Analytic study of solutions for a (3 + 1) -dimensional generalized KP equation

    Science.gov (United States)

    Gao, Hui; Cheng, Wenguang; Xu, Tianzhou; Wang, Gangwei

    2018-03-01

    The (3 + 1) -dimensional generalized KP (gKP) equation is an important nonlinear partial differential equation in theoretical and mathematical physics which can be used to describe nonlinear wave motion. Through the Hirota bilinear method, one-solition, two-solition and N-solition solutions are derived via symbolic computation. Two classes of lump solutions, rationally localized in all directions in space, to the dimensionally reduced cases in (2 + 1)-dimensions, are constructed by using a direct method based on the Hirota bilinear form of the equation. It implies that we can derive the lump solutions of the reduced gKP equation from positive quadratic function solutions to the aforementioned bilinear equation. Meanwhile, we get interaction solutions between a lump and a kink of the gKP equation. The lump appears from a kink and is swallowed by it with the change of time. This work offers a possibility which can enrich the variety of the dynamical features of solutions for higher-dimensional nonlinear evolution equations.

  19. La formación permanente del profesorado en entornos virtuales de aprendizaje

    OpenAIRE

    Sonia Mª SANTOVEÑA CASAL

    2012-01-01

    La educación permanente nos permite adaptarnos a las exigencias sociales y a las demandas de la sociedad del conocimiento. En este contexto se hace imprescindible una formación permanente con apoyo de entornos virtuales de aprendizaje de calidad. El objetivo principal de esta investigación es el estudio de la calidad de los cursos virtuales destinados a la formación del profesorado desde diferentes instituciones públicas. La muestra está formada por cuatro cursos de formación permanente desti...

  20. Experimental study on the Kaiser effect of AE under multiaxial loading in granite

    International Nuclear Information System (INIS)

    Watanabe, Hidehiko; Hiroi, Takehiro

    2012-01-01

    Knowledge of the in-situ stresses is essential for underground excavation design, particularly in evaluating stability of excavation. Acoustic Emission method, which utilizes the Kaiser effect, is one of the simple methods for measuring in-situ stresses. Experiments on the Kaiser effect has been carried out under uniaxial compression and triaxial compression (σ 1 > σ 2 = σ 3 ), but has not been carried out under the three different principal stresses (σ 1 > σ 2 > σ 3 ). In this study, we performed two experiments on the Kaiser effect under multiaxial loading, using a hollow cylindrical granite specimen. The rapidly increasing point of cumulative AE event count was determined as the peak point of AE event count rate increment (AERI). The main results are summarized as follows. (1) In the case of the cyclic incremental σ 1 loading under σ 2 ≠σ 3 , the large peak point of AERI appeared just before the pre-stress level. And as more stresses prior to just before the peak point were estimated, the estimated error showed a tendency to increase. (2) In the case of re-loading under the lower σ 2 and σ 3 more than pre-loading, the estimated stresses using the three peak points of AERI corresponded to the pre-differential stresses (σ 1 -σ 2 ), (σ 1 -σ 3 ) and pre-axial stress σ 1 . The magnitudes of the three principal stresses were estimated under multiaxial loading from the Kaiser effect, using only one specimen. (author)

  1. Intersection local times, loop soups and permanental Wick powers

    CERN Document Server

    Jan, Yves Le; Rosen, Jay

    2017-01-01

    Several stochastic processes related to transient Lévy processes with potential densities u(x,y)=u(y-x), that need not be symmetric nor bounded on the diagonal, are defined and studied. They are real valued processes on a space of measures \\mathcal{V} endowed with a metric d. Sufficient conditions are obtained for the continuity of these processes on (\\mathcal{V},d). The processes include n-fold self-intersection local times of transient Lévy processes and permanental chaoses, which are `loop soup n-fold self-intersection local times' constructed from the loop soup of the Lévy process. Loop soups are also used to define permanental Wick powers, which generalizes standard Wick powers, a class of n-th order Gaussian chaoses. Dynkin type isomorphism theorems are obtained that relate the various processes. Poisson chaos processes are defined and permanental Wick powers are shown to have a Poisson chaos decomposition. Additional properties of Poisson chaos processes are studied and a martingale extension is obt...

  2. The Synergist Effect of P-Hydroxybenzoic Acid and Propyl-Paraben on The Antibacterial Activity of Enterocin KP

    Directory of Open Access Journals (Sweden)

    Zeliha Yıldırım

    2014-01-01

    Full Text Available In this study, the effects of food preservative p-hydroxybenzoic acid and propyl-paraben on the inhibitory activity of enterocin KP produced by Enterococcus faecalis KP were determined. Staphylococcus aureus, Escherichia coli O157:H7 and Salmonella Typhimurium, resistant to enterocin KP bacteriocin, were used as target organisms. The inhibitor activity of enterosin KP (1600 AU/ml alone or in combination with p-hydroxybenzoic acid (%0.1-0.3 and propyl-paraben (%0.008-0.16 on the growth of Staphylococcus aureus, Escherichia coli O157:H7 and Salmonella Typhimurium were determined. The inhibitory activity of enterocin KP was increased when used in combination with p-hydroxybenzoic acid and propyl-paraben at concentrations of 0.1-0.3% and 0.008-0.016%, respectively. Furthermore, Staphylococcus aureus, E. coli O157:H7 and Salmonella Typhimurium became sensitive to enterocin KP. In conclusion, the use of enterocin KP in combination with other food preservatives principles resulted in an increase in its inhibitory activity and spectrum.

  3. Forecasting Kp from solar wind data: input parameter study using 3-hour averages and 3-hour range values

    Science.gov (United States)

    Wintoft, Peter; Wik, Magnus; Matzka, Jürgen; Shprits, Yuri

    2017-11-01

    We have developed neural network models that predict Kp from upstream solar wind data. We study the importance of various input parameters, starting with the magnetic component Bz, particle density n, and velocity V and then adding total field B and the By component. As we also notice a seasonal and UT variation in average Kp we include functions of day-of-year and UT. Finally, as Kp is a global representation of the maximum range of geomagnetic variation over 3-hour UT intervals we conclude that sudden changes in the solar wind can have a big effect on Kp, even though it is a 3-hour value. Therefore, 3-hour solar wind averages will not always appropriately represent the solar wind condition, and we introduce 3-hour maxima and minima values to some degree address this problem. We find that introducing total field B and 3-hour maxima and minima, derived from 1-minute solar wind data, have a great influence on the performance. Due to the low number of samples for high Kp values there can be considerable variation in predicted Kp for different networks with similar validation errors. We address this issue by using an ensemble of networks from which we use the median predicted Kp. The models (ensemble of networks) provide prediction lead times in the range 20-90 min given by the time it takes a solar wind structure to travel from L1 to Earth. Two models are implemented that can be run with real time data: (1) IRF-Kp-2017-h3 uses the 3-hour averages of the solar wind data and (2) IRF-Kp-2017 uses in addition to the averages, also the minima and maxima values. The IRF-Kp-2017 model has RMS error of 0.55 and linear correlation of 0.92 based on an independent test set with final Kp covering 2 years using ACE Level 2 data. The IRF-Kp-2017-h3 model has RMSE = 0.63 and correlation = 0.89. We also explore the errors when tested on another two-year period with real-time ACE data which gives RMSE = 0.59 for IRF-Kp-2017 and RMSE = 0.73 for IRF-Kp-2017-h3. The errors as function

  4. KP solitons and the Grassmannians combinatorics and geometry of two-dimensional wave patterns

    CERN Document Server

    Kodama, Yuji

    2017-01-01

    This is the first book to treat combinatorial and geometric aspects of two-dimensional solitons. Based on recent research by the author and his collaborators, the book presents new developments focused on an interplay between the theory of solitons and the combinatorics of finite-dimensional Grassmannians, in particular, the totally nonnegative (TNN) parts of the Grassmannians. The book begins with a brief introduction to the theory of the Kadomtsev–Petviashvili (KP) equation and its soliton solutions, called the KP solitons. Owing to the nonlinearity in the KP equation, the KP solitons form very complex but interesting web-like patterns in two dimensions. These patterns are referred to as soliton graphs. The main aim of the book is to investigate the detailed structure of the soliton graphs and to classify these graphs. It turns out that the problem has an intimate connection with the study of the TNN part of the Grassmannians. The book also provides an elementary introduction to the recent development of ...

  5. Topological Landau-Ginzburg theory with a rational potential and the dispersionless KP hierarchy

    International Nuclear Information System (INIS)

    Aoyama, S.; Kodama, Y.

    1996-01-01

    Based on the dispersionless KP (dKP) theory, we study a topological Landau-Ginzburg (LG) theory characterized by a rational potential. Writing the dKP hierarchy in a general form treating all the primaries in an equal basis, we find that the hierarchy naturally includes the dispersionless (continuous) limit of Toda hierarchy and its generalizations having a finite number of primaries. Several flat solutions of the topological LG theory are obtained in this formulation, and are identified with those discussed by Dubrovin. We explicitly construct gravitational descendants for all the primary fields. Giving a residue formula for the 3-point functions of the fields, we show that these 3-point functions satisfy the topological recursion relation. The string equation is obtained as the generalized hodograph solutions of the dKP hierarchy, which show that all the gravitational effects to the constitutive equations (2-point functions) can be renormalized into the coupling constants in the small phase space. (orig.)

  6. An algebraic scheme associated with the non-commutative KP hierarchy and some of its extensions

    International Nuclear Information System (INIS)

    Dimakis, Aristophanes; Mueller-Hoissen, Folkert

    2005-01-01

    A well-known ansatz ('trace method') for soliton solutions turns the equations of the (non-commutative) KP hierarchy, and those of certain extensions, into families of algebraic sum identities. We develop an algebraic formalism, in particular involving a (mixable) shuffle product, to explore their structure. More precisely, we show that the equations of the non-commutative KP hierarchy and its extension (xncKP) in the case of a Moyal-deformed product, as derived in previous work, correspond to identities in this algebra. Furthermore, the Moyal product is replaced by a more general associative product. This leads to a new even more general extension of the non-commutative KP hierarchy. Relations with Rota-Baxter algebras are established

  7. Um teste direto da teoria de renda permanente: o caso brasileiro

    Directory of Open Access Journals (Sweden)

    Fábio Augusto Reis Gomes

    2012-01-01

    Full Text Available O presente artigo busca averiguar se a teoria da renda permanente (TRP é capaz de explicar a evolução do consumo no Brasil através de um teste direto com base em revisões de consumo induzidas por inovações na renda. De acordo com a TRP, o consumo reage às mudanças na renda na medida em que a renda corrente contem informação sobre a renda permanente. Para mensurar esta relação, foi estimado um modelo ARIMA (p,1,q para a renda corrente e, como resultado, foi possível verificar se as revisões de consumo e renda permanente se assemelham. Por fim, a TRP foi rejeitada.

  8. ANALISIS DAMPAK PERMEN KP RI NOMOR 1/PERMEN-KP/2015 TERHADAP PERDAGANGAN DOMESTIK ANTAR PROVINSI KOMODITI LOBSTER (Panulirus spp, KEPITING (Scylla serrata DAN RAJUNGAN (Portunus pelagicus DI KALIMANTAN SELATAN

    Directory of Open Access Journals (Sweden)

    Ichi Langlang Buana Machmud

    2017-05-01

    Full Text Available This study aims to (1 analyze the impact of Permen KP RI No. 1/PERMEN-KP/2015 against the decrease/increase of the amount of volume, frequency and value of interprovincial domestic trade of lobster (Panulirus spp, crab (Scylla serrata and small crab (Portunus pelagicus commodities; (2 to analyze the causes of the offense of smuggling attempts by large inter-provincial traders of lobster (Panulirus spp, crab (Scylla serrata and small crab (Portunus pelagicus commodities; and (3 to analyze the impact of Permen KP RI No.1/PERMEN-KP/2015 against the marketing channels of trade of lobster (Panulirus spp, crab (Scylla serrata and small crab (Portunus pelagicus commodities and trade organizations involved in domestic trade of the three commodities.  This thesis study activities were carried out in the province of South Kalimantan. The data collected were data sourced directly from the observation in the study site, and other supporting data relating to the object of study.  The results of this study: (1 Impact of Permen KP RI No. 1/PERMEN-KP/2015 are as follows: (a it has an effect of significantly reducing the volume, frequency and value of inter-provincial domestic trade of live crab (Scylla serrata and small fresh crab (Portunus pelagicus commodities, (b it has an effect of significantly reducing the volume and value of trade and has no significant effect on the frequency of inter-provincial domestic trade of soft-shelled crab commodity (Scylla serrata; (c it has no impact on inter-provincial domestic trade of fresh/frozen lobster commodities (Panulirus spp; (d it has no significant effect on the volume, frequency and value of inter-provincial domestic trade of crab meat (Scylla serrata, small crab meat (Portunus pelagicus, fresh/boiled crab (Scylla serrata and live lobsters (Panulirus spp commodities. (2 The occurrence of repeated violations in the form of an attempt smuggling by entrepreneurs (wholesalers of inter-provincial domestic sender of

  9. XXZ scalar products and KP

    International Nuclear Information System (INIS)

    Foda, O.; Wheeler, M.; Zuparic, M.

    2009-01-01

    Using a Jacobi-Trudi-type identity, we show that the scalar product of a general state and a Bethe eigenstate in a finite-length XXZ spin-1/2 chain is (a restriction of) a KP τ function. This leads to a correspondence between the eigenstates and points on Sato's Grassmannian. Each of these points is a function of the rapidities of the corresponding eigenstate, the inhomogeneity variables of the spin chain and the crossing parameter.

  10. Use of posttreatment imaging and biomarkers in survivors of early-stage breast cancer: Inappropriate surveillance or necessary care?

    Science.gov (United States)

    Hahn, Erin E; Tang, Tania; Lee, Janet S; Munoz-Plaza, Corrine E; Shen, Ernest; Rowley, Braden; Maeda, Jared L; Mosen, David M; Ruckdeschel, John C; Gould, Michael K

    2016-03-15

    Advanced imaging and serum biomarkers are commonly used for surveillance in patients with early-stage breast cancer, despite recommendations against this practice. Incentives to perform such low-value testing may be less prominent in integrated health care delivery systems. The purpose of the current study was to evaluate and compare the use of these services within 2 integrated systems: Kaiser Permanente (KP) and Intermountain Healthcare (IH). The authors also sought to distinguish the indication for testing: diagnostic purposes or routine surveillance. Patients with American Joint Committee on Cancer stage 0 to II breast cancer diagnosed between 2009 and 2010 were identified and the use of imaging and biomarker tests over an 18-month period were quantified, starting at 1 year after diagnosis. Chart abstraction was performed on a random sample of patients who received testing to identify the indication for testing. Multivariate regression was used to explore associations with the use of nonrecommended care. A total of 6585 patients were identified; 22% had stage 0 disease, 44% had stage I disease, and 34% had stage II disease. Overall, 24% of patients received at least 1 imaging test (25% at KP vs 22% at IH; P = .009) and 28% of patients received at least 1 biomarker (36% at KP vs 13% at IH; Ptests were performed to evaluate symptoms or signs. Virtually all biomarkers were ordered for routine surveillance. Stage of disease, medical center that provided the services, and provider experience were found to be significantly associated with the use of biomarkers. Advanced imaging was most often performed for appropriate indications, but biomarkers were used for nonrecommended surveillance. Distinguishing between inappropriate use for surveillance and appropriate diagnostic testing is essential when evaluating adherence to recommendations. © 2015 American Cancer Society.

  11. XXZ scalar products and KP

    Energy Technology Data Exchange (ETDEWEB)

    Foda, O. [Department of Mathematics and Statistics, University of Melbourne, Parkville, Victoria 3010 (Australia)], E-mail: foda@ms.unimelb.edu.au; Wheeler, M. [Department of Mathematics and Statistics, University of Melbourne, Parkville, Victoria 3010 (Australia)], E-mail: mwheeler@ms.unimelb.edu.au; Zuparic, M. [Department of Mathematics and Statistics, University of Melbourne, Parkville, Victoria 3010 (Australia)], E-mail: mzup@ms.unimelb.edu.au

    2009-10-21

    Using a Jacobi-Trudi-type identity, we show that the scalar product of a general state and a Bethe eigenstate in a finite-length XXZ spin-1/2 chain is (a restriction of) a KP {tau} function. This leads to a correspondence between the eigenstates and points on Sato's Grassmannian. Each of these points is a function of the rapidities of the corresponding eigenstate, the inhomogeneity variables of the spin chain and the crossing parameter.

  12. Exact multi-line soliton solutions of noncommutative KP equation

    International Nuclear Information System (INIS)

    Wang, Ning; Wadati, Miki

    2003-01-01

    A method of solving noncommutative linear algebraic equations plays a key role in the extension of the ∂-bar -dressing on the noncommutative space-time manifold. In this paper, a solution-generating method of noncommutative linear algebraic equations is proposed. By use of the proposed method, a class of multi-line soliton solutions of noncommutative KP (ncKP) equation is constructed explicitly. The method is expected to be of use for constructions of noncommutative soliton equations. The significance of the noncommutativity of coordinates is investigated. It is found that the noncommutativity of the space-time coordinate has a role to split the spatial waveform of the classical multi-line solitons and reform it to a new configuration. (author)

  13. Energy conversion through mass loading of escaping ionospheric ions for different Kp values

    Science.gov (United States)

    Yamauchi, Masatoshi; Slapak, Rikard

    2018-01-01

    By conserving momentum during the mixing of fast solar wind flow and slow planetary ion flow in an inelastic way, mass loading converts kinetic energy to other forms - e.g. first to electrical energy through charge separation and then to thermal energy (randomness) through gyromotion of the newly born cold ions for the comet and Mars cases. Here, we consider the Earth's exterior cusp and plasma mantle, where the ionospheric origin escaping ions with finite temperatures are loaded into the decelerated solar wind flow. Due to direct connectivity to the ionosphere through the geomagnetic field, a large part of this electrical energy is consumed to maintain field-aligned currents (FACs) toward the ionosphere, in a similar manner as the solar wind-driven ionospheric convection in the open geomagnetic field region. We show that the energy extraction rate by the mass loading of escaping ions (ΔK) is sufficient to explain the cusp FACs, and that ΔK depends only on the solar wind velocity accessing the mass-loading region (usw) and the total mass flux of the escaping ions into this region (mloadFload), as ΔK ˜ -mloadFloadu2sw/4. The expected distribution of the separated charges by this process also predicts the observed flowing directions of the cusp FACs for different interplanetary magnetic field (IMF) orientations if we include the deflection of the solar wind flow directions in the exterior cusp. Using empirical relations of u0 ∝ Kp + 1.2 and Fload ∝ exp(0.45Kp) for Kp = 1-7, where u0 is the solar wind velocity upstream of the bow shock, ΔK becomes a simple function of Kp as log10(ΔK) = 0.2 ṡ Kp + 2 ṡ log10(Kp + 1.2) + constant. The major contribution of this nearly linear increase is the Fload term, i.e. positive feedback between the increase of ion escaping rate Fload through the increased energy consumption in the ionosphere for high Kp, and subsequent extraction of more kinetic energy ΔK from the solar wind to the current system by the increased

  14. La educación permanente y las plataformas web en España

    Directory of Open Access Journals (Sweden)

    Medina, Beatriz

    2014-04-01

    Full Text Available La Educación Permanente en España, actualmente disfrutando de una etapa de consolidación, está haciéndose eco de las novedades educativas relacionadas con las Tecnologías de la Información y la Comunicación. En este sentido, realizamos un estudio con el objetivo de conocer la presencia de la Educación Permanente en internet y su oferta formativa, para lograrlo utilizamos la metodología comparada. Las distintas administraciones competentes ofrecen una variada oferta de recursos en plataformas web para hacer más accesible la Educación Permanente. Entre los principales hallazgos tenemos que todas las comunidades y ciudades autónomas del país poseen páginas o portales web dirigidos a las personas adultas que se encuentran en esta etapa del sistema educativo español, excepto Baleares; solo la comunidad autónoma Andalucía tiene un portal exclusivo para la Educación Permanente.

  15. EDUCACIÓN PERMANENTE EN SERVICIO DE FORMACIÓN DE PROFESIONALES DE ENFERMERÍA

    Directory of Open Access Journals (Sweden)

    Rosa Gomes Ferreira

    2015-12-01

    Full Text Available A formação é um processo contínuo e deve estar presente no cotidiano de trabalho e para tal, surge a educação permanente, como pactuação teoria-prática. Nossos objetivos são o de descrever as práticas educativas em saúde, enfatizando a educação permanente e analisar os contrapontos e intersecções à efetividade da assistência, mediante a prática de educação permanente. Estudo qualitativo, descritivo, exploratório. O estudo aponta que a educação permanente emerge como ferramenta capaz de despertar desejo, no trabalhador, em discutir e refletir acerca da prática. No entanto, todas as práticas educativas, tal como a educação continuada, tem valor e penetrância no campo do trabalho.  DOI: http://dx.doi.org/10.12957/sustinere.2015.18127

  16. The hamiltonian structures of the KP hierarchy

    International Nuclear Information System (INIS)

    Das, A.; Panda, S.; Huang Wenjui

    1991-01-01

    We obtain the two hamiltonian structures of the KP hierarchy following the method of Drinfeld and Sokolov. We point out how the second structure of Drinfeld and Sokolov needs to be modified in the present case. We briefly comment on the connection between these structures and the W 1+∞ algebra. (orig.)

  17. The Hamiltonian structures of the KP hierarchy

    International Nuclear Information System (INIS)

    Das, A.; Panda, S.; Huang Wenjui

    1991-08-01

    We obtain the two Hamiltonian structures of the KP hierarchy following the method of Drinfeld and Sokolov. We point out how the second structure of Drinfeld and Sokolov needs to be modified in the present case. We briefly comment on the connection between these structures and the W 1+∞ algebra. (author). 18 refs

  18. Additional symmetries of supersymmetric KP hierarchies

    International Nuclear Information System (INIS)

    Stanciu, S.

    1994-01-01

    We investigate the additional symmetries of several supersymmetric KP hierarchies: the SKP hierarchy of Manin and Radul, the SKP 2 hierarchy, and the Jacobian SKP hierarchy. In all three cases we find that the algebra of symmetries is isomorphic to the algebra of superdifferential operators, or equivalently SW 1+∞ . These results seem to suggest that despite their realization depending on the dynamics, the additional symmetries are kinematical in nature. (orig.)

  19. Le tecnologie mobili dell’apprendimento permanente, il progetto MOTILL

    Directory of Open Access Journals (Sweden)

    Marco Arrigo

    2013-03-01

    Full Text Available In questo articolo vengono presentati alcuni dei risultati del progetto MOTILL. MOTILL, ovvero «Le Tecnologie Mobili nell’apprendimento permanente: buone pratiche», è un progetto finanziato dalla Comunità Europea, nell’ambito del National Lifelong Learning Strategies (NLLS. Il progetto, durato un anno e terminato a Marzo 2010, si è focalizzato sull’uso delle tecnologie mobili in contesti di lifelong learning (LLL. L’articolo sarà dedicato a una breve introduzione del progetto, dei suoi obiettivi e delle azioni portate avanti, e a un rapido riassunto dei principali risultati ottenuti, i quali sono stati resi disponibili online alla comunità scientifica e diffusi ai policy makers impegnati nei programmi di apprendimento permanente.

  20. Mutation of HIV-1 Genomes in a Clinical Population Treated with the Mutagenic Nucleoside KP1461

    OpenAIRE

    Mullins, James I.; Heath, Laura; Hughes, James P.; Kicha, Jessica; Styrchak, Sheila; Wong, Kim G.; Rao, Ushnal; Hansen, Alexis; Harris, Kevin S.; Laurent, Jean-Pierre; Li, Deyu; Simpson, Jeffrey H.; Essigmann, John M.; Loeb, Lawrence A.; Parkins, Jeffrey

    2011-01-01

    The deoxycytidine analog KP1212, and its prodrug KP1461, are prototypes of a new class of antiretroviral drugs designed to increase viral mutation rates, with the goal of eventually causing the collapse of the viral population. Here we present an extensive analysis of viral sequences from HIV-1 infected volunteers from the first "mechanism validation" phase II clinical trial of a mutagenic base analog in which individuals previously treated with antiviral drugs received 1600 mg of KP1461 twic...

  1. Generalized Miura transformations, two-bosons KP hierarchies and their reduction to KdV hierarchies

    International Nuclear Information System (INIS)

    Aratyn, H.; Ferreira, L.A.; Gomes, J.F.; Medeiros, R.T.; Zimerman, A.H.

    1993-02-01

    Bracket preserving gauge equivalence is established between several two-boson generated KP type of hierarchies. These KP hierarchies reduce under symplectic reduction (via Dirac constraints) to KdV and Schwarzian KdV hierarchies. Under this reduction the gauge equivalence is taking form of the conventional Miura maps between the above KdV type of hierarchies. (author). 16 refs

  2. Generalized Miura transformations, two-bosons KP hierarchies and their reduction to KdV hierarchies

    Energy Technology Data Exchange (ETDEWEB)

    Aratyn, H. [Illinois Univ., Chicago, IL (United States). Dept. of Physics; Ferreira, L.A.; Gomes, J.F.; Medeiros, R.T.; Zimerman, A.H.

    1993-02-01

    Bracket preserving gauge equivalence is established between several two-boson generated KP type of hierarchies. These KP hierarchies reduce under symplectic reduction (via Dirac constraints) to KdV and Schwarzian KdV hierarchies. Under this reduction the gauge equivalence is taking form of the conventional Miura maps between the above KdV type of hierarchies. (author). 16 refs.

  3. The master T-operator for the Gaudin model and the KP hierarchy

    International Nuclear Information System (INIS)

    Alexandrov, Alexander; Leurent, Sebastien; Tsuboi, Zengo; Zabrodin, Anton

    2014-01-01

    Following the approach of [1], we construct the master T-operator for the quantum Gaudin model with twisted boundary conditions and show that it satisfies the bilinear identity and Hirota equations for the classical KP hierarchy. We also characterize the class of solutions to the KP hierarchy that correspond to eigenvalues of the master T-operator and study dynamics of their zeros as functions of the spectral parameter. This implies a remarkable connection between the quantum Gaudin model and the classical Calogero–Moser system of particles

  4. Las enfermedades neoplásicas como causa de la incapacidad permanente

    OpenAIRE

    Ares Camerino, A.; Sainz Vera, B.; Marchena Aparicio, J.C.; Soto Pino, M.L.

    2008-01-01

    El cáncer es la primera causa de mortalidad en hombres y la segunda en mujeres, tras las enfermedades cardiovasculares. Desde el punto de vista económico, los costes atribuibles a las enfermedades neoplásicas son principalmente indirectos (pérdida de productividad asociada a la mortalidad o a la incapacidad permanente). Analizando las incapacidades permanentes producidas en la Diputación Provincial de Cádiz en el período 1990-2005, que fueron un total de 208, se concluye, por orden de frecuen...

  5. Two-dimensional IR spectroscopy of the anti-HIV agent KP1212 reveals protonated and neutral tautomers that influence pH-dependent mutagenicity.

    Science.gov (United States)

    Peng, Chunte Sam; Fedeles, Bogdan I; Singh, Vipender; Li, Deyu; Amariuta, Tiffany; Essigmann, John M; Tokmakoff, Andrei

    2015-03-17

    Antiviral drugs designed to accelerate viral mutation rates can drive a viral population to extinction in a process called lethal mutagenesis. One such molecule is 5,6-dihydro-5-aza-2'-deoxycytidine (KP1212), a selective mutagen that induces A-to-G and G-to-A mutations in the genome of replicating HIV. The mutagenic property of KP1212 was hypothesized to originate from its amino-imino tautomerism, which would explain its ability to base pair with either G or A. To test the multiple tautomer hypothesis, we used 2D IR spectroscopy, which offers subpicosecond time resolution and structural sensitivity to distinguish among rapidly interconverting tautomers. We identified several KP1212 tautomers and found that >60% of neutral KP1212 is present in the enol-imino form. The abundant proportion of this traditionally rare tautomer offers a compelling structure-based mechanism for pairing with adenine. Additionally, the pKa of KP1212 was measured to be 7.0, meaning a substantial population of KP1212 is protonated at physiological pH. Furthermore, the mutagenicity of KP1212 was found to increase dramatically at pH KP1212 molecules. Overall, our data reveal that the bimodal mutagenic properties of KP1212 result from its unique shape shifting ability that utilizes both tautomerization and protonation.

  6. Hamiltonian structure, (anti-)self-adjoint flows in the KP hierarchy and the W1+∞ and W∞ algebras

    International Nuclear Information System (INIS)

    Yu Feng; Wu Yongshi

    1991-01-01

    The extended conformal W N algebras are known to be related to the generalized KdV hierarchies through their second hamiltonian structure. In this letter we discuss the relationship between the large-N limits of the W N algebras and the KP hierarchy which contains all generalized KdV hierarchies. We show that the Poisson bracket algebra corresponding to the hamiltonian structure found by Watanabe for the KP hierarchy is isomorphic to the classical (or centerless) W 1+∞ algebra, and it contains a subalgebra which is isomorphic to the W ∞ algebra. Moreover, the usual generators of W 1+∞ and W ∞ are explicitly expressed in terms of the KP currents, and are shown to relate in a simple way to certain KP flows satisfying a sort of (anti-)self-duality. Our results not only clarify the underlying algebraic structure of the KP hierarchy, but also hint about a possible relationship between the latter and 4D self-dual Yang-Mills equations or gravity. (orig.)

  7. Non-isospectral flows of noncommutative differential-difference KP equation

    International Nuclear Information System (INIS)

    Huang, Lin; Ilangovane, R.; Tamizhmani, K.M.; Zhang, Da-jun

    2013-01-01

    We present master symmetries of noncommutative differential-difference KP equation by considering Sato approach, where the field variables are defined over associative algebras. The Lie algebraic structures of generalized and master symmetries are given. They form a Virasoro Lie algebraic structure

  8. Treatment changes in patients with psoriasis on etanercept or adalimumab

    DEFF Research Database (Denmark)

    Lee, Erica B; Amin, Mina; Egeberg, Alexander

    2018-01-01

    PURPOSE: To determine the frequency of and reasons for treatment changes in patients with psoriasis. MATERIALS AND METHODS: A retrospective chart review of 140 patients with psoriasis treated with adalimumab or etanercept seen at Kaiser Permanente Los Angeles Medical Center between September 20, ...

  9. ‘God is groot en wij begrijpen Hem niet’: Kaisers populaire sterrenkunde en het einde van de fysiko-theologie

    Directory of Open Access Journals (Sweden)

    Frans van Lunteren

    2011-06-01

    Full Text Available Frederik Kaiser, popular astronomy, and the decline of natural theologyThroughout his remarkable career the Leiden astronomer Frederik Kaiser (1808-1872 struggled to revive Dutch astronomy, which at the time was rather moribund. His efforts comprised mobilizing public support through popularization. In spite of a lack of illustrations, his popular Starry Sky (1844 proved immensely successful with the general public. This work differed in many respects from earlier Dutch popular writings, and helped to establish the new genre of popular science. Kaiser enunciated his idiosyncratic views on popularization in a lecture which he later published as a brochure. Whereas his research reflects the shift from the dilettante to the professional scientist in being focussed on precision measurement, his popular work likewise testified to the transition from natural philosophy to modern science. Charged with the task of composing a natural theological work on astronomy, the deeply religious Kaiser, wriggled his way through the text. Feeling unable to advance the usual arguments, he finally found refuge in the book of Job: 'Behold, God is great and we know him not'. Arguably, the rise of popular science and the decline of natural theology were intimately connected.

  10. Modelling of P-waves velocity function from the PKiKP and PKIKP phases; Modelizacion de la funcion velocidad para las ondas P a partir de las fases PKiKP y PKIKP

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez-Nicolas, M.

    2011-07-01

    The structure of the Earth is characterized by a number of regions which have different physical properties. For their study one uses models such PREM or IASPEI91. These models describe the internal structure of the Earth providing us the theoretical values of the velocity of the waves that pass through each of these regions. In this paper we focus on the waves that cross the inner core (PKIKP), and the reflected waves on the surface of the inner core (PKiKP). The aim of this study is to identify the PKiKP and PKIKP phases in a seismogram and compare them with the theoretical values obtained from the models. Another objective of this work is to propose an expression for the propagation velocity of seismic waves at the discontinuity between the outer and inner core from the minimization of waste of time (time difference between the arrival of the wave PKIKP and PKiKP). For this study we have selected two earthquakes, one occurred in Colombia, 04/26/1999 (Mw 5.9) and the other in Peru-Ecuador 16/11/2007 (Mw = 6.8). We have analyzed only the seismograms from stations with epicentral distances between 130 degree centigrade and 140 degree centigrade, because of the interference phenomena between the PKIKP and the PKiKP for epicentral distances less than 130 degree centigrade. (Author) 14 refs.

  11. Pathways: improving outcomes, not just 'cookbook medicine'.

    Science.gov (United States)

    O'Malley, S

    1997-04-01

    A Kaiser Permanente medical director cites four benefits to be derived from using clinical guidelines: better outcomes, faster patient recovery, reduced costs, and increased physician accountability. And, he notes, physicians are free to deviate from the guidelines--so long as they can justify their actions.

  12. Review of HIV Pre exposure prophylaxis (PrEP) and example of HIV PrEP Toolkit

    Science.gov (United States)

    2017-08-28

    at Initiation of Sexual Activity Correct & Consistent Condom Use Prevention of mother-to- child transmission July 16, 2012: FDA approves...Okulicz JF, Medicine 2016 PrEP Utilization in a Managed Care System (Kaiser Permanente) 1200 ~ 1045 1000 . 800 600 . 400 200 0 835 657 0

  13. Site support program plan for ICF Kaiser Hanford Company, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    This document is the general administrative plan implemented by the Hanford Site contractor, ICF Kaiser Hanford Company. It describes the mission, administrative structure, projected staffing, to be provided by the contractor. The report breaks out the work responsibilities within the different units of the company, a baseline schedule for the different groups, and a cost summary for the different operating units.

  14. Site support program plan for ICF Kaiser Hanford Company, Revision 1

    International Nuclear Information System (INIS)

    1995-10-01

    This document is the general administrative plan implemented by the Hanford Site contractor, ICF Kaiser Hanford Company. It describes the mission, administrative structure, projected staffing, to be provided by the contractor. The report breaks out the work responsibilities within the different units of the company, a baseline schedule for the different groups, and a cost summary for the different operating units

  15. EDUCAÇÃO PERMANENTE EM SAÚDE: Reflexões e desafios

    OpenAIRE

    Palhares Guimarães,Eliane Marina; Haueisen Martin,Sandra; Paolinelli Rabelo,Flávia Cristina

    2010-01-01

    Este trabalho é resultado de uma reflexão sobre o processo de educação permanente em saúde e na enfermagem. Tem como objetivo apresentar algumas perspectivas e tendências da educação em saúde e na enfermagem, com ênfase em educação permanente. Analisa a importância dos avanços tecnológicos e sua incorporação no processo de ensinar e de aprender. O texto é dividido em três partes, abordando inicialmente as mudanças organizacionais e, conseqüentemente, na educação, decorrentes da incorporação t...

  16. Comparison of paper and electronic surveys for measuring patient-reported outcomes after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Bojcic, Jamie L; Sue, Valerie M; Huon, Tomy S; Maletis, Gregory B; Inacio, Maria C S

    2014-01-01

    This study compared response rates of paper and electronic versions of the Knee injury Osteoarthritis and Outcome Score questionnaire and examined the characteristics of patients who responded to each survey method. A total of 1486 patients registered by the Kaiser Permanente Anterior Cruciate Ligament Reconstruction Registry between 2005 and 2010 were included in this study. Response rates by survey modality for the overall cohort, by the specific time periods, and by age and sex at time of anterior cruciate ligament reconstruction were compared using χ(2) tests or the Fisher exact test when appropriate. Independent Student t tests were used to compare the Knee injury Osteoarthritis and Outcome Scores of survey respondents. The overall survey response rate was 42%. The 36% response rate in the electronic-survey group was significantly higher than the 22% response rate in the paper-survey group (p survey produced higher response rates, it is not sufficient alone to replace the traditional paper version among this Kaiser Permanente population.

  17. Reliability and validity of a survey to measure bowel function and quality of life in long-term rectal cancer survivors.

    Science.gov (United States)

    Wendel, Christopher S; Grant, Marcia; Herrinton, Lisa; Temple, Larissa K F; Hornbrook, Mark C; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Krouse, Robert S

    2014-12-01

    Examination of reliability and validity of a specialized health-related quality of life questionnaire for rectal cancer (RC) survivors (≥5 years post-diagnosis). We mailed 1,063 Kaiser Permanente (KP) RC survivors (313 ostomy and 750 anastomosis) a questionnaire containing the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O), SF-12v2, Duke-UNC Functional Social Support Questionnaire (FSSQ), and Memorial Sloan-Kettering Cancer Center Bowel Function Index (BFI). We adapted certain BFI items for use by subjects with intestinal ostomies. We evaluated reliability for all instruments with inter-item correlations and Cronbach's alpha. We assessed construct validity only for the BFI in the ostomy group, because such use has not been reported. The overall response rate was 60.5 % (577 respondents/953 eligible). Compared with non-responders, participants were on average 2 years younger and more likely non-Hispanic white, resided in educationally non-deprived areas, and had KP membership through a group. The mCOH-QOL-O, SF-12, and FSSQ were found to be highly reliable for RC survivors. In the ostomy group, BFI Urgency/Soilage and Dietary subscales were found to be reliable, but Frequency was not. Factor analysis supported the construct of Urgency/Soilage and Dietary subscales in the ostomy group, although one item had a moderate correlation with all three factors. The BFI also demonstrated good concurrent validity with other instruments in the ostomy group. With possible exception of the BFI Frequency subscale in populations with ostomies, components of our survey can be used for the entire population of RC survivors, no matter whether they received anastomosis or ostomy.

  18. Joint Venture Arrangement for RN to BSN: A Model of Synergy between Academia and Service.

    Science.gov (United States)

    Bargagliotti, L. Antoinette; And Others

    1991-01-01

    Joint venture among educational and practice institutions is well on its way toward becoming the norm in nursing education and practice. Kaiser Permanente and the University of San Francisco School of Nursing offer a venture that allows registered nurses to pursue a bachelor of science in nursing degree. (JOW)

  19. Time variations of geomagnetic activity indices Kp and Ap: an update

    Directory of Open Access Journals (Sweden)

    G. K. Rangarajan

    1997-10-01

    Full Text Available Kp and Ap indices covering the period 1932 to 1995 are analysed in a fashion similar to that attempted by Bartels for the 1932–1961 epoch to examine the time variations in their characteristics. Modern analysis techniques on the extended data base are used for further insight. The relative frequencies of occurrence of Kp with different magnitudes and the seasonal and solar cycle dependences are seen to be remarkably consistent despite the addition of 35 years of observations. Many of the earlier features seen in the indices and special intervals are shown to be replicated in the present analysis. Time variations in the occurrence of prolonged periods of geomagnetic calm or of enhanced activity are presented and their relation to solar activity highlighted. It is shown that in the declining phase the occurrence frequencies of Kp = 4–5 (consecutively over 4 intervals can be used as a precursor for the maximum sunspot number to be expected in the next cycle. The semi-annual variation in geomagnetic activity is re-examined utilising not only the Ap index but also the occurrence frequencies of Kp index with different magnitudes. Lack of dependence of the amplitude of semi-annual variation on sunspot number is emphasised. Singular spectrum analysis of the mean monthly Ap index shows some distinct periodic components. The temporal evolution of ~44 month, ~21 month and ~16 month oscillations are examined and it is postulated that while QBO and the 16 month oscillations could be attributed to solar wind and IMF oscillations with analogous periodicity, the 44 month variation is associated with a similar periodicity in recurrent high speed stream caused by sector boundary passage. It is reconfirmed that there could have been only one epoch around 1940 when solar wind speed could have exhibited a 1.3-year periodicity comparable to that seen during the post-1986 period.

  20. Time variations of geomagnetic activity indices Kp and Ap: an update

    Directory of Open Access Journals (Sweden)

    G. K. Rangarajan

    Full Text Available Kp and Ap indices covering the period 1932 to 1995 are analysed in a fashion similar to that attempted by Bartels for the 1932–1961 epoch to examine the time variations in their characteristics. Modern analysis techniques on the extended data base are used for further insight. The relative frequencies of occurrence of Kp with different magnitudes and the seasonal and solar cycle dependences are seen to be remarkably consistent despite the addition of 35 years of observations. Many of the earlier features seen in the indices and special intervals are shown to be replicated in the present analysis. Time variations in the occurrence of prolonged periods of geomagnetic calm or of enhanced activity are presented and their relation to solar activity highlighted. It is shown that in the declining phase the occurrence frequencies of Kp = 4–5 (consecutively over 4 intervals can be used as a precursor for the maximum sunspot number to be expected in the next cycle. The semi-annual variation in geomagnetic activity is re-examined utilising not only the Ap index but also the occurrence frequencies of Kp index with different magnitudes. Lack of dependence of the amplitude of semi-annual variation on sunspot number is emphasised. Singular spectrum analysis of the mean monthly Ap index shows some distinct periodic components. The temporal evolution of ~44 month, ~21 month and ~16 month oscillations are examined and it is postulated that while QBO and the 16 month oscillations could be attributed to solar wind and IMF oscillations with analogous periodicity, the 44 month variation is associated with a similar periodicity in recurrent high speed stream caused by sector boundary passage. It is reconfirmed that there could have been only one epoch around 1940 when solar wind speed could have exhibited a 1.3-year periodicity comparable to that seen during the post-1986 period.

  1. Crack Identification in CFRP Laminated Beams Using Multi-Resolution Modal Teager–Kaiser Energy under Noisy Environments

    Science.gov (United States)

    Xu, Wei; Cao, Maosen; Ding, Keqin; Radzieński, Maciej; Ostachowicz, Wiesław

    2017-01-01

    Carbon fiber reinforced polymer laminates are increasingly used in the aerospace and civil engineering fields. Identifying cracks in carbon fiber reinforced polymer laminated beam components is of considerable significance for ensuring the integrity and safety of the whole structures. With the development of high-resolution measurement technologies, mode-shape-based crack identification in such laminated beam components has become an active research focus. Despite its sensitivity to cracks, however, this method is susceptible to noise. To address this deficiency, this study proposes a new concept of multi-resolution modal Teager–Kaiser energy, which is the Teager–Kaiser energy of a mode shape represented in multi-resolution, for identifying cracks in carbon fiber reinforced polymer laminated beams. The efficacy of this concept is analytically demonstrated by identifying cracks in Timoshenko beams with general boundary conditions; and its applicability is validated by diagnosing cracks in a carbon fiber reinforced polymer laminated beam, whose mode shapes are precisely acquired via non-contact measurement using a scanning laser vibrometer. The analytical and experimental results show that multi-resolution modal Teager–Kaiser energy is capable of designating the presence and location of cracks in these beams under noisy environments. This proposed method holds promise for developing crack identification systems for carbon fiber reinforced polymer laminates. PMID:28773016

  2. Capsule-Targeting Depolymerase, Derived from Klebsiella KP36 Phage, as a Tool for the Development of Anti-Virulent Strategy

    Directory of Open Access Journals (Sweden)

    Grażyna Majkowska-Skrobek

    2016-12-01

    Full Text Available The rise of antibiotic-resistant Klebsiella pneumoniae, a leading nosocomial pathogen, prompts the need for alternative therapies. We have identified and characterized a novel depolymerase enzyme encoded by Klebsiella phage KP36 (depoKP36, from the Siphoviridae family. To gain insights into the catalytic and structural features of depoKP36, we have recombinantly produced this protein of 93.4 kDa and showed that it is able to hydrolyze a crude exopolysaccharide of a K. pneumoniae host. Using in vitro and in vivo assays, we found that depoKP36 was also effective against a native capsule of clinical K. pneumoniae strains, representing the K63 type, and significantly inhibited Klebsiella-induced mortality of Galleria mellonella larvae in a time-dependent manner. DepoKP36 did not affect the antibiotic susceptibility of Klebsiella strains. The activity of this enzyme was retained in a broad range of pH values (4.0–7.0 and temperatures (up to 45 °C. Consistently, the circular dichroism (CD spectroscopy revealed a highly stability with melting transition temperature (Tm = 65 °C. In contrast to other phage tailspike proteins, this enzyme was susceptible to sodium dodecyl sulfate (SDS denaturation and proteolytic cleavage. The structural studies in solution showed a trimeric arrangement with a high β-sheet content. Our findings identify depoKP36 as a suitable candidate for the development of new treatments for K. pneumoniae infections.

  3. Educação permanente em enfermagem em um hospital universitário

    OpenAIRE

    Jesus,Maria Cristina Pinto de; Figueiredo,Mariangela Aparecida Gonçalves; Santos,Sueli Maria dos Reis; Amaral,Arlete Maria Moreira do; Rocha,Letícia de Oliveira; Thiollent,Michel Jean Marie

    2011-01-01

    A educação permanente enfatiza a interdisciplinaridade da equipe de saúde, focaliza a prática como fonte do conhecimento e coloca o profissional para atuar ativamente no processo educativo. Este estudo objetivou identificar demandas e expectativas, fatores que interferem na qualificação de trabalhadores de enfermagem de um hospital universitário e propor práticas de capacitação na perspectiva da educação permanente. O processo investigativo fundamentado nos princípios da pesquisa-ação foi rea...

  4. Restorative Integral Support (RIS) for Older Adults Experiencing Co-Occurring Disorders

    Science.gov (United States)

    Larkin, Heather; MacFarland, Nicole S.

    2012-01-01

    The Restorative Integral Support (RIS) model is a whole person response that assists people to overcome adversity. The Adverse Childhood Experiences (ACE) Study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention shows the association between stressors in childhood and multiple later-life health and social problems.…

  5. Additional symmetries of supersymmetric KP hierarchies

    International Nuclear Information System (INIS)

    Stanciu, S.

    1993-09-01

    We investigate the additional symmetries of several supersymmetric KP hierarchies: The SKP hierarchy of Manin and Radul, the SKP 2 hierarchy, and the Jacobian SKP hierarchy. The main technical tool is the supersymmetric generalisation of a map originally due to Radul between the Lie algebra of superdifferential operators and the Lie algebra of vector fields on the space of supersymmetric Lax operators. In the case of the Manin-Radul SKP hierarchy we identify additional symmetries which form an algebra isomorphic to a subalgebra of superdifferential operators; whereas in the case of the Jacobian SKP, the (additional) symmetries are identified with the algebra itself. (orig.)

  6. Flexibilidad laboral: ¿fin del trabajo permanente?

    Directory of Open Access Journals (Sweden)

    Carmen Añez Hernández

    2016-05-01

    Full Text Available Los trabajos transitorios o atípicos, siguen posicionándose y funcionando trastocando la protección del sistema de regulación y protección del trabajo permanente. De ahí, la importancia de reflexionar teóricamente sobre el tema. Para su desarrollo se plantean los siguientes objetivos: demostrar que la flexibilización laboral ha incidido en la ruptura de las relaciones laborales, caracterizar como la subcontratación laboral encubre dichas relaciones, analizar el despido laboral y sus consecuencias en los trabajadores. El artículo se desarrolló teóricamente, especialmente tomando como referencia autores como: Bravo (2010, Quintero (2010, González (2012 De La Garza (2007, Ugarte (2007, entre otros, lo cual permitió analizar la temática abordada. Los resultados reflejan que dicha estrategia está impulsando la agudización de las condiciones precarias de los derechos laborales, con lo cual se está ante un capitalismo irracional, que tiene como propósito que los trabajadores sufraguen los efectos de las pretensiones de los capitalistas por conseguir mayores tasas de ganancia y niveles más altos de productividad. En consecuencia, la flexibilización de las relaciones laborales está destinada a ocultar los derechos de los trabajadores, agudizar el despido laboral, y propiciar el fin de un trabajo permanente.

  7. Los entornos personales de aprendizaje en el marco de la educación permanente

    Directory of Open Access Journals (Sweden)

    Elvira E. Navas

    2013-01-01

    Full Text Available En este trabajo se presenta un estudio documental sobre el surgimiento, evolución y estado actual de la utilización y desarrollo de los Entornos Personales de Aprendizaje (Personal Learning Environment, PLE en el marco de la Educación Permanente o Aprendizaje para Toda la vida (Lifelong Learning. En primer lugar, se hace una revisión del concepto de Educación Permanente desde la literatura de inicios de siglo XX. A continuación, se procede a estudiar el término PLE, desde sus orígenes hasta la interpretación actual. Se presentan experiencias tanto nacionales como internacionales donde se ejemplifica de forma práctica la utilización de PLE en la educación universitaria. Finalmente, se hace una reflexión de cierre sobre las proyecciones de futuro del uso de los PLE en el marco de la educación permanente.

  8. Agenesia en dentición permanente

    OpenAIRE

    Beltrán Morera, Jazmín

    2009-01-01

    Objetivo Determinar la frecuencia de agenesia dental en dentición permanente.Materiales y Métodos Se incluyeron 112 pacientes que acudieron al servicio de imagenología de la Facultad de Odontología, Universidad Nacional Autónoma de México, de enero a julio del 2008, mayores de 13 años, sin extracciones dentales ni síndromes genéticos, a quienes se les tomó ortopantomografía. Se registraron variablessociodemográficas y antecedentes familiares de agenesia dental. Lainformación se procesó en SPS...

  9. Verification of short lead time forecast models: applied to Kp and Dst forecasting

    Science.gov (United States)

    Wintoft, Peter; Wik, Magnus

    2016-04-01

    In the ongoing EU/H2020 project PROGRESS models that predicts Kp, Dst, and AE from L1 solar wind data will be used as inputs to radiation belt models. The possible lead times from L1 measurements are shorter (10s of minutes to hours) than the typical duration of the physical phenomena that should be forecast. Under these circumstances several metrics fail to single out trivial cases, such as persistence. In this work we explore metrics and approaches for short lead time forecasts. We apply these to current Kp and Dst forecast models. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 637302.

  10. Diagnosing the Kaiser: Psychiatry, Wilhelm II and the Question of German War Guilt The William Bynum Prize Essay 2016.

    Science.gov (United States)

    Freis, David

    2018-07-01

    After his abdication in November 1918, the German emperor Wilhelm II continued to haunt the minds of his people. With the abolition of the lese-majesty laws in the new republic, many topics that were only discussed privately or obliquely before could now be broached openly. One of these topics was the mental state of the exiled Kaiser. Numerous psychiatrists, physicians and laypeople published their diagnoses of Wilhelm in high-circulation newspaper articles, pamphlets, and books shortly after the end of the war. Whether these diagnoses were accurate and whether the Kaiser really was mentally ill became the issue of a heated debate.This article situates these diagnoses of Wilhelm II in their political context. The authors of these diagnoses - none of whom had met or examined Wilhelm II in person - came from all political camps and they wrote with very different motives in mind. Diagnosing the exiled Kaiser as mentally ill was a kind of exorcism of the Hohenzollern rule, opening the way for either a socialist republic or the hoped-for rule of a new leader. But more importantly, it was a way to discuss and allocate political responsibility and culpability. Psychiatric diagnoses were used to exonerate both the Emperor (for whom the treaty of Versailles provided a tribunal as war criminal) and the German nation. They were also used to blame the Kaiser's entourage and groups that had allegedly manipulated the weak-willed monarch. Medical concepts became a vehicle for a debate on the key political questions in interwar Germany.

  11. Experimental and numerical study of the Kaiser effect in cyclic Brazilian tests with disk rotation

    CSIR Research Space (South Africa)

    Lavrov, A

    2002-04-01

    Full Text Available Sensitivity of the Kaiser effect to the deviations of the directions of sigma(1)-principal stress experienced by rock in Successive loading cycles has an important impact on the application of this effect for stress measurements in rocks. The paper...

  12. La incapacidad permanente y su impacto en el sistema español de Seguridad Social

    Directory of Open Access Journals (Sweden)

    César Luis Gómez Garcillán

    Full Text Available Se analizan datos de incapacidad permanente de los últimos años en la seguridad social. Conclusiones: El desglose provincial muestra grandes diferencias a nivel territorial cuyo origen o motivación no se puede determinar actualmente en tanto no se dispone de dos parámetros básicos, el código de diagnóstico de la patología principal determinante de la incapacidad permanente y el código identificativo de la actividad laboral (profesión habitual del interesado que permitirían realizar un análisis fiable de la situación. Entre los factores que podrían incidir de alguna manera en la mayor o menor incidencia de la incapacidad permanente, podemos analizar dos grandes componentes, la población protegida y su composición a nivel de regímenes y la iniciativa en la incoación de los procedimientos. El grupo de provincias con una incidencia más elevada en incapacidad permanente acusa tasas de paro también más elevadas que el grupo con incidencia menor. La tendencia en el número de procedimientos de IP incoados resulta claramente a la baja con una caída de más del 9% en cinco años. El INSS desestima un porcentaje creciente de los mismos, la razón de ese comportamiento no reside en una valoración restrictiva o más exigente por parte de la gestora, sino porque se instruyen menos procesos de incapacidad permanente y porque va tomando mayor protagonismo en la iniciativa de incoación el procedimiento a instancia de parte, cuyo porcentaje de desestimación es el más elevado.

  13. An update on the use of Atripla® in the treatment of HIV in the United States

    Directory of Open Access Journals (Sweden)

    Michael A Horberg

    2010-06-01

    Full Text Available Michael A Horberg1, Daniel B Klein21HIV Interregional Initiative, Kaiser Permanente, Oakland, California, USA; 2Department of Infectious Diseases, Kaiser Permanente Hayward Medical Center, Hayward, California, USAAbstract: Atripla® (Gilead Sciences Inc, Foster City, CA, USA and Bristol-Myers Squibb, New York City, NY, USA is a coformulated single pill composed of efavirenz, emtricitabine, and tenofovir disoproxil, intended as a once-daily potent combination antiretroviral therapeutic agent. Its efficacy is equivalent to the 3 component drugs taken in a combination as single medications. The coformulated antiretroviral regimen can be quite effective in patients whose human immunodeficiency virus is sensitive to all 3 components of Atripla. However, women at risk of pregnancy, already pregnant, or nursing mothers should not take Atripla, due to the teratogenic potential of the efavirenz moiety. Adverse effects are similar to those seen with the constituent medications, including potential central nervous system effects and renal toxicity. Since its US Food and Drug administration approval, prescriptions for Atripla have increased steadily.Keywords: tenofovir, efavirenz, emtricitabine, antiretroviral therapy

  14. Exact solutions of (3 + 1-dimensional generalized KP equation arising in physics

    Directory of Open Access Journals (Sweden)

    Syed Tauseef Mohyud-Din

    Full Text Available In this work, we have obtained some exact solutions to (3 + 1-dimensional generalized KP Equation. The improved tanϕ(ξ2-expansion method has been introduced to construct the exact solutions of nonlinear evolution equations. The obtained solutions include hyperbolic function solutions, trigonometric function solutions, exponential solutions, and rational solutions. Our study has added some new varieties of solutions to already available solutions. It is also worth mentioning that the computational work has been reduced significantly. Keywords: Improved tanϕ(ξ2-expansion method, Hyperbolic function solution, Trigonometric function solution, Rational solution, (3 + 1-dimensional generalized KP equation

  15. Nonlinearly deformed W∞ algebra and second hamiltonian structure of KP hierarchy

    International Nuclear Information System (INIS)

    Yu Feng; Wu Yongshi

    1992-01-01

    The characteristic nonlinearity of W N algebras, appropriate for their many applications in two-dimensional quantum physics, is lost in the usual large-N limits. In this paper we search for nonlinear extensions of the Virasoro algebra that incorporate all higher-spin currents with spin s≥2. We show that under certain natural homogeneity requirements, the Jacobi identities lead to a unique nonlinear, centerless deformation of classical w ∞ and W ∞ . The latter, which we call dW/dt ∞ , constitutes a universal W-algebra which is very likely to contain all W N algebras by reduction. Also it is closely related to the linear W 1+∞ by a set of interesting recursion relations, which suggests the isomorphism of dW/dt ∞ to the second hamiltonian structure of the KP hierarchy proposed by Dickey. The implications for the symmetries in two-dimensional quantum gravity and noncritical c≤1 strings in the context of the KP approach are discussed. (orig.)

