WorldWideScience

Sample records for large-scale health care

  1. Georeferenced and secure mobile health system for large scale data collection in primary care.

    Science.gov (United States)

    Sa, Joao H G; Rebelo, Marina S; Brentani, Alexandra; Grisi, Sandra J F E; Iwaya, Leonardo H; Simplicio, Marcos A; Carvalho, Tereza C M B; Gutierrez, Marco A

    2016-10-01

    Mobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning. Family Health Teams (FHTs) collect this data in periodic visits to families enrolled in governmental programs, following an acquisition procedure that involves filling in paper forms. This procedure compromises the quality of the data provided to health care authorities and slows down the decision-making process. To develop a mobile system (GeoHealth) that should address and overcome the aforementioned problems and deploy the proposed solution in a wide underprivileged metropolitan area of a major city in Brazil. The proposed solution comprises three main components: (a) an Application Server, with a database containing family health conditions; and two clients, (b) a Web Browser running visualization tools for management tasks, and (c) a data-gathering device (smartphone) to register and to georeference the family health data. A data security framework was designed to ensure the security of data, which was stored locally and transmitted over public networks. The system was successfully deployed at six primary care units in the city of Sao Paulo, where a total of 28,324 families/96,061 inhabitants are regularly followed up by government health policies. The health conditions observed from the population covered were: diabetes in 3.40%, hypertension (age >40) in 23.87% and tuberculosis in 0.06%. This estimated prevalence has enabled FHTs to set clinical appointments proactively, with the aim of

  2. Perspectives on Clinical Informatics: Integrating Large-Scale Clinical, Genomic, and Health Information for Clinical Care

    Directory of Open Access Journals (Sweden)

    In Young Choi

    2013-12-01

    Full Text Available The advances in electronic medical records (EMRs and bioinformatics (BI represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.

  3. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    Science.gov (United States)

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

  4. Assessing the Capacity of the US Health Care System to Use Additional Mechanical Ventilators During a Large-Scale Public Health Emergency.

    Science.gov (United States)

    Ajao, Adebola; Nystrom, Scott V; Koonin, Lisa M; Patel, Anita; Howell, David R; Baccam, Prasith; Lant, Tim; Malatino, Eileen; Chamberlin, Margaret; Meltzer, Martin I

    2015-12-01

    A large-scale public health emergency, such as a severe influenza pandemic, can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use. We identified key components of the health care system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (ie, conventional, contingency, and crisis), and determined the constraining key component at each capacity level. Our study results showed that US hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning. The current US health care system may have limited capacity to use additional mechanical ventilators during a large-scale public health emergency. Emergency planners need to understand their health care systems' capability to absorb additional resources and expand care. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or to identify alternatives to manage overwhelming critical care need.

  5. Exploring the Demands on Nurses Working in Health Care Facilities During a Large-Scale Natural Disaster

    Directory of Open Access Journals (Sweden)

    Gillian C. Scrymgeour

    2016-06-01

    Full Text Available Nurses are pivotal to an effective societal response to a range of critical events, including disasters. This presents nurses with many significant and complex challenges that require them to function effectively under highly challenging and stressful circumstances and often for prolonged periods of time. The exponential growth in the number of disasters means that knowledge of disaster preparedness and how this knowledge can be implemented to facilitate the development of resilient and adaptive nurses and health care organizations represents an important adjunct to nurse education, policy development, and research considerations. Although this topic has and continues to attract attention in the literature, a lack of systematic understanding of the contingencies makes it difficult to clearly differentiate what is known and what gaps remain in this literature. Providing a sound footing for future research can be facilitated by first systematically reviewing the relevant literature. Focused themes were identified and analyzed using an ecological and interactive systems framework. Ten of the 12 retained studies included evacuation, revealing that evacuation is more likely to occur in an aged care facility than a hospital. The unpredictability of an event also highlighted organizational, functional, and competency issues in regard to the complexity of decision making and overall preparedness. The integrative review also identified that the unique roles, competencies, and demands on nurses working in hospitals and residential health care facilities during a natural disaster appear invisible within the highly visible event.

  6. Resolute large scale mining company contribution to health services of

    African Journals Online (AJOL)

    Resolute large scale mining company contribution to health services of Lusu ... in terms of socio economic, health, education, employment, safe drinking water, ... The data were analyzed using Scientific Package for Social Science (SPSS).

  7. Large-scale Health Information Database and Privacy Protection.

    Science.gov (United States)

    Yamamoto, Ryuichi

    2016-09-01

    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients' medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

  8. Large-scale Health Information Database and Privacy Protection*1

    Science.gov (United States)

    YAMAMOTO, Ryuichi

    2016-01-01

    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA*2 projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients’ medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

  9. Large-scale Health Information Database and Privacy Protection*1

    OpenAIRE

    YAMAMOTO, Ryuichi

    2016-01-01

    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law...

  10. Performance Health Monitoring of Large-Scale Systems

    Energy Technology Data Exchange (ETDEWEB)

    Rajamony, Ram [IBM Research, Austin, TX (United States)

    2014-11-20

    This report details the progress made on the ASCR funded project Performance Health Monitoring for Large Scale Systems. A large-­scale application may not achieve its full performance potential due to degraded performance of even a single subsystem. Detecting performance faults, isolating them, and taking remedial action is critical for the scale of systems on the horizon. PHM aims to develop techniques and tools that can be used to identify and mitigate such performance problems. We accomplish this through two main aspects. The PHM framework encompasses diagnostics, system monitoring, fault isolation, and performance evaluation capabilities that indicates when a performance fault has been detected, either due to an anomaly present in the system itself or due to contention for shared resources between concurrently executing jobs. Software components called the PHM Control system then build upon the capabilities provided by the PHM framework to mitigate degradation caused by performance problems.

  11. A Large-Scale Internet/Computer-Based, Training Module: Dissemination of Evidence-Based Management of Postpartum Hemorrhage to Front-Line Health Care Workers

    Science.gov (United States)

    Abawi, Karim; Gertiser, Lynn; Idris, Raqibat; Villar, José; Langer, Ana; Chatfield, Alison; Campana, Aldo

    2017-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in most developing and low-income countries and the cause of one-quarter of maternal deaths worldwide. With appropriate and prompt care, these deaths can be prevented. With the current and rapidly developing research and worldwide access to information, a lack of knowledge of…

  12. The NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester: combining empirical, theoretical and experiential evidence to design and evaluate a large-scale implementation strategy.

    Science.gov (United States)

    Harvey, Gill; Fitzgerald, Louise; Fielden, Sandra; McBride, Anne; Waterman, Heather; Bamford, David; Kislov, Roman; Boaden, Ruth

    2011-08-23

    In response to policy recommendations, nine National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were established in England in 2008, aiming to create closer working between the health service and higher education and narrow the gap between research and its implementation in practice. The Greater Manchester (GM) CLAHRC is a partnership between the University of Manchester and twenty National Health Service (NHS) trusts, with a five-year mission to improve healthcare and reduce health inequalities for people with cardiovascular conditions. This paper outlines the GM CLAHRC approach to designing and evaluating a large-scale, evidence- and theory-informed, context-sensitive implementation programme. The paper makes a case for embedding evaluation within the design of the implementation strategy. Empirical, theoretical, and experiential evidence relating to implementation science and methods has been synthesised to formulate eight core principles of the GM CLAHRC implementation strategy, recognising the multi-faceted nature of evidence, the complexity of the implementation process, and the corresponding need to apply approaches that are situationally relevant, responsive, flexible, and collaborative. In turn, these core principles inform the selection of four interrelated building blocks upon which the GM CLAHRC approach to implementation is founded. These determine the organizational processes, structures, and roles utilised by specific GM CLAHRC implementation projects, as well as the approach to researching implementation, and comprise: the Promoting Action on Research Implementation in Health Services (PARIHS) framework; a modified version of the Model for Improvement; multiprofessional teams with designated roles to lead, facilitate, and support the implementation process; and embedded evaluation and learning. Designing and evaluating a large-scale implementation strategy that can cope with and

  13. Disclosing large scale adverse events in the US Veterans Health Administration: lessons from media responses.

    Science.gov (United States)

    Maguire, E M; Bokhour, B G; Asch, S M; Wagner, T H; Gifford, A L; Gallagher, T H; Durfee, J M; Martinello, R A; Elwy, A R

    2016-06-01

    We examined print, broadcast and social media reports about health care systems' disclosures of large scale adverse events to develop future effective messaging. Directed content analysis. We systematically searched four communication databases, YouTube and Really Simple Syndication (RSS) feeds relating to six disclosures of lapses in infection control practices in the Department of Veterans Affairs occurring between 2009 and 2012. We assessed these with a coding frame derived from effective crisis and risk communication models. We identified 148 unique media reports. Some components of effective communication (discussion of cause, reassurance, self-efficacy) were more present than others (apology, lessons learned). Media about 'promoting secrecy' and 'slow response' appeared in reports when time from event discovery to patient notification was over 75 days. Elected officials' quotes (n = 115) were often negative (83%). Hospital officials' comments (n = 165) were predominantly neutral (92%), and focused on information sharing. Health care systems should work to ensure that they develop clear messages focused on what is not well covered by the media, including authentic apologies, remedial actions taken, and shorten the timeframe between event identification and disclosure to patients. Published by Elsevier Ltd.

  14. Large Scale eHealth Deployment in Europe: Insights from Concurrent Use of Standards.

    Science.gov (United States)

    Eichelberg, Marco; Chronaki, Catherine

    2016-01-01

    Large-scale eHealth deployment projects face a major challenge when called to select the right set of standards and tools to achieve sustainable interoperability in an ecosystem including both legacy systems and new systems reflecting technological trends and progress. There is not a single standard that would cover all needs of an eHealth project, and there is a multitude of overlapping and perhaps competing standards that can be employed to define document formats, terminology, communication protocols mirroring alternative technical approaches and schools of thought. eHealth projects need to respond to the important question of how alternative or inconsistently implemented standards and specifications can be used to ensure practical interoperability and long-term sustainability in large scale eHealth deployment. In the eStandards project, 19 European case studies reporting from R&D and large-scale eHealth deployment and policy projects were analyzed. Although this study is not exhaustive, reflecting on the concepts, standards, and tools for concurrent use and the successes, failures, and lessons learned, this paper offers practical insights on how eHealth deployment projects can make the most of the available eHealth standards and tools and how standards and profile developing organizations can serve the users embracing sustainability and technical innovation.

  15. Large-scale mHealth professional support for health workers in rural Maharashtra, India.

    Science.gov (United States)

    Hegde, Shailendra Kumar B; Saride, Sriranga Prasad; Kuruganty, Sudha; Banker, Niraja; Patil, Chetan; Phanse, Vishal

    2018-04-01

    Expanding mobile telephony in India has prompted interest in the potential of mobile-telephone health (mHealth) in linking health workers in rural areas with specialist medical advice and other professional services. In 2012, a toll-free helpline offering specialist medical advice to community-based health workers throughout Maharashtra was launched. Calls are handled via a 24 h centre in Pune, staffed by health advisory officers and medical specialists. Health advisory officers handle general queries, which include medical advice via validated algorithms; blood on-call services; grievance issues; and mental health support - the latter calls are transferred to a qualified counsellor. Calls requiring more specialist advice are transferred to the appropriate medical specialist. This paper describes the experience of the first 4 years of this helpline, in terms of the services used, callers, nature of calls, types of queries serviced and lessons learnt. In the first 4 years of the helpline, 669 265 calls were serviced. Of these calls, 453 373 (67.74%) needed medical advice and were handled by health advisory officers. Specialist services were required to address 199 226 (29.77%) calls. Blood-bank-related services accounted for 7919 (1.18%) calls, while 2462 (0.37%) were grievance calls. Counselling for mental health issues accounted for 6285 (0.94%) calls. The large-scale mHealth professional support provided by this helpline in Maharashtra has reached many health workers serving rural communities. Future work is required to explore ways to expand the reach of the helpline further and to measure its effectiveness in improving health outcomes.

  16. Evaluation of cognitive and social functioning in patients requiring long-term inpatient psychiatric care using the International Classification of Functioning, Disability, and Health: a large-scale, multi-institutional observational study.

    Science.gov (United States)

    Kawaguchi, Hideaki; Taguchi, Masamoto; Sukigara, Masune; Sakuragi, Shoji; Sugiyama, Naoya; Chiba, Hisomu; Kawasaki, Tatsuhito

    2017-06-15

    We comprehensively evaluated cognitive and social functioning in patients requiring long-term inpatient psychiatric care using the International Classification of Functioning, Disability, and Health. We surveyed 1967 patients receiving long-term inpatient psychiatric care. Patients were further categorized into an old long-stay group (n = 892, >5 years in hospitals) and a new long-stay group (n = 1075, 1-5 years in hospitals). We obtained responses for all the International Classification of Functioning, Disability, and Health items in domain b (Body Functions) and domain d (Activities and Participation). We estimated weighted means for each item using the propensity score to adjust for confounding factors. Responses were received from 307 hospitals (response rate of hospitals: 25.5%). Cognitive and social functioning in the old long-stay group was more severely impaired than in the new long-stay group. No statistically significant differences were observed regarding the International Classification of Functioning, Disability, and Health items associated with basic activities of daily living between the two groups. Combined therapy consisting of cognitive remediation and rehabilitation on social functioning for this patient population should be started from the early stage of hospitalization. Non-restrictive, independent environments may also be optimal for this patient population. Implications for rehabilitation Rehabilitation of cognitive and social functioning for patients requiring long-term inpatient psychiatric care should be started in the early stages of hospitalization. In psychiatric fields, the International Classification of Functioning, Disability, and Health checklist could facilitate individualized rehabilitation planning by allowing healthcare professionals to visually assess the comprehensive functioning of each patient using graphics such as radar charts.

  17. Side effects of problem-solving strategies in large-scale nutrition science: towards a diversification of health.

    Science.gov (United States)

    Penders, Bart; Vos, Rein; Horstman, Klasien

    2009-11-01

    Solving complex problems in large-scale research programmes requires cooperation and division of labour. Simultaneously, large-scale problem solving also gives rise to unintended side effects. Based upon 5 years of researching two large-scale nutrigenomic research programmes, we argue that problems are fragmented in order to be solved. These sub-problems are given priority for practical reasons and in the process of solving them, various changes are introduced in each sub-problem. Combined with additional diversity as a result of interdisciplinarity, this makes reassembling the original and overall goal of the research programme less likely. In the case of nutrigenomics and health, this produces a diversification of health. As a result, the public health goal of contemporary nutrition science is not reached in the large-scale research programmes we studied. Large-scale research programmes are very successful in producing scientific publications and new knowledge; however, in reaching their political goals they often are less successful.

  18. Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

    Science.gov (United States)

    Petropoulos, Z.; Clavin, C.; Zuckerman, B.

    2015-12-01

    The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large-scale

  19. 0222 Night work and breast cancer risk among women in the public Danish health care sector - a short-term follow up of a large scale population

    DEFF Research Database (Denmark)

    Tilma Vistisen, Helene; Helene Garde, Anne; Marie Hansen, Aase

    2014-01-01

    prevalence of night shift work and with detailed data regarding occupational title and date and hour for beginning and end of every work duty: The Danish Working Hour Database (DWHD). DWHD encompasses payroll data as of 2007 and is updated on an annual basis. For this analysis we defined night work...... national health registries. RESULTS: The 6-year follow up from 2007 to 2012 included 169.011 women of which 98.297 (58%) had ever worked nights during the follow up. A total of1.281 breast cancer cases occurred within the study population. 846 cases occurred among women never worked nights and 435 cases...... among women ever worked nights. CONCLUSIONS: Internal risk assessment of this dataset that includes alternative exposure metrics based on day-to-day night work exposure information will be presented....

  20. Medical care at mass gatherings: emergency medical services at large-scale rave events.

    Science.gov (United States)

    Krul, Jan; Sanou, Björn; Swart, Eleonara L; Girbes, Armand R J

    2012-02-01

    The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties. Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event. During the 2006-2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs. During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for

  1. Solar powered oxygen systems in remote health centers in Papua New Guinea: a large scale implementation effectiveness trial.

    Science.gov (United States)

    Duke, Trevor; Hwaihwanje, Ilomo; Kaupa, Magdalynn; Karubi, Jonah; Panauwe, Doreen; Sa'avu, Martin; Pulsan, Francis; Prasad, Peter; Maru, Freddy; Tenambo, Henry; Kwaramb, Ambrose; Neal, Eleanor; Graham, Hamish; Izadnegahdar, Rasa

    2017-06-01

    Pneumonia is the largest cause of child deaths in Papua New Guinea (PNG), and hypoxaemia is the major complication causing death in childhood pneumonia, and hypoxaemia is a major factor in deaths from many other common conditions, including bronchiolitis, asthma, sepsis, malaria, trauma, perinatal problems, and obstetric emergencies. A reliable source of oxygen therapy can reduce mortality from pneumonia by up to 35%. However, in low and middle income countries throughout the world, improved oxygen systems have not been implemented at large scale in remote, difficult to access health care settings, and oxygen is often unavailable at smaller rural hospitals or district health centers which serve as the first point of referral for childhood illnesses. These hospitals are hampered by lack of reliable power, staff training and other basic services. We report the methodology of a large implementation effectiveness trial involving sustainable and renewable oxygen and power systems in 36 health facilities in remote rural areas of PNG. The methodology is a before-and after evaluation involving continuous quality improvement, and a health systems approach. We describe this model of implementation as the considerations and steps involved have wider implications in health systems in other countries. The implementation steps include: defining the criteria for where such an intervention is appropriate, assessment of power supplies and power requirements, the optimal design of a solar power system, specifications for oxygen concentrators and other oxygen equipment that will function in remote environments, installation logistics in remote settings, the role of oxygen analyzers in monitoring oxygen concentrator performance, the engineering capacity required to sustain a program at scale, clinical guidelines and training on oxygen equipment and the treatment of children with severe respiratory infection and other critical illnesses, program costs, and measurement of processes and

  2. How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation.

    Science.gov (United States)

    Bokhour, Barbara G; Fix, Gemmae M; Mueller, Nora M; Barker, Anna M; Lavela, Sherri L; Hill, Jennifer N; Solomon, Jeffrey L; Lukas, Carol VanDeusen

    2018-03-07

    Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care. We conducted qualitative semi-structured interviews with 108 employees (22 senior leaders, 42 middle managers, 37 front-line providers and 7 staff). Transcripts of audio recordings were analyzed using a priori codes based on the Consolidated Framework for Implementation Research. We used constant comparison analysis to synthesize codes into meaningful domains. Sites described actions taken to foster patient-centered care in seven domains: 1) leadership; 2) patient and family engagement; 3) staff engagement; 4) focus on innovations; 5) alignment of staff roles and priorities; 6) organizational structures and processes; 7) environment of care. Within each domain, we identified multi-faceted strategies for implementing change. These included efforts by all levels of organizational leaders who modeled patient-centered care in their interactions and fostered willingness to try novel approaches to care amongst staff. Alignment and integration of patient centered care within the organization, particularly surrounding roles, priorities and bureaucratic rules, remained major challenges. Transforming healthcare systems to focus on patient-centered care and better serve the "whole" patient is a complex endeavor. Efforts to transform healthcare culture require robust, multi-pronged efforts at all levels of the organization; leadership is only the beginning. Challenges remain for incorporating patient-centered approaches in the

  3. Large-scale fortification of condiments and seasonings as a public health strategy: equity considerations for implementation.

    Science.gov (United States)

    Zamora, Gerardo; Flores-Urrutia, Mónica Crissel; Mayén, Ana-Lucia

    2016-09-01

    Fortification of staple foods with vitamins and minerals is an effective approach to increase micronutrient intake and improve nutritional status. The specific use of condiments and seasonings as vehicles in large-scale fortification programs is a relatively new public health strategy. This paper underscores equity considerations for the implementation of large-scale fortification of condiments and seasonings as a public health strategy by examining nonexhaustive examples of programmatic experiences and pilot projects in various settings. An overview of conceptual elements in implementation research and equity is presented, followed by an examination of equity considerations for five implementation strategies: (1) enhancing the capabilities of the public sector, (2) improving the performance of implementing agencies, (3) strengthening the capabilities and performance of frontline workers, (3) empowering communities and individuals, and (4) supporting multiple stakeholders engaged in improving health. Finally, specific considerations related to intersectoral action are considered. Large-scale fortification of condiments and seasonings cannot be a standalone strategy and needs to be implemented with concurrent and coordinated public health strategies, which should be informed by a health equity lens. © 2016 New York Academy of Sciences.

  4. Large scale food retailing as an intervention for diet and health: quasi-experimental evaluation of a natural experiment.

    Science.gov (United States)

    Cummins, Steven; Petticrew, Mark; Higgins, Cassie; Findlay, Anne; Sparks, Leigh

    2005-12-01

    To assess the effect on fruit and vegetable consumption, self reported, and psychological health of a "natural experiment"-the introduction of large scale food retailing in a deprived Scottish community. Prospective quasi-experimental design comparing baseline and follow up data in an "intervention" community with a matched "comparison" community in Glasgow, UK. 412 men and women aged 16 or over for whom follow up data on fruit and vegetable consumption and GHQ-12 were available. Fruit and vegetable consumption in portions per day, poor self reported health, and poor psychological health (GHQ-12). Adjusting for age, sex, educational attainment, and employment status there was no population impact on daily fruit and vegetable consumption, self reported, and psychological health. There was some evidence for a net reduction in the prevalence of poor psychological health for residents who directly engaged with the intervention. Government policy has advocated using large scale food retailing as a social intervention to improve diet and health in poor communities. In contrast with a previous uncontrolled study this study did not find evidence for a net intervention effect on fruit and vegetable consumption, although there was evidence for an improvement in psychological health for those who directly engaged with the intervention. Although definitive conclusions about the effect of large scale retailing on diet and health in deprived communities cannot be drawn from non-randomised controlled study designs, evaluations of the impacts of natural experiments may offer the best opportunity to generate evidence about the health impacts of retail interventions in poor communities.

  5. Development of out-of-hours primary care by general practitioners (GPs) in The Netherlands: from small-call rotations to large-scale GP cooperatives.

    Science.gov (United States)

    van Uden, Caro J T; Giesen, Paul H J; Metsemakers, Job F M; Grol, Richard P T M

    2006-09-01

    Over the last 10 years, care outside office hours by primary care physicians in The Netherlands has experienced a radical change. While Dutch general practitioners (GPs) formerly performed these services in small-call rotations, care is nowadays delivered by large-scale GP cooperatives. We searched the literature for relevant studies on the effect of the out-of-hours care reorganization in The Netherlands. We identified research that included before- and afterintervention studies, descriptive studies, and surveys. These studies focused on the consequences of reorganizing several aspects of out-of-hours care, such as patient and GP satisfaction, patient characteristics, utilization of care, and costs. Various studies showed that the reorganization has successfully addressed many of the critical issues that Dutch GPs were confronted with delivering these services. GPs' job satisfaction has increased, and patients seem to be satisfied with current out-of-hours care. Several aspects of out-of-hours care are discussed, such as telephone triage, self referrals, and future expectations, which should receive extra attention by researchers and health policy makers in the near future.

  6. The adolescence of electronic health records: Status and perspectives for large scale implementation

    Directory of Open Access Journals (Sweden)

    Andreas Drauschke

    2013-06-01

    Full Text Available Health informatics started to evolve decades ago with the intention to support healthcare using computers. Since then Electronic health records (EHRs and personal health records (PHRs have become available but widespread adoption was limited by lack of interoperability and security issues. This paper discusses the feasibility of interoperable standards based EHRs and PHRs drawing on experience from implementation projects. It outlines challenges and goals in education and implementation for the next years.

  7. Third generation participatory design in health informatics--making user participation applicable to large-scale information system projects.

    Science.gov (United States)

    Pilemalm, Sofie; Timpka, Toomas

    2008-04-01

    Participatory Design (PD) methods in the field of health informatics have mainly been applied to the development of small-scale systems with homogeneous user groups in local settings. Meanwhile, health service organizations are becoming increasingly large and complex in character, making it necessary to extend the scope of the systems that are used for managing data, information and knowledge. This study reports participatory action research on the development of a PD framework for large-scale system design. The research was conducted in a public health informatics project aimed at developing a system for 175,000 users. A renewed PD framework was developed in response to six major limitations experienced to be associated with the existing methods. The resulting framework preserves the theoretical grounding, but extends the toolbox to suit applications in networked health service organizations. Future research should involve evaluations of the framework in other health service settings where comprehensive HISs are developed.

  8. A Conceptual Framework for Allocation of Federally Stockpiled Ventilators During Large-Scale Public Health Emergencies.

    Science.gov (United States)

    Zaza, Stephanie; Koonin, Lisa M; Ajao, Adebola; Nystrom, Scott V; Branson, Richard; Patel, Anita; Bray, Bruce; Iademarco, Michael F

    2016-01-01

    Some types of public health emergencies could result in large numbers of patients with respiratory failure who need mechanical ventilation. Federal public health planning has included needs assessment and stockpiling of ventilators. However, additional federal guidance is needed to assist states in further allocating federally supplied ventilators to individual hospitals to ensure that ventilators are shipped to facilities where they can best be used during an emergency. A major consideration in planning is a hospital's ability to absorb additional ventilators, based on available space and staff expertise. A simple pro rata plan that does not take these factors into account might result in suboptimal use or unused scarce resources. This article proposes a conceptual framework that identifies the steps in planning and an important gap in federal guidance regarding the distribution of stockpiled mechanical ventilators during an emergency.

  9. Adolescent Linkage to Care After a Large-scale Transfer From a Hospital-based HIV Clinic to the Public Sector in South Africa.

    Science.gov (United States)

    Ramirez-Avila, Lynn; Regan, Susan; Cloete, Christie; Crankshaw, Tamaryn; Rabideau, Dustin J; Freedberg, Kenneth A; Parker, Robert A; Walensky, Rochelle P; Losina, Elena; Bassett, Ingrid V

    2017-03-01

    HIV clinics formerly supported by the President's Emergency Plan for AIDS Relief are transferring patients to public-sector clinics. We evaluated adolescent linkage to care after a large-scale transfer from a President's Emergency Plan for AIDS Relief-subsidized pediatric HIV clinic in Durban, South Africa. All adolescents (11-18 years) in care at a pediatric state-subsidized, hospital-based clinic (HBC) were transferred, from May to June 2012, to government sites [primary health care (PHC) clinic; community health center (CHC); and HBCs] or private clinics. Caregivers were surveyed 7-8 months after transfer to assess their adolescents' linkage to care and their reports were validated by clinic record audits in a subset of randomly selected clinics. Of the 309 (91%) caregivers reached, only 5 (2%) reported that their adolescent did not link. Of the 304 adolescents who linked, 105 (35%) were referred to a PHC, 73 (24%) to a CHC and 106 (35%) to a HBC. A total of 146 (48%) linked adolescents attended a different clinic than that assigned. Thirty-five (20%) of the 178 who linked and were assigned to a PHC or CHC ultimately attended a HBC. Based on clinic validation, the estimated transfer success was 88% (95% confidence interval: 77%-97%). The large majority of adolescents successfully transferred to a new HIV clinic, although nearly half attended a clinic other than that assigned.

  10. A literature review for large-scale health information system project planning, implementation and evaluation.

    Science.gov (United States)

    Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

    2017-01-01

    Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Use of electronic healthcare records in large-scale simple randomized trials at the point of care for the documentation of value-based medicine.

    Science.gov (United States)

    van Staa, T-P; Klungel, O; Smeeth, L

    2014-06-01

    A solid foundation of evidence of the effects of an intervention is a prerequisite of evidence-based medicine. The best source of such evidence is considered to be randomized trials, which are able to avoid confounding. However, they may not always estimate effectiveness in clinical practice. Databases that collate anonymized electronic health records (EHRs) from different clinical centres have been widely used for many years in observational studies. Randomized point-of-care trials have been initiated recently to recruit and follow patients using the data from EHR databases. In this review, we describe how EHR databases can be used for conducting large-scale simple trials and discuss the advantages and disadvantages of their use. © 2014 The Association for the Publication of the Journal of Internal Medicine.

  12. Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Margolis, Amy Lynn; Roper, Allison Yvonne

    2014-03-01

    After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

  13. Inducing a health-promoting change process within an organization: the effectiveness of a large-scale intervention on social capital, openness, and autonomous motivation toward health.

    Science.gov (United States)

    van Scheppingen, Arjella R; de Vroome, Ernest M M; Ten Have, Kristin C J M; Bos, Ellen H; Zwetsloot, Gerard I J M; van Mechelen, W

    2014-11-01

    To examine the effectiveness of an organizational large-scale intervention applied to induce a health-promoting organizational change process. A quasi-experimental, "as-treated" design was used. Regression analyses on data of employees of a Dutch dairy company (n = 324) were used to examine the effects on bonding social capital, openness, and autonomous motivation toward health and on employees' lifestyle, health, vitality, and sustainable employability. Also, the sensitivity of the intervention components was examined. Intervention effects were found for bonding social capital, openness toward health, smoking, healthy eating, and sustainable employability. The effects were primarily attributable to the intervention's dialogue component. The change process initiated by the large-scale intervention contributed to a social climate in the workplace that promoted health and ownership toward health. The study confirms the relevance of collective change processes for health promotion.

  14. Large scale electrolysers

    International Nuclear Information System (INIS)

    B Bello; M Junker

    2006-01-01

    Hydrogen production by water electrolysis represents nearly 4 % of the world hydrogen production. Future development of hydrogen vehicles will require large quantities of hydrogen. Installation of large scale hydrogen production plants will be needed. In this context, development of low cost large scale electrolysers that could use 'clean power' seems necessary. ALPHEA HYDROGEN, an European network and center of expertise on hydrogen and fuel cells, has performed for its members a study in 2005 to evaluate the potential of large scale electrolysers to produce hydrogen in the future. The different electrolysis technologies were compared. Then, a state of art of the electrolysis modules currently available was made. A review of the large scale electrolysis plants that have been installed in the world was also realized. The main projects related to large scale electrolysis were also listed. Economy of large scale electrolysers has been discussed. The influence of energy prices on the hydrogen production cost by large scale electrolysis was evaluated. (authors)

  15. Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes.

    Science.gov (United States)

    Peabody, John W; DeMaria, Lisa; Smith, Owen; Hoth, Angela; Dragoti, Edmond; Luck, Jeff

    2017-09-27

    challenged by poor performance as measured by clinical care vignettes, but there is potential for provision of high-quality care by a sizable proportion of providers. Large-scale assessments of quality of care have been hampered by the lack of effective measurement tools that provide generalizable and reliable results across diverse economic, cultural, and social settings. The feasibility of quality measurement using CPV vignettes in these 6 countries and the ability to combine results with individual feedback could significantly enhance strategies to improve quality of care, and ultimately population health. © Peabody et al.

  16. Inducing a health-promoting change process within an organization the Effectiveness of a Large-Scale Intervention on Social Capital, Openness, and Autonomous Motivation Toward Health

    NARCIS (Netherlands)

    Scheppingen, A.R. van; Vroome, E.M.M. de; Have, K.C.J.M. ten; Bos, E.H.; Zwetsloot, G.I.J.M.; Mechelen, W. van

    2014-01-01

    Objective: To examine the effectiveness of an organizational large-scale intervention applied to induce a health-promoting organizational change process. Design and Methods: A quasi-experimental, "as-treated" design was used. Regression analyses on data of employees of a Dutch dairy company (n =324)

  17. Liver diseases: A major, neglected global public health problem requiring urgent actions and large-scale screening.

    Science.gov (United States)

    Marcellin, Patrick; Kutala, Blaise K

    2018-02-01

    CLDs represent an important, and certainly underestimated, global public health problem. CLDs are highly prevalent and silent, related to different, sometimes associated causes. The distribution of the causes of these diseases is slowly changing, and within the next decade, the proportion of virus-induced CLDs will certainly decrease significantly while the proportion of NASH will increase. There is an urgent need for effective global actions including education, prevention and early diagnosis to manage and treat CLDs, thus preventing cirrhosis-related morbidity and mortality. Our role is to increase the awareness of the public, healthcare professionals and public health authorities to encourage active policies for early management that will decrease the short- and long-term public health burden of these diseases. Because necroinflammation is the key mechanism in the progression of CLDs, it should be detected early. Thus, large-scale screening for CLDs is needed. ALT levels are an easy and inexpensive marker of liver necroinflammation and could be the first-line tool in this process. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Assessing the capacity of the healthcare system to use additional mechanical ventilators during a large-scale public health emergency (PHE)

    Science.gov (United States)

    Ajao, Adebola; Nystrom, Scott V.; Koonin, Lisa M.; Patel, Anita; Howell, David R.; Baccam, Prasith; Lant, Tim; Malatino, Eileen; Chamberlin, Margaret; Meltzer, Martin I.

    2015-01-01

    A large-scale Public Health Emergency (PHE), like a severe influenza pandemic can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use. We identified key components of the healthcare system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (i.e. conventional, contingency and crisis) and determined the constraining key component at each capacity level. Our study results showed that U.S. hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or identify alternatives to manage overwhelming critical care need. PMID:26450633

  19. Disclosure control using partially synthetic data for large-scale health surveys, with applications to CanCORS.

    Science.gov (United States)

    Loong, Bronwyn; Zaslavsky, Alan M; He, Yulei; Harrington, David P

    2013-10-30

    Statistical agencies have begun to partially synthesize public-use data for major surveys to protect the confidentiality of respondents' identities and sensitive attributes by replacing high disclosure risk and sensitive variables with multiple imputations. To date, there are few applications of synthetic data techniques to large-scale healthcare survey data. Here, we describe partial synthesis of survey data collected by the Cancer Care Outcomes Research and Surveillance (CanCORS) project, a comprehensive observational study of the experiences, treatments, and outcomes of patients with lung or colorectal cancer in the USA. We review inferential methods for partially synthetic data and discuss selection of high disclosure risk variables for synthesis, specification of imputation models, and identification disclosure risk assessment. We evaluate data utility by replicating published analyses and comparing results using original and synthetic data and discuss practical issues in preserving inferential conclusions. We found that important subgroup relationships must be included in the synthetic data imputation model, to preserve the data utility of the observed data for a given analysis procedure. We conclude that synthetic CanCORS data are suited best for preliminary data analyses purposes. These methods address the requirement to share data in clinical research without compromising confidentiality. Copyright © 2013 John Wiley & Sons, Ltd.

  20. Youth Mental Health Services Utilization Rates After a Large-Scale Social Media Campaign: Population-Based Interrupted Time-Series Analysis.

    Science.gov (United States)

    Booth, Richard G; Allen, Britney N; Bray Jenkyn, Krista M; Li, Lihua; Shariff, Salimah Z

    2018-04-06

    Despite the uptake of mass media campaigns, their overall impact remains unclear. Since 2011, a Canadian telecommunications company has operated an annual, large-scale mental health advocacy campaign (Bell Let's Talk) focused on mental health awareness and stigma reduction. In February 2012, the campaign began to explicitly leverage the social media platform Twitter and incented participation from the public by promising donations of Can $0.05 for each interaction with a campaign-specific username (@Bell_LetsTalk). The intent of the study was to examine the impact of this 2012 campaign on youth outpatient mental health services in the province of Ontario, Canada. Monthly outpatient mental health visits (primary health care and psychiatric services) were obtained for the Ontario youth aged 10 to 24 years (approximately 5.66 million visits) from January 1, 2006 to December 31, 2015. Interrupted time series, autoregressive integrated moving average modeling was implemented to evaluate the impact of the campaign on rates of monthly outpatient mental health visits. A lagged intervention date of April 1, 2012 was selected to account for the delay required for a patient to schedule and attend a mental health-related physician visit. The inclusion of Twitter into the 2012 Bell Let's Talk campaign was temporally associated with an increase in outpatient mental health utilization for both males and females. Within primary health care environments, female adolescents aged 10 to 17 years experienced a monthly increase in the mental health visit rate from 10.2/1000 in April 2006 to 14.1/1000 in April 2015 (slope change of 0.094 following campaign, Pcampaign, Pcampaign (slope change of 0.005, P=.02; slope change of 0.003, P=.005, respectively). For young adults aged 18 to 24 years, females who used primary health care experienced the most significant increases in mental health visit rates from 26.5/1000 in April 2006 to 29.2/1000 in April 2015 (slope change of 0.17 following

  1. Large-Scale Survey Findings Inform Patients’ Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment

    Science.gov (United States)

    Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-01-01

    Background Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users’ experiences in using secure email messaging. Objective To quantitatively assess veteran patients’ experiences in using secure email messaging in a large patient sample. Methods A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations’ Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. Results The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy

  2. Large-Scale Survey Findings Inform Patients' Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment.

    Science.gov (United States)

    Haun, Jolie N; Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-12-21

    Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users' experiences in using secure email messaging. To quantitatively assess veteran patients' experiences in using secure email messaging in a large patient sample. A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations' Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy-to-use (P≤.001) communication tool, compared

  3. Using Large-Scale Linkage Data to Evaluate the Effectiveness of a National Educational Program on Antithrombotic Prescribing and Associated Stroke Prevention in Primary Care.

    Science.gov (United States)

    Liu, Zhixin; Moorin, Rachael; Worthington, John; Tofler, Geoffrey; Bartlett, Mark; Khan, Rabia; Zuo, Yeqin

    2016-10-13

    The National Prescribing Service (NPS) MedicineWise Stroke Prevention Program, which was implemented nationally in 2009-2010 in Australia, sought to improve antithrombotic prescribing in stroke prevention using dedicated interventions that target general practitioners. This study evaluated the impact of the NPS MedicineWise Stroke Prevention Program on antithrombotic prescribing and primary stroke hospitalizations. This population-based time series study used administrative health data linked to 45 and Up Study participants with a high risk of cardiovascular disease (CVD) to assess the possible impact of the NPS MedicineWise program on first-time aspirin prescriptions and primary stroke-related hospitalizations. Time series analysis showed that the NPS MedicineWise program was significantly associated with increased first-time prescribing of aspirin (P=0.03) and decreased hospitalizations for primary ischemic stroke (P=0.03) in the at-risk study population (n=90 023). First-time aspirin prescription was correlated with a reduction in the rate of hospitalization for primary stroke (P=0.02). Following intervention, the number of first-time aspirin prescriptions increased by 19.8% (95% confidence interval, 1.6-38.0), while the number of first-time stroke hospitalizations decreased by 17.3% (95% confidence interval, 1.8-30.0). Consistent with NPS MedicineWise program messages for the high-risk CVD population, the NPS MedicineWise Stroke Prevention Program (2009) was associated with increased initiation of aspirin and a reduced rate of hospitalization for primary stroke. The findings suggest that the provision of evidence-based multifaceted large-scale educational programs in primary care can be effective in changing prescriber behavior and positively impacting patient health outcomes. © 2016 The Authors and NPS MedicineWise. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. An evaluation of two large scale demand side financing programs for maternal health in India: the MATIND study protocol

    Directory of Open Access Journals (Sweden)

    Sidney Kristi

    2012-08-01

    Full Text Available Abstract Background High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSYand Chiranjeevi Yojana (CY, were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. Methods/designs The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. Discussion The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making

  5. An evaluation of two large scale demand side financing programs for maternal health in India: the MATIND study protocol.

    Science.gov (United States)

    Sidney, Kristi; de Costa, Ayesha; Diwan, Vishal; Mavalankar, Dileep V; Smith, Helen

    2012-08-27

    High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSY)and Chiranjeevi Yojana (CY), were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making among policy makers and program managers who currently work with or

  6. Disclosure Control using Partially Synthetic Data for Large-Scale Health Surveys, with Applications to CanCORS

    OpenAIRE

    Loong, Bronwyn; Zaslavsky, Alan M.; He, Yulei; Harrington, David P.

