The Hamburg/ESO R-process Enhanced Star survey (HERES). XI. The highly r-process-enhanced star CS 29497-004

Science.gov (United States)

Hill, V.; Christlieb, N.; Beers, T. C.; Barklem, P. S.; Kratz, K.-L.; Nordström, B.; Pfeiffer, B.; Farouqi, K.

2017-11-01

We report an abundance analysis for the highly r-process-enhanced (r-II) star CS 29497-004, a very metal-poor giant with solar system Teff = 5013 K and [Fe/H] = -2.85, whose nature was initially discovered in the course of the HERES project. Our analysis is based on high signal-to-noise ratio, high-resolution (R 75 000) VLT/UVES spectra and MARCS model atmospheres under the assumption of local thermodynamic equilibrium, and obtains abundance measurements for a total of 46 elements, 31 of which are neutron-capture elements. As is the case for the other 25 r-II stars currently known, the heavy-element abundance pattern of CS 29497-004 well-matches a scaled solar system second peak r-process-element abundance pattern. We confirm our previous detection of Th, and demonstrate that this star does not exhibit an "actinide boost". Uranium is also detected (log ɛ(U) = -2.20 ± 0.30), albeit with a large measurement error that hampers its use as a precision cosmo-chronometer. Combining the various elemental chronometer pairs that are available for this star, we derive a mean age of 12.2 ± 3.7 Gyr using the theoretical production ratios from published waiting-point approximation models. We further explore the high-entropy wind model (Farouqi et al. 2010, ApJ, 712, 1359) production ratios arising from different neutron richness of the ejecta (Ye), and derive an age of 13.7 ± 4.4 Gyr for a best-fitting Ye = 0.447. The U/Th nuclei-chronometer is confirmed to be the most resilient to theoretical production ratios and yields an age of 16.5 ± 6.6 Gyr. Lead (Pb) is also tentatively detected in CS 29497-004, at a level compatible with a scaled solar r-process, or with the theoretical expectations for a pure r-process in this star. Based on observations collected at the European Southern Observatory, Paranal, Chile (Proposal Number 170.D-0010).Table B.1 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http

Children's preferences concerning ambiance of dental waiting rooms.

Science.gov (United States)

Panda, A; Garg, I; Shah, M

2015-02-01

Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and have a child patient to accept dental treatment readily. Minor changes made in the waiting room design can have a major effect on the way any child perceives the upcoming dental experience. This study was carried out to determine children's preferences regarding the dental waiting area so as to improve their waiting experience and reduce their preoperative anxiety before a dental appointment. This was a cross-sectional descriptive study using survey methodology. A questionnaire designed to evaluate children's preferences regarding the waiting room was distributed to new paediatric patients, aged between 6 and 11 years of age, attending an outpatient dental facility and was completed by 212 children (127 males, 85 females). The analyses were carried out on cross-tables using Phi (for 2×2 tables) or Cramer's V (for larger than 2×2 tables) to assess responses to the questionnaire items across age groups and gender. A majority of children preferred music and the ability to play in a waiting room. They also preferred natural light and walls with pictures. They preferred looking at an aquarium or a television and sitting on beanbags and chairs and also preferred plants and oral hygiene posters Repetious. The results obtained from this study may help the dental team decide on an appropriate design of their paediatric waiting room so as to make children comfortable in the dental environment and improve delivery of health care.

Improving Patient Satisfaction with Waiting Time

Science.gov (United States)

Eilers, Gayleen M.

2004-01-01

Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and…

WAITING TIME IN THE WAITING ROOM IN FAMILY PRACTICE AND PATIENT SATISFACTION

Directory of Open Access Journals (Sweden)

Janko Kersnik

2001-05-01

Full Text Available Background: Appointment system shortens the waiting time in the waiting room for the patient and allows better use of time for the doctor. We wanted to examine how long patients are willing to wait in the waiting room, how long they waited at the last visit, patient satisfaction with the last visit, the satisfaction with the length of waiting in the past 12 months and the overall patient satisfaction score for the last 12 months. Appointment system proved to be effective means of organising practice time. Waiting time in the waiting room with appointment system was considerably shorter (mean 18.5 minutes as compared to the waiting time in the practices without appointment system (mean 55.4 minutes, the fact which is reflected also in higher satisfaction with waiting in the waiting room in the past 12 months. Three quarters of patients in practices with appointment system waited standard 20 minutes or less, as opposed to the other practices where only one quarter of patients waited 20 minutes or less.Conclusions: The overall satisfaction with the doctor with the appointment system does not differ in both types of practices. The patients from practices with appointment system evaluated better possibility to get an appointment to suit the patients, but worse help of the doctors’ staff, possibility to get through to the office by phone, the length of time during the consultation and the doctors’ thoroughness.

Waiting is the hardest part: anticipating medical test results affects processing and recall of important information.

Science.gov (United States)

Portnoy, David B

2010-07-01

Waiting for medical test results that signal physical harm can be a stressful and potentially psychologically harmful experience. Despite this, interventionists and physicians often use this wait time to deliver behavior change messages and other important information about the test, possible results and its implications. This study examined how "bracing" for a medical test result impacts cognitive processing, as well as recall of information delivered during this period. Healthy U.S. university students (N = 150) were tested for a deficiency of a fictitious saliva biomarker that was said to be predictive of long-term health problems using a 2 (Test Result) x 2 (Expected immediacy of result: 10 min, 1 month) factorial design. Participants expecting to get the test result shortly should have been bracing for the result. While waiting for the test results participants completed measures of cognitive processing. After participants received the test result, recall of information about the biomarker was tested in addition to cognitive measures. One week later, participants who were originally told they did not have the deficiency had their recall assessed again. Results showed that anticipating an imminent test result increased cognitive distraction in the processing of information and lowered recall of information about the test and the biomarker. These results suggest that delivering critical information to patients after administering a test and immediately before giving the results may not be optimal.

WAITING TIME DISTRIBUTION OF SOLAR ENERGETIC PARTICLE EVENTS MODELED WITH A NON-STATIONARY POISSON PROCESS

International Nuclear Information System (INIS)

Li, C.; Su, W.; Fang, C.; Zhong, S. J.; Wang, L.

2014-01-01

We present a study of the waiting time distributions (WTDs) of solar energetic particle (SEP) events observed with the spacecraft WIND and GOES. The WTDs of both solar electron events (SEEs) and solar proton events (SPEs) display a power-law tail of ∼Δt –γ . The SEEs display a broken power-law WTD. The power-law index is γ 1 = 0.99 for the short waiting times (<70 hr) and γ 2 = 1.92 for large waiting times (>100 hr). The break of the WTD of SEEs is probably due to the modulation of the corotating interaction regions. The power-law index, γ ∼ 1.82, is derived for the WTD of the SPEs which is consistent with the WTD of type II radio bursts, indicating a close relationship between the shock wave and the production of energetic protons. The WTDs of SEP events can be modeled with a non-stationary Poisson process, which was proposed to understand the waiting time statistics of solar flares. We generalize the method and find that, if the SEP event rate λ = 1/Δt varies as the time distribution of event rate f(λ) = Aλ –α exp (– βλ), the time-dependent Poisson distribution can produce a power-law tail WTD of ∼Δt α –3 , where 0 ≤ α < 2

Heuristics for no-wait flow shop scheduling problem

Directory of Open Access Journals (Sweden)

Kewal Krishan Nailwal

2016-09-01

Full Text Available No-wait flow shop scheduling refers to continuous flow of jobs through different machines. The job once started should have the continuous processing through the machines without wait. This situation occurs when there is a lack of an intermediate storage between the processing of jobs on two consecutive machines. The problem of no-wait with the objective of minimizing makespan in flow shop scheduling is NP-hard; therefore the heuristic algorithms are the key to solve the problem with optimal solution or to approach nearer to optimal solution in simple manner. The paper describes two heuristics, one constructive and an improvement heuristic algorithm obtained by modifying the constructive one for sequencing n-jobs through m-machines in a flow shop under no-wait constraint with the objective of minimizing makespan. The efficiency of the proposed heuristic algorithms is tested on 120 Taillard’s benchmark problems found in the literature against the NEH under no-wait and the MNEH heuristic for no-wait flow shop problem. The improvement heuristic outperforms all heuristics on the Taillard’s instances by improving the results of NEH by 27.85%, MNEH by 22.56% and that of the proposed constructive heuristic algorithm by 24.68%. To explain the computational process of the proposed algorithm, numerical illustrations are also given in the paper. Statistical tests of significance are done in order to draw the conclusions.

Electron Waiting Times of a Cooper Pair Splitter

Science.gov (United States)

Walldorf, Nicklas; Padurariu, Ciprian; Jauho, Antti-Pekka; Flindt, Christian

2018-02-01

Electron waiting times are an important concept in the analysis of quantum transport in nanoscale conductors. Here we show that the statistics of electron waiting times can be used to characterize Cooper pair splitters that create spatially separated spin-entangled electrons. A short waiting time between electrons tunneling into different leads is associated with the fast emission of a split Cooper pair, while long waiting times are governed by the slow injection of Cooper pairs from a superconductor. Experimentally, the waiting time distributions can be measured using real-time single-electron detectors in the regime of slow tunneling, where conventional current measurements are demanding. Our work is important for understanding the fundamental transport processes in Cooper pair splitters and the predictions may be verified using current technology.

Electron Waiting Times of a Cooper Pair Splitter

DEFF Research Database (Denmark)

Walldorf, Nicklas; Padurariu, Ciprian; Jauho, Antti-Pekka

2018-01-01

Electron waiting times are an important concept in the analysis of quantum transport in nanoscale conductors. Here we show that the statistics of electron waiting times can be used to characterize Cooper pair splitters that create spatially separated spin-entangled electrons. A short waiting time...... between electrons tunneling into different leads is associated with the fast emission of a split Cooper pair, while long waiting times are governed by the slow injection of Cooper pairs from a superconductor. Experimentally, the waiting time distributions can be measured using real-time single......-electron detectors in the regime of slow tunneling, where conventional current measurements are demanding. Our work is important for understanding the fundamental transport processes in Cooper pair splitters and the predictions may be verified using current technology....

Factors of Perceived Waiting Time and Implications on Passengers’ Satisfaction with Waiting Time

Directory of Open Access Journals (Sweden)

Shumin Feng

2016-04-01

Full Text Available In order to explore the influence factors on perceived waiting time, a multiple linear regression model has been used to quantitatively describe the relationship between perceived waiting time and various factors. The model is established with 234 data, which is surveyed with questionnaire at three stops in Harbin, China. The results show that several certain factors (“trip purpose - where to”, “presence of a companion - whether one has a companion or not”, “having a timing device - whether one has a timing device or not”, “riding frequency - how many times one takes one line per week” and “waiting behaviour - what one does while waiting for a bus” have significant influence on perceived waiting time, which confirms previous findings and supports transferability of results. The significance of “waiting mood - howabout the mood while waiting for a bus” and “reserved waiting time - how long one will wait” are confirmed for the first time in this study. In contrast to previous studies, “waiting time interval - for how long in one day” is a negative variable and socioeconomic variables are non-significant. And it is found that the relationship between perceived waiting time and passengers’ satisfaction with the waiting time follows a decreasing exponential distribution. With this model, the variation trend of the section, where passenger satisfaction value is larger than 0 is obviously steeper than the section smaller than 0. Such result proves that passenger mood with short waiting time is more sensitive than with longer waiting time. And the borderline perceived waiting time, distinguishing satisfied from dissatisfied passengers is proven to be 7.87 minutes when assignment interval of satisfaction is (-25.25], when satisfaction is positive (larger than 0, the accuracy being 70.30%, while the accuracy is 82.71% fornegative satisfaction (less than 0.

Two Effective Ways to Implement Wait Time. A Symposium on Wait Time.

Science.gov (United States)

Swift, J. Nathan; And Others

The effects of instructional guides and a wait time feedback device (called a "Wait Timer") on the classroom interaction of middle school science teachers are examined. The Wait Timer, an unobtrusive indicator of wait time, is an automatic device that activates a light when a person speaks. The duration of the light at the end of a…

Learning to wait

DEFF Research Database (Denmark)

Dungey, Claire Elisabeth; Meinert, Lotte

2017-01-01

enforced through discipline, prepare young people to expect that waiting and enduring hardship will pay off in the end. This expectation makes the status of adulthood particularly vulnerable because the jobs and opportunities that young men learn to wait for often do not come into being by waiting....

Decreasing laboratory turnaround time and patient wait time by implementing process improvement methodologies in an outpatient oncology infusion unit.

Science.gov (United States)

Gjolaj, Lauren N; Gari, Gloria A; Olier-Pino, Angela I; Garcia, Juan D; Fernandez, Gustavo L

2014-11-01

Prolonged patient wait times in the outpatient oncology infusion unit indicated a need to streamline phlebotomy processes by using existing resources to decrease laboratory turnaround time and improve patient wait time. Using the DMAIC (define, measure, analyze, improve, control) method, a project to streamline phlebotomy processes within the outpatient oncology infusion unit in an academic Comprehensive Cancer Center known as the Comprehensive Treatment Unit (CTU) was completed. Laboratory turnaround time for patients who needed same-day lab and CTU services and wait time for all CTU patients was tracked for 9 weeks. During the pilot, the wait time from arrival to CTU to sitting in treatment area decreased by 17% for all patients treated in the CTU during the pilot. A total of 528 patients were seen at the CTU phlebotomy location, representing 16% of the total patients who received treatment in the CTU, with a mean turnaround time of 24 minutes compared with a baseline turnaround time of 51 minutes. Streamlining workflows and placing a phlebotomy station inside of the CTU decreased laboratory turnaround times by 53% for patients requiring same day lab and CTU services. The success of the pilot project prompted the team to make the station a permanent fixture. Copyright © 2014 by American Society of Clinical Oncology.

Weak interaction rates for Kr and Sr waiting-point nuclei under rp-process conditions

International Nuclear Information System (INIS)

Sarriguren, P.

2009-01-01

Weak interaction rates are studied in neutron deficient Kr and Sr waiting-point isotopes in ranges of densities and temperatures relevant for the rp process. The nuclear structure is described within a microscopic model (deformed QRPA) that reproduces not only the half-lives but also the Gamow-Teller strength distributions recently measured. The various sensitivities of the decay rates to both density and temperature are discussed. Continuum electron capture is shown to contribute significantly to the weak rates at rp-process conditions.

Heart Surgery Waiting Time: Assessing the Effectiveness of an Action

OpenAIRE

Badakhshan, Abbas; Arab, Mohammad; Gholipour, Mahin; Behnampour, Naser; Saleki, Saeid

2015-01-01

Background: Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient’s problems. Objectives: The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for r...

Bell inequalities and waiting times

Energy Technology Data Exchange (ETDEWEB)

Poeltl, Christina; Governale, Michele [School of Chemical and Physical Sciences and MacDiarmid Institute for Advanced Materials and Nanotechnology, Victoria University of Wellington, PO Box 600, Wellington 6140 (New Zealand)

2015-07-01

We propose a Bell test based on waiting time distributions for spin entangled electron pairs, which are generated and split in mesoscopic Coulomb blockade structures, denoted as entanglers. These systems have the advantage that quantum point contacts enable a time resolved observation of the electrons occupying the system, which gives access to quantities such as full counting statistics and waiting time distributions. We use the partial waiting times to define a CHSH-Bell test, which is a purely electronic analogue of the test used in quantum optics. After the introduction of the Bell inequality we discuss the findings on the two examples of a double quantum dot and a triple quantum dot. This Bell test allows the exclusion of irrelevant tunnel processes from the statistics normally used for the Bell correlations. This can improve the parameter range for which a violation of the Bell inequality can be measured significantly.

Worth the wait? How restaurant waiting time influences customer behavior and revenue

NARCIS (Netherlands)

de Vries, J.; Roy, Debjit; De Koster, Rene

2018-01-01

In many service industries, customers have to wait for service. When customers have a choice, this waiting may influence their service experience, sojourn time, and ultimately spending, reneging, and return behavior. Not much is known however, about the system-wide impact of waiting on customer

Wait times in Canada.

Science.gov (United States)

MacKinnon, Janice Christine

2017-07-01

A significant barrier to accessing healthcare in Canada is long waiting lists, which can be linked to the way that Medicare was structured. After significant pressure, provincial governments began to address wait times. An example of a successful strategy to reduce wait times for elective surgery is the Saskatchewan Surgical Initiative, which saw wait times in the province change from being among the longest in Canada to the shortest.

Waiting list in a public health facility in Santiago, Chile

Directory of Open Access Journals (Sweden)

Alejandro Letelier

2014-07-01

Full Text Available Introduction Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. Purpose This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. Methods A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. Results There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation. There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests

Traffic pollutants measured inside vehicles waiting in line at a major US-Mexico Port of Entry.

Science.gov (United States)

Quintana, Penelope J E; Khalighi, Mehdi; Castillo Quiñones, Javier Emmanuel; Patel, Zalak; Guerrero Garcia, Jesus; Martinez Vergara, Paulina; Bryden, Megan; Mantz, Antoinette

2018-05-01

At US-Mexico border Ports of Entry, vehicles idle for long times waiting to cross northbound into the US. Long wait times at the border have mainly been studied as an economic issue, however, exposures to emissions from idling vehicles can also present an exposure risk. Here we present the first data on in-vehicle exposures to driver and passengers crossing the US-Mexico border at the San Ysidro, California Port of Entry (SYPOE). Participants were recruited who regularly commuted across the border in either direction and told to drive a scripted route between two border universities, one in the US and one in Mexico. Instruments were placed in participants' cars prior to commute to monitor-1-minute average levels of the traffic pollutants ultrafine particles (UFP), black carbon (BC) and carbon monoxide (CO) in the breathing zone of drivers and passengers. Location was determined by a GPS monitor. Results reported here are for 68 northbound participant trips. The highest median levels of in-vehicle UFP were recorded during the wait to cross at the SYPOE (median 29,692particles/cm 3 ) significantly higher than the portion of the commute in the US (median 20,508particles/cm 3 ) though not that portion in Mexico (median 22, 191particles/cm 3 ). In-vehicle BC levels at the border were significantly lower than in other parts of the commute. Our results indicate that waiting in line at the SYPOE contributes a median 62.5% (range 15.5%-86.0%) of a cross-border commuter's exposure to UFP and a median 44.5% (range (10.6-79.7%) of exposure to BC inside the vehicle while traveling in the northbound direction. Reducing border wait time can significantly reduce in-vehicle exposures to toxic air pollutants such as UFP and BC, and these preventable exposures can be considered an environmental justice issue. Copyright © 2017 Elsevier B.V. All rights reserved.

Waiting for a pacemaker

DEFF Research Database (Denmark)

Risgaard, Bjarke; Elming, Hanne; Jensen, Gunnar

2012-01-01

AIMS: To determine waiting period-related morbidity, mortality, and adverse events in acute patients waiting for a permanent pacemaker (PPM).METHODS AND RESULTS: A retrospective chart review of all PPM implantations in Region Zealand, Denmark, in 2009 was conducted. Patients were excluded...... at least one adverse event during the waiting period. The present study indicates that a waiting period is dangerous as it is associated with an increased risk of adverse events. Acute PPMs should be implanted with a 24-h pacemaker implantation service capacity....

Effects of a brief cognitive behavioural therapy group intervention on baseline brain perfusion in adolescents with major depressive disorder.

Science.gov (United States)

Sosic-Vasic, Zrinka; Abler, Birgit; Grön, Georg; Plener, Paul; Straub, Joana

2017-04-12

A number of neuroimaging studies have identified altered regional cerebral blood flow (rCBF) related to major depressive disorder (MDD) in adult samples, particularly in the lateral prefrontal, cingular and temporal regions. In contrast, neuroimaging investigations in adolescents with MDD are rare, although investigating young patients during a significant period of brain maturation might offer valuable insights into the neural mechanisms of MDD. We acquired perfusion images obtained with continuous arterial spin labelling in 21 medication-naive adolescents with MDD before and after a five-session cognitive behavioural group therapy (group CBT). A control group included medication-naive patients under treatment as usual while waiting for the psychotherapy. We found relatively increased rCBF in the right dorsolateral prefrontal cortex (DLPFC; BA 46), the right caudate nucleus and the left inferior parietal lobe (BA 40) after CBT compared with before CBT. Relatively increased rCBF in the right DLPFC postgroup CBT was confirmed by time (post vs. pre)×group (intervention/waiting list) interaction analyses. In the waiting group, relatively increased rCBF was found in the thalamus and the anterior cingulate cortex (BA 24). The relatively small number of patients included in this pilot study has to be considered. Our findings indicate that noninvasive resting perfusion scanning is suitable to identify CBT-related changes in adolescents with MDD. rCBF increase in the DLPFC following a significant reduction in MDD symptoms in adolescents might represent the core neural correlate of changes in 'top-down' cognitive processing, a possible correlate of improved self-regulation and cognitive control.

Regional cerebral blood flow (rCBF) changes in major depression

International Nuclear Information System (INIS)

Ohtaki, Junichi

1992-01-01

Regional cerebral blood flow (rCBF) in patients with major depression and in normal controls was measured by single photon emission computed tomography (SPECT) using N-isopropyl-p [ 123 I]-iodoamphetamine (IMP). The subjects were 22 patients with major depression and 14 normal controls. The rCBF was calculated by the ratio of activity per pixel in the cortical regions to activity per pixel in the cerebellum. IMP-SPECT was conducted in patients with major depression under the depressive and remitted states. rCBF values in the frontal, parietal, temporal, basal ganglia and the occipital regions, and the mean rCBF values were significantly lower in depressive patients than in the controls. Increased rCBF values were observed, and the mean rCBF became normal in the state of remittence. There was no significant difference in mean rCBF between depressive patients and the controls. Therefore, because the lower rCBF was normalized following improvement in expressive symptoms, the rCBF values could be useful as 'state dependent markers' in patients with major depression. (author)

Parental satisfaction with paediatric care, triage and waiting times.

Science.gov (United States)

Fitzpatrick, Nicholas; Breen, Daniel T; Taylor, James; Paul, Eldho; Grosvenor, Robert; Heggie, Katrina; Mahar, Patrick D

2014-04-01

The present study aims to determine parental and guardian's perceptions of paediatric emergency care and satisfaction with care, waiting times and triage category in a community ED. A structured questionnaire was provided to parents or guardians of paediatric patients presenting to emergency. The survey evaluated parent perceptions of waiting time, environment/facilities, professionalism and communication skills of staff and overall satisfaction of care. One hundred and thirty-three completed questionnaires were received from parents of paediatric patients. Responses were overall positive with respect to the multiple domains assessed. Parents generally considered waiting times to be appropriate and consistent with triage categories. Overall satisfaction was not significantly different for varying treatment or waiting times. Patients triaged as semi-urgent were of the opinion that waiting times were less appropriate than urgent, less-urgent or non-urgent patients. On the basis of the present study, patient perceptions and overall satisfaction of care does not appear to be primarily influenced by time spent waiting or receiving treatment. Attempts made at the triage process to ensure that semi-urgent patients have reasonable expectations of waiting times might provide an opportunity to improve these patients' expectations and perceptions. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Third degree waiting time discrimination: optimal allocation of a public sector healthcare treatment under rationing by waiting.

Science.gov (United States)

Gravelle, Hugh; Siciliani, Luigi

2009-08-01

In many public healthcare systems treatments are rationed by waiting time. We examine the optimal allocation of a fixed supply of a given treatment between different groups of patients. Even in the absence of any distributional aims, welfare is increased by third degree waiting time discrimination: setting different waiting times for different groups waiting for the same treatment. Because waiting time imposes dead weight losses on patients, lower waiting times should be offered to groups with higher marginal waiting time costs and with less elastic demand for the treatment.

Wait times for gastroenterology consultation in Canada: The patients’ perspective

Science.gov (United States)

Paterson, WG; Barkun, AN; Hopman, WM; Leddin, DJ; Paré, P; Petrunia, DM; Sewitch, MJ; Switzer, C; van Zanten, S Veldhuyzen

2010-01-01

Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms. PMID:20186353

rTMS neuromodulation improves electrocortical functional measures of information processing and behavioral responses in autism

Directory of Open Access Journals (Sweden)

Estate M Sokhadze

2014-08-01

Full Text Available Objectives: Reports in autism spectrum disorders (ASD of a minicolumnopathy with consequent deficits of lateral inhibition help explain observed behavioral and executive dysfunctions. We propose that neuromodulation based on rTMS will enhance lateral inhibition through activation of inhibitory double bouquet interneurons and will be accompanied by improvements in the prefrontal executive functions. Methods: The current study used ERPs in a visual oddball task with illusory figures. We compared clinical, behavioral and electrocortical outcomes in 2 groups of children with autism (TMS, wait-list group [WTL]. We predicted that 18 session long course in autistic patients will have better behavioral and ERP outcomes as compared to age- and IQ-matched wait-list group. We used 18 sessions of 1Hz rTMS applied over the dorso-lateral prefrontal cortex in 27 individuals with ASD diagnosis. The WTL group was comprised of 27 age-matched ASD subjects. Results: Post-TMS evaluations showed decreased irritability and hyperactivity and decreased stereotypic behaviors. Following rTMS we found decreased amplitude and prolonged latency in the fronto-central ERPs to non-targets in the TMS group. These ERP changes along with increased centro-parietal ERPs to targets are indicative of more efficient processing of information post-TMS. Another finding was increased magnitude of error-related negativity (ERN during commission errors. We calculated normative post-error reaction time (RT slowing response in both groups and found that rTMS was accompanied by post-error RT slowing and higher accuracy of responses, whereas the WTL group kept on showing typical for ASD post-error RT speeding and had higher error rate. Conclusion: Results from our study indicate that rTMS improves executive functioning in ASD as evidenced by normalization of ERP responses and behavioral reactions during executive function test, and also by improvements in clinical behavioral evaluations.

A model to prioritize access to elective surgery on the basis of clinical urgency and waiting time

Directory of Open Access Journals (Sweden)

Santori Gregorio

2009-01-01

Full Text Available Abstract Background Prioritization of waiting lists for elective surgery represents a major issue in public systems in view of the fact that patients often suffer from consequences of long waiting times. In addition, administrative and standardized data on waiting lists are generally lacking in Italy, where no detailed national reports are available. This is true although since 2002 the National Government has defined implicit Urgency-Related Groups (URGs associated with Maximum Time Before Treatment (MTBT, similar to the Australian classification. The aim of this paper is to propose a model to manage waiting lists and prioritize admissions to elective surgery. Methods In 2001, the Italian Ministry of Health funded the Surgical Waiting List Info System (SWALIS project, with the aim of experimenting solutions for managing elective surgery waiting lists. The project was split into two phases. In the first project phase, ten surgical units in the largest hospital of the Liguria Region were involved in the design of a pre-admission process model. The model was embedded in a Web based software, adopting Italian URGs with minor modifications. The SWALIS pre-admission process was based on the following steps: 1 urgency assessment into URGs; 2 correspondent assignment of a pre-set MTBT; 3 real time prioritization of every referral on the list, according to urgency and waiting time. In the second project phase a prospective descriptive study was performed, when a single general surgery unit was selected as the deployment and test bed, managing all registrations from March 2004 to March 2007 (1809 ordinary and 597 day cases. From August 2005, once the SWALIS model had been modified, waiting lists were monitored and analyzed, measuring the impact of the model by a set of performance indexes (average waiting time, length of the waiting list and Appropriate Performance Index (API. Results The SWALIS pre-admission model was used for all registrations in the

Towards decision support for waiting lists: an operations management view.

Science.gov (United States)

Vissers, J M; Van Der Bij, J D; Kusters, R J

2001-06-01

This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.

Learning during processing Word learning doesn’t wait for word recognition to finish

Science.gov (United States)

Apfelbaum, Keith S.; McMurray, Bob

2017-01-01

Previous research on associative learning has uncovered detailed aspects of the process, including what types of things are learned, how they are learned, and where in the brain such learning occurs. However, perceptual processes, such as stimulus recognition and identification, take time to unfold. Previous studies of learning have not addressed when, during the course of these dynamic recognition processes, learned representations are formed and updated. If learned representations are formed and updated while recognition is ongoing, the result of learning may incorporate spurious, partial information. For example, during word recognition, words take time to be identified, and competing words are often active in parallel. If learning proceeds before this competition resolves, representations may be influenced by the preliminary activations present at the time of learning. In three experiments using word learning as a model domain, we provide evidence that learning reflects the ongoing dynamics of auditory and visual processing during a learning event. These results show that learning can occur before stimulus recognition processes are complete; learning does not wait for ongoing perceptual processing to complete. PMID:27471082

46 CFR 9.10 - Waiting time.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour. ...

Influence patterns of transportation parameters in suburban traffic on fatigue of passengers during bus waiting

Directory of Open Access Journals (Sweden)

Тетяна Михайлівна Григорова

2015-05-01

Full Text Available The change of transport fatigue of suburban traffic passengers during waiting transport waiting is investigated. The results of the processing site examinations allow defining the regularities of the influence of parameters of transportation process of passengers to change index activity of regulatory systems in passenger waiting at stopping points of suburban traffic. The discovered patterns were mathematically formalized

Consumer behaviour in the waiting area.

Science.gov (United States)

Mobach, Mark P

2007-02-01

To determine consumer behaviour in the pharmacy waiting area. The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each waiting area (brochures, books, illuminated new trailer, children's play area, etc.). Per patient each activity was registered, and at each pharmacy the behaviour was studied for 2 weeks. Most patients only waited during the waiting time at the studied pharmacies. Few consumers obtained written information during their wait. The waiting area may have latent possibilities to expand the information function of the pharmacy and combine this with other activities that distract the consumer from the wait. Transdisciplinary research, combining knowledge from pharmacy practice research with consumer research, has been a useful approach to add information on queueing behaviour of consumers.

The effect of waiting times on demand and supply for elective surgery: Evidence from Italy.

Science.gov (United States)

Riganti, Andrea; Siciliani, Luigi; Fiorio, Carlo V

2017-09-01

Waiting times are a major policy concern in publicly funded health systems across OECD countries. Economists have argued that, in the presence of excess demand, waiting times act as nonmonetary prices to bring demand for and supply of health care in equilibrium. Using administrative data disaggregated by region and surgical procedure over 2010-2014 in Italy, we estimate demand and supply elasticities with respect to waiting times. We employ linear regression models with first differences and instrumental variables to deal with endogeneity of waiting times. We find that demand is inelastic to waiting times while supply is more elastic. Estimates of demand elasticity are between -0.15 to -0.24. Our results have implications on the effectiveness of policies aimed at increasing supply and their ability to reduce waiting times. Copyright © 2017 John Wiley & Sons, Ltd.

Can We Predict Patient Wait Time?

Science.gov (United States)

Pianykh, Oleg S; Rosenthal, Daniel I

2015-10-01

The importance of patient wait-time management and predictability can hardly be overestimated: For most hospitals, it is the patient queues that drive and define every bit of clinical workflow. The objective of this work was to study the predictability of patient wait time and identify its most influential predictors. To solve this problem, we developed a comprehensive list of 25 wait-related parameters, suggested in earlier work and observed in our own experiments. All parameters were chosen as derivable from a typical Hospital Information System dataset. The parameters were fed into several time-predicting models, and the best parameter subsets, discovered through exhaustive model search, were applied to a large sample of actual patient wait data. We were able to discover the most efficient wait-time prediction factors and models, such as the line-size models introduced in this work. Moreover, these models proved to be equally accurate and computationally efficient. Finally, the selected models were implemented in our patient waiting areas, displaying predicted wait times on the monitors located at the front desks. The limitations of these models are also discussed. Optimal regression models based on wait-line sizes can provide accurate and efficient predictions for patient wait time. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Handgun waiting periods reduce gun deaths.

Science.gov (United States)

Luca, Michael; Malhotra, Deepak; Poliquin, Christopher

2017-11-14

Handgun waiting periods are laws that impose a delay between the initiation of a purchase and final acquisition of a firearm. We show that waiting periods, which create a "cooling off" period among buyers, significantly reduce the incidence of gun violence. We estimate the impact of waiting periods on gun deaths, exploiting all changes to state-level policies in the Unites States since 1970. We find that waiting periods reduce gun homicides by roughly 17%. We provide further support for the causal impact of waiting periods on homicides by exploiting a natural experiment resulting from a federal law in 1994 that imposed a temporary waiting period on a subset of states. Copyright © 2017 the Author(s). Published by PNAS.

It's worth the wait: optimizing questioning methods for effective intraoperative teaching.