  16. New dyrosaurid crocodylomorph and evidences for faunal turnover at the K-P transition in Brazil.

    Science.gov (United States)

    Barbosa, José Antonio; Kellner, Alexander Wilhelm Armin; Viana, Maria Somália Sales

    2008-06-22

    The discovery of a new dyrosaurid crocodylomorph from the well-dated Palaeocene deposits of northeastern Brazil sheds new light on the evolutionary history of this extinct group of marine crocodylomorphs that have survived the Cretaceous-Palaeogene (K-P) extinction crisis. Guarinisuchus munizi, the most complete member of this group collected in South America so far, is closely related to the African forms, and this fact suggests that dyrosaurids had crossed the Atlantic Ocean before the K-P boundary and dispersed from there to North America and other parts of South America. This discovery also suggests that on the coast of northeastern Brazil, dyrosaurids replaced the pre-existing Late Cretaceous fauna of diversified mosasaurs, a group of marine lizards, after the K-P extinction event, becoming the main predators, together with sharks, in shallow marine Palaeocene environments. More detailed stratigraphic records and detailed dating of the deposits with dyrosaurids are necessary to correlate this particular pattern found in the ancient northeastern Brazilian coast within the evolution of the group, especially in Africa.

  17. The string difference equation of the D = 1 matrix model and W1+∞ symmetry of the KP hierarchy

    International Nuclear Information System (INIS)

    Awada, M.A.; Sin, S.J.

    1992-01-01

    In this paper, the authors give a connection between the D = 1 matrix model and the generalized KP hierarchy. First, the authors find a difference equation satisfied by F, the Legendre transformation of the free energy of the D = 1 matrix model on a circle of radius R. Then the authors show that it is a special case of the difference equation of the generalized KP hierarchy with its zero mode identified with the scaling variable of the D = 1 string theory. The authors propose that the massive D = 1 matrix model is described by the generalized KP hierarchy, which implies the manifest integrability of D = 1 string theory. The authors also show that the (generalized) KP hierarchy has an underlying W 1 + ∞ symmetry. By reduction, we prove that the generalized KdV hierarchy has a subalgebra of the above symmetry which again forms a W 1+ ∞ . The authors argue that there are no W constraints in D = 1 string theory, which is in contrast to D 1 + ∞ constraints

  18. Evaluation of Rock Stress Estimation by the Kaiser effect

    International Nuclear Information System (INIS)

    Lehtonen, A.

    2005-11-01

    The knowledge of in situ stress is the key input parameter in many rock mechanics analyses. Information on stress allows the definition of boundary conditions for various modelling and engineering tasks. Presently, the estimation of stresses in bedrock is one of the most difficult, time-consuming and high-priced rock mechanical investigations. In addition, the methods used today have not evolved significantly in many years. This brings out a demand for novel, more economical and practical methods for stress estimation. In this study, one such method, Kaiser effect based on acoustic emission of core samples, has been evaluated. It can be described as a 'memory' in rock that is indicated by a change in acoustic emission emitted during uniaxial loading test. The most tempting feature of this method is the ability to estimate the in situ stress state from core specimens in laboratory conditions. This yields considerable cost savings compared to laborious borehole measurements. Kaiser effect has been studied in order to determine in situ stresses for decades without any major success. However, recent studies in Australia and China have been promising and made the estimation of stress tensor possible from differently oriented core samples. The aim of this work has been to develop a similar estimation method in Finland (including both equipment and data reduction), and to test it on samples obtained from Olkiluoto, Eurajoki. The developed measuring system proved to work well. The quality of obtained data varied, but they were still interpretable. The results obtained from these tests were compared with results of previous overcoring measurements, and they showed quite good correlation. Thus, the results were promising, but the method still needs further development and more testing before the final decision on its feasibility can be made. (orig.)

  19. Consider outsourcing IT projects when cutting-edge technology, specialized focus are needed.

    Science.gov (United States)

    1999-05-01

    Looking outside to meet information technology needs proves a smart way to avert extra staffing costs. Kaiser Permanente saves thousands each year by contracting out cutting-edge IT projects instead of hiring more full-time staff it doesn't need. Learn how the organization incorporates outsourcing and other temporary work methods into its IT staffing strategy.

  20. Mineralogical control on thermal damage and the presence of a thermal Kaiser effect during temperature-cycling experiments

    Science.gov (United States)

    Browning, J.; Daoud, A.; Meredith, P. G.; Mitchell, T. M.

    2017-12-01

    Volcanic and geothermal systems are in part controlled by the mechanical and thermal stresses acting on them and so it is important to understand the response of volcanic rocks to thermo-mechanical loading. One such response is the well-known `Kaiser stress-memory' effect observed under cyclic mechanical loading. By contrast, the presence of an analogous `Kaiser temperature-memory effect' during cyclic thermal loading has received little attention. We have therefore explored the possibility of a Kaiser temperature-memory effect using three igneous rocks of different composition, grain size and origin; Slaufrudalur Granophyre (SGP), Nea Kameni Andesite (NKA) and Seljadalur Basalt (SB). We present results from a series of thermal stressing experiments in which acoustic emissions (AE) were recorded contemporaneously with changing temperature. Samples of each rock were subjected to both a single heating and cooling cycle to a maximum temperature of 900 °C and multiple heating/cooling cycles to peak temperatures of 350°C, 500°C, 700°C and 900 °C (all at a constant rate of 1°C/min on heating and a natural cooling rate of memory effect in SGP, but not in either NKA and SB. We further find that the vast majority of thermal crack damage is generated upon cooling in the finer grained materials (NKA and SB), but that substantial thermal crack damage is generated during heating in the coarser grained SGP. The total amount of crack damage generated due to heating or cooling is dependent on the mineral composition and, most importantly, the grain size and arrangement, as well as the maximum temperature to which the rock is exposed. Knowledge of thermal stress history and the presence of a Kaiser temperature-memory effect is potentially important in understanding magma chamber dynamics, where the cyclic nature of mechanical and thermal inflation and deflation can lead to sequential accumulation of damage, potentially leading to critical rupture.

  1. In vitro assessment of Pediococcus acidilactici Kp10 for its potential use in the food industry.

    Science.gov (United States)

    Abbasiliasi, Sahar; Tan, Joo Shun; Bashokouh, Fatemeh; Ibrahim, Tengku Azmi Tengku; Mustafa, Shuhaimi; Vakhshiteh, Faezeh; Sivasamboo, Subhashini; Ariff, Arbakariya B

    2017-05-23

    Selection of a microbial strain for the incorporation into food products requires in vitro and in vivo evaluations. A bacteriocin-producing lactic acid bacterium (LAB), Pediococcus acidilactici Kp10, isolated from a traditional dried curd was assessed in vitro for its beneficial properties as a potential probiotic and starter culture. The inhibitory spectra of the bacterial strain against different gram-positive and gram-negative bacteria, its cell surface hydrophobicity and resistance to phenol, its haemolytic, amylolytic and proteolytic activities, ability to produce acid and coagulate milk together with its enzymatic characteristics and adhesion property were all evaluated in vitro. P. acidilactici Kp10 was moderately tolerant to phenol and adhere to mammalian epithelial cells (Vero cells and ileal mucosal epithelium). The bacterium also exhibited antimicrobial activity against several gram-positive and gram-negative food-spoilage and food-borne pathogens such as Listeria monocytgenes ATCC 15313, Salmonella enterica ATCC 13311, Shigella sonnei ATCC 9290, Klebsiella oxytoca ATCC 13182, Enterobacter cloaca ATCC 35030 and Streptococcus pyogenes ATCC 12378. The absence of haemolytic activity and proteinase (trypsin) and the presence of a strong peptidase (leucine-arylamidase) and esterase-lipase (C4 and C8) were observed in this LAB strain. P. acidilactici Kp10 also produced acid, coagulated milk and has demonstrated proteolytic and amylolactic activities. The properties exhibited by P. acidilactici Kp10 suggested its potential application as probiotic and starter culture in the food industry.

  2. (KP) equation in warm dusty plasma with variable dust charge, two ...

    Indian Academy of Sciences (India)

    In this work, the propagation of nonlinear waves in warm dusty plasmas with variable dust charge, two-temperature ion and nonthermal electron is studied. By using the reductive perturbation theory, the Kadomstev–Petviashvili (KP) equation is derived. The energy of the soliton and the linear dispersion relation are obtained ...

  3. Reply to Nicholson's comment on "Consistent calculation of aquatic gross production from oxygen triple isotope measurements" by Kaiser (2011

    Directory of Open Access Journals (Sweden)

    J. Kaiser

    2012-08-01

    Full Text Available The comment by Nicholson (2011a questions the "consistency" of the "definition" of the "biological end-member" used by Kaiser (2011a in the calculation of oxygen gross production. "Biological end-member" refers to the relative oxygen isotope ratio difference between photosynthetic oxygen and Air-O2 (abbreviated 17δP and 18δP for 17O/16O and 18O/16O, respectively. The comment claims that this leads to an overestimate of the discrepancy between previous studies and that the resulting gross production rates are "30% too high". Nicholson recognises the improved accuracy of Kaiser's direct calculation ("dual-delta" method compared to previous approximate approaches based on 17O excess (17Δ and its simplicity compared to previous iterative calculation methods. Although he correctly points out that differences in the normalised gross production rate (g are largely due to different input parameters used in Kaiser's "base case" and previous studies, he does not acknowledge Kaiser's observation that iterative and dual-delta calculation methods give exactly the same g for the same input parameters (disregarding kinetic isotope fractionation during air-sea exchange. The comment is based on misunderstandings with respect to the "base case" 17δP and 18δP values. Since direct measurements of 17δP and 18δPdo not exist or have been lost, Kaiser constructed the "base case" in a way that was consistent and compatible with literature data. Nicholson showed that an alternative reconstruction of 17δP gives g values closer to previous studies. However, unlike Nicholson, we refrain from interpreting either reconstruction as a benchmark for the accuracy of g. A number of publications over the last 12 months

  4. Matrix integral solutions to the discrete KP hierarchy and its Pfaffianized version

    International Nuclear Information System (INIS)

    Lafortune, Stéphane; Li, Chun-Xia

    2016-01-01

    Matrix integrals used in random matrix theory for the study of eigenvalues of Hermitian ensembles have been shown to provide τ -functions for several hierarchies of integrable equations. In this article, we extend this relation by showing that such integrals can also provide τ -functions for the discrete KP hierarchy and a coupled version of the same hierarchy obtained through the process of Pfaffianization. To do so, we consider the first equation of the discrete KP hierarchy, the Hirota–Miwa equation. We write the Wronskian determinant solutions to the Hirota–Miwa equation and consider a particular form of matrix integrals, which we show is an example of those Wronskian solutions. The argument is then generalized to the whole hierarchy. A similar strategy is used for the Pfaffianized version of the hierarchy except that in that case, the solutions are written in terms of Pfaffians rather than determinants. (paper)

  5. Anticancer ruthenium(III) complex KP1019 interferes with ATP-dependent Ca2+ translocation by sarco-endoplasmic reticulum Ca2+-ATPase (SERCA).

    Science.gov (United States)

    Sadafi, Fabrizio-Zagros; Massai, Lara; Bartolommei, Gianluca; Moncelli, Maria Rosa; Messori, Luigi; Tadini-Buoninsegni, Francesco

    2014-08-01

    Sarco-endoplasmic reticulum Ca2+-ATPase (SERCA), a P-type ATPase that sustains Ca2+ transport and plays a major role in intracellular Ca2+ homeostasis, represents a therapeutic target for cancer therapy. Here, we investigated whether ruthenium-based anticancer drugs, namely KP1019 (indazolium [trans-tetrachlorobis(1H-indazole)ruthenate(III)]), NAMI-A (imidazolium [trans-tetrachloro(1H-imidazole)(S-dimethylsulfoxide)ruthenate(III)]) and RAPTA-C ([Ru(η6-p-cymene)dichloro(1,3,5-triaza-7-phosphaadamantane)]), and cisplatin (cis-diammineplatinum(II) dichloride) might act as inhibitors of SERCA. Charge displacement by SERCA adsorbed on a solid-supported membrane was measured after ATP or Ca2+ concentration jumps. Our results show that KP1019, in contrast to the other metal compounds, is able to interfere with ATP-dependent translocation of Ca2+ ions. An IC50 value of 1 μM was determined for inhibition of calcium translocation by KP1019. Conversely, it appears that KP1019 does not significantly affect Ca2+ binding to the ATPase from the cytoplasmic side. Inhibition of SERCA at pharmacologically relevant concentrations may represent a crucial aspect in the overall pharmacological and toxicological profile of KP1019. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. The master symmetry and time dependent symmetries of the differential–difference KP equation

    International Nuclear Information System (INIS)

    Khanizadeh, Farbod

    2014-01-01

    We first obtain the master symmetry of the differential–difference KP equation. Then we show how this master symmetry, through sl(2,C)-representation of the equation, can construct generators of time dependent symmetries. (paper)

  7. Educação permanente: reflexão na prática da enfermagem hospitalar.

    Directory of Open Access Journals (Sweden)

    José Reginaldo PINTO

    2015-08-01

    Full Text Available Na prática hospitalar, a Educação Permanente é indispensável à formação dos trabalhadores, os quais necessitam ter conhecimentos renovados em sua prática profissional. Nesta perspectiva, buscou-se analisar por meio dessa pesquisa a percepção dos enfermeiros de um hospital de ensino acerca da educação permanente no ambiente hospitalar. Trata-se de uma pesquisa descritiva com abordagem qualitativa, realizada com nove enfermeiros coordenadores de setores, utilizando-se três grupos focais, constituído por três enfermeiros em cada grupo. A investigação ocorreu no Hospital do Coração do município de Sobral, Ceará. Utilizaram-se entrevistas que foram gravadas nas reuniões dos grupos. A análise de conteúdo de Bardin estruturou os achados encontrados. Esses resultados foram separados por unidades temáticas. Foram respeitados os princípios éticos de acordo com a resolução 466/12. A primeira unidade temática investigou o conhecimento dos sujeitos acerca da Educação Permanente, Continuada e em Serviço. Os primeiros achados identificaram divergências de opiniões dos participantes quando conceituaram a diferenciação entre as modalidades de educação em saúde. A segunda unidade resgatou a opinião dos sujeitos sobre as estratégias para implantar uma comissão de educação permanente no hospital. As falas dos participantes revelaram que a comissão deveria motivar os profissionais a continuarem se qualificando no serviço. Ainda indagaram que essas comissões deveria ter caráter multidisciplinar. A última unidade analisada referiu-se a forma de atuar das comissões de educação permanente. Os investigados assinalaram que elas deveriam proporcionar a melhoria do ensino aos profissionais aplicando as metodologias ativas.

  8. Higher-spin and W∞(J) algebras in Virasoro-constrained KP and N-KdV hierarchies

    International Nuclear Information System (INIS)

    Semikhatov, A.M.

    1991-02-01

    Virasoro constraints on the KP hierarchy, arising in matrix models, are studied by reexpressing them in terms of dressing operators of the hierarchy. There exists a one-parameter family of Virasoro representations on the KP hierarchy (depending on a number J which can be identified as the conformal weight of an abstract bc system). The respective full invariance algebra is the ''Borel'' subalgebra of W ∞ (J), which we describe as an extension of the ''wedge'', or higher spin, algebra B λ=J-J 2 by the L 2 Virasoro generator. Reductions of these structures to the N-KdV hierarchies are performed explicitly. (author). 26 refs

  9. del establecimiento permanente

    Directory of Open Access Journals (Sweden)

    V. Ma. Antonieta Martin Granados

    2002-01-01

    Full Text Available A pesar de que en México se han realizado adiciones a la legislación en materia civil y mercantil relacionadas con el uso de medios electrónicos como instrumentos para realizar actos jurídicos, éstas resultan insuficientes, pues nada se ha hecho en materia procesal, penal y laboral, entre otras. En este trabajo se presentan, en materia fiscal, algunas consideraciones acerca del concepto de establecimiento permanente tanto en la legislación mexicana como en el Convenio Modelo (CM de la Organización para la Cooperación y Desarrollo Económico (OCDE y se argumenta que a pesar de que la definición de la legislación mexicana es mucho más amplia que la que se encuentra en el mencionado convenio, el comercio electrónico presenta algunos retos para determinar el lugar en donde residen las partes involucradas, el lugar en donde se celebran las operaciones y se pagan o cobran, sobre todo tratándose de servicios o adquisición de bienes intangibles. Por último, se señala que en materia fiscal es necesario que las autoridades mexicanas permitan el uso de la factura electrónica

  10. Gaussian solitary waves for the logarithmic-KdV and the logarithmic-KP equations

    International Nuclear Information System (INIS)

    Wazwaz, Abdul-Majid

    2014-01-01

    We investigate the logarithmic-KdV equation for more Gaussian solitary waves. We extend this work to derive the logarithmic-KP (Kadomtsev–Petviashvili) equation. We show that both logarithmic models are characterized by their Gaussian solitons. (paper)

  11. LA FORMACIÓN AMBIENTAL PERMANENTE DEL DIRECTIVO EDUCACIONAL DEL SIGLO XXI

    Directory of Open Access Journals (Sweden)

    Mavel Moré Estupiñán

    2013-12-01

    Full Text Available La situación ambiental actual impone nuevos retos a los sistemas educativos, entre ellos el de incorporar la educación ambiental para el desarrollo sostenible al proceso pedagógico en los diferentes subsistemas de educación. Para lograr este propósito, es decisivo el rol del directivo educacional, desde la implementación del sistema de dirección institucional. Por ello, la formación ambiental de este profesional constituye un imperativo y se declara como problema científico de la presente investigación, que se sustenta teórica y metodológicamente en los fundamentos de la formación ambiental permanente del directivo educacional y delimita como objetivo: proponer un Modelo para orientar hacia el desarrollo sostenible este proceso. Garantizan el cumplimiento del objetivo, el empleo de métodos teóricos, estadísticos y/o de procesamiento matemático y empíricos, de corte cuantitativo y cualitativo, que se articulan a partir de las técnicas de la investigación-acción-participativa. El Modelo constituye la contribución a la teoría pedagógica y son aportes de significación práctica los programas de las formas organizativas de la formación permanente. El criterio de la práctica, como resultado de la sistematización de una secuencia de ciclos, y las valoraciones de diferentes evaluadores confirman la pertinencia, relevancia y efectividad del Modelo de formación ambiental permanente del directivo educacional.

  12. Evaluation of a surveillance case definition for anogenital warts, Kaiser Permanente northwest.

    Science.gov (United States)

    Naleway, Allison L; Weinmann, Sheila; Crane, Brad; Gee, Julianne; Markowitz, Lauri E; Dunne, Eileen F

    2014-08-01

    Most studies of anogenital wart (AGW) epidemiology have used large clinical or administrative databases and unconfirmed case definitions based on combinations of diagnosis and procedure codes. We developed and validated an AGW case definition using a combination of diagnosis codes and other information available in the electronic medical record (provider type, laboratory testing). We calculated the positive predictive value (PPV) of this case definition compared with manual medical record review in a random sample of 250 cases. Using this case definition, we calculated the annual age- and sex-stratified prevalence of AGW among individuals 11 through 30 years of age from 2000 through 2005. We identified 2730 individuals who met the case definition. The PPV of the case definition was 82%, and the average annual prevalence was 4.16 per 1000. Prevalence of AGW was higher in females compared with males in every age group, with the exception of the 27- to 30-year-olds. Among females, prevalence peaked in the 19- to 22-year-olds, and among males, the peak was observed in 23- to 26-year-olds. The case definition developed in this study is the first to be validated with medical record review and has a good PPV for the detection of AGW. The prevalence rates observed in this study were higher than other published rates, but the age- and sex-specific patterns observed were consistent with previous reports.

  13. A one-parameter family of hamiltonian structures for the KP hierarchy and a continuous deformation of the nonlinear WKP algebra

    International Nuclear Information System (INIS)

    Figueroa-O'Farrill, J.M.; Mas, J.; Ramos, E.

    1993-01-01

    The KP hierarchy is hamiltonian relative to a one-parameter family of Poisson structures obtained from a generalized Adler map in the space of formal pseudodifferential symbols with noninteger powers. The resulting W-algebra is a one-parameter deformation of W KP admitting a central extension for generic values of the parameter, reducing naturally to W n for special values of the parameter, and contracting to the centrally extended W 1+∞ , W ∞ and further truncations. In the classical limit, all algebras in the one-parameter family are equivalent and isomorphic to W KP . The reduction induced by setting the spin-one field to zero yields a one-parameter deformation of W ∞ which contracts to a new nonlinear algebra of the W ∞ -type. (orig.)

  14. Recombinant Promoter (MUASCsV8CP) Driven Totiviral Killer Protein 4 (KP4) Imparts Resistance Against Fungal Pathogens in Transgenic Tobacco

    Science.gov (United States)

    Deb, Debasish; Shrestha, Ankita; Maiti, Indu B.; Dey, Nrisingha

    2018-01-01

    Development of disease-resistant plant varieties achieved by engineering anti-microbial transgenes under the control of strong promoters can suffice the inhibition of pathogen growth and simultaneously ensure enhanced crop production. For evaluating the prospect of such strong promoters, we comprehensively characterized the full-length transcript promoter of Cassava Vein Mosaic Virus (CsVMV; -565 to +166) and identified CsVMV8 (-215 to +166) as the highest expressing fragment in both transient and transgenic assays. Further, we designed a new chimeric promoter ‘MUASCsV8CP’ through inter-molecular hybridization among the upstream activation sequence (UAS) of Mirabilis Mosaic Virus (MMV; -297 to -38) and CsVMV8, as the core promoter (CP). The MUASCsV8CP was found to be ∼2.2 and ∼2.4 times stronger than the CsVMV8 and CaMV35S promoters, respectively, while its activity was found to be equivalent to that of the CaMV35S2 promoter. Furthermore, we generated transgenic tobacco plants expressing the totiviral ‘Killer protein KP4’ (KP4) under the control of the MUASCsV8CP promoter. Recombinant KP4 was found to accumulate both in the cytoplasm and apoplast of plant cells. The agar-based killing zone assays revealed enhanced resistance of plant-derived KP4 against two deuteromycetous foliar pathogenic fungi viz. Alternaria alternata and Phoma exigua var. exigua. Also, transgenic plants expressing KP4 inhibited the growth progression of these fungi and conferred significant fungal resistance in detached-leaf and whole plant assays. Taken together, we establish the potential of engineering “in-built” fungal stress-tolerance in plants by expressing KP4 under a novel chimeric caulimoviral promoter in a transgenic approach. PMID:29556246

  15. Using a High-Performance Planning Model to Increase Levels of Functional Effectiveness Within Professional Development.

    Science.gov (United States)

    Winter, Peggi

    2016-01-01

    Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.

  16. Unique continuation property for the Kadomtsev-Petviashvili (KP-II equation

    Directory of Open Access Journals (Sweden)

    Mahendra Panthee

    2005-06-01

    Full Text Available We generalize a method introduced by Bourgain in cite{Borg} based on complex analysis to address two spatial dimensional models and prove that if a sufficiently smooth solution to the initial value problem associated with the Kadomtsev-Petviashvili (KP-II equation $$ (u_t+u_{xxx}+uu_{x}_{x} +u_{yy}=0, quad (x, y in mathbb{R}^2, ;tinmathbb{R}, $$ is supported compactly in a nontrivial time interval then it vanishes identically.

  17. Medical Device Plug-and-Play Interoperability Standards and Technology Leadership

    Science.gov (United States)

    2014-10-01

    Kaiser Permanente, Johns Hopkins Medicine, the VA, FDA, NIST, TATRC, computer and information science groups at University of Pennsylvania...for sharing the findings from our TATRC work and from our NIH Quantum work relative to the gaps in existing standards and recommendations on how they...challenges facing the industry in areas such as interoperability, cybersecurity , data stewardship, and system reliability, and policies needed to accelerate

  18. Postcataract endophthalmitis prophylaxis using irrigation, incision hydration, and eye pressurization with vancomycin

    Directory of Open Access Journals (Sweden)

    Schelonka LP

    2015-07-01

    Full Text Available Lee P Schelonka,1 Margaret A SaBell2 1Department of Opthalmology, Kaiser Permanente Lone Tree Medical Offices, Lone Tree, 2Department of Infection Control, Kaiser Permanente Lone Tree Medical Offices, Lone Tree, Denver, CO, USA Purpose: This study aimed to determine whether switching from balanced salt solution (BSS to vancomycin 20 g/mL BSS for incision hydration and eye pressurization reduces the rate of postcataract endophthalmitis.Methods: This was a patient safety/quality improvement project, including all patients undergoing cataract surgery at the Kaiser Permanente Colorado Ophthalmology Department from January 2002 to December 2014. Throughout the study, patients received vancomycin 20 µg/mL in the irrigating solution. During the baseline period from 2002 to 2005, surgeons pressurized eyes and hydrated incisions with plain BSS. During the intervention period from 2006 through 2014, surgeons switched from BSS to the vancomycin/BSS irrigating solution for eye pressurization and incision hydration.Results: A total of 57,263 cataract operations were performed by 24 surgeons at seven surgical centers: 12,400 in the baseline period and 44,863 in the intervention period. The rate of postcataract endophthalmitis declined significantly from 5/12,400 (rate: 0.4/1,000 in the baseline period to 1/44,863 (rate: 0.022/1,000 during the intervention period (odds ratio [OR]: 18.1, 95% confidence interval [CI]: 2.11–154.9; χ2=13.5, P=0.00024. Accounting for an estimated 2.05-fold risk reduction due to confounding variables, the risk reduction attributed to the intervention remained significant: (adjusted OR: 8.78, 95% CI: 1.73–44.5; χ2=10.06, P=0.0015. Since 2009, we have not experienced any cases of postcataract endophthalmitis after 32,753 operations.Conclusion: We experienced a significant reduction in postcataract endophthalmitis when we switched from BSS to the vancomycin/BSS irrigating solution for incision hydration and eye pressurization

  19. Blueberry muffin rash, hyperbilirubinemia, and hypoglycemia: a case of hemolytic disease of the fetus and newborn due to anti-Kp(a).

    Science.gov (United States)

    Brumbaugh, J E; Morgan, S; Beck, J C; Zantek, N; Kearney, S; Bendel, C M; Roberts, K D

    2011-05-01

    Hemolytic disease of the fetus and newborn occurs when maternal IgG antibodies cross the placenta and cause hemolysis of fetal red blood cells. Kp(a) is a low frequency red blood cell antigen that has rarely been implicated in hemolytic disease of the fetus and newborn. The few reported cases attributed to anti-Kp(a) have typically had minimal clinical consequences. We report a critically ill neonate who presented with purpura, respiratory failure, severe liver dysfunction, hyperbilirubinemia, hypoglycemia and anemia. This case report broadens the spectrum of neonatal disease associated with anti-Kp(a), addresses the evaluation of hemolysis with liver failure in a neonate, and emphasizes the importance of screening for antibodies to low frequency red blood cell antigens in suspected hemolytic disease of the fetus and newborn.

  20. On a family of KP multi-line solitons associated to rational degenerations of real hyperelliptic curves and to the finite non-periodic Toda hierarchy

    Science.gov (United States)

    Abenda, Simonetta

    2017-09-01

    We continue the program started in Abenda and Grinevich (2015) of associating rational degenerations of M-curves to points in GrTNN(k , n) using KP theory for real finite gap solutions. More precisely, we focus on the inverse problem of characterizing the soliton data which produce Krichever divisors compatible with the KP reality condition when Γ is a certain rational degeneration of a hyperelliptic M-curve. Such choice is motivated by the fact that Γ is related to the curves associated to points in GrTP(1 , n) and in GrTP(n - 1 , n) in Abenda and Grinevich (2015). We prove that the reality condition on the Krichever divisor on Γ singles out a special family of KP multi-line solitons (T-hyperelliptic solitons) in GrTP(k , n) , k ∈ [ n - 1 ] , naturally connected to the finite non-periodic Toda hierarchy. We discuss the relations between the algebraic-geometric description of KP T-hyperelliptic solitons and of the open Toda system. Finally, we also explain the effect of the space-time transformation which conjugates soliton data in GrTP(k , n) to soliton data in GrTP(n - k , n) on the Krichever divisor for such KP solitons.

  1. On the solutions of the dKP equation: the nonlinear Riemann Hilbert problem, longtime behaviour, implicit solutions and wave breaking

    International Nuclear Information System (INIS)

    Manakov, S V; Santini, P M

    2008-01-01

    We have recently solved the inverse scattering problem for one-parameter families of vector fields, and used this result to construct the formal solution of the Cauchy problem for a class of integrable nonlinear partial differential equations in multidimensions, including the second heavenly equation of Plebanski and the dispersionless Kadomtsev-Petviashvili (dKP) equation. We showed, in particular, that the associated inverse problems can be expressed in terms of nonlinear Riemann-Hilbert problems on the real axis. In this paper, we make use of the nonlinear Riemann-Hilbert problem of dKP (i) to construct the longtime behaviour of the solutions of its Cauchy problem; (ii) to characterize a class of implicit solutions; (iii) to elucidate the spectral mechanism causing the gradient catastrophe of localized solutions of dKP, at finite time as well as in the longtime regime, and the corresponding universal behaviours near breaking

  2. On the solutions of the dKP equation: the nonlinear Riemann Hilbert problem, longtime behaviour, implicit solutions and wave breaking

    Energy Technology Data Exchange (ETDEWEB)

    Manakov, S V [Landau Institute for Theoretical Physics, Moscow (Russian Federation); Santini, P M [Dipartimento di Fisica, Universita di Roma ' La Sapienza' , and Istituto Nazionale di Fisica Nucleare, Sezione di Roma 1, Piazz.le Aldo Moro 2, I-00185 Rome (Italy)

    2008-02-08

    We have recently solved the inverse scattering problem for one-parameter families of vector fields, and used this result to construct the formal solution of the Cauchy problem for a class of integrable nonlinear partial differential equations in multidimensions, including the second heavenly equation of Plebanski and the dispersionless Kadomtsev-Petviashvili (dKP) equation. We showed, in particular, that the associated inverse problems can be expressed in terms of nonlinear Riemann-Hilbert problems on the real axis. In this paper, we make use of the nonlinear Riemann-Hilbert problem of dKP (i) to construct the longtime behaviour of the solutions of its Cauchy problem; (ii) to characterize a class of implicit solutions; (iii) to elucidate the spectral mechanism causing the gradient catastrophe of localized solutions of dKP, at finite time as well as in the longtime regime, and the corresponding universal behaviours near breaking.

  3. Evaluación de la formación permanente del profesorado: enfoque de resultados || Evaluation of permanent teacher training: approach of results

    Directory of Open Access Journals (Sweden)

    José Domínguez

    2015-07-01

    Full Text Available La evolución del sistema educativo ha provocado cambios significativos en la formación permanente del profesorado, por tanto, es necesario un diagnóstico de necesidades utilizando instrumentos y metodologías que informen de las demandas formativas profesionales. En este sentido, el objetivo principal del estudio se centra en aportar luz sobre las percepciones y expectativas del profesorado acerca de la formación permanente en la Comunidad Autónoma de Galicia. Para ello, se utilizó una metodología evaluativa centrada en el contexto, entrada, proceso y producto (diseño CIPP. Los resultados confirman que la evolución de la formación se viene incrementando en su oferta pero disminuyendo su eficacia. Además, se ha comprobado la necesidad de reestructurar la formación permanente, apostando por un modelo más global, con cobertura en todas las necesidades formativas del profesorado. El gran reto de la formación permanente del profesorado es la transferibilidad de la misma al contexto del aula, una cuestión sencilla pero muy difícil de evaluar. Mejorar la calidad educativa depende directamente de la eficiencia y excelencia en la formación docente, la cual debería someterse a un proceso de revisión y actualización permanente.

  4. Integrability and symmetry algebra associated with N=2 KP flows

    International Nuclear Information System (INIS)

    Ghosh, Sasanka; Sarma, Debojit

    2001-01-01

    We show the complete integrability of N=2 nonstandard KP flows establishing the bi-Hamiltonian structures. One of Hamiltonian structures is shown to be isomorphic to the nonlinear N=2 W ∞ algebra with the bosonic sector having W 1+∞ ·W ∞ structure. A consistent free field representation of the super conformal algebra is obtained. The bosonic generators are found to be an admixture of free fermions and free complex bosons, unlike the linear one. The fermionic generators become exponential in free fields, in general

  5. On the Lax representation of the 2-component KP and 2D Toda hierarchies

    International Nuclear Information System (INIS)

    Carlet, Guido; Manas, Manuel

    2010-01-01

    The Lax formulation of the multicomponent Kadomtsev-Petviashvili (KP) and 2D Toda hierarchies involves several implicit constraints. We show that, at least in the 2-component case, it is possible to explicitly solve such constraints and identify a set of free dependent variables for such hierarchies.

  6. Análisis de series temporales en estaciones permanentes GPS

    OpenAIRE

    García Cañada, Laura

    2016-01-01

    En los ultimos años el número de estaciones permanentes GPS ha aumentado considerablemente para diferentes aplicaciones geodésicas y se comienza a disponer de series de coordenadas suficientemente largas como para poder aplicar ánalisis de series temporales. El principal objetivo de esta tesis es estudiar la influencia de la red de estaciones utilizada, marco de referencia y/o estrategia de procesado en las series temporales de coordenadas de estaciones CGPS y todos aquellos parámetros que se...

  7. Análisis de series temporales en estaciones permanentes GPS

    OpenAIRE

    García Cañada, Laura

    2015-01-01

    En los ultimos años el número de estaciones permanentes GPS ha aumentado considerablemente para diferentes aplicaciones geodésicas y se comienza a disponer de series de coordenadas suficientemente largas como para poder aplicar ánalisis de series temporales. El principal objetivo de esta tesis es estudiar la influencia de la red de estaciones utilizada, marco de referencia y/o estrategia de procesado en las series temporales de coordenadas de estaciones CGPS y todos aquellos parámetros que s...

  8. Establishment of design concept of large capacity passive reactor KP1000 and performance evaluation of safety system for LBLOCA

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong O.; Hwang, Young Dong; Kim, Young In; Chang, Moon Hee

    1997-03-01

    This study was performed to establish the design concepts and to evaluate the performance of safety features of large capacity passive reactor (1000 MWe grade). The design concepts of the large capacity passive reactor `KP1000` were established to generate 1000 MW electric power based on the AP600 of Westinghouse by increasing the number of reactor coolant loop and by increasing the size of reactor internals/core. To implement the analysis of the LBLOCA for KP1000, various kinds of computer codes being considered, it was concluded that RELAP5 was the most appropriate one in availability and operations in present situation. By the analysis of the computer code `RELAP5/Mod3.2.1.2`, following conclusions were derived as described below. First, by spectrum analysis of the discharge factor of the berak part, the most conservative discharge factor C{sub D}=1.2 and the PCT value of KP1000 was 1254F, which is slightly higher than the value of AP600 but is much less than the existing active reactor `Kori 3 and 4` where blowdown PCT value is 1693.4 deg F and reflooding PCT is 1918.4 deg F. Second, after the 200 seconds from the initiation of LBLOCA, IRWST water was supplied in a stable state and the maximum temperature of clad were maintained in a saturated condition. Therefore, it was concluded that the passive safety features of KP1000 keep reactor core from being damaged for large break LOCA. (author). 11 refs., 28 tabs., 37 figs.

  9. How dentists diagnose and treat defective restorations: evidence from the dental practice-based research network

    DEFF Research Database (Denmark)

    Gordan, Valeria V; Garvan, Cynthia W; Richman, Joshua S

    2009-01-01

    , Norway and Sweden. METHODS: A questionnaire was sent to all DPBRN practitioner-investigators who reported doing some restorative dentistry (n = 901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment......OBJECTIVES: To (1) identify and quantify the types of treatment that dentists use to manage defective dental restorations and (2) identify characteristics that are associated with these dentists' decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) consists...... of dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi; FL/GA: Florida/Georgia; MN: dentists employed by HealthPartners and private practitioners in Minnesota; PDA: Permanente Dental Associates in cooperation with Kaiser Permanente's Center for Health Research and SK: Denmark...

  10. Epidemiology and risk factors for mortality in bloodstream infection by CP-Kp, ESBL-E, Candida and CDI: A single center retrospective study.

    Science.gov (United States)

    Corcione, Silvia; Angilletta, Roberto; Raviolo, Stefania; Filippini, Claudia; Fossati, Lucina; Di Perri, Giovanni; Cavallo, Rossana; De Rosa, Francesco Giuseppe

    2018-02-01

    The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp) is associated with high mortality. We conducted a single centre retrospective study on patients admitted to Molinette Hospital, Turin, Italy, from January 2013 to April 2015 with CDI or BSI caused by Candida, ESBL-E or CP-Kp. For each patient demographic, clinical and microbiological data were collected. Aims of this study were to describe epidemiology and to evaluate risk factors for in-hospital mortality in this group of patients. Seven hundred-eighty six cases were analyzed: 398 CDI, 137 candidemia, 125 ESBL-E BSI and 126 CP-Kp BSI. CDI, candidemia and ESBL-E BSI were more frequently reported in internal medicine wards (IMW), whilst CP-Kp were more described in intensive care unit (ICU). Sixty-six percent of patients had a previous hospitalization and the majority of patients had several medical comorbidities. In-hospital death occurred in 23.4%. Independent risk factors for mortality were antibiotic therapy before hospital admission, cardiovascular diseases, neutropenia, urinary catheter, total parenteral nutrition, SIRS and higher creatinine levels at diagnosis. Previous abdominal surgery, inflammatory bowel disease, higher serum albumin levels at the admission and fever at diagnosis were significantly associated with survival. Our data showed that CDI, ESBL-E BSI and candidemia are more frequent in frail patients, admitted to IMW, with chronic comorbidities and broad exposure to antibiotic therapies, with the exception for CP-Kp BSI, still more common in the ICU. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  11. Two-dimensional IR spectroscopy of the anti-HIV agent KP1212 reveals protonated and neutral tautomers that influence pH-dependent mutagenicity

    OpenAIRE

    Peng, Chunte Sam; Fedeles, Bogdan I.; Singh, Vipender; Li, Deyu; Amariuta, Tiffany; Essigmann, John M.; Tokmakoff, Andrei

    2015-01-01

    The anti-HIV drug KP1212 was designed to intentionally increase the mutation rate of HIV, thereby causing viral population collapse. Its mutagenicity and thus antiviral activity was proposed to be the result of tautomerization. We used 2D IR spectroscopy to identify rapidly interconverting tautomers under physiological conditions. The traditionally rare enol–imino tautomer for nucleobases was found to be the major species for KP1212, providing a structural support for the tautomer hypothesis....

  12. Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

    Science.gov (United States)

    Jeong, Erwin W; Feger, Erin; Noble, Harmony K; Kmiec, Magdalen; Prayaga, Ram S

    2018-01-01

    Background Nonadherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a variety of reasons. Text message reminders have been used to improve adherence. However, few programs or studies have explored the benefits of text messaging with older populations and at scale. In this paper, we present a program design using tailored and interactive text messaging to improve refill rates of partially adherent or nonadherent Medicare members of a large integrated health plan. Objective The aim of this 3-month program was to gain an understanding of whether tailored interactive text message dialogues could be used to improve medication refills in Medicare patients with one or more chronic diseases. Methods We used the mPulse Mobile interactive text messaging solution with partially adherent and nonadherent Medicare patients (ie, over age 65 years or younger with disabilities) of Kaiser Permanente Southern California (KP), a large integrated health plan, and compared refill rates of the text messaging group (n=12,272) to a group of partially adherent or nonadherent Medicare patients at KP who did not receive text messages (nontext messaging group, n=76,068). Both groups were exposed to other forms of refill and adherence outreach including phone calls, secure emails, and robo-calls from December 2016 to February 2017. Results The text messaging group and nontext messaging group were compared using an independent samples t test to test difference in group average of refill rates. There was a significant difference in medication refill rates between the 2 groups, with a 14.07 percentage points higher refill rate in the text messaging group (Pimprove medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement

  13. Educación permanente y continua en una perspectiva de integridad del ser

    Directory of Open Access Journals (Sweden)

    Izabel Cristina Feijó de Andrade

    2014-12-01

    Full Text Available Este artículo buscó discutir las articulaciones y distinciones entre los conceptos de educación permanente y educación continua de modo que favorezca la perspectiva de integridad del ser, vínculo que requiere saberes hasta entonces poco privilegiados en las Universidades y que demandan el rescate de dimensiones basadas en la experiencia, la didáctica y la existencia del educador, tanto individual, comportamental, cultural, social y espiritual. Consideramos que las nociones de educación permanente y educación continua poseen elementos entrelazables que nos permiten desarrollar la capacidad de reaccionar críticamente por medio de una relación autoformativa. Las revisiones teóricas implementadas permitieron algunas consideraciones sobre los procesos formativos actuales y las prácticas de profesores rumbo a una Educación para la Integridad. Concluimos provisoriamente que las aproximaciones y distinciones entre EP y EC pueden proporcionar a los profesores la toma de conciencia de su vinculación todo/parte y del sentido de la vida.

  14. Feed forward neural networks modeling for K-P interactions

    International Nuclear Information System (INIS)

    El-Bakry, M.Y.

    2003-01-01

    Artificial intelligence techniques involving neural networks became vital modeling tools where model dynamics are difficult to track with conventional techniques. The paper make use of the feed forward neural networks (FFNN) to model the charged multiplicity distribution of K-P interactions at high energies. The FFNN was trained using experimental data for the multiplicity distributions at different lab momenta. Results of the FFNN model were compared to that generated using the parton two fireball model and the experimental data. The proposed FFNN model results showed good fitting to the experimental data. The neural network model performance was also tested at non-trained space and was found to be in good agreement with the experimental data

  15. The geometry of the super KP flows

    International Nuclear Information System (INIS)

    Rabin, J.M.

    1991-01-01

    A supersymmetric generalization of the Krichever map is used to construct algebro-geometric solutions to the various super Kadomtsev-Petviashvili (SKP) hierarchies. The geometric data required consist of a suitable algebraic supercurve of genus g (generally not a super Riemann surface) with a distinguished point and local coordinates (z, θ) there, and a generic line bundle of degree g-1 with a local trivialization near the point. The resulting solutions to the Manin-Radul SKP system describe coupled deformations of the line bundle and the supercurve itself, in contrast to the ordinary KP system which deforms line bundles but not curves. Two new SKP systems are introduced: An integrable 'Jacobian' system whose solutions describe genuine Jacobian flows, deforming the bundle but not the curve; and a nonintegrable 'maximal' system describing independent deformations of bundle and curve. The Kac-van de Leur SKP system describes the same deformations as the maximal system, but in a different parametrization. (orig.)

  16. Supersymmetric KP hierarchy in N=1 superspace and its N=2 reductions

    International Nuclear Information System (INIS)

    Lechtenfeld, O.; Sorin, A.

    2000-01-01

    A wide class of N=2 reductions of the supersymmetric KP hierarchy in N=1 superspace is described. This class includes a new N=2 supersymmetric generalization of the Toda chain hierarchy. The Lax pair representations of the bosonic and fermionic flows, local and non-local Hamiltonians, finite and infinite discrete symmetries, first two Hamiltonian structures and the recursion operator of this hierarchy are constructed. Its secondary reduction to new N=2 supersymmetric modified KdV hierarchy is discussed

  17. Supersymmetric KP hierarchy in N=1 superspace and its N=2 reductions

    International Nuclear Information System (INIS)

    Lechtenfeld, O.; Sorin, A.

    1999-01-01

    A wide class of N=2 reductions of the supersymmetric KP hierarchy in N=1 superspace is described. This class includes a new N=2 supersymmetric generalization of the Toda chain hierarchy. The Lax pair representations of the bosonic and fermionic flows, local and nonlocal Hamiltonians, finite and infinite discrete symmetries, first two Hamiltonian structures and the recursion operator of this hierarchy are constructed. Its secondary reduction to new N=2 supersymmetric modified KdV hierarchy is discussed

  18. Spin Calogero Particles and Bispectral Solutions of the Matrix KP Hierarchy

    International Nuclear Information System (INIS)

    Bergvelt, Maarten; Gekhtman, Michael; Kasman, Alex

    2009-01-01

    Pairs of nxn matrices whose commutator differ from the identity by a matrix of rank r are used to construct bispectral differential operators with rxr matrix coefficients satisfying the Lax equations of the Matrix KP hierarchy. Moreover, the bispectral involution on these operators has dynamical significance for the spin Calogero particles system whose phase space such pairs represent. In the case r = 1, this reproduces well-known results of Wilson and others from the 1990's relating (spinless) Calogero-Moser systems to the bispectrality of (scalar) differential operators

  19. The bi-Hamiltonian structures of the Manin-Radul super KP hierarchy

    International Nuclear Information System (INIS)

    Panda, S.; Roy, S.

    1992-05-01

    We consider the ''even-time'' flow of the Manin-Radul supersymmetric KP hierarchy and show that it possesses bi-Hamiltonian structures by deriving two distinct Gelfand-Dikii brackets corresponding to two successive Hamiltonians of the system. A recursion relation involving them is also obtained. We observe that the first Hamiltonian structure defines a supersymmetric Lie algebra since it is a linear algebra among the super fields appearing in the Lax operator whereas the second Hamiltonian structure is a non-linear algebra and so it does not define a Lie algebra. (author). 25 refs

  20. Genetics as a modernization program: biological research at the Kaiser Wilhelm Institutes and the political economy of the Nazi State.

    Science.gov (United States)

    Gausemeier, Bernd

    2010-01-01

    During the Third Reich, the biological institutes of the Kaiser Wilhelm Society (KWG, Kaiser-Wilhelm-Gesellschaft) underwent a substantial reorganization and modernization. This paper discusses the development of projects in the fields of biochemical genetics, virus research, radiation genetics, and plant genetics that were initiated in those years. These cases exemplify, on the one hand, the political conditions for biological research in the Nazi state. They highlight how leading scientists advanced their projects by building close ties with politicians and science-funding organizations and companies. On the other hand, the study examines how the contents of research were shaped by, and how they contributed to, the aims and needs of the political economy of the Nazi system. This paper therefore aims not only to highlight basic aspects of scientific development under Nazism, but also to provide general insights into the structure of the Third Reich and the dynamics of its war economy.

  1. Molybdenum x-ray absorption studies of the mutant Kp nifV of nitrogenase MO-FE protein

    International Nuclear Information System (INIS)

    Eidsness, M.K.; Smith, B.E.; Flood, A.C.; Garner, C.D.; Cramer, S.P.

    1985-01-01

    The nifV mutant nitrogenase enzyme of Klebsiella pheumoniae exhibits altered substrate reducing activity. This nitrogenase mutant cannot fix N 2 in vivo but can reduce C 2 H 2 to C 2 H 4 . The nifV mutant enzyme differs further from the wild-type enzyme by CO inhibition of its H 2 evolution activity, up to 80%. The NifV - phenotype (NifV - Kp1) has been shown to be associated with the iron-molybdenum cofactor (FeMoco) in the Mo Fe protein which is generally accepted as the site for substrate reduction. An X-Ray absorption study of the Mo site in this mutant may reveal a difference in its FeMoco structure. The authors report here a comparison of Mo X-Ray absorption data from the nitrogenase enzymes of the wild-type and NifV - strains in three different forms: (1) as isolated, (2) dye-oxidized, and (3) fixing enzyme systems. Mo edge structure of NifV - Kp1 and wild-type enzymes are nearly identical. Small shifts to higher energies are observed in the oxidized and fixing states. Mo EXAFS of NifV - Kp1 and wild-type in the ''as isolated'' state appear indistinguishable. Curve fitting results best describe the molybdenum in FeMoco as bound by 4-5 S atoms at 2.36 A ,3 Fe atoms at 2.69 A, and 0-2 O(N) atoms at 2.19 A. The spectral similarity of these results concerning the nifV mutant FeMoco structure is discussed

  2. Biobanking for research: a survey of patient population attitudes and understanding

    OpenAIRE

    Rahm, Alanna Kulchak; Wrenn, Michelle; Carroll, Nikki M.; Feigelson, Heather Spencer

    2013-01-01

    Population-based biobanks are a critical resource for genetic research. It is important to know what potential participants understand about the risks and benefits of providing samples in order to ensure adequate informed consent. Kaiser Permanente Colorado (KPCO) is currently planning a biobank where adult members would be asked to contribute an additional tube of blood during a routine blood draw. Adult KPCO members in clinic waiting rooms were asked to read an informational brochure and in...

  3. Safe Routes to School Local School Project: A health evaluation at 10 low-income schools

    OpenAIRE

    Cooper, Jill F MSW; McMillan, Tracy MPH, PHD

    2010-01-01

    fe Routes to School National Partnership (Partnership) founded the Local School Project (Project) in 2008 to assist ten schools in lowincome communities to: 1) develop and evaluate a school-based SRTS program, 2) build local capacity to apply for state or federal SRTS funding, and 3) increase safe walking and bicycling to and from the school and in the community. The Centers for Disease Control and Prevention, Kaiser Permanente, and the Robert Wood Johnson Foundation provided funding for the ...

  4. Valoración "in vitro" de las fuerzas de adhesión de un sistema adhesivo convencional y otro autograbante en esmalte de dientes temporales y permanentes

    OpenAIRE

    Herrera Martínez, Gilberto de Jesús

    2012-01-01

    El presente trabajo trata de aportar más información sobre un nuevo adhesivo autograbante a esmalte de dientes temporales y permanentes. El objetivo es valorar las fuerzas de adhesión en MPa de los sistemas adhesivos (convencional y autograbante),en el esmalte de dientes temporales y permanentes. Métodos: utilizando una muestra de 160 dientes (temporales y permanentes)a nivel de la estructura del esmalte, divididos en cuatro grupos, no tomándose en cuenta para el criterio de selección la p...

  5. El establecimiento permanente en un contexto virtual

    Directory of Open Access Journals (Sweden)

    Andrés Mauricio Rengifo

    2002-01-01

    Full Text Available La inmediatez, la informalidad y la total irrelevancia de la localización, la distancia y los límites nacionales son ventajas innegables del comercio en Internet. Al mismo, tiempo, son características que plantean interrogantes para los Estados, quienes, conscientes de la importancia de controlar el volumen y la magnitud de las operaciones realizadas en red (al gravarlas directa o indirectamente pueden conseguir fuentes de ingreso para el mantenimiento de las estructuras y la financiación de gastos gubernamentales se cuestionan cuál debe ser el sujeto pasivo de las obligaciones tributarias en un mercado donde las empresas están deslocalizadas o aún, no existen físicamente. El presente artículo aporta a la resolución del problema tras un completo estudio del concepto de establecimiento Permanente de carácter virtual, elaborado por la Organización para la Cooperación y el Desarrollo Económico.

  6. El establecimiento permanente en un contexto virtual

    Directory of Open Access Journals (Sweden)

    Andrés Mauricio Rengifo

    2002-06-01

    Full Text Available La inmediatez, la informalidad y la total irrelevancia de la localización, la distancia y los límites nacionales son ventajas innegables del comercio en Internet. Al mismo, tiempo, son características que plantean interrogantes para los Estados, quienes, conscientes de la importancia de controlar el volumen y la magnitud de las operaciones realizadas en red (al gravarlas directa o indirectamente pueden conseguir fuentes de ingreso para el mantenimiento de las estructuras y la financiación de gastos gubernamentales se cuestionan cuál debe ser el sujeto pasivo de las obligaciones tributarias en un mercado donde las empresas están deslocalizadas o aún, no existen físicamente. El presente artículo aporta a la resolución del problema tras un completo estudio del concepto de establecimiento Permanente de carácter virtual, elaborado por la Organización para la Cooperación y el Desarrollo Económico.

  7. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Prevalence of Childhood Obesity among Young Multiethnic Children from a Health Maintenance Organization in Hawaii.

    Science.gov (United States)

    Novotny, Rachel; Oshiro, Caryn Etsuko Shima; Wilkens, Lynne Ross

    2013-02-01

    Pacific Islander, Asian, and mixed-ethnicity children are not described in national nutrition and health surveys. Data on BMI values of 4608 5- to 8-year-old children available from Kaiser Permanente Hawaii electronic medical records in 2010 were analyzed for prevalence of overweight and obesity and for ethnic differences in BMI and risk for overweight and obesity, controlling for age, sex, neighborhood education level, and on a subset (n=2169) that further controlled for maternal education and maternal age. Kaiser Permanente data allow for reporting of multiple ethnicities. Data revealed that 33% of this child population was of mixed ethnic ancestry. Prevalence of overweight and obesity was 32.6% (12.9% overweight and 19.7% obese). However, Samoan children and children of Native Hawaiian, Filipino, and mixed ethnic ancestries had higher levels of overweight and obesity than whites or Asians. Higher neighborhood education level, higher maternal education level, and older maternal age were associated with decreased risk of overweight and obesity, except for children whose mothers were between 21 and 30 years old, who had a higher risk for obesity than those whose mothers were under 20 years of age (odds ratio=1.34). Populations of mixed ethnicities in the Pacific region deserve further study related to healthy body size and acculturation to environment and lifestyle.