    2013-01-01

    Statistical agencies have begun to partially synthesize public-use data for major surveys to protect the confidentiality of respondents’ identities and sensitive attributes, by replacing high disclosure risk and sensitive variables with multiple imputations. To date, there are few applications of synthetic data techniques to large-scale healthcare survey data. Here, we describe partial synthesis of survey data collected by CanCORS, a comprehensive observational study of the experiences, treat...

  7. Large scale reflood test

    International Nuclear Information System (INIS)

    Hirano, Kemmei; Murao, Yoshio

    1980-01-01

    The large-scale reflood test with a view to ensuring the safety of light water reactors was started in fiscal 1976 based on the special account act for power source development promotion measures by the entrustment from the Science and Technology Agency. Thereafter, to establish the safety of PWRs in loss-of-coolant accidents by joint international efforts, the Japan-West Germany-U.S. research cooperation program was started in April, 1980. Thereupon, the large-scale reflood test is now included in this program. It consists of two tests using a cylindrical core testing apparatus for examining the overall system effect and a plate core testing apparatus for testing individual effects. Each apparatus is composed of the mock-ups of pressure vessel, primary loop, containment vessel and ECCS. The testing method, the test results and the research cooperation program are described. (J.P.N.)

  8. The health system and population health implications of large-scale diabetes screening in India: a microsimulation model of alternative approaches.

    Directory of Open Access Journals (Sweden)

    Sanjay Basu

    2015-05-01

    Full Text Available Like a growing number of rapidly developing countries, India has begun to develop a system for large-scale community-based screening for diabetes. We sought to identify the implications of using alternative screening instruments to detect people with undiagnosed type 2 diabetes among diverse populations across India.We developed and validated a microsimulation model that incorporated data from 58 studies from across the country into a nationally representative sample of Indians aged 25-65 y old. We estimated the diagnostic and health system implications of three major survey-based screening instruments and random glucometer-based screening. Of the 567 million Indians eligible for screening, depending on which of four screening approaches is utilized, between 158 and 306 million would be expected to screen as "high risk" for type 2 diabetes, and be referred for confirmatory testing. Between 26 million and 37 million of these people would be expected to meet international diagnostic criteria for diabetes, but between 126 million and 273 million would be "false positives." The ratio of false positives to true positives varied from 3.9 (when using random glucose screening to 8.2 (when using a survey-based screening instrument in our model. The cost per case found would be expected to be from US$5.28 (when using random glucose screening to US$17.06 (when using a survey-based screening instrument, presenting a total cost of between US$169 and US$567 million. The major limitation of our analysis is its dependence on published cohort studies that are unlikely fully to capture the poorest and most rural areas of the country. Because these areas are thought to have the lowest diabetes prevalence, this may result in overestimation of the efficacy and health benefits of screening.Large-scale community-based screening is anticipated to produce a large number of false-positive results, particularly if using currently available survey-based screening

  9. Collective response to public health emergencies and large-scale disasters: putting hospitals at the core of community resilience.

    Science.gov (United States)

    Paturas, James L; Smith, Deborah; Smith, Stewart; Albanese, Joseph

    2010-07-01

    Healthcare organisations are a critical part of a community's resilience and play a prominent role as the backbone of medical response to natural and manmade disasters. The importance of healthcare organisations, in particular hospitals, to remain operational extends beyond the necessity to sustain uninterrupted medical services for the community, in the aftermath of a large-scale disaster. Hospitals are viewed as safe havens where affected individuals go for shelter, food, water and psychosocial assistance, as well as to obtain information about missing family members or learn of impending dangers related to the incident. The ability of hospitals to respond effectively to high-consequence incidents producing a massive arrival of patients that disrupt daily operations requires surge capacity and capability. The activation of hospital emergency support functions provides an approach by which hospitals manage a short-term shortfall of hospital personnel through the reallocation of hospital employees, thereby obviating the reliance on external qualified volunteers for surge capacity and capability. Recent revisions to the Joint Commission's hospital emergency preparedness standard have impelled healthcare facilities to participate actively in community-wide planning, rather than confining planning exclusively to a single healthcare facility, in order to harmonise disaster management strategies and effectively coordinate the allocation of community resources and expertise across all local response agencies.

  10. Large Scale Solar Heating

    DEFF Research Database (Denmark)

    Heller, Alfred

    2001-01-01

    The main objective of the research was to evaluate large-scale solar heating connected to district heating (CSDHP), to build up a simulation tool and to demonstrate the application of the simulation tool for design studies and on a local energy planning case. The evaluation was mainly carried out...... model is designed and validated on the Marstal case. Applying the Danish Reference Year, a design tool is presented. The simulation tool is used for proposals for application of alternative designs, including high-performance solar collector types (trough solar collectors, vaccum pipe collectors......). Simulation programs are proposed as control supporting tool for daily operation and performance prediction of central solar heating plants. Finaly the CSHP technolgy is put into persepctive with respect to alternatives and a short discussion on the barries and breakthrough of the technology are given....

  11. Large scale model testing

    International Nuclear Information System (INIS)

    Brumovsky, M.; Filip, R.; Polachova, H.; Stepanek, S.

    1989-01-01

    Fracture mechanics and fatigue calculations for WWER reactor pressure vessels were checked by large scale model testing performed using large testing machine ZZ 8000 (with a maximum load of 80 MN) at the SKODA WORKS. The results are described from testing the material resistance to fracture (non-ductile). The testing included the base materials and welded joints. The rated specimen thickness was 150 mm with defects of a depth between 15 and 100 mm. The results are also presented of nozzles of 850 mm inner diameter in a scale of 1:3; static, cyclic, and dynamic tests were performed without and with surface defects (15, 30 and 45 mm deep). During cyclic tests the crack growth rate in the elastic-plastic region was also determined. (author). 6 figs., 2 tabs., 5 refs

  12. Implementing large-scale programmes to optimise the health workforce in low- and middle-income settings: a multicountry case study synthesis.

    Science.gov (United States)

    Gopinathan, Unni; Lewin, Simon; Glenton, Claire

    2014-12-01

    To identify factors affecting the implementation of large-scale programmes to optimise the health workforce in low- and middle-income countries. We conducted a multicountry case study synthesis. Eligible programmes were identified through consultation with experts and using Internet searches. Programmes were selected purposively to match the inclusion criteria. Programme documents were gathered via Google Scholar and PubMed and from key informants. The SURE Framework - a comprehensive list of factors that may influence the implementation of health system interventions - was used to organise the data. Thematic analysis was used to identify the key issues that emerged from the case studies. Programmes from Brazil, Ethiopia, India, Iran, Malawi, Venezuela and Zimbabwe were selected. Key system-level factors affecting the implementation of the programmes were related to health worker training and continuing education, management and programme support structures, the organisation and delivery of services, community participation, and the sociopolitical environment. Existing weaknesses in health systems may undermine the implementation of large-scale programmes to optimise the health workforce. Changes in the roles and responsibilities of cadres may also, in turn, impact the health system throughout. © 2014 John Wiley & Sons Ltd.

  13. Large scale tracking algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Ross L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Love, Joshua Alan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Melgaard, David Kennett [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Karelitz, David B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Pitts, Todd Alan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Zollweg, Joshua David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Anderson, Dylan Z. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Nandy, Prabal [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Whitlow, Gary L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bender, Daniel A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Byrne, Raymond Harry [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-01-01

    Low signal-to-noise data processing algorithms for improved detection, tracking, discrimination and situational threat assessment are a key research challenge. As sensor technologies progress, the number of pixels will increase signi cantly. This will result in increased resolution, which could improve object discrimination, but unfortunately, will also result in a significant increase in the number of potential targets to track. Many tracking techniques, like multi-hypothesis trackers, suffer from a combinatorial explosion as the number of potential targets increase. As the resolution increases, the phenomenology applied towards detection algorithms also changes. For low resolution sensors, "blob" tracking is the norm. For higher resolution data, additional information may be employed in the detection and classfication steps. The most challenging scenarios are those where the targets cannot be fully resolved, yet must be tracked and distinguished for neighboring closely spaced objects. Tracking vehicles in an urban environment is an example of such a challenging scenario. This report evaluates several potential tracking algorithms for large-scale tracking in an urban environment.

  14. Governance of extended lifecycle in large-scale eHealth initiatives: analyzing variability of enterprise architecture elements.

    Science.gov (United States)

    Mykkänen, Juha; Virkanen, Hannu; Tuomainen, Mika

    2013-01-01

    The governance of large eHealth initiatives requires traceability of many requirements and design decisions. We provide a model which we use to conceptually analyze variability of several enterprise architecture (EA) elements throughout the extended lifecycle of development goals using interrelated projects related to the national ePrescription in Finland.

  15. Estimates of occupational safety and health impacts resulting from large-scale production of major photovoltaic technologies

    Energy Technology Data Exchange (ETDEWEB)

    Owens, T.; Ungers, L.; Briggs, T.

    1980-08-01

    The purpose of this study is to estimate both quantitatively and qualitatively, the worker and societal risks attributable to four photovoltaic cell (solar cell) production processes. Quantitative risk values were determined by use of statistics from the California semiconductor industry. The qualitative risk assessment was performed using a variety of both governmental and private sources of data. The occupational health statistics derived from the semiconductor industry were used to predict injury and fatality levels associated with photovoltaic cell manufacturing. The use of these statistics to characterize the two silicon processes described herein is defensible from the standpoint that many of the same process steps and materials are used in both the semiconductor and photovoltaic industries. These health statistics are less applicable to the gallium arsenide and cadmium sulfide manufacturing processes, primarily because of differences in the materials utilized. Although such differences tend to discourage any absolute comparisons among the four photovoltaic cell production processes, certain relative comparisons are warranted. To facilitate a risk comparison of the four processes, the number and severity of process-related chemical hazards were assessed. This qualitative hazard assessment addresses both the relative toxicity and the exposure potential of substances in the workplace. In addition to the worker-related hazards, estimates of process-related emissions and wastes are also provided.

  16. Using large-scale public health data to explore the evolutionary biology of human pregnancy and child bearing

    DEFF Research Database (Denmark)

    Hollegaard, Birgitte

    . Consequently, research has increasingly focused on the underlying causes of disease, shaped by human evolution. Evolutionary medicine is a relatively new field, specifically bridging the gap between conventional medicine and evolutionary biology: Instead of asking how we get sick, we can apply evolutionary...... explanations for this phenomenon. This thesis demonstrates how taking an evolutionary perspective can help us to better understand important aspects of health and medicine that remain opaque, using the specific example of pregnancy-related conditions.......Medicine has made a giant leap forward over the last century when it comes to the treatment of human disease, but even the most cutting edge 21st century medicine cannot prevent new diseases arising, nor those thought to be extinct developing resistance to pharmaceuticals and returning...

  17. Radiations: large scale monitoring in Japan

    International Nuclear Information System (INIS)

    Linton, M.; Khalatbari, A.

    2011-01-01

    As the consequences of radioactive leaks on their health are a matter of concern for Japanese people, a large scale epidemiological study has been launched by the Fukushima medical university. It concerns the two millions inhabitants of the Fukushima Prefecture. On the national level and with the support of public funds, medical care and follow-up, as well as systematic controls are foreseen, notably to check the thyroid of 360.000 young people less than 18 year old and of 20.000 pregnant women in the Fukushima Prefecture. Some measurements have already been performed on young children. Despite the sometimes rather low measures, and because they know that some parts of the area are at least as much contaminated as it was the case around Chernobyl, some people are reluctant to go back home

  18. Large-scale solar purchasing

    International Nuclear Information System (INIS)

    1999-01-01

    The principal objective of the project was to participate in the definition of a new IEA task concerning solar procurement (''the Task'') and to assess whether involvement in the task would be in the interest of the UK active solar heating industry. The project also aimed to assess the importance of large scale solar purchasing to UK active solar heating market development and to evaluate the level of interest in large scale solar purchasing amongst potential large scale purchasers (in particular housing associations and housing developers). A further aim of the project was to consider means of stimulating large scale active solar heating purchasing activity within the UK. (author)

  19. Depression among family caregivers of community-dwelling older people who used services under the Long Term Care Insurance program: a large-scale population-based study in Japan.

    Science.gov (United States)

    Arai, Yumiko; Kumamoto, Keigo; Mizuno, Yoko; Washio, Masakazu

    2014-01-01

    To identify predictors for depression among family caregivers of community-dwelling older people under the Long Term Care Insurance (LTCI) program in Japan through a large-scale population-based survey. All 5938 older people with disabilities, using domiciliary services under the LTCI in the city of Toyama, and their family caregivers participated in this study. Caregiver depression was defined as scores of ≥16 on the Center for Epidemiological Studies Depression Scale (CES-D). Other caregiver measures included age, sex, hours spent caregiving, relationship to the care recipient, income adequacy, living arrangement, self-rated health, and work status. Care recipient measures included age, sex, level of functional disability, and severity of dementia. The data from 4128 pairs of the care recipients and their family caregivers were eligible for further analyses. A multiple logistic regression analysis was used to examine the predictors associated with being at risk of clinical depression (CES-D of ≥16). Overall, 34.2% of caregivers scored ≥16 on the CES-D. The independent predictors for depression by logistic regression analysis were six caregiver characteristics (female, income inadequacy, longer hours spent caregiving, worse subjective health, and co-residence with the care recipient) and one care-recipient characteristic (moderate dementia). This is one of the first population-based examinations of caregivers of older people who are enrolled in a national service system that provides affordable access to services. The results highlighted the importance of monitoring caregivers who manifest the identified predictors to attenuate caregiver depression at the population level under the LTCI.

  20. Large-scale data analytics

    CERN Document Server

    Gkoulalas-Divanis, Aris

    2014-01-01

    Provides cutting-edge research in large-scale data analytics from diverse scientific areas Surveys varied subject areas and reports on individual results of research in the field Shares many tips and insights into large-scale data analytics from authors and editors with long-term experience and specialization in the field

  1. A Numeric Scorecard Assessing the Mental Health Preparedness for Large-Scale Crises at College and University Campuses: A Delphi Study

    Science.gov (United States)

    Burgin, Rick A.

    2012-01-01

    Large-scale crises continue to surprise, overwhelm, and shatter college and university campuses. While the devastation to physical plants and persons is often evident and is addressed with crisis management plans, the number of emotional casualties left in the wake of these large-scale crises may not be apparent and are often not addressed with…

  2. "It's a complex mesh"- how large-scale health system reorganisation affected the delivery of the immunisation programme in England: a qualitative study.

    Science.gov (United States)

    Chantler, Tracey; Lwembe, Saumu; Saliba, Vanessa; Raj, Thara; Mays, Nicholas; Ramsay, Mary; Mounier-Jack, Sandra

    2016-09-15

    The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observations (immunisation board/committee meetings) occurred between December 2014 and June 2015, and September and December 2015. Interviews were audio recorded and transcribed verbatim and written accounts of observed events compiled. Data was imported into NVIVO 10 and analysed thematically. The new immunisation programme in the new health system was described as fragmented, and significant effort was expended to regroup. National tripartite arrangements required joint working and accountability; a shift from the simpler hierarchical pre-reform structure, typical of many public health programmes. New local inter-organisational arrangements resulted in ambiguity about organisational responsibilities and hindered data-sharing. Whilst making immunisation managers responsible for larger areas supported equitable resource distribution and strengthened service commissioning, it also reduced their ability to apply clinical expertise, support and evaluate immunisation providers' performance

  3. Large-scale grid management

    International Nuclear Information System (INIS)

    Langdal, Bjoern Inge; Eggen, Arnt Ove

    2003-01-01

    The network companies in the Norwegian electricity industry now have to establish a large-scale network management, a concept essentially characterized by (1) broader focus (Broad Band, Multi Utility,...) and (2) bigger units with large networks and more customers. Research done by SINTEF Energy Research shows so far that the approaches within large-scale network management may be structured according to three main challenges: centralization, decentralization and out sourcing. The article is part of a planned series

  4. Large scale structure and baryogenesis

    International Nuclear Information System (INIS)

    Kirilova, D.P.; Chizhov, M.V.

    2001-08-01

    We discuss a possible connection between the large scale structure formation and the baryogenesis in the universe. An update review of the observational indications for the presence of a very large scale 120h -1 Mpc in the distribution of the visible matter of the universe is provided. The possibility to generate a periodic distribution with the characteristic scale 120h -1 Mpc through a mechanism producing quasi-periodic baryon density perturbations during inflationary stage, is discussed. The evolution of the baryon charge density distribution is explored in the framework of a low temperature boson condensate baryogenesis scenario. Both the observed very large scale of a the visible matter distribution in the universe and the observed baryon asymmetry value could naturally appear as a result of the evolution of a complex scalar field condensate, formed at the inflationary stage. Moreover, for some model's parameters a natural separation of matter superclusters from antimatter ones can be achieved. (author)

  5. Assessing outcomes of large-scale public health interventions in the absence of baseline data using a mixture of Cox and binomial regressions

    Science.gov (United States)

    2014-01-01

    Background Large-scale public health interventions with rapid scale-up are increasingly being implemented worldwide. Such implementation allows for a large target population to be reached in a short period of time. But when the time comes to investigate the effectiveness of these interventions, the rapid scale-up creates several methodological challenges, such as the lack of baseline data and the absence of control groups. One example of such an intervention is Avahan, the India HIV/AIDS initiative of the Bill & Melinda Gates Foundation. One question of interest is the effect of Avahan on condom use by female sex workers with their clients. By retrospectively reconstructing condom use and sex work history from survey data, it is possible to estimate how condom use rates evolve over time. However formal inference about how this rate changes at a given point in calendar time remains challenging. Methods We propose a new statistical procedure based on a mixture of binomial regression and Cox regression. We compare this new method to an existing approach based on generalized estimating equations through simulations and application to Indian data. Results Both methods are unbiased, but the proposed method is more powerful than the existing method, especially when initial condom use is high. When applied to the Indian data, the new method mostly agrees with the existing method, but seems to have corrected some implausible results of the latter in a few districts. We also show how the new method can be used to analyze the data of all districts combined. Conclusions The use of both methods can be recommended for exploratory data analysis. However for formal statistical inference, the new method has better power. PMID:24397563

  6. Large-scale multimedia modeling applications

    International Nuclear Information System (INIS)

    Droppo, J.G. Jr.; Buck, J.W.; Whelan, G.; Strenge, D.L.; Castleton, K.J.; Gelston, G.M.

    1995-08-01

    Over the past decade, the US Department of Energy (DOE) and other agencies have faced increasing scrutiny for a wide range of environmental issues related to past and current practices. A number of large-scale applications have been undertaken that required analysis of large numbers of potential environmental issues over a wide range of environmental conditions and contaminants. Several of these applications, referred to here as large-scale applications, have addressed long-term public health risks using a holistic approach for assessing impacts from potential waterborne and airborne transport pathways. Multimedia models such as the Multimedia Environmental Pollutant Assessment System (MEPAS) were designed for use in such applications. MEPAS integrates radioactive and hazardous contaminants impact computations for major exposure routes via air, surface water, ground water, and overland flow transport. A number of large-scale applications of MEPAS have been conducted to assess various endpoints for environmental and human health impacts. These applications are described in terms of lessons learned in the development of an effective approach for large-scale applications

  7. Large-scale solar heat

    Energy Technology Data Exchange (ETDEWEB)

    Tolonen, J.; Konttinen, P.; Lund, P. [Helsinki Univ. of Technology, Otaniemi (Finland). Dept. of Engineering Physics and Mathematics

    1998-12-31

    In this project a large domestic solar heating system was built and a solar district heating system was modelled and simulated. Objectives were to improve the performance and reduce costs of a large-scale solar heating system. As a result of the project the benefit/cost ratio can be increased by 40 % through dimensioning and optimising the system at the designing stage. (orig.)

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    care policy which was intended to make health care which of the two alternative methods of health care available to individuals and families in the financing options of free health or DRF was community at very little or no cost at all. However, preferred by the community members within most health facilities would appear to ...

  9. A large-scale field study examining effects of exposure to clothianidin seed-treated canola on honey bee colony health, development, and overwintering success

    OpenAIRE

    Cutler, G. Christopher; Scott-Dupree, Cynthia D.; Sultan, Maryam; McFarlane, Andrew D.; Brewer, Larry

    2014-01-01

    In summer 2012, we initiated a large-scale field experiment in southern Ontario, Canada, to determine whether exposure to clothianidin seed-treated canola (oil seed rape) has any adverse impacts on honey bees. Colonies were placed in clothianidin seed-treated or control canola fields during bloom, and thereafter were moved to an apiary with no surrounding crops grown from seeds treated with neonicotinoids. Colony weight gain, honey production, pest incidence, bee mortality, number of adults, ...

  10. Respiratory Home Health Care

    Science.gov (United States)

    ... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

  11. Japanese large-scale interferometers

    CERN Document Server

    Kuroda, K; Miyoki, S; Ishizuka, H; Taylor, C T; Yamamoto, K; Miyakawa, O; Fujimoto, M K; Kawamura, S; Takahashi, R; Yamazaki, T; Arai, K; Tatsumi, D; Ueda, A; Fukushima, M; Sato, S; Shintomi, T; Yamamoto, A; Suzuki, T; Saitô, Y; Haruyama, T; Sato, N; Higashi, Y; Uchiyama, T; Tomaru, T; Tsubono, K; Ando, M; Takamori, A; Numata, K; Ueda, K I; Yoneda, H; Nakagawa, K; Musha, M; Mio, N; Moriwaki, S; Somiya, K; Araya, A; Kanda, N; Telada, S; Sasaki, M; Tagoshi, H; Nakamura, T; Tanaka, T; Ohara, K

    2002-01-01

    The objective of the TAMA 300 interferometer was to develop advanced technologies for kilometre scale interferometers and to observe gravitational wave events in nearby galaxies. It was designed as a power-recycled Fabry-Perot-Michelson interferometer and was intended as a step towards a final interferometer in Japan. The present successful status of TAMA is presented. TAMA forms a basis for LCGT (large-scale cryogenic gravitational wave telescope), a 3 km scale cryogenic interferometer to be built in the Kamioka mine in Japan, implementing cryogenic mirror techniques. The plan of LCGT is schematically described along with its associated R and D.

  12. Accuracy of Electronic Health Record Data for Identifying Stroke Cases in Large-Scale Epidemiological Studies: A Systematic Review from the UK Biobank Stroke Outcomes Group.

    Directory of Open Access Journals (Sweden)

    Rebecca Woodfield

    Full Text Available Long-term follow-up of population-based prospective studies is often achieved through linkages to coded regional or national health care data. Our knowledge of the accuracy of such data is incomplete. To inform methods for identifying stroke cases in UK Biobank (a prospective study of 503,000 UK adults recruited in middle-age, we systematically evaluated the accuracy of these data for stroke and its main pathological types (ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, determining the optimum codes for case identification.We sought studies published from 1990-November 2013, which compared coded data from death certificates, hospital admissions or primary care with a reference standard for stroke or its pathological types. We extracted information on a range of study characteristics and assessed study quality with the Quality Assessment of Diagnostic Studies tool (QUADAS-2. To assess accuracy, we extracted data on positive predictive values (PPV and-where available-on sensitivity, specificity, and negative predictive values (NPV.37 of 39 eligible studies assessed accuracy of International Classification of Diseases (ICD-coded hospital or death certificate data. They varied widely in their settings, methods, reporting, quality, and in the choice and accuracy of codes. Although PPVs for stroke and its pathological types ranged from 6-97%, appropriately selected, stroke-specific codes (rather than broad cerebrovascular codes consistently produced PPVs >70%, and in several studies >90%. The few studies with data on sensitivity, specificity and NPV showed higher sensitivity of hospital versus death certificate data for stroke, with specificity and NPV consistently >96%. Few studies assessed either primary care data or combinations of data sources.Particular stroke-specific codes can yield high PPVs (>90% for stroke/stroke types. Inclusion of primary care data and combining data sources should improve accuracy in large

  13. Effectiveness of a large-scale health and nutritional education program on anemia in children younger than 5 years in Shifang, a heavily damaged area of Wenchuan earthquake.

    Science.gov (United States)

    Yang, Fan; Wang, Chuan; Yang, Hui; Yang, Huiming; Yang, Sufei; Yu, Tao; Tang, Zhanghui; Ji, Qiaoyun; Li, Fengyi; Shi, Hua; Mao, Meng

    2015-03-01

    This study aimed to explore an ideal way to prevent anemia among children younger than 5 years after disasters especially when health care facilities are not enough. A preliminary survey was carried out involving 13 065 children younger than 5 years. Pretested questionnaires were used for data collection and hemoglobin levels were measured. After 12-month intervention, the impact survey involving 2769 children was conducted. Results showed that there were some improvements both in feeding knowledge and practice related to anemia. The total prevalence of anemia decreased from 14.3% to 7.8% (P education could be an ideal way to combat anemia after disasters especially in less developed areas with multiparty cooperation. The methods and experiences of this study may be well worth learning and implementing. © 2013 APJPH.

  14. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  15. Large scale biomimetic membrane arrays

    DEFF Research Database (Denmark)

    Hansen, Jesper Søndergaard; Perry, Mark; Vogel, Jörg

    2009-01-01

    To establish planar biomimetic membranes across large scale partition aperture arrays, we created a disposable single-use horizontal chamber design that supports combined optical-electrical measurements. Functional lipid bilayers could easily and efficiently be established across CO2 laser micro......-structured 8 x 8 aperture partition arrays with average aperture diameters of 301 +/- 5 mu m. We addressed the electro-physical properties of the lipid bilayers established across the micro-structured scaffold arrays by controllable reconstitution of biotechnological and physiological relevant membrane...... peptides and proteins. Next, we tested the scalability of the biomimetic membrane design by establishing lipid bilayers in rectangular 24 x 24 and hexagonal 24 x 27 aperture arrays, respectively. The results presented show that the design is suitable for further developments of sensitive biosensor assays...

  16. Conference on Large Scale Optimization

    CERN Document Server

    Hearn, D; Pardalos, P

    1994-01-01

    On February 15-17, 1993, a conference on Large Scale Optimization, hosted by the Center for Applied Optimization, was held at the University of Florida. The con­ ference was supported by the National Science Foundation, the U. S. Army Research Office, and the University of Florida, with endorsements from SIAM, MPS, ORSA and IMACS. Forty one invited speakers presented papers on mathematical program­ ming and optimal control topics with an emphasis on algorithm development, real world applications and numerical results. Participants from Canada, Japan, Sweden, The Netherlands, Germany, Belgium, Greece, and Denmark gave the meeting an important international component. At­ tendees also included representatives from IBM, American Airlines, US Air, United Parcel Serice, AT & T Bell Labs, Thinking Machines, Army High Performance Com­ puting Research Center, and Argonne National Laboratory. In addition, the NSF sponsored attendance of thirteen graduate students from universities in the United States and abro...

  17. Large scale nuclear structure studies

    International Nuclear Information System (INIS)

    Faessler, A.

    1985-01-01

    Results of large scale nuclear structure studies are reported. The starting point is the Hartree-Fock-Bogoliubov solution with angular momentum and proton and neutron number projection after variation. This model for number and spin projected two-quasiparticle excitations with realistic forces yields in sd-shell nuclei similar good results as the 'exact' shell-model calculations. Here the authors present results for a pf-shell nucleus 46 Ti and results for the A=130 mass region where they studied 58 different nuclei with the same single-particle energies and the same effective force derived from a meson exchange potential. They carried out a Hartree-Fock-Bogoliubov variation after mean field projection in realistic model spaces. In this way, they determine for each yrast state the optimal mean Hartree-Fock-Bogoliubov field. They apply this method to 130 Ce and 128 Ba using the same effective nucleon-nucleon interaction. (Auth.)

  18. Large-scale river regulation

    International Nuclear Information System (INIS)

    Petts, G.

    1994-01-01

    Recent concern over human impacts on the environment has tended to focus on climatic change, desertification, destruction of tropical rain forests, and pollution. Yet large-scale water projects such as dams, reservoirs, and inter-basin transfers are among the most dramatic and extensive ways in which our environment has been, and continues to be, transformed by human action. Water running to the sea is perceived as a lost resource, floods are viewed as major hazards, and wetlands are seen as wastelands. River regulation, involving the redistribution of water in time and space, is a key concept in socio-economic development. To achieve water and food security, to develop drylands, and to prevent desertification and drought are primary aims for many countries. A second key concept is ecological sustainability. Yet the ecology of rivers and their floodplains is dependent on the natural hydrological regime, and its related biochemical and geomorphological dynamics. (Author)

  19. Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice

    Science.gov (United States)

    Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

    2010-01-01

    Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

  20. Preferences for care towards the end of life when decision-making capacity may be impaired: A large scale cross-sectional survey of public attitudes in Great Britain and the United States.

    Directory of Open Access Journals (Sweden)

    Gemma Clarke

    Full Text Available There is continuing public debate about treatment preferences at the end of life, and the acceptability and legal status of treatments that sustain or end life. However, most surveys use binary yes/no measures, and little is known about preferences in neurological disease when decision-making capacity is lost, as most studies focus on cancer. This study investigates changes in public preferences for care towards the end of life, with a focus on measures to sustain or end life.Large-scale international public opinion surveys using a six-stage patient vignette, respondents chose a level of intervention for each stage as health and decision-making capacity deteriorated. Cross-sectional representative samples of the general public in Great Britain and the USA (N = 2016. Primary outcome measure: changes in respondents' preferences for care, measured on a four-point scale designed before data collection. The scale ranged from: maintaining life at all costs; to intervention with agreement; to no intervention; to measures for ending life.There were no significant differences between GB and USA. Preference for measures to sustain life at all costs peaked at short-term memory loss (30.2%, n = 610. Respondents selecting 'measures to help me die peacefully' increased from 3.9% to 37.0% as the condition deteriorated, with the largest increase occurring when decision-making capacity was lost (10.3% to 23.0%. Predictors of choosing 'measures to help me die peacefully' at any stage were: previous personal experience (OR = 1.34, p<0.010, and older age (OR = 1.09 per decade, p<0.010. Negative predictors: living with children (OR = 0.72, p<0.010 and being of "black" race/ethnicity (OR = 0.45, p<0.001.Public opinion was uniform between GB and USA, but markedly heterogeneous. Despite contemporaneous capacitous consent providing an essential legal safeguard in most jurisdictions, there was a high prevalence of preference for "measures to end my life peacefully" when

  1. Reviving large-scale projects

    International Nuclear Information System (INIS)

    Desiront, A.

    2003-01-01

    For the past decade, most large-scale hydro development projects in northern Quebec have been put on hold due to land disputes with First Nations. Hydroelectric projects have recently been revived following an agreement signed with Aboriginal communities in the province who recognized the need to find new sources of revenue for future generations. Many Cree are working on the project to harness the waters of the Eastmain River located in the middle of their territory. The work involves building an 890 foot long dam, 30 dikes enclosing a 603 square-km reservoir, a spillway, and a power house with 3 generating units with a total capacity of 480 MW of power for start-up in 2007. The project will require the use of 2,400 workers in total. The Cree Construction and Development Company is working on relations between Quebec's 14,000 Crees and the James Bay Energy Corporation, the subsidiary of Hydro-Quebec which is developing the project. Approximately 10 per cent of the $735-million project has been designated for the environmental component. Inspectors ensure that the project complies fully with environmental protection guidelines. Total development costs for Eastmain-1 are in the order of $2 billion of which $735 million will cover work on site and the remainder will cover generating units, transportation and financial charges. Under the treaty known as the Peace of the Braves, signed in February 2002, the Quebec government and Hydro-Quebec will pay the Cree $70 million annually for 50 years for the right to exploit hydro, mining and forest resources within their territory. The project comes at a time when electricity export volumes to the New England states are down due to growth in Quebec's domestic demand. Hydropower is a renewable and non-polluting source of energy that is one of the most acceptable forms of energy where the Kyoto Protocol is concerned. It was emphasized that large-scale hydro-electric projects are needed to provide sufficient energy to meet both

  2. Health Terrain: Visualizing Large Scale Health Data

    Science.gov (United States)

    2015-12-01

    Gonorrhea ,  7)  Chickenpox,  8)   Measles,  9...INFECTION  and   GONORRHEA  are  the  most  common  conditions  in  the  NCD   data.  TRICHOMONIASIS  and  SYPHILIS  are...example  of  the  Ring  Graph  for  Chlamydia  Infection,   Gonorrhea ,  and  Syphilis  over  a  time

  3. Large Scale Glazed Concrete Panels

    DEFF Research Database (Denmark)

    Bache, Anja Margrethe

    2010-01-01

    Today, there is a lot of focus on concrete surface’s aesthitic potential, both globally and locally. World famous architects such as Herzog De Meuron, Zaha Hadid, Richard Meyer and David Chippenfield challenge the exposure of concrete in their architecture. At home, this trend can be seen...... in the crinkly façade of DR-Byen (the domicile of the Danish Broadcasting Company) by architect Jean Nouvel and Zaha Hadid’s Ordrupgård’s black curved smooth concrete surfaces. Furthermore, one can point to initiatives such as “Synlig beton” (visible concrete) that can be seen on the website www.......synligbeton.dk and spæncom’s aesthetic relief effects by the designer Line Kramhøft (www.spaencom.com). It is my hope that the research-development project “Lasting large scale glazed concrete formwork,” I am working on at DTU, department of Architectural Engineering will be able to complement these. It is a project where I...

  4. Large scale cluster computing workshop

    International Nuclear Information System (INIS)

    Dane Skow; Alan Silverman

    2002-01-01

    Recent revolutions in computer hardware and software technologies have paved the way for the large-scale deployment of clusters of commodity computers to address problems heretofore the domain of tightly coupled SMP processors. Near term projects within High Energy Physics and other computing communities will deploy clusters of scale 1000s of processors and be used by 100s to 1000s of independent users. This will expand the reach in both dimensions by an order of magnitude from the current successful production facilities. The goals of this workshop were: (1) to determine what tools exist which can scale up to the cluster sizes foreseen for the next generation of HENP experiments (several thousand nodes) and by implication to identify areas where some investment of money or effort is likely to be needed. (2) To compare and record experimences gained with such tools. (3) To produce a practical guide to all stages of planning, installing, building and operating a large computing cluster in HENP. (4) To identify and connect groups with similar interest within HENP and the larger clustering community

  5. Large scale cross hole testing

    International Nuclear Information System (INIS)

    Ball, J.K.; Black, J.H.; Doe, T.

    1991-05-01

    As part of the Site Characterisation and Validation programme the results of the large scale cross hole testing have been used to document hydraulic connections across the SCV block, to test conceptual models of fracture zones and obtain hydrogeological properties of the major hydrogeological features. The SCV block is highly heterogeneous. This heterogeneity is not smoothed out even over scales of hundreds of meters. Results of the interpretation validate the hypothesis of the major fracture zones, A, B and H; not much evidence of minor fracture zones is found. The uncertainty in the flow path, through the fractured rock, causes sever problems in interpretation. Derived values of hydraulic conductivity were found to be in a narrow range of two to three orders of magnitude. Test design did not allow fracture zones to be tested individually. This could be improved by testing the high hydraulic conductivity regions specifically. The Piezomac and single hole equipment worked well. Few, if any, of the tests ran long enough to approach equilibrium. Many observation boreholes showed no response. This could either be because there is no hydraulic connection, or there is a connection but a response is not seen within the time scale of the pumping test. The fractional dimension analysis yielded credible results, and the sinusoidal testing procedure provided an effective means of identifying the dominant hydraulic connections. (10 refs.) (au)

  6. Large-scale pool fires

    Directory of Open Access Journals (Sweden)

    Steinhaus Thomas

    2007-01-01

    Full Text Available A review of research into the burning behavior of large pool fires and fuel spill fires is presented. The features which distinguish such fires from smaller pool fires are mainly associated with the fire dynamics at low source Froude numbers and the radiative interaction with the fire source. In hydrocarbon fires, higher soot levels at increased diameters result in radiation blockage effects around the perimeter of large fire plumes; this yields lower emissive powers and a drastic reduction in the radiative loss fraction; whilst there are simplifying factors with these phenomena, arising from the fact that soot yield can saturate, there are other complications deriving from the intermittency of the behavior, with luminous regions of efficient combustion appearing randomly in the outer surface of the fire according the turbulent fluctuations in the fire plume. Knowledge of the fluid flow instabilities, which lead to the formation of large eddies, is also key to understanding the behavior of large-scale fires. Here modeling tools can be effectively exploited in order to investigate the fluid flow phenomena, including RANS- and LES-based computational fluid dynamics codes. The latter are well-suited to representation of the turbulent motions, but a number of challenges remain with their practical application. Massively-parallel computational resources are likely to be necessary in order to be able to adequately address the complex coupled phenomena to the level of detail that is necessary.

  7. Based on Real Time Remote Health Monitoring Systems: A New Approach for Prioritization "Large Scales Data" Patients with Chronic Heart Diseases Using Body Sensors and Communication Technology.

    Science.gov (United States)

    Kalid, Naser; Zaidan, A A; Zaidan, B B; Salman, Omar H; Hashim, M; Albahri, O S; Albahri, A S

    2018-03-02

    This paper presents a new approach to prioritize "Large-scale Data" of patients with chronic heart diseases by using body sensors and communication technology during disasters and peak seasons. An evaluation matrix is used for emergency evaluation and large-scale data scoring of patients with chronic heart diseases in telemedicine environment. However, one major problem in the emergency evaluation of these patients is establishing a reasonable threshold for patients with the most and least critical conditions. This threshold can be used to detect the highest and lowest priority levels when all the scores of patients are identical during disasters and peak seasons. A practical study was performed on 500 patients with chronic heart diseases and different symptoms, and their emergency levels were evaluated based on four main measurements: electrocardiogram, oxygen saturation sensor, blood pressure monitoring, and non-sensory measurement tool, namely, text frame. Data alignment was conducted for the raw data and decision-making matrix by converting each extracted feature into an integer. This integer represents their state in the triage level based on medical guidelines to determine the features from different sources in a platform. The patients were then scored based on a decision matrix by using multi-criteria decision-making techniques, namely, integrated multi-layer for analytic hierarchy process (MLAHP) and technique for order performance by similarity to ideal solution (TOPSIS). For subjective validation, cardiologists were consulted to confirm the ranking results. For objective validation, mean ± standard deviation was computed to check the accuracy of the systematic ranking. This study provides scenarios and checklist benchmarking to evaluate the proposed and existing prioritization methods. Experimental results revealed the following. (1) The integration of TOPSIS and MLAHP effectively and systematically solved the patient settings on triage and

  8. Consumer Directed Health Care

    OpenAIRE

    John Goodman

    2006-01-01

    Consumer driven health care (CDHC) is a potential solution to two perplexing problems: (1) How to choose between health care and other uses of money, and (2) how to allocate resources in an industry where normal market forces have been systemically suppressed. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care that they receive. From an employee benefits perspective, consumer driven health care in the broadest sense may refer to limited e...

  9. Distributed leadership in health care

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette

    2018-01-01

    Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...