Science.gov (United States)

Barrett, Meredith; Magas, Christopher P; Gruppen, Larry D; Dedhia, Priya H; Sandhu, Gurjit

2017-07-01

The use of questioning to engage learners is critical to furthering resident education intraoperatively. Previous studies have demonstrated that higher level questioning and optimal wait times (>3 s) result in learner responses reflective of higher cognition and retention. Given the importance of intraoperative learning, we investigated question delivery in the operating room. A total of 12 laparoscopic cholecystectomies were observed and recorded. All questions were transcribed and classified using Bloom's Taxonomy, a framework associated with hierarchical levels of learning outcomes. Wait time between question end and response was recorded. Six faculty attendings and seven house officers at our institution were observed. A total of 133 questions were recorded with an average number of questions per case of 11.2. The majority of questions 112 out of 133 (84%) were classified as Bloom's levels 1-3, with only 6% of questions of the highest level. The wait time before the resident answered the question averaged 1.75 s, with attendings interceding after 2.50 s. Question complexity and wait time did not vary based on resident postgraduate year level suggesting limited tailoring of question to learner. Intraoperative questioning is not aligned with higher level thinking. The majority of questions were Bloom's level 3 or below, limiting the complexity of answer formulation. Most responses were given within 2 s, hindering opportunity to pursue higher-order thinking. This suggests including higher level questions and tailoring questions to learner level may improve retention and maximize gains. In addition, with attendings answering 20% of their own questions, increasing their wait time offers another area for teaching development. © 2017 Royal Australasian College of Surgeons.

Ramsey waits: allocating public health service resources when there is rationing by waiting.

Science.gov (United States)

Gravelle, Hugh; Siciliani, Luigi

2008-09-01

The optimal allocation of a public health care budget across treatments must take account of the way in which care is rationed within treatments since this will affect their marginal value. We investigate the optimal allocation rules for public health care systems where user charges are fixed and care is rationed by waiting. The optimal waiting time is higher for treatments with demands more elastic to waiting time, higher costs, lower charges, smaller marginal welfare loss from waiting by treated patients, and smaller marginal welfare losses from under-consumption of care. The results hold for a wide range of welfarist and non-welfarist objective functions and for systems in which there is also a private health care sector. They imply that allocation rules based purely on cost effectiveness ratios are suboptimal because they assume that there is no rationing within treatments.

The British Columbia Nephrologists' Access Study (BCNAS) - a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations.

Science.gov (United States)

Schachter, Michael E; Romann, Alexandra; Djurdev, Ognjenka; Levin, Adeera; Beaulieu, Monica

2013-08-29

Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists', FPs', and patients' perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an influence on triaging behavior. Further research is needed to determine whether this effect is sustainable.

SU-F-P-20: Predicting Waiting Times in Radiation Oncology Using Machine Learning

International Nuclear Information System (INIS)

Joseph, A; Herrera, D; Hijal, T; Kildea, J; Hendren, L; Leung, A; Wainberg, J; Sawaf, M; Gorshkov, M; Maglieri, R; Keshavarz, M

2016-01-01

. This means that the majority of our estimates are within 6.5 minutes of the actual wait time. Conclusion: The goal of this project was to define an appropriate machine learning algorithm to estimate waiting times based on the collective knowledge and experience learned from previous patients. Our results offer an opportunity to improve the information that is provided to patients and family members regarding the amount of time they can expect to wait for radiotherapy treatment at our centre. AJ acknowledges support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council (Grant number: 432290) and from the 2014 Q+ Initiative of the McGill University Health Centre.

SU-F-P-20: Predicting Waiting Times in Radiation Oncology Using Machine Learning

Energy Technology Data Exchange (ETDEWEB)

Joseph, A; Herrera, D; Hijal, T; Kildea, J [McGill University Health Centre, Montreal, Quebec (Canada); Hendren, L; Leung, A; Wainberg, J; Sawaf, M; Gorshkov, M; Maglieri, R; Keshavarz, M [McGill University, Montreal, Quebec (Canada)

2016-06-15

. This means that the majority of our estimates are within 6.5 minutes of the actual wait time. Conclusion: The goal of this project was to define an appropriate machine learning algorithm to estimate waiting times based on the collective knowledge and experience learned from previous patients. Our results offer an opportunity to improve the information that is provided to patients and family members regarding the amount of time they can expect to wait for radiotherapy treatment at our centre. AJ acknowledges support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council (Grant number: 432290) and from the 2014 Q+ Initiative of the McGill University Health Centre.

The Effectiveness Analysis of Waiting Processes in the Different Branches of a Bank by Queue Model

Directory of Open Access Journals (Sweden)

Abdullah ÖZÇİL

2015-06-01

Full Text Available Despite the appreciable increase in the number of bank branches every year, nowadays queues for services don’t decrease and even become parts of our daily lives. By minimizing waiting processes the least, increasing customer satisfaction should be one of branch managers’ main goals. A quick and also customer oriented service with high quality is the most important factor for customer loyalty. In this study, Queueing theory, one of Operation Research techniques, is handled and in application, the data are obtained related to waiting in queue of customer in six different branches of two banks operating in Denizli and then they are analyzed by Queueing theory and also calculated the average effectiveness of the system. The study’s data are obtained by six branches of two banks called as A1, A2, A3, B1, B2 and B3. At the end of study it is presented to the company some advices that can bring benefits to the staff and customers. In this study, Queueing theory, one of Operation Research techniques, is handled and in application, the data are obtained related to waiting in queue of customer in three different branches of a bank operating in Denizli and then they are analyzed by Queueing theory and also calculated the average effectiveness of the system. The study’s data are obtained by three branches of the bank called A1, A2 and A3. At last it is presented to the company some advices that can bring more benefits to the staff and clients.

Built spaces and features associated with user satisfaction in maternity waiting homes in Malawi.

Science.gov (United States)

McIntosh, Nathalie; Gruits, Patricia; Oppel, Eva; Shao, Amie

2018-07-01

two differently designed maternity waiting homes, with the non-standard design having higher ratings for: adequacy of toilets, and ratings of heating/cooling, air and water quality, sanitation, toilets/showers and kitchen facilities, building maintenance, sleep area, private storage space, comfort level, outdoor spaces and overall satisfaction (p = maternity waiting home user satisfaction are toilets/showers, guardian spaces, safety, building maintenance, sleep area and private storage space (R 2  = 0.28). The design of maternity waiting home built spaces and features is associated with user satisfaction in women at risk for underutilizing maternity waiting homes, especially related to toilets/showers, guardian spaces, safety, building maintenance, sleep area and private storage space. Improving maternity waiting home built spaces and features may offer a promising area for improving maternity waiting home satisfaction and reducing barriers to maternity waiting home use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Waiting when hospitalised

DEFF Research Database (Denmark)

Ludvigsen, Mette Spliid

2004-01-01

on participating observations during a period of one and a half year. The material is analysed with inspiration from Mattingly's ideas of narrative and time. ConclusionsAlthough waiting times is not a clinically serious problem, the satisfaction levels of patients with the care they receive have become...... increasingly important in today's health care environment. The indicative conclusions form this study suggest that nurses play an important role in ensuring that patients are satisfied and receive quality care when waiting....

Reactions to waiting online by men and women.

Science.gov (United States)

Chebat, Jean-Charles; Salem, Narjes Haj; Poirier, Jean-François; Gélinas-Chebat, Claire

2010-06-01

The goal of the present study was to identify factors which may affect the difference between the actual time participants expected to wait for downloading a web page and the perceived waiting time, i.e., the online waiting-time gap. The findings from an experiment in which the music tempo (fast vs. slow) and waiting-duration information (presence vs. absence) were manipulated showed that sex moderated the relation between the manipulated variables and waiting-time gap; emotional response was more important between the manipulated variables and waiting-time gap than was cognitive response. The type of emotional response with an effect on waiting-time gap varied by sex: pleasure for women and arousal for men. For women, pleasure was affected by their cognitive response, while cognitive response played no significant role for men. For both sexes, information on waiting duration increased the perceived waiting time. This study leads to reconsidering the role of emotional response and sex in evaluating waiting time.

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study.

Science.gov (United States)

Sun, Jing; Lin, Qian; Zhao, Pengyu; Zhang, Qiongyao; Xu, Kai; Chen, Huiying; Hu, Cecile Jia; Stuntz, Mark; Li, Hong; Liu, Yuanli

2017-08-22

It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients' satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. The monthly average length of waiting time decreased 3.49 min (P = 0.003) for consultations and 8.70 min (P = 0.02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = -0.71, P = 0.004). The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study

Directory of Open Access Journals (Sweden)

Jing Sun

2017-08-01

Full Text Available Abstract Background It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. Methods We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. Results The monthly average length of waiting time decreased 3.49 min (P = 0.003 for consultations and 8.70 min (P = 0.02 for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003. There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = −0.71, P = 0.004. Conclusions The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives

Waiting-time distributions of magnetic discontinuities: Clustering or Poisson process?

International Nuclear Information System (INIS)

Greco, A.; Matthaeus, W. H.; Servidio, S.; Dmitruk, P.

2009-01-01

Using solar wind data from the Advanced Composition Explorer spacecraft, with the support of Hall magnetohydrodynamic simulations, the waiting-time distributions of magnetic discontinuities have been analyzed. A possible phenomenon of clusterization of these discontinuities is studied in detail. We perform a local Poisson's analysis in order to establish if these intermittent events are randomly distributed or not. Possible implications about the nature of solar wind discontinuities are discussed.

Bottlenecks and Waiting Points in Nucleosynthesis in X-ray bursts and Novae

Science.gov (United States)

Smith, Michael S.; Sunayama, Tomomi; Hix, W. Raphael; Lingerfelt, Eric J.; Nesaraja, Caroline D.

2010-08-01

To better understand the energy generation and element synthesis occurring in novae and X-ray bursts, we give quantitative definitions to the concepts of ``bottlenecks'' and ``waiting points'' in the thermonuclear reaction flow. We use these criteria to search for bottlenecks and waiting points in post-processing element synthesis explosion simulations. We have incorporated these into the Computational Infrastructure for Nuclear Astrophysics, a suite of nuclear astrophysics codes available online at nucastrodata.org, so that anyone may perform custom searches for bottlenecks and waiting points.

Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

Directory of Open Access Journals (Sweden)

Jurgita Januleviciute Gangstøe

2016-06-01

Full Text Available Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i high priority with assigned individual maximum waiting time; (ii low priority without a maximum waiting time; and (iii refusal (not in need for specialized services. We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual

Effect of self-triage on waiting times at a walk-in sexual health clinic.

Science.gov (United States)

Hitchings, Samantha; Barter, Janet

2009-10-01

Lengthy waiting times can be a major problem in walk-in sexual health clinics. They are stressful for both patients and staff and may lead to clients with significant health issues leaving the department before being seen by a clinician. A self-triage system may help reduce waiting times and duplication of work, improve patient pathways and decrease wasted visits. This paper describes implementation of a self-triage system in two busy sexual and reproductive health clinics. Patients were asked to complete a self-assessment form on registration to determine the reason for attendance. This then enabled patients to be directed to the most appropriate specialist or clinical service. The benefits of this approach were determined by measuring patient waiting times, reduction in unnecessary specialist review together with patient acceptability as tested by a patient satisfaction survey. The ease of comprehension of the triage form was also assessed by an independent readers' panel. A total of 193 patients were recruited over a 4-month period from November 2004 to February 2005. Patients from the November and December clinics were assigned to the 'traditional treatment' arm, with patients at subsequent clinics being assigned to the 'self-triage' system. Waiting times were collected by the receptionist and clinic staff. Ninety six patients followed the traditional route, 97 the new self-triage system. Sixty-nine (35.8%) patients completed the satisfaction survey. The self-triage system significantly reduced waiting time from 40 (22, 60) to 23 (10, 40) minutes [results expressed as median (interquartile range)]. There was a non-significant reduction in the proportion of patients seeing two clinicians from 21% to 13% (p = 0.17). Satisfaction levels were not significantly altered (95% compared to 97% satisfied, p = 0.64). The readers' panel found the triage form both easy to understand and to complete. Self-triage can effectively reduce clinic waiting times and allow better

Neutron-capture reactions with the R{sup 3}B-CaveC setup

Energy Technology Data Exchange (ETDEWEB)

Heine, Marcel [IKP, TU Darmstadt (Germany)

2014-07-01

Recent research has shown that the (n,γ) transition-rates on light nuclei can have an influence on the neutron-balance during the r-process. Especially neutron rich carbon isotopes play an important role in r-process nucleo synthesis network calculations which include light nuclei, since these nuclei are aligned along major flow-paths. In particular {sup 18}C is of interest, because it can be interpreted as a waiting point. The {sup 17}C(n,γ){sup 18}C rate could so far only be estimated theoretically and has an uncertainty of a factor of ten [1]. At the R{sup 3}B-CaveC setup at GSI we have measured the (n,γ) time reversed reaction, i.e. {sup 18}C(γ,n){sup 17}C for the above mentioned nucleus, via the Coulomb-breakup of {sup 18}C beam. The kinematically complete measurement allows extracting energy dependent neutron-capture cross section with respect to the excitation energy by using the invariant-mass method. Experimental results are presented in comparison to theoretical calculations.

Time while waiting: patients' experiences of scheduled surgery.

Science.gov (United States)

Carr, Tracey; Teucher, Ulrich C; Casson, Alan G

2014-12-01

Research on patients' experiences of wait time for scheduled surgery has centered predominantly on the relative tolerability of perceived wait time and impacts on quality of life. We explored patients' experiences of time while waiting for three types of surgery with varied wait times--hip or knee replacement, shoulder surgery, and cardiac surgery. Thirty-two patients were recruited by their surgeons. We asked participants about their perceptions of time while waiting in two separate interviews. Using interpretative phenomenological analysis (IPA), we discovered connections between participant suffering, meaningfulness of time, and agency over the waiting period and the lived duration of time experience. Our findings reveal that chronological duration is not necessarily the most relevant consideration in determining the quality of waiting experience. Those findings helped us create a conceptual framework for lived wait time. We suggest that clinicians and policy makers consider the complexity of wait time experience to enhance preoperative patient care. © The Author(s) 2014.

The r-process nucleosynthesis and related challenges

Directory of Open Access Journals (Sweden)

Goriely Stephane

2017-01-01

Full Text Available The rapid neutron-capture process, or r-process, is known to be of fundamental importance for explaining the origin of approximately half of the A > 60 stable nuclei observed in nature. Recently, special attention has been paid to neutron star (NS mergers following the confirmation by hydrodynamic simulations that a non-negligible amount of matter can be ejected and by nucleosynthesis calculations combined with the predicted astrophysical event rate that such a site can account for the majority of r-material in our Galaxy. We show here that the combined contribution of both the dynamical (prompt ejecta expelled during binary NS or NS-black hole (BH mergers and the neutrino and viscously driven outflows generated during the post-merger remnant evolution of relic BH-torus systems can lead to the production of r-process elements from mass number A ≳ 90 up to actinides. The corresponding abundance distribution is found to reproduce the solar distribution extremely well. It can also account for the elemental distributions observed in low-metallicity stars. However, major uncertainties still affect our understanding of the composition of the ejected matter. These concern (i the β-interactions of electron (antineutrinos with free neutrons and protons, as well as their inverse reactions, which may affect the neutron-richness of the matter at the early phase of the ejection, and (ii the nuclear physics of exotic neutron-rich nuclei, including nuclear structure as well as nuclear interaction properties, which impact the calculated abundance distribution. Both aspects are discussed in the light of recent hydrodynamical simulations of NS mergers and microscopic calculations of nuclear decay and reaction probabilities.

Shorter Perceived Outpatient MRI Wait Times Associated With Higher Patient Satisfaction.

Science.gov (United States)

Holbrook, Anna; Glenn, Harold; Mahmood, Rabia; Cai, Qingpo; Kang, Jian; Duszak, Richard

2016-05-01

The aim of this study was to assess differences in perceived versus actual wait times among patients undergoing outpatient MRI examinations and to correlate those times with patient satisfaction. Over 15 weeks, 190 patients presenting for outpatient MR in a radiology department in which "patient experience" is one of the stated strategic priorities were asked to (1) estimate their wait times for various stages in the imaging process and (2) state their satisfaction with their imaging experience. Perceived times were compared with actual electronic time stamps. Perceived and actual times were compared and correlated with standardized satisfaction scores using Kendall τ correlation. The mean actual wait time between patient arrival and examination start was 53.4 ± 33.8 min, whereas patients perceived a mean wait time of 27.8 ± 23.1 min, a statistically significant underestimation of 25.6 min (P perceived wait times at all points during patient encounters were correlated with higher satisfaction scores (P perceived and actual wait times were both correlated with higher satisfaction scores. As satisfaction surveys play a larger role in an environment of metric transparency and value-based payments, better understanding of such factors will be increasingly important. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Decreasing Psychiatric Admission Wait Time in the Emergency Department by Facilitating Psychiatric Discharges.

Science.gov (United States)

Stover, Pamela R; Harpin, Scott

2015-12-01

Limited capacity in a psychiatric unit contributes to long emergency department (ED) admission wait times. Regulatory and accrediting agencies urge hospitals nationally to improve patient flow for better access to care for all types of patients. The purpose of the current study was to decrease psychiatric admission wait time from 10.5 to 8 hours and increase the proportion of patients discharged by 11 a.m. from 20% to 50%. The current study compared pre- and post-intervention data. Plan-Do-Study-Act cycles aimed to improve discharge processes and timeliness through initiation of new practices. Admission wait time improved to an average of 5.1 hours (t = 3.87, p = 0.006). The proportion of discharges occurring by 11 a.m. increased to 46% (odds ratio = 3.42, p planning processes and timeliness in a psychiatric unit significantly decreased admission wait time from the ED, improving access to psychiatric care. Copyright 2015, SLACK Incorporated.

The British Columbia Nephrologists’ Access Study (BCNAS) – a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations

Science.gov (United States)

2013-01-01

Background Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. Methods We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists’, FPs’, and patients’ perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. Results In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an influence on triaging behavior. Further research is needed to determine whether this effect is sustainable. PMID:23988113

Waiting for surgery from the patient perspective

Directory of Open Access Journals (Sweden)

Tracey Carr

2009-10-01

Full Text Available Tracey Carr1, Ulrich Teucher2, Jackie Mann4, Alan G Casson31Health Sciences, 2Department of Psychology, 3Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 4Acute Care, Saskatoon Health Region, Saskatoon, Saskatchewan, CanadaAbstract: The aim of this study was to perform a systematic review of the impact of waiting for elective surgery from the patient perspective, with a focus on maximum tolerance, quality of life, and the nature of the waiting experience. Searches were conducted using Medline, PubMed, CINAHL, EMBASE, and HealthSTAR. Twenty-seven original research articles were identified which included each of these three themes. The current literature suggested that first, patients tend to state longer wait times as unacceptable when they experienced severe symptoms or functional impairment. Second, the relationship between length of wait and health-related quality of life depended on the nature and severity of proposed surgical intervention at the time of booking. Third, the waiting experience was consistently described as stressful and anxiety provoking. While many patients expressed anger and frustration at communication within the system, the experience of waiting was not uniformly negative. Some patients experienced waiting as an opportunity to live full lives despite pain and disability. The relatively unexamined relationship between waiting, illness and patient experience of time represents an area for future research.Keywords: wait time, scheduled surgery, patient perspective, literature review

R-process signatures

International Nuclear Information System (INIS)

Kratz, K.L.; Pfeiffer, B.

2003-01-01

We compare r-process calculations with recent astronomical observations from the solar system and from ultra-metal-poor, neutron-capture-rich halo stars. These measurements include elemental as well as isotopic r-abundances. We deduce astrophysical conditions under which the observed r-patterns can be obtained, and derive criteria to determine Th/U chronometric ages. (orig.)

Waiting experience in railway environments

NARCIS (Netherlands)

van Hagen, M.; Galetzka, Mirjam; Pruyn, Adriaan T.H.

2014-01-01

At railway stations, waiting time is usually an unavoidable aspect of the journey for train passengers. According to the attentional model of time, pleasant surroundings and other forms of distraction reduce perceived waiting time. Not every individual reacts identically in the same surroundings.

Public reporting on quality, waiting times and patient experience in 11 high-income countries

OpenAIRE

Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew

2016-01-01

: This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospi...

Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping

Directory of Open Access Journals (Sweden)

Tara Sampalli

2015-07-01

Full Text Available Background Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions.

New calculations of gross β-decay properties for astrophysical applications: Speeding-up the classical r process

International Nuclear Information System (INIS)

Moeller, Peter; Pfeiffer, Bernd; Kratz, Karl-Ludwig

2003-01-01

Recent compilations of experimental gross β-decay properties, i.e., half-lives (T 1/2 ) and neutron-emission probabilities (P n ), are compared to improved global macroscopic-microscopic model predictions. The model combines calculations within the quasiparticle (QP) random-phase approximation for the Gamow-Teller (GT) part with an empirical spreading of the QP strength and the gross theory for the first-forbidden part of β - decay. Nuclear masses are either taken from the 1995 data compilation of Audi et al., when available, otherwise from the finite-range droplet model. Especially for spherical and neutron-(sub-)magic isotopes a considerable improvement compared to our earlier predictions for pure GT decay (ADNDT, 1997) is observed. T 1/2 and P n values up to the neutron drip line have been used in r-process calculations within the classical 'waiting-point' approximation. With the new nuclear-physics input, a considerable speeding-up of the r-matter flow is observed, in particular at those r-abundance peaks which are related to magic neutron-shell closures

The association between waiting for psychological therapy and therapy outcomes as measured by the CORE-OM.

Science.gov (United States)

Beck, Alison; Burdett, Mark; Lewis, Helen

2015-06-01

To investigate the impact of waiting for psychological therapy on client well-being as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) global distress (GD) score. Global distress scores were retrieved for all clients referred for psychological therapy in a secondary care mental health service between November 2006 and May 2013 and who had completed a CORE-OM at assessment and first session. GD scores for a subgroup of 103 clients who had completed a CORE-OM during the last therapy session were also reviewed. The study sample experienced a median wait of 41.14 weeks between assessment and first session. The relationship between wait time from referral acceptance to assessment, and assessment GD score was not significant. During the period between assessment and first session no significant difference in GD score was observed. Nevertheless 29.1% of the sample experienced reliable change; 16.0% of clients reliably improved and 13.1% reliably deteriorated whilst waiting for therapy. Demographic factors were not found to have a significant effect on the change in GD score between assessment and first session. Waiting time was associated with post-therapy outcomes but not to a degree which was meaningful. The majority of individuals (54.4%), regardless of whether they improved or deteriorated whilst waiting for therapy, showed reliable improvement at end of therapy as measured by the CORE-OM. The majority of GD scores remained stable while waiting for therapy; however, 29.1% of secondary care clients experienced either reliable improvement or deterioration. Irrespective of whether they improved, deteriorated or remained unchanged whilst waiting for therapy, most individuals who had a complete end of therapy assessment showed reliable improvements following therapy. There was no significant difference in GD score between assessment and first session recordings. A proportion of clients (29.1%) showed reliable change, either improvement or

Wait too long to talk about kidney disease and you could be waiting for a kidney.

Science.gov (United States)

... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

Improving Patients Experience in Peadiatric Emergency Waiting Room.

Science.gov (United States)

Ehrler, Frederic; Siebert, Johan; Wipfli, Rolf; Duret, Cyrille; Gervaix, Alain; Lovis, Christian

2016-01-01

When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear.

ENRICHMENT OF r-PROCESS ELEMENTS IN DWARF SPHEROIDAL GALAXIES IN CHEMO-DYNAMICAL EVOLUTION MODEL

Energy Technology Data Exchange (ETDEWEB)

Hirai, Yutaka; Kajino, Toshitaka [Department of Astronomy, Graduate School of Science, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Ishimaru, Yuhri [Department of Material Science,International Christian University, 3-10-2 Osawa, Mitaka, Tokyo 181-8585 (Japan); Saitoh, Takayuki R. [Earth-Life Science Institute, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8551 (Japan); Fujii, Michiko S.; Hidaka, Jun, E-mail: yutaka.hirai@nao.ac.jp [Division of Theoretical Astronomy, National Astronomical Observatory of Japan, 2-21-1 Osawa Mitaka, Tokyo 181-8588 (Japan)

2015-11-20

The rapid neutron-capture process (r-process) is a major process for the synthesis of elements heavier than iron-peak elements, but the astrophysical site(s) of the r-process has not yet been identified. Neutron star mergers (NSMs) are suggested to be a major r-process site according to nucleosynthesis studies. Previous chemical evolution studies, however, required unlikely short merger times of NSMs to reproduce the observed large star-to-star scatters in the abundance ratios of r-process elements to iron: the [Eu/Fe] of extremely metal-poor stars in the Milky Way (MW) halo. This problem can be solved by considering chemical evolution in dwarf spheroidal galaxies (dSphs), which would be building blocks of the MW and have lower star formation efficiencies than the MW halo. We demonstrate the enrichment of r-process elements in dSphs by NSMs using an N-body/smoothed particle hydrodynamics code. Our high-resolution model reproduces the observed [Eu/Fe] due to NSMs with a merger time of 100 Myr when the effect of metal mixing is taken into account. This is because metallicity is not correlated with time ∼300 Myr from the start of the simulation due to the low star formation efficiency in dSphs. We also confirm that this model is consistent with observed properties of dSphs such as radial profiles and metallicity distribution. The merger time and the Galactic rate of NSMs are suggested to be ≲300 Myr and ∼10{sup −4} year{sup −1}, respectively, which are consistent with the values suggested by population synthesis and nucleosynthesis studies. This study supports the argument that NSMs are the major astrophysical site of the r-process.

Transport properties of the continuous-time random walk with a long-tailed waiting-time density

International Nuclear Information System (INIS)

Weissman, H.; Havlin, S.; Weiss, G.H.

1989-01-01

The authors derive asymptotic properties of the propagator p(r, t) of a continuous-time random walk (CTRW) in which the waiting time density has the asymptotic form ψ(t) ∼ T α /t α+1 when t >> T and 0 = ∫ 0 ∞ τψ(τ)dτ is finite. One is that the asymptotic behavior of p(0, t) is demonstrated by the waiting time at the origin rather than by the dimension. The second difference is that in the presence of a field p(r, t) no longer remains symmetric around a moving peak. Rather, it is shown that the peak of this probability always occurs at r = 0, and the effect of the field is to break the symmetry that occurs when < ∞. Finally, they calculate similar properties, although in not such great detail, for the case in which the single-step jump probabilities themselves have an infinite mean

Waiting Time Dynamics in Two-Dimensional Infrared Spectroscopy

NARCIS (Netherlands)

Jansen, Thomas L. C.; Knoester, Jasper

We review recent work on the waiting time dynamics of coherent two-dimensional infrared (2DIR) spectroscopy. This dynamics can reveal chemical and physical processes that take place on the femto- and picosecond time scale, which is faster than the time scale that may be probed by, for example,

Stochastic nature of series of waiting times

Science.gov (United States)

Anvari, Mehrnaz; Aghamohammadi, Cina; Dashti-Naserabadi, H.; Salehi, E.; Behjat, E.; Qorbani, M.; Khazaei Nezhad, M.; Zirak, M.; Hadjihosseini, Ali; Peinke, Joachim; Tabar, M. Reza Rahimi

2013-06-01

Although fluctuations in the waiting time series have been studied for a long time, some important issues such as its long-range memory and its stochastic features in the presence of nonstationarity have so far remained unstudied. Here we find that the “waiting times” series for a given increment level have long-range correlations with Hurst exponents belonging to the interval 1/2waiting time distribution. We find that the logarithmic difference of waiting times series has a short-range correlation, and then we study its stochastic nature using the Markovian method and determine the corresponding Kramers-Moyal coefficients. As an example, we analyze the velocity fluctuations in high Reynolds number turbulence and determine the level dependence of Markov time scales, as well as the drift and diffusion coefficients. We show that the waiting time distributions exhibit power law tails, and we were able to model the distribution with a continuous time random walk.

The effects of immigration on NHS waiting times.

Science.gov (United States)

Giuntella, Osea; Nicodemo, Catia; Vargas-Silva, Carlos

2018-03-01

This paper analyzes the effects of immigration on waiting times for the National Health Service (NHS) in England. Linking administrative records from Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labour Force Survey, we find that immigration reduced waiting times for outpatient referrals and did not have significant effects on waiting times in accident and emergency departments (A&E) and elective care. The reduction in outpatient waiting times can be explained by the fact that immigration increases natives' internal mobility and that immigrants tend to be healthier than natives who move to different areas. Finally, we find evidence that immigration increased waiting times for outpatient referrals in more deprived areas outside of London. The increase in average waiting times in more deprived areas is concentrated in the years immediately following the 2004 EU enlargement and disappears in the medium term (e.g., 3-4 years). Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Outpatient waiting time in Jos University Teaching Hospital ...

African Journals Online (AJOL)

Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

Investigation of miR-1202, miR-135a, and miR-16 in Major Depressive Disorder and Antidepressant Response.

Science.gov (United States)

Fiori, Laura M; Lopez, Juan Pablo; Richard-Devantoy, Stéphane; Berlim, Marcelo; Chachamovich, Eduardo; Jollant, Fabrice; Foster, Jane; Rotzinger, Susan; Kennedy, Sidney H; Turecki, Gustavo

2017-08-01

Major depressive disorder is a debilitating illness, which is most commonly treated with antidepressant drugs. As the majority of patients do not respond on their first trial, there is great interest in identifying biological factors that indicate the most appropriate treatment for each patient. Studies suggest that microRNA represent excellent biomarkers to predict antidepressant response. We investigated the expression of miR-1202, miR-135a, and miR-16 in peripheral blood from 2 cohorts of depressed patients who received 8 weeks of antidepressant therapy. Expression was quantified at baseline and after treatment, and its relationship to treatment response and depressive symptoms was assessed. In both cohorts, responders displayed lower baseline miR-1202 levels compared with nonresponders, which increased following treatment. Ultimately, our results support the involvement of microRNA in antidepressant response and suggest that quantification of their levels in peripheral samples represents a valid approach to informing treatment decisions. © The Author 2017. Published by Oxford University Press on behalf of CINP.

No-Wait Flexible Flow Shop Scheduling with Due Windows

Directory of Open Access Journals (Sweden)

Rong-Hwa Huang

2015-01-01

Full Text Available To improve capacity and reduce processing time, the flow shop with multiprocessors (FSMP system is commonly used in glass, steel, and semiconductor production. No-wait FSMP is a modern production system that responds to periods when zero work is required in process production. The production process must be continuous and uninterrupted. Setup time must also be considered. Just-in-time (JIT production is very popular in industry, and timely delivery is important to customer satisfaction. Therefore, it is essential to consider the time window constraint, which is also very complex. This study focuses on a no-wait FSMP problem with time window constraint. An improved ant colony optimization (ACO, known as ant colony optimization with flexible update (ACOFU, is developed to solve the problem. The results demonstrate that ACOFU is more effective and robust than ACO when applied to small-scale problems. ACOFU has superior solution capacity and robustness when applied to large-scale problems. Therefore, this study concludes that the proposed algorithm ACOFU performs excellently when applied to the scheduling problem discussed in this study.

Weighing waiting

Directory of Open Access Journals (Sweden)

Samuel M. Duncan

2007-12-01

Full Text Available People have been shown to delay decision making to wait for missing noninstrumental attribute information --- information that would not have altered their decision if known at the outset --- with this delay originally attributed to uncertainty obscuring one's true preference (Bastardi and Shafir, 1998. To test this account, relative to an alternative that delay arises from low confidence in one's preference (Tykocinski and Ruffle, 2003, we manipulated information certainty and the magnitude of a penalty for delay, the latter intended to reduce the influence of easily resolved sources of delay and to magnify any influence of uncertainty. Contrary to expectations, the results were largely inconsistent with the uncertainty account in that, under a low penalty, delay did not depend on information certainty; and, under a high penalty, delay rate was actually much lower when information was uncertain. To explain the latter, we propose that people use a strategy for resolving choice under uncertainty that does not require establishing a confident preference for each value of the missing information. These findings are related to others in which choice difficulty has been found to be a major source of delay.

[Influence of waiting time on patient and companion satisfaction].