  9. Genome Sequence of Klebsiella pneumoniae KpQ3, a DHA-1 β-Lactamase-Producing Nosocomial Isolate

    Science.gov (United States)

    Tobes, Raquel; Codoñer, Francisco M.; López-Camacho, Elena; Salanueva, Iñigo J.; Manrique, Marina; Brozynska, Marta; Gómez-Gil, Rosa; Martínez-Blanch, Juan F.; Álvarez-Tejado, Miguel; Pareja, Eduardo

    2013-01-01

    Klebsiella pneumoniae KpQ3 is a multidrug-resistant isolate obtained from a blood culture of a patient in a burn unit in the Hospital Universitario La Paz (Madrid, Spain) in 2008. The genome contains multiple antibiotic resistance genes, including a plasmid-mediated DHA-1 cephalosporinase gene. PMID:23469341

  10. Educação permanente em saúde e no trabalho de enfermagem: perspectiva de uma práxis transformadora.

    OpenAIRE

    da Silva, Luiz Anildo Anacleto; Centro de Educação Superior Norte da Universidade Federal de Santa Maria; Ferraz, Fabiane; Universidade Federal de Santa Catarina; Lino, Mônica Motta; Universidade Federal de Santa Catarina; Backes, Vânia Marli Schubert; Universidade Federal de Santa Catarina; Schmidt, Sandra Marcia Soares; Universidade Federal de Santa Maria

    2011-01-01

    Trata-se de uma reflexão teórica que tem por objetivo estimular os leitores a repensar o papel da educação permanente dos sujeitos-trabalhadores da saúde e de enfermagem na perspectiva do desenvolvimento individual e coletivo, por meio da práxis transformadora. Procurou-se fazer uma articulação reflexiva dos princípios da práxis transformadora apresentada pelo filósofo Adolfo Sánchez Vázquez com os preceitos de educação permanente em saúde e no trabalho de enfermagem. Tal articulação apresent...

  11. A educação permanente da equipe de enfermagem para o cuidado nos serviços de saúde mental

    OpenAIRE

    Tavares,Cláudia Mara de Melo

    2006-01-01

    Estudio exploratório, cuyo objetivo fue analizar la necesidad de la educación permanente del equipo de enfermera para cuidar en los servicios de la salud mental. Fueron estudiadas treinta siete profesionales de enfermería mental. Como resultados, se verificó que él equipe de la enfermería demanda calificación de vasto espectro. Se concluye que la educación permanente del equipo del oficio de enfermera de la salud mental exige más allá de programas educativos establecidos en la def...

  12. Using PKiKP coda to study heterogeneity in the top layer of the inner core's western hemisphere

    Science.gov (United States)

    Wu, Wenbo; Irving, Jessica C. E.

    2017-05-01

    Significant lateral and depth variations of the inner core's properties, such as the large-scale hemispherical pattern, have been confirmed by a variety of seismological observations. However it is still unclear which dynamic processes in the core are responsible for these variations. Small-scale volumetric heterogeneity has been detected in the top layer of the inner core by PKiKP coda observations. Studies of these small-scale heterogeneities can provide critical information, such as the degree of alignment of iron crystals, the presence of possible partial melt and the grain size of iron crystals, all of which can be used to constrain the dynamic processes of the inner core. However, most previous observations sampled the inner core beneath the Pacific Ocean and Asia, often in the inner core's 'eastern hemisphere'. We use seismic stations in the North America, including the Earthscope Transportable Array, to look at PKiKP and its coda waves. We find 21 events with clear signals. In agreement with previous studies, inner core scattering (ICS), resulting in clear PKiKP coda, is found at epicentral distances of 60°-95°. However, the ICS we observe in these 21 western hemisphere events is weaker than previously reported for the eastern hemisphere. Comparing our observations with numerical simulations, we conclude that this relatively weak ICS indicates small-scale heterogeneity in at least the top layer of the inner core beneath Central America. Combining our clear observations with previous studies suggests either a hemispherical difference, or a regional variation, of small-scale heterogeneity in the inner core.

  13. Moving from tacit knowledge to evidence-based practice: the Kaiser Permanente community partners study.

    Science.gov (United States)

    Enguídanos, Susan M; Jamison, Paula M

    2006-01-01

    For several decades both medical and social work practices have failed to consistently include measures to determine the effectiveness of their care and practices. This is especially true of care management practices. With the growth and aging of our population, this is of particular concern when many of our resources for older adults are channeled into services such as geriatric care management. This article describes a randomized controlled trial that tested the effectiveness of four levels of geriatric care management. Results from this study did not support the tacit knowledge of the clinicians in terms of the effectiveness of their practices. This article describes the study methods and results, and how evidence from this study impacted subsequent service provided by geriatric care managers.

  14. A systematic review of interventions conducted in clinical or community settings to improve dual-task postural control in older adults

    OpenAIRE

    Agmon M; Belza B; Nguyen HQ; Logsdon RG; Kelly VE

    2014-01-01

    Maayan Agmon,1 Basia Belza,2 Huong Q Nguyen,2,3 Rebecca G Logsdon,2 Valerie E Kelly41The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Studies, University of Haifa, Israel; 2School of Nursing, University of Washington, Seattle, WA, USA; 3Department of Research and Evaluation, Kaiser Permanente, CA, USA; 4School of Medicine, University of Washington, Seattle, WA, USABackground: Injury due to falls is a major problem among older adults. Decrements in dual-task postu...

  15. [The Internet and shared decision-making between patients and healthcare providers].

    Science.gov (United States)

    Silber, Denise

    2009-10-01

    Insurance companies like Kaiser Permanente in the United States remunerate physicians for their email correspondence with patients, increasing the efficiency of office visits. A survey by the French National Board of Physicians regarding the computerization of medical practices in April 2009, confirms that both physicians and patients in France are very favorable to the development of these tools. When patients can manage and/or access their medical files and determine which providers can access them, they become a true partner.

  16. Teager-Kaiser Energy and Higher-Order Operators in White-Light Interference Microscopy for Surface Shape Measurement

    Directory of Open Access Journals (Sweden)

    Abdel-Ouahab Boudraa

    2005-10-01

    Full Text Available In white-light interference microscopy, measurement of surface shape generally requires peak extraction of the fringe function envelope. In this paper the Teager-Kaiser energy and higher-order energy operators are proposed for efficient extraction of the fringe envelope. These energy operators are compared in terms of precision, robustness to noise, and subsampling. Flexible energy operators, depending on order and lag parameters, can be obtained. Results show that smoothing and interpolation of envelope approximation using spline model performs better than Gaussian-based approach.

  17. Synthesis of nanodiamond derivatives carrying amino functions and quantification by a modified Kaiser test

    Directory of Open Access Journals (Sweden)

    Gerald Jarre

    2014-11-01

    Full Text Available Nanodiamonds functionalized with different organic moieties carrying terminal amino groups have been synthesized. These include conjugates generated by Diels–Alder reactions of ortho-quinodimethanes formed in situ from pyrazine and 5,6-dihydrocyclobuta[d]pyrimidine derivatives. For the quantification of primary amino groups a modified photometric assay based on the Kaiser test has been developed and validated for different types of aminated nanodiamond. The results correspond well to values obtained by thermogravimetry. The method represents an alternative wet-chemical quantification method in cases where other techniques like elemental analysis fail due to unfavourable combustion behaviour of the analyte or other impediments.

  18. Stability of line solitons for the KP-II equation in R2

    CERN Document Server

    Mizumachi, Tetsu

    2015-01-01

    The author proves nonlinear stability of line soliton solutions of the KP-II equation with respect to transverse perturbations that are exponentially localized as x\\to\\infty. He finds that the amplitude of the line soliton converges to that of the line soliton at initial time whereas jumps of the local phase shift of the crest propagate in a finite speed toward y=\\pm\\infty. The local amplitude and the phase shift of the crest of the line solitons are described by a system of 1D wave equations with diffraction terms.

  19. Values of Kp Indices, Ap Indices, Cp Indices, C9 Indices, Sunspot Number, and 10.7 cm Flux

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data file consists of Kp indices, Ap indices, Cp indices, C9 indices, sunspot number, and 10.7 cm flux. The most often requested parameter of this file are the...

  20. Mutation of HIV-1 genomes in a clinical population treated with the mutagenic nucleoside KP1461.

    Science.gov (United States)

    Mullins, James I; Heath, Laura; Hughes, James P; Kicha, Jessica; Styrchak, Sheila; Wong, Kim G; Rao, Ushnal; Hansen, Alexis; Harris, Kevin S; Laurent, Jean-Pierre; Li, Deyu; Simpson, Jeffrey H; Essigmann, John M; Loeb, Lawrence A; Parkins, Jeffrey

    2011-01-14

    The deoxycytidine analog KP1212, and its prodrug KP1461, are prototypes of a new class of antiretroviral drugs designed to increase viral mutation rates, with the goal of eventually causing the collapse of the viral population. Here we present an extensive analysis of viral sequences from HIV-1 infected volunteers from the first "mechanism validation" phase II clinical trial of a mutagenic base analog in which individuals previously treated with antiviral drugs received 1600 mg of KP1461 twice per day for 124 days. Plasma viral loads were not reduced, and overall levels of viral mutation were not increased during this short-term study, however, the mutation spectrum of HIV was altered. A large number (N = 105 per sample) of sequences were analyzed, each derived from individual HIV-1 RNA templates, after 0, 56 and 124 days of therapy from 10 treated and 10 untreated control individuals (>7.1 million base pairs of unique viral templates were sequenced). We found that private mutations, those not found in more than one viral sequence and likely to have occurred in the most recent rounds of replication, increased in treated individuals relative to controls after 56 (p = 0.038) and 124 (p = 0.002) days of drug treatment. The spectrum of mutations observed in the treated group showed an excess of A to G and G to A mutations (p = 0.01), and to a lesser extent T to C and C to T mutations (p = 0.09), as predicted by the mechanism of action of the drug. These results validate the proposed mechanism of action in humans and should spur development of this novel antiretroviral approach.

  1. Mutation of HIV-1 genomes in a clinical population treated with the mutagenic nucleoside KP1461.

    Directory of Open Access Journals (Sweden)

    James I Mullins

    2011-01-01

    Full Text Available The deoxycytidine analog KP1212, and its prodrug KP1461, are prototypes of a new class of antiretroviral drugs designed to increase viral mutation rates, with the goal of eventually causing the collapse of the viral population. Here we present an extensive analysis of viral sequences from HIV-1 infected volunteers from the first "mechanism validation" phase II clinical trial of a mutagenic base analog in which individuals previously treated with antiviral drugs received 1600 mg of KP1461 twice per day for 124 days. Plasma viral loads were not reduced, and overall levels of viral mutation were not increased during this short-term study, however, the mutation spectrum of HIV was altered. A large number (N = 105 per sample of sequences were analyzed, each derived from individual HIV-1 RNA templates, after 0, 56 and 124 days of therapy from 10 treated and 10 untreated control individuals (>7.1 million base pairs of unique viral templates were sequenced. We found that private mutations, those not found in more than one viral sequence and likely to have occurred in the most recent rounds of replication, increased in treated individuals relative to controls after 56 (p = 0.038 and 124 (p = 0.002 days of drug treatment. The spectrum of mutations observed in the treated group showed an excess of A to G and G to A mutations (p = 0.01, and to a lesser extent T to C and C to T mutations (p = 0.09, as predicted by the mechanism of action of the drug. These results validate the proposed mechanism of action in humans and should spur development of this novel antiretroviral approach.

  2. Prevalencia preoperatoria de la fibrilación auricular permanente en cirugía cardíaca

    Directory of Open Access Journals (Sweden)

    Fernando Hornero

    2005-07-01

    Conclusiones: La FA permanente se presenta en nuestro medio quirúrgico preoperatorio en el 13,6%, preferentemente asociada a enfermedad mitral. Los factores de riesgo cardiovasculares están presentes con similar prevalencia en los pacientes con FA que en el resto, excepto el tamaño auricular.

  3. Type C investigation of electrical fabrication projects in ICF Kaiser shops

    International Nuclear Information System (INIS)

    Huckfeldt, R.A.

    1995-06-01

    A Type C Investigation Board was convened to investigate an electrical miswiring problem found during the operation of the electrical distribution trailer for the TWRS Rotary Mode Core Sampling Truck number-sign 2. The trailer was designed by WHC and fabricated ICF KH on site for use in the Characterization Program. This problem resulted in a serious safety hazard since the support truck frame/chassis became electrically energized. This final report provides results of the ''Type C Investigation, Electrical Fabrication Projects in ICF KH Shops, June, 1995.'' It contains the investigation scope, executive summary, relevant facts, analysis, conclusions and corrective actions. DOE Order 5484.1, ''Environmental Protection, Safety and Health Protection Information Reporting Requirements,'' was followed in preparation of this report. Because the incident was electrical in nature and involved both Westinghouse Hanford Company and ICF Kaiser Hanford organizations, the board included members from both contractors and members with considerable electrical expertise

  4. Armouring facility? Nuclear-weapon and reactor reseach at the Kaiser-Wilhelm Institute for Physics; Eine Waffenschmiede? Kernwaffen- und Reaktorforschung am Kaiser-Wilhelm-Institut fuer Physik

    Energy Technology Data Exchange (ETDEWEB)

    Hachtmann, R. (ed.); Walker, M.

    2005-07-01

    The Kaiser Wilhelm Institute for Physics is best known as the place where Werner Heisenberg worked on nuclear weapons for Hitler. Although this is essentially true, there is more to the story. At the start of World War II this institute was taken over by the German Army Ordnance to be the central, but not exclusive site for a research project into the economic and military applications of nuclear fission. The Army physicist Kurt Diebner was installed in the institute as its commissarial director. Heisenberg was affiliated with the institute as an advisor at first, and became the director in 1942. Heisenberg and his colleagues, including in particular Karl-Heinz Hoecker, Carl Friedrich von Weizsaecker, and Karl Wirtz, worked on nuclear reactors and isotope separation with the clear knowledge that these were two different paths to atomic bombs [Atombomben]. However, they were clearly ambivalent about what they were doing. New documents recently returned from Russian archives shed new light on this work and the scientists' motivations. (orig.)

  5. Draft Genome Sequence of Exiguobacterium sp. Strain BMC-KP, an Environmental Isolate from Bryn Mawr, Pennsylvania.

    Science.gov (United States)

    Hyson, Peter; Shapiro, Joshua A; Wien, Michelle W

    2015-10-08

    Exiguobacterium sp. strain BMC-KP was isolated as part of a student environmental sampling project at Bryn Mawr College, PA. Sequencing of bacterial DNA assembled a 3.32-Mb draft genome. Analysis suggests the presence of genes for tolerance to cold and toxic metals, broad carbohydrate metabolism, and genes derived from phage. Copyright © 2015 Hyson et al.

  6. Formación permanente y distribución del profesorado de Educación Secundaria por comarcas y departamentos. El caso de Asturias

    OpenAIRE

    Paula GONZÁLEZ-VALLINAS; José Luis SAN FABIÁN MAROTO

    2009-01-01

    Este estudio se centra en la formación del profesorado y explora las relaciones existentes entre la formación permanente y diversas características del profesorado, las comarcas y departamentos de los IES en Asturias. Como resultado de una investigación basada en el análisis de datos secundarios cuantitativos del profesorado y municipios de Asturias se obtiene una radiografía de la formación permanente de su profesorado (modalidad y materia de formación). Se realizan análisis a nivel de depar...

  7. New Variable Stars in the KP2001 Catalog from the Data Base of the Northern Sky Variability Survey

    Science.gov (United States)

    Petrosyan, G. V.

    2018-03-01

    The optical variability of stars in the KP2001 catalog is studied. Monitor data from the automatic Northern Sky Variability Survey (NSVS) are used for this purpose. Of the 257 objects that were studied, 5 are Mira Ceti variables (mirids), 33 are semiregular (SR), and 108 are irregular variables (Ir). The light curves of the other objects show no noticeable signs of variability. For the first time, 11 stars are assigned to the semiregular and 105 stars to the irregular variables. Of the irregular variables, the light curves of two, No. 8 and No. 194, are distinct and are similar to the curves for eclipsing variables. The periods and amplitudes of the mirids and semiregular variables are determined using the "VStar" program package from AAVSO. The absolute stellar magnitudes M K and distances are also estimated, along with the mass loss for the mirids. The behavior of stars from KP2001 in 2MASS and WISE color diagrams is examined.

  8. Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system

    Directory of Open Access Journals (Sweden)

    Rashid N

    2016-10-01

    Full Text Available Nazia Rashid,1 Han A Koh,2 Hilda C Baca,3 Kathy J Lin,1 Susan E Malecha,4 Anthony Masaquel5 1Drug Information Services, Kaiser Permanente, Downey, 2Southern California Permanente Medical Group, Kaiser Permanente, Bellflower, 3Pharmacy Analytical Services, Kaiser Permanente, Downey, 4US Medical Affairs, Genetech Inc., San Francisco, 5Health Economics and Outcomes, Genentech Inc., San Francisco, CA, USA Background: Breast cancer is treated with many different modalities, including chemotherapy that can be given as a single agent or in combination. Patients often experience adverse events from chemotherapy during the cycles of treatment which can lead to economic burden.Objective: The objective of this study was to evaluate costs related to chemotherapy-related adverse events in patients with metastatic breast cancer (mBC in an integrated health care delivery system.Methods: Patients with mBC newly initiated on chemotherapy were identified and the first infusion was defined as the index date. Patients were ≥18 years old at time of index date, had at least 6 months of health plan membership and drug eligibility prior to their index date. The chemotherapy adverse events were identified after the index date and during first line of chemotherapy. Episodes of care (EOC were created using healthcare visits. Chart review was conducted to establish whether the adverse events were related to chemotherapy. Costs were calculated for each visit, including medications related to the adverse events, and aggregated to calculate the total EOC cost.Results: A total of 1,682 patients with mBC were identified after applying study criteria; 54% of these patients had one or more adverse events related to chemotherapy. After applying the EOC method, there were a total of 5,475 episodes (4,185 single episodes [76.4%] and 1,290 multiple episodes [23.6%] related to chemotherapy-related adverse events. Within single episodes, hematological (1,387 EOC, 33

  9. Application of common y-intercept regression parameters for log Kp vs 1/ T for predicting gas-particle partitioning in the urban environment

    Science.gov (United States)

    Pankow, James F.

    Gas-particle partitioning is examined using a partitioning constant Kp = ( F/ TSP)/ A, where F (ng m -3) and A (ng m -3) are the particulate-associated and gas-phase concentrations, respectively, and TSP is the total suspended particulate matter level (μg m -3). Compound-dependent values of Kp depend on temperature ( T) according to Kp = mp/ T + bp. Limitations in data quality can cause errors in estimates of mp and bp obtained by simple linear regression (SLR). However, within a group of similar compounds, the bp values will be similar. By pooling data, an improved set of mp and a single bp can be obtained by common y-intercept regression (CYIR). SLR estimates for mp and bp for polycyclic aromatic hydrocarbons (PAHs) sorbing to urban Osaka particulate matter are available (Yamasaki et al., 1982, Envir. Sci. Technol.16, 189-194), as are CYIR estimates for the same particulate matter (Pankow, 1991, Atmospheric Environment25A, 2229-2239). In this work, a comparison was conducted of the ability of these two sets of mp and bp to predict A/ F ratios for PAHs based on measured T and TSP values for data obtained in other urban locations, specifically: (1) in and near the Baltimore Harbor Tunnel by Benner (1988, Ph.D thesis, University of Maryland) and Benner et al. (1989, Envir. Sci. Technol.23, 1269-1278); and (2) in Chicago by Cotham (1990, Ph.D. thesis, University of South Carolina). In general, the CYIR estimates for mp and bp obtained for Osaka particulate matter were found to be at least as reliable, and for some compounds more reliable than their SLR counterparts in predicting gas-particle ratios for PAHs. This result provides further evidence of the utility of the CYIR approach in quantitating the dependence of log Kp values on 1/ T.

  10. Estimation of spacial geo-stress components in rock samples by using the Kaiser effect of acoustic emission

    International Nuclear Information System (INIS)

    Kanagawa, Tadashi; Hayashi, Masao; Nakasa, Hiroyasu.

    1976-01-01

    The spacial remaining stress component of the rock core sample is experimentally obtained by using Kaiser effect of acoustic emission (AE), and the estimated ground pressure is compared with the natural ground pressure measured by the conventional over-coring method, in order to see the feasiblity of AE method. In this experiments of AE, 111 specimens were cut out in all directions of the rock cores (tuff) sampled from the place where the ground pressure was measured by the over-coring method, and the generation of AE caused by the load was measured. Whereby, the stress components in three directions are determined. As a result of comparison, t the AE method is proved to be effective enough to estimate the ground pressure of rock geo-dynamically. In the application of the Kaiser effect to the estimation of the geo-stress in rock samples, one of the most difficult problems is how to eliminate the obstruction of erroneous AE signals caused by the strong stress concentration at the end corners of the rock specimen. As the result of comparison, the values obtained by the AE method have a tendency of greater than the values obtained by the over-coring method. It is conceived that the AE method can easily detect the maximum stress value for geo historical long time, and that the stress concentration is apt to mix in AE method by boring. (Iwakiri, K.)

  11. Predicting the 6-month risk of severe hypoglycemia among adults with diabetes: Development and external validation of a prediction model.

    Science.gov (United States)

    Schroeder, Emily B; Xu, Stan; Goodrich, Glenn K; Nichols, Gregory A; O'Connor, Patrick J; Steiner, John F

    2017-07-01

    To develop and externally validate a prediction model for the 6-month risk of a severe hypoglycemic event among individuals with pharmacologically treated diabetes. The development cohort consisted of 31,674 Kaiser Permanente Colorado members with pharmacologically treated diabetes (2007-2015). The validation cohorts consisted of 38,764 Kaiser Permanente Northwest members and 12,035 HealthPartners members. Variables were chosen that would be available in electronic health records. We developed 16-variable and 6-variable models, using a Cox counting model process that allows for the inclusion of multiple 6-month observation periods per person. Across the three cohorts, there were 850,992 6-month observation periods, and 10,448 periods with at least one severe hypoglycemic event. The six-variable model contained age, diabetes type, HgbA1c, eGFR, history of a hypoglycemic event in the prior year, and insulin use. Both prediction models performed well, with good calibration and c-statistics of 0.84 and 0.81 for the 16-variable and 6-variable models, respectively. In the external validation cohorts, the c-statistics were 0.80-0.84. We developed and validated two prediction models for predicting the 6-month risk of hypoglycemia. The 16-variable model had slightly better performance than the 6-variable model, but in some practice settings, use of the simpler model may be preferred. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. IMPLEMENTASI PROGRAM PENANGGULANGAN KEMISKINAN PERKOTAAN (P2KP DI KECAMATAN TONJONG KABUPATEN BREBES TAHUN 2007

    Directory of Open Access Journals (Sweden)

    Yozi Aulia Rahman

    2015-12-01

    Full Text Available Poverty is a serious problem, it’s happened in all the world, such as Indonesia. In September 2006, BPS announced that the poverty rate in Indonesiahad increased during the period February 2005 to march 2006 from 16.0 percent to 17.75 percent contrast to steady declines in the poverty rate since the crisis. Number of Poverty in Indonesiain 2006 have been reached 35,5 milion people. Government of Indonesiahas implemented programs to reduce poverty until village level. These programs such as IDT, PPK, BLT, etc. But, that programs just a short run programs, not long run programs. As long run program, P2KP has many programs, such as micro credits, infrastructure, and training. In Pepedan and Linggapura village implemented infrastructure programs. Its first priority programs because there many roads in that village are broken and disturbs local economic activities. BKM and KSM managed this program so that is success. Based on SWOT analysis, appropriate strategy to improve the function of P2KP is by intregrated horizontal strategy. It means, Local Government (Brebes Regency Goverment must have policy strategic and must cooperation with BKM, KSM and people in village. Project evaluate (Inputs, Outputs, Outcames, Benefits, Impact needs to know programs running.

  13. Otra aproximación a Carl Gangolf Kaiser (1837-1895), arquitecto de la corte del emperador Maximiliano

    OpenAIRE

    Drewes, Michael

    2000-01-01

    Michael Drewes ha estudiado el ambiente artístico que rodeó al que fuera segundo emperador de México, Maximiliano de Austria. En por lo menos dos artículos anteriores publicados en Anales del Instituto de Investigaciones Estéticas (números 59 y 63), se ocupó ya del arquitecto Carl Gangolf Kaiser, un artista que presentó diversos proyectos de construcción y remodelación para Maximiliano. Quizás por su juventud, los proyectos que entonces realizó este arquitecto para remodelar edificios tan imp...

  14. Probabilidad de retención de segundos molares permanentes mandibulares (Estudio piloto

    Directory of Open Access Journals (Sweden)

    Paulo Sandoval Vidal

    Full Text Available Objetivos: Determinar la frecuencia del segundo molar mandibular permanente (MM2 con probabilidad de impactación, en un grupo de pacientes de Ortodoncia de Temuco, Chile. Método: Estudio de corte transversal, con muestra por conveniencia. Se revisaron 2095 fichas de individuos de ambos sexos, con ausencia de patología sindrómica. Los datos recolectados se obtuvieron de radiografías panorámicas. Se midió el ángulo del segundo molar con respecto al plano oclusal, la invasión distal del primer molar y la distancia entre distal del primer molar y el borde anterior de la rama mandibular. Resultados: El promedio de edad de los pacientes relevados fue de 10 años. Se observó un 1,43% de probabilidad de retención de MM2 (n=30; en promedio y el plano el ángulo MM2 resultó de 27° el izquierdo y 26° el derecho; la invasión de MM2 en distal del primer molar resultó de 1,5 mm; el ángulo entre MM2 y el planos oclusal es de 123°; la distancia entre la cara distal del primer molar y el borde anterior de la rama mandibular fue 13 mm. Conclusiones: Existe una baja prevalencia de segundos molares mandibulares permanentes con probabilidad de impactación. La invasión a la cara distal del primer molar fue mayor en pacientes con riesgo de impactación

  15. Achieving performance breakthroughs in an HMO business process through quality planning.

    Science.gov (United States)

    Hanan, K B

    1993-01-01

    Kaiser Permanente's Georgia Region commissioned a quality planning team to design a new process to improve payments to its suppliers and vendors. The result of the team's effort was a 73 percent reduction in cycle time. This team's experiences point to the advantages of process redesign as a quality planning model, as well as some general guidelines for its most effective use in teams. If quality planning project teams are carefully configured, sufficiently expert in the existing process, and properly supported by management, organizations can achieve potentially dramatic improvements in process performance using this approach.

  16. The exact solutions and approximate analytic solutions of the (2 + 1)-dimensional KP equation based on symmetry method.

    Science.gov (United States)

    Gai, Litao; Bilige, Sudao; Jie, Yingmo

    2016-01-01

    In this paper, we successfully obtained the exact solutions and the approximate analytic solutions of the (2 + 1)-dimensional KP equation based on the Lie symmetry, the extended tanh method and the homotopy perturbation method. In first part, we obtained the symmetries of the (2 + 1)-dimensional KP equation based on the Wu-differential characteristic set algorithm and reduced it. In the second part, we constructed the abundant exact travelling wave solutions by using the extended tanh method. These solutions are expressed by the hyperbolic functions, the trigonometric functions and the rational functions respectively. It should be noted that when the parameters are taken as special values, some solitary wave solutions are derived from the hyperbolic function solutions. Finally, we apply the homotopy perturbation method to obtain the approximate analytic solutions based on four kinds of initial conditions.

  17. La normativa de atribución de rentas a establecimientos permanentes en Colombia

    OpenAIRE

    Navarro Ibarrola, Aitor

    2016-01-01

    En el presente trabajo se analizan las reglas para la determinación de la renta de establecimientos permanentes situados en Colombia. A tal efecto, el autor lleva a cabo un estudio sobre la base de las pautas que la OCDE establece en la materia, ya que el sistema de conceptos propuesto por este organismo internacional se adoptó como referencia por parte del legislador colombiano a partir de 2012. En concreto, en el marco del concepto de entidad funcionalmente separada, se analiza el contenido...

  18. Educação Permanente no cotidiano da Atenção Básica no Mato Grosso do Sul

    Directory of Open Access Journals (Sweden)

    Jacinta de Fátima Franco Pereira Machado

    Full Text Available O artigo analisou as ações de Educação Permanente em Saúde na Atenção Básica em Mato Grosso do Sul, Brasil, na perspectiva de 184 equipes participantes da primeira fase do Programa de Melhoria do Acesso e da Qualidade (PMAQ, de junho de 2012 a fevereiro de 2013. Entre as ações de Educação Permanente, os cursos presenciais foram mais prevalentes, seguidos por troca de experiência, teleducação, ensino à distância e tutoria/preceptoria, tanto na capital quanto no interior. As ações de planejamento e apoio à gestão foram mais prevalentes na capital. As ações de apoio da gestão estavam diretamente relacionadas com o planejamento e a organização do processo de trabalho.

  19. Comparative studies on the human serum albumin binding of the clinically approved EGFR inhibitors gefitinib, erlotinib, afatinib, osimertinib and the investigational inhibitor KP2187.

    Science.gov (United States)

    Dömötör, Orsolya; Pelivan, Karla; Borics, Attila; Keppler, Bernhard K; Kowol, Christian R; Enyedy, Éva A

    2018-05-30

    Binding interactions between human serum albumin (HSA) and four approved epidermal growth factor receptor (EGFR) inhibitors gefitinib (GEF), erlotinib (ERL), afatinib (AFA), osimertinib (OSI), as well as the experimental drug KP2187, were investigated by means of spectrofluorometric and molecular modelling methods. Steady-state and time resolved spectrofluorometric techniques were carried out, including direct quenching of protein fluorescence and site marker displacement measurements. Proton dissociation processes and solvent dependent fluorescence properties were investigated as well. The EGFR inhibitors were predominantly presented in their single protonated form (HL + ) at physiological pH except ERL, which is charge-neutral. Significant solvent dependent fluorescence properties were found for GEF, ERL and KP2187, namely their emission spectra show strong dependence on the polarity and the hydrogen bonding ability of the solvents. The inhibitors proved to be bound at site I of HSA (in subdomain IIA) in a weak-to-moderate fashion (logK' 3.9-4.9) using spectrofluorometry. OSI (logK' 4.3) and KP2187 can additionally bind in site II (in subdomain IIIA), while GEF, ERL and AFA clearly show no interaction here. Docking methods qualitatively confirmed binding site preferences of compounds GEF and KP2187, and indicated that they probably bind to HSA in their neutral forms. Binding constants calculated on the basis of the various experimental data indicate a weak-to-moderate binding on HSA, only OSI exhibits somewhat higher affinity towards this protein. However, model calculations performed at physiological blood concentrations of HSA resulted in high (ca. 90%) bound fractions for the inhibitors, highlighting the importance of plasma protein binding. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. La incapacidad permanente en una empresa pública en el periodo 1995-2009 Permanent incapacity in a public company from 1995-2009

    Directory of Open Access Journals (Sweden)

    José Carlos Marchena Aparicio

    2011-09-01

    Full Text Available Objetivos: La cuantificación de las relaciones entre salud, medio laboral y capacidad para el trabajo nos permite descifrar aspectos importantes de la incapacidad permanente. Este trabajo tiene como objetivo describir las características de la población trabajadora de la Diputación Provincial de Cádiz a la que se le concedió una incapacidad permanente en el periodo 1995-2009. Métodos: Se llevó a cabo un estudio descriptivo retrospectivo sobre el total de trabajadores/as con incapacidad permanente en el periodo descrito que considera las siguientes variables: sexo, edad, antigüedad, tipo de ocupación, causa de la incapacidad permanente, días de incapacidad temporal y número de incapacidades temporales concedidas en los 5 años previos, recogidas a través de archivos documentales. Resultados: El número de incapacidades permanentes concedidas ascendió a 192. Un 53,1% fueron mujeres; funcionarios el 59,9%; la edad de concesión fue de 54,06 años de media con 24,98 años de antigüedad en la empresa; el tipo de trabajo en el que más incapacidad permanente se concedieron es el manual, 44,8%; El tipo de patología más frecuente de incapacidad permanente fueron las enfermedades músculo-esqueléticas (29,7%, neoplasias (23,4% y trastornos mentales (18,8%, asociándose significativamente dicha variable con el sexo (p=0,006, el tipo de trabajo desempeñado (p=0,007, la edad de concesión (pObjectives: The quantifying relationship between health, working environment and work capacity allows us to unravel important aspects of permanent incapacity (PI. One of the objectives of this study is to describe working population characteristics of the Provincial Council of Cadiz who were granted permanent incapacity from 1995 to 2009. Method: A retrospective descriptive study was carried out amongst all the workers with PI in the period described with the following variables taken into account: gender, age, time working for the company, type of

  1. La vie rurale en pays kpélé dans le Togo méridional : une ...

    African Journals Online (AJOL)

    Il apparaît au regard de nos travaux que le pays kpélé présente des traits identiques au reste des régions de la grande aire culturelle Adja-Tado, mais dispose aussi, de traits originaux dictés par le cadre de vie et la dynamique sociale interne née depuis les périodes d'occupation du milieu. Enfin, l'étude démontre que ...

  2. Evaluation Techniques of Creating Coherence in Poems of Kaiser Aminpour Relying on the Theory of Halliday’s Linguistics

    Directory of Open Access Journals (Sweden)

    Reza Sattari

    2016-05-01

    Full Text Available AbstractOne of the linguistics theories that are utilized in present age in the analysis of literary texts is the theory of Halliday’s linguistics which is called theory of systemic - functional linguistics. Halliday’s theory in the second half of the twentieth century, in contrast to the "generative linguistics" approach, which is based on formal language like a mental and individual phenomenon.    Hallidayan called the semantic, literal, syntax and logical relationship of words as coherence of a text and believes that the coherence of the text, includes all the semantic relations by which, every piece of speech or writing can serve as text. Hence, cohesion, referred to relations that relates all elements of a sentence to the elements of other sentences. From Hallidayan's  point of view, elements of coherence of a text are divided into two parts: grammatical and lexical. Grammatical cohesion includes factors such as referrals, replacements, removals and relevancy, and lexical coherence includes repetition and collocation in literary language.   Kaiser is one of the contemporary famous poets that have composed many poets in different molds of poetry. Kaiser Manipur's poems benefit the integration due to the poet's fluency in Persian and his familiarity with the vocabulary and grammatical and lexical capacities of Persian literature. In this research, we have studied the cohesion in Kaiser Manipur's poems from two views of lexical and grammatical by using Holidaying theory of coherence as well as the techniques that the poet has applied to reach the cohesion in his poems.    The method of research in the present paper is descriptive-analytical and all the information and data has been collected from the sources of library and electronic. In this paper, we first briefly discussed the Holidaying coherence theory, and then, with a special approach to this theory, the most important techniques that Kaiser Manipur has

  3. Overexpression of K-p21Ras play a prominent role in lung cancer

    Science.gov (United States)

    Zhang, Peng-bo; Zhou, Xin-liang; Yang, Ju-lun

    2018-06-01

    The proto-oncogene ras product, p21Ras, has been found overexpression in many human tumors. However, the subtypes of overexpressed p21Ras still remain unclear. The purpose of this study was to investigate overexpressed isoforms of p21Ras and their roles in the progress of lung cancer. Method: The expression of total p21Ras in normal lung tissues and lung cancers was determined by immunohistochemically staining with monoclonal antibody (Mab) KGHR-1 which could recognize and broad spectrum reaction with the (K/H/N) ras protein. Then, the isoforms of p21Ras was examined by specific Mab for each p21Ras subtypes. Results: Low expression of total p21Ras was found in 26.67% (8/30) of normal lung tissues, and 81.31% (87/107) of adenocarcinoma harbored overexpressed total p21Ras. Besides, 70.00% (35/50) of squamous cell carcinoma were detected overexpressed total p21Ras. In addition, 122 lung cancer tissues from overexpression of total p21Ras protein were selected to detect the expression of each subtype. And all the 122 lung cancer tissues were K-p21Ras overexpression. Moreover, there was a statistical significance difference between the expression level of total p21Ras and differentiation, and the same results were observed between the expression level of total p21Ras and lymph node metastasis (P0.05). Conclusions: Overexpression of K-p21Ras plays a prominent role in the progress of lung cancer and it is suggested that the p21Ras could serve as a promising treatment target in lung cancer.

  4. Un estudio de las concepciones docentes acerca de la formación permanente Um estudo das concepções docentes sobre a formação permanente A Survey of Teachers' Thoughts on Continuing Education

    Directory of Open Access Journals (Sweden)

    Irene Marina Macera

    2012-12-01

    Full Text Available Este trabajo presenta las concepciones docentes acerca de su formación permanente. Se identificaron distintos puntos de análisis relacionados con la antigüedad en la profesión, intereses metodológicos, intereses de actualización de conocimientos, intereses de incorporación de nuevos saberes y, por último, el lugar que ocupa la formación en la subjetividad docente. En los inicios de la docencia, la formación permanente funciona y se concibe como un modo de mantenerse activos mientras se insertan en el mercado laboral. En cambio, para los docentes que ya tienen una trayectoria, esta se concibe como una fuga del trabajo, un recurso que en ocasiones le otorga sentido al trabajo, asumiendo de este modo un lugar subjetivo importante en el quehacer docente. Pero, cualquiera que sea la motivación, la adquisición de nuevos saberes es la razón más antigua que los docentes asumen para formarse.Este trabalho apresenta as concepções docentes sobre sua formação permanente. Identificaram-se diferentes pontos de análise relacionados com a antiguidade na profissão, interesses metodológicos, interesses de atualização de conhecimentos, interesses de incorporação de novos saberes e, por último, o lugar que a formação ocupa na subjetividade docente. No início da docência, a formação permanente funciona e se concebe como um modo de se manterem ativos enquanto se inserem no mercado de trabalho. Em compensação, para os docentes que já têm uma trajetória, esta se concebe como uma fuga do trabalho, um recurso que em ocasiões outorga sentido ao trabalho e assume, desse modo, um lugar subjetivo importante no fazer docente. Contudo, qualquer que seja a motivação, a aquisição de novos saberes é a razão mais antiga que os docentes assumem para se formar.This study delves into what teachers think about their own continuing education. Different points of analysis are identified with respect to seniority in the profession

  5. Formación permanente del profesorado en Jalisco: evaluación y propuesta

    OpenAIRE

    Camacho Buenrostro, Benita

    2016-01-01

    Este trabajo tiene como objetivo realizar una evaluación del modelo de formación permanente para docentes de Educación Básica implementado en Jalisco durante el período 2007-2012. La investigación se ubica en el paradigma naturalista o interpretativo y busca lograr el objetivo a través del enfoque de la evaluación comprensiva. También utiliza métodos cualitativo y cuantitativo y se apoya en distintas técnicas: análisis de documentos, observación directa de este fenómeno, entrevistas a funcion...

  6. Educação permanente no contexto da enfermagem e na saúde

    OpenAIRE

    Mancia,Joel Rolim; Cabral,Leila Chaves; Koerich,Magda Santos

    2004-01-01

    Neste trabalho os autores discutem a proposta atual de educação permanente do Ministério da Saúde, voltada para a formação de recursos humanos para o Sistema Único de Saúde. Traz um resgate da educação em geral e especificamente da educação de adultos, questão que afeta diretamente a enfermagem, visto que esta contribui com o maior contingente de trabalhadoras na área da saúde, constituindo-se em foco central das políticas públicas. Assim apresentam as principais controvérsias e apontam para ...

  7. The Hamiltonian structures of the super KP hierarchy associated with an even parity superlax operator

    International Nuclear Information System (INIS)

    Barcelos Neto, J.; Ghosh, S.; Roy, S.

    1993-07-01

    We consider the even parity superLax operator for the supersymmetric KP hierarchy of the form L = D 2 + Σ ∞ i=0 u i-2 D -i+1 and obtain the two Hamiltonian structures following the standard method of Gelfand and Dikii. We observe that the first Hamiltonian structure is local and linear whereas the second Hamiltonian structure is non-local and nonlinear among the superfields appearing in the Lax operator. We discuss briefly on their connections with the super ω ∞ algebra. (author). 23 refs

  8. Blood group genotyping for Jk(a)/Jk(b), Fy(a)/Fy(b), S/s, K/k, Kp(a)/Kp(b), Js(a)/Js(b), Co(a)/Co(b), and Lu(a)/Lu(b) with microarray beads.

    Science.gov (United States)

    Karpasitou, Katerina; Drago, Francesca; Crespiatico, Loretta; Paccapelo, Cinzia; Truglio, Francesca; Frison, Sara; Scalamogna, Mario; Poli, Francesca

    2008-03-01

    Traditionally, blood group typing has been performed with serologic techniques, the classical method being the hemagglutination test. Serotyping, however, may present important limitations such as scarce availability of rare antisera, typing of recently transfused patients, and those with a positive direct antiglobulin test. Consequently, serologic tests are being complemented with molecular methods. The aim of this study was to develop a low-cost, high-throughput method for large-scale genotyping of red blood cells (RBCs). Single-nucleotide polymorphisms associated with some clinically important blood group antigens, as well as with certain rare blood antigens, were evaluated: Jk(a)/Jk(b), Fy(a)/Fy(b), S/s, K/k, Kp(a)/Kp(b), Js(a)/Js(b), Co(a)/Co(b), and Lu(a)/Lu(b). Polymerase chain reaction (PCR)-amplified targets were detected by direct hybridization to microspheres coupled to allele-specific oligonucleotides. Cutoff values for each genotype were established with phenotyped and/or genotyped samples. The method was validated with a blind panel of 92 blood donor samples. The results were fully concordant with those provided by hemagglutination assays and/or sequence-specific primer (SSP)-PCR. The method was subsequently evaluated with approximately 800 blood donor and patient samples. This study presents a flexible, quick, and economical method for complete genotyping of large donor cohorts for RBC alleles.

  9. Melanoma in patients with chronic lymphocytic leukemia and non-Hodgkin lymphoma.

    Science.gov (United States)

    Famenini, Shannon; Martires, Kathryn J; Zhou, Hui; Xavier, Marin F; Wu, Jashin J

    2015-01-01

    The relationship between melanoma and chronic lymphocytic leukemia (CLL) or non-Hodgkin lymphoma (NHL) has been minimally investigated. The objective of this study was to examine the incidence of melanoma in patients with a history of CLL or NHL, and their associated mortality. Cohorts of Kaiser Permanente Southern California members with a history of CLL and NHL were identified. Age-adjusted incidence density rates of melanoma among patients with CLL or NHL were compared with rates of melanoma among the general population of Kaiser Permanente Southern California patients. The mortality of patients with melanoma was examined using Cox proportional hazards modeling. The age-adjusted incidence rate per 100,000 person-years for melanoma among patients with either CLL or NHL was 107 (95% confidence interval 84.4-129.6) versus 25.9 among the general population (95% confidence interval 84.4-129.6, P < .001). Patients with melanoma and a history of CLL or NHL had 2.46 greater odds of death compared with those without CLL or NHL (95% confidence interval 1.77-3.41). This study was retrospective in nature; the International Classification of Diseases, Ninth Revision codes used may contain diagnostic errors; and only overall survival was used in our analysis. Patients with a history of CLL or NHL have a higher incidence of melanoma. Patients with CLL or NHL who are subsequently given the diagnosis of melanoma have a higher mortality than patients with melanoma without a preceding diagnosis of CLL. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Rapid spread of complex change: a case study in inpatient palliative care

    Directory of Open Access Journals (Sweden)

    Filipski Marta I

    2009-12-01

    Full Text Available Abstract Background Based on positive findings from a randomized controlled trial, Kaiser Permanente's national executive leadership group set an expectation that all Kaiser Permanente and partner hospitals would implement a consultative model of interdisciplinary, inpatient-based palliative care (IPC. Within one year, the number of IPC consultations program-wide increased almost tenfold from baseline, and the number of teams nearly doubled. We report here results from a qualitative evaluation of the IPC initiative after a year of implementation; our purpose was to understand factors supporting or impeding the rapid and consistent spread of a complex program. Methods Quality improvement study using a case study design and qualitative analysis of in-depth semi-structured interviews with 36 national, regional, and local leaders. Results Compelling evidence of impacts on patient satisfaction and quality of care generated 'pull' among adopters, expressed as a remarkably high degree of conviction about the value of the model. Broad leadership agreement gave rise to sponsorship and support that permeated the organization. A robust social network promoted knowledge exchange and built on an existing network with a strong interest in palliative care. Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread. Conclusions A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex.

  11. A proposta da educação permanente em saúde na atualização da equipe de saúde em diabetes mellitus

    OpenAIRE

    Rodrigues,Andreia Cristinha Seabra; Vieira,Gisele de Lacerda Chaves; Torres,Heloisa de Carvalho

    2010-01-01

    O objetivo do estudo foi relatar a experiência da Educação Permanente em Saúde na atualização da equipe de saúde de uma Unidade Básica de Saúde para a atenção integral e humanizada às pessoas com diabetes tipo 2. A metodologia de escolha para a capacitação das equipes de saúde foi a Educação em Permanente em Saúde, por meio de oficinas educativas em diabetes com enfoque na problematização do processo educativo e profissional. Buscou-se, assim, construir um programa de educação em diabetes vis...

  12. Energy conversion through mass loading of escaping ionospheric ions for different Kp values

    Directory of Open Access Journals (Sweden)

    M. Yamauchi

    2018-01-01

    Full Text Available By conserving momentum during the mixing of fast solar wind flow and slow planetary ion flow in an inelastic way, mass loading converts kinetic energy to other forms – e.g. first to electrical energy through charge separation and then to thermal energy (randomness through gyromotion of the newly born cold ions for the comet and Mars cases. Here, we consider the Earth's exterior cusp and plasma mantle, where the ionospheric origin escaping ions with finite temperatures are loaded into the decelerated solar wind flow. Due to direct connectivity to the ionosphere through the geomagnetic field, a large part of this electrical energy is consumed to maintain field-aligned currents (FACs toward the ionosphere, in a similar manner as the solar wind-driven ionospheric convection in the open geomagnetic field region. We show that the energy extraction rate by the mass loading of escaping ions (ΔK is sufficient to explain the cusp FACs, and that ΔK depends only on the solar wind velocity accessing the mass-loading region (usw and the total mass flux of the escaping ions into this region (mloadFload, as ΔK ∼ −mloadFloadu2sw∕4. The expected distribution of the separated charges by this process also predicts the observed flowing directions of the cusp FACs for different interplanetary magnetic field (IMF orientations if we include the deflection of the solar wind flow directions in the exterior cusp. Using empirical relations of u0 ∝ Kp + 1.2 and Fload ∝ exp(0.45Kp for Kp = 1–7, where u0 is the solar wind velocity upstream of the bow shock, ΔK becomes a simple function of Kp as log10(ΔK = 0.2 ⋅ Kp + 2 ⋅ log10(Kp + 1.2 + constant. The major contribution of this nearly linear increase is the Fload term, i.e. positive feedback between the increase of ion escaping rate Fload through the increased energy consumption in the ionosphere for high Kp, and subsequent extraction of more kinetic energy

  13. Ätiologie und Prävalenz permanenter kindlicher Hörstörungen in Deutschland

    OpenAIRE

    Spormann-Lagodzinski, ME; Nubel, K; König, O; Gross, M; Gross, M

    2003-01-01

    Permanente Hörstörungen bei Kindern haben in den letzten Jahren bezüglich Ätiologie und Prävalenz einen deutlichen Wandel erlebt. In den westlichen Industrienationen ist sie auf 1 bis 3 pro 1.000 Neugeborene gesunken. Nach Ergebnissen des Deutschen Zentralregisters für kindliche Hörstörungen (DZH) liegt die Prävalenz in Deutschland bei ca. 1,2:1.000. Von 6.200 ausgewerteten Datensätzen des DZH haben 36% aller permanenten Hörstörungen eine (vermutlich oder gesichert) genetische Ursache, 18% si...

  14. 8-band and 14-band kp modeling of electronic band structure and material gain in Ga(In)AsBi quantum wells grown on GaAs and InP substrates

    Energy Technology Data Exchange (ETDEWEB)

    Gladysiewicz, M.; Wartak, M. S. [Faculty of Fundamental Problems of Technology, Wroclaw University of Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw (Poland); Department of Physics and Computer Science, Wilfrid Laurier University, Waterloo, Ontario N2L 3C5 (Canada); Kudrawiec, R. [Faculty of Fundamental Problems of Technology, Wroclaw University of Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw (Poland)

    2015-08-07

    The electronic band structure and material gain have been calculated for GaAsBi/GaAs quantum wells (QWs) with various bismuth concentrations (Bi ≤ 15%) within the 8-band and 14-band kp models. The 14-band kp model was obtained by extending the standard 8-band kp Hamiltonian by the valence band anticrossing (VBAC) Hamiltonian, which is widely used to describe Bi-related changes in the electronic band structure of dilute bismides. It has been shown that in the range of low carrier concentrations n < 5 × 10{sup 18 }cm{sup −3}, material gain spectra calculated within 8- and 14-band kp Hamiltonians are similar. It means that the 8-band kp model can be used to calculate material gain in dilute bismides QWs. Therefore, it can be applied to analyze QWs containing new dilute bismides for which the VBAC parameters are unknown. Thus, the energy gap and electron effective mass for Bi-containing materials are used instead of VBAC parameters. The electronic band structure and material gain have been calculated for 8 nm wide GaInAsBi QWs on GaAs and InP substrates with various compositions. In these QWs, Bi concentration was varied from 0% to 5% and indium concentration was tuned in order to keep the same compressive strain (ε = 2%) in QW region. For GaInAsBi/GaAs QW with 5% Bi, gain peak was determined to be at about 1.5 μm. It means that it can be possible to achieve emission at telecommunication windows (i.e., 1.3 μm and 1.55 μm) for GaAs-based lasers containing GaInAsBi/GaAs QWs. For GaInAsBi/Ga{sub 0.47}In{sub 0.53}As/InP QWs with 5% Bi, gain peak is predicted to be at about 4.0 μm, i.e., at the wavelengths that are not available in current InP-based lasers.

  15. Tratamiento de un molar permanente inmaduro necrótico mediante pulpotomía

    OpenAIRE

    Boj Quesada, Juan Ramón; Cortés Lillo, Olga; Canalda Sahli, Carlos

    1995-01-01

    Se describe un caso que afecta al primer molar permanente inferior derecho, con tumefacción, fluctuación y fístula , con ápices no cerrados. El tratamiento de elección hubiese sido una técnica clásica de apicoformación con hidróxido de calcio. Pero por motivos de colaboración, se realizó una pulpotomía con hidróxido de calcio. Tras los controles radiológicos a los 3 meses, al año y al año y medio se comprobó que continuaba el desarrollo radicular y finalizaba el cierre apical.

  16. A novel power harmonic analysis method based on Nuttall-Kaiser combination window double spectrum interpolated FFT algorithm

    Science.gov (United States)

    Jin, Tao; Chen, Yiyang; Flesch, Rodolfo C. C.

    2017-11-01

    Harmonics pose a great threat to safe and economical operation of power grids. Therefore, it is critical to detect harmonic parameters accurately to design harmonic compensation equipment. The fast Fourier transform (FFT) is widely used for electrical popular power harmonics analysis. However, the barrier effect produced by the algorithm itself and spectrum leakage caused by asynchronous sampling often affects the harmonic analysis accuracy. This paper examines a new approach for harmonic analysis based on deducing the modifier formulas of frequency, phase angle, and amplitude, utilizing the Nuttall-Kaiser window double spectrum line interpolation method, which overcomes the shortcomings in traditional FFT harmonic calculations. The proposed approach is verified numerically and experimentally to be accurate and reliable.

  17. Movements of permanent health education triggered by the training of facilitators Movimientos de la educación permanente en salud desencadenados a partir de la formación de facilitadores Movimentos da educação permanente em saúde, desencadeados a partir da formação de facilitadores

    Directory of Open Access Journals (Sweden)

    Cinira Magali Fortuna

    2011-04-01

    Full Text Available This study mapped the movements of Permanent Health Education in the region of Araraquara, São Paulo, Brazil, begun by the Permanent Health Education Facilitators program, promoted by the Ministry of Health and the National School of Public Health. This qualitative study was grounded on the theoretical framework of institutional and schizoanalysis. Data were collected from operative groups of individuals who finished the program. The results were grouped into two plans: micropolitics and organization. Micropolitics indicates the production of different concepts concerning permanent education and different ways to establish it. Autonomy and control and also a tenuous relationship between tutorship and autonomy were highlighted, in the plan of organization. In conclusion, the program was an important device that suffered captures/overcoding but also produced changes in practice.Se tuvo por objetivo cartografiar los movimientos de educación permanente en salud, en la región de Araraquara, Sao Paulo, Brasil, iniciados a partir del curso de Facilitadores de Educación Permanente en Salud, del Ministerio de la Salud y Escuela Nacional de Salud Pública. Es un estudio de abordaje cualitativo, sustentado por el referencial teórico del análisis institucional en la línea esquizoanalítica, siendo los datos recolectados mediante grupos operativos con alumnos terminando el referido curso. Los resultados fueron agrupados en dos planos: micropolítica y organización. Con relación a la micropolítica, apuntan que hubo producción de diferentes conceptos sobre educación permanente y diferentes formas de institucionalización de la misma. En el plano de la organización se destacan la autonomía y el control y también la tenue relación entre tutela y autonomía. Concluimos que el curso fue un importante dispositivo que sufrió capturas, pero también produjo cambios en las prácticas.Tem-se, aqui, por objetivo, cartografar os movimentos de educa

  18. Armouring facility? Nuclear-weapon and reactor reseach at the Kaiser-Wilhelm Institute for Physics

    International Nuclear Information System (INIS)

    Hachtmann, R.; Walker, M.

    2005-01-01

    The Kaiser Wilhelm Institute for Physics is best known as the place where Werner Heisenberg worked on nuclear weapons for Hitler. Although this is essentially true, there is more to the story. At the start of World War II this institute was taken over by the German Army Ordnance to be the central, but not exclusive site for a research project into the economic and military applications of nuclear fission. The Army physicist Kurt Diebner was installed in the institute as its commissarial director. Heisenberg was affiliated with the institute as an advisor at first, and became the director in 1942. Heisenberg and his colleagues, including in particular Karl-Heinz Hoecker, Carl Friedrich von Weizsaecker, and Karl Wirtz, worked on nuclear reactors and isotope separation with the clear knowledge that these were two different paths to atomic bombs [Atombomben]. However, they were clearly ambivalent about what they were doing. New documents recently returned from Russian archives shed new light on this work and the scientists' motivations. (orig.)

  19. Multidimensional digital image representations using generalized Kaiser-Bessel window functions.

    Science.gov (United States)

    Lewitt, R M

    1990-10-01

    Inverse problems that require the solution of integral equations are inherent in a number of indirect imaging applications, such as computerized tomography. Numerical solutions based on discretization of the mathematical model of the imaging process, or on discretization of analytic formulas for iterative inversion of the integral equations, require a discrete representation of an underlying continuous image. This paper describes discrete image representations, in n-dimensional space, that are constructed by the superposition of shifted copies of a rotationally symmetric basis function. The basis function is constructed using a generalization of the Kaiser-Bessel window function of digital signal processing. The generalization of the window function involves going from one dimension to a rotationally symmetric function in n dimensions and going from the zero-order modified Bessel function of the standard window to a function involving the modified Bessel function of order m. Three methods are given for the construction, in n-dimensional space, of basis functions having a specified (finite) number of continuous derivatives, and formulas are derived for the Fourier transform, the x-ray transform, the gradient, and the Laplacian of these basis functions. Properties of the new image representations using these basis functions are discussed, primarily in the context of two-dimensional and three-dimensional image reconstruction from line-integral data by iterative inversion of the x-ray transform. Potential applications to three-dimensional image display are also mentioned.