  10. Large-scale galaxy bias

    Science.gov (United States)

    Desjacques, Vincent; Jeong, Donghui; Schmidt, Fabian

    2018-02-01

    This review presents a comprehensive overview of galaxy bias, that is, the statistical relation between the distribution of galaxies and matter. We focus on large scales where cosmic density fields are quasi-linear. On these scales, the clustering of galaxies can be described by a perturbative bias expansion, and the complicated physics of galaxy formation is absorbed by a finite set of coefficients of the expansion, called bias parameters. The review begins with a detailed derivation of this very important result, which forms the basis of the rigorous perturbative description of galaxy clustering, under the assumptions of General Relativity and Gaussian, adiabatic initial conditions. Key components of the bias expansion are all leading local gravitational observables, which include the matter density but also tidal fields and their time derivatives. We hence expand the definition of local bias to encompass all these contributions. This derivation is followed by a presentation of the peak-background split in its general form, which elucidates the physical meaning of the bias parameters, and a detailed description of the connection between bias parameters and galaxy statistics. We then review the excursion-set formalism and peak theory which provide predictions for the values of the bias parameters. In the remainder of the review, we consider the generalizations of galaxy bias required in the presence of various types of cosmological physics that go beyond pressureless matter with adiabatic, Gaussian initial conditions: primordial non-Gaussianity, massive neutrinos, baryon-CDM isocurvature perturbations, dark energy, and modified gravity. Finally, we discuss how the description of galaxy bias in the galaxies' rest frame is related to clustering statistics measured from the observed angular positions and redshifts in actual galaxy catalogs.

  11. Large-scale galaxy bias

    Science.gov (United States)

    Jeong, Donghui; Desjacques, Vincent; Schmidt, Fabian

    2018-01-01

    Here, we briefly introduce the key results of the recent review (arXiv:1611.09787), whose abstract is as following. This review presents a comprehensive overview of galaxy bias, that is, the statistical relation between the distribution of galaxies and matter. We focus on large scales where cosmic density fields are quasi-linear. On these scales, the clustering of galaxies can be described by a perturbative bias expansion, and the complicated physics of galaxy formation is absorbed by a finite set of coefficients of the expansion, called bias parameters. The review begins with a detailed derivation of this very important result, which forms the basis of the rigorous perturbative description of galaxy clustering, under the assumptions of General Relativity and Gaussian, adiabatic initial conditions. Key components of the bias expansion are all leading local gravitational observables, which include the matter density but also tidal fields and their time derivatives. We hence expand the definition of local bias to encompass all these contributions. This derivation is followed by a presentation of the peak-background split in its general form, which elucidates the physical meaning of the bias parameters, and a detailed description of the connection between bias parameters and galaxy (or halo) statistics. We then review the excursion set formalism and peak theory which provide predictions for the values of the bias parameters. In the remainder of the review, we consider the generalizations of galaxy bias required in the presence of various types of cosmological physics that go beyond pressureless matter with adiabatic, Gaussian initial conditions: primordial non-Gaussianity, massive neutrinos, baryon-CDM isocurvature perturbations, dark energy, and modified gravity. Finally, we discuss how the description of galaxy bias in the galaxies' rest frame is related to clustering statistics measured from the observed angular positions and redshifts in actual galaxy catalogs.

  12. A large-scale field study examining effects of exposure to clothianidin seed-treated canola on honey bee colony health, development, and overwintering success

    Directory of Open Access Journals (Sweden)

    G. Christopher Cutler

    2014-10-01

    Full Text Available In summer 2012, we initiated a large-scale field experiment in southern Ontario, Canada, to determine whether exposure to clothianidin seed-treated canola (oil seed rape has any adverse impacts on honey bees. Colonies were placed in clothianidin seed-treated or control canola fields during bloom, and thereafter were moved to an apiary with no surrounding crops grown from seeds treated with neonicotinoids. Colony weight gain, honey production, pest incidence, bee mortality, number of adults, and amount of sealed brood were assessed in each colony throughout summer and autumn. Samples of honey, beeswax, pollen, and nectar were regularly collected, and samples were analyzed for clothianidin residues. Several of these endpoints were also measured in spring 2013. Overall, colonies were vigorous during and after the exposure period, and we found no effects of exposure to clothianidin seed-treated canola on any endpoint measures. Bees foraged heavily on the test fields during peak bloom and residue analysis indicated that honey bees were exposed to low levels (0.5–2 ppb of clothianidin in pollen. Low levels of clothianidin were detected in a few pollen samples collected toward the end of the bloom from control hives, illustrating the difficulty of conducting a perfectly controlled field study with free-ranging honey bees in agricultural landscapes. Overwintering success did not differ significantly between treatment and control hives, and was similar to overwintering colony loss rates reported for the winter of 2012–2013 for beekeepers in Ontario and Canada. Our results suggest that exposure to canola grown from seed treated with clothianidin poses low risk to honey bees.

  13. A large-scale field study examining effects of exposure to clothianidin seed-treated canola on honey bee colony health, development, and overwintering success.

    Science.gov (United States)

    Cutler, G Christopher; Scott-Dupree, Cynthia D; Sultan, Maryam; McFarlane, Andrew D; Brewer, Larry

    2014-01-01

    In summer 2012, we initiated a large-scale field experiment in southern Ontario, Canada, to determine whether exposure to clothianidin seed-treated canola (oil seed rape) has any adverse impacts on honey bees. Colonies were placed in clothianidin seed-treated or control canola fields during bloom, and thereafter were moved to an apiary with no surrounding crops grown from seeds treated with neonicotinoids. Colony weight gain, honey production, pest incidence, bee mortality, number of adults, and amount of sealed brood were assessed in each colony throughout summer and autumn. Samples of honey, beeswax, pollen, and nectar were regularly collected, and samples were analyzed for clothianidin residues. Several of these endpoints were also measured in spring 2013. Overall, colonies were vigorous during and after the exposure period, and we found no effects of exposure to clothianidin seed-treated canola on any endpoint measures. Bees foraged heavily on the test fields during peak bloom and residue analysis indicated that honey bees were exposed to low levels (0.5-2 ppb) of clothianidin in pollen. Low levels of clothianidin were detected in a few pollen samples collected toward the end of the bloom from control hives, illustrating the difficulty of conducting a perfectly controlled field study with free-ranging honey bees in agricultural landscapes. Overwintering success did not differ significantly between treatment and control hives, and was similar to overwintering colony loss rates reported for the winter of 2012-2013 for beekeepers in Ontario and Canada. Our results suggest that exposure to canola grown from seed treated with clothianidin poses low risk to honey bees.

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...

  15. Health Care Delivery.

    Science.gov (United States)

    Starfield, Barbara

    1987-01-01

    The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

  16. Which health-related problems are associated with problematic video-gaming or social media use in adolescents? : A large-scale cross-sectional study

    NARCIS (Netherlands)

    S.Y.M. Mérelle (Saskia); A. Kleiboer (Annet); M. Schotanus (Miriam); T.L.M. Cluitmans (Theresia L. M.); C.M. Waardenburg (Cornelia M.); D. Kramer (Danielle); H. van de Mheen (Dike); A.J. van Rooij (Antonius)

    2017-01-01

    markdownabstract_Objective:_ Problematic video-gaming or social media use may seriously affect adolescents’ health status. However, it is not very well known which health-related problems are most strongly related to these issues. To inform the development of prevention and intervention strategies,

  17. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  18. WHICH HEALTH-RELATED PROBLEMS ARE ASSOCIATED WITH PROBLEMATIC VIDEO-GAMING OR SOCIAL MEDIA USE IN ADOLESCENTS? A LARGE-SCALE CROSS-SECTIONAL STUDY

    OpenAIRE

    Saskia Y. M. Mérelle; Annet M. Kleiboer; Miriam Schotanus; Theresia L. M. Cluitmans; Cornelia M. Waardenburg; Danielle Kramer; Dike van de Mheen; Antonius J. van Rooij

    2017-01-01

    markdownabstract_Objective:_ Problematic video-gaming or social media use may seriously affect adolescents’ health status. However, it is not very well known which health-related problems are most strongly related to these issues. To inform the development of prevention and intervention strategies, this study aims to gain a better understanding of the healthrelated problems and demographical factors associated with problematic video-gaming or social media use in early adolescence. _Method:_ A...

  19. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

    The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

  20. California's "5 a day--for better health!" campaign: an innovative population-based effort to effect large-scale dietary change.

    Science.gov (United States)

    Foerster, S B; Kizer, K W; Disogra, L K; Bal, D G; Krieg, B F; Bunch, K L

    1995-01-01

    The annual toll of diet-related diseases in the United States is similar to that taken by tobacco, but less progress has been achieved in reaching the Public Health Service's Healthy People 2000 objectives for improving food consumption than for reducing tobacco use. In 1988, the California Department of Health Services embarked upon an innovative multi-year social marketing program to increase fruit and vegetable consumption. The 5 a Day--for Better Health! Campaign had several distinctive features, including its simple, positive, behavior-specific message to eat 5 servings of fruits and vegetables every day as part of a low-fat, high fiber diet; its use of mass media; its partnership between the state health department and the produce and supermarket industries; and its extensive use of point-of-purchase messages. Over its nearly three years of operation in California, the 5 a Day Campaign appears to have raised public awareness that fruits and vegetables help reduce cancer risk, increased fruit and vegetable consumption in major population segments, and created an ongoing partnership between public health and agribusiness that has allowed extension of the campaign to other population segments, namely children and Latino adults. In 1991 the campaign was adopted as a national initiative by the National Cancer Institute and the Produce for Better Health Foundation. By 1994, over 700 industry organizations and 48 states, territories, and the District of Columbia were licensed to participate. Preventive medicine practitioners and others involved in health promotion may build upon the 5 a Day Campaign experience in developing and implementing efforts to reach the nation's dietary goals.

  1. The Netherlands: Industrial relations in the health care sector

    NARCIS (Netherlands)

    Schaapman, M.

    2011-01-01

    The most important development in the health care sector in the Netherlands over the past five years had been the introduction and development of market regulation. Unions are critical of this development and point at contraproductive effects of specialisation and large scale companies. Employers

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations ... of Dust Mask among Crushers of Selected Quarry (Crushed ... Journal of Community Medicine and Primary Health Care.

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.

  4. WHICH HEALTH-RELATED PROBLEMS ARE ASSOCIATED WITH PROBLEMATIC VIDEO-GAMING OR SOCIAL MEDIA USE IN ADOLESCENTS? A LARGE-SCALE CROSS-SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Saskia Y. M. Mérelle

    2017-02-01

    Full Text Available Objective: Problematic video-gaming or social media use may seriously affect adolescents’ health status. However, it is not very well known which health-related problems are most strongly related to these issues. To inform the development of prevention and intervention strategies, this study aims to gain a better understanding of the health-related problems and demographical factors associated with problematic video-gaming or social media use in early adolescence. Method: A cross-sectional analysis was performed on data collected by two Municipal Health Services in the Netherlands in 2013-2014. In this survey among youth, 21,053 students from secondary schools (mean age 14.4 years completed a web-based questionnaire. Multivariate analyses were carried out to assess the strength of the associations between mental health problems, life-events, lifestyle and substance use as independent variables, and problematic video-gaming and problematic social media use as dependent variables. Results: Of the participating students, 5.7% reported problematic video-gaming and 9.1% problematic social media use. Problematic video-gaming was most strongly associated with conduct problems, suicidal thoughts (all medium effect sizes, OR ≥2, p<0.01, sedentary behavior (large effect size, OR ≥3, p<0.01, and male gender (large effect size. Problematic social media use was highly associated with conduct problems, hyperactivity and sedentary behavior (all medium effect sizes. Additionally, female gender and non-Western ethnicity were relevant demographics (large and medium effect size. Conclusions: Most mental health problems were consistently associated with both problematic video-gaming and problematic social media use, though associations were only practically relevant for conduct problems (both groups, suicidal thoughts (problematic video-gaming and hyperactivity (problematic social media use. This study also highlights sedentary behavior as health risk as it

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Background: The well-being of women and children is one of the major determinants ... The Sample for the study were women recruited from 11 primary health care ... respondents educational level and knowledge of preconception care (X =24.76, ... single adult or married couple) are in an optimal state .... The major site for.

  6. Ethics of large-scale change

    OpenAIRE

    Arler, Finn

    2006-01-01

      The subject of this paper is long-term large-scale changes in human society. Some very significant examples of large-scale change are presented: human population growth, human appropriation of land and primary production, the human use of fossil fuels, and climate change. The question is posed, which kind of attitude is appropriate when dealing with large-scale changes like these from an ethical point of view. Three kinds of approaches are discussed: Aldo Leopold's mountain thinking, th...

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    enrol in an insurance scheme feeling that they need more information on health insurance and the willingness to enrol in a ... and utilize the benefits of different types of health insurance services. Conclusion: The findings ..... improvements in access and quality of care, and the ... the 'rising tide' of and information technology.

  8. Classification of Large-Scale Remote Sensing Images for Automatic Identification of Health Hazards: Smoke Detection Using an Autologistic Regression Classifier.

    Science.gov (United States)

    Wolters, Mark A; Dean, C B

    2017-01-01

    Remote sensing images from Earth-orbiting satellites are a potentially rich data source for monitoring and cataloguing atmospheric health hazards that cover large geographic regions. A method is proposed for classifying such images into hazard and nonhazard regions using the autologistic regression model, which may be viewed as a spatial extension of logistic regression. The method includes a novel and simple approach to parameter estimation that makes it well suited to handling the large and high-dimensional datasets arising from satellite-borne instruments. The methodology is demonstrated on both simulated images and a real application to the identification of forest fire smoke.

  9. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

    ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care we...... document pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for assessment and benchmarking the clinical management of HIV-patients in any setting worldwide....

  10. [Health care networks].

    Science.gov (United States)

    Mendes, Eugênio Vilaça

    2010-08-01

    The demographic and epidemiologic transition resulting from aging and the increase of life expectation means an increment related to chronic conditions. The healthcare systems contemporary crisis is characterized by the organization of the focus on fragmented systems turned to the acute conditions care, in spite of the chronic conditions prevalence, and by the hierarchical structure without communication flow among the different health care levels. Brazil health care situation profile is now presenting a triple burden of diseases, due to the concomitant presence of infectious diseases, external causes and chronic diseases. The solution is to restore the consistence between the triple burden of diseases on the health situation and the current system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.

  11. Psychological resilience after Hurricane Sandy: the influence of individual- and community-level factors on mental health after a large-scale natural disaster.

    Science.gov (United States)

    Lowe, Sarah R; Sampson, Laura; Gruebner, Oliver; Galea, Sandro

    2015-01-01

    Several individual-level factors are known to promote psychological resilience in the aftermath of disasters. Far less is known about the role of community-level factors in shaping postdisaster mental health. The purpose of this study was to explore the influence of both individual- and community-level factors on resilience after Hurricane Sandy. A representative sample of household residents (N = 418) from 293 New York City census tracts that were most heavily affected by the storm completed telephone interviews approximately 13-16 months postdisaster. Multilevel multivariable models explored the independent and interactive contributions of individual- and community-level factors to posttraumatic stress and depression symptoms. At the individual-level, having experienced or witnessed any lifetime traumatic event was significantly associated with higher depression and posttraumatic stress, whereas demographic characteristics (e.g., older age, non-Hispanic Black race) and more disaster-related stressors were significantly associated with higher posttraumatic stress only. At the community-level, living in an area with higher social capital was significantly associated with higher posttraumatic stress. Additionally, higher community economic development was associated with lower risk of depression only among participants who did not experience any disaster-related stressors. These results provide evidence that individual- and community-level resources and exposure operate in tandem to shape postdisaster resilience.

  12. Use of the balanced scorecard in health care.

    Science.gov (United States)

    Zelman, William N; Pink, George H; Matthias, Catherine B

    2003-01-01

    Since Kaplan and Norton published their article proposing a balanced scorecard, the concept has been widely adopted by industry and health care provider organizations. This article reviews the use of the balanced scorecard in health care and concludes that the balanced scorecard: (1) is relevant to health care, but modification to reflect industry and organizational realities is necessary; (2) is used by a wide range of health care organizations; (3) has been extended to applications beyond that of strategic management; (4) has been modified to include perspectives, such as quality of care, outcomes, and access; (5) increases the need for valid, comprehensive, and timely information; and (6) has been used by two large-scale efforts across many health care organizations in a health care sector, which differ, namely in the units of analysis, purposes, audiences, methods, data, and results.

  13. Large Scale Computations in Air Pollution Modelling

    DEFF Research Database (Denmark)

    Zlatev, Z.; Brandt, J.; Builtjes, P. J. H.

    Proceedings of the NATO Advanced Research Workshop on Large Scale Computations in Air Pollution Modelling, Sofia, Bulgaria, 6-10 July 1998......Proceedings of the NATO Advanced Research Workshop on Large Scale Computations in Air Pollution Modelling, Sofia, Bulgaria, 6-10 July 1998...

  14. Automating large-scale reactor systems

    International Nuclear Information System (INIS)

    Kisner, R.A.

    1985-01-01

    This paper conveys a philosophy for developing automated large-scale control systems that behave in an integrated, intelligent, flexible manner. Methods for operating large-scale systems under varying degrees of equipment degradation are discussed, and a design approach that separates the effort into phases is suggested. 5 refs., 1 fig

  15. Decentralized Large-Scale Power Balancing

    DEFF Research Database (Denmark)

    Halvgaard, Rasmus; Jørgensen, John Bagterp; Poulsen, Niels Kjølstad

    2013-01-01

    problem is formulated as a centralized large-scale optimization problem but is then decomposed into smaller subproblems that are solved locally by each unit connected to an aggregator. For large-scale systems the method is faster than solving the full problem and can be distributed to include an arbitrary...

  16. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    to organize rural health care is more regulatory and distanced in its emphasis on nudging patients and doctors towards the right decisions through economic incentives. This bureaucratic approach to organizing health individually offers a sharp contrast to the religious collectivities that form around health...

  17. Large scale network-centric distributed systems

    CERN Document Server

    Sarbazi-Azad, Hamid

    2014-01-01

    A highly accessible reference offering a broad range of topics and insights on large scale network-centric distributed systems Evolving from the fields of high-performance computing and networking, large scale network-centric distributed systems continues to grow as one of the most important topics in computing and communication and many interdisciplinary areas. Dealing with both wired and wireless networks, this book focuses on the design and performance issues of such systems. Large Scale Network-Centric Distributed Systems provides in-depth coverage ranging from ground-level hardware issu

  18. American Health Care Association

    Science.gov (United States)

    ... MO - St. Louis, Qualifications Required: Bachelor’s degree in business, marketing, health care administration or a related field Current ... Work for AHCA/NCAL News Provider Daily Publications Social Media News Releases LTC Leader Blog Research and Data ...

  19. Resilient health care

    DEFF Research Database (Denmark)

    Hollnagel, E.; Braithwaite, J.; Wears, R. L.

    Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have...... engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering...

  20. HealthCare.gov

    Science.gov (United States)

    ... CAN CHANGE Looking for coverage for a small business? Learn more Need to submit documents? SEE HOW ... Find Local Help Visit the HealthCare.gov blog Facebook Twitter YouTube Google+ All Topics | Glossary | Contact Us | ...

  1. Your Health Care Team

    Science.gov (United States)

    ... Rights Employment Discrimination Health Care Professionals Law Enforcement Driver's License For Lawyers Food & Fitness Home Food MyFoodAdvisor ... Fit Types of Activity Weight Loss Assess Your Lifestyle Getting Started Food Choices In My Community Home ...

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    one strategy that could be conducted anywhere, if the health care workers are trained and positively disposed ... places; regulate advertising, manufacturing. 13 .... Gender. Male. 52 (46.0). 61 (54.0). 0.0001. Significant. Female. 82 (73.2).

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    about teething the world over and especially ... children`s out-patients, dental and the ear, nose and throat clinics of a tertiary hospital in south-west Nigeria. ... parents, health care workers and personal experiences were the sources of beliefs ... None (0%) of the respondents had prior knowledge of proven causes of ear.

  4. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    VPDs, this represents 17% of global total. 1 ... Knowledge, Attitude and Practice of Childhood Immunization ... Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, ... include access to services, parental (maternal) ... Calmette Guerin (BCG) vaccine Oral Polio.

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    2012-05-01

    May 1, 2012 ... with the quality of care in a tertiary health facility in Delta State, Nigeria ... includes contributions from families, charges have been .... employees at 23.5%, self employed 19.1% of showed that most of the respondents (41.3%).

  6. Health Care Services

    Science.gov (United States)

    Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice , 2017 Warning - A phone number that was once used for the Denali KidCare program is now being used to ask people for their credit card number in order to win a prize. The phone number related to this

  7. Health care engineering management.

    Science.gov (United States)

    Jarzembski, W B

    1980-01-01

    Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.

  8. Large-scale numerical simulations of plasmas

    International Nuclear Information System (INIS)

    Hamaguchi, Satoshi

    2004-01-01

    The recent trend of large scales simulations of fusion plasma and processing plasmas is briefly summarized. Many advanced simulation techniques have been developed for fusion plasmas and some of these techniques are now applied to analyses of processing plasmas. (author)

  9. Superconducting materials for large scale applications

    International Nuclear Information System (INIS)

    Dew-Hughes, D.

    1975-01-01

    Applications of superconductors capable of carrying large current densities in large-scale electrical devices are examined. Discussions are included on critical current density, superconducting materials available, and future prospects for improved superconducting materials. (JRD)

  10. Large-scale computing with Quantum Espresso

    International Nuclear Information System (INIS)

    Giannozzi, P.; Cavazzoni, C.

    2009-01-01

    This paper gives a short introduction to Quantum Espresso: a distribution of software for atomistic simulations in condensed-matter physics, chemical physics, materials science, and to its usage in large-scale parallel computing.

  11. Large-scale regions of antimatter

    International Nuclear Information System (INIS)

    Grobov, A. V.; Rubin, S. G.

    2015-01-01

    Amodified mechanism of the formation of large-scale antimatter regions is proposed. Antimatter appears owing to fluctuations of a complex scalar field that carries a baryon charge in the inflation era

  12. Large-scale regions of antimatter

    Energy Technology Data Exchange (ETDEWEB)

    Grobov, A. V., E-mail: alexey.grobov@gmail.com; Rubin, S. G., E-mail: sgrubin@mephi.ru [National Research Nuclear University MEPhI (Russian Federation)

    2015-07-15

    Amodified mechanism of the formation of large-scale antimatter regions is proposed. Antimatter appears owing to fluctuations of a complex scalar field that carries a baryon charge in the inflation era.

  13. Large-scale grid management; Storskala Nettforvaltning

    Energy Technology Data Exchange (ETDEWEB)

    Langdal, Bjoern Inge; Eggen, Arnt Ove

    2003-07-01

    The network companies in the Norwegian electricity industry now have to establish a large-scale network management, a concept essentially characterized by (1) broader focus (Broad Band, Multi Utility,...) and (2) bigger units with large networks and more customers. Research done by SINTEF Energy Research shows so far that the approaches within large-scale network management may be structured according to three main challenges: centralization, decentralization and out sourcing. The article is part of a planned series.

  14. Political consultation and large-scale research

    International Nuclear Information System (INIS)

    Bechmann, G.; Folkers, H.

    1977-01-01

    Large-scale research and policy consulting have an intermediary position between sociological sub-systems. While large-scale research coordinates science, policy, and production, policy consulting coordinates science, policy and political spheres. In this very position, large-scale research and policy consulting lack of institutional guarantees and rational back-ground guarantee which are characteristic for their sociological environment. This large-scale research can neither deal with the production of innovative goods under consideration of rentability, nor can it hope for full recognition by the basis-oriented scientific community. Policy consulting knows neither the competence assignment of the political system to make decisions nor can it judge succesfully by the critical standards of the established social science, at least as far as the present situation is concerned. This intermediary position of large-scale research and policy consulting has, in three points, a consequence supporting the thesis which states that this is a new form of institutionalization of science: These are: 1) external control, 2) the organization form, 3) the theoretical conception of large-scale research and policy consulting. (orig.) [de

  15. Controlling Health Care Costs

    Science.gov (United States)

    Dessoff, Alan

    2009-01-01

    This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

  16. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

  17. Health care in the Netherlands.

    NARCIS (Netherlands)

    Weel, C. van; Schers, H.J.; Timmermans, A.

    2012-01-01

    This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and

  18. Dissecting the large-scale galactic conformity

    Science.gov (United States)

    Seo, Seongu

    2018-01-01

    Galactic conformity is an observed phenomenon that galaxies located in the same region have similar properties such as star formation rate, color, gas fraction, and so on. The conformity was first observed among galaxies within in the same halos (“one-halo conformity”). The one-halo conformity can be readily explained by mutual interactions among galaxies within a halo. Recent observations however further witnessed a puzzling connection among galaxies with no direct interaction. In particular, galaxies located within a sphere of ~5 Mpc radius tend to show similarities, even though the galaxies do not share common halos with each other ("two-halo conformity" or “large-scale conformity”). Using a cosmological hydrodynamic simulation, Illustris, we investigate the physical origin of the two-halo conformity and put forward two scenarios. First, back-splash galaxies are likely responsible for the large-scale conformity. They have evolved into red galaxies due to ram-pressure stripping in a given galaxy cluster and happen to reside now within a ~5 Mpc sphere. Second, galaxies in strong tidal field induced by large-scale structure also seem to give rise to the large-scale conformity. The strong tides suppress star formation in the galaxies. We discuss the importance of the large-scale conformity in the context of galaxy evolution.

  19. Health care reforms.

    Science.gov (United States)

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

    In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  20. Health care reforms

    Directory of Open Access Journals (Sweden)

    Marušič Dorjan

    2016-09-01

    Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  1. Health care need

    DEFF Research Database (Denmark)

    Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter

    2006-01-01

    The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precis......The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need...

  2. Implementation factors affecting the large-scale deployment of digital health and well-being technologies: A qualitative study of the initial phases of the 'Living-It-Up' programme.

    Science.gov (United States)

    Agbakoba, Ruth; McGee-Lennon, Marilyn; Bouamrane, Matt-Mouley; Watson, Nicholas; Mair, Frances S

    2016-12-01

    Little is known about the factors which facilitate or impede the large-scale deployment of health and well-being consumer technologies. The Living-It-Up project is a large-scale digital intervention led by NHS 24, aiming to transform health and well-being services delivery throughout Scotland. We conducted a qualitative study of the factors affecting the implementation and deployment of the Living-It-Up services. We collected a range of data during the initial phase of deployment, including semi-structured interviews (N = 6); participant observation sessions (N = 5) and meetings with key stakeholders (N = 3). We used the Normalisation Process Theory as an explanatory framework to interpret the social processes at play during the initial phases of deployment.Initial findings illustrate that it is clear - and perhaps not surprising - that the size and diversity of the Living-It-Up consortium made implementation processes more complex within a 'multi-stakeholder' environment. To overcome these barriers, there is a need to clearly define roles, tasks and responsibilities among the consortium partners. Furthermore, varying levels of expectations and requirements, as well as diverse cultures and ways of working, must be effectively managed. Factors which facilitated implementation included extensive stakeholder engagement, such as co-design activities, which can contribute to an increased 'buy-in' from users in the long term. An important lesson from the Living-It-Up initiative is that attempting to co-design innovative digital services, but at the same time, recruiting large numbers of users is likely to generate conflicting implementation priorities which hinder - or at least substantially slow down - the effective rollout of services at scale.The deployment of Living-It-Up services is ongoing, but our results to date suggest that - in order to be successful - the roll-out of digital health and well-being technologies at scale requires a delicate and pragmatic trade

  3. Growth Limits in Large Scale Networks

    DEFF Research Database (Denmark)

    Knudsen, Thomas Phillip

    limitations. The rising complexity of network management with the convergence of communications platforms is shown as problematic for both automatic management feasibility and for manpower resource management. In the fourth step the scope is extended to include the present society with the DDN project as its......The Subject of large scale networks is approached from the perspective of the network planner. An analysis of the long term planning problems is presented with the main focus on the changing requirements for large scale networks and the potential problems in meeting these requirements. The problems...... the fundamental technological resources in network technologies are analysed for scalability. Here several technological limits to continued growth are presented. The third step involves a survey of major problems in managing large scale networks given the growth of user requirements and the technological...

  4. Managing large-scale models: DBS

    International Nuclear Information System (INIS)

    1981-05-01

    A set of fundamental management tools for developing and operating a large scale model and data base system is presented. Based on experience in operating and developing a large scale computerized system, the only reasonable way to gain strong management control of such a system is to implement appropriate controls and procedures. Chapter I discusses the purpose of the book. Chapter II classifies a broad range of generic management problems into three groups: documentation, operations, and maintenance. First, system problems are identified then solutions for gaining management control are disucssed. Chapters III, IV, and V present practical methods for dealing with these problems. These methods were developed for managing SEAS but have general application for large scale models and data bases

  5. Accelerating sustainability in large-scale facilities

    CERN Multimedia

    Marina Giampietro

    2011-01-01

    Scientific research centres and large-scale facilities are intrinsically energy intensive, but how can big science improve its energy management and eventually contribute to the environmental cause with new cleantech? CERN’s commitment to providing tangible answers to these questions was sealed in the first workshop on energy management for large scale scientific infrastructures held in Lund, Sweden, on the 13-14 October.   Participants at the energy management for large scale scientific infrastructures workshop. The workshop, co-organised with the European Spallation Source (ESS) and  the European Association of National Research Facilities (ERF), tackled a recognised need for addressing energy issues in relation with science and technology policies. It brought together more than 150 representatives of Research Infrastrutures (RIs) and energy experts from Europe and North America. “Without compromising our scientific projects, we can ...

  6. Large-Scale Analysis of Art Proportions

    DEFF Research Database (Denmark)

    Jensen, Karl Kristoffer

    2014-01-01

    While literature often tries to impute mathematical constants into art, this large-scale study (11 databases of paintings and photos, around 200.000 items) shows a different truth. The analysis, consisting of the width/height proportions, shows a value of rarely if ever one (square) and with majo......While literature often tries to impute mathematical constants into art, this large-scale study (11 databases of paintings and photos, around 200.000 items) shows a different truth. The analysis, consisting of the width/height proportions, shows a value of rarely if ever one (square...

  7. The Expanded Large Scale Gap Test

    Science.gov (United States)

    1987-03-01

    NSWC TR 86-32 DTIC THE EXPANDED LARGE SCALE GAP TEST BY T. P. LIDDIARD D. PRICE RESEARCH AND TECHNOLOGY DEPARTMENT ’ ~MARCH 1987 Ap~proved for public...arises, to reduce the spread in the LSGT 50% gap value.) The worst charges, such as those with the highest or lowest densities, the largest re-pressed...Arlington, VA 22217 PE 62314N INS3A 1 RJ14E31 7R4TBK 11 TITLE (Include Security CIlmsilficatiorn The Expanded Large Scale Gap Test . 12. PEIRSONAL AUTHOR() T

  8. Configuration management in large scale infrastructure development

    NARCIS (Netherlands)

    Rijn, T.P.J. van; Belt, H. van de; Los, R.H.

    2000-01-01

    Large Scale Infrastructure (LSI) development projects such as the construction of roads, rail-ways and other civil engineering (water)works is tendered differently today than a decade ago. Traditional workflow requested quotes from construction companies for construction works where the works to be

  9. Large-scale Motion of Solar Filaments

    Indian Academy of Sciences (India)

    tribpo

    Large-scale Motion of Solar Filaments. Pavel Ambrož, Astronomical Institute of the Acad. Sci. of the Czech Republic, CZ-25165. Ondrejov, The Czech Republic. e-mail: pambroz@asu.cas.cz. Alfred Schroll, Kanzelhöehe Solar Observatory of the University of Graz, A-9521 Treffen,. Austria. e-mail: schroll@solobskh.ac.at.

  10. Sensitivity analysis for large-scale problems

    Science.gov (United States)

    Noor, Ahmed K.; Whitworth, Sandra L.

    1987-01-01

    The development of efficient techniques for calculating sensitivity derivatives is studied. The objective is to present a computational procedure for calculating sensitivity derivatives as part of performing structural reanalysis for large-scale problems. The scope is limited to framed type structures. Both linear static analysis and free-vibration eigenvalue problems are considered.

  11. Ethics of large-scale change

    DEFF Research Database (Denmark)

    Arler, Finn

    2006-01-01

    , which kind of attitude is appropriate when dealing with large-scale changes like these from an ethical point of view. Three kinds of approaches are discussed: Aldo Leopold's mountain thinking, the neoclassical economists' approach, and finally the so-called Concentric Circle Theories approach...

  12. The origin of large scale cosmic structure

    International Nuclear Information System (INIS)

    Jones, B.J.T.; Palmer, P.L.

    1985-01-01

    The paper concerns the origin of large scale cosmic structure. The evolution of density perturbations, the nonlinear regime (Zel'dovich's solution and others), the Gott and Rees clustering hierarchy, the spectrum of condensations, and biassed galaxy formation, are all discussed. (UK)

  13. Large-scale perspective as a challenge

    NARCIS (Netherlands)

    Plomp, M.G.A.

    2012-01-01

    1. Scale forms a challenge for chain researchers: when exactly is something ‘large-scale’? What are the underlying factors (e.g. number of parties, data, objects in the chain, complexity) that determine this? It appears to be a continuum between small- and large-scale, where positioning on that

  14. Computing in Large-Scale Dynamic Systems

    NARCIS (Netherlands)

    Pruteanu, A.S.

    2013-01-01

    Software applications developed for large-scale systems have always been difficult to de- velop due to problems caused by the large number of computing devices involved. Above a certain network size (roughly one hundred), necessary services such as code updating, topol- ogy discovery and data

  15. Learning from large scale neural simulations

    DEFF Research Database (Denmark)

    Serban, Maria

    2017-01-01

    Large-scale neural simulations have the marks of a distinct methodology which can be fruitfully deployed to advance scientific understanding of the human brain. Computer simulation studies can be used to produce surrogate observational data for better conceptual models and new how...

  16. Large-Scale Outflows in Seyfert Galaxies

    Science.gov (United States)

    Colbert, E. J. M.; Baum, S. A.

    1995-12-01

    \\catcode`\\@=11 \\ialign{m @th#1hfil ##hfil \\crcr#2\\crcr\\sim\\crcr}}} \\catcode`\\@=12 Highly collimated outflows extend out to Mpc scales in many radio-loud active galaxies. In Seyfert galaxies, which are radio-quiet, the outflows extend out to kpc scales and do not appear to be as highly collimated. In order to study the nature of large-scale (>~1 kpc) outflows in Seyferts, we have conducted optical, radio and X-ray surveys of a distance-limited sample of 22 edge-on Seyfert galaxies. Results of the optical emission-line imaging and spectroscopic survey imply that large-scale outflows are present in >~{{1} /{4}} of all Seyferts. The radio (VLA) and X-ray (ROSAT) surveys show that large-scale radio and X-ray emission is present at about the same frequency. Kinetic luminosities of the outflows in Seyferts are comparable to those in starburst-driven superwinds. Large-scale radio sources in Seyferts appear diffuse, but do not resemble radio halos found in some edge-on starburst galaxies (e.g. M82). We discuss the feasibility of the outflows being powered by the active nucleus (e.g. a jet) or a circumnuclear starburst.

  17. Stability of large scale interconnected dynamical systems

    International Nuclear Information System (INIS)

    Akpan, E.P.

    1993-07-01

    Large scale systems modelled by a system of ordinary differential equations are considered and necessary and sufficient conditions are obtained for the uniform asymptotic connective stability of the systems using the method of cone-valued Lyapunov functions. It is shown that this model significantly improves the existing models. (author). 9 refs

  18. Results of large scale thyroid dose reconstruction in Ukraine

    International Nuclear Information System (INIS)

    Likhtarev, I.; Sobolev, B.; Kairo, I.; Tabachny, L.; Jacob, P.; Proehl, G.; Goulko, G.

    1996-01-01

    In 1993, the Ukrainian Ministry on Chernobyl Affairs initiated a large scale reconstruction of thyroid exposures to radioiodine after the Chernobyl accident. The objective was to provide the state policy on social compensations with a scientific background. About 7000 settlements from five contaminated regions have gotten certificates of thyroid exposure since then. Certificates contain estimates of the average thyroid dose from 131 I for seven age groups. The primary dose estimates used about 150000 direct measurements of the 131 I activity in the thyroid glands of inhabitants from Chernigiv, Kiev, Zhytomyr, and also Vinnytsa regions. Parameters of the assumed intake function were related to environmental and questionnaire data. The dose reconstruction for the remaining territory was based on empirical relations between intake function parameters and the 137 Cs deposition. The relationship was specified by the distance and the direction to the Chernobyl Nuclear Power Plant. The relations were first derived for territories with direct measurements and then they were spread on other areas using daily iodine releases and atmospheric transportation routes. The results of the dose reconstruction allowed to mark zones on the territory of Ukraine according to the average levels of thyroid exposures. These zones underlay a policy of post-accidental health care and social compensations. Another important application of the thyroid dose reconstruction is the radiation risk assessment of thyroid cancer among people exposed during childhood due to the Chernobyl accident

  19. Health Care Industry Study

    Science.gov (United States)

    2002-01-01

    press conference with President Toledo of Peru on March 23, 2002, President Bush proclaimed, “education, jobs, and health care are the greatest...allow patients with chronic illnesses such as diabetes and high blood pressure to “visit” their doctors “on-line” while in the comfort and privacy of...to maintain a healthy lifestyle. As a result, non-communicable disease such as 10 heart disease, stroke, diabetes , and cancer are prevalent throughout

  20. Large-scale structure of the Universe

    International Nuclear Information System (INIS)

    Doroshkevich, A.G.

    1978-01-01

    The problems, discussed at the ''Large-scale Structure of the Universe'' symposium are considered on a popular level. Described are the cell structure of galaxy distribution in the Universe, principles of mathematical galaxy distribution modelling. The images of cell structures, obtained after reprocessing with the computer are given. Discussed are three hypothesis - vortical, entropic, adiabatic, suggesting various processes of galaxy and galaxy clusters origin. A considerable advantage of the adiabatic hypothesis is recognized. The relict radiation, as a method of direct studying the processes taking place in the Universe is considered. The large-scale peculiarities and small-scale fluctuations of the relict radiation temperature enable one to estimate the turbance properties at the pre-galaxy stage. The discussion of problems, pertaining to studying the hot gas, contained in galaxy clusters, the interactions within galaxy clusters and with the inter-galaxy medium, is recognized to be a notable contribution into the development of theoretical and observational cosmology

  1. Emerging large-scale solar heating applications

    International Nuclear Information System (INIS)

    Wong, W.P.; McClung, J.L.

    2009-01-01

    Currently the market for solar heating applications in Canada is dominated by outdoor swimming pool heating, make-up air pre-heating and domestic water heating in homes, commercial and institutional buildings. All of these involve relatively small systems, except for a few air pre-heating systems on very large buildings. Together these applications make up well over 90% of the solar thermal collectors installed in Canada during 2007. These three applications, along with the recent re-emergence of large-scale concentrated solar thermal for generating electricity, also dominate the world markets. This paper examines some emerging markets for large scale solar heating applications, with a focus on the Canadian climate and market. (author)

  2. Emerging large-scale solar heating applications

    Energy Technology Data Exchange (ETDEWEB)

    Wong, W.P.; McClung, J.L. [Science Applications International Corporation (SAIC Canada), Ottawa, Ontario (Canada)

    2009-07-01

    Currently the market for solar heating applications in Canada is dominated by outdoor swimming pool heating, make-up air pre-heating and domestic water heating in homes, commercial and institutional buildings. All of these involve relatively small systems, except for a few air pre-heating systems on very large buildings. Together these applications make up well over 90% of the solar thermal collectors installed in Canada during 2007. These three applications, along with the recent re-emergence of large-scale concentrated solar thermal for generating electricity, also dominate the world markets. This paper examines some emerging markets for large scale solar heating applications, with a focus on the Canadian climate and market. (author)

  3. Challenges for Large Scale Structure Theory

    CERN Multimedia

    CERN. Geneva

    2018-01-01

    I will describe some of the outstanding questions in Cosmology where answers could be provided by observations of the Large Scale Structure of the Universe at late times.I will discuss some of the theoretical challenges which will have to be overcome to extract this information from the observations. I will describe some of the theoretical tools that might be useful to achieve this goal. 