Science.gov (United States)

Fontova-Almató, A; Juvinyà-Canal, D; Suñer-Soler, R

2015-01-01

To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Prospective, observational study. Hospital de Figueres Emergency Department (Girona, Spain). sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). Perceived waiting time and the information about estimated waiting time determined overall satisfaction. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Astrophysical site(s of r-process elements in galactic chemodynamical evolution model

Directory of Open Access Journals (Sweden)

Hirai Yutaka

2016-01-01

Full Text Available Astrophysical site(s of rapid neutron-capture process (r-process is (are not identified yet. Although core-collapse supernovae have been regarded as one of the possible candidates of the astrophysical site of r-process, nucleosynthesis studies suggest that serious difficulties in core-collapse supernovae to produce heavy elements with mass number of ≳110. Recent studies show that neutron star mergers (NSMs can synthesize these elements due to their neutron rich environment. Some chemical evolution studies of the Milky Way halo, however, hardly reproduce the observed star-to-star scatters of the abundance ratios of r-process elements (e.g., Eu in extremely metal-poor stars. This is because of their low rate (∼ 10−4 yr−1 for a Milky Way size galaxy and long merger time (≳ 100 Myr. This problem might be solved if the stars in the Galactic halo are consisted of the stars formed in dwarf galaxies where the star formation efficiencies were very low. In this study, we carry out numerical simulations of galactic chemo-dynamical evolution using an N-body/smoothed particle hydrodynamics code. We construct detailed chemo-dynamical evolution model for the Local Group dwarf spheroidal galaxies (dSphs assuming that the NSMs are the major source of r-process elements. Our models successfully reproduce the observed dispersion in [Eu/Fe] as a function of [Fe/H] if we set merger time of NSMs, ≲ 300 Myr with the Galactic NSM rate of ∼ 10−4 yr−1. In addition, our results are consistent with the observed metallicity distribution of dSphs. In the early phase (≲1 Gyr of galaxy evolution is constant due to low star formation efficiency of dSphs. This study supports the idea that NSMs are the major site of r-process nucleosynthesis.

Analysis of emergency department waiting lines

Directory of Open Access Journals (Sweden)

Urška Močnik

2014-10-01

Full Text Available Background: Steady increase in the numbers of patients seeking medical assistance has recently been observed at the emergency department of the health center under study. This has led to increases in waiting times for patients. The management of the health center has been considering to implement certain measures to remedy this situation. One proposed solution is to add an additional physician to the emergency department. A computer model was constructed to simulate waiting lines and analyze the economic feasibility of employing an additional physician.Aim: This paper analyzes the waiting lines at the emergency department and performs an economic feasibility study to determine whether adding an additional physician to the department would be economically justified.Methods: Data about waiting times at the emergency department were collected to study the situation. For each patient, the arrival time at the waiting room and the starting and ending times of the examination were registered. The data were collected from 13 June 2011 to 25 September 2011. The sample included data on 65 nightly standbys, nine standbys on Saturdays, and 16 standbys on Sundays. Due to incomplete entries, data for nine weekly standbys and six Saturday standbys were excluded from the sample. Based on the data collected, we calculated the waiting and examination times per patient, average number of patients, average waiting time, average examination time, share of active standby teams in total standby time, and number of patients in different time periods. The study involved 1,039 patients. Using a synthesis method, we designed a computer model of waiting lines and economic feasibility. The model was validated using comparative analysis. A what-if analysis was performed using various computer simulations with various scenarios to consider the outcomes of decision alternatives. We applied economic analysis to select the best possible solution.Results: The research results

Determinants of variability in waiting times for radiotherapy in the treatment of breast cancer

International Nuclear Information System (INIS)

Bouche, Gauthier; Ingrand, Isabelle; Mathoulin-Pelissier, Simone; Ingrand, Pierre; Breton-Callu, Christel; Migeot, Virginie

2010-01-01

Purpose: To examine psycho-social and geographic determinants of delay in starting radiotherapy in early invasive breast cancer patients. Material and methods: Waiting time was defined as the time elapsed until the beginning of radiotherapy, starting from the date of surgery (in absence of chemotherapy) or from the end of chemotherapy. Results: Eight hundred and ninety six women aged 24-89 took part in the study. Mean waiting times were 52 days (sd = 19) between surgery and radiotherapy and 31 days (sd = 14) between chemotherapy and radiotherapy. Differences between radiotherapy centres (p < 0.0001) accounted for 30% and 12%, respectively, of total variance in waiting times. Using a multivariate mixed analysis that took into account intra-centre correlation, the time between surgery and radiotherapy was shorter for young patients (p = 0.020), those who had sought information about their illness (p = 0.024) and those who had undergone surgery and radiotherapy in the same centre (p = 0.021). On the other hand, no patient characteristic was associated with the time between chemotherapy and radiotherapy. Conclusion: Centre is the major factor that explained longer waiting times in radiotherapy, emphasising the structural hypothesis. It is important to pursue initiatives to improve the organization within radiotherapy centres and then to verify that these initiatives have succeeded in shortening waiting times.

Understanding r-process nucleosynthesis with dwarf galaxies

Science.gov (United States)

Ji, Alexander P.

2018-06-01

The Milky Way's faintest dwarf galaxy satellites each sample short, independent bursts of star formation from the first 1-2 Gyr of the universe. Their simple formation history makes them ideal systems to understand how rare events like neutron star mergers contribute to early enrichment of r-process elements. I will focus on the ultra-faint galaxy Reticulum II, which experienced a single prolific r-process event that left ~80% of its stars extremely enriched in r-process elements. I will present abundances of ~40 elements derived from the highest signal-to-noise high-resolution spectrum ever taken for an ultra-faint dwarf galaxy star. Precise measurements of elements from all three r-process peaks reaffirm the universal nature of the r-process abundance pattern from Ba to Ir. The first r-process peak is significantly lower than solar but matches other r-process enhanced stars. This constrains the neutron-richness of r-process ejecta in neutron star mergers. The radioactive element thorium is detected with a somewhat low abundance. Naive application of currently predicted initial production ratios could imply an age >20 Gyr, but more likely indicates that the initial production ratios require revision. The abundance of lighter elements up to Zn are consistent with extremely metal-poor Milky Way halo stars. These elements may eventually provide a way to test for other hypothesized r-process sites, but only after a more detailed understanding of the chemical evolution in this galaxy. Reticulum II provides a clean view of early r-process enrichment that can be used to understand the increasing number of r-process measurements in other dwarf galaxies.

Patients' perceptions of waiting for bariatric surgery: a qualitative study.

Science.gov (United States)

Gregory, Deborah M; Temple Newhook, Julia; Twells, Laurie K

2013-10-18

In Canada waiting lists for bariatric surgery are common, with wait times on average > 5 years. The meaning of waiting for bariatric surgery from the patients' perspective must be understood if health care providers are to act as facilitators in promoting satisfaction with care and quality care outcomes. The aims of this study were to explore patients' perceptions of waiting for bariatric surgery, the meaning and experience of waiting, the psychosocial and behavioral impact of waiting for treatment and identify health care provider and health system supportive measures that could potentially improve the waiting experience. Twenty-one women and six men engaged in in-depth interviews that were digitally recorded, transcribed verbatim and analysed using a grounded theory approach to data collection and analysis between June 2011 and April 2012. The data were subjected to re-analysis to identify perceived health care provider and health system barriers to accessing bariatric surgery. Thematic analysis identified inequity as a barrier to accessing bariatric surgery. Three areas of perceived inequity were identified from participants' accounts: socioeconomic inequity, regional inequity, and inequity related to waitlist prioritization. Although excited about their acceptance as candidates for surgery, the waiting period was described as stressful, anxiety provoking, and frustrating. Anger was expressed towards the health care system for the long waiting times. Participants identified the importance of health care provider and health system supports during the waiting period. Recommendations on how to improve the waiting experience included periodic updates from the surgeon's office about their position on the wait list; a counselor who specializes in helping people going through this surgery, dietitian support and further information on what to expect after surgery, among others. Patients' perceptions of accessing and waiting for bariatric surgery are shaped by perceived

Helium-driven r-process in supernovae

International Nuclear Information System (INIS)

Truran, J.W.; Cowan, J.J.; Cameron, A.G.W.

1978-01-01

The discovery of r-process anomalies in two inclusions in the Allende meteorite, together with their associated oxygen and magnesium anomalies, has caused us to examine the consequences of supernova shocks in the helium zones of massive stars. We find that powerful r-processes can operate under such conditions. The details of these processes will vary in different stellar masses. The studied Allende inclusions apparently did not receive material which had been very extensively r-processed

Nuclear structure and weak rates of heavy waiting point nuclei under rp-process conditions

Science.gov (United States)

Nabi, Jameel-Un; Böyükata, Mahmut

2017-01-01

The structure and the weak interaction mediated rates of the heavy waiting point (WP) nuclei 80Zr, 84Mo, 88Ru, 92Pd and 96Cd along N = Z line were studied within the interacting boson model-1 (IBM-1) and the proton-neutron quasi-particle random phase approximation (pn-QRPA). The energy levels of the N = Z WP nuclei were calculated by fitting the essential parameters of IBM-1 Hamiltonian and their geometric shapes were predicted by plotting potential energy surfaces (PESs). Half-lives, continuum electron capture rates, positron decay rates, electron capture cross sections of WP nuclei, energy rates of β-delayed protons and their emission probabilities were later calculated using the pn-QRPA. The calculated Gamow-Teller strength distributions were compared with previous calculation. We present positron decay and continuum electron capture rates on these WP nuclei under rp-process conditions using the same model. For the rp-process conditions, the calculated total weak rates are twice the Skyrme HF+BCS+QRPA rates for 80Zr. For remaining nuclei the two calculations compare well. The electron capture rates are significant and compete well with the corresponding positron decay rates under rp-process conditions. The finding of the present study supports that electron capture rates form an integral part of the weak rates under rp-process conditions and has an important role for the nuclear model calculations.

Practical Solutions for Reducing Container Ships’ Waiting Times at Ports Using Simulation Model

Institute of Scientific and Technical Information of China (English)

Abdorreza Sheikholeslami; Gholamreza Ilati; Yones Eftekhari Yeganeh

2013-01-01

The main challenge for container ports is the planning required for berthing container ships while docked in port. Growth of containerization is creating problems for ports and container terminals as they reach their capacity limits of various resources which increasingly leads to traffic and port congestion. Good planning and management of container terminal operations reduces waiting time for liner ships. Reducing the waiting time improves the terminal’s productivity and decreases the port difficulties. Two important keys to reducing waiting time with berth allocation are determining suitable access channel depths and increasing the number of berths which in this paper are studied and analyzed as practical solutions. Simulation based analysis is the only way to understand how various resources interact with each other and how they are affected in the berthing time of ships. We used the Enterprise Dynamics software to produce simulation models due to the complexity and nature of the problems. We further present case study for berth allocation simulation of the biggest container terminal in Iran and the optimum access channel depth and the number of berths are obtained from simulation results. The results show a significant reduction in the waiting time for container ships and can be useful for major functions in operations and development of container ship terminals.

Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

Science.gov (United States)

Liu, Jiming; Tao, Li; Xiao, Bo

2011-01-01

Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU). This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p relationships among different characteristics (except for the effect of throughput on wait time in SU). Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

ACToR Chemical Structure processing using Open Source ...

Science.gov (United States)

ACToR (Aggregated Computational Toxicology Resource) is a centralized database repository developed by the National Center for Computational Toxicology (NCCT) at the U.S. Environmental Protection Agency (EPA). Free and open source tools were used to compile toxicity data from over 1,950 public sources. ACToR contains chemical structure information and toxicological data for over 558,000 unique chemicals. The database primarily includes data from NCCT research programs, in vivo toxicity data from ToxRef, human exposure data from ExpoCast, high-throughput screening data from ToxCast and high quality chemical structure information from the EPA DSSTox program. The DSSTox database is a chemical structure inventory for the NCCT programs and currently has about 16,000 unique structures. Included are also data from PubChem, ChemSpider, USDA, FDA, NIH and several other public data sources. ACToR has been a resource to various international and national research groups. Most of our recent efforts on ACToR are focused on improving the structural identifiers and Physico-Chemical properties of the chemicals in the database. Organizing this huge collection of data and improving the chemical structure quality of the database has posed some major challenges. Workflows have been developed to process structures, calculate chemical properties and identify relationships between CAS numbers. The Structure processing workflow integrates web services (PubChem and NIH NCI Cactus) to d

Prediction problem for target events based on the inter-event waiting time

Science.gov (United States)

Shapoval, A.

2010-11-01

In this paper we address the problem of forecasting the target events of a time series given the distribution ξ of time gaps between target events. Strong earthquakes and stock market crashes are the two types of such events that we are focusing on. In the series of earthquakes, as McCann et al. show [W.R. Mc Cann, S.P. Nishenko, L.R. Sykes, J. Krause, Seismic gaps and plate tectonics: seismic potential for major boundaries, Pure and Applied Geophysics 117 (1979) 1082-1147], there are well-defined gaps (called seismic gaps) between strong earthquakes. On the other hand, usually there are no regular gaps in the series of stock market crashes [M. Raberto, E. Scalas, F. Mainardi, Waiting-times and returns in high-frequency financial data: an empirical study, Physica A 314 (2002) 749-755]. For the case of seismic gaps, we analytically derive an upper bound of prediction efficiency given the coefficient of variation of the distribution ξ. For the case of stock market crashes, we develop an algorithm that predicts the next crash within a certain time interval after the previous one. We show that this algorithm outperforms random prediction. The efficiency of our algorithm sets up a lower bound of efficiency for effective prediction of stock market crashes.

Enrichment of r-Process Elements by Neutron Star Mergers through the Sub-Halo Clustering

Science.gov (United States)

Ishimaru, Yuhri; Ojima, Takuya; Wanajo, Shinya; Prantzos, Nikos

Neutron star mergers (NSMs) are suggested to be the most plausible site of r-process by nucleosynthesis studies, while previous chemical evolution models pointed out that the long lifetimes of NS binaries are in conflict with the observed [r/Fe] of the Galactic halo stars. We attempt to solve this problem, assuming the Galactic halo was formed from merging sub-halos. We find that [r/Fe] start increasing at [Fe/H] < -3, if the star formation efficiencies are smaller for less massive sub-halos. We also show that small numbers of NSMs for least massive sub-halos could cause the large enhancement of [r/Fe]. Our results support NSMs as the major site of r-process.

Colour Consideration for Waiting areas in hospitals

Science.gov (United States)

Zraati, Parisa

2012-08-01

Colour is one the most important factors in the nature that can have some affects on human behaviour. Many years ago, it was proven that using colour in public place can have some affect on the users. Depend of the darkness and lightness; it can be vary from positive to negative. The research will mainly focus on the colour and psychological influences and physical factors. The statement of problem in this research is what is impact of colour usually applied to waiting area? The overall aim of the study is to explore the visual environment of hospitals and to manage the colour psychological effect of the hospital users in the waiting area by creating a comfortable, pleasant and cozy environment for users while spend their time in waiting areas. The analysisconcentrate on satisfaction and their interesting regarding applied colour in two private hospital waiting area in Malaysia.

Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

Directory of Open Access Journals (Sweden)

Jiming Liu

Full Text Available INTRODUCTION: Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU on the wait time of cardiac surgery unit (SU. METHODS: This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. RESULTS: Results show that: (i wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01; (ii capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01; (iii within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU. CONCLUSION: Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

The determinants of patient waiting time in the general outpatient department of Debre Markos and Felege Hiwot hospitals in Amhara regional state, North West, Ethiopia

Directory of Open Access Journals (Sweden)

Melesse Belayneh

2017-01-01

Full Text Available Background Patient waiting time is defined as the total time from registration until consultation with a doctor. Experiences of waiting in general are perceived as complex, subjective, and culturally influenced. Registration time, payment process/cash billing, recording classification/triaged time, few human resources and work process are the determinants of patient waiting time in the general outpatient departments. However, the complexity of wait time is poorly understood and has been explored only to a limited extent. The main objective of this study to assess patient waiting time and its determinants in Debre Markos and Felge Hiwot Referral hospitals of Amhara Regional State in North West, Ethiopia. Methods A hospital based comparative cross sectional study design was employed from October 20‐ November 20, 2014. The study population was patients presenting to general outpatient departments, from which 464 patients was selected using systematic random sampling technique. Quantitative Data was collected using structured questionnaire and A check list adopted from studies. Quantitative data was coded, entered, cleaned and analyzed using SPSS Software for windows version 20.0. Linear regression and bivariate logistic regression was applied to identify the determinants of each explanatory variable on outcome (patient waiting time. Finally data was interpreted by referring to the pertinent findings from the relevant literature reviewed. Ethical approval and clearance was obtained from ethical clearance committee of the Jimma University College of Public Health & Medical Sciences Result The measured waiting time in Felge Hiwot referral hospital mean waiting time was and its standard deviation 149.2±72.1 minutes whereas 94.2±58.3 minutes in debere markos referral hospital. The major causes of the long patient waiting time was large numbers of patient with a few doctors 94(40.5%,67(28.9% ,long searching of the cards 67(28.9%,73(31.5,and long

Ultrasound waiting lists: rational queue or extended capacity?

Science.gov (United States)

Brasted, Christopher

2008-06-01

The features and issues regarding clinical waiting lists in general and general ultrasound waiting lists in particular are reviewed, and operational aspects of providing a general ultrasound service are also discussed. A case study is presented describing a service improvement intervention in a UK NHS hospital's ultrasound department, from which arises requirements for a predictive planning model for an ultrasound waiting list. In the course of this, it becomes apparent that a booking system is a more appropriate way of describing the waiting list than a conventional queue. Distinctive features are identified from the literature and the case study as the basis for a predictive model, and a discrete event simulation model is presented which incorporates the distinctive features.

Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

Energy Technology Data Exchange (ETDEWEB)

Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

2016-11-15

We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

How to share concurrent asynchronous wait-free variables: Preliminary version

NARCIS (Netherlands)

M. Li (Ming); P.M.B. Vitányi (Paul)

1989-01-01

textabstractWe use a structured top-down approach to develop algorithms for atomic variables shared by concurrent asynchronous wait-free processes, starting from the problem specification. By this design we obtain a better understanding of what the algorithms do, why they do it, and that they

The Effects of Immigration on NHS Waiting Times

OpenAIRE

Giuntella, Osea; Nicodemo, Catia; Vargas-Silva, Carlos

2015-01-01

This paper analyses the effects of immigration on waiting times in the National Health Service (NHS) in England. Linking administrative records from the Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labour Force Survey, we find that immigration reduced waiting times for outpatient referrals and did not have significant effects on waiting times in Accident and Emergency (A&E) and elective care. These results are explained by the fact that immigration increases...

Asymptotic inference for waiting times and patiences in queues with abandonment

DEFF Research Database (Denmark)

Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

2009-01-01

Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about waiting time and patience distributions in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

R -process Element Cosmic Rays from Neutron Star Mergers

Energy Technology Data Exchange (ETDEWEB)

Komiya, Yutaka; Shigeyama, Toshikazu [Research Center for the Early Universe, Graduate School of Science, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, 113-0033, Tokyo (Japan)

2017-09-10

Neutron star mergers (NSMs) are one of the most plausible sources of r -process elements in the universe. Therefore, NSMs can also be a major source of ultra-heavy elements in cosmic rays. In this paper, we first estimate the contribution of r -process elements synthesized in NSMs to the ultra-heavy element cosmic rays (UHCRs) by calculating transport equations that take into account energy loss processes and spallations. We show that the flux of UHCRs accelerated by the NSMs themselves fluctuates by many orders of magnitude on a timescale of several million years and can overwhelm UHCRs accelerated by supernova remnants (SNRs) after an NSM takes place within a few kiloparsec from the solar system. Experiments with very long exposure times using meteorites as UHCR detectors can detect this fluctuation. As a consequence, we show that if NSMs are the primary source of UHCRs, future experiments using meteorites may be able to reveal the event history of NSMs in the solar vicinity. We also describe a possible difference in the abundance pattern and energy spectrum of UHCRs between NSM and SNR accelerations.

Waiting time distribution in M/D/1 queueing systems

DEFF Research Database (Denmark)

Iversen, Villy Bæk; Staalhagen, Lars

1999-01-01

The well-known formula for the waiting time distribution of M/D/1 queueing systems is numerically unsuitable when the load is close to 1.0 and/or the results for a large waiting time are required. An algorithm for any load and waiting time is presented, based on the state probabilities of M/D/1...

The boarding experience from the patient perspective: the wait.

Science.gov (United States)

Liu, Shan; Milne, Leslie; Yun, Brian; Walsh, Kathleen

2015-11-01

We sought to better understand the experience of being a boarder patient. We conducted a qualitative study between March and August 2012 to examine the experience of boarding in an urban, teaching hospital emergency department (ED). We included boarder patients and selected patients based on a convenience sample. Interviews were semistructured, consisting of eight main open-ended questions. Interviews were transcribed; codes were generated and then organised into categorises and subsequently into one theme. We concluded analysis when we achieved thematic saturation. Our institutional review board approved this study. Our final sample included 18 patients. The average age was 62.3 years. Patients characterised waiting as central to their experience as a boarder patient. One patient stated, "Well if you have to wait for a bed you have to wait for a bed, it's terrible." Three categories exemplified this waiting experience: (1) there was often lack of communication; (2) patients experienced frustration during this waiting period; and yet (3) patients often differentiated the experience of waiting from the care they were receiving. Being a boarder patient was characterised as a waiting experience associated with poor communication and frustration. However, patients may still differentiate their feelings towards the wait from those towards the medical care they are receiving. Our data add more reason to eradicate the practice of ED boarding. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Asymptotic inference for waiting times and patiences in queues with abandonment

DEFF Research Database (Denmark)

Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about the waiting time and patience distribution in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

Waiting Online: A Review and Research Agenda.

Science.gov (United States)

Ryan, Gerard; Valverde, Mireia

2003-01-01

Reviews 21 papers based on 13 separate empirical studies on waiting on the Internet, drawn from the areas of marketing, system response time, and quality of service studies. The article proposes an agenda for future research, including extending the range of research methodologies, broadening the definition of waiting on the Internet, and…

VHA Support Service Center Electronic Wait List (EWL)

Data.gov (United States)

Department of Veterans Affairs — The goal of the Electronic Wait List (EWL) is to provide care to the patient as quickly as possible. To facilitate this goal, patients may be placed on a Wait List...

Parental strategies for assisting children to wait.

Science.gov (United States)

Cuskelly, Monica; Jobling, Anne; Gilmore, Linda; Glenn, Sheila

2006-09-01

This study examined parents' behaviours as they waited with their child. Children were presented with an attractively wrapped gift and then asked not to touch it until the experimenter returned from finishing some work in another room. Three parent groups and their children participated in the study - parents of children with Down syndrome, parents of children with intellectual disability from another cause, and parents of children who were developing typically. There were no significant differences between children in how long they were able to wait before touching the gift. The data from the first two groups were combined for all analyses after it was established that there were no significant differences between them. There were few significant differences between parents of a child with intellectual disability and comparison parents. The former group were more likely to be classified as Authoritarian than were comparison parents, however with one exception, parenting style was unrelated to the strategies parents used in the waiting situation. Very few parents in either group used the opportunity to teach or explicitly praise effective waiting strategies in their children.

EVALUTION OF THE SINGLE INTERCITY FREIGHT TRANSPORTATION WAITING TIME

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N. Ponomariova

2015-07-01

Full Text Available The example of vechicle operation on the pendulum intercity route during single freightages processing is considered. Two approaches to the definition of the single freightage waiting time by the carrier are proposed. These approaches allow to take into account the probability of the single freightage obtaining by the carrier during the different load level of the transport enterprise capacity.

Maternity waiting homes in Rural Health Centers of Ethiop: The ...

African Journals Online (AJOL)

Conclusions: It is necessary to prepare guidelines for the establishment and management of waiting homes as well as set up admission and discharge criteria and to initiate quality control mechanisms. Keywords: Maternity waiting homes, waiting homes, prenatal care, intention to stay postpartum, postpartum care, Ethiopia, ...

The design and testing of interactive hospital spaces to meet the needs of waiting children.

Science.gov (United States)

Biddiss, Elaine; McPherson, Amy; Shea, Geoffrey; McKeever, Patricia

2013-01-01

To design an innovative interactive media display in a pediatric hospital clinic waiting space that addresses the growing demand for accessible, contact-surface-free options for play. In healthcare settings, waiting can be anxiety provoking for children and their accompanying family members. Opportunities for positive distraction have been shown to reduce waiting anxiety, leading to positive health outcomes. An interactive media display, ScreenPlay, was created and evaluated using a participatory design approach and a combination of techniques including quality function deployment and mixed data elicitation methods (questionnaires, focus groups, and observations). The user and organizational design requirements were established and used to review contemporary strategies for positive distraction in healthcare waiting spaces and to conceptualize and test ScreenPlay. Ten staff members, 11 children/youths, and 6 parents participated in the design and evaluation of ScreenPlay. ScreenPlay provided a positive, engaging experience without the use of contact surfaces through which infections can be spread. It was accessible to children, youth, and adults of all motor abilities. All participants strongly agreed that the interactive media display would improve the healthcare waiting experience. ScreenPlay is an interactive display that is the result of a successful model for the design of healthcare waiting spaces that is collaborative, interdisciplinary, and responsive to the needs of its community. Design process, healing environments, hospital, interdisciplinary, pediatric.

Negative Binomial charts for monitoring high-quality processes

NARCIS (Netherlands)

Albers, Willem/Wim

Good control charts for high quality processes are often based on the number of successes between failures. Geometric charts are simplest in this respect, but slow in recognizing moderately increased failure rates p. Improvement can be achieved by waiting until r > 1 failures have occurred, i.e. by

Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost.

Science.gov (United States)

Kim, Byungjoon B J; Delbridge, Theodore R; Kendrick, Dawn B

2017-07-10

Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value A new streaming scheme of patients' flow may improve the performance of fast track system.

wait and wipe

African Journals Online (AJOL)

and wipe strategy” as an alternative to circumcision for HIV prevention. In this paper, we argue that waiting for ten minutes and wiping with a dry cloth does not prevent men from becoming infected by HIV. We ... HIV infected despite having reported no sex or 100% condom .... In a qualitative study conducted in Kenya, men.

Canadian Consensus on Medically Acceptable Wait Times for Digestive Health Care

Directory of Open Access Journals (Sweden)

William G Paterson

2006-01-01

Full Text Available BACKGROUND: Delays in access to health care in Canada have been reported, but standardized systems to manage and monitor wait lists and wait times, and benchmarks for appropriate wait times, are lacking. The objective of the present consensus was to develop evidence- and expertise-based recommendations for medically appropriate maximal wait times for consultation and procedures by a digestive disease specialist.

The r-process nucleosynthesis: Nuclear physics challenges

Energy Technology Data Exchange (ETDEWEB)

Goriely, S. [Institut d' Astronomie et d' Astrophysique, Universite Libre de Bruxelles Campus de la Plaine, CP 226, 1050 Brussels (Belgium)

2012-10-20

About half of the nuclei heavier than iron observed in nature are produced by the socalled rapid neutron capture process, or r-process, of nucleosynthesis. The identification of the astrophysics site and the specific conditions in which the r-process takes place remains, however, one of the still-unsolved mysteries of modern astrophysics. Another underlying difficulty associated with our understanding of the r-process concerns the uncertainties in the predictions of nuclear properties for the few thousands exotic neutron-rich nuclei involved and for which essentially no experimental data exist. The present contribution emphasizes some important future challenges faced by nuclear physics in this problem, particularly in the determination of the nuclear structure properties of exotic neutron-rich nuclei as well as their radiative neutron capture rates and their fission probabilities. These quantities are particularly relevant to determine the composition of the matter resulting from the r-process. Their impact on the r-abundance distribution resulting from the decompression of neutron star matter is discussed.

The R package EchoviewR for automated processing of active acoustic data using Echoview

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Lisa-Marie Katarina Harrison

2015-02-01

Full Text Available Acoustic data is time consuming to process due to the large data size and the requirement to often undertake some data processing steps manually. Manual processing may introduce subjective, irreproducible decisions into the data processing work flow, reducing consistency in processing between surveys. We introduce the R package EchoviewR as an interface between R and Echoview, a commercially available acoustic processing software package. EchoviewR allows for automation of Echoview using scripting which can drastically reduce the manual work required when processing acoustic surveys. This package plays an important role in reducing subjectivity in acoustic data processing by allowing exactly the same process to be applied automatically to multiple surveys and documenting where subjective decisions have been made. Using data from a survey of Antarctic krill, we provide two examples of using EchoviewR: krill estimation and swarm detection.

Effect of emergency physician burnout on patient waiting times.

Science.gov (United States)

De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

2018-04-01

Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24-49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39-1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.

Moderate alcohol consumption and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbaek, Morten

2001-01-01

BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time to pregna...

Enhancing outpatient clinics management software by reducing patients’ waiting time

Directory of Open Access Journals (Sweden)

Iman Almomani

2016-11-01

Full Text Available Summary: The Kingdom of Saudi Arabia (KSA gives great attention to improving the quality of services provided by health care sectors including outpatient clinics. One of the main drawbacks in outpatient clinics is long waiting time for patients—which affects the level of patient satisfaction and the quality of services. This article addresses this problem by studying the Outpatient Management Software (OMS and proposing solutions to reduce waiting times. Many hospitals around the world apply solutions to overcome the problem of long waiting times in outpatient clinics such as hospitals in the USA, China, Sri Lanka, and Taiwan. These clinics have succeeded in reducing wait times by 15%, 78%, 60% and 50%, respectively. Such solutions depend mainly on adding more human resources or changing some business or management policies. The solutions presented in this article reduce waiting times by enhancing the software used to manage outpatient clinics services. Both quantitative and qualitative methods have been used to understand current OMS and examine level of patient’s satisfaction. Five main problems that may cause high or unmeasured waiting time have been identified: appointment type, ticket numbering, doctor late arrival, early arriving patient and patients’ distribution list. These problems have been mapped to the corresponding OMS components. Solutions to the above problems have been introduced and evaluated analytically or by simulation experiments. Evaluation of the results shows a reduction in patient waiting time. When late doctor arrival issues are solved, this can reduce the clinic service time by up to 20%. However, solutions for early arriving patients reduces 53.3% of vital time, 20% of the clinic time and overall 30.3% of the total waiting time. Finally, well patient-distribution lists make improvements by 54.2%. Improvements introduced to the patients’ waiting time will consequently affect patients’ satisfaction and improve

Neutron Star Mergers and the R process

Science.gov (United States)

Joniak, Ronald; Ugalde, Claudio

2017-09-01

About half of the elements of the periodic table that are present today in the Solar System were synthesized before the formation of the Sun via a rapid neutron capture process (r process). However, the astrophysical site of the r process is a longstanding problem that has captivated both experimental and theoretical astrophysicists. Up to date, two possible scenarios for the site of the r process have been suggested: the first involves the high entropy wind of core collapse supernovae, and the second corresponds to the merger of two compact stellar objects such as neutron stars. We will study the robustness of the nucleosynthesis abundance pattern between the second and third r process peaks as produced by neutron star mergers with r process-like neutron exposures. First, we will vary parameters to obtain an understanding of the astrophysical mechanisms that create the r process. Next, we will create a program to obtain the best possible parameters based on a chi-squared test. Once we have the best fits, we will test the effect of fission in the overall isotope abundance pattern distribution. Later on, we will vary the ratio of masses of the two fission fragments and study its effect on elemental abundances. This research was supported by the UIC College of Liberal Arts and Sciences Undergraduate Research Initiative (LASURI).

Reducing pharmacy wait time to promote customer service: a follow-up study.

Science.gov (United States)

Slowiak, Julie M; Huitema, Bradley E

2015-01-01

The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

Moderate alcohol consumption and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbæk, Morten

2001-01-01

BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time...... to pregnancy (0-2, 3-5, 6-12 and >12 months) was used for 39 612 pregnant women, recruited to the Danish National Birth Cohort within the first 24 weeks of pregnancy from 1997 to 2000. Main outcome measures were odds ratios (OR) for a prolonged waiting time to pregnancy according to alcohol intake. RESULTS......: In nulliparous women neither moderate nor high alcohol intake was related with longer waiting time to pregnancy compared with a low intake. In parous women, a modest association was seen only among those with an intake of >14 drinks per week (subfecundity OR 1.3; 95% confidence interval 1.0-1.7). Women who...

Space, place and (waiting) time: reflections on health policy and politics.