  20. A generalization of the simplest equation method and its application to (3+1)-dimensional KP equation and generalized Fisher equation

    International Nuclear Information System (INIS)

    Zhao, Zhonglong; Zhang, Yufeng; Han, Zhong; Rui, Wenjuan

    2014-01-01

    In this paper, the simplest equation method is used to construct exact traveling solutions of the (3+1)-dimensional KP equation and generalized Fisher equation. We summarize the main steps of the simplest equation method. The Bernoulli and Riccati equation are used as simplest equations. This method is straightforward and concise, and it can be applied to other nonlinear partial differential equations

  1. EDUCAÇÃO PERMANENTE NO CONTEXTO HOSPITALAR: A EXPERIÊNCIA QUE RESSIGNIFICA O CUIDADO EM ENFERMAGEM

    OpenAIRE

    Flores,Giovana Ely; Oliveira,Dora Lúcia Leidens de; Zocche,Denise Antunes de Azambuja

    2016-01-01

    Resumo O artigo aborda o processo de formação vivenciado por enfermeiras educadoras no contexto hospitalar, na perspectiva da educação permanente em saúde, com destaques para as experiências que constituíram esse processo, os sentidos dessa formação e as mudanças decorridas no desenvolvimento do cuidado de enfermagem com base nas aprendizagens significativas. Tratou-se de estudo qualitativo exploratório-descritivo, desenvolvido por meio de grupos focais com sete enfermeiras que atuavam no Pro...

  2. Systematic review of economic evaluation studies and budget impact on ambulatory monitoring of capillary glucose in type 2 diabetics.

    Science.gov (United States)

    Olry de Labry Lima, Antonio; Moya Garrido, María Natividad; Espín Balbino, Jaime

    2014-04-01

    Realise a review of studies of economic evaluation about the ambulatory monitoring of capillary glucose (AMGC) in diabetic type II persons. A review of the literature was conducted, in MedLine, various websites, referenced paper and provided by expert's persons. Five studies concluded that the AMGC was a cost-effective strategic, of this papers use Kaiser Permanente data base, its make that these studies could be considered a solely one study. The rest of the papers did not find difference in the AMGC use. The use of AMGC has an uncertainty efficiency. More studies are needed. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  3. Environmental aspects of Kaiser S2 harvester utilization in mountain terrains

    Directory of Open Access Journals (Sweden)

    Jozef Slugeň

    2012-01-01

    Full Text Available This paper deals with evaluating the ecological impacts of Kaiser S2 harvester utilization in mountain terrains. The harvester was used in bark beetle calamity and secondary felling in mixed forest (spruce, fir, beech stand with average incline of 70%. Assisting its movement in these extreme conditions were two supporting bases, which were used to stabilize it in the stand. Our aim was to determine the damage to the trees, underwood and stand soil. The resulting damage of remaining stand was 6.19%, which is, considering the demanding terrain conditions and in comparison with the outcomes of other research, a relatively acceptable value. Damage to the underwood was not found, due to its insufficient height and low representation. Measurements of damage to the soil by its compression indicated that the heaviest damage was under the supporting bases, where a heavy surface damage was found by creation of holes up to 15 cm deep. This type of damage is not dangerous, because it does not create a continuous track dangerous in storm rainfall and subsequent soil erosion. Soil compression in the track and on unimpaired soil reached lower levels. All of the measurements of compression by static penetration were carried out only to the depth of 15 cm due to high soil skeleton. This also negatively affected the measurements, which had to be repeated in many cases.

  4. Antecedentes históricos del proceso de formación permanente del maestro tutor y su sistematización

    Directory of Open Access Journals (Sweden)

    MSc. Nirma Pérez-Pelipiche

    2016-02-01

    Full Text Available El estudio histórico realizado permitió evidenciar que la formación permanente de los maestros tutores de los estudiantes de Licenciatura en Educación Primaria ha transitado desde de una concepción espontánea, ocasional y a veces improvisada, hacia una más organizada en la que se han asumido posiciones de constantes cambios a favor del proceso formativo universitario pedagógico. Sin embargo, aún persisten restricciones epistemológicas y praxiológicas que limitan su efectividad, siendo notorio en el contexto de la microuniversidad durante la práctica laboral de los estudiantes en formación. Los estudios revelan que si bien el maestro tutor se erige en una figura esencial del proceso formativo pedagógico, no siempre su preparación ha sido efectiva, por lo que se requiere de una dinámica contextualizada de formación permanente que propicie nuevos sistemas de relaciones, vías y actitudes que actualicen y renueven las formas de ejercer sus funciones formativas en correspondencia con la realidad educativa contemporánea.

  5. Educação permanente e qualidade da assistência à saúde: aprendizagem significativa no trabalho da enfermagem

    Directory of Open Access Journals (Sweden)

    Fernanda Maria do Carmo da Silveira Neves de Oliveira

    2011-01-01

    Full Text Available El objetivo de este artículo es analizar la educación permanente en la práctica de la enfermería. En la actualidad, existe preocupación por los cambios introducidos en la estructura de enseñanza y la aplicación de metodologías activas para capacitar profesionales de salud. En el artículo se reflexiona sobre aspectos cotidianos de la enfermería y la manera actual de suministrar o proporcionar información tecnocientífica al enfermero durante la práctica en el hospital, tratando de enriquecer la asistencia de enfermería mediante la educación permanente. Se describen las prácticas trasformadoras aplicadas por el enfermero asistencial como elemento facilitador del proceso enseñanza-aprendizaje. Se lleva a cabo una revisión amplia de las bases de datos informáticas. En consecuencia, la selección de los textos se basa en los criterios de inclusión y exclusión, y dio origen a 50 artículos científicos. En años recientes, la educación permanente se introdujo como un método en el área de la salud, convirtiéndose en un aspecto indispensable en las prácticas de formación, atención, gestión, formulación de políticas públicas y control social. Así se estableció la idea de cuidado total y se trasformaron e integraron los saberes y las prácticas en el ámbito real del público al que va dirigido. Se concluye que la motivación para actualizar permanentemente la práctica profesional del equipo de enfermería prevé la aplicación de un instrumento interdisciplinario de solubilidad que promueva la visibilidad de las acciones por los clientes y sus familias.

  6. Parálisis facial permanente: corrección quirúrgica con la técnica de Labbé

    Directory of Open Access Journals (Sweden)

    Rubén Yangali

    2008-12-01

    Full Text Available La parálisis facial genera un gran déficit estético y funcional. Las diversas técnicas quirúrgicas han ido evolucionando, a fin de corregir este defecto de la forma más estructural y fisiológica posible. Consideramos que la mioplastia de alargamiento del temporal constituye actualmente la técnica de elección para corregir los casos de parálisis facial permanente.

  7. Self-affine scaling from non-integer phase-space partition in $\\pi^{+}p$ and $K^{+}p$ collisions at 250 GeV/$c$

    CERN Document Server

    Agababian, N M

    1998-01-01

    A factorial-moment analysis with real (integer and non-integer) phase space partition is applied to $\\pi^+$p and K$^+$p collisions at 250 GeV/$c$. Clear evidence is shown for self-affine rather than self-similar power-law scaling in multiparticle production. The three-dimensional self-affine second-order scaling exponent is determined to be 0.061$\\pm$0.010.

  8. Mediación de la cultura docente en los proyectos de formación permanente (Mediation of culture teaching in lifelong learning projects (Médiation de la culture de l'enseignant dans les projets de formation continue (Mediação da cultura docente nos projectos de formação permanente

    Directory of Open Access Journals (Sweden)

    Rosa Amaya-de Rebolledo

    2010-12-01

    Full Text Available ResumenLa formación permanente del docente juega un papel clave en el cambio educativo; sin embargo, su con- creción práctica representa un reto epistemológico y metodológico. La problemática ha sido abordada des- de diferentes ángulos, en los cuales la relación entre cultura docente y formación permanente no ha sido claramente desvelada. En este artículo, que constituye un avance en la investigación de tesis doctoral de la Facultad de Ciencias de la Educación de la Universidad de Carabobo, se analiza por qué la cultura docente necesita ser reconocida como una realidad dinámica, dialéctica y relacional que afecta la calidad de la for- mación permanente del docente venezolano.AbstractThe continuous training of the teacher plays a key role in educational change; however, to take it to the practice rep- resents an epistemological and meth- odological challenge. The problem has been approached from different angles, where the relation between culture of the teacher and continuous training has not been clearly discussed. In this article, which constitutes an advance in the investigation of doctoral thesis of the Faculty of Sciences of the Education of Carabobo's University, it is analyzed why the culture of the teacher needs to be recognized as a dynamic reality, dialectic and relational that affects the quality of the continuous training in Venezuelan.RésuméLa formation continue des enseignants joue un rôle essentiel dans le changement éducatif, cependant, sa concrétion prati- que représente un défi épistémologique et méthodologique. La problématique a été envisagée dès perspectives différen- tes, dans lesquelles la relation entre la culture de l'enseignant et la formation continue n'a pas encore été nettement dévoilée. Dans cet article, qui constitue une avance dans la recherche de thèse doctorale de la Faculté de Sciences de l'Éducation de l'Université de Carabobo, on

  9. The KP Hierarchy and Aspects of the Painlevé Property

    Science.gov (United States)

    Strampp, W.; Langer, C.

    1990-12-01

    We are concerned with the conjecture that the Painlevé property is a necessary condition for the integrability of nonlinear equations. Following a suggestion by lietratures (1) D. V. Chudnovsky, G. V. Chudnovsky and M. Tabor, Phys. Lett. 97A (1983), 268, and 2) A. K. Pogrebkov, Inverse Problems 5 (1989), L7), our investigations will be based on the Lax-pair which we use in Sato's sense (3) E. Date, M. Jimbo, M. Kashiwara and T. Miwa in Nonlinear Integrable Systems-Classical and Quantum Theory, ed. M. Jimbo and T. Miwa (World Scientific, Singapore, 1983), p. 39, 4) M. Jimbo and T. Miwa, Publ. RIMS, Kyoto Univ. 19 (1983), 943, 5) Y. Ohta, J. Satsuma, D. Takahashi and T. Tokihiro, Prog. Theor. Phys. Suppl. No. 94 (1988), 210). Leading orders, branch points and resonances are described for the Zakharov-Shabat equations of the KP-hierarchy. The symbolic manipulation system REDUCE, in particular its factorization algorithm for polynomials, is employed for finding the resonances. It is shown that the Painlevé structures of various nonlinear equations, which have been discussed a lot in the literature, follow from our results.

  10. A compilation of K+p --> K0 DELTA++ cross sections below 2 GeV/c

    CERN Document Server

    Giacomelli, G; Piccinini, M; Rimondi, F; Serra-Lugaresi, P

    1976-01-01

    Data published up to June 1976 on the quasi-two-body reaction K+p --> K0 DELTA++, with DELTA++ -->ppi+, are compiled for laboratory momenta from 0.7 to 2 GeV/c. They include integrated cross-sections, differencial cross-sections, average and differential density matrix elements, as well as coefficients of the Legendre polynomial expensions of the production differential distributions. The data are presented in the form og graphs and computer-produced tables. The method of computation is the same as in a previous report (CERN-HERA-75-1) on K+N cross-sections below2 GeV/c, to which the reader is referred for details on cards formats, notations, etc.

  11. Large self-affine fractality in $\\pi^{+}p$ and $K^{+}p$ collisions at 250 GeV/c

    CERN Document Server

    Agababian, N M

    1996-01-01

    Taking into account the anisotropy of phase space in multiparticle production, a self-affine analysis of factorial moments was carried out on the NA22 data for $\\pi^{+}p$ and $K^{+}p$ collisions at 250 GeV/$c$. Within the transverse plane, the Hurst exponents measuring the anisotropy are consistent with unit value (i.e. no anisotropy). They are, however, only half that value when the longitudinal direction is compared to the transverse ones. Fractality, indeed, turns out to be self-affine rather than self-similar in multiparticle production. In three-dimensional phase space, power-law scaling is observed to be better realized in self-affine than in self-similar analysis.

  12. Las ciencias naturales me generan... emociones vinculadas a las ciencias en la formación docente permanente

    OpenAIRE

    Mengascini, Adriana

    2017-01-01

    Presentamos y discutimos resultados de una indagación realizada en el contexto de una propuesta de formación docente permanente, respecto de las emociones asociadas a las ciencias naturales, a su enseñanza y a la realización de trabajos experimentales entre docentes de primaria y secundaria de Argentina. Las emociones manifestadas hacia las ciencias fueron positivas (interés, atracción, motivación), aunque respecto de su enseñanza y la realización de actividades experimentales se expresaron a...

  13. One-Year Outcomes of an Integrated Multiple Sclerosis Disease Management Program.

    Science.gov (United States)

    Groeneweg, Marti; Forrester, Sara H; Arnold, Beth; Palazzo, Lorella; Zhu, Weiwei; Yoon, Paul; Scearce, Tim

    2018-05-01

    Multiple sclerosis (MS) is associated with high total health care cost, the majority of which is attributable to medications. Patients with MS are less likely to experience relapses, emergency department (ED) visits, and hospitalizations when they are adherent to disease-modifying treatments. Disease management programs are hypothesized to improve medication adherence thereby improving clinical and economic outcomes. To evaluate the clinical and economic effects of a specialty pharmacy and chronic disease management program for patients with MS from a health plan perspective. This study was a retrospective analysis using prescription drug claims, medical claims, and electronic medical record information (2013-2015) 1 year before and after enrollment in the disease management program for members with 24 months of continuous health plan coverage. Medication adherence was calculated using proportion of days covered (PDC). Relapse rate was defined as an MS outpatient visit associated with a corticosteroid dispense within 7 days of the visit or an MS hospitalization. Disease progression was assessed using the Modified Expanded Disability Status Scale (mEDSS). Resource use included outpatient visits, ED visits, and hospitalizations. Cost information was collected as health plan-paid amount and was reported in 2013 U.S. dollars. The analysis included 377 patients (mean age 55 years, 76.4% female). After enrollment in the program, 78.7% of the study group had a PDC of ≥ 0.80 compared with 70.0% before enrollment (P management for patients with MS can increase the proportion of patients adherent to medication. The increase in health plan spend on MS medications is not offset by savings in health care resource utilization. This study was funded by Kaiser Permanente Washington Health Research Institute and Kaiser Permanente Washington Pharmacy Administration. The authors have no disclosures to report.

  14. Psychiatric and Medical Conditions in Transition-Aged Individuals With ASD.

    Science.gov (United States)

    Davignon, Meghan N; Qian, Yinge; Massolo, Maria; Croen, Lisa A

    2018-04-01

    Children with autism spectrum disorder (ASD) have a variety of medical and psychiatric conditions and an increased use of health care services. There is limited information about the prevalence of psychiatric and medical conditions in adolescents and young adults with ASD. Our objective was to describe the frequency of medical and psychiatric conditions in a large population of diverse, insured transition-aged individuals with ASD. Participants included Kaiser Permanente Northern California members who were enrolled from 2013 to 2015 and who were 14 to 25 years old. Individuals with ASD ( n = 4123) were compared with peers with attention-deficit/hyperactivity disorder ( n = 20 615), diabetes mellitus ( n = 2156), and typical controls with neither condition ( n = 20 615). Over one-third (34%) of individuals with ASD had a co-occurring psychiatric condition; the most commonly reported medical conditions included infections (42%), obesity (25%), neurologic conditions (18%), allergy and/or immunologic conditions (16%), musculoskeletal conditions (15%), and gastrointestinal (11%) conditions. After controlling for sex, age, race, and duration of Kaiser Permanente Northern California membership, most psychiatric conditions were significantly more common in the ASD group than in each comparison group, and most medical conditions were significantly more common in the ASD group than in the attention-deficit/hyperactivity disorder and typical control groups but were similar to or significantly less common than the diabetes mellitus group. Although more research is needed to identify factors contributing to this excess burden of disease, there is a pressing need for all clinicians to approach ASD as a chronic health condition requiring regular follow-up and routine screening and treatment of medical and psychiatric issues. Copyright © 2018 by the American Academy of Pediatrics.

  15. Nurse Knowledge Exchange Plus: Human-Centered Implementation for Spread and Sustainability.

    Science.gov (United States)

    Lin, Mike; Heisler, Scott; Fahey, Linda; McGinnis, Juli; Whiffen, Teri L

    2015-07-01

    Kaiser Permanente implemented a new model of nursing communication at shift change-in the bedside nursing report known as the Nurse Knowledge Exchange (NKE) in 2004-but noted variations in its spread and sustainability across medical centers five years later. The six core elements of NKEplus were as follows: team rounding in the last hour before shift changes, pre-shift patient assignments that limit the number of departing nurses at shift change, unit support for uninterrupted bedside reporting, standardization for report and safety check formats, and collaboration with patients to update in-room care boards. In January 2011 Kaiser Permanente Southern California (KPSC; Pasadena) began implementing NKEplus in 125 nursing units across 14 hospitals, with the use of human-centered design principles: creating shared understanding of the need for change, minimum specifications, and customization by frontline staff. Champion teams on each nursing unit designed and pilot tested unit-specific versions of NKEplus for four to eight weeks. Implementation occurred in waves and proceeded from medical/surgical units to specialty units. Traditional performance improvement strategies of accountability, measurement, and management were also applied. By the end of 2012, 100% of the 64 medical/surgical units and 47 (77.0%) of the 61 specialty units in KPSC medical centers implemented NKEplus-as had all but 1 of the specialty units by May 2013. The mean KPSC score on the NKEplus nursing behavior bundle improved from 65.9% in 2010 to 71.3% in the first quarter of 2014. The mean KPSC Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score for nurse communication improved from 73.1% in 2010 to 76.4% in the first quarter of 2014 (p < . 001). Human-centered implementation appeared to help spread a new model of nursing handoffs and change the culture of professional nursing practice related to shift change.

  16. Career ladder program for registered nurses in ambulatory care.

    Science.gov (United States)

    Nelson, Joan; Sassaman, Becky; Phillips, Alison

    2008-01-01

    RN ladder programs are designed to inspire and reward clinical excellence. Kaiser Permanente Colorado's (KPCO) career ladder program emerged as a result of a labor-management partnership. Career ladder point assignments are reflective of the organization's priorities and values. KPCO's career ladder point tool awards RNs for formal and continuing education, professional presentations, organizational experience and experience as an RN, certifications and active professional memberships, leadership activities, research and publications, and nursing-related volunteer work. Participation in the RN career ladder requires that the nurse achieve a self-determined, manager-approved, measurable goal that will improve patient care. Career ladder nurses at KPCO were significantly more involved in leadership and interdisciplinary activities, quality improvement projects, and preceptorship.

  17. Robo-AO KP: A new era in robotic adaptive optics

    Science.gov (United States)

    Riddle, Reed L.; Baranec, Christoph; Law, Nicholas M.; Kulkarni, Shrinivas R.; Duev, Dmitry; Ziegler, Carl; Jensen-Clem, Rebecca M.; Atkinson, Dani Eleanor; Tanner, Angelle M.; Zhang, Celia; Ray, Amy

    2016-01-01

    Robo-AO is the first and only fully automated adaptive optics laser guide star AO instrument. It was developed as an instrument for 1-3m robotic telescopes, in order to take advantage of their availability to pursue large survey programs and target of opportunity observations that aren't possible with other AO systems. Robo-AO is currently the most efficient AO system in existence, and it can achieve an observation rate of 20+ science targets per hour. In more than three years of operations at Palomar Observatory, it has been quite successful, producing technology that is being adapted by other AO systems and robotic telescope projects, as well as several high impact scientific publications. Now, Robo-AO has been selected to take over operation of the Kitt Peak National Observatory 2.1m telescope. This will give Robo-AO KP the opportunity to pursue multiple science programs consisting of several thousand targets each during the three years it will be on the telescope. One-sixth of the observing time will be allocated to the US community through the NOAO TAC process. This presentation will discuss the process adapting Robo-AO to the KPNO 2.1m telescope, the plans for integration and initial operations, and the science operations and programs to be pursued.

  18. La formación del profesorado de Historia en Chile. La formación inicial y permanente de los educadores de la V región en el marco de la reforma educacional

    OpenAIRE

    Vásquez Lara, Nelson Lorenzo

    2004-01-01

    [spa] Objetivos Generales:A. Conocer las principales características que ha tenido la formación inicial de los Profesores de Historia, Geografía y Ciencias Sociales chilenos.B. Conocer las principales características que ha tenido la formación permanente de los profesores de Historia, Geografía y Ciencias Sociales chilenos.C. Averiguar la percepción que los profesores de historia chilenos tienen sobre el grado de utilidad de la formación inicial y permanente.D. Averiguar la percepción que lo...

  19. Formación del profesorado de Historia en Chile. La formación inicial y permanente de los educadores de la V región en el marco de la reforma educacional, La

    OpenAIRE

    Vásquez Lara, Nelson Lorenzo

    2004-01-01

    Objetivos Generales:A. Conocer las principales características que ha tenido la formación inicial de los Profesores de Historia, Geografía y Ciencias Sociales chilenos.B. Conocer las principales características que ha tenido la formación permanente de los profesores de Historia, Geografía y Ciencias Sociales chilenos.C. Averiguar la percepción que los profesores de historia chilenos tienen sobre el grado de utilidad de la formación inicial y permanente.D. Averiguar la percepción que los prof...

  20. MERCOSUR ambiental. El aporte del Laudo 1/2012 del Tribunal Permanente de Revisión

    Directory of Open Access Journals (Sweden)

    Alberto Cesar Moreira

    2014-03-01

    Full Text Available El trabajo reflexiona acerca de la dimensión ambiental del MERCOSUR, identificando los desarrollos institucionales y normativos más significativos e intentando desentrañar algunas de las causas que dificultan su consolidación. En ese orden de ideas, destaca la escasa utilización que los Estados han hecho del sistema de solución de controversias de este esquema y pone de resalto el aporte del laudo 1/2012 del Tribunal Permanente de Revisión, ya que al resolver sobre su competencia en razón de la materia, reconoce y acompaña a las distintas dimensiones que el MERCOSUR ha ido desarrollado, entre ellas la ambiental.

  1. Heart rate calculation from ensemble brain wave using wavelet and Teager-Kaiser energy operator.

    Science.gov (United States)

    Srinivasan, Jayaraman; Adithya, V

    2015-01-01

    Electroencephalogram (EEG) signal artifacts are caused by various factors, such as, Electro-oculogram (EOG), Electromyogram (EMG), Electrocardiogram (ECG), movement artifact and line interference. The relatively high electrical energy cardiac activity causes EEG artifacts. In EEG signal processing the general approach is to remove the ECG signal. In this paper, we introduce an automated method to extract the ECG signal from EEG using wavelet and Teager-Kaiser energy operator for R-peak enhancement and detection. From the detected R-peaks the heart rate (HR) is calculated for clinical diagnosis. To check the efficiency of our method, we compare the HR calculated from ECG signal recorded in synchronous with EEG. The proposed method yields a mean error of 1.4% for the heart rate and 1.7% for mean R-R interval. The result illustrates that, proposed method can be used for ECG extraction from single channel EEG and used in clinical diagnosis like estimation for stress analysis, fatigue, and sleep stages classification studies as a multi-model system. In addition, this method eliminates the dependence of additional synchronous ECG in extraction of ECG from EEG signal process.

  2. La aspiración de Brasil al asiento permanente en el Consejo de Seguridad de la Organización de las Naciones Unidas: un breve panorama

    Directory of Open Access Journals (Sweden)

    Renata de Melo Rosa

    2009-12-01

    Full Text Available Este artículo analiza la posición de Brasil frente a la aspiración de un asiento permanente al Consejo de Seguridad de las Naciones Unidas. Los esfuerzos entabulados por Brasil en el escenario internacional, los discursos del primer rango del gobierno, así como un protagonismo más acelerado frente a los vecinos latino-americanos confirman esta aspiración. Pero, Brasil aún enfrenta serios problemas internos de seguridad nacional y tendrá que enfrentar otros compañeros regionales también, aspirantes a un assiento de miembro permanente en el Consejo de Seguridad de la ONU, como Canadá, por ejemplo. La ocupación del assiento temporario en el bienio de 2010-2011 también es uno de los factores analizados en este trabajo.

  3. CONTROL DE GESTIÓN: DIMENSIONES Y DIAGNÓSTICO PERMANENTE

    Directory of Open Access Journals (Sweden)

    Maritza Hernández Torres

    2003-04-01

    Full Text Available

    Los actuales entornos competitivos en los que se desarrolla la actividad empresarial, junto a la necesidad de responder de forma adecuada a los continuos cambios y constante incertidumbre a los que las organizaciones han de enfrentarse, conllevan una significativa modificación en lo que a la gestión empresarial se refiere, resultando esencial en este sentido, el papel del control de gestión, que como elemento del proceso de dirección, es el que más contribuye a mejorar las actuaciones de cualquier sistema. Las empresas deben tomar decisiones estratégicas adecuadas que permitan alcanzar alguna ventaja competitiva en la búsqueda de la excelencia empresarial a través de un proceso flexible de mejora continua. Para contribuir a tal propósito, en el presente trabajo se realizan algunas reflexiones acerca del control de gestión, abarcando desde el enfoque clásico hasta el moderno, su evolución y situación en las organizaciones cubanas; así como, el análisis de sus dimensiones soportado en un procedimiento para su permanente diagnóstico en correspondencia con las particularidades en que las diferentes empresas desarrollan su actividad.

  4. Gestión de la formación permanente del docente: reflexión y propuesta

    Directory of Open Access Journals (Sweden)

    MSc. Silvia M. Sarmiento-Berrezueta

    2015-11-01

    Full Text Available La práctica educativa actual exige implementar un nuevo Modelode Gestión de la formación permanente de los docentes basado en los estándares de calidad. Este artículo se centra en cómo alcanzar la calidad de la gestión formativa profesional mediante una propuesta de autoformación y co-formación basada sobre la reflexión, valoración y motivación, normada desde el Código de Convivencia, que conlleva a aprender y desaprender en los colectivos de docentes de educación básica superior en el Ecuador.

  5. Minería de datos en la encuesta permanente de hogares 2009, universidad nacional del litoral, argentina

    OpenAIRE

    Denis Lizazo Torres; Roberto Delfor Meyer; Verena Torres Cárdenas

    2011-01-01

    En este trabajo se aplicó por primera vez la Minería de Datos a la información generada por la Encuesta Permanente de Hogares del año 2009, del Observatorio Social de la Universi-dad del Litoral en Santa Fe, Argentina. El objetivo fue utilizar algoritmos de clasificación que poseen enfoques descriptivos, y es una de las tareas más utilizada en Minería de Datos para obtener nuevos conocimientos sobre la familia santafecina. La base de datos fue confeccio-nada con la información en el relevamie...

  6. The Impact of Telephonic Wellness Coaching on Weight Loss: A “Natural Experiments for Translation in Diabetes (NEXT-D)” Study

    Science.gov (United States)

    Schmittdiel, Julie A.; Adams, Sara R.; Goler, Nancy; Sanna, Rashel S.; Boccio, Mindy; Bellamy, David J.; Brown, Susan D.; Neugebauer, Romain S.; Ferrara, Assiamira

    2016-01-01

    Objective To evaluate the impact of a population-based telephonic wellness coaching program on weight loss. Methods Individual-level segmented regression analysis of interrupted time series data comparing the BMI trajectories in the 12 months before vs. the 12 months after initiating coaching among a cohort of Kaiser Permanente Northern California (KPNC) members (n=954) participating in The Permanente Medical Group (TPMG) Wellness Coaching program in 2011. The control group was a 20:1 propensity-score matched control group (n=19,080) matched with coaching participants based on baseline demographic and clinical characteristics. Results Wellness coaching participants had a significant upward trend in BMI in the 12 months before their first Wellness coaching session, and a significant downward trend in BMI in the 12 months after their first session equivalent to a clinically significant reduction of greater than one unit of baseline BMI (pcoaching has a positive impact on BMI reduction that is both statistically and clinically significant. Future research and quality improvement efforts should focus on disseminating Wellness coaching for weight loss in diabetes patients and those at risk for developing the disease. PMID:28124501

  7. Nuevos retos para el profesorado de secundaria obligatoria: formación permanente para la atención a la diversidad en las aulas (New challenges for teachers of compulsory secondary: lifelong learning for attention to diversity in the classrooms (Nouveaux défis pour le professorat de secondaire obligatoire :formation permanente pour l’attention à la diversité dans la salle de classe (Novos desafios para os professores do ensino médio obrigatório: formação permanente para a atenção à diversidade na sala de aula

    Directory of Open Access Journals (Sweden)

    Mar Prats

    2009-12-01

    Full Text Available La llegada reciente de alumnos inmigrantes a los centros educativos en España ha enfrentado al profesorado a nuevos retos. El presente artículo pone de manifiesto cuáles son estos nuevos retos que afrontan los docentes de la etapa de Educación Secundaria Obligatoria, ESO, a partir de sus propias voces, para conocer las necesidades formativas derivadas de esta situación educativa, con el fin de hacer propuestas de formación permanente para los docentes, como apoyo institucional en la atención de la diversidad de alumnado que coexiste en las aulas. Utilizando como método el estudio de casos múltiples hemos analizado e interpretado la información que conduce a conclusiones prácticas, con muchas posibilidades de ser tenidas en cuenta para la formación permanente de los implicados.

  8. Study of the K-barπ system in the 3 bodies final states, produced by 3 GeV/c K-p interactions

    International Nuclear Information System (INIS)

    Verglas, A.

    1966-01-01

    The K - p → K * (891) π reaction is a good example of a quasi two-body phenomenon, exhibiting the characteristics of 'peripherism'. The predictions of the 'one meson exchange', and 'absorption' models are compared with the experimental results. Conclusions are drawn concerning the production mechanism of the Kp → K * π reaction, as well as on the validity of the models. Finally, the K * (1400) resonance is studied and its isospin determined. (author) [fr

  9. La Educación Permanente en Bibliotecología y Archivología: relato de una experiencia universitaria en Uruguay (1994-2001

    Directory of Open Access Journals (Sweden)

    Edelweiss Zahn

    2013-12-01

    Full Text Available Se indica cómo han variado los roles de la información y la situación relativa de las unindades de información, la producción tecnológica de vías alternativas del almacenamiento documental, tales como las bilbiotecas virtuales o digitales, los archivos y museos electrónicos. El avance de la investigación y del conocimiento en cualquier disciplina, el crecimiento de expectativas y necesidades de formación y actualización por parte de los profesionales, nuevos requerimientos y desafíos en el ámbito laboral y social, y la implantación generalizada de nuevas tecnologías, se han conjugado para obligar a una reflexión profunda de las instituciones responsables de formación especializada. En las Universidades se plantean al menos tres niveles educativos: el grado, los posgrados, y la educación continua o permanente que involucre conocimientos teórico-prácticos y metodológicos, que contribuya a mejorar el desempeño y la jerarquía profesional en la línea de conocimientos "just in time", y que habilite a niveles superiores de conocimiento y a la investigación disciplinaria. Se define y caracteriza la eduación permanente como fenómeno educativo. Se relata el proceso de institucionalización de la Educación Permanente en la Universidad de la República y en la Escuela Universitaria de Bibliotecología y Ciencias Afines en particular. Se desarrollar criterios y políticas académicos, formas de financiación del programa, su evaluación y su proección a futuro. Se presentan datos estadísticos sobre cursos, profesores, y participantes en el período 1994-2001 en la EUBCA     

  10. Searching for the optimal renal prescription. Fresenius, Kaiser Permanente team up to offer new options in dialysis care.

    Science.gov (United States)

    Neumann, M E

    1999-01-01

    The goals are simple: Improve well-being of the dialysis patient and reduce hospitalizations. The tools are diverse: Ultrapure dialysate. On-line blood monitoring. Biocompatible membranes. No reuse. Daily, in-center dialysis and possibly nocturnal dialysis at home. Reimbursement: Full-risk capitation, With Medicare and commercial payor rates varying on a patient-by-patient basis. Create an incubator with approximately 1,000 end-stage renal disease patients, treated at both capitated payment-exclusive dialysis units and mingled in at traditional fee-for-service clinics. Establish a team of nurses and renal care staff to direct the care plan, and put the program in place. After the first year, analyze the data and see if the end--hopefully, improved outcomes and resulting reduced hospitalizations--justifies the means--the higher cost for "optimal technologies."

  11. La cátedra abierta y permanente de Ética

    Directory of Open Access Journals (Sweden)

    Ana María Caballero

    2015-06-01

    Full Text Available La Cátedra Abierta y Permanente de Ética se propuso como un espacio de discusión y reflexión ético-política para debatir las diferentes corrientes del pensamiento axiológico y político, que propicie la resignificación de las representaciones culturales y sociales de sentido que permitan desarrollar una mirada socio histórica sobre las relaciones entre educación, ética y cultura colombiana, de tal manera que los estudiantes de la Universidad Pedagógica Nacional asuman una conciencia clara de su función como actores sociales en la construcción de la sociedad civil, la democracia, la promoción y la defensa de los derechos humanos, el crecimiento económico y el desarrollo social. La formación de valores morales que fundamenten una ética cívica parte del conocimiento de la realidad nacional y global, de la autoconciencia de cada individuo que aspira a constituirse en un ser autónomo usando su pensamiento crítico y participando en la construcción de la democracia, como modelo de gobierno que garantiza las libertades individuales, propiciando espacios para la conquista de los ideales de libertad, equidad, solidaridad y tolerancia, que permitan la convivencia ciudadana y la construcción de la nacionalidad colombiana.

  12. [The history of the Kaiser Wilhelm Society during the Third Reich. Interim reports of the president's commission of the Max Planck Society].

    Science.gov (United States)

    Weber, M M

    2002-11-01

    In 1997 the Max Planck Society set up a presidential commission to do research on the historical development of its precursor organization, the Kaiser Wilhelm Society (KWG), during the Third Reich. This paper presents some of the important results given in the interim reports of this commission that are relevant to psychiatry. It focuses on brain research, anthropology, psychiatric genetics, and the role of the well-known biochemist Adolf Butenandt. In general, the interim reports reflect the numerous links between the biomedical research of the KWG and the institutions of the National Socialist (Nazi) state. However, they do not yet allow a final historical assessment as to the complex situation of this field of research during National Socialism.

  13. Isolation, screening and characterization of a novel extracellular xylanase from Aspergillus niger (KP874102.1) and its application in orange peel hydrolysis.

    Science.gov (United States)

    Uday, Uma Shankar Prasad; Majumdar, Ria; Tiwari, Onkar Nath; Mishra, Umesh; Mondal, Abhijit; Bandyopadhyay, Tarun Kanti; Bhunia, Biswanath

    2017-12-01

    In the present work, a potent xylanase producing fungal strain Aspergillus niger (KP874102.1) was isolated through cultural and morphological observations from soil sample of Baramura forest, Tripura west, India. 28S rDNA technique was applied for genomic identification of this fungal strain. The isolated strain was found to be phylogenetically closely related to Aspergillus niger. Kinetic constants such as K m and V max for extracellular xylanase were determined using various substrate such as beech wood xylan, oat spelt xylan and CM cellulose through Lineweaver-Burk plot. K m , V max and K cat for beech wood xylan are found to be 2.89mg/ml, 2442U and 426178Umlmg -1 respectively. Crude enzyme did not show also CM cellulose activity. The relative efficiency of oat spelt xylan was found to be 0.819 with respect to beech wood xylan. After acid hydrolysis, enzyme was able to produce reducing sugar with 17.7, 35.5, 50.8 and 65% (w/w) from orange peel after 15, 30, 45 and 60min incubation with cellulase free xylanase and maximum reducing sugar formation rate was found to be 55.96μg/ml/min. Therefore, the Aspergillus niger (KP874102.1) is considered as a potential candidate for enzymatic hydrolysis of orange peel. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. COMPETENCIAS EMPRENDEDORAS DEL ALUMNADO DE EDUCACIÓN PERMANENTE DE ADULTOS EN ANDALUCÍA. PERCEPCIÓN DEL PROFESORADO

    Directory of Open Access Journals (Sweden)

    José Ma. Fernández Batanero

    2017-01-01

    Full Text Available En el presente trabajo analizamos la percepción que tiene el profesorado de Educación Permanente de Personas Adultas en Andalucía (España acerca del grado de presencia de competencias emprendedoras en su alumnado. Para dar respuesta al objetivo planteado adoptamos un diseño de investigación de tipo descriptivo, donde el enfoque de recolección y análisis de datos se ha definido como mixto, en el que se integran técnicas cualitativas (entrevistas en profundidad y cuantitativas (cuestionario. Para la validación del cuestionario, se utilizó la técnica de juicio de expertos, seleccionados mediante el procedimiento de «Coeficiente de competencia experta» o «Coeficiente K». El análisis de la fiabilidad del cuestionario a través de la prueba de Cronbach fue de 0,957. El cuestionario ha sido respondido por 549 profesores y profesoras de Centros de Educación Permanente de Andalucía y se han realizado 23 entrevistas en profundidad a informantes claves (directores de centros y coordinadores de sección. Los resultados muestran con claridad la percepción, tanto del profesorado como de aquellos que ejercen el ejercicio de la dirección, que el alumnado de estos centros educativos no están lo suficientemente preparados para iniciar por su cuenta un proyecto empresarial, a pesar de cursar contenidos curriculares de cultura emprendedora. Consideran que aún no poseen las competencias emprendedoras necesarias para crear y gestionar eficazmente un proyecto empresarial, constituyendo la falta de creatividad uno de los mayores obstáculos para dicho fin. Así mismo, se desprende del estudio la escasa incidencia que ejercen los programas de cultura emprendedora que se desarrollan en este tipo de centros.

  15. Fungal Secretome Analysis via PepSAVI-MS: Identification of the Bioactive Peptide KP4 from Ustilago maydis

    Science.gov (United States)

    Kirkpatrick, Christine L.; Parsley, Nicole C.; Bartges, Tessa E.; Cooke, Madeline E.; Evans, Wilaysha S.; Heil, Lilian R.; Smith, Thomas J.; Hicks, Leslie M.

    2018-05-01

    Fungal secondary metabolites represent a rich and largely untapped source for bioactive molecules, including peptides with substantial structural diversity and pharmacological potential. As methods proceed to take a deep dive into fungal genomes, complimentary methods to identify bioactive components are required to keep pace with the expanding fungal repertoire. We developed PepSAVI-MS to expedite the search for natural product bioactive peptides and herein demonstrate proof-of-principle applicability of the pipeline for the discovery of bioactive peptides from fungal secretomes via identification of the antifungal killer toxin KP4 from Ustilago maydis P4. This work opens the door to investigating microbial secretomes with a new lens, and could have broad applications across human health, agriculture, and food safety. [Figure not available: see fulltext.

  16. Exact traveling wave solutions of the KP-BBM equation by using the new approach of generalized (G'/G)-expansion method.

    Science.gov (United States)

    Alam, Md Nur; Akbar, M Ali

    2013-01-01

    The new approach of the generalized (G'/G)-expansion method is an effective and powerful mathematical tool in finding exact traveling wave solutions of nonlinear evolution equations (NLEEs) in science, engineering and mathematical physics. In this article, the new approach of the generalized (G'/G)-expansion method is applied to construct traveling wave solutions of the Kadomtsev-Petviashvili-Benjamin-Bona-Mahony (KP-BBM) equation. The solutions are expressed in terms of the hyperbolic functions, the trigonometric functions and the rational functions. By means of this scheme, we found some new traveling wave solutions of the above mentioned equation.

  17. Caries dental aguda del primer molar permanente en niños de 12 años

    Directory of Open Access Journals (Sweden)

    Daniel Enrique Reyes Romagosa

    Full Text Available Introducción: el primer molar permanente es considerado la llave de la oclusión dentaria, la presencia de caries en éste es elevada, lo que dificulta el logro de las metas trazadas por organizaciones de salud a nivel mundial en este grupo de edad. Objetivo: determinar el comportamiento de la caries dental aguda en primer molar permanente en una población de 12 años de edad atendida en la Clínica Estomatológica Santa Cruz de la Parroquia Goaigoaza. Métodos: se realizó un estudio descriptivo transversal en la Clínica Estomatológica Santa Cruz. Parroquia Goaigoaza, municipio Puerto Cabello, estado Carabobo, en el período comprendido entre abril del 2009 a abril 2010. Se seleccionaron 97 pacientes de 12 años de edad los que constituyeron el universo y la muestra. Acudieron a la consulta por dolor debido a la presencia de caries dental aguda. Se registraron las variables: edad, sexo, grado clínico de la caries dental, estímulos externos que provocaron dolor, la cara dental y la arcada dentaria más afectadas. La información fue recogida mediante interrogatorio y examen clínico. Resultados: el sexo masculino representó el 63,9 %. La caries dental de 3er grado estuvo presente en un 68 %. Los estímulos externos que provocaron dolor fueron: el frío presente en 75,2 % y los alimentos dulces en 69,1 % en ambos sexos. El primer molar inferior derecho resultó más afectado (46,4 % que el izquierdo (36,1 %, así como la arcada dentaria inferior (25,8 % y la cara oclusal (64,9 %. Conclusiones: predominaron el sexo masculino y la caries dental aguda de 3er grado. El frío y los alimentos dulces fueron los estímulos externos más frecuentes. Los más afectados resultaron el primer molar inferior derecho, la cara oclusal y la arcada dentaria inferior.

  18. Las Lesson Study en Andalucía: un modelo de formación permanente

    Directory of Open Access Journals (Sweden)

    Rosa M.ª Caparrós Vida

    2015-01-01

    Full Text Available El presente artículo ofrece los resultados de un estudio de casos desarrollado en el marco de un proyecto de investigación I+D de la Universidad de Málaga a través de una de las modalidades de formación permanente ofertadas por un Centro de Formación del Profesorado, bajo la demanda de un grupo de docentes de una escuela de la comarca de la Axarquía en Málaga. Las Lesson Study se convierten en el eje del estudio de los procesos de comprensión y reconstrucción del conocimiento práctico de una maestra de 1º de primaria sobre la enseñanza y el aprendizaje de la lectura y escritura, encontrando evidencias significativas sobre cómo esta estrategia metodológica y de investigación contribuye a la reconstrucción del mismo.

  19. Permanent education in health. An instrument to enhance interpersonal relations in nursing work La educación permanente en salud. Instrumento potenciador de las relaciones interpersonales del trabajo en enfermería Educação permanente em saúde. Instrumento potencializador das relações interpessoais no trabalho da enfermagem

    Directory of Open Access Journals (Sweden)

    Juliane Portella Ribeiro

    2012-08-01

    Full Text Available This is a reflexive study about the need to adopt Permanent Education in Health, as an instrument capable of transforming interpersonal relations in nursing work, as it values and respect collective construction with a view to the qualification of care. Privileging specialization programs only, with a focus on work techniques, on educative processes, as a training strategy for health services, ends up reinforcing the fragmentation of care, teams and the work process. In conclusion, Permanent Education in Health serves not only as teaching and learning practice to update and transform practices, but also influences team relations, transforming joint action processes and, at the same time, implying each subject-worker involved in health practices.Se trata de un estudio reflexivo sobre la necesidad de adoptar la Educación Permanente en Salud, como un instrumento capaz de transformar las relaciones interpersonales en el trabajo de la enfermería, ya que valora y respeta la construcción colectiva para la calificación de la atención. Privilegiar sólo la especialización con direccionalidad en la técnica del trabajo en los procesos educativos, como estrategia de capacitación para los servicios de salud, acaba por reforzar la fragmentación del cuidado, de los equipos y del proceso de trabajo. Se concluye que la Educación Permanente en Salud, además de servir como práctica de enseñanza y aprendizaje para la actualización y transformación de las prácticas, actúa en las relaciones del equipo, transformando los procesos de acción conjunta y, al mismo tiempo, implicando cada sujeto-trabajador involucrado en las prácticas de salud.Se trata de um estudo reflexivo sobre a necessidade de adotar a Educação Permanente em Saúde, como um instrumento capaz de transformar as relações interpessoais no trabalho da enfermaria, já que, valoriza e respeita a construção coletiva, para a qualificação do atendimento. Privilegiar só a especializa

  20. EL DESARROLLO PROFESIONAL MEDIANTE LA FORMACION PERMANENTE DE LOS PROFESORES CUBANOS DE MATEMÁTICA Y CIENCIAS PARA TRABAJAR EN PAISES DE HABLA INGLESA

    Directory of Open Access Journals (Sweden)

    Noelio Vázquez Vargas

    2014-12-01

    Full Text Available Este artículo trata sobre el desarrollo profesional. Se presenta un estudio histórico sobre la enseñanza del inglés con fines específicos (IFE durante la formación permanente de los profesores cubanos de Matemática y Ciencias, además, se presentan las competencias básicas de los profesores de estas asignaturas, teniendo en cuenta el criterio de diferentes autores.

  1. Manual dexterity aptitude testing: a soap carving study.

    Science.gov (United States)

    Tang, Christopher G; Hilsinger, Raymond L; Cruz, Raul M; Schloegel, Luke J; Byl, Fred M; Rasgon, Barry M

    2014-03-01

    Currently there are few validated metrics for predicting surgical skill among otolaryngology residency applicants. To determine whether manual dexterity aptitude testing in the form of soap carving during otolaryngology residency interviews at Kaiser Permanente Medical Center Oakland predicts surgical skill at the time of graduation from otolaryngology residency programs. This study was conducted to determine how applicants with the best and worst soap carvings compared at the time of graduation with respect to various metrics including visuospatial ability and manual dexterity. Over the last 25 years, applicants to the residency program at Kaiser Permanente Oakland were required to carve soap during their residency interview. The 3 best and 3 worst soap carvings from 1990 through 2006 were determined. Of the individuals who carved those soaps, 62 qualified for the study and matriculated into otolaryngology residency programs. Surveys were sent to the 62 individuals' residency programs to evaluate those individuals on a 5-point Likert scale in various categories as well as to rank those individuals as being in the top 50% or bottom 50% of their graduating class. All else being equal, we hypothesized that applicants who had the manual dexterity and visuospatial skills to accurately carve a bar of soap would more likely possess the skills necessary to become a good surgeon. There was no difference between individuals with the best soap carvings and those with the worst soap carvings in all categories: cognitive knowledge, visuospatial ability, manual dexterity, decision making, and overall score (P > .10 for all categories). There was a 95% response rate, with 35 of 37 residency programs responding and 59 of 62 surveys returned. Manual dexterity aptitude testing in the form of soap carving does not appear to correlate with surgical skill at the time of graduation. Further studies need to be conducted to determine the role of manual dexterity and visuospatial

  2. Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people.

    Science.gov (United States)

    Quinn, Virginia P; Nash, Rebecca; Hunkeler, Enid; Contreras, Richard; Cromwell, Lee; Becerra-Culqui, Tracy A; Getahun, Darios; Giammattei, Shawn; Lash, Timothy L; Millman, Andrea; Robinson, Brandi; Roblin, Douglas; Silverberg, Michael J; Slovis, Jennifer; Tangpricha, Vin; Tolsma, Dennis; Valentine, Cadence; Ward, Kevin; Winter, Savannah; Goodman, Michael

    2017-12-27

    The Study of Transition, Outcomes and Gender (STRONG) was initiated to assess the health status of transgender people in general and following gender-affirming treatments at Kaiser Permanente health plans in Georgia, Northern California and Southern California. The objectives of this communication are to describe methods of cohort ascertainment and data collection and to characterise the study population. A stepwise methodology involving computerised searches of electronic medical records and free-text validation of eligibility and gender identity was used to identify a cohort of 6456 members with first evidence of transgender status (index date) between 2006 and 2014. The cohort included 3475 (54%) transfeminine (TF), 2892 (45%) transmasculine (TM) and 89 (1%) members whose natal sex and gender identity remained undetermined from the records. The cohort was matched to 127 608 enrollees with no transgender evidence (63 825 women and 63 783 men) on year of birth, race/ethnicity, study site and membership year of the index date. Cohort follow-up extends through the end of 2016. About 58% of TF and 52% of TM cohort members received hormonal therapy at Kaiser Permanente. Chest surgery was more common among TM participants (12% vs 0.3%). The proportions of transgender participants who underwent genital reconstruction surgeries were similar (4%-5%) in the two transgender groups. Results indicate that there are sufficient numbers of events in the TF and TM cohorts to further examine mental health status, cardiovascular events, diabetes, HIV and most common cancers. STRONG is well positioned to fill existing knowledge gaps through comparisons of transgender and reference populations and through analyses of health status before and after gender affirmation treatment. Analyses will include incidence of cardiovascular disease, mental health, HIV and diabetes, as well as changes in laboratory-based endpoints (eg, polycythemia and bone density), overall and in relation to

  3. Does the diagnosis of breast or ovarian cancer trigger referral to genetic counseling?

    Science.gov (United States)

    Powell, C Bethan; Littell, Ramey; Hoodfar, Elizabeth; Sinclair, Fiona; Pressman, Alice

    2013-03-01

    Kaiser Permanente Northern California is a large integrated health care delivery system in the United States that has guidelines for referring women with newly diagnosed BRCA1-and BRCA2-associated cancers for genetic counseling. This study assesses adherence to genetic counseling referral guidelines within this health system. Chart review was performed to identify patients with cancer who met the following pathology-based Kaiser Permanente Northern California guidelines for referral for genetic counseling: invasive breast cancer, younger than age 40; nonmucinous epithelial ovarian, fallopian tube, or peritoneal cancer, younger than age 60; women with synchronous or metachronous primary cancers of the breast and ovaries; and male breast cancer. We assessed compliance with referral guidelines. An electronic notice was sent to the managing physician of patients with newly diagnosed cancer to assess the feasibility of this intervention. A total of 340 patients were identified with breast cancer at younger than age 40 or with ovarian, peritoneal, or tubal cancer between January and June, 2008. Upon chart review, 105 of these patients met pathology-based criteria for referral to genetic counseling, of whom 47 (45%) were referred within the 2-year study period. Of the 67 subjects with breast cancer, 40 subjects (60%) were referred. In contrast, only 7 (21%) of 33 patients with ovarian cancer were referred (P < 0.001). A pilot study was performed to test the feasibility of notifying managing oncologists with an electronic letter alerting them of eligibility for genetic referral of patients with new diagnosis (n = 21). In the 3 to 6 months after this notification, 12 of these 21 patients were referred for counseling including 5 of 7 patients with a diagnosis of ovarian cancer. There is a missed opportunity for referring patients to genetic counseling, especially among patients with ovarian cancer. A pilot study suggests that alerting treating physicians is a feasible

  4. N = 2 local and N = 4 non-local reductions of supersymmetric KP hierarchy in N = 2 superspace

    International Nuclear Information System (INIS)

    Delduc, F.; Gallot, L.; Sorin, A.

    1999-01-01

    An N = 4 supersymmetric matrix KP hierarchy is proposed and a wide class of its reductions which are characterized by a finite number of fields are described. This class includes the one-dimensional reduction of the two-dimensional N = (2,2) superconformal Toda lattice hierarchy possessing the N = 4 supersymmetry -- the N = 4 Toda chain hierarchy - which may be relevant in the construction of supersymmetric matrix models. The Lax-pair representations of the bosonic and fermionic flows, corresponding local and non-local Hamiltonians, finite and infinite discrete symmetries, the first two Hamiltonian structures and the recursion operator connecting all evolution equations and the Hamiltonian structures of the N = 4 Toda chain hierarchy are constructed in explicit form. Is secondary reduction to the N 4 supersymmetric α = - 2 KdV hierarchy is

  5. Fórum Permanente da Agenda 21 Paraná: seus vínculos com o processo de mobilização social

    Directory of Open Access Journals (Sweden)

    Myrian Del Vecchio De Lima

    2016-12-01

    Full Text Available Este artigo utiliza a construção dos vínculos entre públicos envolvidos, proposta por Márcio Simeone Henriques (2004, para analisar a ocorrência de um processo de mobilização social, conforme entendimento teórico do sociólogo Bernardo Toro. O trabalho realiza esta proposta especificamente em relação às ações desenvolvidas pelo Fórum Permanente da Agenda 21 no Paraná. O objetivo é observar, por meio dos critérios dos vínculos, as ações de caráter mobilizador com relação a questões socioambientais empreendidas por esse coletivo, a partir do entendimento dos dois autores citados. Para tanto, o texto reflete sobre a compreensão do conceito central em questão, a mobilização social, e o papel da comunicação nesse processo. Após uma breve apresentação do Fórum Permanente da Agenda 21, verifica-se por meio de análise de conteúdo se há, no interior deste coletivo, vínculos que permitam atos de comunicação propícios à mobilização social em torno das diretrizes socioambientais propostas pela Agenda para orientar as políticas públicas.DOI: http://dx.doi.org/10.21882/ruc.v4i7.655 Recebido: 19/09/2016 Publicado: 07/12/2016

  6. Política de Educação Permanente em Saúde: análise de sua implementação

    Directory of Open Access Journals (Sweden)

    Katerine Gonçalves Moraes

    2015-12-01

    Full Text Available Introdução: A política nacional de educação permanente em saúde define novas diretrizes para a gestão democrática na área da educação na saúde, tais como: a gestão participativa, o protagonismo dos trabalhadores e usuários e o fortalecimento do controle social. Objetivo: Analisar o processo de implementação da Política de Educação Permanente em Saúde no Distrito Federal, Brasil. Métodos: Estudo de caso utilizando a teoria da política pública foi realizado no Distrito Federal, envolvendo 24 participantes chave responsáveis pela gestão e implementação dessa política. Resultados: Os achados apontam para um modelo centralizado de gestão com pouca participação de outros segmentos da sociedade civil, obstáculos de financiamento devido a questões burocráticas e desvalorização dos espaços de execução da política. Conclusão: Pode-se concluir que as mudanças políticas e de gestão não têm sido realizadas com a amplitude necessária para a construção coletiva do conhecimento nos serviços de saúde.

  7. The historical development of modern virus research in Germany, especially in the Kaiser-Wilhelm-/Max-Planck-Society, 1936--1954.

    Science.gov (United States)

    Butenandt, A

    1977-01-01

    This is lecture on the historical development of modern virus research in Germany to introduce a symposium dedicated to Prof. Werner Schäfer, Tübingen, on the occasion of his 65th birthday. The author was set the task of relating from his memories the beginning of modern virus research in Germany. This research has, since 1936, essentially taken place in the Kaiser-Wilhelm/Max-Planck-Society and in 1954 led to the founding of the Max-Planck-Institute for Virus Research in Tübingen, an institute which to the present day owes its scientific reputation in considerable part to the activity of Werner Schäfer. Since the author personally experienced and participated in the Institute's development from 1936-1954, his remarks are predominantly influenced by personal recollections, which have been sharpended by a renewed study of old records in the 'Library and Archive of the History of the Max-Planck-Gesellschaft', Berlin-Dahlem.

  8. Hacia un espacio europeo de aprendizaje para toda la vida. Evolución y desarrollo de la Educación Permanente en la Unión Europea.