  4. Methods for Large-Scale Nonlinear Optimization.

    Science.gov (United States)

    1980-05-01

    STANFORD, CALIFORNIA 94305 METHODS FOR LARGE-SCALE NONLINEAR OPTIMIZATION by Philip E. Gill, Waiter Murray, I Michael A. Saunden, and Masgaret H. Wright...typical iteration can be partitioned so that where B is an m X m basise matrix. This partition effectively divides the vari- ables into three classes... attention is given to the standard of the coding or the documentation. A much better way of obtaining mathematical software is from a software library

  5. Large scale inhomogeneities and the cosmological principle

    International Nuclear Information System (INIS)

    Lukacs, B.; Meszaros, A.

    1984-12-01

    The compatibility of cosmologic principles and possible large scale inhomogeneities of the Universe is discussed. It seems that the strongest symmetry principle which is still compatible with reasonable inhomogeneities, is a full conformal symmetry in the 3-space defined by the cosmological velocity field, but even in such a case, the standard model is isolated from the inhomogeneous ones when the whole evolution is considered. (author)

  6. Fires in large scale ventilation systems

    International Nuclear Information System (INIS)

    Gregory, W.S.; Martin, R.A.; White, B.W.; Nichols, B.D.; Smith, P.R.; Leslie, I.H.; Fenton, D.L.; Gunaji, M.V.; Blythe, J.P.

    1991-01-01

    This paper summarizes the experience gained simulating fires in large scale ventilation systems patterned after ventilation systems found in nuclear fuel cycle facilities. The series of experiments discussed included: (1) combustion aerosol loading of 0.61x0.61 m HEPA filters with the combustion products of two organic fuels, polystyrene and polymethylemethacrylate; (2) gas dynamic and heat transport through a large scale ventilation system consisting of a 0.61x0.61 m duct 90 m in length, with dampers, HEPA filters, blowers, etc.; (3) gas dynamic and simultaneous transport of heat and solid particulate (consisting of glass beads with a mean aerodynamic diameter of 10μ) through the large scale ventilation system; and (4) the transport of heat and soot, generated by kerosene pool fires, through the large scale ventilation system. The FIRAC computer code, designed to predict fire-induced transients in nuclear fuel cycle facility ventilation systems, was used to predict the results of experiments (2) through (4). In general, the results of the predictions were satisfactory. The code predictions for the gas dynamics, heat transport, and particulate transport and deposition were within 10% of the experimentally measured values. However, the code was less successful in predicting the amount of soot generation from kerosene pool fires, probably due to the fire module of the code being a one-dimensional zone model. The experiments revealed a complicated three-dimensional combustion pattern within the fire room of the ventilation system. Further refinement of the fire module within FIRAC is needed. (orig.)

  7. Large-scale Complex IT Systems

    OpenAIRE

    Sommerville, Ian; Cliff, Dave; Calinescu, Radu; Keen, Justin; Kelly, Tim; Kwiatkowska, Marta; McDermid, John; Paige, Richard

    2011-01-01

    This paper explores the issues around the construction of large-scale complex systems which are built as 'systems of systems' and suggests that there are fundamental reasons, derived from the inherent complexity in these systems, why our current software engineering methods and techniques cannot be scaled up to cope with the engineering challenges of constructing such systems. It then goes on to propose a research and education agenda for software engineering that identifies the major challen...

  8. Large-scale complex IT systems

    OpenAIRE

    Sommerville, Ian; Cliff, Dave; Calinescu, Radu; Keen, Justin; Kelly, Tim; Kwiatkowska, Marta; McDermid, John; Paige, Richard

    2012-01-01

    12 pages, 2 figures This paper explores the issues around the construction of large-scale complex systems which are built as 'systems of systems' and suggests that there are fundamental reasons, derived from the inherent complexity in these systems, why our current software engineering methods and techniques cannot be scaled up to cope with the engineering challenges of constructing such systems. It then goes on to propose a research and education agenda for software engineering that ident...

  9. LAVA: Large scale Automated Vulnerability Addition

    Science.gov (United States)

    2016-05-23

    LAVA: Large-scale Automated Vulnerability Addition Brendan Dolan -Gavitt∗, Patrick Hulin†, Tim Leek†, Fredrich Ulrich†, Ryan Whelan† (Authors listed...released, and thus rapidly become stale. We can expect tools to have been trained to detect bugs that have been released. Given the commercial price tag...low TCN) and dead (low liveness) program data is a powerful one for vulnera- bility injection. The DUAs it identifies are internal program quantities

  10. Large-Scale Transit Signal Priority Implementation

    OpenAIRE

    Lee, Kevin S.; Lozner, Bailey

    2018-01-01

    In 2016, the District Department of Transportation (DDOT) deployed Transit Signal Priority (TSP) at 195 intersections in highly urbanized areas of Washington, DC. In collaboration with a broader regional implementation, and in partnership with the Washington Metropolitan Area Transit Authority (WMATA), DDOT set out to apply a systems engineering–driven process to identify, design, test, and accept a large-scale TSP system. This presentation will highlight project successes and lessons learned.

  11. Economically viable large-scale hydrogen liquefaction

    Science.gov (United States)

    Cardella, U.; Decker, L.; Klein, H.

    2017-02-01

    The liquid hydrogen demand, particularly driven by clean energy applications, will rise in the near future. As industrial large scale liquefiers will play a major role within the hydrogen supply chain, production capacity will have to increase by a multiple of today’s typical sizes. The main goal is to reduce the total cost of ownership for these plants by increasing energy efficiency with innovative and simple process designs, optimized in capital expenditure. New concepts must ensure a manageable plant complexity and flexible operability. In the phase of process development and selection, a dimensioning of key equipment for large scale liquefiers, such as turbines and compressors as well as heat exchangers, must be performed iteratively to ensure technological feasibility and maturity. Further critical aspects related to hydrogen liquefaction, e.g. fluid properties, ortho-para hydrogen conversion, and coldbox configuration, must be analysed in detail. This paper provides an overview on the approach, challenges and preliminary results in the development of efficient as well as economically viable concepts for large-scale hydrogen liquefaction.

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon ... important information about how well clinicians and the population of women within child bearing. 8 ..... model. Health and Quality of Life outcomes.

  13. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    NARCIS (Netherlands)

    Duenas-Espin, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Carles Contel, Joan; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M. H.; Lluch-Ariet, Magi; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastia; Schonenberg, Helen; Stoerk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives: Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies

  14. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    NARCIS (Netherlands)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    OBJECTIVES: Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies

  15. Volume measurement study for large scale input accountancy tank

    International Nuclear Information System (INIS)

    Uchikoshi, Seiji; Watanabe, Yuichi; Tsujino, Takeshi

    1999-01-01

    Large Scale Tank Calibration (LASTAC) facility, including an experimental tank which has the same volume and structure as the input accountancy tank of Rokkasho Reprocessing Plant (RRP) was constructed in Nuclear Material Control Center of Japan. Demonstration experiments have been carried out to evaluate a precision of solution volume measurement and to establish the procedure of highly accurate pressure measurement for a large scale tank with dip-tube bubbler probe system to be applied to the input accountancy tank of RRP. Solution volume in a tank is determined from substitution the solution level for the calibration function obtained in advance, which express a relation between the solution level and its volume in the tank. Therefore, precise solution volume measurement needs a precise calibration function that is determined carefully. The LASTAC calibration experiments using pure water showed good result in reproducibility. (J.P.N.)

  16. Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study.

    Science.gov (United States)

    Wade, Victoria A; Taylor, Alan D; Kidd, Michael R; Carati, Colin

    2016-05-16

    This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal. Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability. Subsequently, the interviewees and other decision makers attended a deliberative forum in which participants were asked to select a preferred model for future implementation. Finally, all data from the study was synthesised by the researchers to produce a process model. 19 interviews with senior clinicians, managers, and service development staff were conducted, finding strong support for home telehealth but a wide diversity of views on governance, models of clinical care, technical infrastructure operations, and data management. The deliberative forum worked through these options and recommended a collaborative consortium approach for large-scale implementation. The process model proposes that the key factor for large-scale implementation is leadership support, which is enabled by 1) showing solutions to the problems of service demand, budgetary pressure and the relationship between hospital and primary care, 2) demonstrating how home telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Two key actions to enable change were marketing telehealth to patients, clinicians and policy-makers, and building a community of

  17. The Software Reliability of Large Scale Integration Circuit and Very Large Scale Integration Circuit

    OpenAIRE

    Artem Ganiyev; Jan Vitasek

    2010-01-01

    This article describes evaluation method of faultless function of large scale integration circuits (LSI) and very large scale integration circuits (VLSI). In the article there is a comparative analysis of factors which determine faultless of integrated circuits, analysis of already existing methods and model of faultless function evaluation of LSI and VLSI. The main part describes a proposed algorithm and program for analysis of fault rate in LSI and VLSI circuits.

  18. The retailing of health care.

    Science.gov (United States)

    Paul, T; Wong, J

    1984-01-01

    A number of striking parallels between recent developments in health care marketing and changes in the retailing industry exist. The authors have compared retailing paradigms to the area on health care marketing so strategists in hospitals and other health care institutions can gain insight from these parallels. Many of the same economic, demographic, technological and lifestyle forces may be at work in both the health care and retail markets. While the services or products offered in health care are radically different from those of conventional retail markets, the manner in which the products and services are positioned, priced or distributed is surprisingly similar.

  19. RESTRUCTURING OF THE LARGE-SCALE SPRINKLERS

    Directory of Open Access Journals (Sweden)

    Paweł Kozaczyk

    2016-09-01

    Full Text Available One of the best ways for agriculture to become independent from shortages of precipitation is irrigation. In the seventies and eighties of the last century a number of large-scale sprinklers in Wielkopolska was built. At the end of 1970’s in the Poznan province 67 sprinklers with a total area of 6400 ha were installed. The average size of the sprinkler reached 95 ha. In 1989 there were 98 sprinklers, and the area which was armed with them was more than 10 130 ha. The study was conducted on 7 large sprinklers with the area ranging from 230 to 520 hectares in 1986÷1998. After the introduction of the market economy in the early 90’s and ownership changes in agriculture, large-scale sprinklers have gone under a significant or total devastation. Land on the State Farms of the State Agricultural Property Agency has leased or sold and the new owners used the existing sprinklers to a very small extent. This involved a change in crop structure, demand structure and an increase in operating costs. There has also been a threefold increase in electricity prices. Operation of large-scale irrigation encountered all kinds of barriers in practice and limitations of system solutions, supply difficulties, high levels of equipment failure which is not inclined to rational use of available sprinklers. An effect of a vision of the local area was to show the current status of the remaining irrigation infrastructure. The adopted scheme for the restructuring of Polish agriculture was not the best solution, causing massive destruction of assets previously invested in the sprinkler system.

  20. Health care engineering

    CERN Document Server

    Frize, Monique

    2013-01-01

    Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials.This two-

  1. Optical interconnect for large-scale systems

    Science.gov (United States)

    Dress, William

    2013-02-01

    This paper presents a switchless, optical interconnect module that serves as a node in a network of identical distribution modules for large-scale systems. Thousands to millions of hosts or endpoints may be interconnected by a network of such modules, avoiding the need for multi-level switches. Several common network topologies are reviewed and their scaling properties assessed. The concept of message-flow routing is discussed in conjunction with the unique properties enabled by the optical distribution module where it is shown how top-down software control (global routing tables, spanning-tree algorithms) may be avoided.

  2. Adaptive visualization for large-scale graph

    International Nuclear Information System (INIS)

    Nakamura, Hiroko; Shinano, Yuji; Ohzahata, Satoshi

    2010-01-01

    We propose an adoptive visualization technique for representing a large-scale hierarchical dataset within limited display space. A hierarchical dataset has nodes and links showing the parent-child relationship between the nodes. These nodes and links are described using graphics primitives. When the number of these primitives is large, it is difficult to recognize the structure of the hierarchical data because many primitives are overlapped within a limited region. To overcome this difficulty, we propose an adaptive visualization technique for hierarchical datasets. The proposed technique selects an appropriate graph style according to the nodal density in each area. (author)

  3. Neutrinos and large-scale structure

    International Nuclear Information System (INIS)

    Eisenstein, Daniel J.

    2015-01-01

    I review the use of cosmological large-scale structure to measure properties of neutrinos and other relic populations of light relativistic particles. With experiments to measure the anisotropies of the cosmic microwave anisotropies and the clustering of matter at low redshift, we now have securely measured a relativistic background with density appropriate to the cosmic neutrino background. Our limits on the mass of the neutrino continue to shrink. Experiments coming in the next decade will greatly improve the available precision on searches for the energy density of novel relativistic backgrounds and the mass of neutrinos

  4. Puzzles of large scale structure and gravitation

    International Nuclear Information System (INIS)

    Sidharth, B.G.

    2006-01-01

    We consider the puzzle of cosmic voids bounded by two-dimensional structures of galactic clusters as also a puzzle pointed out by Weinberg: How can the mass of a typical elementary particle depend on a cosmic parameter like the Hubble constant? An answer to the first puzzle is proposed in terms of 'Scaled' Quantum Mechanical like behaviour which appears at large scales. The second puzzle can be answered by showing that the gravitational mass of an elementary particle has a Machian character (see Ahmed N. Cantorian small worked, Mach's principle and the universal mass network. Chaos, Solitons and Fractals 2004;21(4))

  5. Neutrinos and large-scale structure

    Energy Technology Data Exchange (ETDEWEB)

    Eisenstein, Daniel J. [Daniel J. Eisenstein, Harvard-Smithsonian Center for Astrophysics, 60 Garden St., MS #20, Cambridge, MA 02138 (United States)

    2015-07-15

    I review the use of cosmological large-scale structure to measure properties of neutrinos and other relic populations of light relativistic particles. With experiments to measure the anisotropies of the cosmic microwave anisotropies and the clustering of matter at low redshift, we now have securely measured a relativistic background with density appropriate to the cosmic neutrino background. Our limits on the mass of the neutrino continue to shrink. Experiments coming in the next decade will greatly improve the available precision on searches for the energy density of novel relativistic backgrounds and the mass of neutrinos.

  6. Concepts for Large Scale Hydrogen Production

    OpenAIRE

    Jakobsen, Daniel; Åtland, Vegar

    2016-01-01

    The objective of this thesis is to perform a techno-economic analysis of large-scale, carbon-lean hydrogen production in Norway, in order to evaluate various production methods and estimate a breakeven price level. Norway possesses vast energy resources and the export of oil and gas is vital to the country s economy. The results of this thesis indicate that hydrogen represents a viable, carbon-lean opportunity to utilize these resources, which can prove key in the future of Norwegian energy e...

  7. Stabilization Algorithms for Large-Scale Problems

    DEFF Research Database (Denmark)

    Jensen, Toke Koldborg

    2006-01-01

    The focus of the project is on stabilization of large-scale inverse problems where structured models and iterative algorithms are necessary for computing approximate solutions. For this purpose, we study various iterative Krylov methods and their abilities to produce regularized solutions. Some......-curve. This heuristic is implemented as a part of a larger algorithm which is developed in collaboration with G. Rodriguez and P. C. Hansen. Last, but not least, a large part of the project has, in different ways, revolved around the object-oriented Matlab toolbox MOORe Tools developed by PhD Michael Jacobsen. New...

  8. Large scale phononic metamaterials for seismic isolation

    International Nuclear Information System (INIS)

    Aravantinos-Zafiris, N.; Sigalas, M. M.

    2015-01-01

    In this work, we numerically examine structures that could be characterized as large scale phononic metamaterials. These novel structures could have band gaps in the frequency spectrum of seismic waves when their dimensions are chosen appropriately, thus raising the belief that they could be serious candidates for seismic isolation structures. Different and easy to fabricate structures were examined made from construction materials such as concrete and steel. The well-known finite difference time domain method is used in our calculations in order to calculate the band structures of the proposed metamaterials

  9. Operations management in health care.

    Science.gov (United States)

    Henderson, M D

    1995-01-01

    Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Colorectal cancer (CRC) is a public health challenge in developed countries and an emerging public health problem in developing ... and public health challenges in their immigrant countries. More so ..... The nutrition transition in Brazil. 46.

  11. Dipolar modulation of Large-Scale Structure

    Science.gov (United States)

    Yoon, Mijin

    For the last two decades, we have seen a drastic development of modern cosmology based on various observations such as the cosmic microwave background (CMB), type Ia supernovae, and baryonic acoustic oscillations (BAO). These observational evidences have led us to a great deal of consensus on the cosmological model so-called LambdaCDM and tight constraints on cosmological parameters consisting the model. On the other hand, the advancement in cosmology relies on the cosmological principle: the universe is isotropic and homogeneous on large scales. Testing these fundamental assumptions is crucial and will soon become possible given the planned observations ahead. Dipolar modulation is the largest angular anisotropy of the sky, which is quantified by its direction and amplitude. We measured a huge dipolar modulation in CMB, which mainly originated from our solar system's motion relative to CMB rest frame. However, we have not yet acquired consistent measurements of dipolar modulations in large-scale structure (LSS), as they require large sky coverage and a number of well-identified objects. In this thesis, we explore measurement of dipolar modulation in number counts of LSS objects as a test of statistical isotropy. This thesis is based on two papers that were published in peer-reviewed journals. In Chapter 2 [Yoon et al., 2014], we measured a dipolar modulation in number counts of WISE matched with 2MASS sources. In Chapter 3 [Yoon & Huterer, 2015], we investigated requirements for detection of kinematic dipole in future surveys.

  12. Internationalization Measures in Large Scale Research Projects

    Science.gov (United States)

    Soeding, Emanuel; Smith, Nancy

    2017-04-01

    Internationalization measures in Large Scale Research Projects Large scale research projects (LSRP) often serve as flagships used by universities or research institutions to demonstrate their performance and capability to stakeholders and other interested parties. As the global competition among universities for the recruitment of the brightest brains has increased, effective internationalization measures have become hot topics for universities and LSRP alike. Nevertheless, most projects and universities are challenged with little experience on how to conduct these measures and make internationalization an cost efficient and useful activity. Furthermore, those undertakings permanently have to be justified with the Project PIs as important, valuable tools to improve the capacity of the project and the research location. There are a variety of measures, suited to support universities in international recruitment. These include e.g. institutional partnerships, research marketing, a welcome culture, support for science mobility and an effective alumni strategy. These activities, although often conducted by different university entities, are interlocked and can be very powerful measures if interfaced in an effective way. On this poster we display a number of internationalization measures for various target groups, identify interfaces between project management, university administration, researchers and international partners to work together, exchange information and improve processes in order to be able to recruit, support and keep the brightest heads to your project.

  13. Large scale integration of photovoltaics in cities

    International Nuclear Information System (INIS)

    Strzalka, Aneta; Alam, Nazmul; Duminil, Eric; Coors, Volker; Eicker, Ursula

    2012-01-01

    Highlights: ► We implement the photovoltaics on a large scale. ► We use three-dimensional modelling for accurate photovoltaic simulations. ► We consider the shadowing effect in the photovoltaic simulation. ► We validate the simulated results using detailed hourly measured data. - Abstract: For a large scale implementation of photovoltaics (PV) in the urban environment, building integration is a major issue. This includes installations on roof or facade surfaces with orientations that are not ideal for maximum energy production. To evaluate the performance of PV systems in urban settings and compare it with the building user’s electricity consumption, three-dimensional geometry modelling was combined with photovoltaic system simulations. As an example, the modern residential district of Scharnhauser Park (SHP) near Stuttgart/Germany was used to calculate the potential of photovoltaic energy and to evaluate the local own consumption of the energy produced. For most buildings of the district only annual electrical consumption data was available and only selected buildings have electronic metering equipment. The available roof area for one of these multi-family case study buildings was used for a detailed hourly simulation of the PV power production, which was then compared to the hourly measured electricity consumption. The results were extrapolated to all buildings of the analyzed area by normalizing them to the annual consumption data. The PV systems can produce 35% of the quarter’s total electricity consumption and half of this generated electricity is directly used within the buildings.

  14. Status: Large-scale subatmospheric cryogenic systems

    International Nuclear Information System (INIS)

    Peterson, T.

    1989-01-01

    In the late 1960's and early 1970's an interest in testing and operating RF cavities at 1.8K motivated the development and construction of four large (300 Watt) 1.8K refrigeration systems. in the past decade, development of successful superconducting RF cavities and interest in obtaining higher magnetic fields with the improved Niobium-Titanium superconductors has once again created interest in large-scale 1.8K refrigeration systems. The L'Air Liquide plant for Tore Supra is a recently commissioned 300 Watt 1.8K system which incorporates new technology, cold compressors, to obtain the low vapor pressure for low temperature cooling. CEBAF proposes to use cold compressors to obtain 5KW at 2.0K. Magnetic refrigerators of 10 Watt capacity or higher at 1.8K are now being developed. The state of the art of large-scale refrigeration in the range under 4K will be reviewed. 28 refs., 4 figs., 7 tabs

  15. Large-scale Intelligent Transporation Systems simulation

    Energy Technology Data Exchange (ETDEWEB)

    Ewing, T.; Canfield, T.; Hannebutte, U.; Levine, D.; Tentner, A.

    1995-06-01

    A prototype computer system has been developed which defines a high-level architecture for a large-scale, comprehensive, scalable simulation of an Intelligent Transportation System (ITS) capable of running on massively parallel computers and distributed (networked) computer systems. The prototype includes the modelling of instrumented ``smart`` vehicles with in-vehicle navigation units capable of optimal route planning and Traffic Management Centers (TMC). The TMC has probe vehicle tracking capabilities (display position and attributes of instrumented vehicles), and can provide 2-way interaction with traffic to provide advisories and link times. Both the in-vehicle navigation module and the TMC feature detailed graphical user interfaces to support human-factors studies. The prototype has been developed on a distributed system of networked UNIX computers but is designed to run on ANL`s IBM SP-X parallel computer system for large scale problems. A novel feature of our design is that vehicles will be represented by autonomus computer processes, each with a behavior model which performs independent route selection and reacts to external traffic events much like real vehicles. With this approach, one will be able to take advantage of emerging massively parallel processor (MPP) systems.

  16. Large-scale motions in the universe: a review

    International Nuclear Information System (INIS)

    Burstein, D.

    1990-01-01

    The expansion of the universe can be retarded in localised regions within the universe both by the presence of gravity and by non-gravitational motions generated in the post-recombination universe. The motions of galaxies thus generated are called 'peculiar motions', and the amplitudes, size scales and coherence of these peculiar motions are among the most direct records of the structure of the universe. As such, measurements of these properties of the present-day universe provide some of the severest tests of cosmological theories. This is a review of the current evidence for large-scale motions of galaxies out to a distance of ∼5000 km s -1 (in an expanding universe, distance is proportional to radial velocity). 'Large-scale' in this context refers to motions that are correlated over size scales larger than the typical sizes of groups of galaxies, up to and including the size of the volume surveyed. To orient the reader into this relatively new field of study, a short modern history is given together with an explanation of the terminology. Careful consideration is given to the data used to measure the distances, and hence the peculiar motions, of galaxies. The evidence for large-scale motions is presented in a graphical fashion, using only the most reliable data for galaxies spanning a wide range in optical properties and over the complete range of galactic environments. The kinds of systematic errors that can affect this analysis are discussed, and the reliability of these motions is assessed. The predictions of two models of large-scale motion are compared to the observations, and special emphasis is placed on those motions in which our own Galaxy directly partakes. (author)

  17. Reforming the health care system: implications for health care marketers.

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    dearth of information on patient satisfaction with HIV/AIDS care. This study sought ... with the doctor. Satisfaction rates were: 94.9% technical quality, ... of the delivery of care into several dimensions of contributed by studies carried out in Western. 14 ... efficiency of services as an index of patient needs of its clients. Secondly ...

  19. Engaging men in health care.

    Science.gov (United States)

    Malcher, Greg

    2009-03-01

    Engaging men in health care involves a multifaceted approach that has as its main principle the recognition that men consume health care differently to women. This article identifies barriers to engaging men in health care and offers potential and existing solutions to overcome these barriers in a range of health care settings. The concept of multiple masculinities recognises that not all men can be engaged via a particular technique or strategy. The perception that men are disinterested in their health is challenged and a range of approaches discussed, both in the community and in health care facilities. In the general practice setting opportunities exist for the engagement of men at the reception desk and waiting room, as well as during the consultation. Use of the workplace in engaging men is discussed. Future activities to build the capacity of health care providers to better engage men are identified and the role of policy and program development is addressed.

  20. Large-scale digitizer system, analog converters

    International Nuclear Information System (INIS)

    Althaus, R.F.; Lee, K.L.; Kirsten, F.A.; Wagner, L.J.

    1976-10-01

    Analog to digital converter circuits that are based on the sharing of common resources, including those which are critical to the linearity and stability of the individual channels, are described. Simplicity of circuit composition is valued over other more costly approaches. These are intended to be applied in a large-scale processing and digitizing system for use with high-energy physics detectors such as drift-chambers or phototube-scintillator arrays. Signal distribution techniques are of paramount importance in maintaining adequate signal-to-noise ratio. Noise in both amplitude and time-jitter senses is held sufficiently low so that conversions with 10-bit charge resolution and 12-bit time resolution are achieved

  1. Engineering management of large scale systems

    Science.gov (United States)

    Sanders, Serita; Gill, Tepper L.; Paul, Arthur S.

    1989-01-01

    The organization of high technology and engineering problem solving, has given rise to an emerging concept. Reasoning principles for integrating traditional engineering problem solving with system theory, management sciences, behavioral decision theory, and planning and design approaches can be incorporated into a methodological approach to solving problems with a long range perspective. Long range planning has a great potential to improve productivity by using a systematic and organized approach. Thus, efficiency and cost effectiveness are the driving forces in promoting the organization of engineering problems. Aspects of systems engineering that provide an understanding of management of large scale systems are broadly covered here. Due to the focus and application of research, other significant factors (e.g., human behavior, decision making, etc.) are not emphasized but are considered.

  2. Grid sensitivity capability for large scale structures

    Science.gov (United States)

    Nagendra, Gopal K.; Wallerstein, David V.

    1989-01-01

    The considerations and the resultant approach used to implement design sensitivity capability for grids into a large scale, general purpose finite element system (MSC/NASTRAN) are presented. The design variables are grid perturbations with a rather general linking capability. Moreover, shape and sizing variables may be linked together. The design is general enough to facilitate geometric modeling techniques for generating design variable linking schemes in an easy and straightforward manner. Test cases have been run and validated by comparison with the overall finite difference method. The linking of a design sensitivity capability for shape variables in MSC/NASTRAN with an optimizer would give designers a powerful, automated tool to carry out practical optimization design of real life, complicated structures.

  3. Large - scale Rectangular Ruler Automated Verification Device

    Science.gov (United States)

    Chen, Hao; Chang, Luping; Xing, Minjian; Xie, Xie

    2018-03-01

    This paper introduces a large-scale rectangular ruler automated verification device, which consists of photoelectric autocollimator and self-designed mechanical drive car and data automatic acquisition system. The design of mechanical structure part of the device refer to optical axis design, drive part, fixture device and wheel design. The design of control system of the device refer to hardware design and software design, and the hardware mainly uses singlechip system, and the software design is the process of the photoelectric autocollimator and the automatic data acquisition process. This devices can automated achieve vertical measurement data. The reliability of the device is verified by experimental comparison. The conclusion meets the requirement of the right angle test procedure.

  4. Large Scale Landform Mapping Using Lidar DEM

    Directory of Open Access Journals (Sweden)

    Türkay Gökgöz

    2015-08-01

    Full Text Available In this study, LIDAR DEM data was used to obtain a primary landform map in accordance with a well-known methodology. This primary landform map was generalized using the Focal Statistics tool (Majority, considering the minimum area condition in cartographic generalization in order to obtain landform maps at 1:1000 and 1:5000 scales. Both the primary and the generalized landform maps were verified visually with hillshaded DEM and an orthophoto. As a result, these maps provide satisfactory visuals of the landforms. In order to show the effect of generalization, the area of each landform in both the primary and the generalized maps was computed. Consequently, landform maps at large scales could be obtained with the proposed methodology, including generalization using LIDAR DEM.

  5. Constructing sites on a large scale

    DEFF Research Database (Denmark)

    Braae, Ellen Marie; Tietjen, Anne

    2011-01-01

    Since the 1990s, the regional scale has regained importance in urban and landscape design. In parallel, the focus in design tasks has shifted from master plans for urban extension to strategic urban transformation projects. A prominent example of a contemporary spatial development approach...... for setting the design brief in a large scale urban landscape in Norway, the Jaeren region around the city of Stavanger. In this paper, we first outline the methodological challenges and then present and discuss the proposed method based on our teaching experiences. On this basis, we discuss aspects...... is the IBA Emscher Park in the Ruhr area in Germany. Over a 10 years period (1988-1998), more than a 100 local transformation projects contributed to the transformation from an industrial to a post-industrial region. The current paradigm of planning by projects reinforces the role of the design disciplines...

  6. Large scale study of tooth enamel

    International Nuclear Information System (INIS)

    Bodart, F.; Deconninck, G.; Martin, M.T.

    Human tooth enamel contains traces of foreign elements. The presence of these elements is related to the history and the environment of the human body and can be considered as the signature of perturbations which occur during the growth of a tooth. A map of the distribution of these traces on a large scale sample of the population will constitute a reference for further investigations of environmental effects. On hundred eighty samples of teeth were first analyzed using PIXE, backscattering and nuclear reaction techniques. The results were analyzed using statistical methods. Correlations between O, F, Na, P, Ca, Mn, Fe, Cu, Zn, Pb and Sr were observed and cluster analysis was in progress. The techniques described in the present work have been developed in order to establish a method for the exploration of very large samples of the Belgian population. (author)

  7. Testing Einstein's Gravity on Large Scales

    Science.gov (United States)

    Prescod-Weinstein, Chandra

    2011-01-01

    A little over a decade has passed since two teams studying high redshift Type Ia supernovae announced the discovery that the expansion of the universe was accelerating. After all this time, we?re still not sure how cosmic acceleration fits into the theory that tells us about the large-scale universe: General Relativity (GR). As part of our search for answers, we have been forced to question GR itself. But how will we test our ideas? We are fortunate enough to be entering the era of precision cosmology, where the standard model of gravity can be subjected to more rigorous testing. Various techniques will be employed over the next decade or two in the effort to better understand cosmic acceleration and the theory behind it. In this talk, I will describe cosmic acceleration, current proposals to explain it, and weak gravitational lensing, an observational effect that allows us to do the necessary precision cosmology.

  8. Large-Scale Astrophysical Visualization on Smartphones

    Science.gov (United States)

    Becciani, U.; Massimino, P.; Costa, A.; Gheller, C.; Grillo, A.; Krokos, M.; Petta, C.

    2011-07-01

    Nowadays digital sky surveys and long-duration, high-resolution numerical simulations using high performance computing and grid systems produce multidimensional astrophysical datasets in the order of several Petabytes. Sharing visualizations of such datasets within communities and collaborating research groups is of paramount importance for disseminating results and advancing astrophysical research. Moreover educational and public outreach programs can benefit greatly from novel ways of presenting these datasets by promoting understanding of complex astrophysical processes, e.g., formation of stars and galaxies. We have previously developed VisIVO Server, a grid-enabled platform for high-performance large-scale astrophysical visualization. This article reviews the latest developments on VisIVO Web, a custom designed web portal wrapped around VisIVO Server, then introduces VisIVO Smartphone, a gateway connecting VisIVO Web and data repositories for mobile astrophysical visualization. We discuss current work and summarize future developments.

  9. Accountability in Health Care

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten; Byrkjeflot, Haldor

    2016-01-01

    The debate on accountability within the public sector has been lively in the past decade. Significant progress has been made in developing conceptual frameworks and typologies for characterizing different features and functions of accountability. However, there is a lack of sector specific...... adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...... that reforms can introduce new forms of accountability, change existing accountability relations or change the relative importance of different accountability forms. They may also change the dominant direction and shift the balance between different functions of accountability. We further suggest...

  10. Federalism and Health Care

    Directory of Open Access Journals (Sweden)

    G. Alan Tarr

    2011-10-01

    Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.

  11. Large-scale sequential quadratic programming algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Eldersveld, S.K.

    1992-09-01

    The problem addressed is the general nonlinear programming problem: finding a local minimizer for a nonlinear function subject to a mixture of nonlinear equality and inequality constraints. The methods studied are in the class of sequential quadratic programming (SQP) algorithms, which have previously proved successful for problems of moderate size. Our goal is to devise an SQP algorithm that is applicable to large-scale optimization problems, using sparse data structures and storing less curvature information but maintaining the property of superlinear convergence. The main features are: 1. The use of a quasi-Newton approximation to the reduced Hessian of the Lagrangian function. Only an estimate of the reduced Hessian matrix is required by our algorithm. The impact of not having available the full Hessian approximation is studied and alternative estimates are constructed. 2. The use of a transformation matrix Q. This allows the QP gradient to be computed easily when only the reduced Hessian approximation is maintained. 3. The use of a reduced-gradient form of the basis for the null space of the working set. This choice of basis is more practical than an orthogonal null-space basis for large-scale problems. The continuity condition for this choice is proven. 4. The use of incomplete solutions of quadratic programming subproblems. Certain iterates generated by an active-set method for the QP subproblem are used in place of the QP minimizer to define the search direction for the nonlinear problem. An implementation of the new algorithm has been obtained by modifying the code MINOS. Results and comparisons with MINOS and NPSOL are given for the new algorithm on a set of 92 test problems.

  12. Occupational Health for Health Care Providers

    Science.gov (United States)

    Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...

  13. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2Department of Community Health, University of Benin, Benin City, Nigeria. ... Mental morbidity is a public health problem that can lead to a great burden of disability in the community. ..... community study in Sao Paulo, Brazil where.

  14. Health Care Provider Value Chain

    OpenAIRE

    Kawczynski , Lukasz; Taisch , Marco

    2009-01-01

    International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...

  15. Health and Disability: Partnerships in Health Care

    Science.gov (United States)

    Tracy, Jane; McDonald, Rachael

    2015-01-01

    Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

  16. National Health-Care Reform

    Science.gov (United States)

    2009-03-24

    and pre/ post partum care during delivery. America should select measures that reflect the health-care goals of the nation. As an example, the Healthy...accidents (8) More than 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression ...reflect the cumulative efforts of different types of individual care. For example, infant mortality is a reflection of pre-natal care, post - natal care

  17. Optimizing Health Care Environmental Hygiene.

    Science.gov (United States)

    Carling, Philip C

    2016-09-01

    This article presents a review and perspectives on aspects of optimizing health care environmental hygiene. The topics covered include the epidemiology of environmental surface contamination, a discussion of cleaning health care patient area surfaces, an overview of disinfecting health care surfaces, an overview of challenges in monitoring cleaning versus cleanliness, a description of an integrated approach to environmental hygiene and hand hygiene as interrelated disciplines, and an overview of the research opportunities and challenges related to health care environmental hygiene. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Multipurpose Health Care Telemedicine System

    National Research Council Canada - National Science Library

    Kyriacou, E

    2001-01-01

    .... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

  19. Health care economy II

    International Nuclear Information System (INIS)

    Beer, G.; Slovak, K.

    2008-01-01

    In Slovakia a strange approach to the purchase of health care equipment has not been limited to ophthalmology. Suspicious procurements are symptomatic. This applies also to specialisation where the correct spending of money can make the difference between life and death and can greatly effect the quality of life. More than a year ago, the Ministry of Health started the procurement of linear accelerators for oncology units in three hospitals. This plan placed on the market a potential order worth more than 11 million EUR without VAT. Three companies produce this complex equipment. The US company, Varian, the German company, Siemens, and the Swedish company, Elekta. Three suppliers, three hospitals. What a coincidence that each hospital - in Presov, Banska Bystrica and Bratislava - received only one envelope with an offer. Each from a different supplier. If anyone wanted to prove that the suppliers did not agree on a common approach, he would soon get into trouble. Each tender was organized by Pro-Tender, Kosice. The tender for the purchase of linear accelerators observed all the legal regulations. For each hospital there was only one offer and so it won. No-one complained, because each company got an order. Amedis Piestany will deliver a Varian product to Bystrica. In Narodny onkologicky ustav in Bratislava the winner was Transkontakt with Elekta products. And in Presov it was Ad Rem from Dunajska Streda that succeeded. The small company owned by a local vet joined up with Siemens and is now opening the doors of state-owned and regional hospitals to the company. (authors)

  20. Large-scale stochasticity in Hamiltonian systems

    International Nuclear Information System (INIS)

    Escande, D.F.

    1982-01-01

    Large scale stochasticity (L.S.S.) in Hamiltonian systems is defined on the paradigm Hamiltonian H(v,x,t) =v 2 /2-M cos x-P cos k(x-t) which describes the motion of one particle in two electrostatic waves. A renormalization transformation Tsub(r) is described which acts as a microscope that focusses on a given KAM (Kolmogorov-Arnold-Moser) torus in phase space. Though approximate, Tsub(r) yields the threshold of L.S.S. in H with an error of 5-10%. The universal behaviour of KAM tori is predicted: for instance the scale invariance of KAM tori and the critical exponent of the Lyapunov exponent of Cantori. The Fourier expansion of KAM tori is computed and several conjectures by L. Kadanoff and S. Shenker are proved. Chirikov's standard mapping for stochastic layers is derived in a simpler way and the width of the layers is computed. A simpler renormalization scheme for these layers is defined. A Mathieu equation for describing the stability of a discrete family of cycles is derived. When combined with Tsub(r), it allows to prove the link between KAM tori and nearby cycles, conjectured by J. Greene and, in particular, to compute the mean residue of a torus. The fractal diagrams defined by G. Schmidt are computed. A sketch of a methodology for computing the L.S.S. threshold in any two-degree-of-freedom Hamiltonian system is given. (Auth.)

  1. Large scale molecular simulations of nanotoxicity.

    Science.gov (United States)

    Jimenez-Cruz, Camilo A; Kang, Seung-gu; Zhou, Ruhong

    2014-01-01

    The widespread use of nanomaterials in biomedical applications has been accompanied by an increasing interest in understanding their interactions with tissues, cells, and biomolecules, and in particular, on how they might affect the integrity of cell membranes and proteins. In this mini-review, we present a summary of some of the recent studies on this important subject, especially from the point of view of large scale molecular simulations. The carbon-based nanomaterials and noble metal nanoparticles are the main focus, with additional discussions on quantum dots and other nanoparticles as well. The driving forces for adsorption of fullerenes, carbon nanotubes, and graphene nanosheets onto proteins or cell membranes are found to be mainly hydrophobic interactions and the so-called π-π stacking (between aromatic rings), while for the noble metal nanoparticles the long-range electrostatic interactions play a bigger role. More interestingly, there are also growing evidences showing that nanotoxicity can have implications in de novo design of nanomedicine. For example, the endohedral metallofullerenol Gd@C₈₂(OH)₂₂ is shown to inhibit tumor growth and metastasis by inhibiting enzyme MMP-9, and graphene is illustrated to disrupt bacteria cell membranes by insertion/cutting as well as destructive extraction of lipid molecules. These recent findings have provided a better understanding of nanotoxicity at the molecular level and also suggested therapeutic potential by using the cytotoxicity of nanoparticles against cancer or bacteria cells. © 2014 Wiley Periodicals, Inc.