Science.gov (United States)

Sheard, Sally

2018-02-19

Health systems have repeatedly addressed concerns about efficiency and equity by employing trans-national comparisons to draw out the strengths and weaknesses of specific policy initiatives. This paper demonstrates the potential for explicit historical analysis of waiting times for hospital treatment to add value to spatial comparative methodologies. Waiting times and the size of the lists of waiting patients have become key operational indicators. In the United Kingdom, as National Health Service (NHS) financial pressures intensified from the 1970s, waiting times have become a topic for regular public and political debate. Various explanations for waiting times include the following: hospital consultants manipulate NHS waiting lists to maintain their private practice; there is under-investment in the NHS; and available (and adequate) resources are being used inefficiently. Other countries have also experienced ongoing tensions between the public and private delivery of universal health care in which national and trans-national comparisons of waiting times have been regularly used. The paper discusses the development of key UK policies, and provides a limited Canadian comparative perspective, to explore wider issues, including whether 'waiting crises' were consciously used by policymakers, especially those brought into government to implement new economic and managerial strategies, to diminish the autonomy and authority of the medical professional in the hospital environment.

Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey.

Science.gov (United States)

Xie, Zhenzhen; Or, Calvin

2017-01-01

The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.

Advertising Emergency Department Wait Times

Directory of Open Access Journals (Sweden)

Scott G. Weiner

2013-03-01

Full Text Available Advertising emergency department (ED wait times has become a common practice in the UnitedStates. Proponents of this practice state that it is a powerful marketing strategy that can help steerpatients to the ED. Opponents worry about the risk to the public health that arises from a patient withan emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standarddefinition of the reported time, and directing lower acuity patients to the higher cost ED setting insteadto primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times arediscussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects tothe public health, caution about its use is advised

Application of Queueing Theory to the Analysis of Changes in Outpatients' Waiting Times in Hospitals Introducing EMR.

Science.gov (United States)

Cho, Kyoung Won; Kim, Seong Min; Chae, Young Moon; Song, Yong Uk

2017-01-01

This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.

Pricing in M/M/1 queues when cost of waiting in queue differs from cost of waiting in service

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Görkem Sarıyer

2016-11-01

Full Text Available Service providers can adjust the entrance price to the state of the demand in real life service systems where the customers' decision to receive the service, is based on this price, state of demand and other system parameters. We analyzed service provider's short and long term pricing problems in unobservable M/M/1 queues having the rational customers, where, for customers, the unit cost of waiting in the queue is higher than unit cost of waiting in the service. We showed that waiting in the queue has a clear negative effect on customers’ utilities, hence the service provider's price values. We also showed that, in the short term, monopolistic pricing is optimal for congested systems with high server utilization levels, whereas in the long term, market capturing pricing is more profitable.

Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management.

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Arnesen, Kjell E; Erikssen, Jan; Stavem, Knut

2002-12-01

In a system with implicit queue management, to examine gender and socioeconomic status as determinants of waiting time for inpatient surgery, after adjusting for other potential predictors. A cohort of 452 subjects was examined in outpatient clinics of a general hospital and referred to inpatient surgery. They were followed until scheduled hospital admission (n=396) or until the requested procedure no longer was relevant (n=56). We compared waiting time between groups from referral date until hospital admission, using Kaplan-Meier estimates of waiting times and log rank test. A Cox proportional hazards model was used for assessing the risk ratio (RR) of hospital admission for scheduled surgery. Gender and socioeconomic status could not explain variations in waiting time. However, patients with suspected/verified neoplastic disease or a risk of serious deterioration without treatment had markedly shorter waiting times than the reference groups, with adjusted RR (95% confidence intervals (95%CI)) of time to receiving in-patient surgery of 2.3 (1.7-3.0) and 2.0 (1.3-3.0), respectively. Being on sick leave was associated with shorter waiting time, adjusted RR of 1.7 (1.2-2.5). Referrals from within the hospital or other hospitals had also shorter waiting times than referrals from primary health care physicians, adjusted RR=1.4 (1.1-1.8). There was no evidence of bias against women or people in lower socioeconomic classes in this implicit queue management system. However, patients' access to inpatient surgery was associated with malignancy, prognosis, sick leave status, physician experience, referral pattern and the major diagnosis category.

Longer wait times affect future use of VHA primary care.

Science.gov (United States)

Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2017-07-29

Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

Waiting Endurance Time Estimation of Electric Two-Wheelers at Signalized Intersections

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Mei Huan

2014-01-01

Full Text Available The paper proposed a model for estimating waiting endurance times of electric two-wheelers at signalized intersections using survival analysis method. Waiting duration times were collected by video cameras and they were assigned as censored and uncensored data to distinguish between normal crossing and red-light running behavior. A Cox proportional hazard model was introduced, and variables revealing personal characteristics and traffic conditions were defined as covariates to describe the effects of internal and external factors. Empirical results show that riders do not want to wait too long to cross intersections. As signal waiting time increases, electric two-wheelers get impatient and violate the traffic signal. There are 12.8% of electric two-wheelers with negligible wait time. 25.0% of electric two-wheelers are generally nonrisk takers who can obey the traffic rules after waiting for 100 seconds. Half of electric two-wheelers cannot endure 49.0 seconds or longer at red-light phase. Red phase time, motor vehicle volume, and conformity behavior have important effects on riders’ waiting times. Waiting endurance times would decrease with the longer red-phase time, the lower traffic volume, or the bigger number of other riders who run against the red light. The proposed model may be applicable in the design, management and control of signalized intersections in other developing cities.

Waiting endurance time estimation of electric two-wheelers at signalized intersections.

Science.gov (United States)

Huan, Mei; Yang, Xiao-bao

2014-01-01

The paper proposed a model for estimating waiting endurance times of electric two-wheelers at signalized intersections using survival analysis method. Waiting duration times were collected by video cameras and they were assigned as censored and uncensored data to distinguish between normal crossing and red-light running behavior. A Cox proportional hazard model was introduced, and variables revealing personal characteristics and traffic conditions were defined as covariates to describe the effects of internal and external factors. Empirical results show that riders do not want to wait too long to cross intersections. As signal waiting time increases, electric two-wheelers get impatient and violate the traffic signal. There are 12.8% of electric two-wheelers with negligible wait time. 25.0% of electric two-wheelers are generally nonrisk takers who can obey the traffic rules after waiting for 100 seconds. Half of electric two-wheelers cannot endure 49.0 seconds or longer at red-light phase. Red phase time, motor vehicle volume, and conformity behavior have important effects on riders' waiting times. Waiting endurance times would decrease with the longer red-phase time, the lower traffic volume, or the bigger number of other riders who run against the red light. The proposed model may be applicable in the design, management and control of signalized intersections in other developing cities.

Advertising emergency department wait times.

Science.gov (United States)

Weiner, Scott G

2013-03-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

Advertising Emergency Department Wait Times

Science.gov (United States)

Weiner, Scott G.

2013-01-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

The relationship between waiting times and 'adherence' to the Scottish Intercollegiate Guidelines Network 98 guideline in autism spectrum disorder diagnostic services in Scotland.

Science.gov (United States)

McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda

2016-05-01

The aim of this study was to explore the extent to which the Scottish Intercollegiate Guidelines Network 98 guidelines on the assessment and diagnosis of autism spectrum disorder were adhered to in child autism spectrum disorder diagnostic services in Scotland and whether there was a significant relationship between routine practice which more closely reflected these recommendations (increased adherence) and increased waiting times. Retrospective, cross-sectional case note analysis was applied to data from 80 case notes. Adherence ranged from a possible 0 (no adherence) to 19 (full adherence). Overall, 17/22 of the recommendations were adhered to in over 50 of the 80 cases and in 70 or more cases for 11/22 of the recommendations, with a mean adherence score of 16 (standard deviation = 1.9). No significant correlation was found between adherence and total wait time for untransformed (r = 0.15, p = 0.32) or transformed data (r = 0.12, p = 0.20). The results indicated that the assessment and diagnostic practices were consistent with the relevant Scottish Intercollegiate Guidelines Network 98 guideline recommendations. Increased adherence to the 19 included recommendations was not significantly related to increased total waiting times, indicating that the Scottish Intercollegiate Guidelines Network 98 recommendations have generally been integrated into practice, without a resultant increase in patient waits. © The Author(s) 2015.

Indication criteria for cataract extraction and gender differences in waiting time.

Science.gov (United States)

Smirthwaite, Goldina; Lundström, Mats; Albrecht, Susanne; Swahnberg, Katarina

2014-08-01

The purpose of this study was to investigate national indication criteria tool for cataract extraction (NIKE), a clinical tool for establishing levels of indications for cataract surgery, in relation to gender differences in waiting times for cataract extraction (CE). Data were collected by The Swedish National Cataract Register (NCR). Eye clinics report to NCR voluntarily and on regular basis (98% coverage). Comparisons regarding gender difference in waiting times were performed between NIKE-categorized and non-NIKE-categorized patients, as well as between different indication groups within the NIKE-system. All calculations were performed in spss version 20. Multivariate analyses were carried out using logistic regression, and single variable analyses were carried out by Student's t-test or chi square as appropriate. Gender, age, visual acuity and NIKE-categorization were associated with waiting time. Female patients had a longer waiting time to CE than male, both within and outside the NIKE-system. Gender difference in waiting time was somewhat larger among patients who had not been categorized by NIKE. In the non-NIKE-categorized group, women waited 0.20 months longer than men. In the group which was NIKE-categorized, women waited 0.18 months longer than men. It is reasonable to assume that prioritizing patients by means of NIKE helps to reduce the gender differences in waiting time. Gender differences in waiting time have decreased as NIKE was introduced and there may be a variety of explanations for this. However, with the chosen study design, we could not distinguish between effects related to NIKE and those due to other factors which occurred during the study period. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Waiting for Merlot: anticipatory consumption of experiential and material purchases.

Science.gov (United States)

Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

2014-10-01

Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases. © The Author(s) 2014.

Impact of 'Ideal Clinic' implementation on patient waiting time in primary healthcare clinics in KwaZulu-Natal Province, South Africa: A before-and-after evaluation.

Science.gov (United States)

Egbujie, B A; Grimwood, A; Mothibi-Wabafor, E C; Fatti, G; Tshabalala, A M E T; Allie, S; Vilakazi, G; Oyebanji, O

2018-03-28

Long waiting times are a major source of dissatisfaction for patients attending public healthcare facilities in South Africa (SA). The National Department of Health has identified this as one of six priority areas for improvement. Health system-strengthening (HSS) interventions to improve patient waiting time are being implemented in public health facilities across SA as part of the 'Ideal Clinic' model. The effect of these interventions on patient waiting time needs to be assessed and evidence generated for system improvement. To determine the effect of Ideal Clinic HSS intervention on patient waiting time in public health facilities in Amajuba District, KwaZulu-Natal Province, SA. We implemented 12 months of HSS activity, including facility reorganisation and patient appointment scheduling. The major outcome of interest was the total time spent by patients in a facility during a visit. This was calculated as the median time spent, obtained through a 'before-and-after' intervention survey. Univariate and multivariate factors associated with waiting time were determined. A total of 1 763 patients from nine clinics were surveyed before and after the intervention (n=860 at baseline and n=903 at follow-up). The median overall waiting time after the intervention was 122 minutes (interquartile range (IQR) 81 - 204), compared with 116 minutes (IQR 66 - 168) before (p<0.05). Individual facility results after the intervention were mixed. Two facilities recorded statistically significant reductions in patient waiting time, while three recorded significant increases (p<0.05). Patient load per nurse, type of service received and time of arrival in facilities were all independently associated with waiting time. Patients' arrival patterns, which were determined by appointment scheduling, played a significant role in the results obtained. Implementation of the Ideal Clinic model in the selected facilities led to changes in patient waiting time. Observed changes were

Study on the interaction between the food and beverage servicescape and customer waiting experience

Directory of Open Access Journals (Sweden)

Yang, Chih-Yun

2014-11-01

Full Text Available Past research on the customer waiting experience tended to focus on two primary areas, namely managing the wait and managing the perception of the wait. Very few studies conducted in-depth analysis and discus¬sion of how external environmental factors affect the experience of customer waiting, which it was also viewed as a negative factor that decreases customer satisfaction toward service. However, in reality, the waiting experience can be positive as a result of certain environmental factors, and subsequently increases customer satisfaction toward the service. This study aimed to further examine the potential influencing factors arising from the servicescape during the customer waiting process, and the interaction between the servicescape and customers during their wait time. This paper is based on the causal feedback loop. A system dynamics perspective was applied to construct a conceptual systems model showing the interaction between the servi¬cescape and the customer waiting experience.Estudios previos sobre la experiencia de espera de los clients suelen centrarse sobre todo en dos áreas: la gestión de la espera y la gestión de la experiencia de espera. Existen muy pocos estudios que hayan realizado análisis y discusiones en profundidad sobre cómo los factores ambientales externos afectan a la experiencia de espera de los clientes, que se ha considerado siempre como un factor negativo que reduce la satisfacción del cliente hacia el servicio. Sin embargo, la experiencia de espera puede incrementar en reali¬dad la satisfacción del cliente hacia el servicio. Este estudio pretende profundizar en la influencia potencial de los factores que surgen del “servicescape” durante el proceso de espera del cliente, así como la interacción entre el “servicescape” y los clientes durante el tiempo de espera. Ese artículo se basa en el bucle de retroa¬limentación causal. Desde la perspectiva de la dinámica de sistemas se construye un

Waiting Lists for Radiation Therapy: A Case Study

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Singer Peter A

2001-04-01

Full Text Available Abstract Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.

Wait watchers: the application of a waiting list active management program in ambulatory care.

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de Belvis, Antonio Giulio; Marino, Marta; Avolio, Maria; Pelone, Ferruccio; Basso, Danila; Dei Tos, Gian Antonio; Cinquetti, Sandro; Ricciardi, Walter

2013-04-01

This study describes and evaluates the application of a waiting list management program in ambulatory care. Waiting list active management survey (telephone call and further contact); before and after controlled trial. Local Health Trust in Veneto Region (North-East of Italy) in 2008-09. Five hundred and one people on a 554 waiting list for C Class ambulatory care diagnostic and/or clinical investigations (electrocardiography plus cardiology ambulatory consultation, eye ambulatory consultation, carotid vessels Eco-color-Doppler, legs Eco-color-Doppler or colonoscopy, respectively). Active list management program consisting of a telephonic interview on 21 items to evaluate socioeconomic features, self-perceived health status, social support, referral physician, accessibility and patients' satisfaction. A controlled before-and-after study was performed to evaluate anonymously the overall impact on patients' self-perceived quality of care. The rate of patients with deteriorating healthcare conditions; rate of dropout; interviewed degree of satisfaction about the initiative; overall impact on citizens' perceived quality of care. 95.4% patients evaluated the initiative as useful. After the intervention, patients more likely to have been targeted with the program showed a statistically significant increase in self-reported quality of care. Positive impact of the program on some dimensions of ambulatory care quality (health status, satisfaction, willingness to remain in the queue), thus confirming the outstanding value of 'not to leave people alone' and 'not to leave them feeling themselves alone' in healthcare delivery.

Experimentally Determining β-Decay Intensities for 103,104Nb to Improve R-process Calculations

Science.gov (United States)

Gombas, J.; Deyoung, P. D.; Spyrou, A.; Dombos, A. C.; Lyons, S.; SuN Collaboration

2017-09-01

The rapid neutron capture process (r-process) is responsible for the formation of nuclei heavier than iron. This process is theorized to occur in supernovas and/or neutron star mergers. R-process calculations require the accurate knowledge of a significant amount of nuclear properties, the majority of which are not known experimentally. Nuclear masses, β-decay properties and neutron-capture reactions are all input ingredients into r-process models. This present study focuses on the β decay of 103Nb and 104Nb. The β decay of 103Nb and 104Nb, two nuclei found in the r-process, were observed at the NSCL using the Summing NaI (SuN) detector. An unstable beam implanted inside SuN. The γ rays were measured in coincidence with the emitted electrons. The β-decay intensity function was then extracted. The experimentally determined functions for 103Nb and 104Nb will be compared to predictions made by the Quasi Random Phase Approximation (QRPA) model. These theoretical calculations are used in astrophysical models of the r-process. This comparison will lead to a better understanding of the nuclear structure for 103Nb and 104Nb. A more dependable prediction of the formation of heavier nuclei birthed from supernovas or neutron star mergers can then be made. This material is based upon work supported by the National Science Foundation under Grant No. PHY-1613188 and PHY-1306074, and by the Hope College Department of Physics Guess Research Fund.

$\\beta$- decay of the N=Z, rp-process waiting points: $^{64}$Ge, $^{68}$Se and the N=Z+2: $^{66}$Ge, $^{70}$Se for accurate stellar weak-decay rates

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The contribution of electron capture to weak-decay rates has been neglected in model calculations of Type I X-ray bursts so far. Nucleosynthesis in these astrophysical events eventually proceeds through the rp-process near the proton drip-line. In particular, several N=Z nuclei such as $^{64}$Ge and $^{68}$Se act as waiting points in the nuclear flow due to the low S${_P}$ values of their Z+1 neighbours. Recent theoretical calculations have shown that, in these high density ($\\thicksim10^{6}$ g/cm$^3$) and high temperature (1 - 2 GK) scenarios, continuum electron capture rates might play an important role, in particular for species at and around these waiting point nuclei. This proposal is aimed at the study of the $\\beta^{+}$/EC-decay of the waiting point nuclei $^{64}$Ge, $^{68}$Se and their N=Z+2 second neighbours $^{66}$Ge and $^{70}$Se with the Total Absorption Spectroscopy method. This will allow for a detailed analysis of their contribution to the EC-decay rates in X-Ray burst explosions. The proposed ...

Magnetization processes in amorphous R-Co/R'-Co/R-Co sandwiches (R, R'=Y, Nd, Gd, Er)

International Nuclear Information System (INIS)

Dieny, B.; Givord, D.; Ndjaka, J.M.B.; Alameda, J.M.

1990-01-01

Sandwiches consisting of three amorphous layers (R 0.33 ,Co 0.67 )( 1000 A / R ' 0.33 ,Co 0.67 ) 1000 A / (R 0.33 Co 0.67 ) 1000 A , have been prepared by dc triode sputtering (R, R' are rare-earth elements). The systems chosen are such that the bulk magnetization alternates from one layer to the next or the coercivity of each layer is significantly different. Magnetic transitions are observed under field. They have been quantitatively analyzed in terms of successive reversals of magnetization in the different layers. The creation or annihilation of planar Bloch walls parallel to the surface are associated with the magnetic transitions. The wall energy and wall width depend essentially on the competition between exchange energy and Zeeman energy. It is suggested that the existence of such Bloch walls may favor magnetization reversal in thin films by coherent processes

Waiting in the surgery.

Science.gov (United States)

Fry, F

1994-07-01

The concise Oxford English Dictionary defines 'dilemma' as an argument forcing one to choose one of two alternatives, both of which are unfavourable. This is a situation that frequently confronts the general practitioner. This paper will present one practitioner's view on the subject of patients waiting to see the doctor.

Waiting narratives of lung transplant candidates.

Science.gov (United States)

Yelle, Maria T; Stevens, Patricia E; Lanuza, Dorothy M

2013-01-01

Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman's concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients' stories and hear what is most meaningful in their lives.

Waiting Narratives of Lung Transplant Candidates

Directory of Open Access Journals (Sweden)

Maria T. Yelle

2013-01-01

Full Text Available Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman’s concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients’ stories and hear what is most meaningful in their lives.

Estimating bus passenger waiting times from incomplete bus arrivals data

OpenAIRE

McLeod, F.N.

2007-01-01

This paper considers the problem of estimating bus passenger waiting times at bus stops using incomplete bus arrivals data. This is of importance to bus operators and regulators as passenger waiting time is a key performance measure. Average waiting times are usually estimated from bus headways, that is, time gaps between buses. It is both time-consuming and expensive to measure bus arrival times manually so methods using automatic vehicle location systems are attractive; however, these syste...

Protocol to Exploit Waiting Resources for UASNs

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Li-Ling Hung

2016-03-01

Full Text Available The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols.

IS WAITING THE HARDEST PART? A CRITICAL STUDY OF THE EXPERIENCE OF WOMEN AWAITING BREAST BIOPSY RESULTS.

Science.gov (United States)

Hodgkinson, T; Govender, C; Rayne, S

2017-06-01

Most previous research efforts have focused on the psychological effects of receiving a cancer diagnosis rather than the period of waiting for definitive Results. Early detection of cancer is directly linked to successful treatment regimes, yet these procedures evoke significant anxiety in patients. The long wait for medical test Results in state health institutions, with one of the possible outcomes being a cancer diagnosis, means that the days of waiting can induce emotional distress before the diagnosis has even been given. Eight research collaborators were invited to, in their own voice, shed light on their individual experiences while waiting for their biopsy Results to gain an understanding of the experiences of each collaborator by letting her tell her story and to explore the possibility of shared experience between collaborators. Research collaborators at a local, government hospital kept a journal for the two-week waiting period for their biopsy Results. Shortly before receiving their Results, they took part in a short semi-structured interview to inquire about their waiting. The theoretical framework used for data interpretation is critical theory focusing on the structures within society and healthcare systems that impact on the experience of waiting. The undercurrent of critical commentary about the roles of the gender, economic, political and cultural factors that contribute to the screening experience for women in South Africa helps to shed light on the complex forces at play within the procedures. The Results indicate that for some women waiting provokes significant psychological stress which manifests in multiple psychological processes including the psychological bracing phenomenon, denial, suppression and negation of their emotional experience all perpetuated by the structures of power within the health care system. More understanding of the psychological experience of awaiting a cancer diagnosis is required and there is an important place for

r-process nucleosynthesis in dynamic helium-burning environments

International Nuclear Information System (INIS)

Cowan, J.J.; Cameron, A.G.W.; Truran, J.W.

1985-01-01

The results of an extended examination of r-process nucleosynthesis in helium-burning environments are presented. Using newly calculated nuclear rates, dynamical r-process calculations have been made of thermal runaways in helium cores typical of low-mass stars and in the helium zones of stars undergoing supernova explosions. These calculations show that, for a sufficient flux of neutrons produced by the 13 C neutron source, r-process nuclei in solar proportions can be produced. The conditions required for r-process production are found to be: 10 20 --10 21 neutrons cm -3 for times of 0.01--0.1 s and neutron number densities in excess of 10 19 cm -3 for times of approx.1 s. The amount of 13 C required is found to be exceedingly high: larger than is found to occur in any current stellar evolutionary model. It is thus unlikely that these helium-burning environments are responsible for producing the bulk of the r-process elements seen in the solar system

A typical R and D center on radiation processing in China

International Nuclear Information System (INIS)

Sun Jlazhen

1995-01-01

The industrial application of radiation processing has been growing rapidly in China since 1980s in such fields as producing radiation-crosslinked heat shrinkable materials and radiation-crosslinked wires and cables, sterilization of medical products and so on. Changchun Institute of Applied Chemistry (CIAC) as one of the earliest organizations in which the fundamental research works on polymer radiation chemistry have been carried out has played a major role for the R and D of the radiation processing of polymers. From the R and D activities at CIAC, it can be seen how a Chinese research institute transfers its results of fundamental research works into large scale production. The improvement of the weakness of fluoropolymers by radiation crosslinking, the modification of the Charlesby-Pinner equation that describes the relationship of sol fraction to irradiation dose, the radiation grafting for preparing functional materials, the radiation crosslinking of polymer blends and the effect of antioxidant on the radiation crosslinking of polymers are reported. Also applied research works and the radiation processing at CIAC are described. (K.I.)

How Tolerable is Delay? Consumers' Evaluations of Internet Web Sites After Waiting

NARCIS (Netherlands)

Dellaert, B.G.C.; Kahn, B.

1998-01-01

How consumers’ waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative effects of waiting

Challenging "Waiting for Superman"

Science.gov (United States)

Bruhn, Molle

2014-01-01

A group of New York City public school teachers, angry about the depiction of public schools in 'Waiting for Superman," decide to make their own film about the realities of the current education reform movement. They persevered even though they had no budget when they started and lacked a background in filmmaking. "The Inconvenient Truth…

Chances of late surgery in relation to length of wait lists

Directory of Open Access Journals (Sweden)

Levy Adrian R

2005-09-01

Full Text Available Abstract Background The proportion of patients who undergo surgery within a clinically safe time is an important performance indicator in health systems that use wait lists to manage access to care. However, little is known about chances of on-time surgery according to variations in existing demand. We sought to determine what proportion of patients have had late coronary bypass surgery after registration on wait lists of different size in a network of hospitals with uniform standards for timing of surgery. Methods Using records from a population-based registry, we studied wait-list times prospectively collected in a cohort of patients registered on wait lists for coronary artery bypass grafting procedures. We compared the number of weeks from registration to surgery against target access times established for three urgency groups. The chances of undergoing surgery within target time have been evaluated in relation to wait-list size at registration and the number of surgeries performed without registration on a wait list. Results In 1991–2001, two in three patients were at risk of late surgery when registered on wait lists for isolated coronary bypass procedures in British Columbia, Canada. Although urgent patients had never seen a wait list with clearance time exceeding one week, the odds of on-time surgery were reduced by 25%, odds ratio [OR] = 0.75 (95% confidence interval [CI] 0.65–0.87 for every additional operation performed without registration on a list. When the wait list at registration required a clearance time of over one month, semi-urgent patients had 51% lower odds of on-time surgery as compared to lists with clearance time less than one week, OR = 0.49 (95%CI 0.41–0.60, after adjustment for age, sex, comorbidity, calendar period, hospital and week on the list. In the non-urgent group, the odds were 69% lower, OR = 0.31 (95%CI 0.20–0.47. Every time an operation in the same hospital was performed without registration on a

Waiting time for cataract surgery and its influence on patient attitudes.

Science.gov (United States)

Chan, Frank Wan-kin; Fan, Alex Hoi; Wong, Fiona Yan-yan; Lam, Philip Tsze-ho; Yeoh, Eng-kiong; Yam, Carrie Ho-kwan; Griffiths, Sian; Lam, Dennis Shun-chiu; Congdon, Nathan

2009-08-01

To characterize willingness to pay for private operations and preferred waiting time among patients awaiting cataract surgery in Hong Kong. This was a cross-sectional survey. Subjects randomly selected from cataract surgical waiting lists in Hong Kong (n = 467) underwent a telephone interview based on a structured, validated questionnaire. Data were collected on private insurance coverage, preferred waiting time, amount willing to pay for surgery, and self-reported visual function and health status. Among 300 subjects completing the interview, 144 (48.2%) were 76 years of age or older, 177 (59%) were women, and mean time waiting for surgery was 17 +/- 15 months. Among 220 subjects (73.3%) willing to pay anything for surgery, the mean amount was US$552 +/- 443. With adjustment for age, education, and monthly household income, subjects willing to pay anything were less willing to wait 12 months for surgery (OR = 4.34; P = 0.002), more likely to know someone having had cataract surgery (OR = 2.20; P = 0.03), and more likely to use their own savings to pay for the surgery (OR = 2.21; P = 0.04). Subjects considering private cataract surgery, knowing people who have had cataract surgery, using nongovernment sources to pay for surgery, and having lower visual function were willing to pay more. Many patients wait significant periods for cataract surgery in Hong Kong, and are willing to pay substantial amounts for private operations. These results may have implications for other countries with cataract waiting lists.

r-process nucleosynthesis in dynamic helium-burning environments

Science.gov (United States)

Cowan, J. J.; Cameron, A. G. W.; Truran, J. W.

1985-01-01

The results of an extended examination of r-process nucleosynthesis in helium-burning enviroments are presented. Using newly calculated nuclear rates, dynamical r-process calculations have been made of thermal runaways in helium cores typical of low-mass stars and in the helium zones of stars undergoing supernova explosions. These calculations show that, for a sufficient flux of neutrons produced by the C-13 neutron source, r-process nuclei in solar proportions can be produced. The conditions required for r-process production are found to be 10 to the 20th-10 to the 21st neutrons per cubic centimeter for times of 0.01-0.1 s and neutron number densities in excess of 10 to the 19th per cubic centimeter for times of about 1 s. The amount of C-13 required is found to be exceedingly high - larger than is found to occur in any current stellar evolutionary model. It is thus unlikely that these helium-burning environments are responsible for producing the bulk of the r-process elements seen in the solar system.

Respiratory viral RNA on toys in pediatric office waiting rooms.

Science.gov (United States)

Pappas, Diane E; Hendley, J Owen; Schwartz, Richard H

2010-02-01

Toys in pediatric office waiting rooms may be fomites for transmission of viruses. Eighteen samples were taken from office objects on 3 occasions. Samples were tested for presence of picornavirus (either rhinovirus or enterovirus) on all 3 sample days; in addition, January samples were tested for respiratory syncytial virus and March samples were tested for influenza A and B. In addition, 15 samples were obtained from the sick waiting room before and after cleaning. Polymerase chain reaction was used to detect picornavirus, respiratory syncytial virus, and influenza A or B virus. Finally, 20 samples were obtained from the fingers of a researcher after handling different toys in the sick waiting room, and samples were then obtained from all the same toys; all samples were tested for picornavirus by polymerase chain reaction. Viral RNA was detected on 11 of 52 (21%) of toys sampled. Ten of the positives were picornavirus; 1 was influenza B virus. Three (30%) of 10 toys from the new toy bag, 6 of 30 (20%) in the sick child waiting room, and 2 of 12 (17%) in the well child waiting room were positive. Six (40%) of 15 toys in the sick waiting room were positive for picornaviral RNA before cleaning; after cleaning, 4 (27%) of 15 were positive in spite of the fact that RNA was removed from 4 of 6 of the original positives. Three (15%) of 20 toys in the sick waiting room were positive for picornaviral RNA, but RNA was not transferred to the fingers of the investigator who handled these toys. About 20% of the objects in a pediatric office may be contaminated with respiratory viral RNA, most commonly picornavirus RNA. Cleaning with a disinfectant cloth was only modestly effective in removing the viral RNA from the surfaces of toys, but transfer of picornaviral RNA from toys to fingers was inefficient.

Heart Surgery Waiting Time: Assessing the Effectiveness of an Action.

Science.gov (United States)

Badakhshan, Abbas; Arab, Mohammad; Gholipour, Mahin; Behnampour, Naser; Saleki, Saeid

2015-08-01

Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient's problems. The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for reducing waiting time and increasing the quality of services from this perspective. This cross-sectional study was performed in 2013. After searching articles on PubMed, Elsevier, Google Scholar, Ovid, Magiran, IranMedex, and SID, a list of several criteria, which relate to waiting time, was provided. Afterwards, the data on waiting time were collected by a researcher-structured checklist from 156 hospitalized patients. The data were analyzed by SPSS 16. The Kolmogorov Smirnov and Shapiro tests were used for determination of normality. Due to the non-normal distribution, non-parametric tests, such as Kruskal-Wallis and Mann-Whitney were chosen for reporting significance. Parametric tests also used reporting medians. Among the studied variables, just economic status had a significant relation with waiting time (P = 0.37). Fifty percent of participants had diabetes, whereas this estimate was 43.58% for high blood pressure. As the cause of delay, 28.2% of patients reported financial problems, 18.6% personal problem and 13.5% a delay in providing equipment by the hospital. It seems the studied hospital should review its waiting time arrangements and detach them, as far as possible, from subjective and personal (specialists) decisions. On the other hand, ministries of health and insurance companies should consider more financial support. It is also recommend that hospitals should arrange preoperational psychiatric consultation for increasing patients' emotionally readiness.

Characterization of 16S rRNA Processing with Pre-30S Subunit Assembly Intermediates from E. coli.

Science.gov (United States)

Smith, Brian A; Gupta, Neha; Denny, Kevin; Culver, Gloria M

2018-06-08

Ribosomal RNA (rRNA) is a major component of ribosomes and is fundamental to the process of translation. In bacteria, 16S rRNA is a component of the small ribosomal subunit and plays a critical role in mRNA decoding. rRNA maturation entails the removal of intervening spacer sequences contained within the pre-rRNA transcript by nucleolytic enzymes. Enzymatic activities involved in maturation of the 5'-end of 16S rRNA have been identified, but those involved in 3'-end maturation of 16S rRNA are more enigmatic. Here, we investigate molecular details of 16S rRNA maturation using purified in vivo-formed small subunit (SSU) assembly intermediates (pre-SSUs) from wild-type Escherichia coli that contain precursor 16S rRNA (17S rRNA). Upon incubation of pre-SSUs with E. coli S100 cell extracts or purified enzymes implicated in 16S rRNA processing, the 17S rRNA is processed into additional intermediates and mature 16S rRNA. These results illustrate that exonucleases RNase R, RNase II, PNPase, and RNase PH can process the 3'-end of pre-SSUs in vitro. However, the endonuclease YbeY did not exhibit nucleolytic activity with pre-SSUs under these conditions. Furthermore, these data demonstrate that multiple pathways facilitate 16S rRNA maturation with pre-SSUs in vitro, with the dominant pathways entailing complete processing of the 5'-end of 17S rRNA prior to 3'-end maturation or partial processing of the 5'-end with concomitant processing of the 3'-end. These results reveal the multifaceted nature of SSU biogenesis and suggest that E. coli may be able to escape inactivation of any one enzyme by using an existing complementary pathway. Copyright © 2018 Elsevier Ltd. All rights reserved.