    Directory of Open Access Journals (Sweden)

    Fernando López Noguero

    2008-01-01

    Full Text Available En sus inicios, la Unión Europea (UE concedió una mínima importancia a la educación en el marco de los derechos y las políticas sociales europeas, aumentando su peso paulatinamente, como comprobaremos en la propia evolución de la Educación Permanente en la UE, desarrollo que hemos dividido en cuatro etapas fundamentales. Así, desde la proclamación del Año Europeo de la Educación y la Formación Permanentes en 1996, en el que se fomentó en el seno de la UE el concepto de aprendizaje durante toda la vida, la Educación Permanente ha cambiado radicalmente en Europa hacia una nueva realidad que se ha dado en llamar “Espacio Europeo de Aprendizaje para toda la vida”, que analizamos en profundidad a través del análisis de la legislación y programas educativos existentes en la UE. ------------------------------------------------------------------------ In its early years, the European Union (EU granted a minimal importance to education in the framework of rights and social policies in Europe, increasing its weight gradually, as we Hill check on the evolution of Continuing Education in EU development which we have divided into tour Basic stages. So we will check how, since the proclamation of the European Year of Education and Training Standing in 1996, which fostered within the EU the concept of lifelong learning, Continuing Education has changed dramatically in Europe towards a new reality that has been termed a “European Area Learning for Life” which analyzed in depth through the analysis of legislation and educational programs existing in the EU.

  9. 2014 Hypertension Guideline: Recommendation for a Change in Goal Systolic Blood Pressure

    Science.gov (United States)

    Handler, Joel

    2015-01-01

    The 2014 Kaiser Permanente Care Management Institute National Hypertension Guideline was developed to assist primary care physicians and other health care professionals in the outpatient treatment of uncomplicated hypertension in adult men and nonpregnant women aged 18 years and older. The new guideline reflects general acceptance, with minor modifications, of the “Evidence-Based Guideline” report by the panel members appointed to the National Heart, Lung, and Blood Institute 8th Joint National Committee. A major practice change is the recommendation for goal systolic blood pressure less than 150 mmHg in patients aged 60 years and older who are treated for hypertension in the absence of diabetes or chronic kidney disease. This article describes the reasons for, evidence for, and consequences of the change, and is followed by the National Guidelines handout. PMID:26057683

  10. Sustaining engagement and partnership: model of enhancing cultural capital among nonaffiliated IRB members.

    Science.gov (United States)

    Hung, Yvonne; Ayala, Armida; Morales, Francisco; Frierman-Hunt, Gina; Moreno, Alva; Nwachuku, Ijeoma

    2013-07-01

    Although federal regulations require the presence of at least one nonaffiliated member on the roster of an institutional review board (IRB), little research exists about how to foster their participation and satisfaction. Guided by principles of justice and diversity, the Kaiser Permanente Southern California IRB adapted the sociological concept of "cultural capital" to develop training and support with its nonaffiliated IRB members. Using in-depth qualitative interviews with four past and current nonaffiliated IRB members, we describe how our initial and ongoing activities enhanced their ability to analyze, communicate, and complete the ethical review of research. This case study is situated in the gaps of existing research about nonaffiliated IRB members by providing insights into how to sustain their engagement while protecting the rights of research volunteers, particularly from vulnerable communities.

  11. Educação permanente: instrumento de trabalho do enfermeiro na instituição de longa permanência

    OpenAIRE

    Silva, Bárbara Tarouco da; Barlem, Edison Luiz Devos; Lunardi, Valeria Lerch; Santos, Silvana Sidney Costa

    2008-01-01

    A questão educacional na enfermagem é ampla, podendo referir-se à educação formal em cursos técnicos, de graduação e de pós-graduação, ou à educação em saúde voltada aos treinamentos em serviço. Ante a problemática do envelhecimento populacional, as características da sociedade moderna e o uso crescente de Instituições de Longa Permanência (ILPs) como residência dos idosos, a proposta deste texto reflexivo é enfatizar a relevância e necessidade da educação permanente para os trabalhadores que...

  12. Evaluación de la formación permanente del profesorado en la República Dominicana : el caso del Infocam

    OpenAIRE

    Ayala de la Cruz, María Esperanza

    2016-01-01

    El presente estudio estuvo orientado a describir y valorar la calidad del sistema de formación, relacionándolo con la aplicación de las políticas educativas y de formación permanente o continua del profesorado en la República Dominicana. Su conexión con las necesidades e intereses de los docentes, su incidencia en el desarrollo personal, profesional, y de desempeño. Teniendo como intención estratégica generar y aportar líneas para avanzar hacia un sistema de evaluación de la formación...

  13. The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: A qualitative study of Kaiser Permanente

    NARCIS (Netherlands)

    E.T. Otte-Trojel (Eva Terese); T.G. Rundall (Thomas); A.A. de Bont (Antoinette); J.J. van de Klundert (Joris); M.E. Reed (Mary E.)

    2015-01-01

    textabstractBackground: Patient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However, despite growing research on patient portals and their effects, our understanding of the organizational dynamics that explain

  14. Suspended sediment entrainment estimation in unsteady turbulent flows by means of a stochastic meted; Computo de la incorporacion de sedimento en suspension en flujos turbulentos no permanentes utilizando un enfoque estocastico

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, Jose Fernando; Garcia, Marcelo Horacio [Universidad de Illinois (United States); Admiraal, David Mark [Universidad de Nebraska en Lincoln (United States)

    2001-06-01

    bibliografia, pero todas ellas han sido derivadas para condiciones de flujo permanente y uniforme. La bondad de estas relaciones para predecir tasas de incorporacion en flujos no permanentes no ha sido demostrada y tampoco se ha intentado desarrollar una formulacion general que sea aplicable tanto en condiciones permanentes como no permanentes. El enfoque tradicional relacionada la incorporacion de sedimento con el esfuerzo de corte asociado con la friccion de grano en una forma deterministica, proveyendo solo una relacion entre valores medios. Una alternativa es considerar el esfuerzo de corte y la incorporacion como magnitudes estocasticas turbulentas y expresarlas en terminos de sus funciones de densidad de probabilidad (PDF). De esta manera se pueden obtener estadisticos de la incorporacion a partir de las PDF del esfuerzo de corte tanto en situaciones de flujos permanentes como no permanentes, dado que el efecto de la impermanencia esta implicito en el PDF. Esta nueva metodologia fue usada para estimar la incorporacion de sedimento debido al paso de embarcaciones en los rios Mississippi e Illinois. Al usar una expansion en cumulantes de bajo orden para describir la PDF del esfuerzo de corte y una version generalizada de la relacion de incorporacion de Garcia y Parker, se obtuvo una expresion para el promedio de la incorporacion, en funcion del promedio, varianza, asimetria y kurtosis del esfuerzo de corte. Los resultados se comparan satisfactoriamente con valores mencionados en la literatura.

  15. Demonstration of shield-type longwall supports at York Canyon Mine of Kaiser Steel Corporation. Final technical report A

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, R.G.; King, R.

    1980-04-01

    This report represents work on a program that was originated by the USBM of the Department of the Interior and was transferred to the Department of Energy on October 1, 1977. A demonstration with the Government funded Hemscheidt 320 HSL caliper type shield supports was conducted at three longwall panels of Kaiser Steel Corporation's York Canyon Mine. The purpose of this longwall demonstration was to provide the US coal industry with information on all aspects of shield longwall mining in high seams. The demonstration provided a working model for the coal industry and during the project, 350 people from the industry, schools, and government agencies visited the demonstration. They were provided with a first hand knowledge of a working shield longwall. The demonstration showed that the control of large coal lumps may be a problem in the mining of coal seam thicker than 8 feet. Mining with shield type supports provided good working conditions and a safe working environment. The shield requires very little maintenance and has a high mechanical availability.

  16. A three-dimensional `Kaiser damage-memory' effect through true-triaxial loading

    Science.gov (United States)

    Meredith, P. G.; Browning, J.; Harland, S. R.; Healy, D.; Stuart, C.; Mitchell, T. M.

    2017-12-01

    Microcrack damage leading to failure in rocks evolves in response to differential loading. The vast majority of experimental studies investigate damage evolution, the `Kaiser damage-memory' effect, and rock failure using conventional triaxial stress states (σ1 > σ2 = σ3). Such stress states develop a crack population that displays cylindrical transverse isotropy. However, in nature the stress state is in general truly triaxial (σ1 > σ2 > σ3) and experiments that utilise such loading conditions can generate crack populations that display planar transverse isotropy which in turn influences properties such as permeability and strength. We investigate the evolution of crack damage under both conventional and true triaxial stress conditions using results from measurements made on cubic samples of sandstone deformed in three orthogonal directions with independently controlled stress paths. We have measured, simultaneously with stress and strain, the changes in ultrasonic compressional and shear wave velocities in the three principal directions, together with the bulk acoustic emission (AE) output. Changes in acoustic wave velocities are associated with both elastic closure and opening of pre-existing cracks, and the inelastic formation of new cracks. By contrast, AE is only associated with the inelastic growth of new crack damage and as such, we use the onset of AE to determine the initiation of new crack damage. By mapping these damage onsets under both conventional triaxial and true triaxial sequential cyclic loading, we have shown that `damage envelopes' evolve dynamically and can be pushed closer to the failure envelope. Whether a stress state has been `visited' before is key to determining and understanding damage states. Crack damage populations can be generated with multiple orientations depending on the arrangement of loading directions and hence principal stress directions. The sequential cyclic loading tests show that further damage in any one population

  17. Minería de datos en la encuesta permanente de hogares 2009, universidad nacional del litoral, argentina

    Directory of Open Access Journals (Sweden)

    Denis Lizazo Torres

    2011-04-01

    Full Text Available En este trabajo se aplicó por primera vez la Minería de Datos a la información generada por la Encuesta Permanente de Hogares del año 2009, del Observatorio Social de la Universi-dad del Litoral en Santa Fe, Argentina. El objetivo fue utilizar algoritmos de clasificación que poseen enfoques descriptivos, y es una de las tareas más utilizada en Minería de Datos para obtener nuevos conocimientos sobre la familia santafecina. La base de datos fue confeccio-nada con la información en el relevamiento de 2009, denominado Onda 2009, y se procesó con el software de minería de datos Weka 3.6.2. Los algoritmos de clasificación que mejores resultados aportaron fueron: ZeroR, Ridor y J48, pertenecientes a los grupos de Reglas y Árboles de Decisión, siendo el algoritmo de clasificación J48 el que mejor clasifica a la En-cuesta Permanente de Hogares 2009 del Observatorio Social de la Universidad Nacional del Litoral. In this work it was applied the Data Mining for the first time, to the information generated by the Permanent Survey of Homes of the year 2009, of the Social Observatory of the University of the Litoral in Santa Fe, Argentina. The objective was to use classification algorithms that possess descriptive focuses and it is one of the tasks more used in Data Mining, to obtain new knowledge on the family of Santa Fe. The database was made with the information of the Permanent Survey of Homes of the year 2009 and it was processed with the software of data mining Weka 3.6.2. The classification algorithms that better results contributed were: ZeroR, Ridor and J48, belonging to the groups of Rules and Trees of Decision, being the classifica-tion algorithm J48 the one that better it classifies to the Permanent Survey of Homes 2009, of the Social Observatory of the National University of the Litoral.

  18. Biopoder e UPPs: alteridade na experiência do policiamento permanente em comunidades cariocas

    Directory of Open Access Journals (Sweden)

    Thiago Benedito Livramento Melicio

    2012-12-01

    Full Text Available O artigo visa refletir sobre a experiência do efetivo policial permanente em dois conjuntos de comunidades cariocas, inserido no escopo das Unidades de Polícia Pacificadora (UPP. Foram realizados dois estudos exploratórios, em agosto e dezembro de 2010. Na esteira do conceito foucaultiano de biopoder, discute-se a UPP como rede de relações de poder que a compõe e a legitima, pensando-se o local em que se instala, a política de Estado a que responde, os atores com que opera e as produções históricas das relações entre Estado e territórios populares. O campo de análise constitui-se, assim, nas práticas e saberes localizados no cotidiano e nos efeitos produzidos com a presença do policial na paisagem da favela. Se novas regras são trazidas com as UPPs, novas identificações são mobilizadas e as modulações de conjunto abrem lacunas, o governo de si não se produz sozinho, mas combina-se com diversidades na gestão da vida.

  19. ANÁLISE DA CORRELAÇÃO ENTRE AS VARIÁVEIS DE DENSIFICAÇÃO DO COMPACTADOR GIRATÓRIO SUPERPAVE E A RESISTÊNCIA À DEFORMAÇÃO PERMANENTE EM MISTURAS ASFÁLTICAS CONVENCIONAIS E COM UTILIZAÇÃO DE RESÍDUOS

    Directory of Open Access Journals (Sweden)

    Felipe Coutinho Onofre

    2011-09-01

    Full Text Available

    Quando se comparam as metodologias de dosagem Superpave e Marshall de misturas asfálticas, uma das vantagens da primeira é a obtenção do gráfico de compactação. Tem sido verificado para misturas densas e contínuas do tipo Concreto Asfáltico (CA que determinadas áreas observadas nesse gráfico podem diferenciar estas misturas quanto à trabalhabilidade e à resistência à deformação permanente. No presente estudo, os parâmetros Compaction Densification Index (CDI e Traffic Densification Index (TDI foram utilizados como indicadores da compactabilidade. Desenvolveu-se um estudo de correlação entre estas variáveis e a resistência à deformação permanente de misturas asfálticas. Foram avaliadas três misturas asfálticas contendo: (i apenas agregados graníticos, (ii 50% de agregados graníticos e 50% de escória de aciaria e (iii 50% de agregados graníticos e 50% de Resíduo de Construção e Demolição (RCD. As variáveis escolhidas para determinação da resistência à deformação permanente foram o ensaio uniaxial de carga repetida (amostras compactadas para dois percentuais de Volume de vazios e o ensaio com um simulador de tráfego do tipo LCPC. Foi utilizado também o Processamento Digital de Imagens (PDI para a determinação da esfericidade dos agregados estudados, propriedade que influencia na resistência à deformação permanente. Os resultados indicam que as variáveis CDI e TDI podem ser usadas como parâmetros de estudo para prever a resistência à deformação permanente, mesmo para misturas com utilização de resíduos. A caracterização pela técnica do PDI mostrou que o agregado de origem granítica possui uma forma menos próxima a uma esfera em relação aos res

  20. Osmium(III) analogues of KP1019: Electrochemical and chemical synthesis, spectroscopic characterization, x-ray crystallography, hydrolytic stability, and antiproliferative activity

    KAUST Repository

    Kuhn, Paul-Steffen

    2014-10-20

    A one-electron reduction of osmium(IV) complexes trans-[OsIVCl4(Hazole)2], where Hazole = 1H-pyrazole ([1]0), 2H-indazole ([2]0), 1H-imidazole ([3]0), and 1H-benzimidazole ([4]0), afforded a series of eight new complexes as osmium analogues of KP1019, a lead anticancer drug in clinical trials, with the general formula (cation)[trans-OsIIICl4(Hazole)2], where cation = H2pz+ (H2pz[1]), H2ind+ (H2ind[2]), H2im+ (H2im[3]), Ph4P+ (Ph4P[3]), nBu4N+ (nBu4N[3]), H2bzim+ (H2bzim[4]), Ph4P+ (Ph4P[4]), and nBu4N+ (nBu4N[4]). All complexes were characterized by elemental analysis, 1H NMR spectroscopy, electrospray ionization mass spectrometry, UV-vis spectroscopy, cyclic voltammetry, while H2pz[1], H2ind[2], and nBu4[3], in addition, by X-ray diffraction. The reduced species [1]- and [4]- are stable in aqueous media in the absence of air oxygen and do not react with small biomolecules such as amino acids and the nucleotide 5′-dGMP. Cell culture experiments in five different human cancer cell lines (HeLa, A549, FemX, MDA-MB-453, and LS-174) and one noncancerous cell line (MRC-5) were performed, and the results were discussed and compared to those for KP1019 and cisplatin. Benzannulation in complexes with similar structure enhances antitumor activity by several orders of magnitude, implicating different mechanisms of action of the tested compounds. In particular, complexes H2ind[2] and H2bzim[4] exhibited significant antiproliferative activity in vitro when compared to H2pz[1] and H2im[3]. (Chemical Equation Presented).

  1. Osmium(III) analogues of KP1019: electrochemical and chemical synthesis, spectroscopic characterization, X-ray crystallography, hydrolytic stability, and antiproliferative activity.

    Science.gov (United States)

    Kuhn, Paul-Steffen; Büchel, Gabriel E; Jovanović, Katarina K; Filipović, Lana; Radulović, Siniša; Rapta, Peter; Arion, Vladimir B

    2014-10-20

    A one-electron reduction of osmium(IV) complexes trans-[Os(IV)Cl4(Hazole)2], where Hazole = 1H-pyrazole ([1](0)), 2H-indazole ([2](0)), 1H-imidazole ([3](0)), and 1H-benzimidazole ([4](0)), afforded a series of eight new complexes as osmium analogues of KP1019, a lead anticancer drug in clinical trials, with the general formula (cation)[trans-Os(III)Cl4(Hazole)2], where cation = H2pz(+) (H2pz[1]), H2ind(+) (H2ind[2]), H2im(+) (H2im[3]), Ph4P(+) (Ph4P[3]), nBu4N(+) (nBu4N[3]), H2bzim(+) (H2bzim[4]), Ph4P(+) (Ph4P[4]), and nBu4N(+) (nBu4N[4]). All complexes were characterized by elemental analysis, (1)H NMR spectroscopy, electrospray ionization mass spectrometry, UV-vis spectroscopy, cyclic voltammetry, while H2pz[1], H2ind[2], and nBu4[3], in addition, by X-ray diffraction. The reduced species [1](-) and [4](-) are stable in aqueous media in the absence of air oxygen and do not react with small biomolecules such as amino acids and the nucleotide 5'-dGMP. Cell culture experiments in five different human cancer cell lines (HeLa, A549, FemX, MDA-MB-453, and LS-174) and one noncancerous cell line (MRC-5) were performed, and the results were discussed and compared to those for KP1019 and cisplatin. Benzannulation in complexes with similar structure enhances antitumor activity by several orders of magnitude, implicating different mechanisms of action of the tested compounds. In particular, complexes H2ind[2] and H2bzim[4] exhibited significant antiproliferative activity in vitro when compared to H2pz[1] and H2im[3].

  2. Osmium(III) analogues of KP1019: Electrochemical and chemical synthesis, spectroscopic characterization, x-ray crystallography, hydrolytic stability, and antiproliferative activity

    KAUST Repository

    Kuhn, Paul-Steffen; Bü chel, Gabriel E.; Jovanović, Katarina K.; Filipović, Lana; Radulović, Siniša S.; Rapta, Peter; Arion, Vladimir B.

    2014-01-01

    A one-electron reduction of osmium(IV) complexes trans-[OsIVCl4(Hazole)2], where Hazole = 1H-pyrazole ([1]0), 2H-indazole ([2]0), 1H-imidazole ([3]0), and 1H-benzimidazole ([4]0), afforded a series of eight new complexes as osmium analogues of KP1019, a lead anticancer drug in clinical trials, with the general formula (cation)[trans-OsIIICl4(Hazole)2], where cation = H2pz+ (H2pz[1]), H2ind+ (H2ind[2]), H2im+ (H2im[3]), Ph4P+ (Ph4P[3]), nBu4N+ (nBu4N[3]), H2bzim+ (H2bzim[4]), Ph4P+ (Ph4P[4]), and nBu4N+ (nBu4N[4]). All complexes were characterized by elemental analysis, 1H NMR spectroscopy, electrospray ionization mass spectrometry, UV-vis spectroscopy, cyclic voltammetry, while H2pz[1], H2ind[2], and nBu4[3], in addition, by X-ray diffraction. The reduced species [1]- and [4]- are stable in aqueous media in the absence of air oxygen and do not react with small biomolecules such as amino acids and the nucleotide 5′-dGMP. Cell culture experiments in five different human cancer cell lines (HeLa, A549, FemX, MDA-MB-453, and LS-174) and one noncancerous cell line (MRC-5) were performed, and the results were discussed and compared to those for KP1019 and cisplatin. Benzannulation in complexes with similar structure enhances antitumor activity by several orders of magnitude, implicating different mechanisms of action of the tested compounds. In particular, complexes H2ind[2] and H2bzim[4] exhibited significant antiproliferative activity in vitro when compared to H2pz[1] and H2im[3]. (Chemical Equation Presented).

  3. Educação Permanente em Saúde e Manoel de Barros: uma Aproximação Desformadora

    Directory of Open Access Journals (Sweden)

    Eluana Borges Leitão de Figueiredo

    Full Text Available RESUMO Trata-se de uma reflexão que promove diálogo entre pressupostos da Educação Permanente em Saúde (EPS e proposições desformadoras do poeta Manoel de Barros, com o objetivo de contribuir para a transvisão da formação e do trabalho em saúde. Optou-se por desvelar tal aproximação com base nos versos do poema “As lições de RQ”, que funcionaram como plataforma para os saltos reflexivos. A discussão encontrou respaldo principal em Paulo Freire e Adolfo Sanchez Vázquez, uma vez que caminhou na perspectiva de uma práxis revolucionária, transformadora e libertadora.

  4. Ações de educação permanente dos enfermeiros facilitadores de um núcleo de educação em enfermagem

    OpenAIRE

    Lavich, Claudia Rosane Perico; Gomes Terra, Marlene; Lemos Mello, Amanda; Raddatz, Michele; Arnemann, Cristiane Trivisiol

    2017-01-01

    Objetivo: Identificar ações desenvolvidas por enfermeiros facilitadores de um Núcleo de Educação Permanente de um Hospital de Ensino.Método: Estudo de caso único com abordagem qualitativa, realizado com oito enfermeiros de um hospital no Estado do Rio Grande do Sul. A produção dos dados foi por meio de análise documental, observação sistemática e grupo focal, realizada de abril a setembro de 2013.Resultados: O estudo aponta para as seguintes categorias: estratégias potentes para promover açõe...

  5. Optimization of tannase production by a novel Klebsiella pneumoniae KP715242 using central composite design

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar

    2015-09-01

    Full Text Available A novel tannase producing bacterial strain was isolated from rhizospheric soil of Acacia species and identified as Klebsiella pneumoniae KP715242. A 3.25-fold increase in tannase production was achieved upon optimization with central composite design using response surface methodology. Four variables namely pH, temperature, incubation period, and agitation speed were used to optimize significant correlation between the effects of these variables on tannase production. A second-order polynomial was fitted to data and validated by ANOVA. The results showed a complex relationship between variables and response given that all factors were significant and could explain 99.6% of the total variation. The maximum production was obtained at 5.2 pH, 34.97 °C temperature, 103.34 rpm agitation speed and 91.34 h of incubation time. The experimental values were in good agreement with the predicted ones and the models were highly significant with a correlation coefficient (R2 of 0.99 and a highly significant F-value of 319.37.

  6. Validation of four devices: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 for home blood pressure measurement according to the European Society of Hypertension International Protocol

    Directory of Open Access Journals (Sweden)

    Topouchian J

    2014-01-01

    Full Text Available Jirar Topouchian,1 Davide Agnoletti,1 Jacques Blacher,1 Ahmed Youssef,1 Mirna N Chahine,2,3 Isabel Ibanez,3 Nathalie Assemani,3 Roland Asmar1–31Centre de Diagnostic, Hôpital Hôtel-Dieu, Paris, France; 2Faculty of Medicine of the Lebanese University, 3Foundation-Medical Research Institutes, Beirut, LebanonBackground: Four oscillometric devices, including the Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670, designed for self-blood pressure measurement (SBPM were evaluated according to the European Society of Hypertension (ESH International Protocol Revision 2010 in four separate studies.Methods: The four devices measure brachial blood pressure (BP using the oscillometric method. The Withings BP-800 has to be connected to an Apple® iOS device such as an iPhone®, iPad®, or iPod®. The ESH International Protocol Revision 2010 includes a total number of 33 subjects. The difference between observer and device BP values was calculated for each measure. Ninety-nine pairs of BP differences were classified into three categories (≤5 mmHg, ≤10 mmHg, ≤15 mmHg. The protocol procedures were followed precisely in each of the four studies.Results: All four tested devices passed the validation process. The mean differences between the device and mercury readings were: −1.8±5.1 mmHg and −0.4±2.8 mmHg for systolic and diastolic BP, respectively, using the Omron M6 Comfort device; 2.5±4.6 mmHg and −1.2±4.3 mmHg for the Omron HEM-7420 device; −0.2±5.0 mmHg and 0.4±4.2 mmHg for the Withings BP-800 device; and 3.0±5.3 mmHg and 0.3±5.2 mmHg for the Polygreen KP-7670 device.Conclusion: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 readings differing by less than 5 mmHg, 10 mmHg, and 15 mmHg fulfill the ESH International Protocol Revision 2010 requirements, and therefore are suitable for use by patients for SBPM, if used correctly.Keywords: Omron M6 Comfort, Omron HEM-7420, Withings BP-800

  7. Personal reminiscences of the Kaiser Wilhelm Institute, Berlin, 1937/38 and of the nuclear project in Canada, 1944/56

    International Nuclear Information System (INIS)

    Cook, L.G.

    1989-01-01

    Part 1 of this talk deals with reminiscences from the Kaiser Wilhelm Institute in Berlin during the period 1937-1938. Topics include the course of experimental events and the continuing search for interpretations that would stand up, the guiding influence of the work of Irene Curie and Pvale Savic on the experimental work of Hahn and Strassmann, the influence and effects of Nazi political pressures within the Institute, the shadows of war, and how uranium fission finally got itself discovered. Part 2 gives reminiscences from the Nuclear Project in Canada from 1944 to 1956 as an extension of the pre-war work in Paris - both in concept and in personnel - created by British effort, the powerful changing US influences, the shift to British direction and a goal, the world's first high power heavy water moderated reactor for the production of massive quantities of synthetic radioactive materials, extraction processes including those for plutonium, the shift to Canadian direction and goals, a heavy water moderated electricity production system, and a postscript

  8. Inmunización y militarización del cuerpo social en Colombia: el Estado en emergencia permanente

    Directory of Open Access Journals (Sweden)

    Juan Pablo Aranguren Romero

    2015-12-01

    Full Text Available En este artículo analizo cómo las estrategias de guerra contrainsurgente emprendidas en Colombia durante las décadas de los sesenta y los setenta recrean un dispositivo inmunitario en donde la nación es entendida como un cuerpo social amenazado e infectado por ideologías comunistas y en donde su seguridad y protección contra los actos violentos, suponen la administración de la violencia. Sostengo que este dispositivo inmunitario, opera bajo una lógica autodestructiva y una noción de amenaza deslocalizada que incentivó la militarización de la sociedad, la gestión del miedo y el sostenimiento de un Estado en emergencia permanente. Hechos que, a su vez, permitieron la apelación a la excepcionalidad constitucional como forma de gobierno normalizada.

  9. The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults.

    Science.gov (United States)

    Strine, Tara W; Edwards, Valerie J; Dube, Shanta R; Wagenfeld, Morton; Dhingra, Satvinder; Prehn, Angela Witt; Rasmussen, Sandra; McKnight-Eily, Lela; Croft, Janet B

    2012-07-13

    Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs) and adult smoking. Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used. Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce). Among men, the associations between ACEs and smoking were not significant. These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.

  10. REFORMAS EDUCATIVAS Y FORMACIÓN PERMANENTE DEL PROFESORADO EN LA ÚLTIMA OBRA DE JULIA VARELA: MEMORIA Y OLVIDO

    Directory of Open Access Journals (Sweden)

    Alberto Luís Gómez

    2009-01-01

    Full Text Available En este artículo se analizan la complejidad del proceso de construcción de los Centros de Profesores y el papel desempeñado por una diversidad de instancias y personas que, desde distintos puntos de vista, defendieron su articulación dentro del más amplio campo de la formación permanente del profesorado español entre 1983 y 1990. Habiendo tomado como punto de partida de nuestras reflexiones el último libro de Julia Varela ¿Las reformas educativas a debate (1982-2006¿ defendemos tanto su interés como la asimetría existente entre la relevancia política de esta obra y su debilidad historiográfica.

  11. Validation of four devices: Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 for home blood pressure measurement according to the European Society of Hypertension International Protocol.

    Science.gov (United States)

    Topouchian, Jirar; Agnoletti, Davide; Blacher, Jacques; Youssef, Ahmed; Chahine, Mirna N; Ibanez, Isabel; Assemani, Nathalie; Asmar, Roland

    2014-01-01

    Four oscillometric devices, including the Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670, designed for self-blood pressure measurement (SBPM) were evaluated according to the European Society of Hypertension (ESH) International Protocol Revision 2010 in four separate studies. The four devices measure brachial blood pressure (BP) using the oscillometric method. The Withings BP-800 has to be connected to an Apple® iOS device such as an iPhone®, iPad®, or iPod®. The ESH International Protocol Revision 2010 includes a total number of 33 subjects. The difference between observer and device BP values was calculated for each measure. Ninety-nine pairs of BP differences were classified into three categories (≤5 mmHg, ≤10 mmHg, ≤15 mmHg). The protocol procedures were followed precisely in each of the four studies. All four tested devices passed the validation process. The mean differences between the device and mercury readings were: -1.8±5.1 mmHg and -0.4±2.8 mmHg for systolic and diastolic BP, respectively, using the Omron M6 Comfort device; 2.5±4.6 mmHg and -1.2±4.3 mmHg for the Omron HEM-7420 device; -0.2±5.0 mmHg and 0.4±4.2 mmHg for the Withings BP-800 device; and 3.0±5.3 mmHg and 0.3±5.2 mmHg for the Polygreen KP-7670 device. Omron M6 Comfort, Omron HEM-7420, Withings BP-800, and Polygreen KP-7670 readings differing by less than 5 mmHg, 10 mmHg, and 15 mmHg fulfill the ESH International Protocol Revision 2010 requirements, and therefore are suitable for use by patients for SBPM, if used correctly.

  12. Políticas y prácticas en la formación permanente del profesorado en TIC en Cataluña

    OpenAIRE

    Adriana Ornellas; Joan\\u2010Anton Sánchez; Leticia Fraga Colman; Laura Domingo

    2015-01-01

    En este artículo presentamos los resultados que emergen de una de las dimensiones investigadas en el proyecto “Políticas y prácticas en torno a las TIC en la enseñanza obligatoria: Implicaciones para la innovación y la mejora” (Ministerio de Ciencia e Innovación. SEJ2007-­‐67562). Nos centramos aquí en uno de los factores determinantes del éxito o fracaso de las políticas destinadas a transformar las prácticas educativas a partir de la integración de las TIC: la formación inicial y permanente...

  13. Políticas y prácticas en la formación permanente del profesorado en TIC en Cataluña

    Directory of Open Access Journals (Sweden)

    Adriana Ornellas

    2015-01-01

    Full Text Available En este artículo presentamos los resultados que emergen de una de las dimensiones investigadas en el proyecto “Políticas y prácticas en torno a las TIC en la enseñanza obligatoria: Implicaciones para la innovación y la mejora” (Ministerio de Ciencia e Innovación. SEJ2007-­‐67562. Nos centramos aquí en uno de los factores determinantes del éxito o fracaso de las políticas destinadas a transformar las prácticas educativas a partir de la integración de las TIC: la formación inicial y permanente del profesorado.

  14. TENDENCIATEMPORALDE LAINCAPACIDAD LABORAL PERMANENTE EN ESPAÑA (1992-2010

    Directory of Open Access Journals (Sweden)

    Xavier Duran

    2012-01-01

    Full Text Available Fundamentos: La incapacidad permanente (IP es un problema de salud laboral en el que intervienen factores laborales, sanitarios o legales, los cuales han variado en España a lo largo de los últimos años. El objetivo del presente estudio es describir la tendencia temporal de la IP en España desde 1992 a 2010 por gravedad de la incapacidad y diferentes variables sociodemográficas y de afiliación a la seguridad social. Métodos: A partir de los datos de la Seguridad Social sobre afiliación y altas de IP en España se describió la tendencia temporal de la incidencia anual de la IP en el periodo comprendido entre 1992 y 2010. Para valorar las tendencias se estimó el porcentaje de cambio anual (PCA y el intervalo de confianza al 95% mediante un modelo de regresión binomial negativa. Resultados: La tendencia de la incidencia de IP se subdividió en tres periodos. El primero (1992 a 1997 presentó una incidencia aproximadamente constante de 75 casos por 10.000 trabajadores (PCA1= -0,1; IC 95%:-1,6 a 1,4. Seguidamente las tasas descendieron durante un período de tres años (PCA2:-12,1%; IC 95%:-13,9 a -10,4, situándose alrededor de 50 nuevos casos por 10.000 trabajadores en el año 2000. A partir de este año la incidencia de IP se mantuvo aproximadamente constante hasta el año 2010 (PCA3=0,4; IC 95%:-0,2 a 1,0. Conclusiones: Apesar del incremento de trabajadores afiliados a la seguridad social en el periodo estudiado, la incidencia de IP se mantiene bastante estable, con un descenso entre 1997 y 2000 que se podría atribuir a las medidas de evaluación y seguimiento de las IP adoptados en 1995.

  15. Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System

    DEFF Research Database (Denmark)

    Schiøtz, Michaela Louise; Strandberg-Larsen, Martin; Frølich, Anne

    2012-01-01

    En væsentlig del af kronikeromsorgen i et sundhedsvæsen er også at understøtte egenomsorgen. Egenomsorg omfatter fx, at patienten kender til, hvad der kan optimere behandlingsindsatsen, herunder ændring af livsstil, kendskab til sundhedsvæsenets tilbud, og at deltage aktivt i at koordinere og sik...

  16. Lysine and Glutamic Acids as the End Products of Multi-response of Optimized Fermented Medium by Mucor mucedo KP736529.

    Science.gov (United States)

    El-Hersh, Mohammed S; Saber, WesamEldin I A; El-Fadaly, Husain A; Mahmoud, Mohammed K

    Amino acids are important for living organisms, they acting as crucial for metabolic activities and energy generation, wherein the deficiency in these amino acids cause various physiological defects. The aim of this study is to investigate the effect of some nutritional factors on the amino acids production by Mucor mucedo KP736529 during fermentation intervals. Mucor mucedo KP736529 was selected according to proteolytic activity. Corn steep liquor and olive cake were used in the fermented medium during Placket-Burman and central composite design to maximize the production of lysine and glutamic acids. During the screening by Plackett-Burman design, olive cake and Corn Steep Liquor (CSL) had potential importance for the higher production of amino acids. The individual fractionation of total amino acids showed both lysine and glutamic as the major amino acids associated with the fermentation process. Moreover, the Central Composite Design (CCD) has been adopted to explain the interaction between olive cake and CSL on the production of lysine and glutamic acids. The model recorded significant F-value, with high values of R 2, adjusted R 2 and predicted R 2 for both lysine and glutamic, indicating the validity of the data. Solving equation for maximum production of lysine recorded theoretical levels of olive cake and CSL, being 2.58 and 1.83 g L -1, respectively, with predicting value of lysine at 1.470 μg mL -1, whereas the predicting value of glutamic acid reached 0.805 mg mL -1 at levels of 2.49 and 1.93 g L -1 from olive cake and CSL, respectively. The desirability function (D) showed the actual responses being 1.473±0.009 and 0.801±0.004 μg mL -1 for lysine and glutamic acids, respectively. The model showed adequate validity to be applied in a large-scale production of both lysine and glutamic acids.

  17. Identifying organisational principles and management practices important to the quality of health care services for chronic conditions.

    Science.gov (United States)

    Frølich, Anne

    2012-02-01

    The quality of health care services offered to people suffering from chronic diseases often fails to meet standards in Denmark or internationally. The population consisting of people with chronic diseases is large and accounts for about 70% of total health care expenses. Given that resources are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved. The aim of this dissertation is to describe the effect of determinants, such as organisational structures and management practices including two selected incentives, on the quality of care in chronic diseases. The dissertation is based on four studies with the following purposes: 1) macro- or healthcare system-level identification of organisational structures and principles that affect the quality of health care services, based on a comparison of KP and the Danish health care system; 2) meso- or organisation-level identification of management practices with positive effects on screening rates for hemoglobin A1c and lipid profile in diabetes; 3) evaluation of the effect of the CCM on quality of health care services and continuity of care in a Danish setting; 4) micro- or practice-level evaluation of the

  18. Changes in School Food Preparation Methods Result in Healthier Cafeteria Lunches in Elementary Schools.

    Science.gov (United States)

    Behrens, Timothy K; Liebert, Mina L; Peterson, Hannah J; Howard Smith, Jennifer; Sutliffe, Jay T; Day, Aubrey; Mack, Jodi

    2018-05-01

    The purpose of this study is to examine the impact of a districtwide food best practices and preparation changes in elementary schools lunches, implemented as part of the LiveWell@School childhood obesity program, funded by LiveWell Colorado/Kaiser Permanente Community Health Initiative. Longitudinal study examining how school changes in best practices for food preparation impacted the types of side items offered from 2009 to 2015 in elementary school cafeterias in a high-need school district in southern Colorado. Specifically, this study examined changes in side items (fruits, vegetables, potatoes, breads, and desserts). In Phase 1 (2009-2010), baseline data were collected. During Phase 2 (2010-2011), breaded and processed foods (e.g., frozen nuggets, pre-packaged pizza) were removed and school chefs were trained on scratch cooking methods. Phase 3 (2011-2012) saw an increased use of fresh/frozen fruits and vegetables after a new commodity order. During Phase 4 (2013-2015), chef consulting and training took place. The frequency of side offerings was tracked across phases. Analyses were completed in Fall 2016. Because of limited sample sizes, data from Phases 2 to 4 (intervention phases) were combined for potatoes and desserts. Descriptive statistics were calculated. After adjusting for length of time for each phase, Pearson chi-square tests were conducted to examine changes in offerings of side items by phase. Fresh fruit offerings increased and canned fruit decreased in Phases 1-4 (p=0.001). A significant difference was observed for vegetables (p=0.001), with raw and steamed vegetables increasing and canned vegetables decreasing from Phase 1 to 4. Fresh potatoes (low in sodium) increased and fried potatoes (high in sodium) decreased from Phase 1 to Phases 2-4 (p=0.001). Breads were eliminated entirely in Phase 2, and dessert changes were not significant (p=0.927). This approach to promoting healthier lunch sides is a promising paradigm for improving elementary

  19. Estrategias del Teatro del Oprimido para la formación permanente del profesorado

    Directory of Open Access Journals (Sweden)

    Tomás Motos-Teruel

    2012-01-01

    Full Text Available Este artículo relata una experiencia y su valoración de formación permanente del profesorado basada en el aprendizaje vivencial utilizando como estrategia metodológica el Teatro del Oprimido (TO para estimular y favorecer la reflexión sobre la práctica educativa. Sus objetivos básicos fueron dar a conocer la formulación teórica y la metodología del TO y hacer la transferencia de las estrategias metodológicas vivenciadas a la práctica docente. El estudio se ha planteado desde una óptica cualitativa con el estudio de caso único. Y como resultados más destacables hay que reseñar el interés y la percepción de la utilidad personal y profesional del TO como instrumento de reflexión sobre la acción y generador de clima positivo. El Teatro del Oprimido es una formulación teórica y un método estético cuya teoría y praxis están inspiradas en la Pedagogía del Oprimido de Paulo Freire, utiliza las técnicas dramáticas como un instrumento eficaz para la comprensión y la búsqueda de alternativas a problemas sociales, interpersonales e individuales.

  20. EDUCAÇÃO PERMANENTE EM ENFERMAGEM E A INTERFACE COM A OUVIDORIA HOSPITALAR

    Directory of Open Access Journals (Sweden)

    Raquel Costa Rodrigues de Souza

    2010-01-01

    Full Text Available Se trata de un estudio descriptivo-exploratorio, con enfoque cualitativo, cuyo objetivo fue investigar las demandas de los usuarios del servicio de Defensoría del Pueblo relacionadas con la asistencia de enfermería y discutir su contribución para la educación permanente. La investigación se desarrolló en hospital público federal, con notoriedad en realización de procedimientos diagnósticos y terapéuticos de alta complejidad en Ortopedia. La recolección de datos se basó en la técnica de análisis documental, incluyendo la gestión de informaciones y materiales, de las demandas de los usuarios que figuran en los registros de la Oficina de Defensoría del Pueblo, relativos al año 2009, (total de 3.895 declaraciones. Hemos clasificado las declaraciones recibidas- en este estudio- según la naturaleza de la comunicación: elogio, pedido de información, queja, sugerencia y denuncia. Hemos considerado la importancia del Servicio de Defensoría del Pueblo para mejorar la actuación de enfermería, teniendo en cuenta las contribuciones extraídas del contexto de las demandas y que la relación interdisciplinar permite percibir y evaluar las necesidades evidenciadas.

  1. Use of Electronic Health Records and Administrative Data for Public Health Surveillance of Eye Health and Vision-Related Conditions

    Science.gov (United States)

    Elliott, Amanda; Davidson, Arthur; Lum, Flora; Chiang, Michael; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E.; Chou, Chiu-Fang

    2014-01-01

    Purpose To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Methods We describe three currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Results Each of the three sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Conclusions Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. PMID:23158225

  2. The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults

    Directory of Open Access Journals (Sweden)

    Strine Tara W

    2012-07-01

    Full Text Available Abstract Background Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs and adult smoking. Method Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used. Results Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce. Among men, the associations between ACEs and smoking were not significant. Conclusions These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.

  3. Outcomes in Treatment for Intradural Spinal Cord Ependymomas

    International Nuclear Information System (INIS)

    Volpp, P. Brian; Han, Khanh; Kagan, A. Robert; Tome, Michael

    2007-01-01

    Purpose: Spinal cord ependymomas are rare tumors, accounting for <2% of all primary central nervous system tumors. This study assessed the treatment outcomes for patients diagnosed with spinal cord ependymomas within the Southern California Kaiser Permanente system. Methods and Materials: We studied 23 patients treated with surgery with or without external beam radiotherapy (EBRT). The local and distant control rates and overall survival rates were determined. Results: The overall local control, overall recurrence, and 9-year overall survival rate was 96%, 17.4%, and 63.9%, respectively. Conclusions: The results of our study indicate that en bloc gross total resection should be the initial treatment, with radiotherapy reserved primarily for postoperative cases with unfavorable characteristics such as residual tumor, anaplastic histologic features, or piecemeal resection. Excellent local control and overall survival rates can be achieved using modern microsurgical techniques, with or without local radiotherapy

  4. Percepção da educação permanente, continuada e em serviço para enfermeiros de um hospital de ensino La percepción de la educación permanente, continuada y en servicio para el enfermero del hospital de enseñanza The perception of permanent, continuous, in service education for nurses in a school hospital

    Directory of Open Access Journals (Sweden)

    Amarílis Schiavon Paschoal

    2007-09-01

    Full Text Available Este estudo tem como objetivo discutir a concepção de educação permanente, continuada e em serviço junto a enfermeiros de um hospital de ensino. É uma pesquisa de natureza qualitativa, na qual a coleta dos dados foi realizada pela técnica do grupo focal, durante seis sessões gravadas em áudio e vídeo. Participaram deste estudo nove enfermeiros de um hospital de ensino. Para analisar os dados, utilizou-se a técnica do discurso do sujeito coletivo, que consiste na organização e tabulação de dados qualitativos de natureza verbal obtidos por meio de depoimentos, da qual resultou um único discurso. A pesquisa demonstrou que os enfermeiros diferenciaram os termos educação permanente, continuada e em serviço, construindo conceitos próprios, ressaltando a importância da diferenciação para definir o tipo de ação a ser tomada diante da necessidade educativa apresentada.Este estudio tiene como objetivo la discusión de la concepción de los términos de la educación permanente, continuada y en servicio con enfermeros del hospital de enseñanza. Es una investigación de naturaleza cualitativa, en que fueron recogidos los datos a través de la técnica del grupo focal, durante seis sesiones grabadas en audio y video. Participaron de este estudio nueve enfermeros de un hospital de enseñanza. Para analizar los datos fue utilizada la técnica del discurso del sujeto colectivo, que consiste en la organización y tabulación de datos cualitativos de naturaleza verbal obtenidos por medio de deposiciones, que resultó de un único discurso. La investigación demostró que los enfermeros diferenciaron los términos educación permanente, continuada y en servicio, construyendo conceptos propios, resaltando la importancia de la diferenciación para definir el tipo de acción a ser tomada delante de la necesidad educativa representada.This study is aimed at discussing the conception of permanent, continuous, in service education among nurses

  5. Defectos del esmalte, caries en dentición primaria, fuentes de fluoruro y su relación con caries en dientes permanentes Enamel defects, caries in primary dentition and fluoride sources: relationship with caries in permanent teeth

    Directory of Open Access Journals (Sweden)

    Ana Alicia Vallejos-Sánchez

    2007-06-01

    Full Text Available Objetivo: Explorar la relación entre la presencia de defectos del esmalte (DE, la experiencia de caries en la dentición temporal, y la exposición a diversas fuentes de fluoruros, con la presencia de caries en la dentición permanente de niños con dentición mixta. Material y métodos: Se realizó un estudio transversal en 713 sujetos de 6-9 años de edad de 4 escuelas de Campeche, México, mediante un cuestionario dirigido a las madres, y un examen clínico bucal a los niños. La variable dependiente fue la prevalencia de caries en la dentición permanente. Resultados: El promedio de dientes temporales cariados, extraídos y obturados (ceod y dientes permanentes cariados, perdidos y obturados (CPOD fue de 2,48 (2,82 (ceod > 0 = 58,9% y 0,40 (0,98 (CPOD > 0 = 18,2%, respectivamente. El índice SiC (índice de caries significativa, calculado en la dentición temporal fue de 5,85 para los niños de 6 años de edad. En el análisis de regresión logística multivariado permanecieron significativas, después de ajustar por variables de exposición a fluoruros, la mayor edad (odds ratio [OR] = 2,99, el ceod > 0 (OR = 5,46, la menor escolaridad de la madre (OR = 1,57 y una interacción entre sexo y defectos del esmalte. Conclusiones: Las caries en la dentición temporal y permanente fueron relativamente menores que las observaciones publicadas por otros estudios en México. Los resultados confirmaron que la caries en la dentición temporal se asoció fuertemente con la caries en la dentición permanente. No hubo una relación significativa entre las fuentes de fluoruro y la caries dental en la dentición permanente.Objective: To examine the relationship between the presence of enamel defects, dental caries in primary teeth, and exposure to various fluoride technologies and the presence of dental caries in permanent teeth in children with mixed dentition. Materials and methods: A cross-sectional study was conducted in 713 children aged 6-9 years old

  6. Scalar evolution equations for shear waves in incompressible solids: a simple derivation of the Z, ZK, KZK and KP equations

    KAUST Repository

    Destrade, M.

    2010-12-08

    We study the propagation of two-dimensional finite-amplitude shear waves in a nonlinear pre-strained incompressible solid, and derive several asymptotic amplitude equations in a simple, consistent and rigorous manner. The scalar Zabolotskaya (Z) equation is shown to be the asymptotic limit of the equations of motion for all elastic generalized neo-Hookean solids (with strain energy depending only on the first principal invariant of Cauchy-Green strain). However, we show that the Z equation cannot be a scalar equation for the propagation of two-dimensional shear waves in general elastic materials (with strain energy depending on the first and second principal invariants of strain). Then, we introduce dispersive and dissipative terms to deduce the scalar Kadomtsev-Petviashvili (KP), Zabolotskaya-Khokhlov (ZK) and Khokhlov- Zabolotskaya-Kuznetsov (KZK) equations of incompressible solid mechanics. © 2010 The Royal Society.

  7. Scalar evolution equations for shear waves in incompressible solids: a simple derivation of the Z, ZK, KZK and KP equations

    KAUST Repository

    Destrade, M.; Goriely, A.; Saccomandi, G.

    2010-01-01

    We study the propagation of two-dimensional finite-amplitude shear waves in a nonlinear pre-strained incompressible solid, and derive several asymptotic amplitude equations in a simple, consistent and rigorous manner. The scalar Zabolotskaya (Z) equation is shown to be the asymptotic limit of the equations of motion for all elastic generalized neo-Hookean solids (with strain energy depending only on the first principal invariant of Cauchy-Green strain). However, we show that the Z equation cannot be a scalar equation for the propagation of two-dimensional shear waves in general elastic materials (with strain energy depending on the first and second principal invariants of strain). Then, we introduce dispersive and dissipative terms to deduce the scalar Kadomtsev-Petviashvili (KP), Zabolotskaya-Khokhlov (ZK) and Khokhlov- Zabolotskaya-Kuznetsov (KZK) equations of incompressible solid mechanics. © 2010 The Royal Society.

  8. Métodos para determinação de parâmetros de máquinas síncronas de ímãs permanentes

    OpenAIRE

    Guilherme Homrich

    2016-01-01

    A teoria de duplo eixo é geralmente utilizada para modelar e caracterizar máquinas síncronas de polos salientes. O conhecimento das indutâncias de eixo direto e eixo em quadratura são fundamentais para o desenvolvimento destes modelos e para o projeto de controladores destas máquinas. No entanto, métodos tradicionais para determinação destas indutâncias através de ensaios tornam-se impraticáveis em máquinas síncronas de ímãs permanentes pela impossibilidade de controlar a corrente de campo. R...

  9. La aspiración de Brasil al asiento permanente en el Consejo de Seguridad de la Organización de las Naciones Unidas: un breve panorama

    OpenAIRE

    Renata de Melo Rosa; Ana Carolina Gomes Lira Linhares

    2009-01-01

    Este artículo analiza la posición de Brasil frente a la aspiración de un asiento permanente al Consejo de Seguridad de las Naciones Unidas. Los esfuerzos entabulados por Brasil en el escenario internacional, los discursos del primer rango del gobierno, así como un protagonismo más acelerado frente a los vecinos latino-americanos confirman esta aspiración. Pero, Brasil aún enfrenta serios problemas internos de seguridad nacional y tendrá que enfrentar otros compañeros regionales también, aspir...

  10. Estudo comparativo entre ensino presencial e a distância para educação permanente de profissionais auxiliares e técnicos de enfermagem

    OpenAIRE

    Silva, Adriane das Neves

    2014-01-01

    As mudanças ocorridas no mundo do trabalho têm exigido do profissional atualização constante de saberes que possibilitem o desenvolvimento de atitude crítico-reflexiva. Este estudo buscou analisar a aplicabilidade das tecnologias da informação e da comunicação na Educação Permanente dos profissionais auxiliares e técnicos de Enfermagem em um hospital público municipal. É um estudo do tipo ensaio clínico, que lançou mão de técnicas quantitativas e qualitativas através de um experimento que oco...

  11. Necesidades y motivaciones de los estudiantes de educación permanente en España. El caso del Centro de Educación Permanente Valle del Guadiato en Córdoba

    Directory of Open Access Journals (Sweden)

    Beatriz del V. Medina F

    2013-05-01

    Full Text Available El objetivo de la investigación en la que está basado el artículo fue identificar las necesidades y las motivaciones de los estudiantes del Centro de Educación Permanente (CEPER Valle del Guadiato de Córdoba, España. Se parte de diferentes teorías para su fundamentación, como las aportadas por Maslow (2005, McClelland (1989, García Aretio (1988, Paz (1984, Palladino (1981, entre otros. Se utilizó la metodología comparada cuyas unidades de comparación se corresponden con las unidades espaciales, que en este estudio son los municipios: Belmez, Espiel, Fuente Obejuna, Peñarroya-Pueblonuevo, Villanueva del Rey y Villaviciosa de Córdoba. Para la recogida de datos se utiliza el estudio documental, el cuestionario escrito y la observación cualitativa. El universo poblacional del CEPER Valle del Guadiato lo conformaron 606 personas adultas del período escolar 2011-2012 (592 estudiantes, 14 maestros, siendo la muestra de 265 personas (251 estudiantes, 14 maestros. Entre las principales conclusiones destacan que las necesidades sociales, laborales y personales de los estudiantes del Centro objeto de estudio se derivan básicamente del deseo de aprender, del deseo de superación personal, y del interés por el tema. Las motivaciones giran en torno a la oportunidad de ocupar sus tiempos libres, a la posibilidad de tener mejores oportunidades de encontrar trabajo, y al apoyo de la familia.

  12. Necesidades y motivaciones de los estudiantes de educación permanente en España. El caso del Centro de Educación Permanente Valle del Guadiato en Córdoba

    Directory of Open Access Journals (Sweden)

    Beatriz del V. Medina F

    2013-01-01

    Full Text Available El objetivo de la investigación en la que está basado el artículo fue identifi-car las necesidades y las motivaciones de los estudiantes del Centro de Educación Permanente (CEPER Valle del Guadiato de Córdoba, España. Se parte de dife-rentes teorías para su fundamentación, como las aportadas por Maslow (2005,McClelland (1989, García Aretio (1988, Paz (1984, Palladino (1981, entre otros. Se utilizó la metodología comparada cuyas unidades de comparación se co-rresponden con las unidades espaciales, que en este estudio son los municipios: Belmez, Espiel, Fuente Obejuna, Peñarroya-Pueblo nuevo, Villanueva del Rey y Villaviciosa de Córdoba. Para la recogida de datos se utiliza el estudio documental, el cuestionario escrito y la observación cualitativa. El universo poblacional del “CEPER Valle del Guadiato” lo conformaron 606 personas adultas del período escolar 2011-2012 (592 estudiantes, 14 maestros, siendo la muestra de 265 personas (251 estudiantes, 14 maestros. Entre las principales conclusiones destacan que las necesidades sociales, laborales y personales de los estudiantes del Centro objeto de estudio se derivan básicamente del deseo de aprender, del deseo de superación personal, y del interés por el tema. Las motivaciones giran en torno a la oportunidad de ocupar sus tiempos libres, a la posibilidad de tener mejores oportunidades de encontrar trabajo, y al apoyo de la familia.

  13. Optical conductivity calculation of a k.p model semiconductor GaAs incorporating first-order electron-hole vertex correction

    Science.gov (United States)

    Nurhuda, Maryam; Aziz Majidi, Muhammad

    2018-04-01

    The role of excitons in semiconducting materials carries potential applications. Experimental results show that excitonic signals also appear in optical absorption spectra of semiconductor system with narrow gap, such as Gallium Arsenide (GaAs). While on the theoretical side, calculation of optical spectra based purely on Density Functional Theory (DFT) without taking electron-hole (e-h) interactions into account does not lead to the appearance of any excitonic signal. Meanwhile, existing DFT-based algorithms that include a full vertex correction through Bethe-Salpeter equation may reveal an excitonic signal, but the algorithm has not provided a way to analyze the excitonic signal further. Motivated to provide a way to isolate the excitonic effect in the optical response theoretically, we develop a method of calculation for the optical conductivity of a narrow band-gap semiconductor GaAs within the 8-band k.p model that includes electron-hole interactions through first-order electron-hole vertex correction. Our calculation confirms that the first-order e-h vertex correction reveals excitonic signal around 1.5 eV (the band gap edge), consistent with the experimental data.