  2. Large-scale tides in general relativity

    Energy Technology Data Exchange (ETDEWEB)

    Ip, Hiu Yan; Schmidt, Fabian, E-mail: iphys@mpa-garching.mpg.de, E-mail: fabians@mpa-garching.mpg.de [Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Str. 1, 85741 Garching (Germany)

    2017-02-01

    Density perturbations in cosmology, i.e. spherically symmetric adiabatic perturbations of a Friedmann-Lemaȋtre-Robertson-Walker (FLRW) spacetime, are locally exactly equivalent to a different FLRW solution, as long as their wavelength is much larger than the sound horizon of all fluid components. This fact is known as the 'separate universe' paradigm. However, no such relation is known for anisotropic adiabatic perturbations, which correspond to an FLRW spacetime with large-scale tidal fields. Here, we provide a closed, fully relativistic set of evolutionary equations for the nonlinear evolution of such modes, based on the conformal Fermi (CFC) frame. We show explicitly that the tidal effects are encoded by the Weyl tensor, and are hence entirely different from an anisotropic Bianchi I spacetime, where the anisotropy is sourced by the Ricci tensor. In order to close the system, certain higher derivative terms have to be dropped. We show that this approximation is equivalent to the local tidal approximation of Hui and Bertschinger [1]. We also show that this very simple set of equations matches the exact evolution of the density field at second order, but fails at third and higher order. This provides a useful, easy-to-use framework for computing the fully relativistic growth of structure at second order.

  3. Food appropriation through large scale land acquisitions

    International Nuclear Information System (INIS)

    Cristina Rulli, Maria; D’Odorico, Paolo

    2014-01-01

    The increasing demand for agricultural products and the uncertainty of international food markets has recently drawn the attention of governments and agribusiness firms toward investments in productive agricultural land, mostly in the developing world. The targeted countries are typically located in regions that have remained only marginally utilized because of lack of modern technology. It is expected that in the long run large scale land acquisitions (LSLAs) for commercial farming will bring the technology required to close the existing crops yield gaps. While the extent of the acquired land and the associated appropriation of freshwater resources have been investigated in detail, the amount of food this land can produce and the number of people it could feed still need to be quantified. Here we use a unique dataset of land deals to provide a global quantitative assessment of the rates of crop and food appropriation potentially associated with LSLAs. We show how up to 300–550 million people could be fed by crops grown in the acquired land, should these investments in agriculture improve crop production and close the yield gap. In contrast, about 190–370 million people could be supported by this land without closing of the yield gap. These numbers raise some concern because the food produced in the acquired land is typically exported to other regions, while the target countries exhibit high levels of malnourishment. Conversely, if used for domestic consumption, the crops harvested in the acquired land could ensure food security to the local populations. (letter)

  4. Large Scale EOF Analysis of Climate Data

    Science.gov (United States)

    Prabhat, M.; Gittens, A.; Kashinath, K.; Cavanaugh, N. R.; Mahoney, M.

    2016-12-01

    We present a distributed approach towards extracting EOFs from 3D climate data. We implement the method in Apache Spark, and process multi-TB sized datasets on O(1000-10,000) cores. We apply this method to latitude-weighted ocean temperature data from CSFR, a 2.2 terabyte-sized data set comprising ocean and subsurface reanalysis measurements collected at 41 levels in the ocean, at 6 hour intervals over 31 years. We extract the first 100 EOFs of this full data set and compare to the EOFs computed simply on the surface temperature field. Our analyses provide evidence of Kelvin and Rossy waves and components of large-scale modes of oscillation including the ENSO and PDO that are not visible in the usual SST EOFs. Further, they provide information on the the most influential parts of the ocean, such as the thermocline, that exist below the surface. Work is ongoing to understand the factors determining the depth-varying spatial patterns observed in the EOFs. We will experiment with weighting schemes to appropriately account for the differing depths of the observations. We also plan to apply the same distributed approach to analysis of analysis of 3D atmospheric climatic data sets, including multiple variables. Because the atmosphere changes on a quicker time-scale than the ocean, we expect that the results will demonstrate an even greater advantage to computing 3D EOFs in lieu of 2D EOFs.

  5. Mirror dark matter and large scale structure

    International Nuclear Information System (INIS)

    Ignatiev, A.Yu.; Volkas, R.R.

    2003-01-01

    Mirror matter is a dark matter candidate. In this paper, we reexamine the linear regime of density perturbation growth in a universe containing mirror dark matter. Taking adiabatic scale-invariant perturbations as the input, we confirm that the resulting processed power spectrum is richer than for the more familiar cases of cold, warm and hot dark matter. The new features include a maximum at a certain scale λ max , collisional damping below a smaller characteristic scale λ S ' , with oscillatory perturbations between the two. These scales are functions of the fundamental parameters of the theory. In particular, they decrease for decreasing x, the ratio of the mirror plasma temperature to that of the ordinary. For x∼0.2, the scale λ max becomes galactic. Mirror dark matter therefore leads to bottom-up large scale structure formation, similar to conventional cold dark matter, for x(less-or-similar sign)0.2. Indeed, the smaller the value of x, the closer mirror dark matter resembles standard cold dark matter during the linear regime. The differences pertain to scales smaller than λ S ' in the linear regime, and generally in the nonlinear regime because mirror dark matter is chemically complex and to some extent dissipative. Lyman-α forest data and the early reionization epoch established by WMAP may hold the key to distinguishing mirror dark matter from WIMP-style cold dark matter

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria .... exercise. All pupils in the selected school later done under the light ..... increased the likelihood of intestinal parasitic of Ilechukwu et al in which a ...

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Subject and Methods: ... To the best of the authors' knowledge, ... increase in percentage of women visiting health categories were decided on because ..... leadership resulted in an empowering work Significant differences in the proportions of.

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Immunization is a proven cost-effective ... immunization programme and control of Vaccine was conducted to assess the ..... HFs where emphasis is on profit maximization revealed that the widespread ... World Health Organization (WHO).

  9. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.

  10. Diaspora, disease, and health care.

    Science.gov (United States)

    Wick, Jeannette Y; Zanni, Guido R

    2007-03-01

    When groups of people relocate from their homelands to other nations, especially if the movement is involuntary, minority populations are created in the countries that receive them. The issues related to these diaspora and diasporic communities--any groups that have been dispersed outside their traditional homelands--are financial, social, historical, political, or religious. In health care, issues include heritable diseases, cultural barriers, patients' health care beliefs, and unique disease presentations. In long-term care, many residents and health care providers have relocated to the United States from other countries.

  11. The Quiet Health Care Revolution.

    Science.gov (United States)

    Herzlinger, Regina

    1994-01-01

    Discusses how entrepreneurs have helped reduce costs in health care and examines the major changes in the health care system that are simultaneously lowering costs and increasing quality. The author then explains how current reform proposals might affect these entrepreneurial innovations. (GLR)

  12. Organizing emotions in health care.

    Science.gov (United States)

    Mark, Annabelle

    2005-01-01

    To introduce the articles in this special issue, discussing emotion in the in health-care organisations. Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff. Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent. The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.

  13. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    compared the perceived availability of essential drugs and patronage of health facilities in a BI and non-BI Local government areas (LGA) of ... 2Medical Directorate, Hospitals Management Board, Uyo, Akwa Ibom State ... majority of the population in Malaysia had access to .... Ethical clearance for this study was obtained.

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    The level of knowledge of HIV/AIDS among senior secondary school students in Ikpoba Okha LGA was poor. Parents were mainly the first source of information on HCT for the respondents. There is need for more research to update knowledge and information on adolescent health issues and services related to HIV/AIDS.

  15. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    A nation's disease control effort is often as good as the surveillance and notification system put in place, .... Department. Community Health. 11. 4.9. Dentistry. 28. 12.5. Family Medicine. 14 .... formal training and a posting in the Infection control.

  16. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Latin America and Southeast Asia. Cervical ... screening method based on visual Inspection with. 10-13 .... 56(49.6%) had poor knowledge while relating to practice of ... articulated road map and policy frame work to address ... European formal of Public ... Knowledge attitude and Practice ... Tertiary Health Institution. Int J.

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the mobile phones of health workers and their role as a source of hospital acquired infection. The study utilised ..... grew organisms which is much lower than may not be as effective as regular hand. 7 .... Akinyemi KO, Atapu AD, Adetona. 2011 ...

  18. Sensitivity technologies for large scale simulation

    International Nuclear Information System (INIS)

    Collis, Samuel Scott; Bartlett, Roscoe Ainsworth; Smith, Thomas Michael; Heinkenschloss, Matthias; Wilcox, Lucas C.; Hill, Judith C.; Ghattas, Omar; Berggren, Martin Olof; Akcelik, Volkan; Ober, Curtis Curry; van Bloemen Waanders, Bart Gustaaf; Keiter, Eric Richard

    2005-01-01

    Sensitivity analysis is critically important to numerous analysis algorithms, including large scale optimization, uncertainty quantification,reduced order modeling, and error estimation. Our research focused on developing tools, algorithms and standard interfaces to facilitate the implementation of sensitivity type analysis into existing code and equally important, the work was focused on ways to increase the visibility of sensitivity analysis. We attempt to accomplish the first objective through the development of hybrid automatic differentiation tools, standard linear algebra interfaces for numerical algorithms, time domain decomposition algorithms and two level Newton methods. We attempt to accomplish the second goal by presenting the results of several case studies in which direct sensitivities and adjoint methods have been effectively applied, in addition to an investigation of h-p adaptivity using adjoint based a posteriori error estimation. A mathematical overview is provided of direct sensitivities and adjoint methods for both steady state and transient simulations. Two case studies are presented to demonstrate the utility of these methods. A direct sensitivity method is implemented to solve a source inversion problem for steady state internal flows subject to convection diffusion. Real time performance is achieved using novel decomposition into offline and online calculations. Adjoint methods are used to reconstruct initial conditions of a contamination event in an external flow. We demonstrate an adjoint based transient solution. In addition, we investigated time domain decomposition algorithms in an attempt to improve the efficiency of transient simulations. Because derivative calculations are at the root of sensitivity calculations, we have developed hybrid automatic differentiation methods and implemented this approach for shape optimization for gas dynamics using the Euler equations. The hybrid automatic differentiation method was applied to a first

  19. GPU-based large-scale visualization

    KAUST Repository

    Hadwiger, Markus

    2013-11-19

    Recent advances in image and volume acquisition as well as computational advances in simulation have led to an explosion of the amount of data that must be visualized and analyzed. Modern techniques combine the parallel processing power of GPUs with out-of-core methods and data streaming to enable the interactive visualization of giga- and terabytes of image and volume data. A major enabler for interactivity is making both the computational and the visualization effort proportional to the amount of data that is actually visible on screen, decoupling it from the full data size. This leads to powerful display-aware multi-resolution techniques that enable the visualization of data of almost arbitrary size. The course consists of two major parts: An introductory part that progresses from fundamentals to modern techniques, and a more advanced part that discusses details of ray-guided volume rendering, novel data structures for display-aware visualization and processing, and the remote visualization of large online data collections. You will learn how to develop efficient GPU data structures and large-scale visualizations, implement out-of-core strategies and concepts such as virtual texturing that have only been employed recently, as well as how to use modern multi-resolution representations. These approaches reduce the GPU memory requirements of extremely large data to a working set size that fits into current GPUs. You will learn how to perform ray-casting of volume data of almost arbitrary size and how to render and process gigapixel images using scalable, display-aware techniques. We will describe custom virtual texturing architectures as well as recent hardware developments in this area. We will also describe client/server systems for distributed visualization, on-demand data processing and streaming, and remote visualization. We will describe implementations using OpenGL as well as CUDA, exploiting parallelism on GPUs combined with additional asynchronous

  20. Limited accessibility to designs and results of Japanese large-scale clinical trials for cardiovascular diseases.

    Science.gov (United States)

    Sawata, Hiroshi; Ueshima, Kenji; Tsutani, Kiichiro

    2011-04-14

    Clinical evidence is important for improving the treatment of patients by health care providers. In the study of cardiovascular diseases, large-scale clinical trials involving thousands of participants are required to evaluate the risks of cardiac events and/or death. The problems encountered in conducting the Japanese Acute Myocardial Infarction Prospective (JAMP) study highlighted the difficulties involved in obtaining the financial and infrastructural resources necessary for conducting large-scale clinical trials. The objectives of the current study were: 1) to clarify the current funding and infrastructural environment surrounding large-scale clinical trials in cardiovascular and metabolic diseases in Japan, and 2) to find ways to improve the environment surrounding clinical trials in Japan more generally. We examined clinical trials examining cardiovascular diseases that evaluated true endpoints and involved 300 or more participants using Pub-Med, Ichushi (by the Japan Medical Abstracts Society, a non-profit organization), websites of related medical societies, the University Hospital Medical Information Network (UMIN) Clinical Trials Registry, and clinicaltrials.gov at three points in time: 30 November, 2004, 25 February, 2007 and 25 July, 2009. We found a total of 152 trials that met our criteria for 'large-scale clinical trials' examining cardiovascular diseases in Japan. Of these, 72.4% were randomized controlled trials (RCTs). Of 152 trials, 9.2% of the trials examined more than 10,000 participants, and 42.8% examined between 1,000 and 10,000 participants. The number of large-scale clinical trials markedly increased from 2001 to 2004, but suddenly decreased in 2007, then began to increase again. Ischemic heart disease (39.5%) was the most common target disease. Most of the larger-scale trials were funded by private organizations such as pharmaceutical companies. The designs and results of 13 trials were not disclosed. To improve the quality of clinical

  1. Limited accessibility to designs and results of Japanese large-scale clinical trials for cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Tsutani Kiichiro

    2011-04-01

    Full Text Available Abstract Background Clinical evidence is important for improving the treatment of patients by health care providers. In the study of cardiovascular diseases, large-scale clinical trials involving thousands of participants are required to evaluate the risks of cardiac events and/or death. The problems encountered in conducting the Japanese Acute Myocardial Infarction Prospective (JAMP study highlighted the difficulties involved in obtaining the financial and infrastructural resources necessary for conducting large-scale clinical trials. The objectives of the current study were: 1 to clarify the current funding and infrastructural environment surrounding large-scale clinical trials in cardiovascular and metabolic diseases in Japan, and 2 to find ways to improve the environment surrounding clinical trials in Japan more generally. Methods We examined clinical trials examining cardiovascular diseases that evaluated true endpoints and involved 300 or more participants using Pub-Med, Ichushi (by the Japan Medical Abstracts Society, a non-profit organization, websites of related medical societies, the University Hospital Medical Information Network (UMIN Clinical Trials Registry, and clinicaltrials.gov at three points in time: 30 November, 2004, 25 February, 2007 and 25 July, 2009. Results We found a total of 152 trials that met our criteria for 'large-scale clinical trials' examining cardiovascular diseases in Japan. Of these, 72.4% were randomized controlled trials (RCTs. Of 152 trials, 9.2% of the trials examined more than 10,000 participants, and 42.8% examined between 1,000 and 10,000 participants. The number of large-scale clinical trials markedly increased from 2001 to 2004, but suddenly decreased in 2007, then began to increase again. Ischemic heart disease (39.5% was the most common target disease. Most of the larger-scale trials were funded by private organizations such as pharmaceutical companies. The designs and results of 13 trials were not

  2. Large Scale Self-Organizing Information Distribution System

    National Research Council Canada - National Science Library

    Low, Steven

    2005-01-01

    This project investigates issues in "large-scale" networks. Here "large-scale" refers to networks with large number of high capacity nodes and transmission links, and shared by a large number of users...

  3. Distributed large-scale dimensional metrology new insights

    CERN Document Server

    Franceschini, Fiorenzo; Maisano, Domenico

    2011-01-01

    Focuses on the latest insights into and challenges of distributed large scale dimensional metrology Enables practitioners to study distributed large scale dimensional metrology independently Includes specific examples of the development of new system prototypes

  4. Health care of hunting dogs

    OpenAIRE

    Spasojević-Kosić, Ljubica; Savić, Sara

    2013-01-01

    There are two basic aspects of hunting dog’s health care: infectious diseases of hunting dogs and dog’s hunting performance. Concerning infectious diseases of hunting dogs, special attention is paid to public health, preventing possible dangers that could possibly arise. On the other hand, hunting performance of dogs depends on their nutrition. A complete analysis of hunting dogs’ health care in our country requires an assessment of awareness level in hunte...

  5. Probes of large-scale structure in the Universe

    International Nuclear Information System (INIS)

    Suto, Yasushi; Gorski, K.; Juszkiewicz, R.; Silk, J.

    1988-01-01

    Recent progress in observational techniques has made it possible to confront quantitatively various models for the large-scale structure of the Universe with detailed observational data. We develop a general formalism to show that the gravitational instability theory for the origin of large-scale structure is now capable of critically confronting observational results on cosmic microwave background radiation angular anisotropies, large-scale bulk motions and large-scale clumpiness in the galaxy counts. (author)

  6. Gender disparities in health care.

    Science.gov (United States)

    Kent, Jennifer A; Patel, Vinisha; Varela, Natalie A

    2012-01-01

    The existence of disparities in delivery of health care has been the subject of increased empirical study in recent years. Some studies have suggested that disparities between men and women exist in the diagnoses and treatment of health conditions, and as a result measures have been taken to identify these differences. This article uses several examples to illustrate health care gender bias in medicine. These examples include surgery, peripheral artery disease, cardiovascular disease, critical care, and cardiovascular risk factors. Additionally, we discuss reasons why these issues still occur, trends in health care that may address these issues, and the need for acknowledgement of the current system's inequities in order to provide unbiased care for women in the future. © 2012 Mount Sinai School of Medicine.

  7. Hope for health and health care.

    Science.gov (United States)

    Stempsey, William E

    2015-02-01

    Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers.

  8. Large scale dynamics of protoplanetary discs

    Science.gov (United States)

    Béthune, William

    2017-08-01

    Planets form in the gaseous and dusty disks orbiting young stars. These protoplanetary disks are dispersed in a few million years, being accreted onto the central star or evaporated into the interstellar medium. To explain the observed accretion rates, it is commonly assumed that matter is transported through the disk by turbulence, although the mechanism sustaining turbulence is uncertain. On the other side, irradiation by the central star could heat up the disk surface and trigger a photoevaporative wind, but thermal effects cannot account for the observed acceleration and collimation of the wind into a narrow jet perpendicular to the disk plane. Both issues can be solved if the disk is sensitive to magnetic fields. Weak fields lead to the magnetorotational instability, whose outcome is a state of sustained turbulence. Strong fields can slow down the disk, causing it to accrete while launching a collimated wind. However, the coupling between the disk and the neutral gas is done via electric charges, each of which is outnumbered by several billion neutral molecules. The imperfect coupling between the magnetic field and the neutral gas is described in terms of "non-ideal" effects, introducing new dynamical behaviors. This thesis is devoted to the transport processes happening inside weakly ionized and weakly magnetized accretion disks; the role of microphysical effects on the large-scale dynamics of the disk is of primary importance. As a first step, I exclude the wind and examine the impact of non-ideal effects on the turbulent properties near the disk midplane. I show that the flow can spontaneously organize itself if the ionization fraction is low enough; in this case, accretion is halted and the disk exhibits axisymmetric structures, with possible consequences on planetary formation. As a second step, I study the launching of disk winds via a global model of stratified disk embedded in a warm atmosphere. This model is the first to compute non-ideal effects from

  9. Large-Scale Spacecraft Fire Safety Tests

    Science.gov (United States)

    Urban, David; Ruff, Gary A.; Ferkul, Paul V.; Olson, Sandra; Fernandez-Pello, A. Carlos; T'ien, James S.; Torero, Jose L.; Cowlard, Adam J.; Rouvreau, Sebastien; Minster, Olivier; hide

    2014-01-01

    An international collaborative program is underway to address open issues in spacecraft fire safety. Because of limited access to long-term low-gravity conditions and the small volume generally allotted for these experiments, there have been relatively few experiments that directly study spacecraft fire safety under low-gravity conditions. Furthermore, none of these experiments have studied sample sizes and environment conditions typical of those expected in a spacecraft fire. The major constraint has been the size of the sample, with prior experiments limited to samples of the order of 10 cm in length and width or smaller. This lack of experimental data forces spacecraft designers to base their designs and safety precautions on 1-g understanding of flame spread, fire detection, and suppression. However, low-gravity combustion research has demonstrated substantial differences in flame behavior in low-gravity. This, combined with the differences caused by the confined spacecraft environment, necessitates practical scale spacecraft fire safety research to mitigate risks for future space missions. To address this issue, a large-scale spacecraft fire experiment is under development by NASA and an international team of investigators. This poster presents the objectives, status, and concept of this collaborative international project (Saffire). The project plan is to conduct fire safety experiments on three sequential flights of an unmanned ISS re-supply spacecraft (the Orbital Cygnus vehicle) after they have completed their delivery of cargo to the ISS and have begun their return journeys to earth. On two flights (Saffire-1 and Saffire-3), the experiment will consist of a flame spread test involving a meter-scale sample ignited in the pressurized volume of the spacecraft and allowed to burn to completion while measurements are made. On one of the flights (Saffire-2), 9 smaller (5 x 30 cm) samples will be tested to evaluate NASAs material flammability screening tests

  10. Large-scale fuel cycle centres

    International Nuclear Information System (INIS)

    Smiley, S.H.; Black, K.M.

    1977-01-01

    The US Nuclear Regulatory Commission (NRC) has considered the nuclear energy centre concept for fuel cycle plants in the Nuclear Energy Centre Site Survey 1975 (NECSS-75) Rep. No. NUREG-0001, an important study mandated by the US Congress in the Energy Reorganization Act of 1974 which created the NRC. For this study, the NRC defined fuel cycle centres as consisting of fuel reprocessing and mixed-oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle centre sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000-300,000MW(e). The types of fuel cycle facilities located at the fuel cycle centre permit the assessment of the role of fuel cycle centres in enhancing the safeguard of strategic special nuclear materials - plutonium and mixed oxides. Siting fuel cycle centres presents a smaller problem than siting reactors. A single reprocessing plant of the scale projected for use in the USA (1500-2000t/a) can reprocess fuel from reactors producing 50,000-65,000MW(e). Only two or three fuel cycle centres of the upper limit size considered in the NECSS-75 would be required in the USA by the year 2000. The NECSS-75 fuel cycle centre evaluation showed that large-scale fuel cycle centres present no real technical siting difficulties from a radiological effluent and safety standpoint. Some construction economies may be achievable with fuel cycle centres, which offer opportunities to improve waste-management systems. Combined centres consisting of reactors and fuel reprocessing and mixed-oxide fuel fabrication plants were also studied in the NECSS. Such centres can eliminate shipment not only of Pu but also mixed-oxide fuel. Increased fuel cycle costs result from implementation of combined centres unless the fuel reprocessing plants are commercial-sized. Development of Pu-burning reactors could reduce any economic penalties of combined centres. The need for effective fissile

  11. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  12. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  13. Conscientious objection in health care

    Directory of Open Access Journals (Sweden)

    Kuře Josef

    2016-12-01

    Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.

  14. Understanding the faint red galaxy population using large-scale clustering measurements from SDSS DR7

    OpenAIRE

    Ross, Ashley; Tojeiro, Rita; Percival, Will

    2011-01-01

    We use data from the SDSS to investigate the evolution of the large-scale galaxy bias as a function of luminosity for red galaxies. We carefully consider correlation functions of galaxies selected from both photometric and spectroscopic data, and cross-correlations between them, to obtain multiple measurements of the large-scale bias. We find, for our most robust analyses, a strong increase in bias with luminosity for the most luminous galaxies, an intermediate regime where bias does not evol...

  15. Adherence and health care costs

    Directory of Open Access Journals (Sweden)

    Iuga AO

    2014-02-01

    Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost

  16. Towards Sustainable Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Mauro ROMANELLI

    2017-09-01

    Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

  17. Large scale injection test (LASGIT) modelling

    International Nuclear Information System (INIS)

    Arnedo, D.; Olivella, S.; Alonso, E.E.

    2010-01-01

    Document available in extended abstract form only. With the objective of understanding the gas flow processes through clay barriers in schemes of radioactive waste disposal, the Lasgit in situ experiment was planned and is currently in progress. The modelling of the experiment will permit to better understand of the responses, to confirm hypothesis of mechanisms and processes and to learn in order to design future experiments. The experiment and modelling activities are included in the project FORGE (FP7). The in situ large scale injection test Lasgit is currently being performed at the Aespoe Hard Rock Laboratory by SKB and BGS. An schematic layout of the test is shown. The deposition hole follows the KBS3 scheme. A copper canister is installed in the axe of the deposition hole, surrounded by blocks of highly compacted MX-80 bentonite. A concrete plug is placed at the top of the buffer. A metallic lid anchored to the surrounding host rock is included in order to prevent vertical movements of the whole system during gas injection stages (high gas injection pressures are expected to be reached). Hydration of the buffer material is achieved by injecting water through filter mats, two placed at the rock walls and two at the interfaces between bentonite blocks. Water is also injected through the 12 canister filters. Gas injection stages are performed injecting gas to some of the canister injection filters. Since the water pressure and the stresses (swelling pressure development) will be high during gas injection, it is necessary to inject at high gas pressures. This implies mechanical couplings as gas penetrates after the gas entry pressure is achieved and may produce deformations which in turn lead to permeability increments. A 3D hydro-mechanical numerical model of the test using CODE-BRIGHT is presented. The domain considered for the modelling is shown. The materials considered in the simulation are the MX-80 bentonite blocks (cylinders and rings), the concrete plug

  18. Large-scale fuel cycle centers

    International Nuclear Information System (INIS)

    Smiley, S.H.; Black, K.M.

    1977-01-01

    The United States Nuclear Regulatory Commission (NRC) has considered the nuclear energy center concept for fuel cycle plants in the Nuclear Energy Center Site Survey - 1975 (NECSS-75) -- an important study mandated by the U.S. Congress in the Energy Reorganization Act of 1974 which created the NRC. For the study, NRC defined fuel cycle centers to consist of fuel reprocessing and mixed oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle center sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000 - 300,000 MWe. The types of fuel cycle facilities located at the fuel cycle center permit the assessment of the role of fuel cycle centers in enhancing safeguarding of strategic special nuclear materials -- plutonium and mixed oxides. Siting of fuel cycle centers presents a considerably smaller problem than the siting of reactors. A single reprocessing plant of the scale projected for use in the United States (1500-2000 MT/yr) can reprocess the fuel from reactors producing 50,000-65,000 MWe. Only two or three fuel cycle centers of the upper limit size considered in the NECSS-75 would be required in the United States by the year 2000 . The NECSS-75 fuel cycle center evaluations showed that large scale fuel cycle centers present no real technical difficulties in siting from a radiological effluent and safety standpoint. Some construction economies may be attainable with fuel cycle centers; such centers offer opportunities for improved waste management systems. Combined centers consisting of reactors and fuel reprocessing and mixed oxide fuel fabrication plants were also studied in the NECSS. Such centers can eliminate not only shipment of plutonium, but also mixed oxide fuel. Increased fuel cycle costs result from implementation of combined centers unless the fuel reprocessing plants are commercial-sized. Development of plutonium-burning reactors could reduce any

  19. Large-scale assembly of colloidal particles

    Science.gov (United States)

    Yang, Hongta

    This study reports a simple, roll-to-roll compatible coating technology for producing three-dimensional highly ordered colloidal crystal-polymer composites, colloidal crystals, and macroporous polymer membranes. A vertically beveled doctor blade is utilized to shear align silica microsphere-monomer suspensions to form large-area composites in a single step. The polymer matrix and the silica microspheres can be selectively removed to create colloidal crystals and self-standing macroporous polymer membranes. The thickness of the shear-aligned crystal is correlated with the viscosity of the colloidal suspension and the coating speed, and the correlations can be qualitatively explained by adapting the mechanisms developed for conventional doctor blade coating. Five important research topics related to the application of large-scale three-dimensional highly ordered macroporous films by doctor blade coating are covered in this study. The first topic describes the invention in large area and low cost color reflective displays. This invention is inspired by the heat pipe technology. The self-standing macroporous polymer films exhibit brilliant colors which originate from the Bragg diffractive of visible light form the three-dimensional highly ordered air cavities. The colors can be easily changed by tuning the size of the air cavities to cover the whole visible spectrum. When the air cavities are filled with a solvent which has the same refractive index as that of the polymer, the macroporous polymer films become completely transparent due to the index matching. When the solvent trapped in the cavities is evaporated by in-situ heating, the sample color changes back to brilliant color. This process is highly reversible and reproducible for thousands of cycles. The second topic reports the achievement of rapid and reversible vapor detection by using 3-D macroporous photonic crystals. Capillary condensation of a condensable vapor in the interconnected macropores leads to the

  20. Experimental Investigation of Large-Scale Bubbly Plumes

    Energy Technology Data Exchange (ETDEWEB)

    Zboray, R.; Simiano, M.; De Cachard, F

    2004-03-01

    Carefully planned and instrumented experiments under well-defined boundary conditions have been carried out on large-scale, isothermal, bubbly plumes. The data obtained is meant to validate newly developed, high-resolution numerical tools for 3D transient, two-phase flow modelling. Several measurement techniques have been utilised to collect data from the experiments: particle image velocimetry, optical probes, electromagnetic probes, and visualisation. Bubble and liquid velocity fields, void-fraction distributions, bubble size and interfacial-area-concentration distributions have all been measured in the plume region, as well as recirculation velocities in the surrounding pool. The results obtained from the different measurement techniques have been compared. In general, the two-phase flow data obtained from the different techniques are found to be consistent, and of high enough quality for validating numerical simulation tools for 3D bubbly flows. (author)

  1. Experimental Investigation of Large-Scale Bubbly Plumes

    International Nuclear Information System (INIS)

    Zboray, R.; Simiano, M.; De Cachard, F.

    2004-01-01

    Carefully planned and instrumented experiments under well-defined boundary conditions have been carried out on large-scale, isothermal, bubbly plumes. The data obtained is meant to validate newly developed, high-resolution numerical tools for 3D transient, two-phase flow modelling. Several measurement techniques have been utilised to collect data from the experiments: particle image velocimetry, optical probes, electromagnetic probes, and visualisation. Bubble and liquid velocity fields, void-fraction distributions, bubble size and interfacial-area-concentration distributions have all been measured in the plume region, as well as recirculation velocities in the surrounding pool. The results obtained from the different measurement techniques have been compared. In general, the two-phase flow data obtained from the different techniques are found to be consistent, and of high enough quality for validating numerical simulation tools for 3D bubbly flows. (author)

  2. Understanding your health care costs

    Science.gov (United States)

    ... ency/patientinstructions/000878.htm Understanding your health care costs To use the sharing features on this page, ... on out-of-pocket costs. Out-of-Pocket Costs The good news is there is a limit ...

  3. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.

  5. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    %) was the least common. On bivariate analysis ... the power to determine what their wives do or fail to ... pregnancy care while joint decision-making ... Other maternal health services rendered This data collection was done by a team of trained.

  6. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

  7. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  8. Health care entrepreneurship: financing innovation.

    Science.gov (United States)

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

    Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects.

  9. Thermal power generation projects ``Large Scale Solar Heating``; EU-Thermie-Projekte ``Large Scale Solar Heating``

    Energy Technology Data Exchange (ETDEWEB)

    Kuebler, R.; Fisch, M.N. [Steinbeis-Transferzentrum Energie-, Gebaeude- und Solartechnik, Stuttgart (Germany)

    1998-12-31

    The aim of this project is the preparation of the ``Large-Scale Solar Heating`` programme for an Europe-wide development of subject technology. The following demonstration programme was judged well by the experts but was not immediately (1996) accepted for financial subsidies. In November 1997 the EU-commission provided 1,5 million ECU which allowed the realisation of an updated project proposal. By mid 1997 a small project was approved, that had been requested under the lead of Chalmes Industriteteknik (CIT) in Sweden and is mainly carried out for the transfer of technology. (orig.) [Deutsch] Ziel dieses Vorhabens ist die Vorbereitung eines Schwerpunktprogramms `Large Scale Solar Heating`, mit dem die Technologie europaweit weiterentwickelt werden sollte. Das daraus entwickelte Demonstrationsprogramm wurde von den Gutachtern positiv bewertet, konnte jedoch nicht auf Anhieb (1996) in die Foerderung aufgenommen werden. Im November 1997 wurden von der EU-Kommission dann kurzfristig noch 1,5 Mio ECU an Foerderung bewilligt, mit denen ein aktualisierter Projektvorschlag realisiert werden kann. Bereits Mitte 1997 wurde ein kleineres Vorhaben bewilligt, das unter Federfuehrung von Chalmers Industriteknik (CIT) in Schweden beantragt worden war und das vor allem dem Technologietransfer dient. (orig.)

  10. Health Care Wide Hazards

    Science.gov (United States)

    ... Glossary | References | Site Map | Credits Freedom of Information Act | Privacy & Security Statement | Disclaimers | Important Web Site Notices | International | Contact Us U.S. Department of Labor | Occupational Safety & Health Administration | 200 Constitution Ave., NW, Washington, DC 20210 ...

  11. Primary health care in India.

    Science.gov (United States)

    Deodhar, N S

    1982-03-01

    Concurrently with the development of the general health services infrastructure in India, serveral special health programs were instituted at the national level to provide a massive and concentrated assault on the major public health problems of malaria, smallpox, cholera, trachoma, tuberculosis, leprosy, filariasis, and the rapid population growth. These vertical programs were expected to reduce the heavy morbidity and mortality within the shortest possible time to where they were no longer major public health problems. The impact was variable. Major steps toward providing integrated health care were taken during the first 5-year plan. Emphasis was on the provision of a packet of inttegrated health, family planning, and nutrition services to the vulnerable groups, i.e., children, pregnant women, and nursing mothers. To rectify past shortcomings ssuch as the failures of the national health programs, ineffective coordination in the nutrition programs, and slow rate of development as a result of interdependence of different sectors, it was necessary to improve the health infrastructure and to launch a frontal attack on poverty. The Multipurpose Health Workers Scheme was planned to rationalize the organization and use of available manpower to reduce the area and population covered by each of the field staff in order to reduce travel time and to make services more effective and more satisfactory. Each multipurpose health worker was entrusted with the task of providing comprehensive health care to about 5000 people. Communicable diseases were the main public health problems, and many specific control/eradication programs were launched. the immunization programs against common childhood diseases have not taken deep roots and coverage continues to be poor. The adoption of the Western model of medical services has resulted in emphasis on "cure" rather than on "care". Another problem is maldistribution of the facilities. Overemphasis on medical education has resulted in the

  12. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  13. Analysis using large-scale ringing data

    Directory of Open Access Journals (Sweden)

    Baillie, S. R.

    2004-06-01

    survival and recruitment estimates from the French CES scheme to assess the relative contributions of survival and recruitment to overall population changes. He develops a novel approach to modelling survival rates from such multi–site data by using within–year recaptures to provide a covariate of between–year recapture rates. This provided parsimonious models of variation in recapture probabilities between sites and years. The approach provides promising results for the four species investigated and can potentially be extended to similar data from other CES/MAPS schemes. The final paper by Blandine Doligez, David Thomson and Arie van Noordwijk (Doligez et al., 2004 illustrates how large-scale studies of population dynamics can be important for evaluating the effects of conservation measures. Their study is concerned with the reintroduction of White Stork populations to the Netherlands where a re–introduction programme started in 1969 had resulted in a breeding population of 396 pairs by 2000. They demonstrate the need to consider a wide range of models in order to account for potential age, time, cohort and “trap–happiness” effects. As the data are based on resightings such trap–happiness must reflect some form of heterogeneity in resighting probabilities. Perhaps surprisingly, the provision of supplementary food did not influence survival, but it may havehad an indirect effect via the alteration of migratory behaviour. Spatially explicit modelling of data gathered at many sites inevitably results in starting models with very large numbers of parameters. The problem is often complicated further by having relatively sparse data at each site, even where the total amount of data gathered is very large. Both Julliard (2004 and Doligez et al. (2004 give explicit examples of problems caused by needing to handle very large numbers of parameters and show how they overcame them for their particular data sets. Such problems involve both the choice of appropriate

  14. Help Yourself to Health Care.

    Science.gov (United States)

    Snyder, Sarah

    A booklet on health care for limited English speakers provides information on choosing the right doctor, buying medicine, paying the bill, and the individual's role in maintaining his or her health. Cartoons, questions and puzzles concerning the message in cartoons and narrative passages, checklists about an individual's personal habits related to…

  15. Health care marketing: Basic features

    OpenAIRE

    Gajić-Stevanović Milena

    2006-01-01

    Paper discuss an introduction to importance's as well as challenges facing health care sector in many countries. Particular attention is devoted to the preconditions and/or basic requirements have to be developed in order to make health sector to functioned. Focusing to end users as well as employing marketing tools ought to be right orientation.

  16. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  17. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    ... Experience in a primary health care facility in Rivers State, South-South Nigeria. ... health center increased by 3.09% (p-value > 0.05); the patients that had their babies in the facility were ... 100, 000 live births, based on historical studies and.

  18. Health care in rural areas.

    Science.gov (United States)

    Nath, L M

    1994-02-01

    In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.

  19. Unmet dental needs and barriers to care for children with significant special health care needs.

    Science.gov (United States)

    Nelson, Linda P; Getzin, Anne; Graham, Dionne; Zhou, Jing; Wagle, Elke M; McQuiston, Jessie; McLaughlin, Suzanne; Govind, Akshay; Sadof, Matthew; Huntington, Noelle L

    2011-01-01

    The purpose of this study was to conduct the first known large scale survey of parents of children with special health care needs (CSHCN) to determine their child's: oral health status; access to dental care; perceived barriers (environmental/system and nonenvironmental/family); and oral health quality of life, accounting for each child's medical diagnosis and severity of diagnosis. A 72-item survey was sent to 3760 families of CSHCN throughout urban and rural Massachusetts. The study yielded 1,128 completed surveys. More than 90% of the children had seen a dentist within the past year; 66% saw a pediatric dentist, and 21% needed intense behavioral interventions. Although most families had high education levels, private dental insurance, and above average incomes, 20% of CSHCN had an unmet dental need. Children with craniofacial anomalies had twice as many unmet needs and children with cystic fibrosis had fewer unmet needs. Children with cerebral palsy, autism, developmental delay, and Down syndrome had more aversions to dental treatment, more treatment complications posed by their medical conditions, and more difficulty finding a dentist willing to provide care. Children with cystic fibrosis, metabolic disorders, or hemophilia encountered fewer barriers to care. The data paint a picture of high unmet dental needs with subpopulations of children with special health care needs who are more at risk for system barriers and internal family barriers to care based on their medical diagnoses.