Waiting time and the psychosocial consequences of false-positive mammography

DEFF Research Database (Denmark)

Heleno, Bruno M.; Siersma, Volkert; Brodersen, John

2015-01-01

Background: There is wide variation in the psychosocial response to false-positive mammography. We aimed to assess whether women having to wait longer to exclude cancer had increased psychosocial consequences that persisted after cancer was ruled out. Findings: We selected women with false......-positive mammography (n = 272), screened for breast cancer in Copenhagen and Funen (Denmark) over a 1-year period. We measured psychosocial consequences immediately before women attended their recall visit and 1, 6, 18 and 36 months after women received their final diagnosis. After women were told that cancer had been...... ruled out, adverse psychosocial consequences decreased with time. We found no statistically significant differences between women who had cancer ruled out immediately at the recall visit (waiting time of 0) and women who had to wait longer before cancer was ruled out (waiting times 1-30, 30...

No-waiting dentine self-etch concept-Merit or hype.

Science.gov (United States)

Huang, Xue-Qing; Pucci, César R; Luo, Tao; Breschi, Lorenzo; Pashley, David H; Niu, Li-Na; Tay, Franklin R

2017-07-01

A recently-launched universal adhesive, G-Premio Bond, provides clinicians with the alternative to use the self-etch technique for bonding to dentine without waiting for the adhesive to interact with the bonding substrate (no-waiting self-etch; Japanese brochure), or after leaving the adhesive undisturbed for 10s (10-s self-etch; international brochure). The present study was performed to examine in vitro performance of this new universal adhesive bonded to human coronal dentine using the two alternative self-etch modes. One hundred and ten specimens were bonded using two self-etch application modes and examined with or without thermomechanical cycling (10,000 thermal cycles and 240,000 mechanical cycles) to simulate one year of intraoral functioning. The bonded specimens were sectioned for microtensile bond testing, ultrastructural and nanoleakage examination using transmission electron microscopy. Changes in the composition of mineralised dentine after adhesive application were examined using Fourier transform infrared spectroscopy. Both reduced application time and thermomechanical cycling resulted in significantly lower bond strengths, thinner hybrid layers, and significantly more extensive nanoleakage after thermomechanical cycling. Using the conventional 10-s application time improved bonding performance when compared with the no-waiting self-etch technique. Nevertheless, nanoleakage was generally extensive under all testing parameters employed for examining the adhesive. Although sufficient bond strength to dentine may be achieved using the present universal adhesive in the no-waiting self-etch mode that does not require clinicians to wait prior to polymerisation of the adhesive, this self-etch concept requires further technological refinement before it can be recommended as a clinical technique. Although the surge for cutting application time to increase user friendliness remains the most frequently sought conduit for advancement of dentine bonding

Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times.

Science.gov (United States)

Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Sanmartin, Claudia; Decoster, Carolyn; Clavel, Nathalie; Warren, Elaine; Drew, Madeleine; Noseworthy, Tom

2013-06-06

Long waits for core specialized services have consistently been identified as a key barrier to access. Governments and organizations at all levels have responded with strategies for better wait list management. While these initiatives are promising, insufficient attention has been paid to factors influencing the implementation and sustainability of wait time management strategies (WTMS) implemented at the organizational level. A systematic review was conducted using the main electronic databases, such as CINAHL, MEDLINE, and Cochrane Database of Systematic Reviews, to identify articles published between 1990 and 2011 on WTMS for scheduled care implemented at the organizational level or higher and on frameworks for analyzing factors influencing their success. Data was extracted on governance, culture, resources, and tools. We organized a workshop with Canadian healthcare policy-makers and managers to compare our initial findings with their experience. Our systematic review included 47 articles: 36 related to implementation and 11 to sustainability. From these, we identified a variety of WTMS initiated at the organizational level or higher, and within these, certain factors that were specific to either implementation or sustainability and others common to both. The main common factors influencing success at the contextual level were stakeholder engagement and strong funding, and at the organizational level, physician involvement, human resources capacity, and information management systems. Specific factors for successful implementation at the contextual level were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. For sustainability, we found no new factors. The workshop participants identified the same major factors as found in the articles and added others, such as information sharing between physicians and managers. Factors related to implementation were studied

Analysis of launch site processing effectiveness for the Space Shuttle 26R payload

Science.gov (United States)

Flores, Carlos A.; Heuser, Robert E.; Pepper, Richard E., Jr.; Smith, Anthony M.

1991-01-01

A trend analysis study has been performed on problem reports recorded during the Space Shuttle 26R payload's processing cycle at NASA-Kennedy, using the defect-flow analysis (DFA) methodology; DFA gives attention to the characteristics of the problem-report 'population' as a whole. It is established that the problem reports contain data which distract from pressing problems, and that fully 60 percent of such reports were caused during processing at NASA-Kennedy. The second major cause of problem reports was design defects.

Minimizing makespan for a no-wait flowshop using genetic algorithm

Indian Academy of Sciences (India)

This paper explains minimization of makespan or total completion time .... lead to a natural reduction of the no-wait flow shop problem to the travelling sales- ... FCH can also be applied in real time scheduling and rescheduling for no-wait flow.

The Psychosocial Influences of Waiting Periods on Patients Undergoing Endoscopic Submucosal Dissection.

Science.gov (United States)

Nagao, Noriko; Tsuchiya, Aya; Ando, Sae; Arita, Mizue; Toyonaga, Takashi; Miyawaki, Ikuko

This study aimed to clarify psychosocial influences of waiting periods on patients undergoing endoscopic submucosal dissection for cancer at an advanced medical care facility in Japan. Subjects were consenting patients hospitalized from 2009 to 2010. Qualitative and quantitative data were gathered about patients' characteristics, disease and stage, and waiting period. Qualitative content analysis was used to analyze free statements and interview data. Subjects included 154 patients with an average wait period of 46.28 days for admission. Qualitative analysis revealed the following wait period perceptions. For calmness, results indicated (1) no anxiety, (2) relief based on doctors' positive judgment, (3) whatever happens/no choice, and (4) trust in doctor. For uneasiness, perceptions included (1) the sooner, the better/eagerly waiting, (2) anxiety and concern, and (3) emotional instability. Four waiting period coping types were identified: (1) making phone inquiries, (2) busy and forgot about the medical procedure, (3) relief from anxiety, and (4) unable to function well in daily life. Patients need to be educated about cancer progression and provided an estimated wait time. They also require more information about how to manage daily life such as monitoring factors from the nursing domain including physical condition, digestive symptoms, diet, and exercise.

Probability-Based Determination Methods for Service Waiting in Service-Oriented Computing Environments

Science.gov (United States)

Zeng, Sen; Huang, Shuangxi; Liu, Yang

Cooperative business processes (CBP)-based service-oriented enterprise networks (SOEN) are emerging with the significant advances of enterprise integration and service-oriented architecture. The performance prediction and optimization for CBP-based SOEN is very complex. To meet these challenges, one of the key points is to try to reduce an abstract service’s waiting number of its physical services. This paper introduces a probability-based determination method (PBDM) of an abstract service’ waiting number, M l , and time span, τ i , for its physical services. The determination of M i and τ i is according to the physical services’ arriving rule and their overall performance’s distribution functions. In PBDM, the arriving probability of the physical services with the best overall performance value is a pre-defined reliability. PBDM has made use of the information of the physical services’ arriving rule and performance distribution functions thoroughly, which will improve the computational efficiency for the scheme design and performance optimization of the collaborative business processes in service-oriented computing environments.

Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

Energy Technology Data Exchange (ETDEWEB)

Kildea, John; Hijal, Tarek [McGill University Health Center (Canada)

2016-08-15

We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

International Nuclear Information System (INIS)

Kildea, John; Hijal, Tarek

2016-01-01

We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

Barium from a mini r-process in supernovae

Science.gov (United States)

Heymann, D.

1983-01-01

McCulloch and Wasserburg (1978) have reported nonlinear isotopic anomalies in barium for two Ca-Al-rich inclusions of the Allende carbonaceous chondrite, known as EK-1-4-1 and C-1. In an attempt to account for these anomalies, it has been proposed that Ba from an r-process of nucleosynthesis, containing Ba-135 and Ba-137, was injected into the primeval color system but was not totally homogenized. Questions arise in connection with the relations of Xe isotopes in carbonaceous chondrites. This has prompted Heymann and Dziczkaniec (1979, 1980, 1981) to study the formation of r-Xe, r-Kr, and r-Te by the mini r-process which is thought to occur in the O, Ne-rich shells of Type II supernovae. Lee et al. (1979) have studied the formation of r-Ba, r-Nd, and r-Sm by the same process. Certain differences regarding the approaches used by Lee et al. and by Heymann and Dziczkaniec make it necessary to restudy the work of Lee et al. Attention is given to the survival probabilities of nuclear species of interest, taking into accounts the elements Cs, Ba, I, and Xe.

The unethical focus on access: a study of medical ethics and the waiting-time guarantee.

Science.gov (United States)

Karlberg, H I; Brinkmo, B-M

2009-03-01

All civilized societies favour ethical principles of equity. In healthcare, these principles generally focus on needs for medical care. Methods for establishing priorities among such needs are instrumental in this process. In this study, we analysed whether rules on access to healthcare, waiting-time guarantees, conflict with ethical principles of distributive justice. We interviewed directors, managers and other decision-makers of various healthcare providers of hospitals, primary care organizations and purchasing offices. We also conducted focus group interviews with professionals from a number of distinct medical areas. Our informants and their co-workers were reasonably familiar with the ethical platforms for priority-setting established by the Swedish parliament, giving the sickest patients complete priority. However, to satisfy the waiting-time guarantees, the informants often had to make priority decisions contrary to the ethical principles by favouring access before needs to keep waiting times within certain limits. The common opinion was that the waiting-time guarantee leads to crowding-out effects, overruling the ethical principles based on needs. For more than a decade, the interpretation in Sweden of the equitable principle based on medical needs has been distorted through political decisions, leading to healthcare providers giving priority to access rather than needs for care.

Optimising radiation outcomes, scheduling patient waiting lists for maximum population tumour control

International Nuclear Information System (INIS)

Ebert, M.A.; Jennings, L.; Kearvell, R.; Bydder, S.

2011-01-01

Full text: Delays in the commencement of radiotherapy, possibly due to resource constraints, are known to impact on control-related outcomes. We sought an objective solution for patient prioritisation based on tumour control probability (TCP). With a utilitarian objective for maximising TCP in a population of M patients, with patient i waiting a time between diagnosis and treatment of Ti and a mean wait time of TMean, the optimisation problem is as shown. A linear-quadratic/Poissonian model for cell survival/TCP was considered including cell doubling during the wait time. Solutions to several distributions of patient population characteristics were examined together with the expected change in TCP for the population and individuals. An analytical solution to the optimisation problem was found which gives the optimal wait time for each patient as a function of the distribution of radiobiological characteristics in the population. This solution does not allow a negativity constraint on an individual's optimised waiting time so a waiting list simulation was developed to enforce that. Optimal wait time distributions were calculated for situations where patients are allocated distinct diagnostic groups (sharing radiobiological parameters) and for a (log-normal) distribution of doubling times in the population. In order to meet the utilitarian objective, the optimal solutions require patients with rapid cell doubling times to be accelerated up the waiting list at the expense of those with slowly proliferating tumours. The net population benefit however is comparable to or greater then the expected benefit from beam intensity modulation or dose escalation.

Public views on a wait time management initiative: a matter of communication.

Science.gov (United States)

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2010-08-05

Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative--the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

[Waiting time for the first colposcopic examination in women with abnormal Papanicolaou test].

Science.gov (United States)

Nascimento, Maria Isabel do; Rabelo, Irene Machado Moraes Alvarenga; Cardoso, Fabrício Seabra Polidoro; Musse, Ricardo Neif Vieira

2015-08-01

To evaluate the waiting times before obtaining the first colposcopic examination for women with abnormal Papanicolaou smears. Retrospective cohort study conducted on patients who required a colposcopic examination to clarify an abnormal pap test, between 2002 January and 2008 August, in a metropolitan region of Brazil. The waiting times were defined as: Total Waiting Time (interval between the date of the pap test result and the date of the first colposcopic examination); Partial A Waiting Time (interval between the date of the pap test result and the date of referral); Partial B Waiting Time (interval between the date of referral and the date of the first colposcopic examination). Means, medians, relative and absolute frequencies were calculated. The Kruskal-Wallis test and Pearson's chi-square test were used to determine statistical significance. A total of 1,544 women with mean of age of 34 years (SD=12.6 years) were analyzed. Most of them had access to colposcopic examination within 30 days (65.8%) or 60 days (92.8%) from referral. Mean Total Waiting Time, Partial A Waiting Time, and Partial B Waiting Time were 94.5 days (SD=96.8 days), 67.8 days (SD=95.3 days) and 29.2 days (SD=35.1 days), respectively. A large part of the women studied had access to colposcopic examination within 60 days after referral, but Total waiting time was long. Measures to reduce the waiting time for obtaining the first colposcopic examination can help to improve the quality of care in the context of cervical cancer control in the region, and ought to be addressed at the phase between the date of the pap test results and the date of referral to the teaching hospital.

Brazil well worth the wait

Energy Technology Data Exchange (ETDEWEB)

Duey, R.

1999-11-01

Oil companies weren't the only ones waiting for Brazil to make up its mind about privatizing its oil and gas industry. Seismic firms are flocking to the area in droves to work their spec magic. Exploratory activities in these large offshore blocks are described.

Approaching stationarity: competition between long jumps and long waiting times

International Nuclear Information System (INIS)

Dybiec, Bartłomiej

2010-01-01

Within the continuous-time random walk (CTRW) scenarios, properties of the overall motion are determined by the waiting time and the jump length distributions. In the decoupled case, with power-law distributed waiting times and jump lengths, the CTRW scenario is asymptotically described by the double (space and time) fractional Fokker–Planck equation. Properties of a system described by such an equation are determined by the subdiffusion parameter and the jump length exponent. Nevertheless, the stationary state is determined solely by the jump length distribution and the potential. The waiting time distribution determines only the rate of convergence to the stationary state. Here, we inspect the competition between long waiting times and long jumps and how this competition is reflected in the way in which a stationary state is reached. In particular, we show that the distance between a time-dependent and a stationary solution changes in time as a double power law

Should I stay or should I go? Hospital emergency department waiting times and demand.

Science.gov (United States)

Sivey, Peter

2018-03-01

In the absence of the price mechanism, hospital emergency departments rely on waiting times, alongside prioritisation mechanisms, to restrain demand and clear the market. This paper estimates by how much the number of treatments demanded is reduced by a higher waiting time. I use variation in waiting times for low-urgency patients caused by rare and resource-intensive high-urgency patients to estimate the relationship. I find that when waiting times are higher, more low-urgency patients are deterred from treatment and leave the hospital during the waiting period without being treated. The waiting time elasticity of demand for low-urgency patients is approximately -0.25 and is highest for the lowest-urgency patients. Copyright © 2017 John Wiley & Sons, Ltd.

Portuguese Society of Cardiothoracic and Vascular Surgery/Portuguese Society of Cardiology recommendations for waiting times for cardiac surgery.

Science.gov (United States)

Neves, José; Pereira, Hélder; Sousa Uva, Miguel; Gavina, Cristina; Leite Moreira, Adelino; Loureiro, Maria José

2015-11-01

Appointed jointly by the Portuguese Society of Cardiothoracic and Vascular Surgery (SPCCTV) and the Portuguese Society of Cardiology (SPC), the Working Group on Waiting Times for Cardiac Surgery was established with the aim of developing practical recommendations for clinically acceptable waiting times for the three critical phases of the care of adults with heart disease who require surgery or other cardiological intervention: cardiology appointments; the diagnostic process; and invasive treatment. Cardiac surgery has specific characteristics that are not comparable to other surgical specialties. It is important to reduce maximum waiting times and to increase the efficacy of systems for patient monitoring and tracking. The information in this document is mainly based on available clinical information. The methodology used to establish the criteria was based on studies on the natural history of heart disease, clinical studies comparing medical treatment with intervention, retrospective and prospective analyses of patients on waiting lists, and the opinions of experts and working groups. Following the first step, represented by publication of this document, the SPCCTV and SPC, as the bodies best suited to oversee this process, are committed to working together to define operational strategies that will reconcile the clinical evidence with the actual situation and with available resources. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Monte Carlo calculations for r-process nucleosynthesis

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Mumpower, Matthew Ryan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2015-11-12

A Monte Carlo framework is developed for exploring the impact of nuclear model uncertainties on the formation of the heavy elements. Mass measurements tightly constrain the macroscopic sector of FRDM2012. For r-process nucleosynthesis, it is necessary to understand the microscopic physics of the nuclear model employed. A combined approach of measurements and a deeper understanding of the microphysics is thus warranted to elucidate the site of the r-process.

Retainment of r-process material in dwarf galaxies

Science.gov (United States)

Beniamini, Paz; Dvorkin, Irina; Silk, Joe

2018-04-01

The synthesis of r-process elements is known to involve extremely energetic explosions. At the same time, recent observations find significant r-process enrichment even in extremely small ultra-faint dwarf (UFD) galaxies. This raises the question of retainment of those elements within their hosts. We estimate the retainment fraction and find that it is large ˜0.9, unless the r-process event is very energetic (≳ 1052erg) and / or the host has lost a large fraction of its gas prior to the event. We estimate the r-process mass per event and rate as implied by abundances in UFDs, taking into account imperfect retainment and different models of UFD evolution. The results are consistent with previous estimates (Beniamini et al. 2016b) and with the constraints from the recently detected macronova accompanying a neutron star merger (GW170817). We also estimate the distribution of abundances predicted by these models. We find that ˜0.07 of UFDs should have r-process enrichment. The results are consistent with both the mean values and the fluctuations of [Eu/Fe] in galactic metal poor stars, supporting the possibility that UFDs are the main 'building blocks' of the galactic halo population.

(R)-3-hydroxyhexan-2-one is a major pheromone component of Anelaphus inflaticollis (Coleoptera: Cerambycidae).

Science.gov (United States)

Ray, A M; Swift, I P; Moreira, J A; Millar, J G; Hanks, L M

2009-10-01

We report the identification and field bioassays of a major component of the male-produced aggregation pheromone of Anelaphus inflaticollis Chemsak, an uncommon desert cerambycine beetle. Male A. inflaticollis produced a sex-specific blend of components that included (R)-3-hydroxyhexan-2-one, (S)-2-hydroxyhexan-3-one, 2,3-hexanedione, and (2R,3R)- and (2R,3S)-2,3-hexanediols. Field trials with baited bucket traps determined that the reconstructed synthetic pheromone blend and (R)-3-hydroxyhexan-2-one alone attracted adult A. inflaticollis of both sexes, with significantly more beetles being attracted to the blend. We conclude that (R)-3-hydroxyhexan-2-one is a major pheromone component of A. inflaticollis, and our results suggest that one or more of the minor components may further increase attraction of conspecifics. Scanning electron microscopy showed that male A. inflaticollis have pores on the prothorax that are consistent in structure with sex-specific pheromone gland pores in related species. Males also displayed stereotyped calling behavior similar to that observed in other cerambycine species. This study represents the first report of volatile pheromones for a cerambycine species in the tribe Elaphidiini.

Waiting for the right time: how and why young Thai women manage to avoid heterosexual intercourse.

Science.gov (United States)

Supametaporn, Pinhatai; Stern, Phyllis Noerager; Rodcumdee, Branom; Chaiyawat, Waraporn

2010-08-01

Nineteen young Thai women were purposively selected from networks of nongovernmental organizations involving children and youths in Bangkok. Our grounded theory findings indicated that these young women used the basic social process they called "waiting for the right time" in order to maintain heterosexual abstinence. Waiting for the right time involved one overarching condition, honoring parental love, and included three overlapping properties: learning rules, planning life path, and ways of preserving virginity. The findings provide information that may lead to the development of culturally competent interventions for middle-class Thai youths to remain healthy and avoid pregnancy.

Maternity waiting homes in Rural Health Centers of Ethiop: The ...

African Journals Online (AJOL)

kim

1 The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis ... The main aim of this study was to assess the situation of maternity waiting ... experiences and challenges of mothers using waiting homes. ..... education on MWHs were home visits by HEWs ... travel long distances to deliver food, which meant.

Atomic processes and application in honour of David R. Bates' 60th birthday

CERN Document Server

Burke, P G

2013-01-01

Atomic Processes and Applications is a collection of review articles that discusses major atomic and molecular processes and their applications to upper atmospheric physics and to astrophysics. The book also serves as a 60th birthday tribute to Dr. David R. Bates. The coverage of the text includes the overview of stratospheric aeronomy; upper atmosphere of the earth; and problems in atmospheric pollution. The book also deals with technical and highly specialized issues including photoionization of atomic systems; atomic structure and oscillator strengths; and atomic scattering computations. Th

Waiting Time Distributions for Pattern Occurrence in a Constrained Sequence

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Valeri Stefanov

2007-01-01

Full Text Available A binary sequence of zeros and ones is called a (d,k-sequence if it does not contain runs of zeros of length either less than d or greater than k, where d and k are arbitrary, but fixed, non-negative integers and d < k. Such sequences find an abundance of applications in communications, in particular for magnetic and optical recording. Occasionally, one requires that (d,k-sequences do not contain a specific pattern w. Therefore, distribution results concerning pattern occurrence in (d,k-sequences are of interest. In this paper we study the distribution of the waiting time until the r th occurrence of a pattern w in a random (d,k-sequence generated by a Markov source. Numerical examples are also provided.

MDRL lncRNA regulates the processing of miR-484 primary transcript by targeting miR-361.

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Kun Wang

2014-07-01

Full Text Available Long noncoding RNAs (lncRNAs are emerging as new players in gene regulation, but whether lncRNAs operate in the processing of miRNA primary transcript is unclear. Also, whether lncRNAs are involved in the regulation of the mitochondrial network remains to be elucidated. Here, we report that a long noncoding RNA, named mitochondrial dynamic related lncRNA (MDRL, affects the processing of miR-484 primary transcript in nucleus and regulates the mitochondrial network by targeting miR-361 and miR-484. The results showed that miR-361 that predominantly located in nucleus can directly bind to primary transcript of miR-484 (pri-miR-484 and prevent its processing by Drosha into pre-miR-484. miR-361 is able to regulate mitochondrial fission and apoptosis by regulating miR-484 levels. In exploring the underlying molecular mechanism by which miR-361 is regulated, we identified MDRL and demonstrated that it could directly bind to miR-361 and downregulate its expression levels, which promotes the processing of pri-miR-484. MDRL inhibits mitochondrial fission and apoptosis by downregulating miR-361, which in turn relieves inhibition of miR-484 processing by miR-361. Our present study reveals a novel regulating model of mitochondrial fission program which is composed of MDRL, miR-361 and miR-484. Our work not only expands the function of the lncRNA pathway in gene regulation but also establishes a new mechanism for controlling miRNA expression.

Public views on a wait time management initiative: a matter of communication

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Laupacis Andreas

2010-08-01

Full Text Available Abstract Background Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative - the Ontario Wait Time Strategy (OWTS (Canada. Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Methods Two qualitative studies: 1 an analysis of all emails sent by the public to the (OWTS email address; and 2 in-depth interviews with members of the Ontario public. Results Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Conclusions Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study.

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Jiang, Shan; Powers, Matthew; Allison, David; Vincent, Ellen

2017-07-01

This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people's preference scores. The factor analysis indicated additional supportive features that may affect people's preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.

Waiting time guarantee - an update

DEFF Research Database (Denmark)

Socha, Karolina; Bech, Mickael

2008-01-01

The rule of extended free choice of hospital, in force since 2002, provides patients with an option to choose a private hospital if the public system is unable to provide a treatment within the guaranteed waiting time of one month. In June 2008 the Government declared in their yearly budget agree...

A state of limbo: the politics of waiting in neo-liberal Latvia.

Science.gov (United States)

Ozoliņa-Fitzgerald, Liene

2016-09-01

This article presents an ethnographic study of politics of waiting in a post-Soviet context. While activation has been explored in sociological and anthropological literature as a neo-liberal governmental technology and its application in post-socialist context has also been compellingly documented, waiting as a political artefact has only recently been receiving increased scholarly attention. Drawing on ethnographic fieldwork at a state-run unemployment office in Riga, this article shows how, alongside activation, state welfare policies also produce passivity and waiting. Engaging with the small but developing field of sociological literature on the politics of waiting, I argue that, rather than interpreting it as a clash between 'neo-liberal' and 'Soviet' regimes, we should understand the double-move of activation and imposition of waiting as a key mechanism of neo-liberal biopolitics. This article thus extends the existing theorizations of the temporal politics of neo-liberalism. © London School of Economics and Political Science 2016.

Practical evaluation of organic polymer thermoelectrics by large-area R2R processing on flexible substrates

OpenAIRE

Søndergaard, Roar R.; Hösel, Markus; Espinosa Martinez, Nieves; Jørgensen, Mikkel; Krebs, Frederik C

2013-01-01

Here, we present a process based on roll-to-roll (R2R) technology which allows for very fast processing of polymer thermoelectric (TE) devices and we furthermore demonstrate a simplified but more efficient way of serially connecting these devices by means of R2R thin-film processing. The new device architecture makes it possible to use only one TE material (opposed to two materials which are employed in well-known Peltier elements), and a total of 18,000 serially connected junctions were prep...

Development of an Information Model for Kidney Transplant Wait List.

Science.gov (United States)

Bircan, Hüseyin Yüce; Özçelik, Ümit; Uysal, Nida; Demirağ, Alp; Haberal, Mehmet

2015-11-01

Deceased-donor kidney transplant is unique among surgical procedures that are an urgent procedure performed in an elective population. It has not been possible to accurately determine when a given patient will be called for transplant. Patients on the active transplant list can be called for a transplant at any time. As a result, every effort must be made to optimize their health according to best practices and published clinical practice guidelines. Once the patient is placed on the transplant wait list after undergoing an initial extensive evaluation, continued surveillance is required. Therefore, we developed a kidney transplant wait list surveillance software program that alerts organ transplant coordinator on time regarding which patients need a work-up. The new designed software has a database of our waiting patients with their completed and pending controls. The software also has built-in functions to warn the responsible staff with an E-mail. If one of the controls of a recipient delayed, the software sends an automated E-mail to the staff regarding the patients delayed controls. The software is a Web application that works on any platform with a Web browser and Internet connection and allows access by multiple users. The software has been developed with NET platform. The database is SQL server. The software has the following functions: patient communication info, search, alert list, alert E-mail, control entry, and system management. As of January 2014, a total of 21 000 patients were registered on the National Kidney Transplant wait list in Turkey and the kidney transplant wait list had been expanding by 2000 to 3000 patients each year. Therefore computerized wait list programs are crucial to help to transplant centers to keep their patients up-to-date on time.

General practice cooperatives: long waiting times for home visits due to long distances?

Science.gov (United States)

Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

2007-02-12

The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minutes decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance.

The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients

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Knol Dirk L

2007-02-01

Full Text Available Abstract Background Problematic waiting lists in public health care threaten the equity and timeliness of care provision in several countries. This study assesses different stakeholders' views on the acceptability of waiting lists in health care, their preferences for priority care of patients, and their judgements on acceptable waiting times for surgical patients. Methods A questionnaire survey was conducted among 257 former patients (82 with varicose veins, 86 with inguinal hernia, and 89 with gallstones, 101 surgeons, 95 occupational physicians, and 65 GPs. Judgements on acceptable waiting times were assessed using vignettes of patients with varicose veins, inguinal hernia, and gallstones. Results Participants endorsed the prioritisation of patients based on clinical need, but not on ability to benefit. The groups had significantly different opinions (p Acceptable waiting times ranged between 2 and 25 weeks depending on the type of disorder (p Conclusion The explicit prioritisation of patients seems an accepted means for reducing the overall burden from waiting lists. The disagreement about appropriate prioritisation criteria and the need for uniformity, however, raises concern about equity when implementing prioritisation in daily practice. Single factor waiting time thresholds seem insufficient for securing timely care provision in the presence of long waiting lists as they do not account for the different consequences of waiting between patients.

Astrocyte IP3R2-dependent Ca2+ signaling is not a major modulator of neuronal pathways governing behavior.

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Jeremy ePetravicz

2014-11-01

Full Text Available Calcium-dependent release of gliotransmitters by astrocytes is reported to play a critical role in synaptic transmission and be necessary for long-term potentiation (LTP, long-term depression (LTD and other forms of synaptic modulation that are correlates of learning and memory . Further, physiological processes reported to be dependent on Ca2+ fluxes in astrocytes include functional hyperemia, sleep, and regulation of breathing. The preponderance of findings indicate that most, if not all, receptor dependent Ca2+ fluxes within astrocytes are due to release of Ca2+ through IP3 receptor/channels in the endoplasmic reticulum. Findings from several laboratories indicate that astrocytes only express IP3 receptor type 2 (IP3R2 and that a knockout of IP3R2 obliterates the GPCR-dependent astrocytic Ca2+ responses. Assuming that astrocytic Ca2+ fluxes play a critical role in synaptic physiology, it would be predicted that eliminating of astrocytic Ca2+ fluxes would lead to marked changes in behavioral tests. Here, we tested this hypothesis by conducting a broad series of behavioral tests that recruited multiple brain regions, on an IP3R2 conditional knockout mouse model. We present the novel finding that behavioral processes are unaffected by lack of astrocyte IP3R-mediated Ca2+ signals. IP3R2 cKO animals display no change in anxiety or depressive behaviors, and no alteration to motor and sensory function. Morris water maze testing, a behavioral correlate of learning and memory, was unaffected by lack of astrocyte IP3R2-mediated Ca2+-signaling. Therefore, in contrast to the prevailing literature, we find that neither receptor-driven astrocyte Ca2+ fluxes nor, by extension, gliotransmission is likely to be a major modulating force on the physiological processes underlying behavior.

ON THE r -PROCESS ENRICHMENT OF DWARF SPHEROIDAL GALAXIES

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Bramante, Joseph [Department of Physics, 225 Nieuwland Science Hall, University of Notre Dame, Notre Dame, IN 46556 (United States); Linden, Tim [Center for Cosmology and AstroParticle Physics (CCAPP) and Department of Physics The Ohio State University, Columbus OH, 43210 (United States)

2016-07-20

Recent observations of Reticulum II have uncovered an overabundance of r -process elements compared to similar ultra-faint dwarf spheroidal galaxies (UFDs). Because the metallicity and star formation history of Reticulum II appear consistent with all known UFDs, the high r -process abundance of Reticulum II suggests enrichment through a single, rare event, such as a double neutron star (NS) merger. However, we note that this scenario is extremely unlikely, as binary stellar evolution models require significant supernova natal kicks to produce NS–NS or NS–black hole (BH) mergers, and these kicks would efficiently remove compact binary systems from the weak gravitational potentials of UFDs. We examine alternative mechanisms for the production of r -process elements in UFDs, including a novel mechanism wherein NSs in regions of high dark matter (DM) density implode after accumulating a BH-forming mass of DM. We find that r -process proto-material ejection by tidal forces, when a single NS implodes into a BH, can occur at a rate matching the r -process abundance of both Reticulum II and the Milky Way. Remarkably, DM models which collapse a single NS in observed UFDs also solve the missing pulsar problem in the Milky Way Galactic Center. We propose tests specific to DM r -process production which may uncover or rule out this model.