  14. Association between clinical parameters and the presence of active caries lesions in first permanent molars Associação entre parâmetros clínicos e a presença de lesões ativas de cárie em primeiros molares permanentes

    Directory of Open Access Journals (Sweden)

    Juliana Maria Quaglio

    2006-12-01

    Full Text Available The aim of the present study was to evaluate the association between clinical parameters and the presence of active caries lesions on the occlusal surface of first permanent molars. Forty eight children (5.8-13.8 years-old with at least one first permanent molar present were selected. The clinical parameters evaluated were gender, age, DMF-T and dmf-t, presence of active white spots in other teeth, general plaque index, tooth's dental arch (upper or lower, tooth's side (right or left, presence of visible plaque and eruption degree of the first permanent molars. The first permanent molars were evaluated through visual inspection by two examiners in order to assess the presence of active or inactive caries lesions on the occlusal surface. Univariate and multivariate analyses for determination of the association between clinical parameters and the presence of active caries lesions in these teeth were performed. The presence of active white spots in other teeth was associated with the presence of active caries lesions in the first permanent molars, in both univariate and multivariate analyses (Odds ratio = 8.8 and 1.9, respectively. The presence of abundant visible plaque on the occlusal surface of the first permanent molars (Odds ratio = 3.5 in the univariate analysis, and 3.9 in the multivariate one also presented a significant association. In conclusion, the presence of active white spots in other teeth and the presence of considerable visible plaque were associated with the presence of active caries lesions on the occlusal surfaces of first permanent molars.O objetivo do presente trabalho foi avaliar a associação entre parâmetros clínicos e presença de lesões ativas de cárie sobre a superfície oclusal de primeiros molares permanentes. Quarenta e oito crianças (5,8-13,8 anos com pelo menos um primeiro molar permanente foram selecionadas. Os parâmetros clínicos avaliados foram sexo, idade, CPO-D e ceo-d, presença de manchas brancas

  15. Growth and Characterization of Lithium Potassium Phthalate (LiKP) Single Crystals for Third Order Nonlinear Optical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Sivakumar, B.; Mohan, R. [Preidency College, Bangalore (India); Raj, S. Gokul [RR and Dr. SR Technical Univ., Avadi (India); Kumar, G. Ramesh [Anna Univ., Arni (India)

    2012-11-15

    Single crystals of lithium potassium phthalate (LiKP) were successfully grown from aqueous solution by solvent evaporation technique. The grown crystals were characterized by single crystal X-ray diffraction. The lithium potassium phthalate C{sub 16} H{sub 12} K Li{sub 3} O{sub 11} belongs to triclinic system with the following unit-cell dimensions at 298(2) K; a = 7.405(5) A; b = 9.878(5) A; c = 13.396(5) A; α = 71.778(5) .deg.; β = 87.300(5) .deg.; γ = 85.405(5) .deg.; having a space group P1. Mass spectrometric analysis provides the molecular weight of the compound and possible ways of fragmentations occurs in the compound. Thermal stability of the crystal was also studied by both simultaneous TGA/DTA analyses. The UV-Vis-NIR spectrum shows a good transparency in the whole of Visible and as well as in the near IR range. Third order nonlinear optical studies have also been studied by Z-scan technique. Nonlinear absorption and nonlinear refractive index were found out and the third order bulk susceptibility of compound was also estimated.

  16. Use of electronic health records and administrative data for public health surveillance of eye health and vision-related conditions in the United States.

    Science.gov (United States)

    Elliott, Amanda F; Davidson, Arthur; Lum, Flora; Chiang, Michael F; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E; Chou, Chiu-Fang

    2012-12-01

    To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Perspective, comparing systems. We describe 3 currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Each of the 3 sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors.

    Science.gov (United States)

    Gianfrancesco, Milena A; Acuna, Brigid; Shen, Ling; Briggs, Farren B S; Quach, Hong; Bellesis, Kalliope H; Bernstein, Allan; Hedstrom, Anna K; Kockum, Ingrid; Alfredsson, Lars; Olsson, Tomas; Schaefer, Catherine; Barcellos, Lisa F

    2014-01-01

    To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors. Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied. In analyses stratified by gender, being overweight at ages 10 and 20 were associated with MS in females (pchildhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  18. A Origem Histórica do Conceito de Área de Preservação Permanente no Brasil

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    Glaucus Vinicius Biasetto Ribeiro

    2011-01-01

    Full Text Available A nossa atualidade vem sendo marcada por uma crescente preocupação com as questões ligadas ao meio ambiente e com a preservação do nosso planeta. De uma maneira geral o aquecimento global, a influência antrópica, a degradação de ambientes naturais, os processos ecológicos, a biodiversidade, a sustentabilidade, bem como a cidadania ambiental tem se tornado temas de discussão nas diversas esferas de convívio social.Dentro da história brasileira podemos identificar uma série de regramentos de caráter ambiental considerando-se como marco a Lei 4.771 de 15 de setembro de 1965, que instituiu o novo Código Florestal Brasileiro. Ao longo do presente artigo procuraremos investigar a origem da conceituação das áreas de preservação permanentes, tema alvo de grandes discussões na atualidade, tal qual surgiu e foi inserida na legislação brasileira, procurando recuperar esse aspecto específico da história do Brasil.

  19. Enzootic transmission of Trypanosoma cruzi and T. rangeli in the Federal District of Brazil Transmissão enzoótica de Trypanosoma cruzi e T. rangeli no Distrito Federal, Brasil

    Directory of Open Access Journals (Sweden)

    Rodrigo Gurgel-Gonçalves

    2004-04-01

    Full Text Available The Federal District of Brazil (DF lies within the Cerrado biome, where open shrubland (savannas is interspersed with riverside gallery forests and permanent swamps (veredas. Trypanosoma cruzi-infected native triatomines occur in the area, but the enzootic transmission of trypanosomatids remains poorly characterized. A parasitological survey involving sylvatic triatomines (166 Rhodnius neglectus collected from Mauritia flexuosa palms and small mammals (98 marsupials and 70 rodents, totaling 18 species was conducted in 18 sites (mainly gallery forests and veredas of the DF. Parasites were isolated, morphologically identified, and characterized by PCR of nuclear (mini-exon gene and kinetoplast DNA (kDNA. Six R. neglectus, seven Didelphis albiventris and one Akodon cursor were infected by trypanosomes; wild reservoir infection is documented for the first time in the DF. kDNA PCR detected T. cruzi in five R. neglectus and mini-exon gene PCR revealed T. cruzi I in isolates from D. albiventris. Parasites infecting one bug yielded T. rangeli KP1+ kDNA amplicons. In spite of the occurrence of T. cruzi-infected D. albiventris (an important wild and peridomestic reservoir and R. neglectus (a secondary vector displaying synanthropic behavior, a low-risk of human Chagas disease transmission could be expected in the DF, considering the low prevalence infection recorded in this work. The detection of T. rangeli KP1+ associated with R. neglectus in the DF widens the known range of this parasite in Brazil and reinforces the hypothesis of adaptation of T. rangeli populations (KP1+ and KP1- to distinct evolutionary Rhodnius lineages.O Distrito Federal (DF do Brasil está localizado no bioma Cerrado, um complexo de fisionomias savânicas incluindo matas de galeria e campos úmidos permanentes (veredas. Triatomíneos silvestres infectados por Trypanosoma cruzi ocorrem na área, mas a transmissão enzoótica de tripanossomatídeos permanece insuficientemente

  20. Efeitos de faixas de amplitude de CP na aprendizagem do saque tipo tênis do voleibol Effects of the bandwidth KP on the learning of the volleyball tennis serve

    Directory of Open Access Journals (Sweden)

    Herbert Ugrinowitsch

    2011-03-01

    Full Text Available Este estudo teve como objetivo investigar os efeitos de duas faixas de amplitude de Conhecimento de Performance (CP na aprendizagem do saque tipo tênis do voleibol. Essa questão foi testada com uma faixa de amplitude estreita e uma ampla e mais um grupo controle. O estudo foi composto por um pré-teste, fase de aquisição e teste de retenção. Foram analisadas medidas de desempenho e dos componentes do padrão da habilidade. Apesar dos grupos mostrarem desempenho semelhante no teste de retenção, a faixa ampla foi a única que levou a melhora do desempenho. Além disso, a faixa ampla conduziu a mais mudanças no padrão da habilidade do que a faixa estreita ou o grupo controle.This study aimed to investigate two bandwidth Knowledge of Performance (KP effects on the learning of the volleyball tennis serve. This question was tested with a thin and wide bandwidth KP plus a control group. The study was composed by a pre test, acquisition phase and retention test. It was analyzed performance and components of the motor pattern measures. Although the groups showed similar performance on retention test, only wide bandwidth conducted to a better performance. Although all groups showed similar performance during retention test only the wide bandwidth conducted to performance improvement. Moreover, the wide bandwidth conducted to more changes in movement pattern than thin bandwidth or control group.

  1. Deformación permanente de materiales granulares en pavimentos flexibles: estado del conocimiento Permanent strain of granular materials in flexible pavements: state of the art

    Directory of Open Access Journals (Sweden)

    Hugo Alexánder Rondón

    2009-01-01

    Full Text Available Diversos estudios han sido desarrollados en el área de los pavimentos para comprender el comportamiento elastoplástico que experimentan materiales granulares bajo carga cíclica. Este es el segundo de dos artículos que presentan el estado del conocimiento de investigaciones desarrolladas en esta área. Basado en una amplia revisión bibliográfica, este artículo da cuenta de la forma como ha sido estudiado el fenómeno de deformación permanente en materiales granulares empleados para conformar capas de base y sub-base de estructuras de pavimentos flexibles. Además, se exponen y se discuten los factores que afectan la resistencia a la deformación permanente y la evolución de las ecuaciones matemáticas desarrolladas para predecir la deformación que experimentan estos materiales bajo carga cíclica. Un estado del conocimiento sobre el comportamiento resiliente de estos materiales es presentado en el primer artículo (Rondón y Reyes, 2007.Several studies have been conducted in pavement field for trying to understand the elastoplastic behavior experienced by granular materials under a cyclic load. This is the second out of two articles which show state-of-the-art of researches conducted in this field. Based on a wide literature review, this article accounts for the way how permanent strain phenomenon has been studied in granular materials used for creating base and sub-base layers of flexible pavement structures. Besides, this article displays and discusses factors which affect resistance to permanent strain and evolution of mathematical equations developed for predicting that strain experienced by these materials under a cyclic load. A state-of-the-art about resilient behavior of these materials has been presented in the first article (Rondón and Reyes, 2007.

  2. Gestão participativa na educação permanente em saúde: olhar das enfermeiras Gestión participativa en la educación permanente en salud: visión de las enfermeras Participative management in permanent health education: view of the nurses

    Directory of Open Access Journals (Sweden)

    Adriane Calvetti de Medeiros

    2010-02-01

    Full Text Available Este estudo de abordagem qualitativa teve como objetivo conhecer as estratégias de gestão, com base na Educação Permanente em Saúde (EPS. Os participantes da pesquisa foram seis enfermeiras assistenciais de uma unidade de terapia intensiva de um hospital universitário do Estado do Rio Grande do Sul. Utilizou-se como instrumento de coleta de dados o Método de Círculo de Cultura de Freire. Os dados foram coletados nos meses de junho a agosto/2007. Os resultados apontam para o planejamento participativo e tomada de decisão como estratégias da EPS que promovem a autonomia, a valorização, a competência técnica e a construção do trabalho em equipe, em seu próprio percurso de aprendizagem.Este estudio de abordaje cualitativa tuvo como objetivo conocer las estrategias de gestión, con base en la Educación Permanente en Salud (EPS. Los participantes de la investigación fueron seis enfermeras asistenciales de una unidad de terapia intensiva de un hospital universitario del Estado de Rio Grande do Sul. Se utilizó como instrumento de recollección de datos el Método de Círculo de Cultura de Freire. Los dados fueran recogidos en los meses de junio a agosto/2007. Los resultados apuntan para la planificación participativo y toma de decisión como estrategias de la EPS que promueven la autonomía, la valorización, la competencia técnica y la construcción del trabajo en equipo, en su propio recorrido de aprendizajeThis study is of qualitative approach, and aimed at knowing the management strategies, on the basis of the Permanent Education in Health (PEH. The participants of the research had been six nurses of an intensive care unit from an university hospital in the State of Rio Grande do Sul, Brazil. The Method Circle of Culture of Freire was used like as instrument for collection of data. The data were collected in the period from June to august, 2007. Results point out participative planning and decision making as strategies of the

  3. Política de formação e educação permanente em saúde no brasil: bases legais e referências teóricas

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    Renata Lúcia Gigante

    Full Text Available Resumo Este artigo teve como objetivo discutir as inter-relações dos relatórios das Conferências Nacionais de Saúde com as propostas apresentadas em documentos oficiais do Sistema Único de Saúde referentes à formação e desenvolvimento de recursos humanos, buscando relacioná-los à incorporação de novos referenciais pedagógicos pautados pelas metodologias ativas de ensino-aprendizagem. O estudo aqui apresentado foi do tipo exploratório, referente à pesquisa na literatura das áreas de saúde e educação, no período de 1941 – realização da 1a Conferência Nacional de Saúde – até 2007, quando foi publicada a portaria n. 1.996 GM/MS. Essa portaria definiu novas diretrizes e estratégias para a implementação da Política Nacional de Educação Permanente em Saúde, com o objetivo de evidenciar a importância da formação de recursos humanos para a consolidação do Sistema Único de Saúde. Verificou-se que há correlação entre as reivindicações que emergem de necessidades sociais identificadas na construção do Sistema Único de Saúde e as propostas inscritas nas legislações pertinentes. Destaca-se que o sucesso de projetos de educação permanente depende de profunda imbricação entre processos educativos e de intervenção institucional, que contemplem a complexidade dos modos de fazer saúde.

  4. Historias de vida de mujeres afincadas de forma permanente en situación de exclusión social

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    Gabriela Moriana Mateo

    2016-07-01

    Full Text Available Este artículo presenta parte de los resultados de un trabajo de campo etnográfico realizado en distintos centros de Servicios Sociales Especializados para mujeres de la Generalitat Valenciana. Su objetivo es conocer los tipos de violencia y los factores de exclusión social que subyacen en las historias de vida de las mujeres institucionalizadas. La metodología de investigación utilizada ha sido de índole cualitativa. Se ha realizado observación participante y entrevistas tanto informales como biográficas que, junto con documentos personales e informes sociales, han permitido elaborar 15 historias de vida. Aunque en esta aproximación tan sólo se analizan las cuatro afincadas en la situación de exclusión social de forma permanente. Respecto a los resultados, cabe señalar que en las trayectorias vitales analizadas subyacen distintos factores de exclusión social que afectan tanto a los hombres como a las mujeres, pero también importantes factores específicos de género, como la violencia contra las mujeres intrafamiliar y de género.

  5. Las redes sociales en los procesos de adaptación a cambios permanentes de hábitat* Un estudio con habitantes de la Depresión Momposina (Norte de Colombia)

    OpenAIRE

    Gabriel Garrido Escudero; Camilo Madariaga

    2001-01-01

    En este artículo se describen las redes sociales durante los procesos de adaptación a los permanentes cambios que viven los pobladores de la Depresión Momposina en La Travesía, corregimiento de Mompox (Colombia). La información se recogió en una muestra de 262 personas, mediante la triangulación se compararon los resultados cuantitativos y los cuantitativos y se contrastó la información desde diversas estrategias para describir de mejor forma los fenómenos estudiados. Con ba...

  6. Educação permanente: uma ferramenta para o desenvolvimento docente na graduação

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Lazarini

    Full Text Available OBJETIVO: Descrever a percepção dos docentes tutores e dos docentes da Unidade de Prática Profissional (UPP da primeira série dos cursos de Medicina e Enfermagem da Famema quanto à relevância de participar do programa de Educação Permanente (EP. MÉTODOS: Estudo exploratório com questionário semiestruturado. Empregou-se a técnica de análise temática do Discurso do Sujeito Coletivo. RESULTADOS: A quase totalidade dos sujeitos considerou a atividade de EP como relevante. Os docentes da UPP apontaram ótimo espaço para aprendizagem, troca de experiências e reflexão sobre a prática. As ideias centrais dos tutores foram bom espaço de discussão e reflexão, porém um momento mal aproveitado. CONSIDERAÇÕES: Para os docentes da UPP, a proposta da EP (reflexão sobre a prática vem sendo atingida, mas não tem respondido às expectativas e ao entendimento dos tutores. Dada a importância do desenvolvimento docente para a sustentação de um currículo inovador, é necessário problematizar os sentidos implícitos nesta fala em busca de uma EP mais responsiva aos tutores

  7. Propuesta de un plan permanente de relaciones públicas para educar adolescentes sobre los riesgos que existen en las redes sociales

    Directory of Open Access Journals (Sweden)

    Gina Gilbert Toral

    2014-06-01

    redes sociales, utilizadas como un medio de comunicación altamente efectivo; hoy en día existe un notorio cambio en la manera en que los adolescentes se relacionan e interactúan entre sí, se evidencia que los niños a temprana edad adquieren dominio sobre las redes sociales y el internet en general, por lo que están expuestos a peligros de tipo psicológico, tales como: ciberbullying, sexting, grooming y morphing. Por lo antes expuesto, y con el fin de incidir de manera positiva en los adolescentes, el presente trabajo de investigación propone la creación de un plan permanente de relaciones públicas, que entre otras actividades conlleva: charlas de psicología, talleres de concientización, la elaboración de un código de conducta online que minimice los riesgos, y finalmente el desarrollo de campañas en internet y medios tradicionales.

  8. Reporting on a Talk I Gave Some Months Ago, the Headline in "La Opinion," Los Angeles' Premier Spanish Language Newspaper, Declared the City's School System "en crisis permanente." No One Wrote in to Disagree. The Claremont Letter. Volume 3, Issue 1

    Science.gov (United States)

    Kerchner, Charles T.

    2008-01-01

    Reporting on a talk the author gave some months ago, the headline in "La Opinion," Los Angeles' premier Spanish language newspaper, declared the city's school system "en crisis permanente." No one wrote in to disagree. Indeed, at the end of "Learning from L.A.: Institutional Change in American Public Education" (Harvard Education Press) the author…

  9. Implantação das mesas nacionais de negociação permanente do Sistema Único de Saúde em secretarias estaduais e municipais de saúde

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    Carinne Magnago

    Full Text Available Resumo O objetivo deste artigo é avaliar a implantação da mesa de negociação permanente e identificar os entraves e os avanços decorridos dos processos de negociação no âmbito dos estados e dos municípios brasileiros. O método usado foi estudo descritivo e exploratório, de abrangência nacional. A coleta de dados se deu em 2012 e 2013, por meio de survey com 519 gestores de saúde e grupos focais com 49 gestores e 11 integrantes da Mesa Nacional de Negociação Permanente. Dados foram analisados por estatística descritiva e por análise de conteúdo. Verificou-se existência de 132 mesas de negociação, das quais apenas 87 estão em funcionamento. Os principais motivos para não implantação das mesas são a falta de assessoria técnica e a utilização de outras ferramentas para negociação do trabalho. As principais mudanças nas relações de trabalho em decorrência da atuação das mesas de negociação foram a realização de concursos e de processos seletivos públicos, políticas de desprecarização do trabalho e a implantação de planos de cargos, carreiras e salários. Conclui-se que apesar da potencialidade das mesas como dispositivos de negociação, sua implantação e seu pleno funcionamento esbarram em grandes desafios.

  10. 76 FR 11243 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2011-03-01

    ... CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, US EPA, Office... Alicia Kaiser, Designated Federal Officer, at the contact information above. All requests must be... individuals with disabilities, please contact Alicia Kaiser at 202-564- 7273 or kaiser.alicia@epa.gov . To...

  11. Social organization of self-management support of persons with diabetes: a health systems comparison.

    Science.gov (United States)

    Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

    2012-09-01

    Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

  12. NFP Investor Conference. Growth is back in sight.

    Science.gov (United States)

    Haugh, Richard

    2002-06-01

    In a whirlwind of high-stakes meetings in New York City in mid-May, two dozen of the nation's largest hospitals and health systems strutted their stuff with a single goal: securing their future. Their message was clear: back-to-basics works, and now it's time to grow the business. Executives from 23 providers outlined their work on increasing revenue, boosting margins and shoring up balance sheets. They presented their market positions, strategic initiatives and financial results for investment analysts, credit raters and bond traders. The third annual Non-Profit Healthcare Investor Conference was co-sponsored by the American Hospital Association, Health Forum, the Healthcare Financial Management Association and Salomon Smith Barney. The focus on growth doesn't come without challenges Several common themes emerged from the presentations, among them pressure on reimbursement, workforce shortages, liability insurance issues and capacity constraints. Yet executives agree: it all comes down to the basics, and building the strength to keep their missions alive. As Thomas Meier, vice president and treasurer of Oakland, Calif.-based Kaiser Permanente, put it: "No margin, no mission, no más."

  13. Data that drive: Closing the loop in the learning hospital system.

    Science.gov (United States)

    Liu, Vincent X; Morehouse, John W; Baker, Jennifer M; Greene, John D; Kipnis, Patricia; Escobar, Gabriel J

    2016-11-01

    The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning. We use an object lesson-sepsis care within the 21 hospitals of the Kaiser Permanente Northern California integrated healthcare delivery system-to offer insight into the critical elements necessary for developing a learning hospital system. We then describe how a hospital-wide data-driven approach to inpatient care can facilitate improvements in the quality of hospital care. Journal of Hospital Medicine 2016;11:S11-S17. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  14. Determination of differential cross-sections for the natK(p, p0) and 39K(p, α0) reactions in the backscattering geometry

    International Nuclear Information System (INIS)

    Kokkoris, M.; Tsaris, A.; Misaelides, P.; Sokaras, D.; Lagoyannis, A.; Harissopulos, S.; Vlastou, R.; Papadopoulos, C.T.

    2010-01-01

    In the present work, new, differential cross-section values are presented for the nat K(p, p 0 ) reaction in the energy range E lab = 3000-5000 keV (with an energy step of 25 keV) and for detector angles between 140 o and 170 o (with an angular step of 10 o ). A qualitative discussion of the observed cross-section variations through the influence of strong, closely spaced resonances in the p + 39 K system is also presented. Information has also been extracted concerning the 39 K(p,α 0 ) reaction for E lab = 4000-5000 keV in the same angular range. As a result, more than ∼500 data points will soon be available to the scientific community through IBANDL (Ion Beam Analysis Nuclear Data Library - (http://www-nds.iaea.org/ibandl/)) and could thus be incorporated in widely used IBA algorithms (e.g. SIMNRA, WINDF, etc.) for potassium depth profiling at relatively high proton beam energies.

  15. "Presumed fair: Ironic effects of organizational diversity structures": Correction to Kaiser et al. (2013).

    Science.gov (United States)

    2016-06-01

    Reports an error in "Presumed fair: Ironic effects of organizational diversity structures" by Cheryl R. Kaiser, Brenda Major, Ines Jurcevic, Tessa L. Dover, Laura M. Brady and Jenessa R. Shapiro (Journal of Personality and Social Psychology, 2013[Mar], Vol 104[3], 504-519). In the article, a raw data merging error in one racial discrimination claim condition from Experiment 6 inadvertently resulted in data analyses on an inaccurate data set. When the error was discovered by the authors and corrected, all analyses reported in Experiment 6 for claim validity, seriousness of the claim, and support for the claimant were inaccurate and none were statistically significant. The conclusions should be altered to indicate that participants with management experience who reflected on their own workplace diversity policies did not show the predicted effects. The literature review, remaining five studies, and remaining conclusions in the article are unaffected by this error. Experiment 6 should also report that 26.4% (not 26.4.7%) of participants had a graduate degree and eight participants (not 8%) did not provide educational data. Experiment 5 should have referred to the claim validity measure as a six-item measure ( .92) rather than a five-item measure; analyses on claim validity are accurate in text. Table 2's note should have said standard errors, not standard deviations. (The following abstract of the original article appeared in record 2012-31077-001.) This research tests the hypothesis that the presence (vs. absence) of organizational diversity structures causes high-status group members (Whites, men) to perceive organizations with diversity structures as procedurally fairer environments for underrepresented groups (racial minorities, women), even when it is clear that underrepresented groups have been unfairly disadvantaged within these organizations. Furthermore, this illusory sense of fairness derived from the mere presence of diversity structures causes high

  16. Historia poblacional, orígenes africanos y microevolución de los actuales afro-colombianos inferidos desde caracteres epigenéticos en la dentición decidua y permanente

    Directory of Open Access Journals (Sweden)

    Delgado Burbano, Miguel E.

    2006-01-01

    Full Text Available Setenta y cinco rasgos coronales no-métricos en la dentición permanente y decidua fueron registrados en 178 modelos dentales de individuos afro-colombianos pertenecientes a la comunidad de Guapi. Se recolectaron datos comparativos de 33 grupos africanos, otro grupo afro-estadounidense en la dentición permanente, en 4 grupos afro-americanos y otros 12 grupos de diferente ascendencia étnica, en la dentición decidua. Un análisis multivariado de componentes principales basado en frecuencias dentales, mostró que los afro-colombianos poseen gran afinidad genética con el Africa Sub-Sahariana, específicamente con grupos del Occidente, del Oriente y del Sur-Oriente africano. Este mismo análisis detectó una marcada divergencia dental con las poblaciones Norafricanas. Los resultados de esta investigación concuerdan con recientes estudios genéticos, basados en marcadores de ADNmt. A pesar que la dentición es evolutivamente conservativa y estable en una escala diacrónica corta, se concluyó que en 400 años de microevolución de los africanos en Colombia, su pool genético original se ha modificado levemente, debido a la influencia de presiones selectivas y flujo génico interétnico, con nativos americanos y grupos de origen caucásico. Se sugiere que los grupos afro-descendientes del Norte, Centro y Sur de América poseen historias poblacionales y evolutivas distintas, debido tanto a procesos de diferenciación fenotípica regional y local como a orígenes geográficos y étnicos diferentes.

  17. A influência da perda bilateral do primeiro molar inferior permanente na morfologia dentofacial: um estudo cefalométrico The influence of bilateral lower first permanent molar loss on dentofacial morfology: a cephalometric study

    Directory of Open Access Journals (Sweden)

    David Normando

    2010-12-01

    Full Text Available OBJETIVO: avaliar as alterações cefalométricas em pacientes com perda bilateral do primeiro molar inferior permanente. MÉTODOS: foram analisadas 68 telerradiografias laterais de pacientes de consultórios particulares. A amostra foi dividida em dois grupos pareados quanto ao sexo e idade - 34 indivíduos sem perdas (grupo controle e 34 com perda bilateral do primeiro molar inferior permanente (grupo com perda. Foram excluídos da amostra pacientes que haviam perdido outros dentes que não o primeiro molar inferior, casos de agenesia e pacientes com menos de 16 anos de idade. Buscou-se avaliar somente indivíduos que tivessem relatado a perda há pelo menos 5 anos. RESULTADOS: demonstraram que a perda bilateral do primeiro molar inferior permanente leva ao suave fechamento do ângulo GnSN (P=0,05, um giro anti-horário do plano oclusal (P=0,0001, uma suave diminuição da altura facial anteroinferior (P=0,05, uma acentuada inclinação lingual (P=0,04 e retrusão dos incisivos inferiores (P=0,03. Por outro lado, a perda bilateral do primeiro molar inferior permanente não foi capaz de influenciar a relação maxilomandibular no sentido anteroposterior (P=0,21, a quantidade de mento (P=0,45, a inclinação dos incisivos superiores (P=0,12 e a posição anteroposterior dos incisivos superiores (P=0,46. CONCLUSÃO: a perda bilateral dos primeiros molares inferiores é capaz de produzir alterações marcantes no posicionamento dos incisivos inferiores e no plano oclusal, além de uma suave redução vertical da faceOBJECTIVE: To evaluate cephalometric changes in patients after bilateral loss of lower first permanent molar teeth. METHODS: Sixty-eight lateral radiographs of patients from private practices were analyzed. The sample was divided into two groups matched for age and gender: 34 individuals without loss (control group and 34 presenting with bilateral loss of lower first permanent molar teeth (loss group. Patients who had lost teeth other

  18. La formación inicial y permanente del profesorado de Educación Física a través del practicum

    Directory of Open Access Journals (Sweden)

    Herminia María García Ruso

    2013-05-01

    Full Text Available En este artículo se muestran los aspectos más importantes del desarrollo de un proyecto de innovación educativa realizado durante las prácticas de enseñanza. En el proyecto intervinieron cuatro alumnos, futuros maestros especialistas de Educación Física, cuatro tutoras y dos supervisoras. Trataremos de exponer, con cierto matiz descriptivo, las fases seguidas en la realización de un proyecto de investigación-acción, los objetivos formulados, la metodología empleada, la elaboración de una unidad didáctica de expresión corporal y el análisis e interpretación de la información. Finalmente, explicaremos las conclusiones que giran alrededor de tres ejes: la relación de la Universidad y los Centros Educativos, la relación del supervisor y el tutor, y la valoración del propio seminario de investigación-acción como herramienta para la investigación y la formación inicial y permanente del profesorado.

  19. Anomalías dentomaxilofaciales en dientes permanentes y su relación con traumas en la primera infancia Dental-maxillary-facial anomalies in permanent teeth and their relation to traumas in early childhood

    Directory of Open Access Journals (Sweden)

    Arlene Liset Corrales León

    2009-03-01

    Full Text Available Se realizó un estudio descriptivo, longitudinal y retrospectivo que incluyó niños de 7 a 14 años de edad, pertenecientes al área de salud de la "Clínica Estomatológica Docente Guama" del municipio Pinar del Río, en el período comprendido entre febrero del 2003 a marzo de 2005, con el objetivo de determinar la presencia de anomalías dentomaxilofaciales en dentición permanente y su relación con traumas en la primera infancia. El universo de estudio estuvo constituido por 250 niños, y de ellos, se seleccionó una muestra de 60 niños y se les confeccionó una planilla recolectora de datos para la investigación. Los resultados obtenidos fueron procesados estadísticamente mediante el sistema automatizado STATISTIC y la prueba de CHI CUADRADO, en su aplicación de bondad de ajuste, y el paquete SPSS, para la prueba de comparación de proporciones. En todos los casos se prefija un nivel de significación de 0,05. Entre los resultados globales más significativos encontramos que fueron los traumas ocurridos en las edades de 5-6 años los que más anomalías dentomaxilofaciales causaron en la dentición permanente. Resultó el sexo masculino el más afectado por estas alteraciones, fueron los traumas recibidos directamente sobre los dientes, los mayores causantes de anomalías en la dentición permanente. Resultaron las hipoplasias del esmalte, como otras anomalías no ortodóncicas las más frecuentes; se comprobó que el sexo femenino tuvo mayor implicación psicosocial por estas alteraciones y se divulgaron a estomatólogos, padres y maestros orientaciones sobre la relación entre los traumas en la primera infancia y las anomalías dentomaxilofaciales en la dentición permanente.A descriptive, longitudinal and retrospective research was carried out including children from 7 to 14 years old belonging to the health area of "Guama" Dental University Clinic in Pinar del Rio Municipality, from February 2003 to March 2005 aimed at determining

  20. Técnica para identificar faltas transitorias y permanentes en líneas de transmisión, utilizando la transformada Wavelet

    Directory of Open Access Journals (Sweden)

    Miguel Martínez

    2009-01-01

    Full Text Available En el presente documento, se presenta un algoritmo que permite distinguir de forma clara y precisa, las faltas transitorias de las permanentes. Adicionalmente se determina el instante de extinción del arco secundario, para así evitar o controlar de forma efectiva y segura la operación de reconexión monofásica en sistemas de transporte de energía. El método de identificación se basa en la determinación de las características de alta frecuencia que posee la señal de tensión de la fase en falta antes del despeje y de la corriente en una fase sana y las relaciona de forma independiente mediante una auto-correlación cruzada. Para el análisis de la señal y extracción de los componentes de alta frecuencia, se ha utilizado la transformada Wavelet. El algoritmo propuesto se probó en un sistema base de 380 kV, funcionando de forma correcta en todos los escenarios planteados y logrando una identificación precisa en los primeros 25 ms de la falta.

  1. The impact of SHS exposure on health status and exacerbations among patients with COPD

    Directory of Open Access Journals (Sweden)

    Mark D Eisner

    2009-05-01

    Full Text Available Mark D Eisner1,3, Carlos Iribarren3, Edward H Yelin2, Stephen Sidney3, Patricia P Katz2, Gabriela Sanchez3, Paul D Blanc11Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine; 2Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco, CA, USA; 3Division of Research, Kaiser Permanente, Oakland, CA, USAAbstract: Secondhand smoke (SHS is a major contributor to indoor air pollution. Because it contains respiratory irritants, it may adversely influence the clinical course of persons with chronic obstructive pulmonary disease (COPD. We used data from nonsmoking members of the FLOW cohort of COPD (n = 809 to elucidate the impact of SHS exposure on health status and exacerbations (requiring emergency department visits or hospitalization. SHS exposure was measured by a validated survey instrument (hours of exposure during the past week. Physical health status was measured by the SF-12 Physical Component Summary Score and disease-specific health-related quality of life (HRQL by the Airways Questionnaire 20-R. Health care utilization for COPD was determined from Kaiser Permanente Northern California computerized databases. Compared to no SHS exposure, higher level SHS exposure was associated with poorer physical health status (mean score decrement −1.78 points; 95% confidence interval [CI] −3.48 to −0.074 points after controlling for potential confounders. Higher level SHS exposure was also related to poorer disease-specific HRQL (mean score increment 0.63; 95% CI 0.016 to 1.25 and less distance walked during the Six-Minute Walk test (mean decrement −50 feet; 95% CI −102 to 1.9. Both lower level and higher level SHS exposure was related to increased risk of emergency department (ED visits (hazard ratio [HR] 1.40; 95% CI 0.96 to 2.05 and HR 1.41; 95% CI 0.94 to 2.13. Lower level and higher level SHS exposure were associated with a greater risk of

  2. 75 FR 55578 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2010-09-13

    ... basis. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov... statements to the FRRCC should be sent to Alicia Kaiser, Designated Federal Officer, at the contact... information on access or services for individuals with disabilities, please contact Alicia Kaiser at 202-564...

  3. Design thinking.

    Science.gov (United States)

    Brown, Tim

    2008-06-01

    In the past, design has most often occurred fairly far downstream in the development process and has focused on making new products aesthetically attractive or enhancing brand perception through smart, evocative advertising. Today, as innovation's terrain expands to encompass human-centered processes and services as well as products, companies are asking designers to create ideas rather than to simply dress them up. Brown, the CEO and president of the innovation and design firm IDEO, is a leading proponent of design thinking--a method of meeting people's needs and desires in a technologically feasible and strategically viable way. In this article he offers several intriguing examples of the discipline at work. One involves a collaboration between frontline employees from health care provider Kaiser Permanente and Brown's firm to reengineer nursing-staff shift changes at four Kaiser hospitals. Close observation of actual shift changes, combined with brainstorming and rapid prototyping, produced new procedures and software that radically streamlined information exchange between shifts. The result was more time for nursing, better-informed patient care, and a happier nursing staff. Another involves the Japanese bicycle components manufacturer Shimano, which worked with IDEO to learn why 90% of American adults don't ride bikes. The interdisciplinary project team discovered that intimidating retail experiences, the complexity and cost of sophisticated bikes, and the danger of cycling on heavily trafficked roads had overshadowed people's happy memories of childhood biking. So the team created a brand concept--"Coasting"--to describe a whole new category of biking and developed new in-store retailing strategies, a public relations campaign to identify safe places to cycle, and a reference design to inspire designers at the companies that went on to manufacture Coasting bikes.

  4. Resultados da correção cirúrgica da exotropia permanente em pacientes amblíopes e não-amblíopes

    Directory of Open Access Journals (Sweden)

    Adriana Valim Portes

    2011-08-01

    Full Text Available A exotropia permanente (XT acomete cerca de 1 a 2% da população. Seu tratamento é clínico: antiambliogênico e correção dos erros refrativos, e cirúrgico. O objetivo do tratamento cirúrgico é alinhar os olhos na posição primária do olhar, proporcionando melhor resultado estético. Há muito tempo diversos autores estudam os fatores pré, per e pós-operatórios relacionados ao resultado cirúrgico, uma vez que a taxa de sucesso varia de 60 a 80%. Ainda são poucos os estudos que comparam a presença de ambliopia como fator de influência no resultado final. OBJETIVO: Comparar o resultado cirúrgico dos pacientes amblíopes e não-amblíopes submetidos à cirurgia de correção de XT. MÉTODOS: Análise retrospectiva de 37 prontuários de pacientes amblíopes (Grupo A e não-amblíopes (Grupo B submetidos à correção cirúrgica de XT por retrocessoressecção monocular, sendo avaliados os registros pós-operatórios imediatos e tardios. Idade: grupo A 24,7 ± 14,2 anos, grupo B 22,6 ±18,6 anos; Desvio pré-operatório: grupo A 29,1± 7,2Δ, grupo B 28,4 ± 6,8Δ. RESULTADOS: A taxa de sucesso foi de 60% e 100% (p<0,05, no pós-operatório imediato e 50% e 82,3% (p=0,082, no pós-operatório final, nos grupos A e B, respectivamente. Não houve diferença significante quanto aos desvios pós-operatórios imediatos, tardios e variação do desvio. CONCLUSÃO: Pode-se concluir que o grupo B mostrou melhor resultado no pós-operatório imediato; porém não houve diferença no resultado cirúrgico de correção de exotropia permanente entre pacientes amblíopes e não-amblíopes no período pós-operatório de seis meses.

  5. Something is amiss in Denmark: A comparison of preventable hospitalisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente

    DEFF Research Database (Denmark)

    Schiøtz, Michaela Louise; Price, Mary; Frølich, Anne

    2011-01-01

    As many other European healthcare systems the Danish healthcare system (DHS) has targeted chronic condition care in its reform efforts. Benchmarking is a valuable tool to identify areas for improvement. Prior work indicates that chronic care coordination is poor in the DHS, especially in comparison...

  6. 77 FR 60430 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2012-10-03

    ... Time. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov... teleconference, make brief oral comments, or provide a written statement to the FRRCC must contact Alicia Kaiser, Designated Federal Officer, at kaiser.alicia@epa.gov or 202-564-7273 by October 15, 2012. Meeting Access: For...

  7. 77 FR 75152 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2012-12-19

    ... CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, US EPA, Office... provide a written statement to the FRRCC must contact Alicia Kaiser, Designated Federal Officer, at kaiser.alicia@epa.gov or 202-564-7273 by January 4, 2013. Meeting Access: For information on access or services...

  8. 76 FR 73631 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2011-11-29

    ... FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , (202) 564... comments may be submitted and will be provided to the Committee. Please send all written comments to Alicia... disabilities, please contact Alicia Kaiser at (202) 564-7273 or kaiser.alicia@epa.gov . To request [[Page 73632...

  9. "Estudo in vitro do potencial cariostático dos selantes resinosos, dos cimentos ionoméricos, do diamino fluoreto de prata e do verniz fluoretado, aplicados em superfície oclusal de molares permanentes humanos".

    OpenAIRE

    Thereza Christina Lopes Coutinho

    2002-01-01

    O objetivo deste trabalho foi avaliar, in vitro, ao Microscópio de Luz Polarizada (MLP), o potencial cariostático dos selantes resinosos, dos cimentos ionoméricos, do diamino fluoreto de prata e do verniz fluoretado aplicados em superfície oclusal de molares permanentes humanos. Para tanto, 70 terceiros molares humanos hígidos, extraídos por razões clínicas, foram divididos aleatoriamente em sete grupos (N=10): GI – controle (sem selamento); GII – selante resinoso sem flúor Delton ®; G III – ...

  10. 77 FR 41185 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2012-07-12

    ..., from 1:00 p.m. until 2:30 p.m. Eastern Daylight Time. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, U.S. EPA, Office of the Administrator... statement to the FRRCC must contact Alicia Kaiser, Designated Federal Officer, at kaiser.alicia@epa.gov or...

  11. Usos da terra e Áreas de Preservação Permanente (APP na Bacia do Rio da Prata, Castelo-ES

    Directory of Open Access Journals (Sweden)

    Luciano Melo Coutinho

    Full Text Available Este trabalho avaliou o uso da terra e identificou Áreas de Preservação Permanente (APPs na Bacia Hidrográfica do Rio da Prata (BRP, município de Castelo-ES, via técnicas de geoprocessamento. A BRP é marcada pela supressão de vegetação nativa, para expansão da fronteira agropecuária. As classes de uso da terra foram vetorizadas por fotointerpretação de aerofotos ortorretificadas. A delimitação das APPs foi realizada a partir de dados de hidrografia e altimetria de cartas topográficas digitais, com respeito às determinações do Código Florestal Brasileiro. A principal forma de uso da terra é a agropecuária (60,84% da área total, composta pela agricultura (30,21% e pela pecuária (30,63%, sendo que a área preservada com floresta nativa é de 36,85%. As APPs representam 55,48% da área total e sua maior parte (50,40% é utilizada para fins socioeconômicos, enquanto a cobertura florestal representa apenas 49,60%.

  12. Estrategias del Teatro del Oprimido para la formación permanente del profesorado (Strategies from the Theatre of the Oppressed for Permanent Training of Teaching Staff (Stratégies du théâtre de l'opprimé pour la formation permanente du corps d'enseignants (Estratégias do teatro do oprimido para a formação permanente do professorado

    Directory of Open Access Journals (Sweden)

    Tomás Motos-Teruel

    2012-06-01

    Full Text Available ResumenEste artículo relata una experiencia y su valoración de forma- ción permanente del profesorado basada en el aprendizaje vi- vencial utilizando como estrategia metodológica el Teatro del Oprimido (TO para estimular y favorecer la reflexión sobre la práctica educativa. Sus objetivos básicos fueron dar a conocer la formulación teórica y la metodología del TO y hacer la trans- ferencia de las estrategias metodológicas vivenciadas a la práctica docente. El estudio se ha planteado desde una óptica cualitativa con el estudio de caso único. Y como resultados más destacables hay que reseñar el interés y la percepción de la utili- dad personal y profesional del TO como instrumento de reflexión sobre la acción y generador de clima positivo. El Teatro del Opri- mido es una formulación teórica y un método estético cuya teo- ría y praxis están inspiradas en la Pedagogía del Oprimido de Paulo Freire, utiliza las técnicas dramáticas como un instrumen- to eficaz para la comprensión y la búsqueda de alternativas a problemas sociales, interpersonales e individuales.AbstractThis paper describes an experience and its as- sessment for application in permanent training of teaching staff, based on experiential learning and using the Theatre of the Oppressed (TO to stimu- late the thought about educational practice. The principal aims were to bring to the attention the theory and methodology of TO and to transfer its experiential methodological strategies to educa- tion practice. The study was designed as a quali- tative analysis of a single case study. The principal results include the interest and perception of use- fulness both at personal and professional levels, of TO as an instrument of thought and a generator of positive environments. The Theatre of the Oppres- sed is a theoretic concept and aesthetic method, the theory and praxis of which are inspired by Paulo Freire's Pedagogy of the Oppressed. It uses dra- ma techniques as

  13. GEOPROCESSAMENTO APLICADO NO DIAGNÓSTICO DOS CONFLITOS DE USO E OCUPAÇÃO DO SOLO EM ÁREAS DE PRESERVAÇÃO PERMANENTE NO RIBEIRÃO DAS AGULHAS – BOTUCATU (SP

    Directory of Open Access Journals (Sweden)

    Sérgio Campos et al.

    2017-03-01

    Las Áreas de Preservación Permanente (APP tienen una función ambiental para preservar los recursos naturales, la biodiversidad, el flujo genético de fauna y flora, el suelo y la seguridad del bienestar de las poblaciones humanas. La degradación de los bosques ribereños contribuye a la sedimentación e incremento en la turbidez del agua, a la erosión de las orillas de los cursos de agua y al transporte de sustancias contaminantes, como pesticidas y fertilizantes agrícolas. El trabajo tuvo como objetivo determinar el uso incorrecto de las áreas de preservación permanente de la cuenca del río das Agulhas – Botucatu (SP, basada en la carta planialtimétrica de Botucatu y la imagen de satélite de 2011. La metodología consistió en el uso de GIS-IDRISI Selva para la georreferenciación, la generación de los amortiguamientos de las APPs y la superposición de los conflictos de uso y ocupación. El gran uso de la cuenca se correspondió con pastizales, 675,34ha. Las APPs (166,10ha se utilizan inadecuadamente, con 93, 33ha de pastizales. El diagnóstico indica la necesidad de un plan de protección vinculado al medio ambiente, y destinado a la recuperación de áreas degradadas, que permita la regeneración de la cubierta natural de las APPs, que se utilizan sin cumplir con la legislación ambiental brasileña. Las geotecnologías fueron herramientas indispensables para el diagnóstico del uso y ocupación del suelo en el área analizada. Palabras clave: SIG; Uso y Ocupación del Suelo; Preservación del Medio Ambiente.

  14. CB4-03: An Eye on the Future: A Review of Data Virtualization Techniques to Improve Research Analytics

    Science.gov (United States)

    Richter, Jack; McFarland, Lela; Bredfeldt, Christine

    2012-01-01

    Background/Aims Integrating data across systems can be a daunting process. The traditional method of moving data to a common location, mapping fields with different formats and meanings, and performing data cleaning activities to ensure valid and reliable integration across systems can be both expensive and extremely time consuming. As the scope of needed research data increases, the traditional methodology may not be sustainable. Data Virtualization provides an alternative to traditional methods that may reduce the effort required to integrate data across disparate systems. Objective Our goal was to survey new methods in data integration, cloud computing, enterprise data management and virtual data management for opportunities to increase the efficiency of producing VDW and similar data sets. Methods Kaiser Permanente Information Technology (KPIT), in collaboration with the Mid-Atlantic Permanente Research Institute (MAPRI) reviewed methodologies in the burgeoning field of Data Virtualization. We identified potential strengths and weaknesses of new approaches to data integration. For each method, we evaluated its potential application for producing effective research data sets. Results Data Virtualization provides opportunities to reduce the amount of data movement required to integrate data sources on different platforms in order to produce research data sets. Additionally, Data Virtualization also includes methods for managing “fuzzy” matching used to match fields known to have poor reliability such as names, addresses and social security numbers. These methods could improve the efficiency of integrating state and federal data such as patient race, death, and tumors with internal electronic health record data. Discussion The emerging field of Data Virtualization has considerable potential for increasing the efficiency of producing research data sets. An important next step will be to develop a proof of concept project that will help us understand to benefits

  15. Simulación del Comportamiento Dinámico de un Pequeño Aerogenerador de Imán Permanente Sin Multiplicador en operación autónoma haciendo uso del MatLab

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    Osley López González

    2011-10-01

    Full Text Available En este trabajo los autores hacen uso del software MATLAB SIMULINK versión 7.7.0.471 R2008b para el análisis del comportamiento de un sistema generación eólico de 2 kW autónomo sin multiplicador con generador de imanes permanentes y batería de Plomo-ácido. Se utilizan para ello los modelos de los generadores de imanes permanentes, batería, convertidores así como otros elementos del sistema eléctrico existente en el toolbox SimPowerSystems de este software y se obtiene y discute el comportamiento dinámico de las variables del conjuntoturbina-generador, las variables del bus de directa, así como también las variables de la carga, ante diferentes condiciones de trabajo del sistema. Los resultados basados en simulaciones muestran el correcto funcionamiento de todas las variables de control que regulan el sistema generador eólico-elemento almacenador-carga eléctrica consumida, cuando se somete a perturbaciones típicas como lo son la variación en racha del viento y variación de la carga repentina. The utilization of the popular software MATLAB SIMULINK 7.7.0.471 in order to analyze a 2kW Direct driven Permanent Magnet generator for wind turbine in autonomous operation, including battery of Lead-acid is exposed by the authors. The existent models of the SimPowerSystems MATLAB toolbox are used in order to obtain and discuss the dynamic behavior of the principal variables under different conditions of work of the system.

  16. Construção de descritores para o processo de educação permanente em atenção básica Building descriptors for the permanent basic care education process

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    Rosita Saupe

    2007-11-01

    Full Text Available Educação permanente e atenção básica fazem parte do sistema de saúde brasileiro desde suas origens. Recentemente estas políticas públicas foram atualizadas, gerando um movimento inovador de construção de conhecimento visando apoiar sua implementação e consolidação. Este estudo, através de uma metodologia quantitativa, procurou evidenciar os principais descritores que devem orientar os processos de educação permanente em atenção básica. O método é originário da Universidade da Carolina do Norte. É desenvolvido em duas etapas. Os dados apresentados neste artigo dizem respeito à primeira etapa, que inclui as seguintes fases: elaboração de um diagrama com todos os componentes a serem avaliados; sua análise por um grupo de especialistas, indicando o que deve ser mantido, retirado ou incluído; avaliação por juízes, utilizando escala Likert de 1 a 5; verificação da concordância entre os juízes. O diagrama foi decomposto em quatro dimensões, procurando responder as seguintes questões: para quem? - audiências ou população alvo; o quê? - módulos de conteúdos e experiências de aprendizagem; para quê? - competências a serem desenvolvidas; e como? - metodologia a ser priorizada. Os resultados evidenciaram a procedência dos descritores propostos e avaliados, constituindo em material que pode contribuir para a tomada de decisão sobre educação permanente em atenção básica.Permanent education and basic care have been part of the Brazilian health system from the beginning. These public policies were recently updated, leading to an innovative knowledge construction movement to support their implementation and consolidation. This study, which used a quantitative approach, attempted to single-out the main descriptors that must guide the permanent basic care education processes. The method originated at the University of North Carolina and is carried out in two stages. The data shown in this article concern the

  17. Understanding Faculty and Trainee Needs Related to Scholarly Activity in a Large, Nonuniversity Graduate Medical Education Program.

    Science.gov (United States)

    Becker, Davida; Garth, Hanna; Hollander, Rachel; Klein, Felice; Klau, Marc

    2017-01-01

    Graduate medical education (GME) programs must develop curriculum to ensure scholarly activity among trainees and faculty to meet accreditation requirements and to support evidence-based medicine. Test whether research-related needs and interests varied across four groups: primary care trainees, specialty trainees, primary care faculty, and specialty faculty. We surveyed a random sample of trainees and faculty in Kaiser Permanente Southern California's GME programs. We investigated group differences in outcomes using Fisher exact and Kruskal-Wallis tests. Research experiences, skills, barriers, motivators, and interests in specific research skills development. Participants included 47 trainees and 26 faculty (response rate = 30%). Among primary care faculty, 12 (71%) reported little or no research experience vs 1 (11%) for specialty faculty, 14 (41%) for primary care trainees, and 1 (8%) for specialty trainees (p work roles taking priority; desire for work-life balance; and lack of managerial support, research equipment, administrative support, and funding. Faculty and trainees in primary care and specialties have differing research-related needs that GME programs should consider when designing curricula to support scholarly activity. Developing research skills of primary care faculty is a priority to support trainees' scholarly activity.

  18. Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries.

    Science.gov (United States)

    Dowling, Sean Taylor; Lin, Brian Wai

    2017-10-01

    A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. Emergency department of Kaiser Permanente Medical Center, San Francisco, California. Six patients were treated in the emergency department for fingertip dermal avulsion injuries using a tourniquet and tissue adhesive glue (Dermabond by Ethicon, Somerville, New Jersey). Patients were subsequently contacted to assess healing and satisfaction with cosmetic outcome through interview and photographs of their wounds at 9 months following the date of injury. All 6 patients were satisfied with the cosmetic outcome of treatment, and none received a diagnosis of serious complications. This series demonstrates cosmetic outcomes for injuries treated with the technique, highlights potential problems that may be perceived by patients during their clinical course, and creates the groundwork for a larger clinical study examining the use of the technique.

  19. Linked analysis for definition of nurse advice line syndrome groups, and comparison to encounters.

    Science.gov (United States)

    Magruder, Steven F; Henry, J; Snyde, M

    2005-08-26

    Nurse advice call centers are a potentially important source of data for syndromic surveillance purposes. For this reason, researchers at Johns Hopkins University Applied Physics Laboratory and Kaiser Permanente of the Mid-Atlantic States (KPMAS) have been collaborating to develop methods to use this data within the ESSENCE II Syndromic Surveillance System in the National Capital Region. The objective of this report is to present a general method for finding syndrome groups in data sources that can be linked to physician encounters and to determine effective advice call syndrome groups for use with KPMAS advice data. Advice calls are linked to physician encounters and stratified by patient age. They are placed in groups according to a maximum positive predictive value criterion. The groups are evaluated by correlating the resulting syndrome time series against physician encounter data. Potentially useful advice syndrome groups are found for respiratory, lower gastrointestinal (GI), and total GI syndromes for each age stratum. The time series of the advice data for respiratory, lower GI, and upper GI syndromes accurately predict the physician encounter time series for the corresponding syndromes for each age stratum.

  20. The greatest challenges reported by long-term colorectal cancer survivors with stomas.

    Science.gov (United States)

    McMullen, Carmit K; Hornbrook, Mark C; Grant, Marcia; Baldwin, Carol M; Wendel, Christopher S; Mohler, M Jane; Altschuler, Andrea; Ramirez, Michelle; Krouse, Robert S

    2008-04-01

    This paper presents a qualitative analysis of the greatest challenges reported by long-term colorectal cancer survivors with ostomies. Surveys that included an open-ended question about challenges of living with an ostomy were administered at three Kaiser Permanente regions: Northern California, Northwest, and Hawaii. The study was coordinated at the Southern Arizona Veterans Affairs Health Care System in Tucson. The City of Hope Quality of Life Model for Ostomy Patients provided a framework for the study's design, measures, data collection, and data analysis. The study's findings may be generalized broadly to community settings across the United States. Results replicate those of previous research among veterans, California members of the United Ostomy Association, Koreans with ostomies, and colorectal cancer survivors with ostomies residing in the United Kingdom. The greatest challenges reported by 178 colorectal cancer survivors with ostomies confirmed the Institute of Medicine's findings that survivorship is a distinct, chronic phase of cancer care and that cancer's effects are broad and pervasive. The challenges reported by study participants should inform the design, testing and integration of targeted education, early interventions, and ongoing support services for colorectal cancer patients with ostomies.

  1. Is a reduction in distance to nearest supermarket associated with BMI change among type 2 diabetes patients?

    Science.gov (United States)

    Zhang, Y Tara; Laraia, Barbara A; Mujahid, Mahasin S; Blanchard, Samuel D; Warton, E Margaret; Moffet, Howard H; Karter, Andrew J

    2016-07-01

    We examined whether residing within 2 miles of a new supermarket opening was longitudinally associated with a change in body mass index (BMI). We identified 12 new supermarkets that opened between 2009 and 2010 in 8 neighborhoods. Using the Kaiser Permanente Northern California Diabetes Registry, we identified members with type 2 diabetes residing continuously in any of these neighborhoods 12 months prior to the first supermarket opening until 10 months following the opening of the last supermarket. Exposure was defined as a reduction (yes/no) in travel distance to the nearest supermarket as a result of a new supermarket opening. First difference regression models were used to estimate the impact of reduced supermarket distance on BMI, adjusting for longitudinal changes in patient and neighborhood characteristics. Among patients in the exposed group, new supermarket openings reduced travel distance to the nearest supermarket by 0.7 miles on average. However, reduced distance to nearest supermarket was not associated with BMI changes. Overall, we found no evidence that reduced supermarket distance was associated with reduced levels of obesity for residents with type 2 diabetes. Published by Elsevier Ltd.