  20. Health-Terrain: Visualizing Large Scale Health Data

    Science.gov (United States)

    2015-04-01

    An extension of LifeLine, LifeLine2 [3], enables multiple patient comparisons and aggregation for analysis , but the visualization design limited its...and enables users to explore data using various visualization and analysis methods. Concept terms are derived from data mining and text-mining...clustering algorithms [30] were applied to normalize the lexical variants and duplications of the terms. Term correlations were computed using the

  1. Health-Terrain: Visualizing Large Scale Health Data

    Science.gov (United States)

    2014-12-01

    Hepatitis B, 5) Hepatitis C, 6) Gonorrhea , 7) Chickenpox, 8) Measles, 9) Hepatitis A, 10) Enterococcus Vancomycin-Resistant (VRE) 11) Trichomoniasis...representing the occurrence percentage of disease among white patients. It shows that among black patients, CHLAMYDIA INFECTION and GONORRHEA are the most...Infection, Gonorrhea , and Syphilis over a time period. Figure 9. A Ring Graph for Chlamydia Infection

  2. EVALUATION OF HEALTH CARE QUALITY

    Directory of Open Access Journals (Sweden)

    Zlatko Fras

    2002-12-01

    Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.

  3. Radiations: large scale monitoring in Japan; Radiations: suivi a grande echelle au Japon

    Energy Technology Data Exchange (ETDEWEB)

    Linton, M.; Khalatbari, A.

    2011-10-15

    As the consequences of radioactive leaks on their health are a matter of concern for Japanese people, a large scale epidemiological study has been launched by the Fukushima medical university. It concerns the two millions inhabitants of the Fukushima Prefecture. On the national level and with the support of public funds, medical care and follow-up, as well as systematic controls are foreseen, notably to check the thyroid of 360.000 young people less than 18 year old and of 20.000 pregnant women in the Fukushima Prefecture. Some measurements have already been performed on young children. Despite the sometimes rather low measures, and because they know that some parts of the area are at least as much contaminated as it was the case around Chernobyl, some people are reluctant to go back home

  4. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  5. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  6. Measuring large-scale social networks with high resolution.

    Directory of Open Access Journals (Sweden)

    Arkadiusz Stopczynski

    Full Text Available This paper describes the deployment of a large-scale study designed to measure human interactions across a variety of communication channels, with high temporal resolution and spanning multiple years-the Copenhagen Networks Study. Specifically, we collect data on face-to-face interactions, telecommunication, social networks, location, and background information (personality, demographics, health, politics for a densely connected population of 1000 individuals, using state-of-the-art smartphones as social sensors. Here we provide an overview of the related work and describe the motivation and research agenda driving the study. Additionally, the paper details the data-types measured, and the technical infrastructure in terms of both backend and phone software, as well as an outline of the deployment procedures. We document the participant privacy procedures and their underlying principles. The paper is concluded with early results from data analysis, illustrating the importance of multi-channel high-resolution approach to data collection.

  7. Automatic management software for large-scale cluster system

    International Nuclear Information System (INIS)

    Weng Yunjian; Chinese Academy of Sciences, Beijing; Sun Gongxing

    2007-01-01

    At present, the large-scale cluster system faces to the difficult management. For example the manager has large work load. It needs to cost much time on the management and the maintenance of large-scale cluster system. The nodes in large-scale cluster system are very easy to be chaotic. Thousands of nodes are put in big rooms so that some managers are very easy to make the confusion with machines. How do effectively carry on accurate management under the large-scale cluster system? The article introduces ELFms in the large-scale cluster system. Furthermore, it is proposed to realize the large-scale cluster system automatic management. (authors)

  8. Marketing occupational health care.

    Science.gov (United States)

    Norris, M J; Harris, J C

    1981-01-01

    A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.

  9. Large scale chromatographic separations using continuous displacement chromatography (CDC)

    International Nuclear Information System (INIS)

    Taniguchi, V.T.; Doty, A.W.; Byers, C.H.

    1988-01-01

    A process for large scale chromatographic separations using a continuous chromatography technique is described. The process combines the advantages of large scale batch fixed column displacement chromatography with conventional analytical or elution continuous annular chromatography (CAC) to enable large scale displacement chromatography to be performed on a continuous basis (CDC). Such large scale, continuous displacement chromatography separations have not been reported in the literature. The process is demonstrated with the ion exchange separation of a binary lanthanide (Nd/Pr) mixture. The process is, however, applicable to any displacement chromatography separation that can be performed using conventional batch, fixed column chromatography

  10. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.

  11. Nanotechnology in health care

    CERN Document Server

    Sahoo, Sanjeeb K

    2012-01-01

    Nanomedicine: Emerging Field of Nanotechnology to Human HealthNanomedicines: Impacts in Ocular Delivery and TargetingImmuno-Nanosystems to CNS Pathologies: State of the Art PEGylated Zinc Protoporphyrin: A Micelle-Forming Polymeric Drug for Cancer TherapyORMOSIL Nanoparticles: Nanomedicine Approach for Drug/Gene Delivery to the BrainMagnetic Nanoparticles: A Versatile System for Therapeutic and Imaging SystemNanobiotechnology: A New Generation of Biomedicine Application of Nanotechnology-Based Drug Delivery and Targeting to LungsAptamers and Nanomedicine in C

  12. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    2010-11-09

    This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.  Created: 11/9/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/9/2010.

  13. A Dutch and American commentary on IT in health care: roundtable discussions on IT and innovations in health care.

    Science.gov (United States)

    Savage, Grant T; van der Reis, Leo

    2012-01-01

    This chapter reports on experts' perspectives on health information technology (HIT) and how it may be used to improve health care quality and to lower health care costs. Two roundtables were convened that focused on how to best use HIT to improve the quality of health care while ensuring it is accessible and affordable. Participants drew upon lessons learned in the Netherlands, the United States, and other countries. The first roundtable focused on the use of (1) electronic health records (EHRs) by health care providers, (2) cloud computing for EHRs and health portals for consumers, and (3) data registries and networks for public health surveillance. The second roundtable highlighted (1) the rapid growth of personalized medicine, (2) the corresponding growth and sophistication of bioinformatics and analytics, (3) the increasing presence of mobile HIT, and (4) the disruptive changes in the institutional structures of biomedical research and development. Governmental sponsorship of small pilot projects to solve practicable health system problems would encourage HIT innovation among key stakeholders. However, large-scale HIT solutions developed through small pilot projects--should be pursued through public-private partnerships. At the same time, governments should speed up legislative and regulatory procedures to encourage adoption of cost-effective HIT innovations. Mobile HIT and social media are capable of fostering disease prevention and encouraging personal responsibility for improving or stabilizing chronic diseases. Both health services researchers and policy makers should find this chapter of value since it highlights trends in HIT and addresses how health care quality may be improved while costs are contained.

  14. Phytotherapy in primary health care

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  15. Innovation in Health Care Delivery.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2016-02-01

    As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.

  16. Health Care Regulation Spending Trap

    Directory of Open Access Journals (Sweden)

    Timothy McTighe

    2017-07-01

    Full Text Available Our health care system has faced many challenges over the past 40 plus years. Now these challenges have forced us into a complicated situation that makes it confusing on how best to proceed. Today third party insurance payers make most health care payments. Our premiums are paid into a risk pool-on medical services for other people. Consumers are disconnected from knowing the cost of goods or services that they are receiving. This commentary reviews the current situation and provides a few common sense approaches for pursuing the best potential policies.

  17. Health disparities among health care workers.

    Science.gov (United States)

    Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann

    2010-01-01

    In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field.

  18. FastStats: Home Health Care

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  19. Costs of health care across primary care models in Ontario.

    Science.gov (United States)

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-08-01

    The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

  20. Prospects for large scale electricity storage in Denmark

    DEFF Research Database (Denmark)

    Krog Ekman, Claus; Jensen, Søren Højgaard

    2010-01-01

    In a future power systems with additional wind power capacity there will be an increased need for large scale power management as well as reliable balancing and reserve capabilities. Different technologies for large scale electricity storage provide solutions to the different challenges arising w...

  1. Large-scale matrix-handling subroutines 'ATLAS'

    International Nuclear Information System (INIS)

    Tsunematsu, Toshihide; Takeda, Tatsuoki; Fujita, Keiichi; Matsuura, Toshihiko; Tahara, Nobuo

    1978-03-01

    Subroutine package ''ATLAS'' has been developed for handling large-scale matrices. The package is composed of four kinds of subroutines, i.e., basic arithmetic routines, routines for solving linear simultaneous equations and for solving general eigenvalue problems and utility routines. The subroutines are useful in large scale plasma-fluid simulations. (auth.)

  2. Large-scale Agricultural Land Acquisitions in West Africa | IDRC ...

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

    This project will examine large-scale agricultural land acquisitions in nine West African countries -Burkina Faso, Guinea-Bissau, Guinea, Benin, Mali, Togo, Senegal, Niger, and Côte d'Ivoire. ... They will use the results to increase public awareness and knowledge about the consequences of large-scale land acquisitions.

  3. Large-scale synthesis of YSZ nanopowder by Pechini method

    Indian Academy of Sciences (India)

    Administrator

    structure and chemical purity of 99⋅1% by inductively coupled plasma optical emission spectroscopy on a large scale. Keywords. Sol–gel; yttria-stabilized zirconia; large scale; nanopowder; Pechini method. 1. Introduction. Zirconia has attracted the attention of many scientists because of its tremendous thermal, mechanical ...

  4. Linking research to practice: the organisation and implementation of The Netherlands health and social care improvement programmes

    NARCIS (Netherlands)

    Ovretveit, John; Klazinga, Niek

    2013-01-01

    Both public and private health and social care services are facing increased and changing demands to improve quality and reduce costs. To enable local services to respond to these demands, governments and other organisations have established large scale improvement programmes. These usually seek to

  5. Algorithm 896: LSA: Algorithms for Large-Scale Optimization

    Czech Academy of Sciences Publication Activity Database

    Lukšan, Ladislav; Matonoha, Ctirad; Vlček, Jan

    2009-01-01

    Roč. 36, č. 3 (2009), 16-1-16-29 ISSN 0098-3500 R&D Pro jects: GA AV ČR IAA1030405; GA ČR GP201/06/P397 Institutional research plan: CEZ:AV0Z10300504 Keywords : algorithms * design * large-scale optimization * large-scale nonsmooth optimization * large-scale nonlinear least squares * large-scale nonlinear minimax * large-scale systems of nonlinear equations * sparse pro blems * partially separable pro blems * limited-memory methods * discrete Newton methods * quasi-Newton methods * primal interior-point methods Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.904, year: 2009

  6. Islamic Cultures: Health Care Beliefs and Practices.

    Science.gov (United States)

    Kemp, Charles

    1996-01-01

    Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

  7. Health care reform and federalism.

    Science.gov (United States)

    Greer, Scott L; Jacobson, Peter D

    2010-04-01

    Health policy debates are replete with discussions of federalism, most often when advocates of reform put their hopes in states. But health policy literature is remarkably silent on the question of allocation of authority, rarely asking which levels of government ought to lead. We draw on the larger literatures about federalism, found mostly in political science and law, to develop a set of criteria for allocating health policy authority between states and the federal government. They are social justice, procedural democracy, compatibility with value pluralism, institutional capability, and economic sustainability. Of them, only procedural democracy and compatibility with value pluralism point to state leadership. In examining these criteria, we conclude that American policy debates often get federalism backward, putting the burden of health care coverage policy on states that cannot enact or sustain it, while increasing the federal role in issues where the arguments for state leadership are compelling. We suggest that the federal government should lead present and future financing of health care coverage, since it would require major changes in American intergovernmental relations to make innovative state health care financing sustainable outside a strong federal framework.

  8. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...

  9. Relationship marketing in health care.

    Science.gov (United States)

    Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W

    1994-01-01

    Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

  10. Reengineering health care materials management.

    Science.gov (United States)

    Connor, L R

    1998-01-01

    Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management.

  11. Intercultural Health Care and Welfare

    DEFF Research Database (Denmark)

    Nielsen, Ben

    2014-01-01

    Artiklen har fokus på undervisning, planlægning, udvikling og evaluering af et internationalt tværfagligt valgfag Intercultural Health Care and Welfare, der udbydes på Det Sundhedsfaglige og Teknologiske Fakultet på Professionshøjskolen Metropol. Ifølge den tysk-amerikanske professor Iris Varner og...

  12. Health care insolvency and bankruptcy.

    Science.gov (United States)

    Handelsman, L; Speiser, M; Maltz, A; Kirpalani, S

    1998-08-01

    Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace.

  13. Lower Costs, Better Care- Reforming Our Health Care Delivery

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...

  14. Managed consumerism in health care.

    Science.gov (United States)

    Robinson, James C

    2005-01-01

    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  15. Preserving community in health care.

    Science.gov (United States)

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  16. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

    Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

  17. Improving eye care in the primary health care setting

    Directory of Open Access Journals (Sweden)

    M de Wet

    2000-09-01

    Full Text Available One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.

  18. Oral Health Care Delivery Within the Accountable Care Organization.

    Science.gov (United States)

    Blue, Christine; Riggs, Sheila

    2016-06-01

    The accountable care organization (ACO) provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based health care in action. Inspired by health care reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. A dental insurance Chief Operating Officer and a dental hygiene educator used their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general health care have the potential to ensure a truly comprehensive healthcare system. Published by Elsevier Inc.

  19. Financing the health care Internet.

    Science.gov (United States)

    Robinson, J C

    2000-01-01

    Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms.

  20. Large-Scale Seismic Test Program at Hualien, Taiwan

    International Nuclear Information System (INIS)

    Tang, H.T.; Graves, H.L.; Yeh, Y.S.

    1991-01-01

    The Large-Scale Seismic Test (LSST) Program at Hualien, Taiwan, is a follow-on to the soil-structure interaction (SSI) experiments at Lotung, Taiwan. The planned SSI studies will be performed at a stiff soil site in Hualien, Taiwan, that historically has had slightly more destructive earthquakes in the past than Lotung. The objectives of the LSST project is as follows: To obtain earthquake-induced SSI data at a stiff soil site having similar prototypical nuclear power plant soil conditions. To confirm the findings and methodologies validated against the Lotung soft soil SSI data for prototypical plant condition applications. To further validate the technical basis of realistic SSI analysis approaches. To further support the resolution of USI A-40 Seismic Design Criteria issue. These objectives will be accomplished through an integrated and carefully planned experimental program consisting of: soil characterization, test model design and field construction, instrumentation layout and deployment, in-situ geophysical information collection, forced vibration test, and synthesis of results and findings. The LSST is a joint effort among many interested parties. EPRI and Taipower are the organizers of the program and have the lead in planning and managing the program

  1. An Novel Architecture of Large-scale Communication in IOT

    Science.gov (United States)

    Ma, Wubin; Deng, Su; Huang, Hongbin

    2018-03-01

    In recent years, many scholars have done a great deal of research on the development of Internet of Things and networked physical systems. However, few people have made the detailed visualization of the large-scale communications architecture in the IOT. In fact, the non-uniform technology between IPv6 and access points has led to a lack of broad principles of large-scale communications architectures. Therefore, this paper presents the Uni-IPv6 Access and Information Exchange Method (UAIEM), a new architecture and algorithm that addresses large-scale communications in the IOT.

  2. Large scale and big data processing and management

    CERN Document Server

    Sakr, Sherif

    2014-01-01

    Large Scale and Big Data: Processing and Management provides readers with a central source of reference on the data management techniques currently available for large-scale data processing. Presenting chapters written by leading researchers, academics, and practitioners, it addresses the fundamental challenges associated with Big Data processing tools and techniques across a range of computing environments.The book begins by discussing the basic concepts and tools of large-scale Big Data processing and cloud computing. It also provides an overview of different programming models and cloud-bas

  3. Comparison Between Overtopping Discharge in Small and Large Scale Models

    DEFF Research Database (Denmark)

    Helgason, Einar; Burcharth, Hans F.

    2006-01-01

    The present paper presents overtopping measurements from small scale model test performed at the Haudraulic & Coastal Engineering Laboratory, Aalborg University, Denmark and large scale model tests performed at the Largde Wave Channel,Hannover, Germany. Comparison between results obtained from...... small and large scale model tests show no clear evidence of scale effects for overtopping above a threshold value. In the large scale model no overtopping was measured for waveheights below Hs = 0.5m as the water sunk into the voids between the stones on the crest. For low overtopping scale effects...

  4. The Impact of Health Insurance on Health Care Provision in ...

    African Journals Online (AJOL)

    This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

  5. Attending Unintended Transformations of Health Care Infrastructure

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theor......Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background...

  6. What is the health care product?

    Science.gov (United States)

    France, K R; Grover, R

    1992-06-01

    Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.

  7. Infrastructure for large-scale quality-improvement projects: early lessons from North Carolina Improving Performance in Practice.

    Science.gov (United States)

    Newton, Warren P; Lefebvre, Ann; Donahue, Katrina E; Bacon, Thomas; Dobson, Allen

    2010-01-01

    Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3) quality-improvement consultants (QICs), or practice facilitators; (4) learning networks; and (5) alignment of incentives. We emphasized a community-based strategy and developing a statewide infrastructure. Results are reported from the first 2 years of the North Carolina Improving Performance in Practice (IPIP) project. A coalition was formed to include professional societies, North Carolina AHEC, Community Care of North Carolina, insurers, and other organizations. Wave One started with 18 practices in 2 of 9 regions of the state. Quality-improvement consultants recruited practices. Over 80 percent of practices attended all quarterly regional meetings. In 9 months, almost all diabetes measures improved, and a bundled asthma measure improved from 33 to 58 percent. Overall, the magnitude of improvement was clinically and statistically significant (P = .001). Quality improvements were maintained on review 1 year later. Wave Two has spread to 103 practices in all 9 regions of the state, with 42 additional practices beginning the enrollment process. Large-scale health care quality improvement is feasible, when broadly supported by statewide leadership and community infrastructure. Practice-collected data and lack of a control group are limitations of the study design. Future priorities include maintaining improved sustainability for practices and communities. Our long-term goal is to transform all 2000 primary-care practices in our state.

  8. Solidarity as a national health care strategy.

    Science.gov (United States)

    West-Oram, Peter

    2018-05-02

    The Trump Administration's recent attempts to repeal the Affordable Care Act have reignited long-running debates surrounding the nature of justice in health care provision, the extent of our obligations to others, and the most effective ways of funding and delivering quality health care. In this article, I respond to arguments that individualist systems of health care provision deliver higher-quality health care and promote liberty more effectively than the cooperative, solidaristic approaches that characterize health care provision in most wealthy countries apart from the United States. I argue that these claims are mistaken and suggest one way of rejecting the implied criticisms of solidaristic practices in health care provision they represent. This defence of solidarity is phrased in terms of the advantages solidaristic approaches to health care provision have over individualist alternatives in promoting certain important personal liberties, and delivering high-quality, affordable health care. © 2018 John Wiley & Sons Ltd.

  9. Evaluations of treatment efficacy of depression from perspective of both patients' symptoms and general sense of mental health and wellbeing: A large scale, multi-centered, longitudinal study in China.

    Science.gov (United States)

    Zeng, Qingzhi; Wang, Wei Chun; Fang, Yiru; Mellor, David; Mccabe, Marita; Byrne, Linda; Zuo, Sai; Xu, Yifeng

    2016-07-30

    Relying on the absence, presence of level of symptomatology may not provide an adequate indication of the effects of treatment for depression, nor sufficient information for the development of treatment plans that meet patients' needs. Using a prospective, multi-centered, and observational design, the present study surveyed a large sample of outpatients with depression in China (n=9855). The 17-item Hamilton Rating Scale for Depression (HRSD-17) and the Remission Evaluation and Mood Inventory Tool (REMIT) were administered at baseline, two weeks later and 4 weeks, to assess patients' self-reported symptoms and general sense of mental health and wellbeing. Of 9855 outpatients, 91.3% were diagnosed as experiencing moderate to severe depression. The patients reported significant improvement over time on both depressive symptoms and general sense after 4-week treatment. The effect sizes of change in general sense were lower than those in symptoms at both two week and four week follow-up. Treatment effects on both general sense and depressive symptomatology were associated with demographic and clinical factors. The findings indicate that a focus on both general sense of mental health and wellbeing in addition to depressive symptomatology will provide clinicians, researchers and patients themselves with a broader perspective of the status of patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Large-scale land transformations in Indonesia: The role of ...

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

    ... enable timely responses to the impacts of large-scale land transformations in Central Kalimantan ... In partnership with UNESCO's Organization for Women in Science for the ... New funding opportunity for gender equality and climate change.

  11. Personalized Opportunistic Computing for CMS at Large Scale

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    **Douglas Thain** is an Associate Professor of Computer Science and Engineering at the University of Notre Dame, where he designs large scale distributed computing systems to power the needs of advanced science and...

  12. Bottom-Up Accountability Initiatives and Large-Scale Land ...

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

    Corey Piccioni

    fuel/energy, climate, and finance has occurred and one of the most ... this wave of large-scale land acquisitions. In fact, esti- ... Environmental Rights Action/Friends of the Earth,. Nigeria ... map the differentiated impacts (gender, ethnicity,.

  13. Large-scale linear programs in planning and prediction.

    Science.gov (United States)

    2017-06-01

    Large-scale linear programs are at the core of many traffic-related optimization problems in both planning and prediction. Moreover, many of these involve significant uncertainty, and hence are modeled using either chance constraints, or robust optim...

  14. Bottom-Up Accountability Initiatives and Large-Scale Land ...

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

    ... Security can help increase accountability for large-scale land acquisitions in ... to build decent economic livelihoods and participate meaningfully in decisions ... its 2017 call for proposals to establish Cyber Policy Centres in the Global South.

  15. Amplification of large-scale magnetic field in nonhelical magnetohydrodynamics

    KAUST Repository

    Kumar, Rohit

    2017-08-11

    It is typically assumed that the kinetic and magnetic helicities play a crucial role in the growth of large-scale dynamo. In this paper, we demonstrate that helicity is not essential for the amplification of large-scale magnetic field. For this purpose, we perform nonhelical magnetohydrodynamic (MHD) simulation, and show that the large-scale magnetic field can grow in nonhelical MHD when random external forcing is employed at scale 1/10 the box size. The energy fluxes and shell-to-shell transfer rates computed using the numerical data show that the large-scale magnetic energy grows due to the energy transfers from the velocity field at the forcing scales.

  16. Needs, opportunities, and options for large scale systems research

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, G.L.

    1984-10-01

    The Office of Energy Research was recently asked to perform a study of Large Scale Systems in order to facilitate the development of a true large systems theory. It was decided to ask experts in the fields of electrical engineering, chemical engineering and manufacturing/operations research for their ideas concerning large scale systems research. The author was asked to distribute a questionnaire among these experts to find out their opinions concerning recent accomplishments and future research directions in large scale systems research. He was also requested to convene a conference which included three experts in each area as panel members to discuss the general area of large scale systems research. The conference was held on March 26--27, 1984 in Pittsburgh with nine panel members, and 15 other attendees. The present report is a summary of the ideas presented and the recommendations proposed by the attendees.

  17. Large-Scale 3D Printing: The Way Forward

    Science.gov (United States)

    Jassmi, Hamad Al; Najjar, Fady Al; Ismail Mourad, Abdel-Hamid

    2018-03-01

    Research on small-scale 3D printing has rapidly evolved, where numerous industrial products have been tested and successfully applied. Nonetheless, research on large-scale 3D printing, directed to large-scale applications such as construction and automotive manufacturing, yet demands a great a great deal of efforts. Large-scale 3D printing is considered an interdisciplinary topic and requires establishing a blended knowledge base from numerous research fields including structural engineering, materials science, mechatronics, software engineering, artificial intelligence and architectural engineering. This review article summarizes key topics of relevance to new research trends on large-scale 3D printing, particularly pertaining (1) technological solutions of additive construction (i.e. the 3D printers themselves), (2) materials science challenges, and (3) new design opportunities.

  18. No Large Scale Curvature Perturbations during Waterfall of Hybrid Inflation

    OpenAIRE

    Abolhasani, Ali Akbar; Firouzjahi, Hassan

    2010-01-01

    In this paper the possibility of generating large scale curvature perturbations induced from the entropic perturbations during the waterfall phase transition of standard hybrid inflation model is studied. We show that whether or not appreciable amounts of large scale curvature perturbations are produced during the waterfall phase transition depend crucially on the competition between the classical and the quantum mechanical back-reactions to terminate inflation. If one considers only the clas...

  19. Bayesian hierarchical model for large-scale covariance matrix estimation.

    Science.gov (United States)

    Zhu, Dongxiao; Hero, Alfred O

    2007-12-01

    Many bioinformatics problems implicitly depend on estimating large-scale covariance matrix. The traditional approaches tend to give rise to high variance and low accuracy due to "overfitting." We cast the large-scale covariance matrix estimation problem into the Bayesian hierarchical model framework, and introduce dependency between covariance parameters. We demonstrate the advantages of our approaches over the traditional approaches using simulations and OMICS data analysis.

  20. Benefits of transactive memory systems in large-scale development

    OpenAIRE

    Aivars, Sablis

    2016-01-01

    Context. Large-scale software development projects are those consisting of a large number of teams, maybe even spread across multiple locations, and working on large and complex software tasks. That means that neither a team member individually nor an entire team holds all the knowledge about the software being developed and teams have to communicate and coordinate their knowledge. Therefore, teams and team members in large-scale software development projects must acquire and manage expertise...

  1. Capabilities of the Large-Scale Sediment Transport Facility

    Science.gov (United States)

    2016-04-01

    pump flow meters, sediment trap weigh tanks , and beach profiling lidar. A detailed discussion of the original LSTF features and capabilities can be...ERDC/CHL CHETN-I-88 April 2016 Approved for public release; distribution is unlimited. Capabilities of the Large-Scale Sediment Transport...describes the Large-Scale Sediment Transport Facility (LSTF) and recent upgrades to the measurement systems. The purpose of these upgrades was to increase

  2. Comparative Analysis of Different Protocols to Manage Large Scale Networks

    OpenAIRE

    Anil Rao Pimplapure; Dr Jayant Dubey; Prashant Sen

    2013-01-01

    In recent year the numbers, complexity and size is increased in Large Scale Network. The best example of Large Scale Network is Internet, and recently once are Data-centers in Cloud Environment. In this process, involvement of several management tasks such as traffic monitoring, security and performance optimization is big task for Network Administrator. This research reports study the different protocols i.e. conventional protocols like Simple Network Management Protocol and newly Gossip bas...

  3. Internet in Continuous Health Care

    Czech Academy of Sciences Publication Activity Database

    Zvárová, Jana; Hanzlíček, Petr

    2005-01-01

    Roč. 13, č. 5 (2005), s. 451-452 ISSN 0928-7329. [MedNet 2005. World Congress on the Internet in Medicine /10./. 04.12.2005-07.12.2005, Prague] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : Internet * health care * technology Subject RIV: BD - Theory of Information

  4. Oncology in primary health care

    International Nuclear Information System (INIS)

    Mendoza del Pino, Mario Valentín

    2009-01-01

    The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

  5. Trends in large-scale testing of reactor structures

    International Nuclear Information System (INIS)

    Blejwas, T.E.

    2003-01-01

    Large-scale tests of reactor structures have been conducted at Sandia National Laboratories since the late 1970s. This paper describes a number of different large-scale impact tests, pressurization tests of models of containment structures, and thermal-pressure tests of models of reactor pressure vessels. The advantages of large-scale testing are evident, but cost, in particular limits its use. As computer models have grown in size, such as number of degrees of freedom, the advent of computer graphics has made possible very realistic representation of results - results that may not accurately represent reality. A necessary condition to avoiding this pitfall is the validation of the analytical methods and underlying physical representations. Ironically, the immensely larger computer models sometimes increase the need for large-scale testing, because the modeling is applied to increasing more complex structural systems and/or more complex physical phenomena. Unfortunately, the cost of large-scale tests is a disadvantage that will likely severely limit similar testing in the future. International collaborations may provide the best mechanism for funding future programs with large-scale tests. (author)

  6. A large-scale study of epilepsy in Ecuador: methodological aspects.

    Science.gov (United States)

    Placencia, M; Suarez, J; Crespo, F; Sander, J W; Shorvon, S D; Ellison, R H; Cascante, S M

    1992-01-01

    The methodology is presented of a large-scale study of epilepsy carried out in a highland area in northern Ecuador, South America, covering a population of 72,121 people; The study was carried out in two phases, the first, a cross-sectional phase, consisted of a house-to-house survey of all persons in this population, screening for epileptic seizures using a specially designed questionnaire. Possible cases identified in screening were assessed in a cascade diagnostic procedure applied by general doctors and neurologists. Its objectives were: to establish a comprehensive epidemiological profile of epileptic seizures; to describe the clinical phenomenology of this condition in the community; to validate methods for diagnosis and classification of epileptic seizures by a non-specialised team; and to ascertain the community's knowledge, attitudes and practices regarding epilepsy. A sample was selected in this phase in order to study the social aspects of epilepsy in this community. The second phase, which was longitudinal, assessed the ability of non-specialist care in the treatment of epilepsy. It consisted of a prospective clinical trial of antiepileptic therapy in untreated patients using two standard anti-epileptic drugs. Patients were followed for 12 months by a multidisciplinary team consisting of a primary health worker, rural doctor, neurologist, anthropologist, and psychologist. Standardised, reproducible instruments and methods were used. This study was carried out through co-operation between the medical profession, political agencies and the pharmaceutical industry, at an international level. We consider this a model for further large-scale studies of this type.

  7. Empowering women and health care.

    Science.gov (United States)

    Shiva, M

    1993-02-01

    Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e

  8. An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

    Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

  9. Reduced high-molecular-weight adiponectin and elevated high-sensitivity C-reactive protein are synergistic risk factors for metabolic syndrome in a large-scale middle-aged to elderly population: the Shimanami Health Promoting Program Study.

    Science.gov (United States)

    Tabara, Yasuharu; Osawa, Haruhiko; Kawamoto, Ryuichi; Tachibana-Iimori, Rieko; Yamamoto, Miyuki; Nakura, Jun; Miki, Tetsuro; Makino, Hideich; Kohara, Katsuhiko

    2008-03-01

    In Western countries, one of the most important modifiable targets for the prevention of cardiovascular diseases is metabolic syndrome. Adiponectin is an adipose tissue-specific plasma protein that inversely associates with metabolic syndrome. Among several molecular isoforms, high-molecular-weight (HMW) complex is considered the active form. Increased serum high-sensitivity C-reactive protein (hsCRP) concentration also associates with metabolic syndrome, and adiponectin could modulate plasma C-reactive protein levels. Here, through cross-sectional investigation, we investigated whether reduced HMW adiponectin and increased hsCRP levels in plasma are synergistically associated with metabolic syndrome. Measurement of HMW complex of adiponectin is one of the novelties of this study. We analyzed 1845 community-dwelling middle-aged to elderly subjects (62+/-13 yr). Plasma HMW adiponectin levels were measured by ELISA. Clinical parameters were obtained from the subjects' personal health records, evaluated at their annual medical check-up. Each component of metabolic syndrome, except for raised blood pressure, showed significantly lower plasma HMW adiponectin concentrations for both men and women (P<0.001). In contrast, plasma hsCRP levels were significantly higher in subjects with metabolic disorders (P<0.001). After adjusting for other confounding factors, HMW adiponectin [log normalized, odds ratio 0.084 (95% confidence interval 0.050-0.142), P<0.001] and hsCRP [3.009 (2.175-4.163), P<0.001] were identified as independent determinants of metabolic syndrome. In addition to the direct associations, we also observed a synergistic effect between these two molecules (F=11.8, P<0.001). Reduced HMW adiponectin and elevated hsCRP are synergistically associated with the accumulation of metabolic disorders. The combination of these markers would be useful for identifying at-risk populations.

  10. Consumer Attitudes toward Health and Health Care: A Differential Perspective.

    Science.gov (United States)

    Gould, Stephen J.

    1988-01-01

    Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)

  11. Managed care: employers' influence on the health care system.

    Science.gov (United States)

    Corder, K T; Phoon, J; Barter, M

    1996-01-01

    Health care reform is a complex issue involving many key sectors including providers, consumers, insurers, employers, and the government. System changes must involve all sectors for reform to be effective. Each sector has a responsibility to understand not only its own role in the health care system, but the roles of others as well. The role of business employers is often not apparent to health care providers, especially nurses. Understanding the influence employers have on the health care system is vital if providers want to be proactive change agents ensuring quality care.

  12. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

    Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

  13. Technology in health care logistics

    DEFF Research Database (Denmark)

    Jørgensen, Pelle; Wallin, Michael

    In most of the developed countries hospitals are facing a major challenge – they have to provide more health care using the same resources. Due to the demographic trend and the increasing share of the population being in a more health-demanding age, the hospitals will have to deal with more...... patients in the future. It is therefore essential that the hospitals are more efficient in order to meet the requirement of providing more health for the same or less resources. Studies have shown that more than 30% of hospital expenditures are related to various logistics cost, making the logistics...... papers presented at scientific conferences, and three articles submitted to scientific journals. In addition to the results, the thesis presents a detailed description of the scientific approach taken, as well as considerations in relation to the scientific approach and the achieved results....

  14. Teaching Health Care in Introductory Economics

    Science.gov (United States)

    Cutler, David M.

    2017-01-01

    Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…

  15. Women's health care: from whom and why?

    NARCIS (Netherlands)

    Brink-Muinen, A. van den

    1997-01-01

    Differences are investigated between female practice populations of female general practitioners providing women's health care and of women and men general practitioners providing regular health care. Women's health care in the Netherlands is provided in the general practice "Aletta" and is based

  16. Phylogenetic distribution of large-scale genome patchiness

    Directory of Open Access Journals (Sweden)

    Hackenberg Michael

    2008-04-01

    Full Text Available Abstract Background The phylogenetic distribution of large-scale genome structure (i.e. mosaic compositional patchiness has been explored mainly by analytical ultracentrifugation of bulk DNA. However, with the availability of large, good-quality chromosome sequences, and the recently developed computational methods to directly analyze patchiness on the genome sequence, an evolutionary comparative analysis can be carried out at the sequence level. Results The local variations in the scaling exponent of the Detrended Fluctuation Analysis are used here to analyze large-scale genome structure and directly uncover the characteristic scales present in genome sequences. Furthermore, through shuffling experiments of selected genome regions, computationally-identified, isochore-like regions were identified as the biological source for the uncovered large-scale genome structure. The phylogenetic distribution of short- and large-scale patchiness was determined in the best-sequenced genome assemblies from eleven eukaryotic genomes: mammals (Homo sapiens, Pan troglodytes, Mus musculus, Rattus norvegicus, and Canis familiaris, birds (Gallus gallus, fishes (Danio rerio, invertebrates (Drosophila melanogaster and Caenorhabditis elegans, plants (Arabidopsis thaliana and yeasts (Saccharomyces cerevisiae. We found large-scale patchiness of genome structure, associated with in silico determined, isochore-like regions, throughout this wide phylogenetic range. Conclusion Large-scale genome structure is detected by directly analyzing DNA sequences in a wide range of eukaryotic chromosome sequences, from human to yeast. In all these genomes, large-scale patchiness can be associated with the isochore-like regions, as directly detected in silico at the sequence level.

  17. Large-scale projects between regional planning and environmental protection

    International Nuclear Information System (INIS)

    Schmidt, G.

    1984-01-01

    The first part of the work discusses the current law of land-use planning, municipal and technical construction planning, and licensing under the atomic energy law and the federal law on immission protection. In the second part some theses suggesting modifications are submitted. In the sector of land-use planning substantial contributions to the protection of the environment can only be expected from programs and plans (aims). For the environmental conflicts likely to arise from large-scale projects (nuclear power plant, fossil-fuel power plant) this holds good for the most part of site selection plans. They have bearings on environmental protection in that they presuppose thorough examination of facts, help to recognize possible conflicts at an early date and provide a frame for solving those problems. Municipal construction planning is guided by the following principles: Environmental protection is an equivalent planning target. Environmental data and facts and their methodical processing play a fundamental part as they constitute the basis of evaluation. Under the rules and regulations of the federal law on immission protection, section 5, number 2 - prevention of nuisances - operators are obliged to take preventive care of risks. That section is not concerned with planning or distribution. Neither does the licensing of nuclear plants have planning character. So far as the legal preconditions of licensing are fulfilled, the scope for rejection of an application under section 7, subsection 2 of the atomic energy law in view of site selection and requirement of a plant hardly carries any practical weight. (orig./HP) [de

  18. Rationalising health care in india : Challenges & strategies

    Directory of Open Access Journals (Sweden)

    K I Mathai

    2014-01-01

    Full Text Available An overview of health care delivery in India is essential, if we are to plan and to improve health care delivery and the indices of health in the coming decades. The health sector in India is a mix of private and government services. While some health care indices appear dismal, several others, including life expectancy are heartening. A balance between regulation and free enterprise is possibly the best option. In this paper we provide a glimpse of health and health related statistics & a n overview of the public health care delivery systems. In the end, we offer suggestion on rationalisation of health care delivery to provide maximum services for the majority of our population within the budget of an optimal health care system outlay

  19. Effect Of A Large-Scale Social Franchising And Telemedicine Program On Childhood Diarrhea And Pneumonia Outcomes In India.

    Science.gov (United States)

    Mohanan, Manoj; Babiarz, Kimberly S; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

    2016-10-01

    Despite the rapid growth of social franchising, there is little evidence on its population impact in the health sector. Similar in many ways to private-sector commercial franchising, social franchising can be found in sectors with a social objective, such as health care. This article evaluates the World Health Partners (WHP) Sky program, a large-scale social franchising and telemedicine program in Bihar, India. We studied appropriate treatment for childhood diarrhea and pneumonia and associated health care outcomes. We used multivariate difference-in-differences models to analyze data on 67,950 children ages five and under in 2011 and 2014. We found that the WHP-Sky program did not improve rates of appropriate treatment or disease prevalence. Both provider participation and service use among target populations were low. Our results do not imply that social franchising cannot succeed; instead, they underscore the importance of understanding factors that explain variation in the performance of social franchises. Our findings also highlight, for donors and governments in particular, the importance of conducting rigorous impact evaluations of new and potentially innovative health care delivery programs before investing in scaling them up. Published by Project HOPE—The People-to-People Health Foundation, Inc.

  20. Remote Health Care Provision in Care Homes.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve

    2017-01-01

    A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.

  1. Let's put "care" back into health care.

    Science.gov (United States)

    Wesolowski, C E

    1990-01-01

    Organizations that clearly demonstrate they care about their people reap the benefits of a positive self-image, higher productivity and financial gains. Consider the effects that a demoralized, unappreciated staff have on productivity, recruitment and retention, public relations, marketing, customer satisfaction and the resulting financial repercussions. Can we afford not to care?

  2. EFFECTS OF LARGE-SCALE POULTRY FARMS ON AQUATIC MICROBIAL COMMUNITIES: A MOLECULAR INVESTIGATION.

    Science.gov (United States)

    The effects of large-scale poultry production operations on water quality and human health are largely unknown. Poultry litter is frequently applied as fertilizer to agricultural lands adjacent to large poultry farms. Run-off from the land introduces a variety of stressors into t...

  3. Hospitals and health care establishments

    International Nuclear Information System (INIS)

    1999-01-01

    These guidelines have been drown up to assist all those involved in the management and maintenance of hospitals and health care establishments. Compliance with this guidance should minimise the risk of pollution occurring. The guidelines are jointly produced by the Environment Agency for England and Wales, the Scottish Environment Protection Agency and the Environment and Heritage Service for Northern Ireland, referred to as the Agency or Agencies. It includes guidelines on site drainage, sewage and waste water disposal, treatment of surface water drainage and waste management

  4. Simulation studies of a wide area health care network.

    Science.gov (United States)

    McDaniel, J. G.