The control of deliberate waiting strategies in a stop-signal task

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R.P. Sylwan

2004-06-01

Full Text Available To inhibit an ongoing flow of thoughts or actions has been largely considered to be a crucial executive function, and the stop-signal paradigm makes inhibitory control measurable. Stop-signal tasks usually combine two concurrent tasks, i.e., manual responses to a primary task (go-task are occasionally countermanded by a stimulus which signals participants to inhibit their response in that trial (stop-task. Participants are always instructed not to wait for the stop-signal, since waiting strategies cause the response times to be unstable, invalidating the data. The aim of the present study was to experimentally control the strategies of waiting deliberately for the stop-signal in a stop-task by means of an algorithm that measured the variation in the reaction times to go-stimuli on-line, and displayed a warning legend urging participants to be faster when their reaction times were more than two standard deviations of the mean. Thirty-four university students performed a stop-task with go- and stop-stimuli, both of which were delivered in the visual modality and were lateralized within the visual field. The participants were divided into two groups (group A, without the algorithm, vs group B, with the algorithm. Group B exhibited lower variability of reaction times to go-stimuli, whereas no significant between-group differences were found in any of the measures of inhibitory control, showing that the algorithm succeeded in controlling the deliberate waiting strategies. Differences between deliberate and unintentional waiting strategies, and anxiety as a probable factor responsible for individual differences in deliberate waiting behavior, are discussed.

Sustainability: orthopaedic surgery wait time management strategies.

Science.gov (United States)

Amar, Claudia; Pomey, Marie-Pascale; SanMartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2015-01-01

The purpose of this paper is to examine Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months. The research design is a multiple cases study. The paper selected three cases: Case 1 - staff were able to maintain compliance with requirements for more than 18 months; Case 2 - staff were able to meet requirements for 18 months, but unable to sustain this level; Case 3 - staff were never able to meet the requirements. For each case the authors interviewed persons involved in the strategies and collected documents. The paper analysed systemic and organizational-level factors; including governance and leadership, culture, resources, methods and tools. Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: an exclusive mandate to do only hip and knee replacement surgery; motivated staff who were not distracted by other concerns; and a strong team spirit. The authors' research highlights an important gradient between three cases regarding the factors that sustain waiting times. The paper show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.

Use of maternity waiting home in rural Zambia.

Science.gov (United States)

van Lonkhuijzen, Luc; Stegeman, Margreet; Nyirongo, Rebecca; van Roosmalen, Jos

2003-04-01

This study was conducted to assess the results from the use of a maternity waiting home, a health facility to which women with high risk pregnancies are referred during the last weeks of pregnancy in rural Zambia. It compared the risk status and pregnancy outcome in women staying as waiters with those women who give birth in hospital after direct admission (non-waiters). Forty seven per-cent of the non-waiters (n = 292) had no maternal risk factors and 85% had no antenatal risk factors as compared to 17% and 78% among the waiters (n = 218). Eighty six per cent of waiters had spontaneous vaginal vertex delivery as compared to 95% of non-waiters. Although the differences in risk status were statistically significant, no differences were found in birth weight and maternal and perinatal mortality. The similar obstetric outcome among waiters with more high risk pregnancies and non-waiters could be interpreted as a possible outcome of the maternity waiting home. When dependent on a proper functioning referral system, such waiting homes can reduce perinatal mortality.

A RFID-based JIT Application for Least Waiting Time for Dynamic Smart Diet Customers

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Chen Long-Fei

2017-01-01

Full Text Available Waiting in queue is part of everyone’s life. A day may include several different waiting in queue. Waiting in line is always a bit of phenomena for a prosperous restaurant at dinner time. How to manage the queues and keep their feet into customers is the operating challenge facing everyone manager. In addition, rising energy costs and growing demand for protection of the environment call for a shorter waiting queue. Thus, we devise a dynamic smart diet App manager to reduce customer waiting time through radio frequency identification (RFID and just in time (JIT principle to reduce inventory of restaurant food materials, thereby increasing customer satisfaction and loyalty, and improving revenue and social responsibility.

The effects of a long wait for children's dental general anaesthesia.

Science.gov (United States)

North, Sarah; Davidson, Lesley E; Blinkhorn, Anthony S; Mackie, Iain C

2007-03-01

The purpose of this study was to monitor the effect of an interruption in a service for children who were scheduled to have dental extractions under general anaesthesia (GA). The reasons for offering GA and the treatment given while the service was not available, together with the history of the pain, antibiotic usage and alterations to the number of teeth extracted were recorded. When the GA extraction service stopped, the children who were scheduled to have their teeth extracted were placed on a waiting list. When the service recommenced 6 months later, the children were invited to attend a reassessment. Relevant data were collected at this visit using a proforma. A total of 321 children had their extractions delayed. Only 249 of these attended for a reassessment. During the waiting period, 102 parents (41.0%) reported that their children required analgesics, 71 (28.5%) stated that their children's sleep was disturbed and 82 (32.9%) recorded problems with eating. One hundred and twenty-three children (49.4%) had received antibiotics, with 49 (19.6%) having been prescribed two or more courses. The majority of treatment plans (85.5%) remained unchanged. Many children who had had their extractions delayed suffered further pain and disruption to their life.

Applying industrial process improvement techniques to increase efficiency in a surgical practice.

Science.gov (United States)

Reznick, David; Niazov, Lora; Holizna, Eric; Siperstein, Allan

2014-10-01

The goal of this study was to examine how industrial process improvement techniques could help streamline the preoperative workup. Lean process improvement was used to streamline patient workup at an endocrine surgery service at a tertiary medical center utilizing multidisciplinary collaboration. The program consisted of several major changes in how patients are processed in the department. The goal was to shorten the wait time between initial call and consult visit and between consult and surgery. We enrolled 1,438 patients enrolled in the program. The wait time from the initial call until consult was reduced from 18.3 ± 0.7 to 15.4 ± 0.9 days. Wait time from consult until operation was reduced from 39.9 ± 1.5 to 33.9 ± 1.3 days for the overall practice and to 15.0 ± 4.8 days for low-risk patients. Patient cancellations were reduced from 27.9 ± 2.4% to 17.3 ± 2.5%. Overall patient flow increased from 30.9 ± 5.1 to 52.4 ± 5.8 consults per month (all P process improvement methodology, surgery patients can benefit from an improved, streamlined process with significant reduction in wait time from call to initial consult and initial consult to surgery, with reduced cancellations. This generalized process has resulted in increased practice throughput and efficiency and is applicable to any surgery practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Strategic focus on 3R principles reveals major reductions in the use of animals in pharmaceutical toxicity testing.

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Elin Törnqvist

Full Text Available The principles of the 3Rs, Replacement, Reduction and Refinement, are being increasingly incorporated into legislations, guidelines and practice of animal experiments in order to safeguard animal welfare. In the present study we have studied the systematic application of 3R principles to toxicological research in the pharmaceutical industry, with particular focus on achieving reductions in animal numbers used in regulatory and investigatory in vivo studies. The work also details major factors influencing these reductions including the conception of ideas, cross-departmental working and acceptance into the work process. Data from 36 reduction projects were collected retrospectively from work between 2006 and 2010. Substantial reduction in animal use was achieved by different strategies, including improved study design, method development and project coordination. Major animal savings were shown in both regulatory and investigative safety studies. If a similar (i.e. 53% reduction had been achieved simultaneously within the twelve largest pharmaceutical companies, the equivalent reduction world-wide would be about 150,000 rats annually. The results point at the importance of a strong 3R culture, with scientific engagement, collaboration and a responsive management being vital components. A strong commitment in leadership for the 3R is recommended to be translated into cross-department and inter-profession involvement in projects for innovation, validation and implementation. Synergies between all the three Rs are observed and conclude that in silico-, in vitro- and in vivo-methods all hold the potential for applying the reduction R and should be consequently coordinated at a strategic level.

[Reducing patient waiting time for the outpatient phlebotomy service using six sigma].

Science.gov (United States)

Kim, Yu Kyung; Song, Kyung Eun; Lee, Won Kil

2009-04-01

One of the challenging issues of the outpatient phlebotomy services at most hospitals is that patients have a long wait. The outpatient phlebotomy team of Kyungpook National University Hospital applied six sigma breakthrough methodologies to reduce the patient waiting time. The DMAIC (Define, Measure, Analyze, Improve, and Control) model was employed to approach the project. Two hundred patients visiting the outpatient phlebotomy section were asked to answer the questionnaires at inception of the study to ascertain root causes. After correction, we surveyed 285 patients for same questionnaires again to follow-up the effects. A defect was defined as extending patient waiting time so long and at the beginning of the project, the performance level was 2.61 sigma. Using fishbone diagram, all the possible reasons for extending patient waiting time were captured, and among them, 16 causes were proven to be statistically significant. Improvement plans including a new receptionist, automatic specimen transport system, and adding one phlebotomist were put into practice. As a result, the number of patients waited more than 5 min significantly decreased, and the performance level reached 3.0 sigma in December 2007 and finally 3.35 sigma in July 2008. Applying the six sigma, the performance level of waiting times for blood drawing exceeding five minutes were improved from 2.61 sigma to 3.35 sigma.

Quality of Life in Rectal Cancer Patients After Chemoradiation: Watch-and-Wait Policy Versus Standard Resection - A Matched-Controlled Study.

Science.gov (United States)

Hupkens, Britt J P; Martens, Milou H; Stoot, Jan H; Berbee, Maaike; Melenhorst, Jarno; Beets-Tan, Regina G; Beets, Geerard L; Breukink, Stéphanie O

2017-10-01

with a limited number of patients and with quality-of-life measurements on nonpredefined and variable intervals after surgery. After a successful watch-and-wait approach, the quality of life was better than after chemoradiation and surgery on several domains. However, chemoradiation therapy on its own is not without long-term side effects, because one-third of the watch-and-wait patients experienced major low anterior resection syndrome symptoms, compared with 66.7% of the patients in the total mesorectal excision group. See Video Abstract at http://links.lww.com/DCR/A395.

Waiting time distribution revealing the internal spin dynamics in a double quantum dot

Science.gov (United States)

Ptaszyński, Krzysztof

2017-07-01

Waiting time distribution and the zero-frequency full counting statistics of unidirectional electron transport through a double quantum dot molecule attached to spin-polarized leads are analyzed using the quantum master equation. The waiting time distribution exhibits a nontrivial dependence on the value of the exchange coupling between the dots and the gradient of the applied magnetic field, which reveals the oscillations between the spin states of the molecule. The zero-frequency full counting statistics, on the other hand, is independent of the aforementioned quantities, thus giving no insight into the internal dynamics. The fact that the waiting time distribution and the zero-frequency full counting statistics give a nonequivalent information is associated with two factors. Firstly, it can be explained by the sensitivity to different timescales of the dynamics of the system. Secondly, it is associated with the presence of the correlation between subsequent waiting times, which makes the renewal theory, relating the full counting statistics and the waiting time distribution, no longer applicable. The study highlights the particular usefulness of the waiting time distribution for the analysis of the internal dynamics of mesoscopic systems.

Sensitivity studies for the main r process: nuclear masses

Directory of Open Access Journals (Sweden)

A. Aprahamian

2014-02-01

Full Text Available The site of the rapid neutron capture process (r process is one of the open challenges in all of physics today. The r process is thought to be responsible for the creation of more than half of all elements beyond iron. The scientific challenges to understanding the origin of the heavy elements beyond iron lie in both the uncertainties associated with astrophysical conditions that are needed to allow an r process to occur and a vast lack of knowledge about the properties of nuclei far from stability. One way is to disentangle the nuclear and astrophysical components of the question. On the nuclear physics side, there is great global competition to access and measure the most exotic nuclei that existing facilities can reach, while simultaneously building new, more powerful accelerators to make even more exotic nuclei. On the astrophysics side, various astrophysical scenarios for the production of the heaviest elements have been proposed but open questions remain. This paper reports on a sensitivity study of the r process to determine the most crucial nuclear masses to measure using an r-process simulation code, several mass models (FRDM, Duflo-Zuker, and HFB-21, and three potential astrophysical scenarios.

Survey of Access to GastroEnterology in Canada: The SAGE wait times program

Science.gov (United States)

Leddin, Desmond; Bridges, Ronald J; Morgan, David G; Fallone, Carlo; Render, Craig; Plourde, Victor; Gray, Jim; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E Jan

2010-01-01

BACKGROUND: Assessment of current wait times for specialist health services in Canada is a key method that can assist government and health care providers to plan wisely for future health needs. These data are not readily available. A method to capture wait time data at the time of consultation or procedure has been developed, which should be applicable to other specialist groups and also allows for assessment of wait time trends over intervals of years. METHODS: In November 2008, gastroenterologists across Canada were asked to complete a questionnaire (online or by fax) that included personal demographics and data from one week on at least five consecutive new consultations and five consecutive procedure patients who had not previously undergone a procedure for the same indication. Wait times were collected for 18 primary indications and results were then compared with similar survey data collected in 2005. RESULTS: The longest wait times observed were for screening colonoscopy (201 days) and surveillance of previous colon cancer or polyps (272 days). The shortest wait times were for cancer-likely based on imaging or physical examination (82 days), severe or rapidly progressing dysphagia or odynophagia (83 days), documented iron-deficiency anemia (90 days) and dyspepsia with alarm symptoms (99 days). Compared with 2005 data, total wait times in 2008 were lengthened overall (127 days versus 155 days; Pgastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005. PMID:20186352

Fission and r-process nucleosynthesis in neutron star mergers

International Nuclear Information System (INIS)

Giuliani, Samuel Andrea

2018-01-01

Fission plays a crucial role for the r-process nucleosynthesis in neutron star mergers. Due to the high neutron densities achieved in this astrophysical scenario the sequence of neutron captures and beta decays that constitutes the r process produces superheavy neutron rich nuclei that become unstable against fission. Fission determines thus the heaviest nuclei that can be produced by the r process and the fission yields shape the abundances of lighter nuclei. But despite the key role of fission the sensitivity of the r-process nucleosynthesis to uncertainties in fission predictions has not been explored. Nowadays there are only few set of fission rates suited for r-process calculations and most of them rely on a simplified treatment of the fission process. In this thesis we go beyond these approximations and compute the fission properties of r-process nuclei using the energy density functional approach. Fission is described as a tunneling process where the nucleus ''moves'' in a collective space characterized by coordinates describing the nuclear shape. Thus fission depends on the evolution of the energy with the deformation but also on the inertia due to the motion in the collective space. This is analogous to the quantum mechanical tunneling of a particle inside a potential well. In our study the relevant quantities for the description of the fission process are consistently computed for 3642 nuclei following the Hartree-Fock-Bogolyubov theory with constraining operators. We perform an extensive benchmark against the available experimental data and explore the variations of the fission properties along the superheavy landscape. We find that while collective inertias have a strong impact in the fission probabilities of light nuclei their role becomes less relevant in r -process nuclei. Within the statistical model we compute the neutron induced stellar reaction rates relevant for the r-process nucleosynthesis. These sets of stellar reaction

Consumer behaviour in the waiting area

NARCIS (Netherlands)

Mobach, M.P.

Objective of the study: To determine consumer behaviour in the pharmacy waiting area. Method: The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each

Patient Satisfaction Is Associated With Time With Provider But Not Clinic Wait Time Among Orthopedic Patients.

Science.gov (United States)

Patterson, Brendan M; Eskildsen, Scott M; Clement, R Carter; Lin, Feng-Chang; Olcott, Christopher W; Del Gaizo, Daniel J; Tennant, Joshua N

2017-01-01

Clinic wait time is considered an important predictor of patient satisfaction. The goal of this study was to determine whether patient satisfaction among orthopedic patients is associated with clinic wait time and time with the provider. The authors prospectively enrolled 182 patients at their outpatient orthopedic clinic. Clinic wait time was defined as the time between patient check-in and being seen by the surgeon. Time spent with the provider was defined as the total time the patient spent in the examination room with the surgeon. The Consumer Assessment of Healthcare Providers and Systems survey was used to measure patient satisfaction. Factors associated with increased patient satisfaction included patient age and increased time with the surgeon (P=.024 and P=.037, respectively), but not clinic wait time (P=.625). Perceived wait time was subject to a high level of error, and most patients did not accurately report whether they had been waiting longer than 15 minutes to see a provider until they had waited at least 60 minutes (P=.007). If the results of the current study are generalizable, time with the surgeon is associated with patient satisfaction in orthopedic clinics, but wait time is not. Further, the study findings showed that patients in this setting did not have an accurate perception of actual wait time, with many patients underestimating the time they waited to see a provider. Thus, a potential strategy for improving patient satisfaction is to spend more time with each patient, even at the expense of increased wait time. [Orthopedics. 2017; 40(1):43-48.]. Copyright 2016, SLACK Incorporated.

Toys are a potential source of cross-infection in general practitioners' waiting rooms.

Science.gov (United States)

Merriman, Eileen; Corwin, Paul; Ikram, Rosemary

2002-01-01

The waiting rooms of general practitioners' surgeries usually have toys provided for children. The level of contamination of these toys and the effectiveness of toy decontamination was investigated in this study. Hard toys from general practitioners' waiting rooms had relatively low levels of contamination, with only 13.5% of toys showing any coliform counts. There were no hard toys with heavy contamination by coliforms or other bacteria. Soft toys were far more likely to be contaminated, with 20% of toys showing moderate to heavy coliform contamination and 90% showing moderate to heavy bacterial contamination. Many waiting-room toys are not cleaned routinely. Soft toys are hard to disinfect and tend to rapidly become recontaminated after cleaning. Conversely, hard toys can be cleaned and disinfected easily. Soft toys in general practitioners' waiting rooms pose an infectious risk and it is therefore recommended that soft toys are unsuitable for doctors' waiting rooms. PMID:11885823

Waiting times for prostate cancer diagnosis in KwaZulu-Natal, South ...

African Journals Online (AJOL)

prostate cancer (an elevated prostate-specific antigen level or abnormal findings on digital rectal examination) wait to have a prostate biopsy. Objectives. To improve the overall efficiency of the prostate biopsy service offered at St Aidan's Regional Hospital, Durban, SA, by quantifying the burden of disease and waiting times ...

Universality and the astrophysical sites for the r-process

International Nuclear Information System (INIS)

Otsuki, Kaori; Mathews, Grant J.; Wilson, James; Kajino, Toshitaka; Aoki, Wako; Honda, Satoshi

2003-01-01

Several observations of r-process elements in metal-deficient halo stars have been reported which show a Z>56 formed abundance distribution pattern similar to the Solar-system r-process distribution. It was believed that r-process elements for Z>56 in the same ratio and their astrophysical origin is unique because of this. However, quite recently, several controversial observational results have been reported. We calculated nucleosynthesis in various environments using a dynamical code. We find it is possible to reproduce the observed universal abundance distribution for stable Z>56 elements in various environments. Our results do not support a unique astrophysical site for Z>56 elements. These results significantly affect nuclear chronology using actinide elements. We also introduce a recent r-process nucleosynthesis calculation based on a supernovae simulation. Our tentative results indicate over-production of lighter elements and a shortage of actinide elements. (author)

Shape study of the N=Z waiting-point nucleus 72Kr via beta decay

CERN Document Server

Briz Monago, Jose Antonio; Nácher González, Enrique

The Ph.D. thesis entitled “Shape study of the N=Z waiting-point nucleus 72Kr via beta decay” is devoted to the study of the shape of the ground state of the 72Kr nucleus. It is an N=Z nucleus in the mass region A~70-80 where shape transitions and the shape coexistence phenomena have been identified. Furthermore, this nucleus participates in the rp-process as a waiting point due to the slowdown of the process taking place at the arrival to this nucleus. The study of the properties of this nucleus is interesting from the Nuclear Structure point of view, for the phenomena occurring in its mass region and have been predicted for it, and from the Nuclear Astrophysics for the accurate performance of astrophysical calculations. The β+/EC decay of the 72Kr nucleus has been studied through two complementary experiments at the ISOLDE facility at CERN in Geneva (Switzerland). In one of them, the low-spin structure of the daughter nucleus, 72Br, has been revised via conversion electron spectroscopy where the convers...

Iran - waiting and watching

International Nuclear Information System (INIS)

Malhotra, T. C.

2007-01-01

Global oil companies are reported to be divided on the issue of possible energy deals in Iran. Some companies may adopt wait and watch policy before singing a fresh deal with Iran, but there are some oil companies, those are still interested to sign a deal with Iran, despite the risks, even as Tehran decided to expand its uranium enrichment programme rather than complying with a UN Security Council ultimatum to freeze it, which clears the path for further harsher sanctions (author) (ml)

Did Not Wait Patient Management Strategy (DNW PMS) Study.

LENUS (Irish Health Repository)

O'Keeffe, Fran

2011-06-14

Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

Did Not Wait Patient Management Strategy (DNW PMS) Study.

LENUS (Irish Health Repository)

2012-02-01

Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

Falling R and D but stable investments by oil companies, why? A study on R and D and investment in fixed assets in the oil industry

International Nuclear Information System (INIS)

Creusen, H.; Minne, B.

2000-04-01

In the last decade the world-wide research expenditures of the major oil companies have dropped. This is remarkable since their investments in fixed assets remained stable. This study reveals that the level of fixed investments particularly depend on their financial strength, while R and D mainly relates to competitors' research and common expectations. The decline in R and D is initiated by common expectations. In the mature oil industry, companies foresee diminishing research potential within the current technology. This is also confirmed by the declining number of patent applications. The high risks of research on renewable energy may lead to wait and see behaviour instead of new research initiatives. Actually, oil companies have hardly applied for patents on renewable energy. The R and D decline is intensified by a dwindling R and D-race, which is due to a large overlap in research topics. The companies protect their research results because they largely compete on their unique technologies which embody their research results. The research overlap appears from patents: the oil companies apply for patents in exactly the same patent classes. 19 refs

Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department.

Science.gov (United States)

Ng, David; Vail, Gord; Thomas, Sophia; Schmidt, Nicki

2010-01-01

In recognition of patient wait times, and deteriorating patient and staff satisfaction, we set out to improve these measures in our emergency department (ED) without adding any new funding or beds. In 2005 all staff in the ED at Hôtel-Dieu Grace Hospital began a transformation, employing Toyota Lean manufacturing principles to improve ED wait times and quality of care. Lean techniques such as value-stream mapping, just-in-time delivery techniques, workplace organization, reduction of systemic wastes, use of the worker as the source of quality improvement and ongoing refinement of our process steps formed the basis of our project. Our ED has achieved major improvements in departmental flow without adding any additional ED or inpatient beds. The mean registration to physician time has decreased from 111 minutes to 78 minutes. The number of patients who left without being seen has decreased from 7.1% to 4.3%. The length of stay (LOS) for discharged patients has decreased from a mean of 3.6 to 2.8 hours, with the largest decrease seen in our patients triaged at levels 4 or 5 using the Canadian Emergency Department Triage and Acuity Scale. We noted an improvement in ED patient satisfaction scores following the implementation of Lean principles. Lean manufacturing principles can improve the flow of patients through the ED, resulting in greater patient satisfaction along with reduced time spent by the patient in the ED.

How tolerable is delay? : Consumers' evaluations of internet web sites after waiting

NARCIS (Netherlands)

B.G.C. Dellaert (Benedict); B.E. Kahn

1998-01-01

textabstractHow consumer's waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative

Supernova and r-process simulations with relativistic EOS table

International Nuclear Information System (INIS)

Sumiyoshi, Kohsuke

2000-01-01

We study the neutrino-driven wind from the proto-neutron star by the general relativistic hydrodynamical simulations. We examine the properties of the neutrino-driven wind to explore the possibility of the r-process nucleosynthesis. The numerical simulations with the neutrino heating and cooling processes are performed with the assumption of the constant neutrino luminosity by using realistic profiles of the proto-neutron star (PNS) as well as simplified models. The dependence on the mass of PNS and the neutrino luminosity is studied systematically. Comparisons with the analytic treatment in the previous studies are also done. In the cases with the realistic PNS, we found that the entropy per baryon and the expansion time scale are neither high nor short enough for the r-process within the current assumptions. On the other hand, we found that the expansion time scale obtained by the hydrodynamical simulations is systematically shorter than that in the analytic solutions due to our proper treatment of the equation of state. This fact might lead to the increase of the neutron-to-seed ratio, which is suitable for the r-process in the neutrino-driven wind. Indeed, in the case of massive and compact proto-neutron stars with high neutrino luminosities, the expansion time scale is found short enough in the hydrodynamical simulations and the r-process elements up to A ∼ 200 are produced in the r-process network calculation. (author)

Impact of visual art on patient behavior in the emergency department waiting room.

Science.gov (United States)

Nanda, Upali; Chanaud, Cheryl; Nelson, Michael; Zhu, Xi; Bajema, Robyn; Jansen, Ben H

2012-07-01

Wait times have been reported to be one of the most important concerns for people visiting emergency departments (EDs). Affective states significantly impact perception of wait time. There is substantial evidence that art depicting nature reduces stress levels and anxiety, thus potentially impacting the waiting experience. To analyze the effect of visual art depicting nature (still and video) on patients' and visitors' behavior in the ED. A pre-post research design was implemented using systematic behavioral observation of patients and visitors in the ED waiting rooms of two hospitals over a period of 4 months. Thirty hours of data were collected before and after new still and video art was installed at each site. Significant reduction in restlessness, noise level, and people staring at other people in the room was found at both sites. A significant decrease in the number of queries made at the front desk and a significant increase in social interaction were found at one of the sites. Visual art has positive effects on the ED waiting experience. Copyright © 2012 Elsevier Inc. All rights reserved.

Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France.

Science.gov (United States)

Molinié, F; Leux, C; Delafosse, P; Ayrault-Piault, S; Arveux, P; Woronoff, A S; Guizard, A V; Velten, M; Ganry, O; Bara, S; Daubisse-Marliac, L; Tretarre, B

2013-10-01

Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France. Copyright © 2013 Elsevier Ltd. All rights reserved.

Reasons for dropping out from a waiting list for in vitro fertilization

NARCIS (Netherlands)

van Dongen, Angelique J. C. M.; Verhagen, Tamara E. M.; Dumoulin, John C. M.; Land, Jolande A.; Evers, Johannes L. H.

2010-01-01

Objective: To determine the incidence of couples dropping out of the in vitro fertilization (IVF) waiting list and to describe the couples' reasons. Design: Prospective cohort study. Setting: Fertility center in an academic hospital. Patient(s): 674 women placed consecutively on the IVF waiting list

Impact of waiting on the perception of service quality in nuclear medicine

NARCIS (Netherlands)

De Man, S; Vlerick, P; Gemmel, P; De Bondt, P; Matthys, D; Dierckx, RA

Background This is the first study examining the link between waiting and various dimensions of perceived service quality in nuclear medicine. Methods We tested the impact of selected waiting experience variables on the evaluation of service quality, measured using the Servqual tool, of 406 patients

Worth the Wait? Using Past Patterns to Determine Wait Periods for E-Books Released after Print

Science.gov (United States)

Kohn, Karen

2018-01-01

This paper asks if there is an optimal wait period for e-books that balances libraries' desire to acquire books soon after their publication with the frequent desire to purchase books electronically whenever feasible. Analyzing 13,043 titles that Temple University Libraries received on its e-preferred approval plan in 2014-15, the author looks at…

Effect of socioeconomic deprivation on waiting time for cardiac surgery: retrospective cohort study

Science.gov (United States)

Pell, Jill P; Pell, Alastair C H; Norrie, John; Ford, Ian; Cobbe, Stuart M

2000-01-01

Objective To determine whether the priority given to patients referred for cardiac surgery is associated with socioeconomic status. Design Retrospective study with multivariate logistic regression analysis of the association between deprivation and classification of urgency with allowance for age, sex, and type of operation. Multivariate linear regression analysis was used to determine association between deprivation and waiting time within each category of urgency, with allowance for age, sex, and type of operation. Setting NHS waiting lists in Scotland. Participants 26 642 patients waiting for cardiac surgery, 1 January 1986 to 31 December 1997. Main outcome measures Deprivation as measured by Carstairs deprivation category. Time spent on NHS waiting list. Results Patients who were most deprived tended to be younger and were more likely to be female. Patients in deprivation categories 6 and 7 (most deprived) waited about three weeks longer for surgery than those in category 1 (mean difference 24 days, 95% confidence interval 15 to 32). Deprived patients had an odds ratio of 0.5 (0.46 to 0.61) for having their operations classified as urgent compared with the least deprived, after allowance for age, sex, and type of operation. When urgent and routine cases were considered separately, there was no significant difference in waiting times between the most and least deprived categories. Conclusions Socioeconomically deprived patients are thought to be more likely to develop coronary heart disease but are less likely to be investigated and offered surgery once it has developed. Such patients may be further disadvantaged by having to wait longer for surgery because of being given lower priority. PMID:10617517

TSA Security Checkpoint Wait Times – API (PMIS)

Data.gov (United States)

Department of Homeland Security — TSA operational data including: Airport wait time (hourly) data Airport throughput (hourly) data Prohibited item (hourly) data Monthly Objectives Report (MOR) data...

Analysing passenger arrivals rates and waiting time at bus stops

OpenAIRE

Kaparias, I.; Rossetti, C.; Trozzi, V.

2015-01-01

The present study investigates the rather under-explored topic of passenger waiting times at public transport facilities. Using data collected from part of London’s bus network by means of physical counts, measurements and observations, and complemented by on-site passenger interviews, the waiting behaviour is analysed for a number of bus stops served by different numbers of lines. The analysis employs a wide range of statistical methods and tools, and concentrates on three aspects: passenger...

Waiting room crowding and agitation in a dedicated psychiatric emergency service.

Science.gov (United States)

El-Mallakh, Rif S; Whiteley, Amanda; Wozniak, Tanya; Ashby, McCray; Brown, Shawn; Colbert-Trowel, Danya; Pennington, Tammy; Thompson, Michael; Tasnin, Rokeya; Terrell, Christina L

2012-05-01

Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services. The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month. A total of 689 patients were seen in 31 days. The average hourly census was 6.8 ± 2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2 = 0.3, F = 5.47, P = .036). Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.

Posted wait times an added advantage to multi-facility systems?

Science.gov (United States)

2011-04-01

Methodist Le Bonheur Healthcare in Memphis, TN, is investigating whether posting ED wait times via the internet can positively impact patient flow in the six EDs the health system operates in the Memphis region. The health system began posting wait times in August 2010, resulting in increases in ED volume ranging from 6% to 10%. The health system is monitoring ED arrivals by zip code to assess any impact on load balancing between its busy EDs. One marketing challenge is that a competitor is posting ED wait times as well, but it is posting the time it takes for a patient to be placed in a bed as opposed to the door-to-provider time that Methodist Le Bonheur is posting. The approach has the most impact on lower-acuity patients, but experts worry that in the future, payers may not be reimbursed for ED care for these patients.

Waiting for Art: The Experience of Real Time in Sculpture

Directory of Open Access Journals (Sweden)

Elizabeth Buhe

2011-05-01

Full Text Available Why and how does some contemporary art make us wait, and why does the beholder choose to stay? This study seeks to answer this question by exploring what happens to the viewer while waiting in front of a “time sculpture,” a term coined here to mean a three-dimensional artwork that is dynamic over a set period of time. Through an analysis of select works by artists Anish Kapoor, Amelia Whitelaw, Michael Sailstorfer, and Roman Signer, the article posits that while in front of these time sculptures, the viewer experiences an anxiety of waiting and temporal confusion that glues him to the spot. Ultimately, by drawing upon Henri Bergson’s concept of duration, the essay suggests that the viewership of time sculpture allows for a heightened state of perception. Normal 0 false false false EN-US X-NONE X-NONE

Lung transplantation: overall approach regarding its major aspects

Science.gov (United States)

de Camargo, Priscila Cilene León Bueno; Teixeira, Ricardo Henrique de Oliveira Braga; Carraro, Rafael Medeiros; Campos, Silvia Vidal; Afonso, José Eduardo; Costa, André Nathan; Fernandes, Lucas Matos; Abdalla, Luis Gustavo; Samano, Marcos Naoyuki; Pêgo-Fernandes, Paulo Manuel

2015-01-01

ABSTRACT Lung transplantation is a well-established treatment for patients with advanced lung disease. The evaluation of a candidate for transplantation is a complex task and involves a multidisciplinary team that follows the patient beyond the postoperative period. Currently, the mean time on the waiting list for lung transplantation in the state of São Paulo, Brazil, is approximately 18 months. For Brazil as a whole, data from the Brazilian Organ Transplant Association show that, in 2014, there were 67 lung transplants and 204 patients on the waiting list for lung transplantation. Lung transplantation is most often indicated in cases of COPD, cystic fibrosis, interstitial lung disease, non-cystic fibrosis bronchiectasis, and pulmonary hypertension. This comprehensive review aimed to address the major aspects of lung transplantation: indications, contraindications, evaluation of transplant candidates, evaluation of donor candidates, management of transplant recipients, and major complications. To that end, we based our research on the International Society for Heart and Lung Transplantation guidelines and on the protocols used by our Lung Transplant Group in the city of São Paulo, Brazil. PMID:26785965

Costly waiting for the future gas energy

International Nuclear Information System (INIS)

1999-01-01

The article discusses solutions while waiting for the pollution free gas power plant and points out that Norway will have to import Danish power from coal and Swedish nuclear energy for a long time yet. Various future scenarios are mentioned

Rosen's (M,R) system in process algebra.