  2. PS3-21: Extracting Utilization Data from Clarity into VDW Using Oracle and SAS

    Science.gov (United States)

    Chimmula, Srivardhan

    2013-01-01

    Background/Aims The purpose of the presentation is to demonstrate how we use SAS and Oracle to load VDW_Utilization, VDW_DX, and VDW_PX tables from Clarity at the Kaiser Permanente Northern California (KPNC) Division of Research (DOR) site. Methods DOR uses the best of Oracle PL/ SQL and SAS capabilities in building Extract Transform and Load (ETL) processes. These processes extract patient encounter, diagnosis, and procedure data from Teradata-based Clarity. The data is then transformed to fit HMORN’s VDW definitions of the table. This data is then loaded into the Oracle-based VDW table on DOR’s research database and then finally a copy of the table is also created as a SAS dataset. Results DOR builds robust and efficient ETL processes that refresh VDW Utilization table on a monthly basis processing millions of records/observations. The ETL processes have the capability to identify daily changes in Clarity and update the VDW tables on a daily basis. Conclusions KPNC DOR combines the best of both Oracle and SAS worlds to build ETL processes that load the data into VDW Utilization tables efficiently.

  3. Overview of the consortium of hospitals advancing research on tobacco (chart

    Directory of Open Access Journals (Sweden)

    Riley William T

    2012-08-01

    Full Text Available Abstract Background The Consortium of Hospitals Advancing Research on Tobacco (CHART is a network of six projects and a research coordinating unit funded by the National Heart, Lung, and Blood Institute, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institutes of Health (NIH Office of Behavioral and Social Science Research. The CHART projects will assess the effectiveness and cost-effectiveness of smoking cessation interventions initiated during hospitalization and continued post-discharge. Methods/design Along with a seventh project funded previously under the NIH Challenge grants, the CHART projects will assess smoking cessation strategies delivered to approximately 10,000 hospitalized smokers across a geographically diverse group of nearly 20 private, public, academic, and community hospitals. The CHART research coordinating unit at Kaiser Permanente Center for Health Research provides organizational and data coordination support, facilitating the development of common measures for combining data from multiple CHART projects. Discussion The targeted enrollment in CHART, if achieved, will represent the largest, most diverse pooled dataset of hospitalized smokers receiving smoking cessation assistance, and is designed to contribute to the dissemination and implementation of smoking cessation interventions provided by hospital systems.

  4. Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test.

    Science.gov (United States)

    Gage, Julia C; Schiffman, Mark; Katki, Hormuzd A; Castle, Philip E; Fetterman, Barbara; Wentzensen, Nicolas; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Kinney, Walter K

    2014-08-01

    Primary human papillomavirus (HPV) testing (without concurrent Pap tests) every 3 years is under consideration in the United States as an alternative to the two recommended cervical cancer screening strategies: primary Pap testing every 3 years, or concurrent Pap and HPV testing ("cotesting") every 5 years. Using logistic regression and Weibull survival models, we estimated and compared risks of cancer and cervical intraepithelial neoplasia grade 3 or worse (CIN3+) for the three strategies among 1011092 women aged 30 to 64 years testing HPV-negative and/or Pap-negative in routine screening at Kaiser Permanente Northern California since 2003. All statistical tests were two sided. Three-year risks following an HPV-negative result were lower than 3-year risks following a Pap-negative result (CIN3+ = 0.069% vs 0.19%, P < .0001; Cancer = 0.011% vs 0.020%, P < .0001) and 5-year risks following an HPV-negative/Pap-negative cotest (CIN3+ = 0.069% vs 0.11%, P < .0001; Cancer = 0.011% vs 0.014%, P = .21). These findings suggest that primary HPV testing merits consideration as another alternative for cervical screening. © Published by Oxford University Press 2014.

  5. La difusión e interpretación del Patrimonio cultural e histórico-educativo como tema de estudio en el Centro de Formación Permanente de la Universidad de Sevilla

    Directory of Open Access Journals (Sweden)

    Pablo Álvarez Domínguez

    2010-06-01

    Full Text Available (ES Recoge este texto el resultado de una experiencia educativa organizada por el Museo Pedagógico Andaluz y desarrollada el pasado mes de mayo de 2010 en el Centro de Formación Permanente de la Universidad de Sevilla, con la finalidad de propiciar una reflexión teórico-práctica ligada a las nuevas posibilidades didácticas y de difusión del patrimonio cultural e histórico-educativo que se pueden desplegar en el ámbito museístico, con el fin de facilitar su estudio, comprensión y valoración.

  6. As equações dos estados quase-permanentes e uma visão alternativa da indução eletromagnética

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    Ferreira G. F. Leal

    2001-01-01

    Full Text Available Apresenta-se o sistema de equações que descreve consistentemente os estados quase-permanentes, campos e potenciais, abrangendo a eletrostática, a magnetostática e a lei de indução de Faraday. Mostra-se que ele é correto até a ordem de v² = c² e de wr = c² em que v e w são a velocidade e a aceleração tópicas das cargas, c a velocidade da luz e r a distância ao ponto considerado. Pode-se então obter o campo elétrico de uma carga em movimento nessa aproximação, o qual corrige o campo de Coulomb por termos dependentes da velocidade e da aceleração da carga. Mostra-se assim, como feito anteriormente por Ritz e O'Rahilly, que a indução eletromagnética pode ser atribuída à aceleração das cargas do circuito indutor, propiciando uma visão alternativa dessa interação, usualmente atribuída à variação do fluxo no interior do circuito.

  7. ["A decision meaning a new foundation...": from the Kaiser Wilhelm Institute for Anthropology, Human Genetics and Eugenics to the Max Planck Institute for Molecular Genetics].

    Science.gov (United States)

    Sachse, Carola

    2011-01-01

    The Max Planck Institute for Molecular Genetics (MPIMG) in Berlin-Dahlem dates its establishment to 1964. Its homepage makes no mention of its predecessor institutes, the Kaiser Wilhelm Institute for Anthropology, Human Genetics and Eugenics (KWIA) and the subsequent MPI for Comparative Genetics and Hereditary Pathology (MPIVEE). This article traces the two critical phases of transition regarding the constellations of academic staff, institutional and epistemic ruptures and continuities specific to the era. Only one of the five department heads from the final war years, Hans Nachtsheim, remained a researcher within the Max Planck Society (MPG); he nevertheless continued to advocate the pre-war and wartime eugenic agenda in the life sciences and social policy. The generational change of 1959/60 became a massive struggle within the institute, in which microbial genetics (with Fritz Kaudewitz) was pitted against human genetics (with Friedrich Vogel) and managed to establish itself after a fresh change in personnel in 1964/65. For the Dahlem institute, this involved a far-reaching reorientation of its research, but for the genetically oriented life sciences in the Max Planck Society as a whole it only meant that molecular biology, which was already being pursued in the West German institutes, gained an additional facility. With this realignment of research traditions, the Society was able to draw a line under the Nazi past without having to address it head-on.

  8. 78 FR 40266 - Agency Information Collection Activity Under OMB Review; Reports, Forms and Recordkeeping...

    Science.gov (United States)

    2013-07-03

    ... forwarded to the Office of Management and Budget (OMB) for review and approval. The nature of the... the U.S. Merchant Marine Academy. Form Numbers: KP2-66-DK1, KP2-67-DK2, KP3-68-DK3, KP2-69-ENG1, KP2- 70-ENG2, KP2-71-ENG3. Abstract: 46 U.S.C. 51309 authorizes the Academy to confer academic degrees. To...

  9. Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.

    Science.gov (United States)

    Steger, Florian

    2006-09-01

    During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945.

  10. Contação de história: tecnologia cuidativa na educação permanente para o envelhecimento ativo

    Directory of Open Access Journals (Sweden)

    Nadia Pinheiro da Costa

    Full Text Available RESUMO Objetivo: avaliar pertinência e efetividade da tecnologia cuidativo-educacional "contação de histórias" como estratégia no cultivo do envelhecimento ativo (EA para usuários idosos de uma Unidade Básica de Saúde (UBS, da Amazônia. Método: Pesquisa Convergente Assistencial (PCA, realizada em UBS de Belém, estado do Pará, com oito idosas para testagem da tecnologia. Aplicou-se questionário de avaliação do EA e WHOQOL - breve, avaliação de qualidade de vida. Após capacitação com vistas à educação permanente, idosas contaram histórias para uma plateia que se manifestou respondendo à pergunta: "O que você tirou dela para a sua vida?" Resultados: histórias populares contadas provocaram reações das quais emergiram as categorias: Solidariedade; Respeito ao outro; Imaginação, sonhos, esperança e Cultura do imaginário amazônida. Tal prática resultou positiva, com mudança na qualidade de vida das idosas, no domínio psicológico. Conclusão: "contação de histórias" revelou-se uma tecnologia inovadora, recurso pertinente e efetivo à educação em saúde, especialmente para o envelhecimento ativo.

  11. A nova gestão pública na Inglaterra: a permanente instabilidade da reforma neoliberal

    Directory of Open Access Journals (Sweden)

    David Hall

    2015-09-01

    Full Text Available RESUMO: A reforma da educação na Inglaterra tem sido intimamente associada a um programa mais amplo da nova gestão pública, centrado na reforma dos serviços públicos. Este artigo analisa as características deste programa de reformas inspirado na NGP, tendo em vista que o sistema educacional inglês se deslocou de uma forma cívica e de proteção social ("cívico-welfarista" para um modo em que o neoliberalismo despontou em ascendência. Atenção particular é dada tanto aos aspectos centralizadores da reforma, em que tem havido um acentuado aumento na intervenção do governo central na educação, quanto aos aspectos descentralizadores da reforma, incluindo a criação de escolas como unidades de negócios e a mercantilização da educação em termos mais gerais. As origens das reformas estão situadas em uma construção discursiva de uma crise educacional, inspirada na Nova Direita, que encontrou posterior expressão em uma série de alterações na legislação que emergiram de e cimentaram um consenso educacional trans-político-partidário que já perdura por mais de trinta anos neste contexto. Este artigo examina os efeitos dessas reformas da NGP na educação na Inglaterra, e as continuidades e descontinuidades entre as diferentes administrações políticas, considerando que a Inglaterra passou por sucessivas ondas de reformas até chegarmos a um período pós-NGP. Concluímos que a permanente instabilidade do sistema educacional inglês pode ser identificado nas tensões que atingem o próprio âmago do processo da NGP, de formas que, antecipamos, continuarão a perturbar um setor rapidamente privatizador.

  12. Effect of electrode contact area on the information content of the recorded electrogastrograms: An analysis based on Rényi entropy and Teager-Kaiser Energy

    Science.gov (United States)

    Alagumariappan, Paramasivam; Krishnamurthy, Kamalanand; Kandiah, Sundravadivelu; Ponnuswamy, Mannar Jawahar

    2017-06-01

    Electrogastrograms (EGG) are electrical signals originating from the digestive system, which are closely correlated with its mechanical activity. Electrogastrography is an efficient non-invasive method for examining the physiological and pathological states of the human digestive system. There are several factors such as fat conductivity, abdominal thickness, change in electrode surface area etc, which affects the quality of the recorded EGG signals. In this work, the effect of variations in the contact area of surface electrodes on the information content of the measured electrogastrograms is analyzed using Rényi entropy and Teager-Kaiser Energy (TKE). Two different circular cutaneous electrodes with approximate contact areas of 201.14 mm2 and 283.64 mm2, have been adopted and EGG signals were acquired using the standard three electrode protocol. Further, the information content of the measured EGG signals were analyzed using the computed values of entropy and energy. Results demonstrate that the information content of the measured EGG signals increases by 6.72% for an increase in the contact area of the surface electrode by 29.09%. Further, it was observed that the average energy increases with increase in the contact surface area. This work appears to be of high clinical significance since the accurate measurement of EGG signals without loss in its information content, is highly useful for the design of diagnostic assistance tools for automated diagnosis and mass screening of digestive disorders.

  13. Educação permanente em saúde: uma estratégia para a formação dos agentes comunitários de saúde Educación continua en materia de salud: una estrategia para la formación de agentes de salud de la comunidad Continuing health educating: a strategy for the training of community health agents

    Directory of Open Access Journals (Sweden)

    Vanessa Baliego de Andrade Barbosa

    2012-03-01

    Full Text Available Este artigo teve por objetivo descrever e analisar o processo de educação dos Agentes Comunitários da Saúde (ACS utilizado pelos enfermeiros na Estratégia Saúde da Família. Trata-se de uma pesquisa qualitativa, e contou com 17 sujeitos. Para a coleta de dados, utilizou-se entrevista semiestruturada, e a análise dos dados foi realizada por meio da técnica de análise de conteúdo. Identificou-se a categoria: organização do processo de educação nas unidades de saúde da família, cujas temáticas elencadas foram: enfermeiros como líderes da equipe de referência, educação permanente, metodologias tradicionais e educação centrada nas necessidades dos ACS. Através deste estudo, pudemos compreender que os enfermeiros têm pouco contato com a ferramenta da Educação Permanente, realizando as atividades de capacitação fundamentadas na metodologia tradicional de ensino, sendo necessário um investimento dos gestores no sentido de capacitá-los, no que se refere à educação permanente, possibilitando-lhes a atuação com os ACS.Este artículo objetivó describir y analizar el proceso de educacional de los Agentes Comunitarios de Salud (ACS, usan todo el enfermeros en la estrategia de la Salud de la Familia. Acerca de una pesquisa cualitativa, contó con 17 sujetos. Para la colección de datos, eligió-se la entrevista semi-estructurada y el análisis través la técnica del análisis del contenido .Fue identificada una categoría: la organización del proceso educacional en las unidades de la Salud de la Familia, cuyas temáticas elegidas fueron: enfermeros como líderes del equipo de referencia, educación permanente, metodologías tradicionales y educación centrada en las necesidades de los ACS. Través de este estudio pudimos comprender que los enfermeros poseen poca aproximación con la herramienta de educación permanente, realizando las actividades de capacitación de los ACS basadas en la metodología tradicional de ense

  14. Molecular characterisation of Trypanosoma rangeli strains isolated from Rhodnius ecuadoriensis in Peru, R. colombiensis in Colombia and R. pallescens in Panama, supports a co-evolutionary association between parasites and vectors.

    Science.gov (United States)

    Urrea, D A; Carranza, J C; Cuba, C A Cuba; Gurgel-Gonçalves, R; Guhl, F; Schofield, C J; Triana, O; Vallejo, G A

    2005-03-01

    We present data on the molecular characterisation of strains of Trypanosoma rangeli isolated from naturally infected Rhodnius ecuadoriensis in Peru, from Rhodnius colombiensis, Rhodnius pallescens and Rhodnius prolixus in Colombia, and from Rhodnius pallescens in Panama. Strain characterisation involved a duplex PCR with S35/S36/KP1L primers. Mini-exon gene analysis was also carried out using TrINT-1/TrINT-2 oligonucleotides. kDNA and mini-exon amplification indicated dimorphism within both DNA sequences: (i) KP1, KP2 and KP3 or (ii) KP2 and KP3 products for kDNA, and 380 bp or 340 bp products for the mini-exon. All T. rangeli strains isolated from R. prolixus presented KP1, KP2 and KP3 products with the 340 bp mini-exon product. By contrast, all T. rangeli strains isolated from R. ecuadoriensis, R. pallescens and R. colombiensis, presented profiles with KP2 and KP3 kDNA products and the 380 bp mini-exon product. Combined with other studies, these results provide evidence of co-evolution of T. rangeli strains associated with different Rhodnius species groups east and west of the Andean mountains.

  15. Value Focused Thinking Approach Using Multivariate Validation for Junior Enlisted Performance Reporting in the United States Air Force

    Science.gov (United States)

    2014-03-22

    Dataset) ...................... 102 Equation 12. Kaiser-Meyer-Olkin ( KMO ) Index Measure of Sampling Adequacy ....... 102 Equation 13. Bartlett’s Test of...was performed was the Kaiser-Meyer-Olkin (Kaiser, 1970) test. The Kaiser-Meyer- Olkin ( KMO ) test was used as an index to measure sampling adequacy. In...essence KMO is a measure of the strength of the relationship among variables (Williams et al., 2012). The KMO formula is shown in Equation 12

  16. Trypanosoma rangeli: RAPD-PCR and LSSP-PCR analyses of isolates from southeast Brazil and Colombia and their relation with KPI minicircles.

    Science.gov (United States)

    Marquez, D S; Ramírez, L E; Moreno, J; Pedrosa, A L; Lages-Silva, E

    2007-09-01

    This study presents the first genetic characterization of five Trypanosoma rangeli isolates from Minas Gerais, in the southeast of Brazil and their comparison with Colombian populations by minicircle classification, RAPD-PCR and LSSP-PCR analyses. Our results demonstrated a homogenous T. rangeli population circulating among Didelphis albiventris as reservoir host in Brazil while heterogeneous populations were found in different regions of Colombia. KP1(+) minicircles were found in 100% isolates from Brazil and in 36.4% of the Colombian samples, whereas the KP2 and KP3 minicircles were detected in both groups. RAPD-PCR and LSSP-PCR profiles revealed a polymorphism within KP1(+) and KP1(-) T. rangeli populations and allowed the division of T. rangeli in two branches. The Brazilian KP1(+) isolates were more homogenous than the KP1(+) isolates from Colombia. The RAPD-PCR were entirely consistent with the distribution of KP1 minicircles while those obtained by LSSP-PCR were associated in 88.9% and 71.4% with KP1(+) and KP1(-) populations, respectively.

  17. Utilization and costs of home-based and community-based care within a social HMO: trends over an 18-year period

    Directory of Open Access Journals (Sweden)

    Walter Leutz

    2005-10-01

    Full Text Available Purpose: Our objective was to describe the utilization and costs of services from 1985 to 2002 of a Social Health Maintenance Organization (SHMO demonstration project providing a benefit for home-based and community-based as well as short-term institutional (HCB care at Kaiser Permanente Northwest (KPNW, serving the Portland, Oregon area. The HCB care benefit was offered by KPNW as a supplement to Medicare's acute care medical benefits, which KPNW provides in an HMO model. KPNW receives a monthly per capita payment from Medicare to provide medical benefits, and Medicare beneficiaries who choose to join pay a supplemental premium that covers prescription drugs, HCB care benefits, and other services. A HCB care benefit of up to $12,000 per year in services was available to SHMO members meeting requirement for nursing home certification (NHC. Methods: We used aggregate data to track temporal changes in the period 1985 to 2002 on member eligibility, enrollment in HCB care plans, age, service utilization and co-payments. Trends in the overall costs and financing of the HCB care benefit were extracted from quarterly reports, management data, and finance data. Results: During the time period, 14,815 members enrolled in the SHMO and membership averaged 4,531. The proportion of SHMO members aged 85 or older grew from 12 to 25%; proportion meeting requirements for NHC rose from 4 to 27%; and proportion with HCB care plans rose from 4 to 18%. Costs for the HCB care benefit rose from $21 per SHMO member per month in 1985 to $95 in 2002. The HCB care costs were equivalent to 12% to 16% of Medicare reimbursement. The HCB program costs were covered by member premiums (which rose from $49 to $180 and co-payments from members with care plans. Over the 18-year period, spending shifted from nursing homes to a range of community services, e.g. personal care, homemaking, member reimbursement, lifeline, equipment, transportation, shift care, home nursing, adult day

  18. Kaempferia parviflora Extract Exhibits Anti-cancer Activity against HeLa Cervical Cancer Cells.

    Science.gov (United States)

    Potikanond, Saranyapin; Sookkhee, Siriwoot; Na Takuathung, Mingkwan; Mungkornasawakul, Pitchaya; Wikan, Nitwara; Smith, Duncan R; Nimlamool, Wutigri

    2017-01-01

    Kaempferia parviflora (KP) has been traditionally used as a folk remedy to treat several diseases including cancer, and several studies have reported cytotoxic activities of extracts of KP against a number of different cancer cell lines. However, many aspects of the molecular mechanism of action of KP remain unclear. In particular, the ability of KP to regulate cancer cell growth and survival signaling is still largely unexplored. The current study aimed to investigate the effects of KP on cell viability, cell migration, cell invasion, cell apoptosis, and on signaling pathways related to growth and survival of cervical cancer cells, HeLa. We discovered that KP reduced HeLa cell viability in a concentration-dependent manner. The potent cytotoxicity of KP against HeLa cells was associated with a dose-dependent induction of apoptotic cell death as determined by flow cytometry and observation of nuclear fragmentation. Moreover, KP-induced cell apoptosis was likely to be mediated through the intrinsic apoptosis pathway since caspase 9 and caspase 7, but not BID, were shown to be activated after KP exposure. Based on the observation that KP induced apoptosis in HeLa cell, we further investigated the effects of KP at non-cytotoxic concentrations on suppressing signal transduction pathways relevant to cell growth and survival. We found that KP suppressed the MAPK and PI3K/AKT signaling pathways in cells activated with EGF, as observed by a significant decrease in phosphorylation of ERK1/2, Elk1, PI3K, and AKT. The data suggest that KP interferes with the growth and survival of HeLa cells. Consistent with the inhibitory effect on EGF-stimulated signaling, KP potently suppressed the migration of HeLa cells. Concomitantly, KP was demonstrated to markedly inhibit HeLa cell invasion. The ability of KP in suppressing the migration and invasion of HeLa cells was associated with the suppression of matrix metalloproteinase-2 production. These data strongly suggest that KP may slow

  19. Are the different gully morphologies due to different formation processes on the Kaiser dune field on Mars?

    Science.gov (United States)

    Pasquon, K.; Gargani, J.; Nachon, M.; Conway, S. J.; Massé, M.; Jouannic, G.; Balme, M. R.; Costard, F.; Vincendon, M.

    2017-12-01

    Diverse gully morphologies are seen on Mars and differences are often neglected for simplification. Here we describe in detail the morphology and present-day activity of two gully-systems on the Kaiser dune field in the southern hemisphere of Mars. We then compare their activity with that of the morphologically distinct linear dune gullies present on the same dunes. The studied gully-systems have large depositional aprons (named "large apron gullies") and occur on dune faces oriented westward. They are active from mid-autumn to late winter (i.e. from Ls 50° to Ls 180°) coinciding with CO2 ice condensation/sublimation cycles. Sandy material collapses from the alcove flanks onto the alcove floor sporadically throughout this period. This accumulated sand is remobilized by punctuated mass flows which we estimate to be up to 7100 m3 in volume. These flows run out on to the apron and occur between Ls 120° and Ls 160°. These mass flow events occur when the number of "digitate flows" is at its seasonal maximum. Digitate flows are characterized by long-narrow zig-zagging low-albedo tracks and do not seem to transport appreciable sediment, and they can number in the hundreds. Small pits appear at their termini or midway along and sometimes these pits are re-deepened by subsequent flows. These events repeat every year and using volume balance calculations we find that the whole system could be built on a timescale of hundreds of martian ears. These large apron gullies differ in morphology and timing from the linear dune gullies. The linear dune gullies are active in late winter, or beginning of spring when the CO2 frost finally sublimates, which occurs after the activity of the large apron gullies. Due to the difference of orientation between large apron gullies and linear dune as well as timing, we infer that insolation, which may influence (i) the depth to ground ice, (ii) the amount of volatiles deposits, is the main cause their differences. Sediment transport by CO2

  20. 76 FR 33280 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2011-06-08

    ...-come, first-served basis. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, US EPA, Office of the Administrator (1101A), 1200 Pennsylvania... provide written statements to the FRRCC should be sent to Alicia Kaiser, Designated Federal Officer, at...

  1. 76 FR 59396 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2011-09-26

    ...-come, first-served basis. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, US EPA, Office of the Administrator (1101A), 1200 Pennsylvania... provide written statements to the FRRCC should be sent to Alicia Kaiser, Designated Federal Officer, at...

  2. Obtención del Valor Genético Predicho en Animales Incluyendo el Efecto del Medio Ambiente Permanente Obtención del Valor Genético Predicho en Animales Incluyendo el Efecto del Medio Ambiente Permanente

    Directory of Open Access Journals (Sweden)

    Mauricio Valencia Posadas

    2012-02-01

    Full Text Available The genetic improvement of the animals based in productive records and genealogical information, is a fundamental mechanism to increase the economic income of the commercial farms, through the estimation of the predicted breeding values (VGP’s. The VGP’s allows the identification of animals genetically superior to be used as parents of the next generation. In many parts of the world the best linear unbiased predictor procedure (MPLI is used as an animal model, for its appropriate properties, to obtain the VGP’s. In these models the permanent environment effect is usually included in order to increase the accuracy of the VGP’s. In this work a developed example is presented using supposed data to obtain VGP’s with the MPLI procedure and an animal model where the methodology, interpretation and use of the VGP’s are shown.El mejoramiento genético de los animales, con base en los registros de rendimiento e información genealógica, es un mecanismo fundamental para incrementar los rendimientos económicos de las explotaciones comerciales, a partir de la estimación de valores genéticos predichos (VGP’s. Los VGP permiten identificar a los animales genéticamente superiores de una forma objetiva, para que sean utilizados como padres de la siguiente generación. En muchas partes del mundo se utiliza el procedimiento del mejor predictor lineal insesgado (MPLI con un modelo animal por sus adecuadas propiedades para obtenerlos VGP’s. En dichos modelos se suele incluir el efecto del medio ambiente permanente con el objeto de incrementar la precisión de los VGP’s. En este trabajos e presenta un ejemplo desarrollado utilizando datos supuestos para obtener VGP’s con el procedimiento MPLI y un modelo animal, donde se muestra la metodología, interpretación y uso que tienen los VGP’s.

  3. Study of the influence of the metal partition coefficient on the human health risk evaluation, applied to Figueira (PR) soil region, using C-Soil model

    International Nuclear Information System (INIS)

    Camargo, Iara Maria Carneiro de.

    2005-01-01

    Studies of partition coefficient show that Kp values of metals can vary orders of magnitude according to the soil physical-chemistry characteristics. Therefore, the Kp is a sensible parameter in human health risk assessment model. In general, a default value is adopted by environmental agencies and often it is not represent suitably the soil studied and can cause errors in the risk calculation. The objectives of this work are: evaluate the heavy metals soil contamination around the Figueira coal-fired power plant; determine the metal Kp of As, Cd, Co, Cr, Cu, Mo, Ni, Pb and Zn in soil by the ratio between the metal concentration obtained by concentrate HNO 3 digestion and the metal concentration obtained by extraction with EDTA 0,05 mol L -1 (Kp EDTA ) or Ca(NO 3 ) 2 0,1 mol L -1 (Kp Ca(NO3)2 ); and evaluate the influence of the application of different Kp values in human health risk assessment C-Soil model in risk calculation. The main conclusions of the present study were: As, Cd, Mo, Pb e Zn were the Figueira soil metal contaminants, being As the pollutant of major human health concern; either Kp Ca(NO3)2 or Kp EDTA values could be used for human health risk calculation, in Figueira case, except for Pb, and the Kp EDTA values were preferably recommended due to the less dispersion of their values; the KpC Soil metals default values could be applied for the human health risk calculation in Figueira case, in other words, it would not have necessity to determine Kp values of region (Kp EDTA and Kp Ca(NO3)2 ), except to Pb. (author)

  4. α-Estrogen and Progesterone Receptors Modulate Kisspeptin Effects on Prolactin: Role in Estradiol-Induced Prolactin Surge in Female Rats.

    Science.gov (United States)

    Aquino, Nayara S S; Araujo-Lopes, Roberta; Henriques, Patricia C; Lopes, Felipe E F; Gusmao, Daniela O; Coimbra, Candido C; Franci, Celso R; Reis, Adelina M; Szawka, Raphael E

    2017-06-01

    Kisspeptin (Kp) regulates prolactin (PRL) in an estradiol-dependent manner. We investigated the interaction between ovarian steroid receptors and Kp in the control of PRL secretion. Intracerebroventricular injections of Kp-10 or Kp-234 were performed in ovariectomized (OVX) rats under different hormonal treatments. Kp-10 increased PRL release and decreased 3,4-dihydroxyphenylacetic acid levels in the median eminence (ME) of OVX rats treated with estradiol (OVX+E), which was prevented by tamoxifen. Whereas these effects of Kp-10 were absent in OVX rats, they were replicated in OVX rats treated with selective agonist of estrogen receptor (ER)α, propylpyrazole triol, but not of ERβ, diarylpropionitrile. Furthermore, the Kp-10-induced increase in PRL was two times higher in OVX+E rats also treated with progesterone (OVX+EP), which was associated with a reduced expression of both tyrosine hydroxylase (TH) and Ser40-phosphorylated TH in the ME. Kp-10 also reduced dopamine levels in the ME of OVX+EP rats, an effect blocked by the progesterone receptor (PR) antagonist RU486. We also determined the effect of Kp antagonism with Kp-234 on the estradiol-induced surges of PRL and luteinizing hormone (LH), using tail-tip blood sampling combined with ultrasensitive enzyme-linked immunosorbent assay. Kp-234 impaired the early phase of the PRL surge and prevented the LH surge in OVX+E rats. Thus, we provide evidence that Kp stimulation of PRL release requires ERα and is potentiated by progesterone via PR activation. Moreover, alongside its essential role in the LH surge, Kp seems to play a role in the peak phase of the estradiol-induced PRL surge. Copyright © 2017 Endocrine Society.

  5. Diversidad y carbono almacenado en el área forestal permanente de Álvaro Obregón, Calakmul, Campeche

    Directory of Open Access Journals (Sweden)

    Ligia Guadalupe Esparza Olguín

    2018-01-01

    Full Text Available El Área Forestal Permanente (AFP del ejido Álvaro Obregón en Calakmul resguarda selvas subperennifolias que han estado expuestas al manejo forestal. Dada su importancia como reservorios de carbono y biodiversidad, el objetivo de este estudio fue analizar la diversidad arbórea, la acumulación de biomasa y la captura de carbono en diferentes comunidades de dicho tipo de vegetación (selva mediana – SMSP y selva inundable - SI presentes en el AFP, las cuales están en periodo de recuperación desde hace más de 20 años. El trabajo se realizó en parcelas circulares de 1 000 m2, en donde se etiquetaron, midieron (altura y diámetro a la altura de 1.30 m, e identificaron los taxa arbóreos presentes. En las SMSP se determinó una riqueza de 90 especies, con densidades de 5 170 y 3 720 ind ha-1, con una diversidad (H intermedia (2.8 a 2.65. En las SI se identificaron 75 especies, con una densidad (5 920 a 8 630 ind ha-1, y una diversidad (H alta (3.02 a 3.06. La diversidad estructural promedio (Hsdh fue baja para SMSP y SI, con valores de carbono de 16.6 a 37.17 Mg C ha-1, en SMSP; y 36.44 a 44.58 en SI. Se concluye que las selvas subperennifolias analizadas están en recuperación, con procesos de regeneración y captura de carbono importantes para la conservación de la diversidad.

  6. Neuropeptide co-expression in hypothalamic kisspeptin neurons of laboratory animals and the human

    Directory of Open Access Journals (Sweden)

    Katalin eSkrapits

    2015-02-01

    Full Text Available Hypothalamic peptidergic neurons using kisspeptin (KP and its co-transmitters for communication are critically involved in the regulation of mammalian reproduction and puberty. This article provides an overview of neuropeptides present in KP neurons, with a focus on the human species. Immunohistochemical studies reveal that large subsets of human KP neurons synthesize neurokinin B, as also shown in laboratory species. In contrast, dynorphin described in KP neurons of rodents and sheep is found rarely in KP cells of human males and postmenopausal females. Similarly, galanin is detectable in mouse, but not human, KP cells, whereas substance P, cocaine- and amphetamine-regulated transcript and proenkephalin-derived opioids are expressed in varying subsets of KP neurons in humans, but not reported in ARC of other species. Human KP neurons do not contain neurotensin, cholecystokinin, proopiomelanocortin-derivatives, agouti-related protein, neuropeptide Y, somatostatin or tyrosine hydroxylase (dopamine. These data identify the possible co-transmitters of human KP cells. Neurochemical properties distinct from those of laboratory species indicate that humans use considerably different neurotransmitter mechanisms to regulate fertility.

  7. Whitham modulation theory for (2  +  1)-dimensional equations of Kadomtsev–Petviashvili type

    Science.gov (United States)

    Ablowitz, Mark J.; Biondini, Gino; Rumanov, Igor

    2018-05-01

    Whitham modulation theory for certain two-dimensional evolution equations of Kadomtsev–Petviashvili (KP) type is presented. Three specific examples are considered in detail: the KP equation, the two-dimensional Benjamin–Ono (2DBO) equation and a modified KP (m2KP) equation. A unified derivation is also provided. In the case of the m2KP equation, the corresponding Whitham modulation system exhibits features different from the other two. The approach presented here does not require integrability of the original evolution equation. Indeed, while the KP equation is known to be a completely integrable equation, the 2DBO equation and the m2KP equation are not known to be integrable. In each of the cases considered, the Whitham modulation system obtained consists of five first-order quasilinear partial differential equations. The Riemann problem (i.e. the analogue of the Gurevich–Pitaevskii problem) for the one-dimensional reduction of the m2KP equation is studied. For the m2KP equation, the system of modulation equations is used to analyze the linear stability of traveling wave solutions.

  8. Limites e possibilidades do ensino à distância (EaD na educação permanente em saúde: revisão integrativa

    Directory of Open Access Journals (Sweden)

    Adriane das Neves Silva

    2015-04-01

    Full Text Available Trata-se de um estudo sobre o uso do ensino a distância (EaD como uma estratégia de ensino na educação permanente em saúde (EPS, que teve como objetivo identificar e analisar os limites e possibilidades do uso da EaD na EPS. Estudo de revisão integrativa. O resultado aponta que a EaD é uma estratégia inovadora possível e potencial para a EPS, facilitando o desenvolvimento da aprendizagem dentro ou fora da instituição de saúde, porém é evidente a escassez de pesquisas na área. As limitações para a realização dos programas estão relacionadas à variável tempo, preparação para lidar com as tecnologias e importância do tutor como facilitador da aprendizagem. Conclui-se que o uso da EaD tem tido uma importante contribuição para o desenvolvimento dos recursos humanos em saúde, seja no processo de formação e/ou no processo contínuo de conhecimento.

  9. La Diputación Permanente en la Constitución de Cádiz o el intento frustrado de crear un órgano con funciones de garantía constitucional

    Directory of Open Access Journals (Sweden)

    Ángel Luis Alonso de Antonio

    2012-01-01

    Full Text Available La Diputación Permanente de la Constitución de 1812 es el órgano de continuidad parlamentaria para mantener la representación de la voluntad popular en los períodos en los que las Cortes no estuvieran trabajando en plenitud. Significó también un intento frustrado de establecer un mecanismo eficaz para garantizar el cumplimiento del propio texto constitucional y por tanto su defensa ante las violaciones por parte de otros órganos del Estado. The Permanent Delegation of the Constitution of 1812 is the parliamentary body to maintain continuity of the representation of popular will in the periods in which the courts were not working fully. It also meant an unsuccessful attempt to establish an effective mechanism to ensure compliance with the constitutional text itself and therefore its defense against violations by other state bodies.

  10. Human epidermal growth factor receptor 2 assessment in a case-control study: comparison of fluorescence in situ hybridization and quantitative reverse transcription polymerase chain reaction performed by central laboratories.

    Science.gov (United States)

    Baehner, Frederick L; Achacoso, Ninah; Maddala, Tara; Shak, Steve; Quesenberry, Charles P; Goldstein, Lynn C; Gown, Allen M; Habel, Laurel A

    2010-10-01

    The optimal method to assess human epidermal growth factor receptor 2 (HER2) status remains highly controversial. Before reporting patient HER2 results, American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines mandate that laboratories demonstrate ≥ 95% concordance to another approved laboratory or methodology. Here, we compare central laboratory HER2 assessed by fluorescence in situ hybridization (FISH) and quantitative reverse transcriptase polymerase chain reaction (RT-PCR) using Oncotype DX in lymph node-negative, chemotherapy-untreated patients from a large Kaiser Permanente case-control study. Breast cancer specimens from the Kaiser-Genomic Health study were examined. Central FISH assessment of HER2 amplification and polysomy 17 was conducted by PhenoPath Laboratories (ratios > 2.2, 1.8 to 2.2, and < 1.8 define HER2 positive, HER2 equivocal, and HER2 negative, respectively). HER2 expression by RT-PCR was conducted using Oncotype DX by Genomic Health (normalized expression units ≥ 11.5, 10.7 to < 11.5, and < 10.7 define HER2 positive, HER2 equivocal, and HER2 negative, respectively). Concordance analyses followed ASCO/CAP guidelines. HER2 concordance by central FISH and central RT-PCR was 97% (95% CI, 96% to 99%). Twelve percent (67 of 568 patients) and 11% (60 of 568 patients) of patients were HER2 positive by RT-PCR and FISH, respectively. HER2-positive patients had increased odds of dying from breast cancer compared with HER2-negative patients. Polysomy 17 was demonstrated in 12.5% of all patients and 33% of FISH-positive patients. Nineteen of 20 FISH-positive patients with polysomy 17 were also RT-PCR HER2 positive. Although not statistically significantly different, HER2-positive/polysomy 17 patients tended to have the worst prognosis, followed by HER2-positive/eusomic, HER2-negative/polysomy 17, and HER2-negative/eusomic patients. There is a high degree of concordance between central FISH and quantitative RT

  11. Comparative genome analysis of novel Podoviruses lytic for hypermucoviscous Klebsiella pneumoniae of K1, K2, and K57 capsular types.

    Science.gov (United States)

    Solovieva, Ekaterina V; Myakinina, Vera P; Kislichkina, Angelina A; Krasilnikova, Valentina M; Verevkin, Vladimir V; Mochalov, Vladimir V; Lev, Anastasia I; Fursova, Nadezhda K; Volozhantsev, Nikolay V

    2018-01-02

    Hypermucoviscous (HV) strains of capsular types K1, K2 and K57 are the most virulent representatives of the Klebsiella pneumoniae species. Eight novel bacteriophages lytic for HV K. pneumoniae were isolated and characterized. Three bacteriophages, KpV41, KpV475, and KpV71 were found to have a lytic activity against mainly K. pneumoniae of capsular type K1. Two phages, KpV74, and KpV763 were lytic for K2 capsular type K. pneumoniae, and the phage KpV767 was specific to K57-type K. pneumoniae only. Two more phages, KpV766, and KpV48 had no capsular specificity. The phage genomes consist of a linear double-stranded DNA of 40,395-44,623bp including direct terminal repeats of 180-246 bp. The G + C contents are 52.3-54.2 % that is slightly lower than that of genomes of K. pneumoniae strains being used for phage propagation. According to the genome structures, sequence similarity and phylogenetic data, the phages are classified within the genus Kp32virus and Kp34virus of subfamily Autographivirinae, family Podoviridae. In the phage genomes, genes encoding proteins with putative motifs of polysaccharide depolymerase were identified. Depolymerase genes of phages KpV71 and KpV74 lytic for hypermucoviscous K. pneumoniae of K1 and K2 capsular type, respectively, were cloned and expressed in Escherichia coli, and the recombinant gene products were purified. The specificity and polysaccharide-degrading activity of the recombinant depolymerases were demonstrated. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Inclusión educativa de alumnos con discapacidades graves y permanentes : análisis de un modelo : la Comunidad Valenciana (España = Educational inclusion of students with severe and permanent disabilities : analysis of a model : the Region of Valencia

    Directory of Open Access Journals (Sweden)

    Manuel López-Torrijo

    2014-09-01

    Full Text Available Este artículo analiza la inclusión educativa del alumnado con discapacidades graves y permanentes en la Comunidad Valenciana (España a través de los siguientes indicadores: concepción de las discapacidades graves y permanentes; responsabilidad de la escolarización y prestación de servicios; marco normativo; identificación, valoración y atención temprana; incidencia en la población; modelos y modalidades de escolarización; propuesta curricular; Centros y Unidades Específicos de Educación Especial; recursos personales y materiales; papel de las familias y financiación. Utiliza el método descriptivo en la revisión legislativa, documental, y bibliográfica, así como en el análisis de las fuentes estadísticas. Concluye señalando las mejoras inmediatas aplicables para una inclusión educativa real y de calidad.This article analyzes the educational inclusion of students with severe and permanent disabilities in the Region of Valencia with the following indicators: design of severe and permanent disabilities, regulatory framework, responsibility for providing schooling and services, identification and assessment of deficits, prevalence, proposed curriculum (model and modalities of care, special schools, human and material resources, role of families and funding. It utilizes the descriptive method in the legislative, documental and bibliographic revision, as well as in the analysis of statistical sources. The analysis concludes by pointing out the challenges that must guide future improvements to achieve a true educational equality.

  13. Prevalence of Childhood and Adolescent Overweight and Obesity from 2003 to 2010 in an Integrated Health Care Delivery System

    Directory of Open Access Journals (Sweden)

    Scott Gee

    2013-01-01

    Full Text Available An observational study of the Kaiser Permanente Northern California (KPNC BMI coding distributions was conducted to ascertain the trends in overweight and obesity prevalence among KPNC members aged 2–19 between the periods of 2003–2005 and 2009-2010. A decrease in the prevalence of overweight (−11.1% change and obesity (−3.6% change and an increase in the prevalence of healthy weight (+2.7% change were demonstrated. Children aged 2–5 had the greatest improvement in obesity prevalence (−11.5% change. Adolescents aged 12–19 were the only age group to not show a decrease in obesity prevalence. Of the racial and ethnic groups, Hispanics/Latinos had the highest prevalence of obesity across all age groups. The KPNC prevalence of overweight and obesity compares favorably to external benchmarks, although differences in methodologies limit our ability to draw conclusions. Physician counseling as well as weight management programs and sociodemographic factors may have contributed to the overall improvements in BMI in the KPNC population. Physician training, practice tools, automated BMI reminders and performance feedback improved the frequency and quality of physician counseling. BMI screening and counseling at urgent visits, in addition to well-child care visits, increased the reach and dose of physician counseling.

  14. Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system.

    Science.gov (United States)

    Keegan, Theresa H M; Kurian, Allison W; Gali, Kathleen; Tao, Li; Lichtensztajn, Daphne Y; Hershman, Dawn L; Habel, Laurel A; Caan, Bette J; Gomez, Scarlett L

    2015-05-01

    We examined the combined influence of race/ethnicity and neighborhood socioeconomic status (SES) on short-term survival among women with uniform access to health care and treatment. Using electronic medical records data from Kaiser Permanente Northern California linked to data from the California Cancer Registry, we included 6262 women newly diagnosed with invasive breast cancer. We analyzed survival using multivariable Cox proportional hazards regression with follow-up through 2010. After consideration of tumor stage, subtype, comorbidity, and type of treatment received, non-Hispanic White women living in low-SES neighborhoods (hazard ratio [HR] = 1.28; 95% confidence interval [CI] = 1.07, 1.52) and African Americans regardless of neighborhood SES (high SES: HR = 1.44; 95% CI = 1.01, 2.07; low SES: HR = 1.88; 95% CI = 1.42, 2.50) had worse overall survival than did non-Hispanic White women living in high-SES neighborhoods. Results were similar for breast cancer-specific survival, except that African Americans and non-Hispanic Whites living in high-SES neighborhoods had similar survival. Strategies to address the underlying factors that may influence treatment intensity and adherence, such as comorbidities and logistical barriers, should be targeted at low-SES non-Hispanic White and all African American patients.

  15. Shared familial transmission of autism spectrum and attention-deficit/hyperactivity disorders.

    Science.gov (United States)

    Musser, Erica D; Hawkey, Elizabeth; Kachan-Liu, Svetlana S; Lees, Paul; Roullet, Jean-Baptiste; Goddard, Katrina; Steiner, Robert D; Nigg, Joel T

    2014-07-01

    To determine whether familial transmission is shared between autism spectrum disorders and attention-deficit/hyperactivity disorder, we assessed the prevalence, rates of comorbidity, and familial transmission of both disorders in a large population-based sample of children during a recent 7 year period. Study participants included all children born to parents with the Kaiser Permanente Northwest (KPNW) Health Plan between 1 January 1998 and 31 December 2004 (n = 35,073). Children and mothers with physician-identified autism spectrum disorders (ASD) and/or attention-deficit/hyperactivity disorder (ADHD) were identified via electronic medical records maintained for all KPNW members. Among children aged 6-12 years, prevalence was 2.0% for ADHD and 0.8% for ASD; within those groups, 0.2% of the full sample (19% of the ASD sample and 9.6% of the ADHD sample) had co-occurring ASD and ADHD, when all children were included. When mothers had a diagnosis of ADHD, first born offspring were at 6-fold risk of ADHD alone (OR = 5.02, p disorders shares familial transmission with ADHD. ADHD and ASD have a partially overlapping diathesis. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

  16. Patient attitudes about the clinical use of placebo: qualitative perspectives from a telephone survey.

    Science.gov (United States)

    Ortiz, Robin; Chandros Hull, Sara; Colloca, Luana

    2016-04-04

    To examine qualitative responses regarding the use of placebo treatments in medical care in a sample of US patients.Survey studies suggest a deliberate clinical use of placebos by physicians, and prior research has found that although most US patients find placebo use acceptable, the rationale for these beliefs is largely unknown. Members of the Outpatient Clinic at the Kaiser Permanente Northern California interviewed research participants who had been seen for a chronic health problem at least once in the prior 6 months. 853 women (61%) and men, white (58%) and non-white participants aged 18-75 years. Qualitative responses on perceptions of placebo use from one-time telephone surveys were analysed for common themes and associations with demographic variables. Prior results indicated that a majority of respondents felt it acceptable for doctors to recommend placebo treatments. Our study found that a lack of harm (n=291, 46.1%) and potential benefit (n=250, 39.6%) were the most common themes to justify acceptability of placebo use. Responses citing potential benefit were associated with higher education (r=0.787; pright to know and power of the mind. Older age was associated with likelihood to cite overall physician, as opposed to treatment, related themes (r=0.753; prights-and-licensing/

  17. Creativity and Innovation in Health Care: Tapping Into Organizational Enablers Through Human-Centered Design.

    Science.gov (United States)

    Zuber, Christi Dining; Moody, Louise

    There is an increasing drive in health care for creativity and innovation to tackle key health challenges, improve quality and access, and reduce harm and costs. Human-centered design (HCD) is a potential approach to achieving organizational innovation. However, research suggests the nursing workforce feels unsupported to take the risks needed for innovation, and leaders may not understand the conditions required to fully support them. The aim of this study was to identify enabling conditions that support frontline nurses in their attempts to behave as champions of innovation and change. An HCD workshop was undertaken with 125 nurses employed in clinical practice at Kaiser Permanente. The workshop included empathy mapping and semistructured questions that probed participant experiences with innovation and change. The data were collated and thematic analysis undertaken through a Grounded Theory approach. The data were analyzed to identify key enabling conditions. Seven enablers emerged: personal need for a solution; challenges that have meaningful purpose; clarity of goal and control of resources; active experimentation; experiences indicating progress; positive encouragement and confidence; and provision of psychological safety. These enablers were then translated into pragmatic guidelines for leaders on how the tools of HCD may be leveraged for innovation and change in health care.

  18. Integrated delivery systems: the cure for fragmentation.

    Science.gov (United States)

    Enthoven, Alain C

    2009-12-01

    Our healthcare system is fragmented, with a misalignment of incentives, or lack of coordination, that spawns inefficient allocation of resources. Fragmentation adversely impacts quality, cost, and outcomes. Eliminating waste from unnecessary, unsafe care is crucial for improving quality and reducing costs--and making the system financially sustainable. Many believe this can be achieved through greater integration of healthcare delivery, more specifically via integrated delivery systems (IDSs). An IDS is an organized, coordinated, and collaborative network that links various healthcare providers to provide a coordinated, vertical continuum of services to a particular patient population or community. It is also accountable, both clinically and fiscally, for the clinical outcomes and health status of the population or community served, and has systems in place to manage and improve them. The marketplace already contains numerous styles and degrees of integration, ranging from Kaiser Permanente-style full integration, to more loosely organized individual practice associations, to public-private partnerships. Evidence suggests that IDSs can improve healthcare quality, improve outcomes, and reduce costs--especially for patients with complex needs--if properly implemented and coordinated. No single approach or public policy will fix the fragmented healthcare system, but IDSs represent an important step in the right direction.

  19. Prevalence of migraine in a diverse community--electronic methods for migraine ascertainment in a large integrated health plan.

    Science.gov (United States)

    Pressman, Alice; Jacobson, Alice; Eguilos, Roderick; Gelfand, Amy; Huynh, Cynthia; Hamilton, Luisa; Avins, Andrew; Bakshi, Nandini; Merikangas, Kathleen

    2016-04-01

    The growing availability of electronic health data provides an opportunity to ascertain diagnosis-specific cases via systematic methods for sample recruitment for clinical research and health services evaluation. We developed and implemented a migraine probability algorithm (MPA) to identify migraine from electronic health records (EHR) in an integrated health plan. We identified all migraine outpatient diagnoses and all migraine-specific prescriptions for a five-year period (April 2008-March 2013) from the Kaiser Permanente, Northern California (KPNC) EHR. We developed and evaluated the MPA in two independent samples, and derived prevalence estimates of medically-ascertained migraine in KPNC by age, sex, and race. The period prevalence of medically-ascertained migraine among KPNC adults during April 2008-March 2013 was 10.3% (women: 15.5%, men: 4.5%). Estimates peaked with age in women but remained flat for men. Prevalence among Asians was half that of whites. We demonstrate the feasibility of an EHR-based algorithm to identify cases of diagnosed migraine and determine that prevalence patterns by our methods yield results comparable to aggregate estimates of treated migraine based on direct interviews in population-based samples. This inexpensive, easily applied EHR-based algorithm provides a new opportunity for monitoring changes in migraine prevalence and identifying potential participants for research studies. © International Headache Society 2015.

  20. Endodoncia regenerativa: utilización de fibrina rica en plaquetas autóloga en dientes permanentes vitales con patología pulpar. Revisión narrativa de la literatura*

    Directory of Open Access Journals (Sweden)

    Tatiana Ramírez Giraldo

    2014-01-01

    Full Text Available Actualmente una de las mayores controversias en el tratamiento de dientes permanentes con diagnóstico de pulpitis está en la decisión de realizar una Terapia Pulpar Vital (TPV o un tratamiento convencional de conductos. Diferentes estudios han reportado que se pueden obtener resultados previsibles mediante la realización de una TPV. El éxito del tratamiento dependerá de una adecuada comprensión de la  biología pulpar, un estricto protocolo de tratamiento y una adecuada selección del caso. Con este fin, diferentes materiales han sido sugeridos. Recientemente se ha utilizado la Fibrina Rica en Plaquetas, biomaterial que cumple con propiedades biológicas para lograr una mayor rapidez y adecuada cicatrizacion del tejido. Es necesario desarrollar tratamientos dirigidos a preservar la vitalidad de la pulpa, evitando recurrir como primera opción al tratamiento convencional de conductos, teniendo como objetivo conservar o regenerar el complejo dentino pulpar.

  1. Endodoncia regenerativa: utilización de fibrina rica en plaquetas autóloga en dientes permanentes vitales con patología pulpar. Revisión narrativa de la literatura*

    Directory of Open Access Journals (Sweden)

    Tatiana Ramírez Giraldo

    2014-07-01

    Full Text Available Actualmente una de las mayores controversias en el tratamiento de dientes permanentes con diagnóstico de pulpitis está en la decisión de realizar una Terapia Pulpar Vital (TPV o un tratamiento convencional de conductos. Diferentes estudios han reportado que se pueden obtener resultados previsibles mediante la realización de una TPV. El éxito del tratamiento dependerá de una adecuada comprensión de la  biología pulpar, un estricto protocolo de tratamiento y una adecuada selección del caso. Con este fin, diferentes materiales han sido sugeridos. Recientemente se ha utilizado la Fibrina Rica en Plaquetas, biomaterial que cumple con propiedades biológicas para lograr una mayor rapidez y adecuada cicatrizacion del tejido. Es necesario desarrollar tratamientos dirigidos a preservar la vitalidad de la pulpa, evitando recurrir como primera opción al tratamiento convencional de conductos, teniendo como objetivo conservar o regenerar el complejo dentino pulpar.

  2. Transgressões no campo da Ciência da Informação: abordagens de uma prática científica em permanente constituição

    Directory of Open Access Journals (Sweden)

    Meri Nadia Marques Gerlin

    2017-04-01

    Full Text Available O estudo apresenta conceitos ligados à disciplinaridade no campo da Ciência da Informação, assim como, inicia uma discussão em torno da natureza interdisciplinar dessa ciência atravessada pela transgressão metodológica. Reflete sobre a capacidade de interação com outras disciplinas que a atravessam, buscando, com isso, obter soluções de problemas perante a composição de seu objeto: a informação. Para tanto, dialoga-se com autores como Le Coadic, Bicalho e Oliveira, Francelin, Japiassú, Marques, Morin, Pinheiro, Tálamo e Smit. Considera-se que compreender como se deram as transgressões disciplinares no campo da Ciência da Informação torna-se condição essencial para dar conta de pensar a relação inter, multi e, principalmente, transdisciplinar necessária à manutenção de uma prática científica em permanente constituição.

  3. Percutaneous Absorption and Metabolism of Ketoprofen Isopropyl Ester via Excised Nude Mouse‘s and Monkey’s Skin

    Institute of Scientific and Technical Information of China (English)

    ZHUQuan-gang; HUJin-hong

    2003-01-01

    Aim:To study percutaneous absorption and metabolism of ketoprofen isopropyl ester (KPE)via excised nude mouse's and monkey's skin.Methods:Excised skin was prepared by surgical excision and enzyme digestion.Sideby-side diffusion cells were used for in vitro permeation studies.The concentrations of KPE and its metabolite in samples were assayed by HPLC.Results:All KPE penetration through whole thickness skin and stripped skin was metabolized to ketoprofen(KP).the concentration of which in the reciiver solution increased linearly with time.As to the nude mouse skin.the steady-state flux of KP through whole thickness skin was 2.5 times that of KPE through the whloe thickness skin,but the KP and KPE remaining in the whole thickness skin after the finishing of KPE penetration was 22.2 times in compered with the KP remaining in the whole thickness skin after the finshing of KP penetration.The rate of formation of the steady state KP from KPE throught dermis was significantly lower than that of KPE through the whole thickness skin.In he monkey skin,the rate of formation of the steady-state KP from KPE through the whole thickness skin was 0.7 times that from KPE through stripped skin.The KP and KPE remaining in the whole thickness skin after the finishing of KPE penetration was 2.0 time that in the stripped skin after the finishing of KPE penetration.The rate of fornation of the steady-state KP from KPE through dermis was lower than that from KPE through the whole thickness skin and the stripped skin.the KP remaining in dermis after the finsihing of KPE penetration was also significantly lower than the KP remaining in the whole thickness skin and the stripped skin after the finishing of KPE penetration.Conclusion:KP esters are of benefit to imporove the local action of KP.and skin esterase metabolism mainly develops in the epidermis.