    1994-01-01

    There is an increasing number of efforts to install wide area health care networks. Some of these networks are being built to support several applications over a wide user base consisting primarily of medical practices, hospitals, pharmacies, medical laboratories, payors, and suppliers. Although on-line, multi-media telecommunication is desirable for some purposes such as cardiac monitoring, store-and-forward messaging is adequate for many common, high-volume applications. Laboratory test results and payment claims, for example, can be distributed using electronic messaging networks. Several network prototypes have been constructed to determine the technical problems and to assess the effectiveness of electronic messaging in wide area health care networks. Our project, Health Link, developed prototype software that was able to use the public switched telephone network to exchange messages automatically, reliably and securely. The network could be configured to accommodate the many different traffic patterns and cost constraints of its users. Discrete event simulations were performed on several network models. Canonical star and mesh networks, that were composed of nodes operating at steady state under equal loads, were modeled. Both topologies were found to support the throughput of a generic wide area health care network. The mean message delivery time of the mesh network was found to be less than that of the star network. Further simulations were conducted for a realistic large-scale health care network consisting of 1,553 doctors, 26 hospitals, four medical labs, one provincial lab and one insurer. Two network topologies were investigated: one using predominantly peer-to-peer communication, the other using client-server communication.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7949966

  5. PKI security in large-scale healthcare networks.

    Science.gov (United States)

    Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

    2012-06-01

    During the past few years a lot of PKI (Public Key Infrastructures) infrastructures have been proposed for healthcare networks in order to ensure secure communication services and exchange of data among healthcare professionals. However, there is a plethora of challenges in these healthcare PKI infrastructures. Especially, there are a lot of challenges for PKI infrastructures deployed over large-scale healthcare networks. In this paper, we propose a PKI infrastructure to ensure security in a large-scale Internet-based healthcare network connecting a wide spectrum of healthcare units geographically distributed within a wide region. Furthermore, the proposed PKI infrastructure facilitates the trust issues that arise in a large-scale healthcare network including multi-domain PKI infrastructures.

  6. Large-Scale Agriculture and Outgrower Schemes in Ethiopia

    DEFF Research Database (Denmark)

    Wendimu, Mengistu Assefa

    , the impact of large-scale agriculture and outgrower schemes on productivity, household welfare and wages in developing countries is highly contentious. Chapter 1 of this thesis provides an introduction to the study, while also reviewing the key debate in the contemporary land ‘grabbing’ and historical large...... sugarcane outgrower scheme on household income and asset stocks. Chapter 5 examines the wages and working conditions in ‘formal’ large-scale and ‘informal’ small-scale irrigated agriculture. The results in Chapter 2 show that moisture stress, the use of untested planting materials, and conflict over land...... commands a higher wage than ‘formal’ large-scale agriculture, while rather different wage determination mechanisms exist in the two sectors. Human capital characteristics (education and experience) partly explain the differences in wages within the formal sector, but play no significant role...

  7. Seismic safety in conducting large-scale blasts

    Science.gov (United States)

    Mashukov, I. V.; Chaplygin, V. V.; Domanov, V. P.; Semin, A. A.; Klimkin, M. A.

    2017-09-01

    In mining enterprises to prepare hard rocks for excavation a drilling and blasting method is used. With the approach of mining operations to settlements the negative effect of large-scale blasts increases. To assess the level of seismic impact of large-scale blasts the scientific staff of Siberian State Industrial University carried out expertise for coal mines and iron ore enterprises. Determination of the magnitude of surface seismic vibrations caused by mass explosions was performed using seismic receivers, an analog-digital converter with recording on a laptop. The registration results of surface seismic vibrations during production of more than 280 large-scale blasts at 17 mining enterprises in 22 settlements are presented. The maximum velocity values of the Earth’s surface vibrations are determined. The safety evaluation of seismic effect was carried out according to the permissible value of vibration velocity. For cases with exceedance of permissible values recommendations were developed to reduce the level of seismic impact.

  8. Balancing modern Power System with large scale of wind power

    DEFF Research Database (Denmark)

    Basit, Abdul; Altin, Müfit; Hansen, Anca Daniela

    2014-01-01

    Power system operators must ensure robust, secure and reliable power system operation even with a large scale integration of wind power. Electricity generated from the intermittent wind in large propor-tion may impact on the control of power system balance and thus deviations in the power system...... frequency in small or islanded power systems or tie line power flows in interconnected power systems. Therefore, the large scale integration of wind power into the power system strongly concerns the secure and stable grid operation. To ensure the stable power system operation, the evolving power system has...... to be analysed with improved analytical tools and techniques. This paper proposes techniques for the active power balance control in future power systems with the large scale wind power integration, where power balancing model provides the hour-ahead dispatch plan with reduced planning horizon and the real time...

  9. The role of large scale motions on passive scalar transport

    Science.gov (United States)

    Dharmarathne, Suranga; Araya, Guillermo; Tutkun, Murat; Leonardi, Stefano; Castillo, Luciano

    2014-11-01

    We study direct numerical simulation (DNS) of turbulent channel flow at Reτ = 394 to investigate effect of large scale motions on fluctuating temperature field which forms a passive scalar field. Statistical description of the large scale features of the turbulent channel flow is obtained using two-point correlations of velocity components. Two-point correlations of fluctuating temperature field is also examined in order to identify possible similarities between velocity and temperature fields. The two-point cross-correlations betwen the velocity and temperature fluctuations are further analyzed to establish connections between these two fields. In addition, we use proper orhtogonal decompotion (POD) to extract most dominant modes of the fields and discuss the coupling of large scale features of turbulence and the temperature field.

  10. Large-Scale Structure and Hyperuniformity of Amorphous Ices

    Science.gov (United States)

    Martelli, Fausto; Torquato, Salvatore; Giovambattista, Nicolas; Car, Roberto

    2017-09-01

    We investigate the large-scale structure of amorphous ices and transitions between their different forms by quantifying their large-scale density fluctuations. Specifically, we simulate the isothermal compression of low-density amorphous ice (LDA) and hexagonal ice to produce high-density amorphous ice (HDA). Both HDA and LDA are nearly hyperuniform; i.e., they are characterized by an anomalous suppression of large-scale density fluctuations. By contrast, in correspondence with the nonequilibrium phase transitions to HDA, the presence of structural heterogeneities strongly suppresses the hyperuniformity and the system becomes hyposurficial (devoid of "surface-area fluctuations"). Our investigation challenges the largely accepted "frozen-liquid" picture, which views glasses as structurally arrested liquids. Beyond implications for water, our findings enrich our understanding of pressure-induced structural transformations in glasses.

  11. Large-scale networks in engineering and life sciences

    CERN Document Server

    Findeisen, Rolf; Flockerzi, Dietrich; Reichl, Udo; Sundmacher, Kai

    2014-01-01

    This edited volume provides insights into and tools for the modeling, analysis, optimization, and control of large-scale networks in the life sciences and in engineering. Large-scale systems are often the result of networked interactions between a large number of subsystems, and their analysis and control are becoming increasingly important. The chapters of this book present the basic concepts and theoretical foundations of network theory and discuss its applications in different scientific areas such as biochemical reactions, chemical production processes, systems biology, electrical circuits, and mobile agents. The aim is to identify common concepts, to understand the underlying mathematical ideas, and to inspire discussions across the borders of the various disciplines.  The book originates from the interdisciplinary summer school “Large Scale Networks in Engineering and Life Sciences” hosted by the International Max Planck Research School Magdeburg, September 26-30, 2011, and will therefore be of int...

  12. Managing Cancer Care - Finding Health Care Services

    Science.gov (United States)

    ... my condition? Has it been rated by state, consumer, or other groups for its quality of care? ... be both rewarding and demanding. It can change relationships and require families to cope with all aspects ...

  13. Large Scale Meteorological Pattern of Extreme Rainfall in Indonesia

    Science.gov (United States)

    Kuswanto, Heri; Grotjahn, Richard; Rachmi, Arinda; Suhermi, Novri; Oktania, Erma; Wijaya, Yosep

    2014-05-01

    Extreme Weather Events (EWEs) cause negative impacts socially, economically, and environmentally. Considering these facts, forecasting EWEs is crucial work. Indonesia has been identified as being among the countries most vulnerable to the risk of natural disasters, such as floods, heat waves, and droughts. Current forecasting of extreme events in Indonesia is carried out by interpreting synoptic maps for several fields without taking into account the link between the observed events in the 'target' area with remote conditions. This situation may cause misidentification of the event leading to an inaccurate prediction. Grotjahn and Faure (2008) compute composite maps from extreme events (including heat waves and intense rainfall) to help forecasters identify such events in model output. The composite maps show large scale meteorological patterns (LSMP) that occurred during historical EWEs. Some vital information about the EWEs can be acquired from studying such maps, in addition to providing forecaster guidance. Such maps have robust mid-latitude meteorological patterns (for Sacramento and California Central Valley, USA EWEs). We study the performance of the composite approach for tropical weather condition such as Indonesia. Initially, the composite maps are developed to identify and forecast the extreme weather events in Indramayu district- West Java, the main producer of rice in Indonesia and contributes to about 60% of the national total rice production. Studying extreme weather events happening in Indramayu is important since EWEs there affect national agricultural and fisheries activities. During a recent EWE more than a thousand houses in Indramayu suffered from serious flooding with each home more than one meter underwater. The flood also destroyed a thousand hectares of rice plantings in 5 regencies. Identifying the dates of extreme events is one of the most important steps and has to be carried out carefully. An approach has been applied to identify the

  14. Large Scale Processes and Extreme Floods in Brazil

    Science.gov (United States)

    Ribeiro Lima, C. H.; AghaKouchak, A.; Lall, U.

    2016-12-01

    Persistent large scale anomalies in the atmospheric circulation and ocean state have been associated with heavy rainfall and extreme floods in water basins of different sizes across the world. Such studies have emerged in the last years as a new tool to improve the traditional, stationary based approach in flood frequency analysis and flood prediction. Here we seek to advance previous studies by evaluating the dominance of large scale processes (e.g. atmospheric rivers/moisture transport) over local processes (e.g. local convection) in producing floods. We consider flood-prone regions in Brazil as case studies and the role of large scale climate processes in generating extreme floods in such regions is explored by means of observed streamflow, reanalysis data and machine learning methods. The dynamics of the large scale atmospheric circulation in the days prior to the flood events are evaluated based on the vertically integrated moisture flux and its divergence field, which are interpreted in a low-dimensional space as obtained by machine learning techniques, particularly supervised kernel principal component analysis. In such reduced dimensional space, clusters are obtained in order to better understand the role of regional moisture recycling or teleconnected moisture in producing floods of a given magnitude. The convective available potential energy (CAPE) is also used as a measure of local convection activities. We investigate for individual sites the exceedance probability in which large scale atmospheric fluxes dominate the flood process. Finally, we analyze regional patterns of floods and how the scaling law of floods with drainage area responds to changes in the climate forcing mechanisms (e.g. local vs large scale).

  15. Integrated occupational health care at sea

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2011-01-01

    exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing......Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...

  16. Controversies in faith and health care.

    Science.gov (United States)

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Mothers' health services utilization and health care seeking ...

    African Journals Online (AJOL)

    Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...

  18. Report of the LASCAR forum: Large scale reprocessing plant safeguards

    International Nuclear Information System (INIS)

    1992-01-01

    This report has been prepared to provide information on the studies which were carried out from 1988 to 1992 under the auspices of the multinational forum known as Large Scale Reprocessing Plant Safeguards (LASCAR) on safeguards for four large scale reprocessing plants operated or planned to be operated in the 1990s. The report summarizes all of the essential results of these studies. The participants in LASCAR were from France, Germany, Japan, the United Kingdom, the United States of America, the Commission of the European Communities - Euratom, and the International Atomic Energy Agency

  19. Large-scale structure observables in general relativity

    International Nuclear Information System (INIS)

    Jeong, Donghui; Schmidt, Fabian

    2015-01-01

    We review recent studies that rigorously define several key observables of the large-scale structure of the Universe in a general relativistic context. Specifically, we consider (i) redshift perturbation of cosmic clock events; (ii) distortion of cosmic rulers, including weak lensing shear and magnification; and (iii) observed number density of tracers of the large-scale structure. We provide covariant and gauge-invariant expressions of these observables. Our expressions are given for a linearly perturbed flat Friedmann–Robertson–Walker metric including scalar, vector, and tensor metric perturbations. While we restrict ourselves to linear order in perturbation theory, the approach can be straightforwardly generalized to higher order. (paper)

  20. Topology Optimization of Large Scale Stokes Flow Problems

    DEFF Research Database (Denmark)

    Aage, Niels; Poulsen, Thomas Harpsøe; Gersborg-Hansen, Allan

    2008-01-01

    This note considers topology optimization of large scale 2D and 3D Stokes flow problems using parallel computations. We solve problems with up to 1.125.000 elements in 2D and 128.000 elements in 3D on a shared memory computer consisting of Sun UltraSparc IV CPUs.......This note considers topology optimization of large scale 2D and 3D Stokes flow problems using parallel computations. We solve problems with up to 1.125.000 elements in 2D and 128.000 elements in 3D on a shared memory computer consisting of Sun UltraSparc IV CPUs....

  1. Fatigue Analysis of Large-scale Wind turbine

    Directory of Open Access Journals (Sweden)

    Zhu Yongli

    2017-01-01

    Full Text Available The paper does research on top flange fatigue damage of large-scale wind turbine generator. It establishes finite element model of top flange connection system with finite element analysis software MSC. Marc/Mentat, analyzes its fatigue strain, implements load simulation of flange fatigue working condition with Bladed software, acquires flange fatigue load spectrum with rain-flow counting method, finally, it realizes fatigue analysis of top flange with fatigue analysis software MSC. Fatigue and Palmgren-Miner linear cumulative damage theory. The analysis result indicates that its result provides new thinking for flange fatigue analysis of large-scale wind turbine generator, and possesses some practical engineering value.

  2. Generation of large-scale vortives in compressible helical turbulence

    International Nuclear Information System (INIS)

    Chkhetiani, O.G.; Gvaramadze, V.V.

    1989-01-01

    We consider generation of large-scale vortices in compressible self-gravitating turbulent medium. The closed equation describing evolution of the large-scale vortices in helical turbulence with finite correlation time is obtained. This equation has the form similar to the hydromagnetic dynamo equation, which allows us to call the vortx genertation effect the vortex dynamo. It is possible that principally the same mechanism is responsible both for amplification and maintenance of density waves and magnetic fields in gaseous disks of spiral galaxies. (author). 29 refs

  3. The Obama health care plan: what it means for mental health care of older adults.

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  4. Delegation within municipal health care.

    Science.gov (United States)

    Bystedt, Maria; Eriksson, Maria; Wilde-Larsson, Bodil

    2011-05-01

    To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  5. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  6. Reforming health care in Hungary.

    Science.gov (United States)

    Császi, L; Kullberg, P

    1985-01-01

    Over the past two decades Hungary has initiated a series of social and economic reforms which have emphasized decentralization of control and the reintroduction of market mechanisms into the socialized economy. These reforms both reflect and reinforce a changing social structure, in particular the growing influence of upper class special interest groups. Market reforms are an expression of concurrent ideological shifts in Hungarian society. We examined the political significance of three recent proposals to reform health services against the backdrop of broader social and economic changes taking place. The first proposes a bureaucratic reorganization, the second, patient co-payments, and the third, a voucher system. The problems each proposal identifies, as well as the constituency each represents, reveal a trend toward consolidation of class structure in Hungary. Only one of these proposals has any potential to democratize the control and management of the heath care system. Moreover, despite a governmental push toward decentralization, two of these proposals would actually increase centralized bureaucratic control. Two of the reforms incorporate market logic into their arguments, an indication that the philosophical premises of capitalism are re-emerging as an important component of the Hungarian world-view. In Hungary, as well as in other countries, social analysis of proposed health care reforms can effectively illuminate the social and political dynamics of the larger society.

  7. [Teletransmission, health care and deontology].

    Science.gov (United States)

    Lousson, J P

    1995-01-01

    EDI is the technique the most frequently used by Chemists to relay their daily orders to their suppliers. Three out of four Chemists in France are computerised using various forms of computer hardware and software. The Health Care organisations propose that Chemists use the EDI to relay to the CETELIC all the items of information concerning their invoicing. This means handing over administrative information identifying the patient, the doctor ... as well as financial and confidential data such as the CIP code of the prescribed and delivered medicine. The law of the 4th January 1993 was instigated to control the rising expenses of the Health Care organisations and it mandates the Caisse Primaire d'Assurance Maladie (the French social security organisations) to retrieve and analyse the information thus gathered from all of the medical professionals involved. However, the accumulation of all these items of computerised information constitutes in effect a confidential medical file on each patient. This raises the following issues: Who does this confidential data belong to? Who should the Chemists give it to? What is to be done with it? Who will be responsible for its analysis in respect of the confidentiality problem? (Another medical professional bound by oath?) And how can we insure against subsequent abuse of this material?

  8. Latex allergy in health care

    Directory of Open Access Journals (Sweden)

    Tina Virtič

    2012-11-01

    Full Text Available The increasing use of natural rubber latex medical gloves in the last three decades has caused an increase in latex allergy. The majority of risk groups for allergy development include health care workers, workers in the rubber industry, atopic individuals and children with congenital malformations. Three types of pathological reactions can occur in people using latex medical gloves: irritant contact dermatitis, allergic contact dermatitis and immediate hypersensitivity. The latex allergy is caused by constituent components of latex gloves and added powders; there are also numerous latex allergens involved in cross-reactivity between latex and fruits and vegetables, the so-called latex-fruit syndrome. The diagnosis is based on an accurate history of exposure, clinical presentation and confirmatory in vivo and in vitro tests. Prevention is the easiest, most effective and least expensive way to avoid latex allergy. Powder-free latex gloves with reduced levels of proteins and chemicals, and synthetic gloves for allergic workers must be provided in the work environment. There are already many health care institutions around the world where all latex products have been replaced by synthetic material products.

  9. Collaborative HIV care in primary health care: nurses' views.

    Science.gov (United States)

    Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S

    2017-12-01

    Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.

  10. Home Health Care: Services and Cost

    Science.gov (United States)

    Widmer, Geraldine; And Others

    1978-01-01

    Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

  11. Data-Driven Diffusion Of Innovations: Successes And Challenges In 3 Large-Scale Innovative Delivery Models.

    Science.gov (United States)

    Dorr, David A; Cohen, Deborah J; Adler-Milstein, Julia

    2018-02-01

    Failed diffusion of innovations may be linked to an inability to use and apply data, information, and knowledge to change perceptions of current practice and motivate change. Using qualitative and quantitative data from three large-scale health care delivery innovations-accountable care organizations, advanced primary care practice, and EvidenceNOW-we assessed where data-driven innovation is occurring and where challenges lie. We found that implementation of some technological components of innovation (for example, electronic health records) has occurred among health care organizations, but core functions needed to use data to drive innovation are lacking. Deficits include the inability to extract and aggregate data from the records; gaps in sharing data; and challenges in adopting advanced data functions, particularly those related to timely reporting of performance data. The unexpectedly high costs and burden incurred during implementation of the innovations have limited organizations' ability to address these and other deficits. Solutions that could help speed progress in data-driven innovation include facilitating peer-to-peer technical assistance, providing tailored feedback reports to providers from data aggregators, and using practice facilitators skilled in using data technology for quality improvement to help practices transform. Policy efforts that promote these solutions may enable more rapid uptake of and successful participation in innovative delivery system reforms.

  12. Large-scale Lurgi plant would be uneconomic: study group

    Energy Technology Data Exchange (ETDEWEB)

    1964-03-21

    Gas Council and National Coal Board agreed that building of large scale Lurgi plant on the basis of study is not at present acceptable on economic grounds. The committee considered that new processes based on naphtha offered more economic sources of base and peak load production. Tables listing data provided in contractors' design studies and summary of contractors' process designs are included.

  13. Origin of large-scale cell structure in the universe

    International Nuclear Information System (INIS)

    Zel'dovich, Y.B.

    1982-01-01

    A qualitative explanation is offered for the characteristic global structure of the universe, wherein ''black'' regions devoid of galaxies are surrounded on all sides by closed, comparatively thin, ''bright'' layers populated by galaxies. The interpretation rests on some very general arguments regarding the growth of large-scale perturbations in a cold gas

  14. Large-Scale Systems Control Design via LMI Optimization

    Czech Academy of Sciences Publication Activity Database

    Rehák, Branislav

    2015-01-01

    Roč. 44, č. 3 (2015), s. 247-253 ISSN 1392-124X Institutional support: RVO:67985556 Keywords : Combinatorial linear matrix inequalities * large-scale system * decentralized control Subject RIV: BC - Control Systems Theory Impact factor: 0.633, year: 2015

  15. Identification of low order models for large scale processes

    NARCIS (Netherlands)

    Wattamwar, S.K.

    2010-01-01

    Many industrial chemical processes are complex, multi-phase and large scale in nature. These processes are characterized by various nonlinear physiochemical effects and fluid flows. Such processes often show coexistence of fast and slow dynamics during their time evolutions. The increasing demand

  16. Worldwide large-scale fluctuations of sardine and anchovy ...

    African Journals Online (AJOL)

    Worldwide large-scale fluctuations of sardine and anchovy populations. ... African Journal of Marine Science. Journal Home · ABOUT THIS JOURNAL · Advanced ... Fullscreen Fullscreen Off. http://dx.doi.org/10.2989/AJMS.2008.30.1.13.463.

  17. Worldwide large-scale fluctuations of sardine and anchovy ...

    African Journals Online (AJOL)

    Worldwide large-scale fluctuations of sardine and anchovy populations. ... African Journal of Marine Science. Journal Home · ABOUT THIS JOURNAL · Advanced ... http://dx.doi.org/10.2989/AJMS.2008.30.1.13.463 · AJOL African Journals ...

  18. Large-scale coastal impact induced by a catastrophic storm

    DEFF Research Database (Denmark)

    Fruergaard, Mikkel; Andersen, Thorbjørn Joest; Johannessen, Peter N

    breaching. Our results demonstrate that violent, millennial-scale storms can trigger significant large-scale and long-term changes on barrier coasts, and that coastal changes assumed to take place over centuries or even millennia may occur in association with a single extreme storm event....

  19. Success Factors of Large Scale ERP Implementation in Thailand

    OpenAIRE

    Rotchanakitumnuai; Siriluck

    2010-01-01

    The objectives of the study are to examine the determinants of ERP implementation success factors of ERP implementation. The result indicates that large scale ERP implementation success consist of eight factors: project management competence, knowledge sharing, ERP system quality , understanding, user involvement, business process re-engineering, top management support, organization readiness.

  20. Planck intermediate results XLII. Large-scale Galactic magnetic fields

    DEFF Research Database (Denmark)

    Adam, R.; Ade, P. A. R.; Alves, M. I. R.

    2016-01-01

    Recent models for the large-scale Galactic magnetic fields in the literature have been largely constrained by synchrotron emission and Faraday rotation measures. We use three different but representative models to compare their predicted polarized synchrotron and dust emission with that measured ...

  1. Large Scale Simulations of the Euler Equations on GPU Clusters

    KAUST Repository

    Liebmann, Manfred; Douglas, Craig C.; Haase, Gundolf; Horvá th, Zoltá n

    2010-01-01

    The paper investigates the scalability of a parallel Euler solver, using the Vijayasundaram method, on a GPU cluster with 32 Nvidia Geforce GTX 295 boards. The aim of this research is to enable large scale fluid dynamics simulations with up to one

  2. Breakdown of large-scale circulation in turbulent rotating convection

    NARCIS (Netherlands)

    Kunnen, R.P.J.; Clercx, H.J.H.; Geurts, Bernardus J.

    2008-01-01

    Turbulent rotating convection in a cylinder is investigated both numerically and experimentally at Rayleigh number Ra = $10^9$ and Prandtl number $\\sigma$ = 6.4. In this Letter we discuss two topics: the breakdown under rotation of the domain-filling large-scale circulation (LSC) typical for

  3. Penalized Estimation in Large-Scale Generalized Linear Array Models

    DEFF Research Database (Denmark)

    Lund, Adam; Vincent, Martin; Hansen, Niels Richard

    2017-01-01

    Large-scale generalized linear array models (GLAMs) can be challenging to fit. Computation and storage of its tensor product design matrix can be impossible due to time and memory constraints, and previously considered design matrix free algorithms do not scale well with the dimension...

  4. A Chain Perspective on Large-scale Number Systems

    NARCIS (Netherlands)

    Grijpink, J.H.A.M.

    2012-01-01

    As large-scale number systems gain significance in social and economic life (electronic communication, remote electronic authentication), the correct functioning and the integrity of public number systems take on crucial importance. They are needed to uniquely indicate people, objects or phenomena

  5. Image-based Exploration of Large-Scale Pathline Fields

    KAUST Repository

    Nagoor, Omniah H.

    2014-01-01

    structure in which each pixel contains a list of pathlines segments. With this view-dependent method it is possible to filter, color-code and explore large-scale flow data in real-time. In addition, optimization techniques such as early-ray termination

  6. Temporal Variation of Large Scale Flows in the Solar Interior ...

    Indian Academy of Sciences (India)

    tribpo

    Temporal Variation of Large Scale Flows in the Solar Interior. 355. Figure 2. Zonal and meridional components of the time-dependent residual velocity at a few selected depths as marked above each panel, are plotted as contours of constant velocity in the longitude-latitude plane. The left panels show the zonal component, ...

  7. Facile Large-Scale Synthesis of 5- and 6-Carboxyfluoresceins

    DEFF Research Database (Denmark)

    Hammershøj, Peter; Ek, Pramod Kumar; Harris, Pernille

    2015-01-01

    A series of fluorescein dyes have been prepared from a common precursor through a very simple synthetic procedure, giving access to important precursors for fluorescent probes. The method has proven an efficient access to regioisomerically pure 5- and 6-carboxyfluoresceins on a large scale, in good...

  8. The Large-Scale Structure of Scientific Method

    Science.gov (United States)

    Kosso, Peter

    2009-01-01

    The standard textbook description of the nature of science describes the proposal, testing, and acceptance of a theoretical idea almost entirely in isolation from other theories. The resulting model of science is a kind of piecemeal empiricism that misses the important network structure of scientific knowledge. Only the large-scale description of…

  9. Newton Methods for Large Scale Problems in Machine Learning

    Science.gov (United States)

    Hansen, Samantha Leigh

    2014-01-01

    The focus of this thesis is on practical ways of designing optimization algorithms for minimizing large-scale nonlinear functions with applications in machine learning. Chapter 1 introduces the overarching ideas in the thesis. Chapters 2 and 3 are geared towards supervised machine learning applications that involve minimizing a sum of loss…

  10. Large-Scale Machine Learning for Classification and Search

    Science.gov (United States)

    Liu, Wei

    2012-01-01

    With the rapid development of the Internet, nowadays tremendous amounts of data including images and videos, up to millions or billions, can be collected for training machine learning models. Inspired by this trend, this thesis is dedicated to developing large-scale machine learning techniques for the purpose of making classification and nearest…

  11. Large scale solar district heating. Evaluation, modelling and designing - Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Heller, A.

    2000-07-01

    The appendices present the following: A) Cad-drawing of the Marstal CSHP design. B) Key values - large-scale solar heating in Denmark. C) Monitoring - a system description. D) WMO-classification of pyranometers (solarimeters). E) The computer simulation model in TRNSYS. F) Selected papers from the author. (EHS)

  12. Proceedings of the meeting on large scale computer simulation research

    International Nuclear Information System (INIS)

    2004-04-01

    The meeting to summarize the collaboration activities for FY2003 on the Large Scale Computer Simulation Research was held January 15-16, 2004 at Theory and Computer Simulation Research Center, National Institute for Fusion Science. Recent simulation results, methodologies and other related topics were presented. (author)

  13. Chirping for large-scale maritime archaeological survey

    DEFF Research Database (Denmark)

    Grøn, Ole; Boldreel, Lars Ole

    2014-01-01

    Archaeological wrecks exposed on the sea floor are mapped using side-scan and multibeam techniques, whereas the detection of submerged archaeological sites, such as Stone Age settlements, and wrecks, partially or wholly embedded in sea-floor sediments, requires the application of high-resolution ...... the present state of this technology, it appears well suited to large-scale maritime archaeological mapping....

  14. Large-scale Homogenization of Bulk Materials in Mammoth Silos

    NARCIS (Netherlands)

    Schott, D.L.

    2004-01-01

    This doctoral thesis concerns the large-scale homogenization of bulk materials in mammoth silos. The objective of this research was to determine the best stacking and reclaiming method for homogenization in mammoth silos. For this purpose a simulation program was developed to estimate the

  15. Large Scale Survey Data in Career Development Research

    Science.gov (United States)

    Diemer, Matthew A.

    2008-01-01

    Large scale survey datasets have been underutilized but offer numerous advantages for career development scholars, as they contain numerous career development constructs with large and diverse samples that are followed longitudinally. Constructs such as work salience, vocational expectations, educational expectations, work satisfaction, and…

  16. Large Scale Anomalies of the Cosmic Microwave Background with Planck

    DEFF Research Database (Denmark)

    Frejsel, Anne Mette

    This thesis focuses on the large scale anomalies of the Cosmic Microwave Background (CMB) and their possible origins. The investigations consist of two main parts. The first part is on statistical tests of the CMB, and the consistency of both maps and power spectrum. We find that the Planck data...

  17. Fractals and the Large-Scale Structure in the Universe

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 7; Issue 4. Fractals and the Large-Scale Structure in the Universe - Is the Cosmological Principle Valid? A K Mittal T R Seshadri. General Article Volume 7 Issue 4 April 2002 pp 39-47 ...

  18. LARGE-SCALE COMMERCIAL INVESTMENTS IN LAND: SEEKING ...

    African Journals Online (AJOL)

    extent of large-scale investment in land or to assess its impact on the people in recipient countries. .... favorable lease terms, apparently based on a belief that this is necessary to .... Harm to the rights of local occupiers of land can result from a dearth. 24. ..... applies to a self-identified group based on the group's traditions.

  19. Mixing Metaphors: Building Infrastructure for Large Scale School Turnaround

    Science.gov (United States)

    Peurach, Donald J.; Neumerski, Christine M.

    2015-01-01

    The purpose of this analysis is to increase understanding of the possibilities and challenges of building educational infrastructure--the basic, foundational structures, systems, and resources--to support large-scale school turnaround. Building educational infrastructure often exceeds the capacity of schools, districts, and state education…

  20. Reconsidering Replication: New Perspectives on Large-Scale School Improvement

    Science.gov (United States)

    Peurach, Donald J.; Glazer, Joshua L.

    2012-01-01

    The purpose of this analysis is to reconsider organizational replication as a strategy for large-scale school improvement: a strategy that features a "hub" organization collaborating with "outlet" schools to enact school-wide designs for improvement. To do so, we synthesize a leading line of research on commercial replication to construct a…

  1. First Mile Challenges for Large-Scale IoT

    KAUST Repository

    Bader, Ahmed; Elsawy, Hesham; Gharbieh, Mohammad; Alouini, Mohamed-Slim; Adinoyi, Abdulkareem; Alshaalan, Furaih

    2017-01-01

    The Internet of Things is large-scale by nature. This is not only manifested by the large number of connected devices, but also by the sheer scale of spatial traffic intensity that must be accommodated, primarily in the uplink direction. To that end

  2. VESPA: Very large-scale Evolutionary and Selective Pressure Analyses

    Directory of Open Access Journals (Sweden)

    Andrew E. Webb

    2017-06-01

    Full Text Available Background Large-scale molecular evolutionary analyses of protein coding sequences requires a number of preparatory inter-related steps from finding gene families, to generating alignments and phylogenetic trees and assessing selective pressure variation. Each phase of these analyses can represent significant challenges, particularly when working with entire proteomes (all protein coding sequences in a genome from a large number of species. Methods We present VESPA, software capable of automating a selective pressure analysis using codeML in addition to the preparatory analyses and summary statistics. VESPA is written in python and Perl and is designed to run within a UNIX environment. Results We have benchmarked VESPA and our results show that the method is consistent, performs well on both large scale and smaller scale datasets, and produces results in line with previously published datasets. Discussion Large-scale gene family identification, sequence alignment, and phylogeny reconstruction are all important aspects of large-scale molecular evolutionary analyses. VESPA provides flexible software for simplifying these processes along with downstream selective pressure variation analyses. The software automatically interprets results from codeML and produces simplified summary files to assist the user in better understanding the results. VESPA may be found at the following website: http://www.mol-evol.org/VESPA.

  3. Technologies and challenges in large-scale phosphoproteomics

    DEFF Research Database (Denmark)

    Engholm-Keller, Kasper; Larsen, Martin Røssel

    2013-01-01

    become the main technique for discovery and characterization of phosphoproteins in a nonhypothesis driven fashion. In this review, we describe methods for state-of-the-art MS-based analysis of protein phosphorylation as well as the strategies employed in large-scale phosphoproteomic experiments...... with focus on the various challenges and limitations this field currently faces....

  4. Solving Large Scale Crew Scheduling Problems in Practice

    NARCIS (Netherlands)

    E.J.W. Abbink (Erwin); L. Albino; T.A.B. Dollevoet (Twan); D. Huisman (Dennis); J. Roussado; R.L. Saldanha

    2010-01-01

    textabstractThis paper deals with large-scale crew scheduling problems arising at the Dutch railway operator, Netherlands Railways (NS). NS operates about 30,000 trains a week. All these trains need a driver and a certain number of guards. Some labor rules restrict the duties of a certain crew base

  5. The large scale microwave background anisotropy in decaying particle cosmology

    International Nuclear Information System (INIS)

    Panek, M.

    1987-06-01

    We investigate the large-scale anisotropy of the microwave background radiation in cosmological models with decaying particles. The observed value of the quadrupole moment combined with other constraints gives an upper limit on the redshift of the decay z/sub d/ < 3-5. 12 refs., 2 figs

  6. Dual Decomposition for Large-Scale Power Balancing

    DEFF Research Database (Denmark)

    Halvgaard, Rasmus; Jørgensen, John Bagterp; Vandenberghe, Lieven

    2013-01-01

    Dual decomposition is applied to power balancing of exible thermal storage units. The centralized large-scale problem is decomposed into smaller subproblems and solved locallyby each unit in the Smart Grid. Convergence is achieved by coordinating the units consumption through a negotiation...

  7. Evaluation of Large-scale Public Sector Reforms

    DEFF Research Database (Denmark)

    Breidahl, Karen Nielsen; Gjelstrup, Gunnar; Hansen, Hanne Foss

    2017-01-01

    and more delimited policy areas take place. In our analysis we apply four governance perspectives (rational-instrumental, rational-interest based, institutional-cultural and a chaos perspective) in a comparative analysis of the evaluations of two large-scale public sector reforms in Denmark and Norway. We...

  8. Assessment of climate change impacts on rainfall using large scale ...

    Indian Academy of Sciences (India)

    Many of the applied techniques in water resources management can be directly or indirectly influenced by ... is based on large scale climate signals data around the world. In order ... predictand relationships are often very complex. .... constraints to solve the optimization problem. ..... social, and environmental sustainability.

  9. Factors Influencing Uptake of a Large Scale Curriculum Innovation.

    Science.gov (United States)

    Adey, Philip S.

    Educational research has all too often failed to be implemented on a large-scale basis. This paper describes the multiplier effect of a professional development program for teachers and for trainers in the United Kingdom, and how that program was developed, monitored, and evaluated. Cognitive Acceleration through Science Education (CASE) is a…

  10. ability in Large Scale Land Acquisitions in Kenya

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

    Corey Piccioni

    Kenya's national planning strategy, Vision 2030. Agri- culture, natural resource exploitation, and infrastruc- ... sitions due to high levels of poverty and unclear or in- secure land tenure rights in Kenya. Inadequate social ... lease to a private company over the expansive Yala. Swamp to undertake large-scale irrigation farming.

  11. New Visions for Large Scale Networks: Research and Applications

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This paper documents the findings of the March 12-14, 2001 Workshop on New Visions for Large-Scale Networks: Research and Applications. The workshops objectives were...

  12. Large-scale silviculture experiments of western Oregon and Washington.

    Science.gov (United States)

    Nathan J. Poage; Paul D. Anderson

    2007-01-01

    We review 12 large-scale silviculture experiments (LSSEs) in western Washington and Oregon with which the Pacific Northwest Research Station of the USDA Forest Service is substantially involved. We compiled and arrayed information about the LSSEs as a series of matrices in a relational database, which is included on the compact disc published with this report and...

  13. Participatory Design and the Challenges of Large-Scale Systems

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten

    2008-01-01

    With its 10th biannual anniversary conference, Participatory Design (PD) is leaving its teens and must now be considered ready to join the adult world. In this article we encourage the PD community to think big: PD should engage in large-scale information-systems development and opt for a PD...

  14. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander

    2012-12-01

    Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

  15. Open architecture for health care systems: the European RICHE experience.

    Science.gov (United States)

    Frandji, B

    1997-01-01

    Groupe RICHE is bringing to the market of health IT the Open Systems approach allowing a new generation of health information systems to arise with benefit for patients, health care professionals, hospital managers, agencies and citizens. Groupe RICHE is a forum for exchanging information, expertise around open systems in health care. It is open to any organisation interested by open systems in health care and wanting to participate and influence the work done by its user, marketing and technical committees. The Technical Committee is in charge of the maintenance of the architecture and impact the results of industrial experiences on new releases. Any Groupe RICHE member is entitled to participate to this process. This unique approach in Europe allows health care professionals to benefit from applications supporting their business processes, including providing a cooperative working environment, a shared electronic record, in an integrated system where the information is entered only once, customised according to the user needs and available to the administrative applications. This allows Hospital managers to satisfy their health care professionals, to smoothly migrate from their existing environment (protecting their investment), to choose products in a competitive environment, being able to mix and match system components and services from different suppliers, being free to change suppliers without having to replace their existing system (minimising risk), in line with national and regional strategies. For suppliers, this means being able to commercialise products well fitted to their field of competence in a large market, reducing investments and increasing returns. The RICHE approach also allows agencies to define a strategy, allowing to create a supporting infrastructure, organising the market leaving enough freedom to health care organisations and suppliers. Such an approach is based on the definition of an open standard architecture. The RICHE esprit project

  16. Using appreciative inquiry to transform health care.

    Science.gov (United States)

    Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

    2013-08-01

    Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.

  17. Dual Loyalty in Prison Health Care

    Science.gov (United States)

    Stöver, Heino; Wolff, Hans

    2012-01-01

    Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510

  18. The impact of emotional intelligence in health care professionals on caring behaviour towards patients in clinical and long-term care settings: Findings from an integrative review.

    Science.gov (United States)

    Nightingale, Suzanne; Spiby, Helen; Sheen, Kayleigh; Slade, Pauline

    2018-04-01

    Over recent years there has been criticism within the United Kingdom's health service regarding a lack of care and compassion, resulting in adverse outcomes for patients. The impact of emotional intelligence in staff on patient health care outcomes has been recently highlighted. Many recruiters now assess emotional intelligence as part of their selection process for health care staff. However, it has been argued that the importance of emotional intelligence in health care has been overestimated. To explore relationships between emotional intelligence in health care professionals, and caring behaviour. To further explore any additional factors related to emotional intelligence that may impact upon caring behaviour. An integrative review design was used. Psychinfo, Medline, CINAHL Plus, Social Sciences Citation Index, Science Citation Index, and Scopus were searched for studies from 1995 to April 2017. Studies providing quantitative or qualitative exploration of how any healthcare professionals' emotional intelligence is linked to caring in healthcare settings were selected. Twenty two studies fulfilled the inclusion criteria. Three main types of health care professional were identified: nurses, nurse leaders, and physicians. Results indicated that the emotional intelligence of nurses was related to both physical and emotional caring, but emotional intelligence may be less relevant for nurse leaders and physicians. Age, experience, burnout, and job satisfaction may also be relevant factors for both caring and emotional intelligence. This review provides evidence that developing emotional intelligence in nurses may positively impact upon certain caring behaviours, and that there may be differences within groups that warrant further investigation. Understanding more about which aspects of emotional intelligence are most relevant for intervention is important, and directions for further large scale research have been identified. Copyright © 2018 Elsevier Ltd. All

  19. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  20. Integrated primary health care in Australia.