Science.gov (United States)

Gatherer, Derek; Galpin, Vashti

2013-11-17

Robert Rosen's Metabolism-Replacement, or (M,R), system can be represented as a compact network structure with a single source and three products derived from that source in three consecutive reactions. (M,R) has been claimed to be non-reducible to its components and algorithmically non-computable, in the sense of not being evaluable as a function by a Turing machine. If (M,R)-like structures are present in real biological networks, this suggests that many biological networks will be non-computable, with implications for those branches of systems biology that rely on in silico modelling for predictive purposes. We instantiate (M,R) using the process algebra Bio-PEPA, and discuss the extent to which our model represents a true realization of (M,R). We observe that under some starting conditions and parameter values, stable states can be achieved. Although formal demonstration of algorithmic computability remains elusive for (M,R), we discuss the extent to which our Bio-PEPA representation of (M,R) allows us to sidestep Rosen's fundamental objections to computational systems biology. We argue that the behaviour of (M,R) in Bio-PEPA shows life-like properties.

The R-Process Alliance: 2MASS J09544277+5246414, the Most Actinide-enhanced R-II Star Known

Science.gov (United States)

Holmbeck, Erika M.; Beers, Timothy C.; Roederer, Ian U.; Placco, Vinicius M.; Hansen, Terese T.; Sakari, Charli M.; Sneden, Christopher; Liu, Chao; Lee, Young Sun; Cowan, John J.; Frebel, Anna

2018-06-01

We report the discovery of a new actinide-boost star, 2MASS J09544277+5246414, originally identified as a very bright (V = 10.1), extremely metal-poor ([Fe/H] = ‑2.99) K giant in the LAMOST survey, and found to be highly r-process-enhanced (r-II; [Eu/Fe] = +1.28]), during the snapshot phase of the R-Process Alliance (RPA). Based on a high signal-to-noise ratio (S/N), high-resolution spectrum obtained with the Harlan J. Smith 2.7 m telescope, this star is the first confirmed actinide-boost star found by RPA efforts. With an enhancement of [Th/Eu] = +0.37, 2MASS J09544277+5246414 is also the most actinide-enhanced r-II star yet discovered, and only the sixth metal-poor star with a measured uranium abundance ([U/Fe] = +1.40). Using the Th/U chronometer, we estimate an age of 13.0 ± 4.7 Gyr for this star. The unambiguous actinide-boost signature of this extremely metal-poor star, combined with additional r-process-enhanced and actinide-boost stars identified by the RPA, will provide strong constraints on the nature and origin of the r-process at early times.

The impact of different prioritisation policies on waiting times: case studies of Norway and Scotland.

Science.gov (United States)

Januleviciute, Jurgita; Askildsen, Jan Erik; Kaarboe, Oddvar; Holmås, Tor Helge; Sutton, Matt

2013-11-01

We investigate the distributional consequences of two different waiting times initiatives, one in Norway, and one in Scotland. The primary focus of Scotland's recent waiting time reforms, introduced in 2003, and modified in 2005 and 2007, has been on reducing maximum waiting times through the imposition of high profile national targets accompanied by increases in resources. In Norway, the focus of the reform introduced in September 2004, has been on assigning patients referred to hospital a maximum waiting time based on disease severity, the expected benefit and the cost-effectiveness of the treatment. We use large, national administrative datasets from before and after each of these reforms and assign priority groups based on the maximum waiting times stipulated in medical guidelines. The analysis shows that the lowest priority patients benefited most from both reforms. This was at the cost of longer waiting times for patients that should have been given higher priority in Norway, while Scotland's high priority patients remained unaffected. Copyright © 2013 Elsevier Ltd. All rights reserved.

Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study

Directory of Open Access Journals (Sweden)

Petrelli Alessio

2012-08-01

Full Text Available Abstract Background Widespread literature on inequity in healthcare access and utilization has been published, but research on socioeconomic differences in waiting times is sparse and the evidence is fragmentary and controversial. The objective of the present study is the analysis of the relationship between individual socioeconomic level and waiting times for in-hospital elective surgery. Methods We retrospectively studied the waiting times experienced by patients registered on hospital waiting lists for 6 important surgical procedures by using the Hospital Discharge Database (HDD of the Piedmont Region (4,000,000 inhabitants in the North West of Italy from 2006 to 2008. The surgical procedures analyzed were: coronary artery by-pass (CABG, angioplasty, coronarography, endarterectomy, hip replacement and cholecystectomy. Cox regression models were estimated to study the relationship between waiting times and educational level taking into account the confounding effect of the following factors: sex, age, comorbidity, registration period, and Local Health Authorities (LHA as a proxy of supply. Results Median waiting times for low educational level were higher than for high educational level for all the selected procedures. Differences were particularly high for endarterectomy and hip replacement. For all considered procedures, except CABG, an inverse gradient between waiting times and educational level was observed: the conditional probabilities of undergoing surgery were lower among individuals with a low to middle level education than for individuals with a higher level of education after adjustment for sex, age, comorbidities, registration period, and LHAs. For most procedures the effect decreases over the follow up period. Conclusions The results of the study show evidence of inequalities in access to elective surgery in Italy. Implementation of policies aimed to promote national information initiatives that guarantee wider access to those

Sci-Fri AM: Quality, Safety, and Professional Issues 04: Predicting waiting times in Radiation Oncology using machine learning

International Nuclear Information System (INIS)

Joseph, Ackeem; Herrera, David; Hijal, Tarek; Hendren, Laurie; Leung, Alvin; Wainberg, Justin; Sawaf, Marya; Maxim, Gorshkov; Maglieri, Robert; Keshavarz, Mehryar; Kildea, John

2016-01-01

We describe a method for predicting waiting times in radiation oncology. Machine learning is a powerful predictive modelling tool that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The patient waiting experience remains one of the most vexing challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick and in pain, to worry about when they will receive the care they need. In radiation oncology, patients typically experience three types of waiting: Waiting at home for their treatment plan to be prepared Waiting in the waiting room for daily radiotherapy Waiting in the waiting room to see a physician in consultation or follow-up These waiting periods are difficult for staff to predict and only rough estimates are typically provided, based on personal experience. In the present era of electronic health records, waiting times need not be so uncertain. At our centre, we have incorporated the electronic treatment records of all previously-treated patients into our machine learning model. We found that the Random Forest Regression model provides the best predictions for daily radiotherapy treatment waiting times (type 2). Using this model, we achieved a median residual (actual minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes. The main features that generated the best fit model (from most to least significant) are: Allocated time, median past duration, fraction number and the number of treatment fields.

Sci-Fri AM: Quality, Safety, and Professional Issues 04: Predicting waiting times in Radiation Oncology using machine learning

Energy Technology Data Exchange (ETDEWEB)

Joseph, Ackeem; Herrera, David; Hijal, Tarek; Hendren, Laurie; Leung, Alvin; Wainberg, Justin; Sawaf, Marya; Maxim, Gorshkov; Maglieri, Robert; Keshavarz, Mehryar; Kildea, John [McGill University Health Centre (Canada)

2016-08-15

We describe a method for predicting waiting times in radiation oncology. Machine learning is a powerful predictive modelling tool that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The patient waiting experience remains one of the most vexing challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick and in pain, to worry about when they will receive the care they need. In radiation oncology, patients typically experience three types of waiting: Waiting at home for their treatment plan to be prepared Waiting in the waiting room for daily radiotherapy Waiting in the waiting room to see a physician in consultation or follow-up These waiting periods are difficult for staff to predict and only rough estimates are typically provided, based on personal experience. In the present era of electronic health records, waiting times need not be so uncertain. At our centre, we have incorporated the electronic treatment records of all previously-treated patients into our machine learning model. We found that the Random Forest Regression model provides the best predictions for daily radiotherapy treatment waiting times (type 2). Using this model, we achieved a median residual (actual minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes. The main features that generated the best fit model (from most to least significant) are: Allocated time, median past duration, fraction number and the number of treatment fields.

Lean-driven improvements slash wait times, drive up patient satisfaction scores.

Science.gov (United States)

2012-07-01

Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

Wait times in the emergency department for patients with mental illness

Science.gov (United States)

Atzema, Clare L.; Schull, Michael J.; Kurdyak, Paul; Menezes, Natasja M.; Wilton, Andrew S.; Vermuelen, Marian J.; Austin, Peter C.

2012-01-01

Background: It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department. Methods: We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period. Results: The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41–147 min v. median 75 [IQR 36–140] min; p < 0.001). The median time from the decision to admit the patient to hospital to ward transfer was markedly shorter for patients with mental illness than for other patients (median 74 [IQR 15–215] min v. median 152 [IQR 45–605] min; p < 0.001). After adjustment for other variables, patients with mental illness waited 10 minutes longer to see a physician compared with other patients during noncrowded periods (95% confidence interval [CI] 8 to 11), but they waited significantly less time than other patients as crowding increased (mild crowding: −14 [95% CI −12 to −15] min; moderate crowding: −38 [95% CI −35 to −42] min; severe crowding: −48 [95% CI −39 to −56] min; p < 0.001). Interpretation: Patients with mental illness were triaged appropriately in Ontario’s emergency departments. These patients waited less time than other patients to see a physician under crowded conditions and only slightly longer under noncrowded conditions. PMID:23148052

The role of nuclear inputs in r-process nucleosynthesis

Energy Technology Data Exchange (ETDEWEB)

Giuliani, Samuel Andrea; Arzhanov, Alexander; Friess, Stephen; Martinez-Pinedo, Gabriel; Moeller, Heiko; Sieverding, Andre; Wu, Meng-Ru [TU Darmstadt (Germany)

2016-07-01

We have studied the sensitivity of the r-process abundances produced in dynamical ejecta from neutron star mergers to different nuclear mass models. For each mass model, the resulting abundances are almost independent of the astrophysical conditions and reproduce the general features of the observed r-process abundance. We find that the second peak around A ∝ 130 is produced by the fission yields of the material that piles up in nuclei with A >or similar 250. We also find distinct differences in the predictions at and just above the third peak (A ∝ 195) for different mass models, due to different neutron separation energies at N = 130. Due to the crucial role that fission plays in r-process nucleosynthesis, we have computed the fission properties of superheavy nuclei using the BCPM energy density functional. We found that certain combinations of neutron and proton number lead to an enhanced stability against the spontaneous fission process, related with the existence of magic numbers in the superheavy region. However, the systematic of the fission properties is strongly affected by the choice of the collective degree of freedom when the fission path is obtained by minimizing the action integral. Finally, a comparison with other theoretical models and the consequences for r-process nucleosynthesis are discussed.

Reading of Waiting, Time and Social Change in S. N. A. Agoro's ...

African Journals Online (AJOL)

It is against this backdrop that we attempt to explore the depiction and treatment of waiting, time and social change in the dramatic universe of existentialism created by some playwrights who have not been given scholarly attention. The study shall therefore undertake a dialectical consideration of the concept of waiting and ...

Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India

Directory of Open Access Journals (Sweden)

Yogesh Tiwari

2014-01-01

Full Text Available Background: Emergency Department (ED of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients. Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD. Materials and Methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc. of the emergency. Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be "9.00-12.00 h" in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients "under observation" (29.6%; "waiting for routine diagnostic tests" (16.4% and "waiting for discharge" (14.6%. Around 71% patients were waiting due to reasons within emergency complex. Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

Research on the waiting time of passengers and escalator energy consumption at the railway station

Energy Technology Data Exchange (ETDEWEB)

Ma, Wei-wu; Liu, Xiao-yan; Li, Liqing; Shi, Xiangnan; Zhou, Chenn Q. [School of Energy Science and Engineering, Central South University, Changsha 410083 (China)

2009-12-15

Based on the Little Formula and the classical queuing model of multi-channel M vertical stroke D vertical stroke n, the relation of the average queue length, the maximum waiting time and the escalator service intensity were identified and the waiting time simulation model was established. With the passenger delivery data at A railway station in China and the probability distribution model of waiting time, a detailed analysis was made on the escalator allocation, power and energy consumption on holidays, ordinary working days and the largest-passengers-volume days; meanwhile, the fixed and variable energy consumption were compared and studied when the waiting time are 5, 10 and 30 s. The result shows that the waiting time settings affect the allocation and the energy consumption of the escalators and the fixed energy consumption takes 70%. (author)

Patient satisfaction with wait times at an emergency ophthalmology on-call service.

Science.gov (United States)

Chan, Brian J; Barbosa, Joshua; Moinul, Prima; Sivachandran, Nirojini; Donaldson, Laura; Zhao, Lily; Mullen, Sarah J; McLaughlin, Christopher R; Chaudhary, Varun

2018-04-01

To assess patient satisfaction with emergency ophthalmology care and determine the effect provision of anticipated appointment wait time has on scores. Single-centre, randomized control trial. Fifty patients triaged at the Hamilton Regional Eye Institute (HREI) from November 2015 to July 2016. Fifty patients triaged for next-day appointments at the HREI were randomly assigned to receive standard-of-care preappointment information or standard-of-care information in addition to an estimated appointment wait time. Patient satisfaction with care was assessed postvisit using the modified Judgements of Hospital Quality Questionnaire (JHQQ). In determining how informing patients of typical wait times influenced satisfaction, the Mann-Whitney U test was performed. As secondary study outcomes, we sought to determine patient satisfaction with the intervention material using the Fisher exact test and the effect that wait time, age, sex, education, mobility, and number of health care providers seen had on satisfaction scores using logistic regression analysis. The median JHQQ response was "very good" (4/5) and between "very good" and "excellent" (4.5/5) in the intervention and control arms, respectively. There was no difference in patient satisfaction between the cohorts (Mann-Whitney U = 297.00, p = 0.964). Logistic regression analysis demonstrated that wait times influenced patient satisfaction (OR = 0.919, 95% CI 0.864-0.978, p = 0.008). Of the intervention arm patients, 92.0% (N = 23) found the preappointment information useful, whereas only 12.5% (N = 3) of the control cohort patients noted the same (p < 0.001). Provision of anticipated wait time information to patients in an emergency on-call ophthalmology clinic did not influence satisfaction with care as captured by the JHQQ. Copyright © 2018 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

The human nucleolar protein FTSJ3 associates with NIP7 and functions in pre-rRNA processing.

Directory of Open Access Journals (Sweden)

Luis G Morello

Full Text Available NIP7 is one of the many trans-acting factors required for eukaryotic ribosome biogenesis, which interacts with nascent pre-ribosomal particles and dissociates as they complete maturation and are exported to the cytoplasm. By using conditional knockdown, we have shown previously that yeast Nip7p is required primarily for 60S subunit synthesis while human NIP7 is involved in the biogenesis of 40S subunit. This raised the possibility that human NIP7 interacts with a different set of proteins as compared to the yeast protein. By using the yeast two-hybrid system we identified FTSJ3, a putative ortholog of yeast Spb1p, as a human NIP7-interacting protein. A functional association between NIP7 and FTSJ3 is further supported by colocalization and coimmunoprecipitation analyses. Conditional knockdown revealed that depletion of FTSJ3 affects cell proliferation and causes pre-rRNA processing defects. The major pre-rRNA processing defect involves accumulation of the 34S pre-rRNA encompassing from site A' to site 2b. Accumulation of this pre-rRNA indicates that processing of sites A0, 1 and 2 are slower in cells depleted of FTSJ3 and implicates FTSJ3 in the pathway leading to 18S rRNA maturation as observed previously for NIP7. The results presented in this work indicate a close functional interaction between NIP7 and FTSJ3 during pre-rRNA processing and show that FTSJ3 participates in ribosome synthesis in human cells.

Public reporting on quality, waiting times and patient experience in 11 high-income countries.

Science.gov (United States)

Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew; Palm, Willy; Nolte, Ellen

2016-04-01

This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

R-process enrichment from a single event in an ancient dwarf galaxy.

Science.gov (United States)

Ji, Alexander P; Frebel, Anna; Chiti, Anirudh; Simon, Joshua D

2016-03-31

Elements heavier than zinc are synthesized through the rapid (r) and slow (s) neutron-capture processes. The main site of production of the r-process elements (such as europium) has been debated for nearly 60 years. Initial studies of trends in chemical abundances in old Milky Way halo stars suggested that these elements are produced continually, in sites such as core-collapse supernovae. But evidence from the local Universe favours the idea that r-process production occurs mainly during rare events, such as neutron star mergers. The appearance of a plateau of europium abundance in some dwarf spheroidal galaxies has been suggested as evidence for rare r-process enrichment in the early Universe, but only under the assumption that no gas accretes into those dwarf galaxies; gas accretion favours continual r-process enrichment in these systems. Furthermore, the universal r-process pattern has not been cleanly identified in dwarf spheroidals. The smaller, chemically simpler, and more ancient ultrafaint dwarf galaxies assembled shortly after the first stars formed, and are ideal systems with which to study nucleosynthesis events such as the r-process. Reticulum II is one such galaxy. The abundances of non-neutron-capture elements in this galaxy (and others like it) are similar to those in other old stars. Here, we report that seven of the nine brightest stars in Reticulum II, observed with high-resolution spectroscopy, show strong enhancements in heavy neutron-capture elements, with abundances that follow the universal r-process pattern beyond barium. The enhancement seen in this 'r-process galaxy' is two to three orders of magnitude higher than that detected in any other ultrafaint dwarf galaxy. This implies that a single, rare event produced the r-process material in Reticulum II. The r-process yield and event rate are incompatible with the source being ordinary core-collapse supernovae, but consistent with other possible sources, such as neutron star mergers.

The Impact of Patient-to-Patient Interaction in Health Facility Waiting Rooms on Their Perception of Health Professionals.

Science.gov (United States)

Willis, William Kent; Ozturk, Ahmet Ozzie; Chandra, Ashish

2015-01-01

Patients have to wait in waiting rooms prior to seeing the physician. But there are few studies that demonstrate what they are actually doing in the waiting room. This exploratory study was designed to investigate the types of discussions that patients in the waiting room typically engage in with other patients and how the conversations affected their opinion on general reputation of the clinic, injections/blocks as treatment procedures, waiting time, time spent with the caregiver, overall patient satisfaction, and the pain medication usage policy. The study demonstrates that patient interaction in the waiting room has a positive effect on patient opinion of the pain clinic and the caregivers.

Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

Science.gov (United States)

Charoenthanakit, C; Junchotikul, P; Sittiudomsuk, R; Saiyud, A; Pratumphai, P

2016-04-01

A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P multimedia program had good average, 4.58. Copyright © 2016 Elsevier Inc. All rights reserved.

Inter-firm R&D networks in the global software industry : An overview of major trends and patterns

NARCIS (Netherlands)

Cloodt, M.M.A.H.; Hagedoorn, J.; Roijakkers, N.

2010-01-01

This paper presents an analysis of some major historical trends in inter-firm R&D partnering in the international software industry during the period 1970–1999. Our research demonstrates an overall growth pattern of newly made R&D partnerships and reveals the important role played by leading firms.

Raising Introspective Awareness in Resisting Colonizing Ideologies: Coetzee's Waiting for the Barbarians

Directory of Open Access Journals (Sweden)

Sameer M. Al-Shraah

2017-11-01

Full Text Available Deconstructing colonization and the colonizing discourse is a long and continuing process. Many intellectuals participated, and still participate, in this noble mission. However, "Waiting for the Barbarians" is a literary work that resists the colonial ideology through raising the colonizer's, and consequently the reader's, awareness of the pervasive ideology of dehumanization; it is this ideology that makes possible the severe torture of the prisoners without the torturers' feeling or awareness of their criminal deeds. This ideology of dehumanization and the struggle against its domination is manifested by the character of the protagonist who, as a representative of the colonizer, experiences a gradual process of confusion, introspection, and remorse that enables the reader to experience closely, rather than merely witness from a distance, an exemplary process of self-questioning. This theme of self-questioning is one of the main themes of Coetzee's Waiting for the Barbarians. The novel creates in us an ability to question the different ideologies that enslaved us unconsciously, especially at our modern time when It seems that we became so obsessed with materialism and our existential needs that risking one's physical safety or financial security to stand up for one's principles will never be an issue for most people, especially those living in what was known as colonizing countries or, in modern terminology, the developed or first world. Thus, the aim of this paper is to investigate how the novel creates in its reader a revival of a moral and ultimately political sensibility that is usually inhibited by the ideology of dehumanization.

Impact of Delayed Whole Blood Processing Time on Plasma Levels of miR-1 and miR-423-5p up to 24 Hours.

Science.gov (United States)

Borges, Danielle Pazzotti; Cunha-Neto, Edecio; Bocchi, Edimar A; Rigaud, Vagner Oliveira Carvalho

2018-03-21

Circulating cell-free miRNAs hold great promise as a new class of biomarkers due to their high stability in body fluids and association with disease stages. However, even using sensitive and specific methods, technical challenges are associated with miRNA analysis in body fluids. A major source of variation in plasma and serum is the potential cell-derived miRNA contamination from hemolysis. To evaluate the effect of the delayed whole blood processing time on the concentrations of miR-1 and -423-5p. Ten blood samples were incubated for 0, 3 and 24 hours at room temperature prior processing into plasma. For each time point, hemolysis was assessed in plasma by UV spectrophotometry at 414nm wavelength (λ414). Circulating levels of miR-1 and -423-5p were measured by RT-qPCR; miR-23a and -451 were also analyzed as controls. A significant hemolysis was observed only after 24h (λ414 0.3±0.02, plevels were observed up to 24h of storage at room temperature (Ct 31.5±0.5 to 31.8±0.6for miR-1, p=0.989; and 29.01±0.3 to 29.04±0.3, p=0.614 for -423-5p). No correlation was observed between hemolysis and levels of miR-1 and -423-5p. Our data indicate the storage of whole blood samples at room temperature for up to 24h prior their processing into plasma does not appear to have a significant impact on miR-1 and -423-5p concentrations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Simulating neutron star mergers as r-process sources in ultrafaint dwarf galaxies

Science.gov (United States)

Safarzadeh, Mohammadtaher; Scannapieco, Evan

2017-10-01

To explain the high observed abundances of r-process elements in local ultrafaint dwarf (UFD) galaxies, we perform cosmological zoom simulations that include r-process production from neutron star mergers (NSMs). We model star formation stochastically and simulate two different haloes with total masses ≈108 M⊙ at z = 6. We find that the final distribution of [Eu/H] versus [Fe/H] is relatively insensitive to the energy by which the r-process material is ejected into the interstellar medium, but strongly sensitive to the environment in which the NSM event occurs. In one halo, the NSM event takes place at the centre of the stellar distribution, leading to high levels of r-process enrichment such as seen in a local UFD, Reticulum II (Ret II). In a second halo, the NSM event takes place outside of the densest part of the galaxy, leading to a more extended r-process distribution. The subsequent star formation occurs in an interstellar medium with shallow levels of r-process enrichment that results in stars with low levels of [Eu/H] compared to Ret II stars even when the maximum possible r-process mass is assumed to be ejected. This suggests that the natal kicks of neutron stars may also play an important role in determining the r-process abundances in UFD galaxies, a topic that warrants further theoretical investigation.

Client waiting time in an urban primary health care centre in Lagos ...

African Journals Online (AJOL)

Background: Primary Health Care is the usual entry point into the health system and has the potential to touch the lives of most people. However one of the reasons for poor uptake of health services at primary health care facilities in Nigeria is long waiting time. This study was carried out to assess client waiting time and ...

Self-Referential Processing, Rumination, and Cortical Midline Structures in Major Depression

Science.gov (United States)

Nejad, Ayna Baladi; Fossati, Philippe; Lemogne, Cédric

2013-01-01

Major depression is associated with a bias toward negative emotional processing and increased self-focus, i.e., the process by which one engages in self-referential processing. The increased self-focus in depression is suggested to be of a persistent, repetitive and self-critical nature, and is conceptualized as ruminative brooding. The role of the medial prefrontal cortex in self-referential processing has been previously emphasized in acute major depression. There is increasing evidence that self-referential processing as well as the cortical midline structures play a major role in the development, course, and treatment response of major depressive disorder. However, the links between self-referential processing, rumination, and the cortical midline structures in depression are still poorly understood. Here, we reviewed brain imaging studies in depressed patients and healthy subjects that have examined these links. Self-referential processing in major depression seems associated with abnormally increased activity of the anterior cortical midline structures. Abnormal interactions between the lateralized task-positive network, and the midline cortical structures of the default mode network, as well as the emotional response network, may underlie the pervasiveness of ruminative brooding. Furthermore, targeting this maladaptive form of rumination and its underlying neural correlates may be key for effective treatment. PMID:24124416

Self-referential processing, rumination, and cortical midline structures in major depression

Directory of Open Access Journals (Sweden)

Ayna Baladi Nejad

2013-10-01

Full Text Available Major depression is associated with a bias towards negative emotional processing and increased self-focus, i.e. the process by which one engages in self-referential processing. The increased self-focus in depression is suggested to be of a persistent, repetitive and self-critical nature and is conceptualised as ruminative brooding. The role of the medial prefrontal cortex in self-referential processing has been previously emphasised in acute major depression. There is increasing evidence that self-referential processing as well as the cortical midline structures play a major role in the development, course and treatment response of major depressive disorder. However, the links between self-referential processing, rumination, and the cortical midline structures in depression are still poorly understood. Here, we reviewed brain imaging studies in depressed patients and healthy subjects that have examined these links. The literature suggests that self-referential processing in major depression is associated with increased activity of the anterior cortical midline structures. Abnormal interactions between the lateralised task-positive network, and the midline cortical structures of the default mode network, as well as the emotional response network, may underlie the pervasiveness of ruminative brooding. Furthermore, targeting this maladaptive form of rumination and its underlying neural correlates may be key for effective treatment.

Intake of wine, beer and spirits and waiting time to pregnancy.

Science.gov (United States)

Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo; Grønbaek, Morten

2003-09-01

A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. Self-reported data were used for 29,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. All levels of wine intake compared with non-wine drinking or with consumption of beer or spirits had subfecundity odds ratios between 0.7 and 0.9. No association was seen regarding beer drinking, while the association with spirits was J-shaped. Our findings suggest that wine drinkers have slightly shorter waiting times to pregnancy than both non-wine drinkers and consumers of other alcoholic beverages. Whether this is an effect of wine itself or the characteristics of the wine drinker is not known.

Intake of wine, beer and spirits and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

2003-01-01

BACKGROUND: A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers...... appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. METHODS: Self-reported data were used for 29......,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. RESULTS: All levels of wine intake compared with non-wine drinking or with consumption of beer...

The waiting time distribution as a graphical approach to epidemiologic measures of drug utilization

DEFF Research Database (Denmark)

Hallas, J; Gaist, D; Bjerrum, L

1997-01-01

that effectively conveys some essential utilization parameters for a drug. The waiting time distribution for a group of drug users is a charting of their first prescription presentations within a specified time window. For a drug used for chronic treatment, most current users will be captured at the beginning...... of the window. After a few months, the graph will be dominated by new, incident users. As examples, we present waiting time distributions for insulin, ulcer drugs, systemic corticosteroids, antidepressants, and disulfiram. Appropriately analyzed and interpreted, the waiting time distributions can provide...... information about the period prevalence, point prevalence, incidence, duration of use, seasonality, and rate of prescription renewal or relapse for specific drugs. Each of these parameters has a visual correlate. The waiting time distributions may be an informative supplement to conventional drug utilization...

A Systematic Translation and Cultural Adaptation Process for Three-Factor Eating Questionnaire (TFEQ-R21).

Science.gov (United States)

Rosnah, I; Noor Hassim, I; Shafizah, A S

2013-10-01

The Three-Factor Eating Questionnaire was first constructed to measure eating behavior in an English population in the United States. It has been validated and translated for various populations in different languages. The aim of this article is to describe a systematic process for translating the questionnaire from English to Malay language. The report of the International Society for Pharmacoeconomics and Outcome Research (ISPOR) Task Force was used as the basis for the systematic translation process. The process began with preparation; followed by forward translation (2 independent translators), reconciliation, back translation (2 independent translators), back translation review, harmonization, cognitive debriefing, review of cognitive debriefing results and finalization, proofreading; and ended with the final report. Four independent Malay translators who fluent in English and reside in Malaysia were involved in the process. A team of health care researchers had assisted the review of the new translated questionnaires. Majority of the TFEQ-R21 items were experiencing, conceptually and semantically equivalence between original English and translated English. However, certain phrase such as "feels like bottomless pit" was difficult to translate by forward translators. Cognitive debriefing was a very helpful process to ensure the TFEQ-R21 Malay version was appropriate in term of wording and culturally accepted. A total of four redundant comments in regards to response scale wording, word confusion and wording arrangement. The systematic translation process is a way to reduce the linguistic discrepancies between the English and Malay language in order to promote equivalence and culturally adapted TFEQ-R21 questionnaire.

Astrophysical r- and rp-processes, and radioactive nuclear beams

International Nuclear Information System (INIS)

Boyd, Richard N.

1998-01-01

The modern description of the r-process follows naturally from α-rich freezeout, thought to occur in the hot neutrino wind just beyond the nascent neutron star in a type II supernova. Initially, all pre-existing nuclei are reduced to α-particles and neutrons. As the environment cools, nuclei up to about mass 90 to 100 u are synthesized, in nuclear statistical equilibrium, in about 1 s. In the next few seconds, the remaining neutrons are captured to form the r-process progenitors, which then decay to the r-process nuclides. The rp-process occurs in a high-temperature H-rich environment. It is one of the processes that synthesize the p-process nuclei, the most neutron-poor nuclei in the periodic table. It is thought to occur during the explosion of a C-O white dwarf in a type Ia supernova or in a binary system during accretion onto a white dwarf or a neutron star. It appears to be capable of forming the p-nuclei up to about mass 90 u. Both processes pass through nuclei that are far from stability. Thus, their description requires the masses, half-lives, decay modes, and structure of these nuclei. The next generation of radioactive beam facilities promises to allow the study of many such nuclei. (author)

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department.

Science.gov (United States)

Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

2016-01-01

Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the "bed area" server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study.

Science.gov (United States)

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2007-11-16

As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

Directory of Open Access Journals (Sweden)

Laupacis Andreas

2007-11-01

Full Text Available Abstract Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1 over 25 documents (e.g. strategic planning reports, public updates, and (2 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario

Advertising Emergency Department Wait Times

OpenAIRE

Weiner, Scott G

2013-01-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED se...

WAITING FOR GODOT - ABSURD TEATER

OpenAIRE

Thorup, Rasmus; Leitthof, Anneliese; Kock, Felizia; Johansson, Lars; Moustgaard, Mie; Rosenkrands, Tobias; Staalhøj, Sarah; Jeppesen, Freja

2013-01-01

This project aims to reassess and discuss the different interpretations of Samuel Beckett’s play Waiting for Godot, made by Martin Esslin and Michael Y. Bennett. The analytical tools needed to enable the reassessment is found in the dimensional courses of Philosophy and Scientific theory (Da: Filosofi og Videnskabsteori) and Text-analysis (Da: Tekst og Tegn) and the discussion is based on Esslin’s The Theatre of The Absurd and Bennett’s Reassessing The Theatre of The Absurd. The conclusion is...

Urgency coding as a dynamic tool in management of waiting lists for psychogeriatric nursing home care in The Netherlands

NARCIS (Netherlands)

Meiland, F. J. M.; Danse, J. A. C.; Wendte, J. F.; Gunning-Schepers, L. J.; Klazinga, N. S.

2002-01-01

Criteria are used to prioritise patients on waiting lists for health care services. This is also true for waiting lists for admission to psychogeriatric nursing homes. A patient's position on these latter waiting lists is determined by (changes in) urgency and waiting time. The present article

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

Directory of Open Access Journals (Sweden)

Geeta Yadav

Full Text Available Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services.A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service.Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05. Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR = 0.4-3.4, followed by Urgent care (9.0 weeks; IQR = 2.1-12.9, then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4. Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks.Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

Science.gov (United States)

Yadav, Geeta; Goldberg, Hanna R; Barense, Morgan D; Bell, Chaim M

2016-01-01

Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4-3.4), followed by Urgent care (9.0 weeks; IQR = 2.1-12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

To Construction and Standardization of the Waiting Anxiety Questionnaire (WAQ in Iran.