  4. Sensibilidad de diferentes especies de Rhodnius (Hemiptera, Reduviidae, Triatominae a una cepa brasileña de Trypanosoma rangeli (SC58/KP1-

    Directory of Open Access Journals (Sweden)

    Daniella Barreto-Santana

    2015-03-01

    Materiales y métodos. Se seleccionaron treinta ninfas de cada especie después de xenodiagnóstico artificial en sangre infectada con T. rangeli. Se examinaron periódicamente muestras de heces y hemolinfa. Los insectos con hemolinfas infectadas fueron alimentados en ratones a fin de comprobar la transmisión por picadura y posteriormente disecados para confirmar la infección de las glándulas salivales. Resultados. En Rhodnius pictipes se encontró un mayor porcentaje de infección intestinal que en las otras especies. Se detectaron epimastigotes y tripomastigotes en la hemolinfa de las cuatro especies, y se encontró que el parasitismo fue menor en las especies del linaje R. robustus. Rhodnius robustus y R. neglectus no transmitían T. rangeli a ratones por picadura: después de la disección, sus glándulas no estaban infectadas. Solo un espécimen de R. nasutus y dos de R. pictipes transmitieron el parásito por la picadura. La tasa de infección glandular fue de 16 % para R. pictipes y de 4 % para R. nasutus. Conclusiones. La capacidad infecciosa (hemolinfática, intestinal y glandular y la transmisión de T. rangeli (SC-58/KP1- fueron mayores y más eficientes en R. pictipes. Estos resultados refuerzan la hipótesis de que estos triatominos actúan como filtros biológicos en la transmisión de T. rangeli.

  5. Stability of Modified K-dV soliton in plasma with negative ion

    International Nuclear Information System (INIS)

    Matsukawa, Michiaki; Watanabe, Shinsuke

    1988-01-01

    The K-P and Modified K-P equations for ion acoustic wave are derived from the fluid equations for plasma with negative ion. At the critical density of the negative ion where the nonlinearity of the K-P equation vanishes, the ion acoustic soliton is described by the Modified K-P equation. The stability of Modified K-dV soliton against bending are investigated by using the Modified K-P equation. It is found that the soliton is stable, independent of the sign of amplitude. (author)

  6. Sebaceous Gland, Hair Shaft, and Epidermal Barrier Abnormalities in Keratosis Pilaris with and without Filaggrin Deficiency

    Science.gov (United States)

    Gruber, Robert; Sugarman, Jeffrey L.; Crumrine, Debra; Hupe, Melanie; Mauro, Theodora M.; Mauldin, Elizabeth A.; Thyssen, Jacob P.; Brandner, Johanna M.; Hennies, Hans-Christian; Schmuth, Matthias; Elias, Peter M.

    2016-01-01

    Although keratosis pilaris (KP) is common, its etiopathogenesis remains unknown. KP is associated clinically with ichthyosis vulgaris and atopic dermatitis and molecular genetically with filaggrin-null mutations. In 20 KP patients and 20 matched controls, we assessed the filaggrin and claudin 1 genotypes, the phenotypes by dermatoscopy, and the morphology by light and transmission electron microscopy. Thirty-five percent of KP patients displayed filaggrin mutations, demonstrating that filaggrin mutations only partially account for the KP phenotype. Major histologic and dermatoscopic findings of KP were hyperkeratosis, hypergranulosis, mild T helper cell type 1-dominant lymphocytic inflammation, plugging of follicular orifices, striking absence of sebaceous glands, and hair shaft abnormalities in KP lesions but not in unaffected skin sites. Changes in barrier function and abnormal paracellular permeability were found in both interfollicular and follicular stratum corneum of lesional KP, which correlated ultrastructurally with impaired extracellular lamellar bilayer maturation and organization. All these features were independent of filaggrin genotype. Moreover, ultrastructure of corneodesmosomes and tight junctions appeared normal, immunohistochemistry for claudin 1 showed no reduction in protein amounts, and molecular analysis of claudin 1 was unremarkable. Our findings suggest that absence of sebaceous glands is an early step in KP pathogenesis, resulting in downstream hair shaft and epithelial barrier abnormalities. PMID:25660180

  7. Twice-weekly administration of kisspeptin-54 for 8 weeks stimulates release of reproductive hormones in women with hypothalamic amenorrhea.

    Science.gov (United States)

    Jayasena, C N; Nijher, G M K; Abbara, A; Murphy, K G; Lim, A; Patel, D; Mehta, A; Todd, C; Donaldson, M; Trew, G H; Ghatei, M A; Bloom, S R; Dhillo, W S

    2010-12-01

    Kisspeptin is a novel therapeutic target for infertility. A single kisspeptin-54 (KP-54) injection acutely stimulates the release of reproductive hormones in women with hypothalamic amenorrhea (HA), a commonly occurring condition characterized by absence of menstruation; however, twice-daily administration of KP-54 results in tachyphylaxis. We determined the time course of desensitization to twice-daily KP-54 injections, compared the effects of twice-daily and twice-weekly administration regimens of KP-54, and studied the effects of long-term twice-weekly administration of KP-54 on the release of reproductive hormones in women with HA. When KP-54 was administered twice daily, responsiveness to luteinizing hormone (LH) diminished gradually, whereas responsiveness to follicle-stimulating hormone (FSH) was nearly abolished by day 2. Twice-weekly KP-54 administration resulted in only partial desensitization, in contrast to the complete tolerance achieved with twice-daily administration. Women with HA who were treated with twice-weekly KP-54 injections had significantly elevated levels of reproductive hormones after 8 weeks as compared with treatment with saline. No adverse effects were observed. This study provides novel pharmacological data on the effects of KP-54 on the release of reproductive hormones in women with HA.

  8. A gestão urbana e ocupação em áreas de preservação permanente na cidade de Guarapuava (PR: o caso do arroio do Carro Quebrado / Management in urban areas and occupation of permanent preservation areas in the city of Guarapuava (PR: the case of the

    Directory of Open Access Journals (Sweden)

    Nilmar Pussinini

    2011-04-01

    Full Text Available Na cidade, o capitalismo se reproduz de forma muito dinâmica. É nela, que o ambiente, antes natural, torna-se cada vez mais artificial, ou seja, ambiente construído. Com isso, cada vez mais o relevo e os rios são cobertos pelas edificações. Neste contexto, falar de áreas de preservação permanente nas cidades correlacionando-as com as políticas públicas que gerenciam e gestam as cidades, bem como o processo de produção e reprodução do espaço urbano é algo complexo, pois envolve muitos interesses, principalmente dos agentes que o produzem. Neste contexto o trabalho visa discutir as condições socioambientais das áreas de preservação permanente na cidade. As áreas de preservação permanente são preocupações da temática ambiental relacionadas à sociedade e ao ambiente. Preservá-las é uma preocupação social, que envolve a discussão de conceitos como a natureza, preservação, e qualidade de vida no meio ambiente urbano. Através de imagens de satélite, fotografias aéreas e dados coletados, diretamente no campo, buscamos localizar e espacializar as informações, de forma a obter uma visão de conjunto da distribuição do curso hídrico estudado, juntamente com as condições das áreas ao seu em torno que, a priori, deveriam ser destinadas à preservação permanente. Em Guarapuava, há uma importante rede de drenagem, contudo, os rios urbanos estão praticamente todos canalizados, e aqueles que ainda preservam seu curso original, estão degradados pelo lançamento de esgoto e assoreamento. Pensar condições e formas de planejamento e de gestão pública voltados para a conservação dessas áreas que a priori seriam de preservação, é um caminho para a recuperação dos cursos hídricos que ainda resistem à expansão da cidade. AbstractIn the urban area, capitalism increases really dinamically, it is in this place that the natural environment becomes more and more artificial, that is, a built environment. Thus

  9. The Army Learning Organisation Questionnaire: Developing a Valid and Reliable Measure of Learning Organisation Characteristics

    Science.gov (United States)

    2014-07-01

    FIML Full Information Maximum Likelihood KMO Kaiser-Meyer-Oklin LEQ Learning Environment Questionnaire LO Learning Organisation LOS Learning...adequacy of the correlations’ magnitude was initially tested by using Kaiser-Meyer-Oklin ( KMO ) (Kaiser, 1974) and Bartlett’s test of sphericity (see...Table 4). Table 4: EFA assumption testing of ALOQ: Adequacy of correlation strength Assumption tests 44 item set* 21 item set KMO measure of

  10. Invasive infection caused by Klebsiella pneumoniae is a disease affecting patients with high comorbidity and associated with high long-term mortality

    Science.gov (United States)

    Nauclér, P.; Kalin, M.; Giske, C. G.

    2018-01-01

    Klebsiella pneumoniae (KP) is after Escherichia coli (EC) the most common gram-negative species causing invasive infections. Herein, we analyzed risk factors and prognosis in invasive infections caused by KP versus EC, in an area with low antimicrobial resistance. Moreover, we compared antimicrobial resistance and relative prevalence of KP and EC (KP/EC-ratio) in different European countries, using EARS-Net data. Adult patients admitted to Karolinska University Hospital 2006–2012 with invasive infection caused by KP (n = 599) were matched regarding sex and age with patients infected by EC. The medical records were retrospectively reviewed. Comorbidity was adjusted for with multivariable analysis. European data were retrieved from the EARS-Net database. No differences were observed in 7- and 30-day mortality between the groups. The 90-day mortality was significantly higher in the KP cohort (26% versus 17%, pKarolinska University Hospital compared to aggregate data from 20 EARS-Net countries could be related to absence of clonal spread of multidrug-resistant KP. PMID:29624618

  11. Las redes sociales en los procesos de adaptación a cambios permanentes de hábitat* Un estudio con habitantes de la Depresión Momposina (Norte de Colombia

    Directory of Open Access Journals (Sweden)

    Gabriel Garrido Escudero

    2001-01-01

    Full Text Available En este artículo se describen las redes sociales durante los procesos de adaptación a los permanentes cambios que viven los pobladores de la Depresión Momposina en La Travesía, corregimiento de Mompox (Colombia. La información se recogió en una muestra de 262 personas, mediante la triangulación se compararon los resultados cuantitativos y los cuantitativos y se contrastó la información desde diversas estrategias para describir de mejor forma los fenómenos estudiados. Con base en lo encontrado se observa que las redes continúan teniendo funcionalidad y un alto grado de intensidad cuando los pobladores se desplazan de un lugar a otro, debido a la cercanía física, a la cercanía económica y a la cercanía emocional existente, lo cual hace patente la importancia de las redes como potenciadoras de desarrollo social en el contexto de la cultura anfibia.

  12. Functionality of kumquat (Fortunella margarita) in the production of fruity ice cream.

    Science.gov (United States)

    Çakmakçı, Songül; Topdaş, Elif Feyza; Çakır, Yusuf; Kalın, Pınar

    2016-03-30

    The aim of this study was to investigate the effect of kumquat (Fortunella margarita) on the quality characteristics of ice cream. Kumquat paste (KP) was added to an ice cream mix at four concentrations, 0 (control), 5, 10 and 15% (w/w), for ice cream production. The increment of KP level caused an increase in acidity, vitamin C content, b* value and overrun value compared with the control ice cream. The apparent viscosity of samples decreased with the addition of KP at concentrations of 5 and 10% compared with the control. Results indicated that lyophilized water extract of KP (LKE) contained remarkable phenolic compounds. It was observed that LKE exhibited moderate in vitro antioxidant capacity. KP enhanced the color, flavor, vitamin C content and Mg and K contents of the ice cream. The addition of KP positively affected the sensory properties. KP may be used as a suitable source of natural color and flavor agent in ice cream production. KP enhanced the vitamin C content and Mg and K contents of ice cream and improved its sensory properties. © 2015 Society of Chemical Industry.

  13. Perspectivas de las Tecnologías de la Información y las Comunicaciones en la formación permanente del profesorado universitario

    Directory of Open Access Journals (Sweden)

    Dr. C. Oscar Antonio Martínez Molina

    2018-02-01

    Full Text Available El acelerado avance científico y tecnológico pasa por el ámbito educativo haciendo que asuma nuevos retos de elevación del nivel educativo. Las Tecnologías de la Información y las Comunicaciones en la educación proporcionan potencia, fortalecimiento y transformación en el quehacer educativo, al momento que incrementa, en la práctica docente, la calidad del servicio. En el presente artículo se exponen las herramientas tecnológicas en el uso de las TIC en la formación permanente del profesorado universitario, haciéndose una adecuada utilización de las Tecnologías de la Información y las Comunicaciones lo que marcará gran impacto en la organización, desarrollo y productos en el proceso de enseñanza-aprendizaje si se tiene en cuenta que las nuevas tecnologías de la información y de la comunicación han evolucionado espectacularmente en los últimos años, debido especialmente a su capacidad de interconexión a través de la Red. Esta nueva fase de desarrollo va a tener gran impacto en la organización de la enseñanza y el proceso de aprendizaje

  14. Dispersive solitary wave solutions of Kadomtsev-Petviashvili and modified Kadomtsev-Petviashvili dynamical equations in unmagnetized dust plasma

    Science.gov (United States)

    Seadawy, A. R.; El-Rashidy, K.

    2018-03-01

    The Kadomtsev-Petviashvili (KP) and modified KP equations are two of the most universal models in nonlinear wave theory, which arises as a reduction of system with quadratic nonlinearity which admit weakly dispersive waves. The generalized extended tanh method and the F-expansion method are used to derive exact solitary waves solutions of KP and modified KP equations. The region of solutions are displayed graphically.

  15. Papular, profuse, and precocious keratosis pilaris.

    Science.gov (United States)

    Castela, Emeline; Chiaverini, Christine; Boralevi, Franck; Hugues, Rosalind; Lacour, Jean Philippe

    2012-01-01

    Keratosis pilaris (KP) is a frequent and benign condition in children characterized by the presence of rough, follicular papules and varying degrees of erythema. Different variants have been described, including simple KP and red KP. Between September 2007 and October 2010, 11 children with profuse and precocious KP seen at the department of pediatric dermatology were included. They defined an underemphasized clinical variant of childhood KP: the papular, profuse, and precocious KP characterized by early age of onset (<18 mos), extensive involvement of the limbs and cheeks, and papular nature of lesions. No clinical association has been found. The main complication was episodes of folliculitis. Diagnosis was delayed for all patients. Treatment is difficult, but association between emollient and keratolytic agents can provide some help. © 2011 Wiley Periodicals, Inc.

  16. An Analysis of Turnover Intentions: A Reexamination of Air Force Civil Engineering Company Grade Officers

    Science.gov (United States)

    2012-03-01

    edu 75 Appendix C Factor Analysis of Measurement Items Interrole conflict Factor Analysis (FA): Table: KMO and Bartlett’s Test Kaiser-Meyer...Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. 77 POS FA: Table: KMO and Bartlett’s...Tempo FA: Table: KMO and Bartlett’s Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy. .733 Bartlett’s Test of Sphericity Approx. Chi-Square

  17. Educação Permanente em SBV e SAVC: impacto no conhecimento dos profissionais de enfermagem Educación permanente en SBV y SAV: impacto en el conocimiento de los profesionales de enfermería Permanent Education in BLS and ACLS: impact on the knowledge of nursing professionals

    Directory of Open Access Journals (Sweden)

    Sandro Gonçalves de Lima

    2009-12-01

    Full Text Available FUNDAMENTO: O conhecimento teórico e as habilidades práticas das equipes de Suporte Básico de Vida (SBV e Suporte Avançado de Vida (SAV estão entre os determinantes mais importantes das taxas de sucesso em reanimação cardiopulmonar. OBJETIVO: Avaliar o impacto de um programa permanente de treinamento em SBV e SAV no conhecimento dos profissionais de enfermagem. MÉTODO: Estudo de corte transversal. A população foi composta por profissionais de enfermagem de um hospital de nível terciário. Foram realizadas avaliações antes e após o treinamento. Abordaram-se pontos críticos das diretrizes do International Liaison Committee on Resuscitation (ILCOR. RESULTADOS: Foram avaliados 213 profissionais (76 enfermeiros, 35,7%; 38 auxiliares, 17,8%; e 99 técnicos, 46,7%. As médias na avaliação pré-curso foram estatisticamente diferentes (pFUNDAMENTO: El conocimiento teórico y las habilidades prácticas de los equipos de Soporte Básico de Vida (SBV y Soporte Avanzado de Vida (SAV están entre los determinantes más importantes de los índices de éxito en reanimación cardiopulmonar. OBJETIVO: Evaluar el impacto de un programa permanente de entrenamiento en SBV y SAV en el conocimiento de los profesionales de enfermería. MÉTODO: Estudio de corte transversal. La población estaba compuesta por profesionales de enfermería de un hospital de nivel terciario. Se realizaron evaluaciones antes y después del entrenamiento. Se abordaron puntos críticos de las directrices del International Liaison Committee on Resuscitation (ILCOR. RESULTADOS: Se evaluaron 213 profesionales (76 enfermeros, 35,7%, 38 auxiliares, 17,8% y 99 técnicos, 46,7%. Los promedios en la evaluación previa al curso fueron estadísticamente diferentes (pBACKGROUND: The theoretical knowledge and practical skills of the Basic Life Support (BLS and the Advanced Life Support (ALS are among the most important determining factors of the cardiopulmonary reanimation success rates

  18. Caracterização das atividades educativas de trabalhadores de enfermagem na ótica da educação permanente

    Directory of Open Access Journals (Sweden)

    Adriana Marques da Silva

    2009-09-01

    Full Text Available Este estudo discute a reciprocidade entre práticas de saúde e educativas e objetiva caracterizar os trabalhadores deenfermagem e suas atividades educativas em região do município de São Paulo. Estudo exploratório-descritivoquantitativo, realizado em 18 serviços de saúde entre 2005/2006, cuja coleta de dados foi feita por meio de entrevistae aplicação de dois formulários. Identificou-se que 84,8% dos trabalhadores de enfermagem atuam nos hospitais epronto socorro (PS; 22,5% são enfermeiros, 15,2%, técnicos de enfermagem (TE e 62,3%, auxiliares deenfermagem (AE. Das 245 ações educativas mapeadas, 78,4% são realizadas nos hospitais e PS,predominantemente, focadas na recuperação da saúde; 46,9% estão direcionadas aos enfermeiros, 39,6% aosenfermeiros, TE e AE e 13,5%, aos TE e AE; 21,2% ações utilizam estratégias tradicionais de ensino e 15,1%, asparticipativas; 69% têm duração de 01-20h; 55,5% são realizadas fora do serviço. Apesar de predominar atividadeseducativas voltadas aos enfermeiros, orientadas para recuperação da saúde, com utilização de estratégias de ensinotradicionais, a presença de ações ancoradas no cotidiano de trabalho, remete à concepção de educação permanente eassinala possibilidades de mudança da abordagem das práticas educativas de trabalhadores na perspectiva daintegralidade da saúde e do cuidado integral de enfermagem.

  19. Variations of plasmaspheric field-aligned electron and ion densities (90-4000 km) during quiet to moderately active (Kp < 4) geomagnetic conditions

    Science.gov (United States)

    Sonwalkar, V. S.; Reddy, A.

    2017-12-01

    Variation in field-aligned electron and ion densities as a function of geomagnetic activity are important parameters in the physics of the thermosphere-ionosphere-magnetosphere coupling. Using whistler mode sounding from IMAGE, we report variations in field-aligned electron density and O+/H+ transition height (HT) during two periods (16-23 Aug 2005; 24 Sep-06 Oct 2005) when geomagnetic conditions were quiet (maximum Kp in the past 24 hours, Kpmax,24 ≤ 2) to moderately active (2 quiet time, during moderate geomagnetic activity: (1) O+/H+ transition height was roughly same; (2) electron density variations below HT showed no trend; (3) electron density above HT increased ( 10-40 %). The measured electron density is in agreement with in situ measurements from CHAMP (350 km) and DMSP (850 km) and past space borne (e. g., ISIS) measurements but the F2 peak density is a factor of 2 lower relative to that measured by ground ionosondes and that predicted by IRI-2012 empirical model. The measured transition height is consistent with OGO 4, Explorer 31, and C/NOFS measurements but is lower than that from IRI-2012. The observed variations in electron density at F2 peak are consistent with past work and are attributed to solar, geomagnetic, and meteorological causes [e. g. Risibeth and Mendillo, 2001; Forbes et al., 2000]. To the best of our knowledge, variations in field-aligned electron density above transition height at mid-latitudes during quiet to moderately active periods have not been reported in the past. Further investigation using physics based models (e. g., SAMI3) is required to explain the observed variations.

  20. Risk factors for infections due to carbapenem-resistant Klebsiella pneumoniae after open heart surgery.

    Science.gov (United States)

    Salsano, Antonio; Giacobbe, Daniele Roberto; Sportelli, Elena; Olivieri, Guido Maria; Brega, Carlotta; Di Biase, Carlo; Coppo, Erika; Marchese, Anna; Del Bono, Valerio; Viscoli, Claudio; Santini, Francesco

    2016-11-01

    Patients undergoing major surgery are at increased risk of developing infections due to resistant organisms, including carbapenem-resistant Klebsiella pneumoniae (CR-Kp). In this study, we assessed risk factors for CR-Kp infections after open heart surgery in a teaching hospital in northern Italy. A retrospective study was conducted from January to December 2014. The primary outcome measure was postoperative CR-Kp infection, defined as a time-to-event end-point. The effect of potentially related variables was assessed by univariable and multivariable analyses. Secondary end-points were in-hospital mortality and 180-day postoperative mortality. Among 553 patients undergoing open heart surgery, 32 developed CR-Kp infections (6%). In the final multivariable model, CR-Kp colonization [hazard ratio (HR) 227.45, 95% confidence intervals (CI) 67.13-1225.20, P open heart surgery. CR-Kp infection after surgery significantly affected survival. Preventing colonization is conceivably the most effective current strategy to reduce the impact of CR-Kp. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  1. Immunomodulatory pretreatment with Kalanchoe pinnata extract and its quercitrin flavonoid effectively protects mice against fatal anaphylactic shock.

    Science.gov (United States)

    Cruz, E A; Da-Silva, S A G; Muzitano, M F; Silva, P M R; Costa, S S; Rossi-Bergmann, B

    2008-12-10

    Previously, we reported the immunosuppressive action of the aqueous extract of Kalanchoe pinnata (Kp) in mice. In the present study, we report on the protective effect of Kp in fatal anaphylactic shock, likewise a Th2-driven immunopathology, and the identification of its active component. Mice daily treated with oral Kp during hypersensitization with ovalbumin were all protected against death when challenged with the allergen, as compared with the 100% mortality in the untreated group. A single intraperitoneal dose 3 h prior to challenge was partially effective. Oral protection was accompanied by a reduced production of OVA-specific IgE antibodies, reduced eosinophilia, and impaired production of the IL-5, IL-10 and TNF-alpha cytokines. In vitro, Kp prevented antigen-induced mast cell degranulation and histamine release. Oral treatment with the quercitrin flavonoid isolated from Kp prevented fatal anaphylaxis in 75% of the animals. These findings indicate that oral treatment with Kp effectively downmodulates pro-anaphylactic inducing immune responses. Protection achieved with quercitrin, although not maximal, suggests that this flavonoid is a critical component of Kp extract against this extreme allergic reaction.

  2. Integrable Hierarchies and Dispersionless Limit

    OpenAIRE

    Takasaki, Kanehisa; Takebe, Takashi

    1994-01-01

    Analogues of the KP and the Toda lattice hierarchy called dispersionless KP and Toda hierarchy are studied. Dressing operations in the dispersionless hierarchies are introduced as a canonical transformation, quantization of which is dressing operators of the ordinary KP and Toda hierarchy. An alternative construction of general solutions of the ordinary KP and Toda hierarchy is given as twistor construction which is quatization of the similar construction of solutions of dispersionless hierar...

  3. MECANISMOS DE GERAÇÃO DE ESCOAMENTO E ÁREAS HIDROLOGICAMENTE SENSÍVEIS: UMA ABORDAGEM HIDROGEOMORFOLÓGICA PARA DELIMITAÇÃO DE ÁREAS DE PRESERVAÇÃO PERMANENTE

    Directory of Open Access Journals (Sweden)

    Cesar Augusto Crovador SIEFERT

    2012-03-01

    Full Text Available Este artigo apresenta uma revisão conceitual sobre a relação entre os mecanismos de geração de escoamento e as áreas hidrologicamente sensíveis (AHS. Propõe-se a aproximação do conceito de AHSs na delimitação de áreas de preservação permanente (APPs devido à capacidade de geração de escoamento superficial por saturação destas áreas, estabelecendo assim a transferência de sedimentos e poluentes incidentes à jusante em direção aos canais. Reconhece-se a importância das AHSs como um novo paradigma na delimitação de APPs de acordo com características hidrogeomorfológicas da bacia hidrográfica. Por fim, observa-se ainda a necessidade de um aprofundamento na busca de um indicador de sensibilidade hidrológica das paisagens que possa ser utilizado em bacias hidrográficas com distintas características fisiográficas.

  4. Gas-particle partitioning of semivolatile organic compounds (SOCs) on mixtures of aerosols in a smog chamber.

    Science.gov (United States)

    Chandramouli, Bharadwaj; Jang, Myoseon; Kamens, Richard M

    2003-09-15

    The partitioning behavior of a set of diverse SOCs on two and three component mixtures of aerosols from different sources was studied using smog chamber experimental data. A set of SOCs of different compound types was introduced into a system containing a mixture of aerosols from two or more sources. Gas and particle samples were taken using a filter-filter-denuder sampling system, and a partitioning coefficient Kp was estimated using Kp = Cp/(CgTSP). Particle size distributions were measured using a differential mobility analyzer and a light scattering detector. Gas and particle samples were analyzed using GCMS. The aerosol composition in the chamber was tracked chemically using a combination of signature compounds and the organic matter mass fraction (f(om)) of the individual aerosol sources. The physical nature of the aerosol mixture in the chamber was determined using particle size distributions, and an aggregate Kp was estimated from theoretically calculated Kp on the individual sources. Model fits for Kp showed that when the mixture involved primary sources of aerosol, the aggregate Kp of the mixture could be successfully modeled as an external mixture of the Kp on the individual aerosols. There were significant differences observed for some SOCs between modeling the system as an external and as an internal mixture. However, when one of the aerosol sources was secondary, the aggregate model Kp required incorporation of the secondary aerosol products on the preexisting aerosol for adequate model fits. Modeling such a system as an external mixture grossly overpredicted the Kp of alkanes in the mixture. Indirect evidence of heterogeneous, acid-catalyzed reactions in the particle phase was also seen, leading to a significant increase in the polarity of the resulting aerosol mix and a resulting decrease in the observed Kp of alkanes in the chamber. The model was partly consistent with this decrease but could not completely explain the reduction in Kp because of

  5. Functional representations of integrable hierarchies

    International Nuclear Information System (INIS)

    Dimakis, Aristophanes; Mueller-Hoissen, Folkert

    2006-01-01

    We consider a general framework for integrable hierarchies in Lax form and derive certain universal equations from which 'functional representations' of particular hierarchies (such as KP, discrete KP, mKP, AKNS), i.e. formulations in terms of functional equations, are systematically and quite easily obtained. The formalism genuinely applies to hierarchies where the dependent variables live in a noncommutative (typically matrix) algebra. The obtained functional representations can be understood as 'noncommutative' analogues of 'Fay identities' for the KP hierarchy

  6. Crosstalks between kisspeptin neurons and somatostatin neurons are not photoperiod dependent in the ewe hypothalamus.

    Science.gov (United States)

    Dufourny, Laurence; Lomet, Didier

    2017-12-01

    Seasonal reproduction is under the control of gonadal steroid feedback, itself synchronized by day-length or photoperiod. As steroid action on GnRH neurons is mostly indirect and therefore exerted through interneurons, we looked for neuroanatomical interactions between kisspeptin (KP) neurons and somatostatin (SOM) neurons, two populations targeted by sex steroids, in three diencephalic areas involved in the central control of ovulation and/or sexual behavior: the arcuate nucleus (ARC), the preoptic area (POA) and the ventrolateral part of the ventromedial hypothalamus (VMHvl). KP is the most potent secretagogue of GnRH secretion while SOM has been shown to centrally inhibit LH pulsatile release. Notably, hypothalamic contents of these two neuropeptides vary with photoperiod in specific seasonal species. Our hypothesis is that SOM inhibits KP neuron activity and therefore indirectly modulate GnRH release and that this effect may be seasonally regulated. We used sections from ovariectomized estradiol-replaced ewes killed after photoperiodic treatment mimicking breeding or anestrus season. We performed triple immunofluorescent labeling to simultaneously detect KP, SOM and synapsin, a marker for synaptic vesicles. Sections from the POA and from the mediobasal hypothalamus were examined using a confocal microscope. Randomly selected KP or SOM neurons were observed in the POA and ARC. SOM neurons were also observed in the VMHvl. In both the ARC and POA, nearly all KP neurons presented numerous SOM contacts. SOM neurons presented KP terminals more frequently in the ARC than in the POA and VMHvl. Quantitative analysis failed to demonstrate major seasonal variations of KP and SOM interactions. Our data suggest a possible inhibitory action of SOM on all KP neurons in both photoperiodic statuses. On the other hand, the physiological significance of KP modulation of SOM neuron activity and vice versa remain to be determined. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Educação permanente de docentes: análise crítica de experiências não sistematizadas

    Directory of Open Access Journals (Sweden)

    Henriqueta Galvanin Guidio de Almeida

    Full Text Available Quando alterações curriculares abrangentes são propostas para os cursos de Medicina, como no caso da implantação de um currículo integrado, exige-se do professor a modificação de seu papel central de transmissor de conhecimentos para um papel mais cooperativo efacilitador do processo de ensino-aprendizagem, o que pode gerar insegurança, sensação de perda de poder e resistência. A capacitação formal dos docentes para suas novas funções é imperiosa para o sucesso nas mudanças. Além das ações educativas sistematizadas, atividades alternativas podem contribuir para aperfeiçoar a função docente. Este artigo analisa a experiência de docentes do curso de Medicina da Universidade Estadual de Londrina (UEL, membros das comissões de apoio ao colegiado, que desenvolveram, nos primeiros anos da implantação do currículo integrado, atividades não sistematizadas de educação permanente junto a docentes do curso. São comentadas informações a respeito: da reunião semanal realizada com os tutores; da pesquisação sobre a inserção e o desenvolvimento docente no currículo integrado; da revisão dos conteúdos dos módulos temáticos; da pesquisação com os coordenadores dos módulos temáticos; e do inquérito realizado com os preceptores de áreas do internato médico. As atividades analisadas forneceram respostas a demandas locais e contribuíram com a dinâmica de um processo de implantação que deve permanecer em contínua renovação.

  8. 77 FR 2719 - Farm, Ranch, and Rural Communities Advisory Committee; Charter Renewal

    Science.gov (United States)

    2012-01-19

    ... be directed to Alicia Kaiser, U.S. EPA, (mail code 1101-A), 1200 Pennsylvania Avenue NW., Washington, DC 20460, telephone (202) 564-7273, or kaiser.alicia@epa.gov . Dated: January 4, 2012. Lawrence...

  9. La formación permanente en competencia digital docente y la mejora de la calidad del centro educativo desde la perspectiva de los docentes: un estudio de caso

    Directory of Open Access Journals (Sweden)

    Mercè Gisbert Cervera

    2015-07-01

    Full Text Available La sociedad del s. XXI demanda sistemas educativos flexibles y con capacidad de adaptación constante, capaces de hacer frente a las necesidades formativas, en forma de competencias, propias de un ciudadano que utiliza las TIC de forma natural y habitual en su vida cotidiana. Para ello se precisa de docentes competentes digitales que puedan formar a estas nuevas generaciones de ciudadanos. La formación permanente en TIC de los maestros, además de necesaria, dado el carácter dinámico de la tecnología, es un elemento de mejora de la calidad institucional de los centros educativos. Este trabajo, realizado a partir de una investigación-acción, evidencia que el propio centro de trabajo es capaz de organizar y diseñar su plan de formación, como parte de un proceso más amplio de mejora de la calidad basado en la incorporación de las TIC. A la vez, gestiona los ejes articuladores de una estrategia formativa que facilita la transferencia de ésta a la actividad del docente y aumenta la calidad del centro como institución. 

  10. KP11 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  11. KP60 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  12. KP88 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  13. KP61 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  14. KP28 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  15. KP07 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  16. KP75 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  17. KP35 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  18. KP59 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  19. KP68 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  20. KP58 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  1. KP53 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  2. KP08 METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  3. 77 FR 8854 - Farm, Ranch, and Rural Communities Advisory Committee (FRRCC)

    Science.gov (United States)

    2012-02-15

    ... Agency by law. Inquiries may be directed to Alicia Kaiser, U.S. EPA, (mail code 1101-A), 1200 Pennsylvania Avenue NW., Washington, DC 20460, telephone (202) 564-7273, or kaiser.alicia@epa.gov . Dated...

  4. Food Insecurity in Older Adults in an Integrated Health Care System.

    Science.gov (United States)

    Steiner, John F; Stenmark, Sandra H; Sterrett, Andrew T; Paolino, Andrea R; Stiefel, Matthew; Gozansky, Wendolyn S; Zeng, Chan

    2018-05-01

    To estimate food insecurity prevalence and develop a statistical prediction model for food insecurity. Retrospective cohort study. Kaiser Permanente Colorado. Adult members who completed a pre-Medicare Annual Wellness Visit survey. Food insecurity was assessed using a single screening question. Sociodemographic and clinical characteristics from electronic health records and self-reported characteristics from the survey were used to develop the prediction model. Of 130,208 older adult members between January 2012 and December 2015, 50,097 (38.5%) completed food insecurity screening, 2,859 of whom (5.7% of respondents) reported food insecurity. The prevalence of food insecurity was 10.0% or greater among individuals who were black or Hispanic, had less than high school education, had Medicaid insurance, were extremely obese, had poor health status or quality of life, had depression or anxiety, had impairments in specific activities of daily living, had other nutritional risk factors, or were socially isolated (all pinsecurity and those without and 14.3% of individuals in the highest quintile of risk reported food insecurity. Food insecurity is prevalent even in older adults with private-sector healthcare coverage. Specific individual characteristics, and a model based on those characteristics, can identify older adults at higher risk of food insecurity. System-level interventions will be necessary to connect older adults with community-based food resources. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  5. Infants 1-90 days old hospitalized with human rhinovirus infection.

    Science.gov (United States)

    Bender, Jeffrey M; Taylor, Charla S; Cumpio, Joven; Novak, Susan M; She, Rosemary C; Steinberg, Evan A; Marlowe, Elizabeth M

    2014-09-01

    Human rhinovirus (HRV) is a common cause of respiratory illness in children. The impact of HRV infection on 1- to 90-day-old infants is unclear. We hypothesized that HRV infection would be clinically similar to respiratory syncytial virus (RSV) infection in the hospitalized infants. We conducted a retrospective study of hospitalized infants, who were 1-90 days old, with HRV or RSV within the Southern California Kaiser Permanente network over a 1-year period (August 2010 to October 2011). We identified 245 hospitalized infants who underwent respiratory virus testing. HRV was found in 52 infants (21%) compared to 79 infants (32%) with RSV (P = 0.008). Infants with HRV infection experienced longer hospital stays compared to those with RSV (median length of stay 4 days vs. 3 days, P = 0.009) and had fewer short hospital stays ≤3 days (P = 0.029). There was a trend in infants with HRV infection to be younger (P = 0.071) and have more fevers (P = 0.052). Recent advances in diagnostics allow for identification of a broad range of viral pathogens in infants. Compared to RSV, HRV was associated with longer hospital stays. Additional studies and improved, more specific testing, methods are needed to further define the effects of HRV infection in infants 1-90 days old. © 2014 Wiley Periodicals, Inc.

  6. Quadrivalent human papillomavirus vaccine uptake in adolescent boys and maternal utilization of preventive care and history of sexually transmitted infections.

    Science.gov (United States)

    Hechter, Rulin C; Chao, Chun; Sy, Lina S; Ackerson, Bradley K; Slezak, Jeff M; Sidell, Margo A; Jacobsen, Steven J

    2013-09-01

    We examined whether maternal utilization of preventive care and history of sexually transmitted infections (STIs) predicted quadrivalent human papillomavirus vaccine (HPV4) uptake among adolescent boys 1 year following the recommendation for permissive use of HPV4 for males. We linked maternal information with electronic health records of 254 489 boys aged 9 to 17 years who enrolled in Kaiser Permanente Southern California health plan from October 21, 2009, through December 21, 2010. We used multivariable Poisson regression with robust error variance to examine whether HPV4 initiation was associated with maternal uptake of influenza vaccine, Papanicolaou (Pap) screening, and history of STIs. We identified a modest but statistically significant association between initiation of HPV4 series and maternal receipt of influenza vaccine (rate ratio [RR] = 1.16; 95% confidence interval [CI] = 1.07, 1.26) and Pap screening (RR = 1.13; 95% CI = 1.01, 1.26). Boys whose mothers had a history of genital warts were more likely to initiate HPV4 (RR = 1.47; 95% CI = 0.93, 2.34), although the association did not reach statistical significance (P = .1). Maternal utilization of preventive care and history of genital warts may influence HPV4 uptake among adolescent boys. The important role of maternal health characteristics and health behaviors needs be considered in intervention efforts to increase vaccine uptake among boys.

  7. Provider Factors and Patient-Reported Healthcare Discrimination in the Diabetes Study of California (DISTANCE)

    Science.gov (United States)

    Lyles, Courtney R.; Karter, Andrew J.; Young, Bessie A.; Spigner, Clarence; Grembowski, David; Schillinger, Dean; Adler, Nancy

    2011-01-01

    Objective We examined provider-level factors and reported discrimination in the healthcare setting. Methods With data from the Diabetes Study of Northern California (DISTANCE)—a race-stratified survey of diabetes patients in Kaiser Permanente Northern California—we analyzed patient-reported racial/ethnic discrimination from providers. Primary exposures were characteristics of the primary care provider (PCP, who coordinates care in this system), including specialty/type, and patient-provider relationship variables including racial concordance. Results Subjects (n=12,151) included 20% black, 20% Latino, 23% Asian, 30% white, and 6% other patients, with 2% to 8% reporting discrimination by racial/ethnic group. Patients seeing nurse practitioners as their PCP (OR=0.09; 95% CI: 0.01–0.67), those rating their provider higher on communication (OR=0.70; 95% CI: 0.66–0.74) were less likely to report discrimination, while those with more visits (OR=1.10; 95% CI: 1.03–1.18) were more likely to report discrimination. Racial concordance was not significant once adjusting for patient race/ethnicity. Conclusions Among diverse diabetes patients in managed care, provider type and communication were significantly related to patient-reported discrimination. Practice Implications Given potential negative impacts on patient satisfaction and treatment decisions, future studies should investigate which interpersonal aspects of the provider-patient relationship reduce patient perceptions of unfair treatment. PMID:21605956

  8. [The PROPRESE trial: results of a new health care organizational model in primary care for patients with chronic coronary heart disease based on a multifactorial intervention].

    Science.gov (United States)

    Ruescas-Escolano, Esther; Orozco-Beltran, Domingo; Gaubert-Tortosa, María; Navarro-Palazón, Ana; Cordero-Fort, Alberto; Navarro-Pérez, Jorge; Carratalá-Munuera, Concepción; Pertusa-Martínez, Salvador; Soler-Bahilo, Enrique; Brotons-Muntó, Francisco; Bort-Cubero, Jose; Núñez-Martínez, Miguel A; Bertomeu-Martínez, Vicente; López-Pineda, Adriana; Gil-Guillén, Vicente F

    2014-06-01

    Comparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care. In this randomized clinical trial with a 1-year follow-up period, we recruited patients with a diagnosis of coronary heart disease (145 for the intervention group and 1461 for the control group). An organizational intervention on the patient-professional relationship (centered on the Chronic Care Model, the Stanford Expert Patient Programme and the Kaiser Permanente model) and formative strategy for professionals were carried out. The main outcomes were smoking control, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP). A multivariate analysis was performed. The characteristics of patients were: age (68.4±11.8 years), male (71.6%), having diabetes mellitus (51.3%), dyslipidemia (68.5%), arterial hypertension (76.7%), non-smokers (76.1%); LDL-C cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  9. Vitamin D-Binding Protein Polymorphisms, 25-Hydroxyvitamin D, Sunshine and Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Annette Langer-Gould

    2018-02-01

    Full Text Available Blacks have different dominant polymorphisms in the vitamin D-binding protein (DBP gene that result in higher bioavailable vitamin D than whites. This study tested whether the lack of association between 25-hydroxyvitamin D (25OHD and multiple sclerosis (MS risk in blacks and Hispanics is due to differences in these common polymorphisms (rs7041, rs4588. We recruited incident MS cases and controls (blacks 116 cases/131 controls; Hispanics 183/197; whites 247/267 from Kaiser Permanente Southern California. AA is the dominant rs7041 genotype in blacks (70.0% whereas C is the dominant allele in whites (79.0% AC/CC and Hispanics (77.1%. Higher 25OHD levels were associated with a lower risk of MS in whites who carried at least one copy of the C allele but not AA carriers. No association was found in Hispanics or blacks regardless of genotype. Higher ultraviolet radiation exposure was associated with a lower risk of MS in blacks (OR = 0.06, Hispanics and whites who carried at least one copy of the C allele but not in others. Racial/ethnic variations in bioavailable vitamin D do not explain the lack of association between 25OHD and MS in blacks and Hispanics. These findings further challenge the biological plausibility of vitamin D deficiency as causal for MS.

  10. A Survey of Parents with Children on the Autism Spectrum: Experience with Services and Treatments.

    Science.gov (United States)

    Becerra, Tracy A; Massolo, Maria L; Yau, Vincent M; Owen-Smith, Ashli A; Lynch, Frances L; Crawford, Phillip M; Pearson, Kathryn A; Pomichowski, Magdalena E; Quinn, Virginia P; Yoshida, Cathleen K; Croen, Lisa A

    2017-01-01

    Autism spectrum disorders (ASD) are lifelong neurodevelopmental disorders, and little is known about how parents address the health and psychosocial consequences of ASD. Few studies have examined use of various treatments and services in a large, diverse sample of children with ASD and their families. This paper presents methods to create an autism research resource across multiple large health delivery systems and describes services and treatments used by children with ASD and their families. Four study sites conducted a Web survey of parents of children and adolescents with ASD who were members of Kaiser Permanente. We tabulated data distributions of survey responses and calculated χ 2 statistics for differences between responders and nonresponders. The children of the 1155 respondents were racially and ethnically diverse (55% white, 6% black, 5% Asian, 9% multiracial, 24% Hispanic) and representative of the total population invited to participate with respect to child sex (83% male), child age (57% Education Programs (85%), family physician visits (78%), and occupational and speech therapy (55% and 60%, respectively). Home-based programs frequently included implementation of social skills training (44%) and behavior management (42%). Prescription medication use was high (48%). Caregivers reported disruption of personal and family routines because of problem behaviors. These survey data help to elucidate parents' experiences with health services for their children with ASD and serve as a potential resource for future research.

  11. Predictors of Bowel Function in Long-term Rectal Cancer Survivors with Anastomosis.

    Science.gov (United States)

    Alavi, Mubarika; Wendel, Christopher S; Krouse, Robert S; Temple, Larissa; Hornbrook, Mark C; Bulkley, Joanna E; McMullen, Carmit K; Grant, Marcia; Herrinton, Lisa J

    2017-11-01

    Bowel function in long-term rectal cancer survivors with anastomosis has not been characterized adequately. We hypothesized that bowel function is associated with patient, disease, and treatment characteristics. The cohort study included Kaiser Permanente members who were long-term (≥5 years) rectal cancer survivors with anastomosis. Bowel function was scored using the self-administered, 14-item Memorial Sloan-Kettering Cancer Center Bowel Function Index. Patient, cancer, and treatment variables were collected from the electronic medical chart. We used multiple regression to assess the relationship of patient- and treatment-related variables with the bowel function score. The study included 381 anastomosis patients surveyed an average 12 years after their rectal cancer surgeries. The total bowel function score averaged 53 (standard deviation, 9; range, 31-70, higher scores represent better function). Independent factors associated with worse total bowel function score included receipt of radiation therapy (yes vs. no: 5.3-unit decrement, p 6 cm: 3.2-unit decrement, p decrement, p decrement, p model explained 20% of the variation in the total bowel function score. Low tumor location, radiation therapy, temporary ostomy during initial treatment, and history of smoking were linked with decreased long-term bowel function following an anastomosis. These results should improve decision-making about surgical options.

  12. The human factor: the critical importance of effective teamwork and communication in providing safe care.

    Science.gov (United States)

    Leonard, M; Graham, S; Bonacum, D

    2004-10-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.

  13. Ten-year detection rate of brain arteriovenous malformations in a large, multiethnic, defined population.

    Science.gov (United States)

    Gabriel, Rodney A; Kim, Helen; Sidney, Stephen; McCulloch, Charles E; Singh, Vineeta; Johnston, S Claiborne; Ko, Nerissa U; Achrol, Achal S; Zaroff, Jonathan G; Young, William L

    2010-01-01

    To evaluate whether increased neuroimaging use is associated with increased brain arteriovenous malformation (BAVM) detection, we examined detection rates in the Kaiser Permanente Medical Care Program of northern California between 1995 and 2004. We reviewed medical records, radiology reports, and administrative databases to identify BAVMs, intracranial aneurysms (IAs: subarachnoid hemorrhage [SAH] and unruptured aneurysms), and other vascular malformations (OVMs: dural fistulas, cavernous malformations, Vein of Galen malformations, and venous malformations). Poisson regression (with robust standard errors) was used to test for trend. Random-effects meta-analysis generated a pooled measure of BAVM detection rate from 6 studies. We identified 401 BAVMs (197 ruptured, 204 unruptured), 570 OVMs, and 2892 IAs (2079 SAHs and 813 unruptured IAs). Detection rates per 100 000 person-years were 1.4 (95% CI, 1.3 to 1.6) for BAVMs, 2.0 (95% CI, 1.8 to 2.3) for OVMs, and 10.3 (95% CI, 9.9 to 10.7) for IAs. Neuroimaging utilization increased 12% per year during the time period (PIAs (PIAs (P4) per 100 000 person-years, without heterogeneity between studies (P=0.25). Rates for BAVMs, OVMs, and IAs in this large, multiethnic population were similar to those in other series. During 1995 to 2004, a period of increasing neuroimaging utilization, we did not observe an increased rate of detection of unruptured BAVMs, despite increased detection of unruptured IAs.

  14. Prevalence of migraine in a diverse community—electronic methods for migraine ascertainment in a large integrated health plan

    Science.gov (United States)

    Pressman, Alice; Jacobson, Alice; Eguilos, Roderick; Gelfand, Amy; Huynh, Cynthia; Hamilton, Luisa; Avins, Andrew; Bakshi, Nandini; Merikangas, Kathleen

    2016-01-01

    Introduction The growing availability of electronic health data provides an opportunity to ascertain diagnosis-specific cases via systematic methods for sample recruitment for clinical research and health services evaluation. We developed and implemented a migraine probability algorithm (MPA) to identify migraine from electronic health records (EHR) in an integrated health plan. Methods We identified all migraine outpatient diagnoses and all migraine-specific prescriptions for a five-year period (April 2008–March 2013) from the Kaiser Permanente, Northern California (KPNC) EHR. We developed and evaluated the MPA in two independent samples, and derived prevalence estimates of medically-ascertained migraine in KPNC by age, sex, and race. Results The period prevalence of medically-ascertained migraine among KPNC adults during April 2008–March 2013 was 10.3% (women: 15.5%, men: 4.5%). Estimates peaked with age in women but remained flat for men. Prevalence among Asians was half that of whites. Conclusions We demonstrate the feasibility of an EHR-based algorithm to identify cases of diagnosed migraine and determine that prevalence patterns by our methods yield results comparable to aggregate estimates of treated migraine based on direct interviews in population-based samples. This inexpensive, easily applied EHR-based algorithm provides a new opportunity for monitoring changes in migraine prevalence and identifying potential participants for research studies. PMID:26069243

  15. Distribution and seasonal variation in hypothalamic RF-amide peptides in a semi-desert rodent, the jerboa

    DEFF Research Database (Denmark)

    Janati, A; Talbi, R; Klosen, P

    2013-01-01

    , kisspeptin (Kp) and RF-amide-related peptide (RFRP)-3, displays seasonal variation in jerboa. Kp and/or RFRP-3 immunoreactivity was investigated in the hypothalamus of jerboas captured in the field of the Middle Atlas mountain (Morocco), either in the spring or autumn. As in other rodents, the Kp...

  16. 75 FR 9894 - Farm, Ranch, and Rural Communities Advisory Committee (FRRCC)

    Science.gov (United States)

    2010-03-04

    .... Inquiries may be directed to Alicia Kaiser, U.S. EPA, (mail code 1101-A), 1200 Pennsylvania Avenue, NW., Washington, DC 20460, telephone (202) 564-7273, or kaiser.alicia@epa.gov . Dated: February 18, 2010. Lawrence...

  17. Different metabolic profiles of K1 serotype and non-serotype K1 and K2 Klebsiella pneumoniae isolates in oral infection mice model.

    Science.gov (United States)

    Chen, Nan; Wang, Lin-Lin; Xue, Juan; Ma, Xiang-Bo; Zhao, Sheng; Rong, Rui-Xue; Li, Hong-Quan; Ding, Liang; Zheng, Ming-Zhi; Chen, Ying-Ying; Duan, Fei; Shen, Yue-Liang

    2014-10-01

    K1 or K2 serotype Klebsiella pneumoniae isolate caused clinical pyogenic liver abscess (KLA) infection is prevalent in many areas. It has been identified that K1 or K2 serotype K. pneumoniae isolates caused KLA infection in mice by oral inoculation. In our study, K1 serotype K. pneumoniae isolate Kp1002 with hypermucoviscosity (HV)-positive phenotype caused KLA infection in C57BL/6 mice by oral inoculation. Simultaneously, non-serotype K1 and K2 isolate Kp1014 with HV-negative phenotype failed to cause KLA infection in the same manner. It seems that gastrointestinal tract translocation is the pathway by which K1 or K2 serotype K. pneumoniae caused KLA infection. Liquid chromatography-tandem mass spectrometry was used to further analyze metabolic profile changes in mice with KLA infection. Data showed that after Kp1002 or Kp1014 oral inoculation, serum Phosphatidylcholine (PC) and Lysophosphatidylcholine (LPC) levels significantly changed in mice. Some PC and LPC molecules showed changes both in the Kp1002 KLA group and the Kp1014 no-KLA group compared with the control group. The level of 18:1/18:2-PC significantly changed in the Kp1002 KLA group compared with the control group, but showed no change between the Kp1014 no-KLA group and the control group. The level of 18:1/18:2-PC might have been particularly affected by KLA infection caused by K1 serotype K. pneumoniae Kp1002. It may be a potential biomarker for KLA infection. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Educação à Distância como estratégia para a educação permanente em saúde: possibilidades e desafios Educación a la Distancia como estratégia para la educación permanente en salud: posibilidades y desafíos Distance Education as strategy for permanent education in health: possibilities and challenges

    Directory of Open Access Journals (Sweden)

    Marluce Alves Nunes Oliveira

    2007-10-01

    Full Text Available Este estudo objetivou refletir sobre a importância da Educação Permanente em Saúde (EPS na promoção do processo de mudança nos docentes da UEFS; estabelecer estratégias para a promoção da EPS e apontar as possibilidades e os desafios para a operacionalização da EAD como estratégia para a EPS. Estudo de revisão bibliográfica. O resultado aponta que a EPS é uma das estratégias para a formação do profissional através de trabalhos coletivos entre os docentes. Como possibilidade: EAD possibilita construir um novo estilo na formação. Desafios: necessidade de conhecimento para utilizar as novas tecnologias da informação e comunicação; dificuldade de acesso a estas tecnologias; escassez de tempo para desenvolver as atividades do curso. Apreendemos que a EAD apresenta nova perspectiva para EPS.Este estudio buscó reflexionar al respecto de la importancia de la Educación Permanente em Salud (EPS em la promoción del proceso de cambios em los docentes de la Universidad Estatal de Feira de Santana (UEFS; establecer estratégias para la promoción de la EPS y apuntar las posibilidades y los desafíos para la operacionalización de la Educación a la Distancia (EAD como estratégia para la EPS. Estudio de una revización bibliográfica. El resultado apunta a que la EPS és una de las estratégias para la formación del profesional por médio de trabajos colectivos entre los docentes. Como posibilidad: EAD posibilita construir um nuevo estilo em lá formación. Desafíos: necesidad de conocimiento para utilizar las nuevas tecnologíes de la información y comunicación; dificultad de acceso a estas tecnologias; poco tiempo para desarrollar las actividades del curso. Aprendimos que la EAD presenta nueva perspectiva para la EPS.The point of this study is to reflect about how important Permanent Education in Health (PEH is in the promotion of the changes process of professors of UEFS; to establish strategies to promote PEH and show the

  19. Educação permanente em saúde e as Diretrizes Curriculares Nacionais para Educação das relações étnico-raciais e para ensino de História e Cultura Afro-Brasileira e Africana

    Directory of Open Access Journals (Sweden)

    Rosana Batista Monteiro

    Full Text Available Resumo Este texto é um ensaio sobre algumas contribuições que o curso de especialização em Saúde da Mulher Negra pode ter produzido para a abordagem dos conteúdos relacionados nas Diretrizes Curriculares Nacionais para a Educação das Relações Étnico-raciais e para o Ensino de História e Cultura Afro-brasileira e Africana, bem como em atenção à Política Nacional de Saúde Integral da População Negra, com destaque para a educação permanente. A partir de breve contextualização sobre o debate no campo das relações raciais e ações afirmativas no Brasil passamos a apresentar a organização e funcionamento do curso, destacando seus objetivos, conteúdos, estratégias. Com foco nos profissionais da saúde, o curso contou com significativa presença de profissionais da educação básica pública, municipal e estadual, das cidades de São Luís e Pinheiro, no Maranhão, implicando a discussão do tema saúde da população negra (especialmente da mulher negra no âmbito da escola. O curso propiciou a elaboração de projetos de pesquisa relacionados diretamente com o atendimento à saúde de mulheres negras e sua relação com processos formativos de profissionais da área da saúde, bem como educação escolar e saúde de mulheres negras. Pode-se concluir, ainda que provisoriamente, que o curso, na perspectiva da educação permanente, resultou em estratégia eficaz para o desenvolvimento de conteúdos relacionados às DCNERER e, especialmente, de viabilização de implementação da Política Nacional de Saúde Integral da População Negra, realizadas ou desencadeadas nos serviços de saúde pelos cursistas.

  20. 65 A Contrastive Study of the Phonology of Igbo and Yoruba Cecilia ...

    African Journals Online (AJOL)

    Tracie1

    done for pedagogical purposes, with the aim to provide better descriptions and better .... kp 'mould', àkpà 'bag' gb. /gb/ voiced labial-velar plosive. Plosive p b t d k g kp gb kw gw. Nasal. M n w .... wá 'search', owo 'money', wàhála. 'trouble'.