    Science.gov (United States)

    Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

    2009-10-14

    To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  1. Health care of youth aging out of foster care.

    Science.gov (United States)

    2012-12-01

    Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

  2. Role of optometry school in single day large scale school vision testing

    Science.gov (United States)

    Anuradha, N; Ramani, Krishnakumar

    2015-01-01

    Background: School vision testing aims at identification and management of refractive errors. Large-scale school vision testing using conventional methods is time-consuming and demands a lot of chair time from the eye care professionals. A new strategy involving a school of optometry in single day large scale school vision testing is discussed. Aim: The aim was to describe a new approach of performing vision testing of school children on a large scale in a single day. Materials and Methods: A single day vision testing strategy was implemented wherein 123 members (20 teams comprising optometry students and headed by optometrists) conducted vision testing for children in 51 schools. School vision testing included basic vision screening, refraction, frame measurements, frame choice and referrals for other ocular problems. Results: A total of 12448 children were screened, among whom 420 (3.37%) were identified to have refractive errors. 28 (1.26%) children belonged to the primary, 163 to middle (9.80%), 129 (4.67%) to secondary and 100 (1.73%) to the higher secondary levels of education respectively. 265 (2.12%) children were referred for further evaluation. Conclusion: Single day large scale school vision testing can be adopted by schools of optometry to reach a higher number of children within a short span. PMID:25709271

  3. The impact of new forms of large-scale general practice provider collaborations on England's NHS: a systematic review.

    Science.gov (United States)

    Pettigrew, Luisa M; Kumpunen, Stephanie; Mays, Nicholas; Rosen, Rebecca; Posaner, Rachel

    2018-03-01

    Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant. To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England. Systematic review. Embase, MEDLINE, Health Management Information Consortium, and Social Sciences Citation Index were searched for studies reporting the impact on clinical processes and outcomes, patient experience, workforce satisfaction, or costs of new forms of provider collaborations between general practices in England. A total of 1782 publications were screened. Five studies met the inclusion criteria and four examined the same general practice networks, limiting generalisability. Substantial financial investment was required to establish the networks and the associated interventions that were targeted at four clinical areas. Quality improvements were achieved through standardised processes, incentives at network level, information technology-enabled performance dashboards, and local network management. The fifth study of a large-scale multisite general practice organisation showed that it may be better placed to implement safety and quality processes than conventional practices. However, unintended consequences may arise, such as perceptions of disenfranchisement among staff and reductions in continuity of care. Good-quality evidence of the impacts of scaling up general practice provider organisations in England is scarce. As more general practice collaborations emerge, evaluation of their impacts will be important to understand which work, in which settings, how, and why. © British Journal of General Practice 2018.

  4. Medical and health care sector

    International Nuclear Information System (INIS)

    Ainul Hayati Daud; Hazmimi Kasim

    2010-01-01

    The medical and health care sector in general supplies products and provides services that can be categorized as diagnostic radiology, therapeutic application and nuclear medicine (both, diagnostic and/ or therapeutic). The institutions offer different categories of services. Some provide only one category of service, for example, diagnostic radiology. Others may provide more than one categories, for example, diagnostic nuclear medicine and therapeutic nuclear medicine services. A total of 90 entities comprising 65 public agencies and 34 private companies were selected in this study for this sector. The majority of the entities, 75.6 %, operate in Peninsular Malaysia. The remainders operate in Sabah and Sarawak. The findings of the study on both public agencies and private companies are presented in subsequent sections of this chapter. (author)

  5. Managing Home Health Care (For Parents)

    Science.gov (United States)

    ... this topic for: Parents Kids Teens Palliative Care Electronic Health Records When Your Child's in the Pediatric Intensive Care ... Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice of Nondiscrimination Visit ...

  6. 8 ways to cut health care costs

    Science.gov (United States)

    ... care include strep throat, bladder infection, or a dog bite. You will save both time and money ... health services. www.healthcare.gov/coverage/preventive-care-benefits . Accessed October 18, 2016. U.S. Preventive Services Taskforce ...

  7. The Phelophepa Health Care Train: a pharmacoepidemiological ...

    African Journals Online (AJOL)

    2009-11-19

    Nov 19, 2009 ... Background: The Phelophepa Health Care Train is the only primary healthcare train in the world. Phelophepa is an ... history of caring.3. The Phelophepa .... Skin conditions were, according to the pharmacists, common in the ...

  8. Effect of Health Care Professionals' Continuing Education ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...

  9. Health Care Access among Deaf People

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  10. Predictors of Adolescent Health Care Utilization

    Science.gov (United States)

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

    This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

  11. Competition in the Dutch Health Care Sector

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1995-01-01

    textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of

  12. Health care law versus constitutional law.

    Science.gov (United States)

    Hall, Mark A

    2013-04-01

    National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status.

  13. Going Digital: A Survey on Digitalization and Large Scale Data Analytics in Healthcare

    OpenAIRE

    Tresp, Volker; Overhage, J. Marc; Bundschus, Markus; Rabizadeh, Shahrooz; Fasching, Peter A.; Yu, Shipeng

    2016-01-01

    We provide an overview of the recent trends towards digitalization and large scale data analytics in healthcare. It is expected that these trends are instrumental in the dramatic changes in the way healthcare will be organized in the future. We discuss the recent political initiatives designed to shift care delivery processes from paper to electronic, with the goals of more effective treatments with better outcomes; cost pressure is a major driver of innovation. We describe newly developed ne...

  14. Health care: economic impact of caring for geriatric patients.

    Science.gov (United States)

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Intervention studies for improving global health and health care: An important arena for epidemiologists

    Directory of Open Access Journals (Sweden)

    Gunnar Kvåle

    2009-10-01

    Full Text Available Marginalised populations in many low- and middle-income countries experience an increasing burden of disease, in sub-Saharan Africa to a large extent due to faltering health systems and serious HIV epidemics. Also other poverty related diseases (PRDs are prevalent, especially respiratory and diarrhoeal diseases in children, malnutrition, maternal and perinatal health problems, tuberculosis and malaria. Daily, nearly 30,000 children under the age of 5 die, most from preventable causes, and 8,000 people die from HIV infections. In spite of the availability of powerful preventive and therapeutic tools for combating these PRDs, their implementation, especially in terms of equitable delivery, leaves much to be desired. The research community must address this tragic gap between knowledge and implementation. Epidemiologists have a very important role to play in conducting studies on diseases that account for the largest share of the global disease burden. A shift of focus of epidemiologic research towards intervention studies addressing health problems of major public health importance for disadvantaged population groups is needed. There is a need to generate an evidence-base for interventions that can be implemented on a large scale; this can result in increased funding of health promotion programs as well as enable rational prioritization and integration between different health interventions. This will require close and synergetic teamwork between epidemiologists and other professions across disciplines and sectors. In this way epidemiologists can contribute significantly to improve health and optimise health care delivery for marginalized populations.

  16. Costs of health care across primary care models in Ontario

    OpenAIRE

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-01-01

    Background The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients? primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Methods Utilization data for a one year period was measured using administrative databases for a 1...

  17. Discrimination against older women in health care.

    Science.gov (United States)

    Belgrave, L L

    1993-01-01

    Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.

  18. Understanding a Value Chain in Health Care.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2015-10-01

    As the US health care system transitions toward a value-based system, providers and health care organizations will have to closely scrutinize their current processes of care. To do this, a value chain analysis can be performed to ensure that only the most efficient steps are followed in patient care. Ultimately this will produce a higher quality or equal quality product for less cost by eliminating wasteful steps along the way.

  19. Depressive Disorders in Primary Health Care

    OpenAIRE

    Vuorilehto, Maria

    2008-01-01

    The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

  20. Health care and equity in India.

    Science.gov (United States)

    Balarajan, Y; Selvaraj, S; Subramanian, S V

    2011-02-05

    In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India. These challenges include an imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioural factors that affect the demand for appropriate health care. Use of equity metrics in monitoring, assessment, and strategic planning; investment in development of a rigorous knowledge base of health-systems research; development of a refined equity-focused process of deliberative decision making in health reform; and redefinition of the specific responsibilities and accountabilities of key actors are needed to try to achieve equity in health care in India. The implementation of these principles with strengthened public health and primary-care services will help to ensure a more equitable health care for India's population. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Attending unintended transformations of health care infrastructure

    Directory of Open Access Journals (Sweden)

    Helle Wentzer

    2007-11-01

    Full Text Available Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results: This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion: The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes.

  2. Celiac Disease Testing (for Health Care Professionals)

    Science.gov (United States)

    ... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an effective first step in identifying candidates ...

  3. Cross-cultural barriers to health care.

    Science.gov (United States)

    Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju

    2015-01-01

    Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. To overcome difficulties in culturally dissimilar interactions and eventually remove cross-cultural barriers to health care, a culturally sensitive physician considers his or her own identity, values, and beliefs; recognizes the similarities and differences among cultures; understands what those similarities and differences mean; and is able to bridge the differences to accomplish clear and effective communication.

  4. Care of children with disabilities in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Thaís Giudice Schultz

    2016-07-01

    Full Text Available Objective: This article describes an experience report that aimed to present perceptions on the care of children with disabilities in the Family Health Strategy (FHS, showing its limits and potentials based on the experience of participation in the program ‘PET-Saúde’. Method: Data were collected from field notes which recorded the monitoring of the care process offered to children with disabilities by the FHS teams. The study was conducted in a health facility in the city of Rio de Janeiro for one year. Results: Content analysis results listed the two main themes that composed the issues of concern for child care in this experience: the coordination of health care and the family and community orientation as the core for child care in the FHS. Conclusion: Despite the weakness in compliance with these categories, which are principles and fundamentals of the FHS, this is a privileged space with regard to care practices for children with disabilities.

  5. GAIA: A WINDOW TO LARGE-SCALE MOTIONS

    Energy Technology Data Exchange (ETDEWEB)

    Nusser, Adi [Physics Department and the Asher Space Science Institute-Technion, Haifa 32000 (Israel); Branchini, Enzo [Department of Physics, Universita Roma Tre, Via della Vasca Navale 84, 00146 Rome (Italy); Davis, Marc, E-mail: adi@physics.technion.ac.il, E-mail: branchin@fis.uniroma3.it, E-mail: mdavis@berkeley.edu [Departments of Astronomy and Physics, University of California, Berkeley, CA 94720 (United States)

    2012-08-10

    Using redshifts as a proxy for galaxy distances, estimates of the two-dimensional (2D) transverse peculiar velocities of distant galaxies could be obtained from future measurements of proper motions. We provide the mathematical framework for analyzing 2D transverse motions and show that they offer several advantages over traditional probes of large-scale motions. They are completely independent of any intrinsic relations between galaxy properties; hence, they are essentially free of selection biases. They are free from homogeneous and inhomogeneous Malmquist biases that typically plague distance indicator catalogs. They provide additional information to traditional probes that yield line-of-sight peculiar velocities only. Further, because of their 2D nature, fundamental questions regarding vorticity of large-scale flows can be addressed. Gaia, for example, is expected to provide proper motions of at least bright galaxies with high central surface brightness, making proper motions a likely contender for traditional probes based on current and future distance indicator measurements.

  6. Large-scale innovation and change in UK higher education

    Directory of Open Access Journals (Sweden)

    Stephen Brown

    2013-09-01

    Full Text Available This paper reflects on challenges universities face as they respond to change. It reviews current theories and models of change management, discusses why universities are particularly difficult environments in which to achieve large scale, lasting change and reports on a recent attempt by the UK JISC to enable a range of UK universities to employ technology to deliver such changes. Key lessons that emerged from these experiences are reviewed covering themes of pervasiveness, unofficial systems, project creep, opposition, pressure to deliver, personnel changes and technology issues. The paper argues that collaborative approaches to project management offer greater prospects of effective large-scale change in universities than either management-driven top-down or more champion-led bottom-up methods. It also argues that while some diminution of control over project outcomes is inherent in this approach, this is outweighed by potential benefits of lasting and widespread adoption of agreed changes.

  7. Measuring Cosmic Expansion and Large Scale Structure with Destiny

    Science.gov (United States)

    Benford, Dominic J.; Lauer, Tod R.

    2007-01-01

    Destiny is a simple, direct, low cost mission to determine the properties of dark energy by obtaining a cosmologically deep supernova (SN) type Ia Hubble diagram and by measuring the large-scale mass power spectrum over time. Its science instrument is a 1.65m space telescope, featuring a near-infrared survey camera/spectrometer with a large field of view. During its first two years, Destiny will detect, observe, and characterize 23000 SN Ia events over the redshift interval 0.4Destiny will be used in its third year as a high resolution, wide-field imager to conduct a weak lensing survey covering >lo00 square degrees to measure the large-scale mass power spectrum. The combination of surveys is much more powerful than either technique on its own, and will have over an order of magnitude greater sensitivity than will be provided by ongoing ground-based projects.

  8. Prototype Vector Machine for Large Scale Semi-Supervised Learning

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Kai; Kwok, James T.; Parvin, Bahram

    2009-04-29

    Practicaldataminingrarelyfalls exactlyinto the supervisedlearning scenario. Rather, the growing amount of unlabeled data poses a big challenge to large-scale semi-supervised learning (SSL). We note that the computationalintensivenessofgraph-based SSLarises largely from the manifold or graph regularization, which in turn lead to large models that are dificult to handle. To alleviate this, we proposed the prototype vector machine (PVM), a highlyscalable,graph-based algorithm for large-scale SSL. Our key innovation is the use of"prototypes vectors" for effcient approximation on both the graph-based regularizer and model representation. The choice of prototypes are grounded upon two important criteria: they not only perform effective low-rank approximation of the kernel matrix, but also span a model suffering the minimum information loss compared with the complete model. We demonstrate encouraging performance and appealing scaling properties of the PVM on a number of machine learning benchmark data sets.

  9. Large-scale influences in near-wall turbulence.

    Science.gov (United States)

    Hutchins, Nicholas; Marusic, Ivan

    2007-03-15

    Hot-wire data acquired in a high Reynolds number facility are used to illustrate the need for adequate scale separation when considering the coherent structure in wall-bounded turbulence. It is found that a large-scale motion in the log region becomes increasingly comparable in energy to the near-wall cycle as the Reynolds number increases. Through decomposition of fluctuating velocity signals, it is shown that this large-scale motion has a distinct modulating influence on the small-scale energy (akin to amplitude modulation). Reassessment of DNS data, in light of these results, shows similar trends, with the rate and intensity of production due to the near-wall cycle subject to a modulating influence from the largest-scale motions.

  10. First Mile Challenges for Large-Scale IoT

    KAUST Repository

    Bader, Ahmed

    2017-03-16

    The Internet of Things is large-scale by nature. This is not only manifested by the large number of connected devices, but also by the sheer scale of spatial traffic intensity that must be accommodated, primarily in the uplink direction. To that end, cellular networks are indeed a strong first mile candidate to accommodate the data tsunami to be generated by the IoT. However, IoT devices are required in the cellular paradigm to undergo random access procedures as a precursor to resource allocation. Such procedures impose a major bottleneck that hinders cellular networks\\' ability to support large-scale IoT. In this article, we shed light on the random access dilemma and present a case study based on experimental data as well as system-level simulations. Accordingly, a case is built for the latent need to revisit random access procedures. A call for action is motivated by listing a few potential remedies and recommendations.

  11. Cosmic ray acceleration by large scale galactic shocks

    International Nuclear Information System (INIS)

    Cesarsky, C.J.; Lagage, P.O.

    1987-01-01

    The mechanism of diffusive shock acceleration may account for the existence of galactic cosmic rays detailed application to stellar wind shocks and especially to supernova shocks have been developed. Existing models can usually deal with the energetics or the spectral slope, but the observed energy range of cosmic rays is not explained. Therefore it seems worthwhile to examine the effect that large scale, long-lived galactic shocks may have on galactic cosmic rays, in the frame of the diffusive shock acceleration mechanism. Large scale fast shocks can only be expected to exist in the galactic halo. We consider three situations where they may arise: expansion of a supernova shock in the halo, galactic wind, galactic infall; and discuss the possible existence of these shocks and their role in accelerating cosmic rays

  12. Efficient algorithms for collaborative decision making for large scale settings

    DEFF Research Database (Denmark)

    Assent, Ira

    2011-01-01

    to bring about more effective and more efficient retrieval systems that support the users' decision making process. We sketch promising research directions for more efficient algorithms for collaborative decision making, especially for large scale systems.......Collaborative decision making is a successful approach in settings where data analysis and querying can be done interactively. In large scale systems with huge data volumes or many users, collaboration is often hindered by impractical runtimes. Existing work on improving collaboration focuses...... on avoiding redundancy for users working on the same task. While this improves the effectiveness of the user work process, the underlying query processing engine is typically considered a "black box" and left unchanged. Research in multiple query processing, on the other hand, ignores the application...

  13. Lagrangian space consistency relation for large scale structure

    International Nuclear Information System (INIS)

    Horn, Bart; Hui, Lam; Xiao, Xiao

    2015-01-01

    Consistency relations, which relate the squeezed limit of an (N+1)-point correlation function to an N-point function, are non-perturbative symmetry statements that hold even if the associated high momentum modes are deep in the nonlinear regime and astrophysically complex. Recently, Kehagias and Riotto and Peloso and Pietroni discovered a consistency relation applicable to large scale structure. We show that this can be recast into a simple physical statement in Lagrangian space: that the squeezed correlation function (suitably normalized) vanishes. This holds regardless of whether the correlation observables are at the same time or not, and regardless of whether multiple-streaming is present. The simplicity of this statement suggests that an analytic understanding of large scale structure in the nonlinear regime may be particularly promising in Lagrangian space

  14. The Large-scale Effect of Environment on Galactic Conformity

    Science.gov (United States)

    Sun, Shuangpeng; Guo, Qi; Wang, Lan; Wang, Jie; Gao, Liang; Lacey, Cedric G.; Pan, Jun

    2018-04-01

    We use a volume-limited galaxy sample from the SDSS Data Release 7 to explore the dependence of galactic conformity on the large-scale environment, measured on ˜ 4 Mpc scales. We find that the star formation activity of neighbour galaxies depends more strongly on the environment than on the activity of their primary galaxies. In under-dense regions most neighbour galaxies tend to be active, while in over-dense regions neighbour galaxies are mostly passive, regardless of the activity of their primary galaxies. At a given stellar mass, passive primary galaxies reside in higher density regions than active primary galaxies, leading to the apparently strong conformity signal. The dependence of the activity of neighbour galaxies on environment can be explained by the corresponding dependence of the fraction of satellite galaxies. Similar results are found for galaxies in a semi-analytical model, suggesting that no new physics is required to explain the observed large-scale conformity.

  15. Electron drift in a large scale solid xenon

    International Nuclear Information System (INIS)

    Yoo, J.; Jaskierny, W.F.

    2015-01-01

    A study of charge drift in a large scale optically transparent solid xenon is reported. A pulsed high power xenon light source is used to liberate electrons from a photocathode. The drift speeds of the electrons are measured using a 8.7 cm long electrode in both the liquid and solid phase of xenon. In the liquid phase (163 K), the drift speed is 0.193 ± 0.003 cm/μs while the drift speed in the solid phase (157 K) is 0.397 ± 0.006 cm/μs at 900 V/cm over 8.0 cm of uniform electric fields. Therefore, it is demonstrated that a factor two faster electron drift speed in solid phase xenon compared to that in liquid in a large scale solid xenon

  16. Active power reserves evaluation in large scale PVPPs

    DEFF Research Database (Denmark)

    Crăciun, Bogdan-Ionut; Kerekes, Tamas; Sera, Dezso

    2013-01-01

    The present trend on investing in renewable ways of producing electricity in the detriment of conventional fossil fuel-based plants will lead to a certain point where these plants have to provide ancillary services and contribute to overall grid stability. Photovoltaic (PV) power has the fastest...... growth among all renewable energies and managed to reach high penetration levels creating instabilities which at the moment are corrected by the conventional generation. This paradigm will change in the future scenarios where most of the power is supplied by large scale renewable plants and parts...... of the ancillary services have to be shared by the renewable plants. The main focus of the proposed paper is to technically and economically analyze the possibility of having active power reserves in large scale PV power plants (PVPPs) without any auxiliary storage equipment. The provided reserves should...

  17. Real-time simulation of large-scale floods

    Science.gov (United States)

    Liu, Q.; Qin, Y.; Li, G. D.; Liu, Z.; Cheng, D. J.; Zhao, Y. H.

    2016-08-01

    According to the complex real-time water situation, the real-time simulation of large-scale floods is very important for flood prevention practice. Model robustness and running efficiency are two critical factors in successful real-time flood simulation. This paper proposed a robust, two-dimensional, shallow water model based on the unstructured Godunov- type finite volume method. A robust wet/dry front method is used to enhance the numerical stability. An adaptive method is proposed to improve the running efficiency. The proposed model is used for large-scale flood simulation on real topography. Results compared to those of MIKE21 show the strong performance of the proposed model.

  18. The Child Health Care System in Italy.

    Science.gov (United States)

    Corsello, Giovanni; Ferrara, Pietro; Chiamenti, Gianpietro; Nigri, Luigi; Campanozzi, Angelo; Pettoello-Mantovani, Massimo

    2016-10-01

    Pediatric care in Italy has been based during the last 40 years on the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. The pediatric health care system in Italy is part of the national health system. It is made up of 3 main levels of intervention: first access/primary care, secondary care/hospital care, and tertiary care based on specialty hospital care. This overview will also include a brief report on neonatal care, pediatric preventive health care, health service accreditation programs, and postgraduate training in pediatrics. The quality of the Italian child health care system is now considered to be in serious danger because of the restriction of investments in public health caused both by the 2008 global and national economic crisis and by a reduction of the pediatric workforce as a result of progressively insufficient replacement of specialists in pediatrics. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Some Statistics for Measuring Large-Scale Structure

    OpenAIRE

    Brandenberger, Robert H.; Kaplan, David M.; A, Stephen; Ramsey

    1993-01-01

    Good statistics for measuring large-scale structure in the Universe must be able to distinguish between different models of structure formation. In this paper, two and three dimensional ``counts in cell" statistics and a new ``discrete genus statistic" are applied to toy versions of several popular theories of structure formation: random phase cold dark matter model, cosmic string models, and global texture scenario. All three statistics appear quite promising in terms of differentiating betw...

  20. Foundations of Large-Scale Multimedia Information Management and Retrieval

    CERN Document Server

    Chang, Edward Y

    2011-01-01

    "Foundations of Large-Scale Multimedia Information Management and Retrieval - Mathematics of Perception" covers knowledge representation and semantic analysis of multimedia data and scalability in signal extraction, data mining, and indexing. The book is divided into two parts: Part I - Knowledge Representation and Semantic Analysis focuses on the key components of mathematics of perception as it applies to data management and retrieval. These include feature selection/reduction, knowledge representation, semantic analysis, distance function formulation for measuring similarity, and

  1. PKI security in large-scale healthcare networks

    OpenAIRE

    Mantas, G.; Lymberopoulos, D.; Komninos, N.

    2012-01-01

    During the past few years a lot of PKI (Public Key Infrastructures) infrastructures have been proposed for healthcare networks in order to ensure secure communication services and exchange of data among healthcare professionals. However, there is a plethora of challenges in these healthcare PKI infrastructures. Especially, there are a lot of challenges for PKI infrastructures deployed over large-scale healthcare networks. In this paper, we propose a PKI infrastructure to ensure security in a ...

  2. Experimental simulation of microinteractions in large scale explosions

    Energy Technology Data Exchange (ETDEWEB)

    Chen, X.; Luo, R.; Yuen, W.W.; Theofanous, T.G. [California Univ., Santa Barbara, CA (United States). Center for Risk Studies and Safety

    1998-01-01

    This paper presents data and analysis of recent experiments conducted in the SIGMA-2000 facility to simulate microinteractions in large scale explosions. Specifically, the fragmentation behavior of a high temperature molten steel drop under high pressure (beyond critical) conditions are investigated. The current data demonstrate, for the first time, the effect of high pressure in suppressing the thermal effect of fragmentation under supercritical conditions. The results support the microinteractions idea, and the ESPROSE.m prediction of fragmentation rate. (author)

  3. A Classification Framework for Large-Scale Face Recognition Systems

    OpenAIRE

    Zhou, Ziheng; Deravi, Farzin

    2009-01-01

    This paper presents a generic classification framework for large-scale face recognition systems. Within the framework, a data sampling strategy is proposed to tackle the data imbalance when image pairs are sampled from thousands of face images for preparing a training dataset. A modified kernel Fisher discriminant classifier is proposed to make it computationally feasible to train the kernel-based classification method using tens of thousands of training samples. The framework is tested in an...

  4. Large Scale Visual Recommendations From Street Fashion Images

    OpenAIRE

    Jagadeesh, Vignesh; Piramuthu, Robinson; Bhardwaj, Anurag; Di, Wei; Sundaresan, Neel

    2014-01-01

    We describe a completely automated large scale visual recommendation system for fashion. Our focus is to efficiently harness the availability of large quantities of online fashion images and their rich meta-data. Specifically, we propose four data driven models in the form of Complementary Nearest Neighbor Consensus, Gaussian Mixture Models, Texture Agnostic Retrieval and Markov Chain LDA for solving this problem. We analyze relative merits and pitfalls of these algorithms through extensive e...

  5. Design study on sodium cooled large-scale reactor

    International Nuclear Information System (INIS)

    Murakami, Tsutomu; Hishida, Masahiko; Kisohara, Naoyuki

    2004-07-01

    In Phase 1 of the 'Feasibility Studies on Commercialized Fast Reactor Cycle Systems (F/S)', an advanced loop type reactor has been selected as a promising concept of sodium-cooled large-scale reactor, which has a possibility to fulfill the design requirements of the F/S. In Phase 2, design improvement for further cost reduction of establishment of the plant concept has been performed. This report summarizes the results of the design study on the sodium-cooled large-scale reactor performed in JFY2003, which is the third year of Phase 2. In the JFY2003 design study, critical subjects related to safety, structural integrity and thermal hydraulics which found in the last fiscal year has been examined and the plant concept has been modified. Furthermore, fundamental specifications of main systems and components have been set and economy has been evaluated. In addition, as the interim evaluation of the candidate concept of the FBR fuel cycle is to be conducted, cost effectiveness and achievability for the development goal were evaluated and the data of the three large-scale reactor candidate concepts were prepared. As a results of this study, the plant concept of the sodium-cooled large-scale reactor has been constructed, which has a prospect to satisfy the economic goal (construction cost: less than 200,000 yens/kWe, etc.) and has a prospect to solve the critical subjects. From now on, reflecting the results of elemental experiments, the preliminary conceptual design of this plant will be preceded toward the selection for narrowing down candidate concepts at the end of Phase 2. (author)

  6. Design study on sodium-cooled large-scale reactor

    International Nuclear Information System (INIS)

    Shimakawa, Yoshio; Nibe, Nobuaki; Hori, Toru

    2002-05-01

    In Phase 1 of the 'Feasibility Study on Commercialized Fast Reactor Cycle Systems (F/S)', an advanced loop type reactor has been selected as a promising concept of sodium-cooled large-scale reactor, which has a possibility to fulfill the design requirements of the F/S. In Phase 2 of the F/S, it is planed to precede a preliminary conceptual design of a sodium-cooled large-scale reactor based on the design of the advanced loop type reactor. Through the design study, it is intended to construct such a plant concept that can show its attraction and competitiveness as a commercialized reactor. This report summarizes the results of the design study on the sodium-cooled large-scale reactor performed in JFY2001, which is the first year of Phase 2. In the JFY2001 design study, a plant concept has been constructed based on the design of the advanced loop type reactor, and fundamental specifications of main systems and components have been set. Furthermore, critical subjects related to safety, structural integrity, thermal hydraulics, operability, maintainability and economy have been examined and evaluated. As a result of this study, the plant concept of the sodium-cooled large-scale reactor has been constructed, which has a prospect to satisfy the economic goal (construction cost: less than 200,000yens/kWe, etc.) and has a prospect to solve the critical subjects. From now on, reflecting the results of elemental experiments, the preliminary conceptual design of this plant will be preceded toward the selection for narrowing down candidate concepts at the end of Phase 2. (author)

  7. Large-Scale Optimization for Bayesian Inference in Complex Systems

    Energy Technology Data Exchange (ETDEWEB)

    Willcox, Karen [MIT; Marzouk, Youssef [MIT

    2013-11-12

    The SAGUARO (Scalable Algorithms for Groundwater Uncertainty Analysis and Robust Optimization) Project focused on the development of scalable numerical algorithms for large-scale Bayesian inversion in complex systems that capitalize on advances in large-scale simulation-based optimization and inversion methods. The project was a collaborative effort among MIT, the University of Texas at Austin, Georgia Institute of Technology, and Sandia National Laboratories. The research was directed in three complementary areas: efficient approximations of the Hessian operator, reductions in complexity of forward simulations via stochastic spectral approximations and model reduction, and employing large-scale optimization concepts to accelerate sampling. The MIT--Sandia component of the SAGUARO Project addressed the intractability of conventional sampling methods for large-scale statistical inverse problems by devising reduced-order models that are faithful to the full-order model over a wide range of parameter values; sampling then employs the reduced model rather than the full model, resulting in very large computational savings. Results indicate little effect on the computed posterior distribution. On the other hand, in the Texas--Georgia Tech component of the project, we retain the full-order model, but exploit inverse problem structure (adjoint-based gradients and partial Hessian information of the parameter-to-observation map) to implicitly extract lower dimensional information on the posterior distribution; this greatly speeds up sampling methods, so that fewer sampling points are needed. We can think of these two approaches as ``reduce then sample'' and ``sample then reduce.'' In fact, these two approaches are complementary, and can be used in conjunction with each other. Moreover, they both exploit deterministic inverse problem structure, in the form of adjoint-based gradient and Hessian information of the underlying parameter-to-observation map, to

  8. NASA: Assessments of Selected Large-Scale Projects

    Science.gov (United States)

    2011-03-01

    REPORT DATE MAR 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Assessments Of Selected Large-Scale Projects...Volatile EvolutioN MEP Mars Exploration Program MIB Mishap Investigation Board MMRTG Multi Mission Radioisotope Thermoelectric Generator MMS Magnetospheric...probes designed to explore the Martian surface, to satellites equipped with advanced sensors to study the earth , to telescopes intended to explore the

  9. Perturbation theory instead of large scale shell model calculations

    International Nuclear Information System (INIS)

    Feldmeier, H.; Mankos, P.

    1977-01-01

    Results of large scale shell model calculations for (sd)-shell nuclei are compared with a perturbation theory provides an excellent approximation when the SU(3)-basis is used as a starting point. The results indicate that perturbation theory treatment in an SU(3)-basis including 2hω excitations should be preferable to a full diagonalization within the (sd)-shell. (orig.) [de

  10. Primordial large-scale electromagnetic fields from gravitoelectromagnetic inflation

    Energy Technology Data Exchange (ETDEWEB)

    Membiela, Federico Agustin [Departamento de Fisica, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Funes 3350, (7600) Mar del Plata (Argentina); Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET) (Argentina)], E-mail: membiela@mdp.edu.ar; Bellini, Mauricio [Departamento de Fisica, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Funes 3350, (7600) Mar del Plata (Argentina); Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET) (Argentina)], E-mail: mbellini@mdp.edu.ar

    2009-04-20

    We investigate the origin and evolution of primordial electric and magnetic fields in the early universe, when the expansion is governed by a cosmological constant {lambda}{sub 0}. Using the gravitoelectromagnetic inflationary formalism with A{sub 0}=0, we obtain the power of spectrums for large-scale magnetic fields and the inflaton field fluctuations during inflation. A very important fact is that our formalism is naturally non-conformally invariant.

  11. Primordial large-scale electromagnetic fields from gravitoelectromagnetic inflation

    Science.gov (United States)

    Membiela, Federico Agustín; Bellini, Mauricio

    2009-04-01

    We investigate the origin and evolution of primordial electric and magnetic fields in the early universe, when the expansion is governed by a cosmological constant Λ0. Using the gravitoelectromagnetic inflationary formalism with A0 = 0, we obtain the power of spectrums for large-scale magnetic fields and the inflaton field fluctuations during inflation. A very important fact is that our formalism is naturally non-conformally invariant.

  12. Primordial large-scale electromagnetic fields from gravitoelectromagnetic inflation

    International Nuclear Information System (INIS)

    Membiela, Federico Agustin; Bellini, Mauricio

    2009-01-01

    We investigate the origin and evolution of primordial electric and magnetic fields in the early universe, when the expansion is governed by a cosmological constant Λ 0 . Using the gravitoelectromagnetic inflationary formalism with A 0 =0, we obtain the power of spectrums for large-scale magnetic fields and the inflaton field fluctuations during inflation. A very important fact is that our formalism is naturally non-conformally invariant.

  13. Rotation invariant fast features for large-scale recognition

    Science.gov (United States)

    Takacs, Gabriel; Chandrasekhar, Vijay; Tsai, Sam; Chen, David; Grzeszczuk, Radek; Girod, Bernd

    2012-10-01

    We present an end-to-end feature description pipeline which uses a novel interest point detector and Rotation- Invariant Fast Feature (RIFF) descriptors. The proposed RIFF algorithm is 15× faster than SURF1 while producing large-scale retrieval results that are comparable to SIFT.2 Such high-speed features benefit a range of applications from Mobile Augmented Reality (MAR) to web-scale image retrieval and analysis.

  14. Concurrent Programming Using Actors: Exploiting Large-Scale Parallelism,

    Science.gov (United States)

    1985-10-07

    ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK* Artificial Inteligence Laboratory AREA Is WORK UNIT NUMBERS 545 Technology Square...D-R162 422 CONCURRENT PROGRMMIZNG USING f"OS XL?ITP TEH l’ LARGE-SCALE PARALLELISH(U) NASI AC E Al CAMBRIDGE ARTIFICIAL INTELLIGENCE L. G AGHA ET AL...RESOLUTION TEST CHART N~ATIONAL BUREAU OF STANDA.RDS - -96 A -E. __ _ __ __’ .,*- - -- •. - MASSACHUSETTS INSTITUTE OF TECHNOLOGY ARTIFICIAL

  15. On a Game of Large-Scale Projects Competition

    Science.gov (United States)

    Nikonov, Oleg I.; Medvedeva, Marina A.

    2009-09-01

    The paper is devoted to game-theoretical control problems motivated by economic decision making situations arising in realization of large-scale projects, such as designing and putting into operations the new gas or oil pipelines. A non-cooperative two player game is considered with payoff functions of special type for which standard existence theorems and algorithms for searching Nash equilibrium solutions are not applicable. The paper is based on and develops the results obtained in [1]-[5].

  16. The Phoenix series large scale LNG pool fire experiments.

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Richard B.; Jensen, Richard Pearson; Demosthenous, Byron; Luketa, Anay Josephine; Ricks, Allen Joseph; Hightower, Marion Michael; Blanchat, Thomas K.; Helmick, Paul H.; Tieszen, Sheldon Robert; Deola, Regina Anne; Mercier, Jeffrey Alan; Suo-Anttila, Jill Marie; Miller, Timothy J.

    2010-12-01

    The increasing demand for natural gas could increase the number and frequency of Liquefied Natural Gas (LNG) tanker deliveries to ports across the United States. Because of the increasing number of shipments and the number of possible new facilities, concerns about the potential safety of the public and property from an accidental, and even more importantly intentional spills, have increased. While improvements have been made over the past decade in assessing hazards from LNG spills, the existing experimental data is much smaller in size and scale than many postulated large accidental and intentional spills. Since the physics and hazards from a fire change with fire size, there are concerns about the adequacy of current hazard prediction techniques for large LNG spills and fires. To address these concerns, Congress funded the Department of Energy (DOE) in 2008 to conduct a series of laboratory and large-scale LNG pool fire experiments at Sandia National Laboratories (Sandia) in Albuquerque, New Mexico. This report presents the test data and results of both sets of fire experiments. A series of five reduced-scale (gas burner) tests (yielding 27 sets of data) were conducted in 2007 and 2008 at Sandia's Thermal Test Complex (TTC) to assess flame height to fire diameter ratios as a function of nondimensional heat release rates for extrapolation to large-scale LNG fires. The large-scale LNG pool fire experiments were conducted in a 120 m diameter pond specially designed and constructed in Sandia's Area III large-scale test complex. Two fire tests of LNG spills of 21 and 81 m in diameter were conducted in 2009 to improve the understanding of flame height, smoke production, and burn rate and therefore the physics and hazards of large LNG spills and fires.

  17. Large scale 2D spectral compressed sensing in continuous domain

    KAUST Repository

    Cai, Jian-Feng

    2017-06-20

    We consider the problem of spectral compressed sensing in continuous domain, which aims to recover a 2-dimensional spectrally sparse signal from partially observed time samples. The signal is assumed to be a superposition of s complex sinusoids. We propose a semidefinite program for the 2D signal recovery problem. Our model is able to handle large scale 2D signals of size 500 × 500, whereas traditional approaches only handle signals of size around 20 × 20.

  18. Large scale 2D spectral compressed sensing in continuous domain

    KAUST Repository

    Cai, Jian-Feng; Xu, Weiyu; Yang, Yang

    2017-01-01

    We consider the problem of spectral compressed sensing in continuous domain, which aims to recover a 2-dimensional spectrally sparse signal from partially observed time samples. The signal is assumed to be a superposition of s complex sinusoids. We propose a semidefinite program for the 2D signal recovery problem. Our model is able to handle large scale 2D signals of size 500 × 500, whereas traditional approaches only handle signals of size around 20 × 20.

  19. Large-scale nuclear energy from the thorium cycle

    International Nuclear Information System (INIS)

    Lewis, W.B.; Duret, M.F.; Craig, D.S.; Veeder, J.I.; Bain, A.S.

    1973-02-01

    The thorium fuel cycle in CANDU (Canada Deuterium Uranium) reactors challenges breeders and fusion as the simplest means of meeting the world's large-scale demands for energy for centuries. Thorium oxide fuel allows high power density with excellent neutron economy. The combination of thorium fuel with organic caloporteur promises easy maintenance and high availability of the whole plant. The total fuelling cost including charges on the inventory is estimated to be attractively low. (author) [fr

  20. Large scale particle image velocimetry with helium filled soap bubbles

    Energy Technology Data Exchange (ETDEWEB)

    Bosbach, Johannes; Kuehn, Matthias; Wagner, Claus [German Aerospace Center (DLR), Institute of Aerodynamics and Flow Technology, Goettingen (Germany)

    2009-03-15

    The application of particle image velocimetry (PIV) to measurement of flows on large scales is a challenging necessity especially for the investigation of convective air flows. Combining helium filled soap bubbles as tracer particles with high power quality switched solid state lasers as light sources allows conducting PIV on scales of the order of several square meters. The technique was applied to mixed convection in a full scale double aisle aircraft cabin mock-up for validation of computational fluid dynamics simulations. (orig.)