Directory of Open Access Journals (Sweden)

Sodeh Tavakkoli

2014-09-01

Full Text Available This study aimed to develop and validate a questionnaire to measure waiting anxiety.This was a cross-sectional study. Extensive review of literature and expert opinions were used to develop and validate the waiting anxiety questionnaire. A sample of 321 participants was recruited through random cluster sampling (n= 190 Iranian men and n= 131 women. The participants filled out WAQ, the Speilberger's State-Trait Anxiety Inventory (STAI, Burtner Rating scale (BRS and Eysenk Personality questionnaire (EPQ for adults.Internal consistency of WAQ was revealed, meaning that all the 20 items were highly correlated with the total score. The Cronbach alpha equaled 0.83 for the Waiting Anxiety Questionnaire. The Pearson correlation coefficient of the questionnaire with the STAI, BRS and extraversion and neuroticism subscales of EPQ was 0.65, 0.78, - 0.47 and 0.43, respectively, which confirmed its convergent and divergent validity. Factors analysis extracting four cognitive, behavioral, sentimental and physiological factors could explain 67% of the total variance with an Eigen value of greater than 1.Our findings suggest that WAQ possesses appropriate validity and reliability to measure the individuals' anxiety during the waiting time.

Burst wait time simulation of CALIBAN reactor at delayed super-critical state

International Nuclear Information System (INIS)

Humbert, P.; Authier, N.; Richard, B.; Grivot, P.; Casoli, P.

2012-01-01

In the past, the super prompt critical wait time probability distribution was measured on CALIBAN fast burst reactor [4]. Afterwards, these experiments were simulated with a very good agreement by solving the non-extinction probability equation [5]. Recently, the burst wait time probability distribution has been measured at CEA-Valduc on CALIBAN at different delayed super-critical states [6]. However, in the delayed super-critical case the non-extinction probability does not give access to the wait time distribution. In this case it is necessary to compute the time dependent evolution of the full neutron count number probability distribution. In this paper we present the point model deterministic method used to calculate the probability distribution of the wait time before a prescribed count level taking into account prompt neutrons and delayed neutron precursors. This method is based on the solution of the time dependent adjoint Kolmogorov master equations for the number of detections using the generating function methodology [8,9,10] and inverse discrete Fourier transforms. The obtained results are then compared to the measurements and Monte-Carlo calculations based on the algorithm presented in [7]. (authors)

Burst wait time simulation of CALIBAN reactor at delayed super-critical state

Energy Technology Data Exchange (ETDEWEB)

Humbert, P. [Commissariat a l' Energie Atomique CEA, Centre de Bruyeres-le-Chatel, 91297 Arpajon (France); Authier, N.; Richard, B.; Grivot, P.; Casoli, P. [Commissariat a l' Energie Atomique CEA, Centre de Valduc, 21120 Is-sur-Tille (France)

2012-07-01

In the past, the super prompt critical wait time probability distribution was measured on CALIBAN fast burst reactor [4]. Afterwards, these experiments were simulated with a very good agreement by solving the non-extinction probability equation [5]. Recently, the burst wait time probability distribution has been measured at CEA-Valduc on CALIBAN at different delayed super-critical states [6]. However, in the delayed super-critical case the non-extinction probability does not give access to the wait time distribution. In this case it is necessary to compute the time dependent evolution of the full neutron count number probability distribution. In this paper we present the point model deterministic method used to calculate the probability distribution of the wait time before a prescribed count level taking into account prompt neutrons and delayed neutron precursors. This method is based on the solution of the time dependent adjoint Kolmogorov master equations for the number of detections using the generating function methodology [8,9,10] and inverse discrete Fourier transforms. The obtained results are then compared to the measurements and Monte-Carlo calculations based on the algorithm presented in [7]. (authors)

The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada

Science.gov (United States)

Leddin, Desmond; Armstrong, David; Borgaonkar, Mark; Bridges, Ronald J; Fallone, Carlo A; Telford, Jennifer J; Chen, Ying; Colacino, Palma; Sinclair, Paul

2013-01-01

BACKGROUND: Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time. METHODS: During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005. RESULTS: Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (Pgastroenterology services continue to exceed recommended targets, remain unchanged since 2008 and exceed wait times reported in 2005. PMID:23472243

24 CFR 982.203 - Special admission (non-waiting list): Assistance targeted by HUD.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Special admission (non-waiting list... Admission to Tenant-Based Program § 982.203 Special admission (non-waiting list): Assistance targeted by HUD... family residing in a multifamily rental housing project when HUD sells, forecloses or demolishes the...

Randomized controlled trial on promoting influenza vaccination in general practice waiting rooms.

Directory of Open Access Journals (Sweden)

Christophe Berkhout

Full Text Available Most of general practitioners (GPs use advertising in their waiting rooms for patient's education purposes. Patients vaccinated against seasonal influenza have been gradually lessening. The objective of this trial was to assess the effect of an advertising campaign for influenza vaccination using posters and pamphlets in GPs' waiting rooms.Registry based 2/1 cluster randomized controlled trial, a cluster gathering the enlisted patients of 75 GPs aged over 16 years. The trial, run during the 2014-2015 influenza vaccination campaign, compared patient's awareness from being in 50 GPs' standard waiting rooms (control group versus that of waiting in 25 rooms from GPs who had received and exposed pamphlets and one poster on influenza vaccine (intervention group, in addition to standard mandatory information. The main outcome was the number of vaccination units delivered in pharmacies. Data were extracted from the SIAM-ERASME claim database of the Health Insurance Fund of Lille-Douai (France. The association between the intervention (yes/no and the main outcome was assessed through a generalized estimating equation. Seventy-five GPs enrolled 10,597 patients over 65 years or suffering from long lasting diseases (intervention/control as of 3781/6816 patients from October 15, 2014 to February 28, 2015. No difference was found regarding the number of influenza vaccination units delivered (Relative Risk (RR = 1.01; 95% Confidence interval: 0.97 to 1.05; p = 0.561.Effects of the monothematic campaign promoting vaccination against influenza using a poster and pamphlets exposed in GPs' waiting rooms could not be demonstrated.

Willingness to Pay for a Maternity Waiting Home Stay in Zambia

Science.gov (United States)

White, Emily E.; Biemba, Godfrey; Mataka, Kaluba; Scott, Nancy

2016-01-01

Introduction Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability. Methods We conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context. Results The maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use. Discussion While Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households. PMID:28419708

Evolutionary Hybrid Particle Swarm Optimization Algorithm for Solving NP-Hard No-Wait Flow Shop Scheduling Problems

Directory of Open Access Journals (Sweden)

Laxmi A. Bewoor

2017-10-01

Full Text Available The no-wait flow shop is a flowshop in which the scheduling of jobs is continuous and simultaneous through all machines without waiting for any consecutive machines. The scheduling of a no-wait flow shop requires finding an appropriate sequence of jobs for scheduling, which in turn reduces total processing time. The classical brute force method for finding the probabilities of scheduling for improving the utilization of resources may become trapped in local optima, and this problem can hence be observed as a typical NP-hard combinatorial optimization problem that requires finding a near optimal solution with heuristic and metaheuristic techniques. This paper proposes an effective hybrid Particle Swarm Optimization (PSO metaheuristic algorithm for solving no-wait flow shop scheduling problems with the objective of minimizing the total flow time of jobs. This Proposed Hybrid Particle Swarm Optimization (PHPSO algorithm presents a solution by the random key representation rule for converting the continuous position information values of particles to a discrete job permutation. The proposed algorithm initializes population efficiently with the Nawaz-Enscore-Ham (NEH heuristic technique and uses an evolutionary search guided by the mechanism of PSO, as well as simulated annealing based on a local neighborhood search to avoid getting stuck in local optima and to provide the appropriate balance of global exploration and local exploitation. Extensive computational experiments are carried out based on Taillard’s benchmark suite. Computational results and comparisons with existing metaheuristics show that the PHPSO algorithm outperforms the existing methods in terms of quality search and robustness for the problem considered. The improvement in solution quality is confirmed by statistical tests of significance.

Intake of wine, beer and spirits and waiting time to pregnancy

DEFF Research Database (Denmark)

Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

2003-01-01

A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to have...... fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy....

Managing patients' wait time in specialist out-patient clinic using real-time data from existing queue management and ADT systems.

Science.gov (United States)

Ju, John Chen; Gan, Soon Ann; Tan Siew Wee, Justine; Huang Yuchi, Peter; Mei Mei, Chan; Wong Mei Mei, Sharon; Fong, Kam Weng

2013-01-01

In major cancer centers, heavy patients load and multiple registration stations could cause significant wait time, and can be result in patient complains. Real-time patient journey data and visual display are useful tools in hospital patient queue management. This paper demonstrates how we capture patient queue data without deploying any tracing devices; and how to convert data into useful patient journey information to understand where interventions are likely to be most effective. During our system development, remarkable effort has been spent on resolving data discrepancy and balancing between accuracy and system performances. A web-based dashboard to display real-time information and a framework for data analysis were also developed to facilitate our clinics' operation. Result shows our system could eliminate more than 95% of data capturing errors and has improved patient wait time data accuracy since it was deployed.

Managing a major R et D program: isotope separation

International Nuclear Information System (INIS)

Ferrari, A.

1988-01-01

After the choice (in 1969) of the pressurized water type reactors which use enriched uranium, it became imperative for France to have facilities to enrich the uranium. The choice of the industrial process, the correlative decisions related to research and development and the search for alliances with partners abroad in a disturbed and changing energy context are retraced in this article. The choice of the Eurodif plant was the gaseous diffusion process. It still remains necessary to maintain research efforts concerning competitive technologies, i.e. ultracentrifuging and chemical process. The oil crisis augured well for massive recourse to nuclear energy. Then there was a cut-back in nuclear programs and enrichment capacities became lastingly higher than needs. So it became necessary to optimally pilot a selection of research paths, with long term orientation. The techniques, based on the use of the laser, provide an advance glimpse of major, even spectacular prospects of lowering the costs of isotope separation [fr

The ecology of the patient visit: physical attractiveness, waiting times, and perceived quality of care.

Science.gov (United States)

Becker, Franklin; Douglass, Stephanie

2008-01-01

This study examined the relationship between the attractiveness of the physical environment of healthcare facilities and patient perceptions of quality, service, and waiting time through systematic observations and patient satisfaction surveys at 7 outpatient practices at Weill Cornell Medical Center. Findings indicate positive correlations between more attractive environments and higher levels of perceived quality, satisfaction, staff interaction, and reduction of patient anxiety. The comparison of actual observed time and patients' perception of time showed that patients tend to overestimate shorter waiting times and underestimate longer waiting times in both the waiting area and the examination room. Further examinations of the way outpatient-practice environments impact patient and staff perceptions and how those perceptions impact behavior and medical outcomes are suggested.

β-Decay half-lives and nuclear structure of exotic proton-rich waiting point nuclei under rp-process conditions

Science.gov (United States)

Nabi, Jameel-Un; Böyükata, Mahmut

2016-03-01

We investigate even-even nuclei in the A ∼ 70 mass region within the framework of the proton-neutron quasi-particle random phase approximation (pn-QRPA) and the interacting boson model-1 (IBM-1). Our work includes calculation of the energy spectra and the potential energy surfaces V (β , γ) of Zn, Ge, Se, Kr and Sr nuclei with the same proton and neutron number, N = Z. The parametrization of the IBM-1 Hamiltonian was performed for the calculation of the energy levels in the ground state bands. Geometric shape of the nuclei was predicted by plotting the potential energy surfaces V (β , γ) obtained from the IBM-1 Hamiltonian in the classical limit. The pn-QRPA model was later used to compute half-lives of the neutron-deficient nuclei which were found to be in very good agreement with the measured ones. The pn-QRPA model was also used to calculate the Gamow-Teller strength distributions and was found to be in decent agreement with the measured data. We further calculate the electron capture and positron decay rates for these N = Z waiting point (WP) nuclei in the stellar environment employing the pn-QRPA model. For the rp-process conditions, our total weak rates are within a factor two compared with the Skyrme HF +BCS +QRPA calculation. All calculated electron capture rates are comparable to the competing positron decay rates under rp-process conditions. Our study confirms the finding that electron capture rates form an integral part of the weak rates under rp-process conditions and should not be neglected in the nuclear network calculations.

Argentine tango dance compared to mindfulness meditation and a waiting-list control: a randomised trial for treating depression.

Science.gov (United States)

Pinniger, Rosa; Brown, Rhonda F; Thorsteinsson, Einar B; McKinley, Patricia

2012-12-01

To determine whether tango dancing is as effective as mindfulness meditation in reducing symptoms of psychological stress, anxiety and depression, and in promoting well-being. This study employed analysis of covariance (ANCOVA) and multiple regression analysis. Ninety-seven people with self-declared depression were randomised into tango dance or mindfulness meditation classes, or to control/waiting-list. classes were conducted in a venue suitable for both activities in the metropolitan area of Sydney, Australia. Participants completed six-week programmes (1½h/week of tango or meditation). The outcome measures were assessed at pre-test and post-test. Depression, Anxiety and Stress Scale; The Self Esteem Scale; Satisfaction with Life Scale, and Mindful Attention Awareness Scale. Sixty-six participants completed the program and were included in the statistical analysis. Depression levels were significantly reduced in the tango (effect size d=0.50, p=.010), and meditation groups (effect size d=0.54, p=.025), relative to waiting-list controls. Stress levels were significantly reduced only in the tango group (effect size d=0.45, p=.022). Attending tango classes was a significant predictor for the increased levels of mindfulness R(2)=.10, adjusted R(2)=.07, F (2,59)=3.42, p=.039. Mindfulness-meditation and tango dance could be effective complementary adjuncts for the treatment of depression and/or inclusion in stress management programmes. Subsequent trials are called to explore the therapeutic mechanisms involved. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Fission properties of superheavy nuclei for r -process calculations

Science.gov (United States)

Giuliani, Samuel A.; Martínez-Pinedo, Gabriel; Robledo, Luis M.

2018-03-01

We computed a new set of static fission properties suited for r -process calculations. The potential energy surfaces and collective inertias of 3640 nuclei in the superheavy region are obtained from self-consistent mean-field calculations using the Barcelona-Catania-Paris-Madrid energy density functional. The fission path is computed as a function of the quadrupole moment by minimizing the potential energy and exploring octupole and hexadecapole deformations. The spontaneous fission lifetimes are evaluated employing different schemes for the collective inertias and vibrational energy corrections. This allows us to explore the sensitivity of the lifetimes to those quantities together with the collective ground-state energy along the superheavy landscape. We computed neutron-induced stellar reaction rates relevant for r -process nucleosynthesis using the Hauser-Feshbach statistical approach and study the impact of collective inertias. The competition between different reaction channels including neutron-induced rates, spontaneous fission, and α decay is discussed for typical r -process conditions.

r-Process Nucleosynthesis in the Early Universe Through Fast Mergers of Compact Binaries in Triple Systems

Science.gov (United States)

Bonetti, Matteo; Perego, Albino; Capelo, Pedro R.; Dotti, Massimo; Miller, M. Coleman

2018-05-01

Surface abundance observations of halo stars hint at the occurrence of r-process nucleosynthesis at low metallicity ([Fe/H] scale of the inner compact object binaries. Our results are highly sensitive to the assumed initial distribution of the inner binary semi-major axes. Distributions with mostly wide compact object binaries are most affected by the third object, resulting in a strong increase (by more than a factor of 2) in the fraction of fast coalescences. If instead the distribution preferentially populates very close compact binaries, general relativistic precession prevents the third body from increasing the inner binary eccentricity to very high values. In this last case, the fraction of coalescing binaries is increased much less by tertiaries, but the fraction of binaries that would coalesce within 108 yr even without a third object is already high. Our results provide additional support to the compact-binary merger scenario for r-process nucleosynthesis.

What Are We Waiting For Customer Wait Time, Fill Rate, And Marine Corps Equipment Operational Availability

Science.gov (United States)

2016-12-01

directed the use of Customer Wait Time (CWT) as a measure of supply chain performance (Department of Defense [DOD], 2000). CWT is defined as “the total...time elapsed between issuance of a customer order and satisfaction of the order” (United States Marine Corps [USMC], 2014, pp. 2–29). In theory...rate is a widely used metric for setting inventory levels and is also a useful measure of customer satisfaction . In general, high fill-rates can be

Maternity waiting homes: A panacea for maternal/neonatal ...

African Journals Online (AJOL)

women to inadequately equipped delivery settings 4,5. Eritrea has made some ... Maternity waiting homes were introduced in Eritrea in 2007 as a strategy to mitigate .... 24(4):472-8. 5. Chandramohan D, Cutts F, Millard P The effect of stay in.

Assembly of proteins and 5 S rRNA to transcripts of the major structural domains of 23 S rRNA

DEFF Research Database (Denmark)

Ostergaard, P; Phan, H; Johansen, L B

1998-01-01

The six major structural domains of 23 S rRNA from Escherichia coli, and all combinations thereof, were synthesized as separate T7 transcripts and reconstituted with total 50 S subunit proteins. Analysis by one and two-dimensional gel electrophoresis demonstrated the presence of at least one prim...... approach was used to map the putative binding regions on domain V of protein L9 and the 5 S RNA-L5-L18 complex....

The Origin of r-process Elements in the Milky Way

Science.gov (United States)

Côté, Benoit; Fryer, Chris L.; Belczynski, Krzysztof; Korobkin, Oleg; Chruślińska, Martyna; Vassh, Nicole; Mumpower, Matthew R.; Lippuner, Jonas; Sprouse, Trevor M.; Surman, Rebecca; Wollaeger, Ryan

2018-03-01

Some of the heavy elements, such as gold and europium (Eu), are almost exclusively formed by the rapid neutron capture process (r-process). However, it is still unclear which astrophysical site between core-collapse supernovae and neutron star–neutron star (NS–NS) mergers produced most of the r-process elements in the universe. Galactic chemical evolution (GCE) models can test these scenarios by quantifying the frequency and yields required to reproduce the amount of europium (Eu) observed in galaxies. Although NS–NS mergers have become popular candidates, their required frequency (or rate) needs to be consistent with that obtained from gravitational wave measurements. Here, we address the first NS–NS merger detected by LIGO/Virgo (GW170817) and its associated gamma-ray burst and analyze their implication for the origin of r-process elements. The range of NS–NS merger rate densities of 320–4740 Gpc‑3 yr‑1 provided by LIGO/Virgo is remarkably consistent with the range required by GCE to explain the Eu abundances in the Milky Way with NS–NS mergers, assuming the solar r-process abundance pattern for the ejecta. Under the same assumption, this event has produced about 1–5 Earth masses of Eu, and 3–13 Earth masses of gold. When using theoretical calculations to derive Eu yields, constraining the role of NS–NS mergers becomes more challenging because of nuclear astrophysics uncertainties. This is the first study that directly combines nuclear physics uncertainties with GCE calculations. If GW170817 is a representative event, NS–NS mergers can produce Eu in sufficient amounts and are likely to be the main r-process site.

Stroke Education in an Emergency Department Waiting Room: a Comparison of Methods

Directory of Open Access Journals (Sweden)

Yu-Feng Yvonne Chan1

2015-03-01

Full Text Available Background: Since the emergency department (ED waiting room hosts a large, captive audience of patients and visitors, it may be an ideal location for conduct-ing focused stroke education. The aim of this study was to assess the effective-ness of various stroke education methods.Methods: Patients and visitors of an urban ED waiting room were randomized into one of the following groups: video, brochure, one-to-one teaching, combi-nation of these three methods, or control group. We administered a 13-question multiple-choice test to assess stroke knowledge prior to, immediately after, and at 1 month post-education to patients and visitors in the ED waiting room.Results: Of 4 groups receiving education, all significantly improved their test scores immediately post intervention (test scores 9.4±2.5-10.3±2.0, P<0.01. At 1 month, the combination group retained the most knowledge (9.4±2.4 exceed-ing pre-intervention and control scores (both 6.7±2.6, P<0.01.Conclusion: Among the various stroke education methods delivered in the ED waiting room, the combination method resulted in the highest knowledge reten-tion at 1-month post intervention.

The everyday of people waiting for kidney transplantation

Directory of Open Access Journals (Sweden)

Micheli Rezende Ferreira Cruz

2016-01-01

Full Text Available Objective: to understand the everyday of people experiencing the waiting list for kidney transplantation. Methods: this is a qualitative research, based on Heideggerian phenomenology. 14 deponents participated in hemodialysis and registered on the waiting list for kidney transplantation. Phenomenological interview with the research question: How is the experience awaiting the kidney transplant? Color marking technique for analyzing demarcating lines that show similarity, of these, emerged the essential structures that enabled the units of meaning. Results: changing lifestyles, imposing a routine and rigidity of treatment signaling everyday stress and exhaustion of hemodialysis being. Emerging from the modes of gossip, curiosity, and bureaucracy, unfolding-inauthentic and impersonal regarding their care. Conclusion: hemodialysis dependence and awaiting kidney transplantation transfer care for family/professional caregivers. To understand the everyday marked by impositions and restrictions, the reflection about how professional health interaction/being-care becomes important.

The r-process nucleosynthesis during the decompression of neutron star crust material

Energy Technology Data Exchange (ETDEWEB)

Goriely, S. [Institut d' Astronomie et d' Astrophysique, CP-226, Université Libre de Bruxelles, 1050 Brussels (Belgium); Bauswein, A. [Department of Physics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece and Max-Planck-Institut für Astrophysik, Postfach 1317, 85741 Garching (Germany); Janka, H.-T. [Max-Planck-Institut für Astrophysik, Postfach 1317, 85741 Garching (Germany); Sida, J.-L.; Lemaître, J.-F.; Panebianco, S. [C.E.A. Saclay, Irfu/Service de Physique Nucléaire, 91191 Gif-sur-Yvette (France); Dubray, N.; Hilaire, S. [CEA, DAM, DIF, F-91297 Arpajon (France)

2014-05-02

About half of the nuclei heavier than iron observed in nature are produced by the so-called rapid neutron capture process, or r-process, of nucleosynthesis. The identification of the astrophysics site and the specific conditions in which the r-process takes place remains, however, one of the still-unsolved mysteries of modern astrophysics. Another underlying difficulty associated with our understanding of the r-process concerns the uncertainties in the predictions of nuclear properties for the few thousands exotic neutron-rich nuclei involved, for which essentially no experimental data exist. The present paper emphasizes some important future challenges faced by nuclear physics in this problem, particularly in the determination of the nuclear structure properties of exotic neutron-rich nuclei as well as their radiative neutron capture rates and their fission probabilities. These quantities are particularly relevant to determine the composition of the matter resulting from the r-process. Both the astrophysics and the nuclear physics difficulties are critically reviewed with special attention paid to the r-process taking place during the decompression of neutron star matter following the merging of two neutron stars.

A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care

Science.gov (United States)

Yadav, Geeta; Goldberg, Hanna R.; Barense, Morgan D.; Bell, Chaim M.

2016-01-01

Background Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. Methods A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Results Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care. PMID:27632206

Evolution of r-process elements in the hot supernova bubble

International Nuclear Information System (INIS)

Mathews, G.J.; Wilson, J.R.; Woosley, S.E.

1993-02-01

We review some of the recent arguments as to why the r-process is thought to be associated with supernovae and how the high-temperature, high-entropy inner region of a core-collapse supernova is an ideal r-process site. We present preliminary extensions of our earlier work on the formation of the high-entropy ''bubble'' that describe more accurately its late-time evolution and the ejection of the neutrino-energized wind from the surface of the nascent neutron star. This site leads naturally to a distribution of temperature, density, neutron excess, and entropy for material ejected at different times in the wind as required by Solar abundances. We present simple analytic expressions which approximate these distributions. This site also predicts an amount of reprocess material ejected per event in agreement with simple galactic evolution arguments. However, it is not yet clear whether the entropy in this model is high enough (or the electron fraction is low enough) to produce an optimum fit to the Solar r-process abundance curve and additional mechanisms may be required to increase the entropy per baryon. We conclude with a discussion of nuclear measurements which would help to probe this r-process environment

The impact of global nuclear mass model uncertainties on r-process abundance predictions

Directory of Open Access Journals (Sweden)

Mumpower M.

2015-01-01

Full Text Available Rapid neutron capture or ‘r-process’ nucleosynthesis may be responsible for half the production of heavy elements above iron on the periodic table. Masses are one of the most important nuclear physics ingredients that go into calculations of r-process nucleosynthesis as they enter into the calculations of reaction rates, decay rates, branching ratios and Q-values. We explore the impact of uncertainties in three nuclear mass models on r-process abundances by performing global monte carlo simulations. We show that root-mean-square (rms errors of current mass models are large so that current r-process predictions are insufficient in predicting features found in solar residuals and in r-process enhanced metal poor stars. We conclude that the reduction of global rms errors below 100 keV will allow for more robust r-process predictions.

Reachability analysis to design zero-wait entry guidance

NARCIS (Netherlands)

Gonzalez-Puerta, Alejandro; Mooij, E.; Valles, Celia Yabar

2018-01-01

This paper presents a novel reentry guidance architecture that aims to improve cur- rent mission safety by enabling zero-wait orbital aborts. To do so, an on-board trajectory planner based on Adaptive Multivariate Pseudospectral Interpolation (AMPI) is devel- oped. This planner generates

DETECTION OF THE SECOND r-PROCESS PEAK ELEMENT TELLURIUM IN METAL-POOR STARS ,

International Nuclear Information System (INIS)

Roederer, Ian U.; Lawler, James E.; Cowan, John J.; Beers, Timothy C.; Frebel, Anna; Ivans, Inese I.; Schatz, Hendrik; Sobeck, Jennifer S.; Sneden, Christopher

2012-01-01

Using near-ultraviolet spectra obtained with the Space Telescope Imaging Spectrograph on board the Hubble Space Telescope, we detect neutral tellurium in three metal-poor stars enriched by products of r-process nucleosynthesis, BD +17 3248, HD 108317, and HD 128279. Tellurium (Te, Z = 52) is found at the second r-process peak (A ≈ 130) associated with the N = 82 neutron shell closure, and it has not been detected previously in Galactic halo stars. The derived tellurium abundances match the scaled solar system r-process distribution within the uncertainties, confirming the predicted second peak r-process residuals. These results suggest that tellurium is predominantly produced in the main component of the r-process, along with the rare earth elements.

Transformation of a Pediatric Primary Care Waiting Room: Creating a Bridge to Community Resources.

Science.gov (United States)

Henize, Adrienne W; Beck, Andrew F; Klein, Melissa D; Morehous, John; Kahn, Robert S

2018-06-01

Introduction Children and families living in poverty frequently encounter social risks that significantly affect their health and well-being. Physicians' near universal access to at-risk children and their parents presents opportunities to address social risks, but time constraints frequently interfere. We sought to redesign our waiting room to create a clinic-to-community bridge and evaluate the impact of that redesign on family-centered outcomes. Methods We conducted a pre-post study of a waiting room redesign at a large, academic pediatric primary care center. Design experts sought input about an optimal waiting room from families, community partners and medical providers. Family caregivers were surveyed before and after redesign regarding perceived availability of help with social needs and access to community resources, and hospitality and feelings of stress. Pre-post differences were assessed using the Chi square or Wilcoxon rank sum test. Results The key redesign concepts that emerged included linkages to community organizations, a welcoming environment, and positive distractions for children. A total of 313 caregiver surveys were completed (pre-160; post-153). Compared to pre-redesign, caregivers surveyed post-redesign were significantly more likely to perceive the waiting room as a place to obtain help connecting to community resources and find information about clinical and educational resources (both p < 0.05). Families were also significantly more likely to report the waiting room as more welcoming and relaxing, with sufficient privacy and space (all p < 0.05). Discussion Waiting rooms, typically a place of wasted time and space, can be redesigned to enhance families' engagement and connection to community resources.

The Influence of Ambient Scent and Music on Patients' Anxiety in a Waiting Room of a Plastic Surgeon

NARCIS (Netherlands)

Fenko, Anna; Loock, Caroline

2014-01-01

OBJECTIVE: This study investigates the influence of ambient scent and music, and their combination, on patients' anxiety in a waiting room of a plastic surgeon. BACKGROUND: Waiting for an appointment with a plastic surgeon can increase a patient's anxiety. It is important to make the waiting time

Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

DEFF Research Database (Denmark)

Lyhne, N M; Christensen, A; Alanin, M C

2013-01-01

BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

DNW--"did not wait" or "demographic needing work": a study of the profile of patients who did not wait to be seen in an Irish emergency department.

LENUS (Irish Health Repository)

Gilligan, P

2009-11-01

Patients who fail to wait for medical assessment in the emergency department (ED) have been referred to in the international literature as "did not wait" (DNW) or "left without being seen" (LWBS) patients or, indeed, simply as "walkouts". This is taken as a performance indicator internationally. In common with many countries, Ireland has very considerable problems in the delivery of ED care due largely to inadequate resources and the inappropriate use of EDs as holding bays for admitted patients. This is the first study of this size to profile the DNW phenomenon in Ireland.

Fission in R-processes Elements (FIRE) - Annual Report: Fiscal Year 2017

Energy Technology Data Exchange (ETDEWEB)

Schunck, Nicolas [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2017-10-18

The goal of the FIRE topical collaboration in nuclear theory is to determine the astrophysical conditions of the rapid neutron capture process (r-process), which is responsible for the formation of heavy elements. This will be achieved by including in r-process simulations the most advanced models of fission (spontaneous, neutron-induced, beta-delayed) that have been developed at LLNL and LANL. The collaboration is composed of LLNL (lead) and LANL for work on nuclear data (ground-state properties, fission, beta-decay), BNL for nuclear data management, and the university of Notre Dame and North Carolina State University for r-process simulations. Under DOE/NNSA agreement, both universities receive funds from the DOE Office of Science, while national laboratories receive funds directly from NA221.

Estimating the waiting time of multi-priority emergency patients with downstream blocking.

Science.gov (United States)

Lin, Di; Patrick, Jonathan; Labeau, Fabrice

2014-03-01

To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital.

Self-Stabilization of Wait-Free Shared Memory Objects

NARCIS (Netherlands)

Hoepman, J.H.; Papatriantafilou, Marina; Tsigas, Philippas

2002-01-01

This paper proposes a general definition of self-stabilizing wait-free shared memory objects. The definition ensures that, even in the face of processor failures, every execution after a transient memory failure is linearizable except for an a priori bounded number of actions. Shared registers have

Ability to use the wait-and-see strategy in pathological gamblers.

Science.gov (United States)

Kertzman, Semion; Vainder, Michael; Visne, Tali; Aizer, Anat; Kotler, Moshe; Dannon, Pinhas N

2015-12-15

Pathological gamblers (PGs) perform differently on neurocognitive tests than do healthy controls (HC). The aim of this study was to assess "waiting ability" - a major components of inhibition control-using a modified Stop Signal Task (SST) in a population of male PGs (N=55), and HCs (N=53). Results indicated no differences between PGs and HCs in reaction times, intra-individual response variability, or number of false alarms and misses. In conclusion, PGs were not impaired in their ability to manipulate their on-line response strategy during the experimental task and were instead able to change their strategy to decrease the number of false alarms. However, much more empirical and theoretical work needs to be carried out in order to understand the key neural basis of impulsivity among PGs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Waiting for transplant: physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care.

Science.gov (United States)

Anthony, Samantha J; Annunziato, Rachel A; Fairey, Elise; Kelly, Vicky L; So, Stephanie; Wray, Jo

2014-08-01

The waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been given to the physical, psychological, or social impact of the waiting period in the literature. In this review, we discuss the physical, nutritional, and psychosocial implications of the waiting period for child and adolescent transplant candidates and the impact on their parents and siblings. We identify areas for future research and provide recommendations for clinical practice to support children, adolescents, and families during the waiting period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of Wait Time When Communicating with Children Who Have Sensory and Additional Disabilities

Science.gov (United States)

Johnson, Nicole; Parker, Amy T.

2013-01-01

Introduction: This study utilized wait-time procedures to determine if they are effective in helping children with deafblindness or multiple disabilities that include a visual impairment communicate in their home. Methods: A single subject with an alternating treatment design was used for the study. Zero- to one-second wait time was utilized…

Waiting to Drive (A Minute of Health with CDC)

Centers for Disease Control (CDC) Podcasts

Over the past 10 years, the number of fatal motor-vehicle crashes involving teenage drivers has declined by more than 50 percent. This podcast discusses the trend of teens waiting until they are older to drive.

Statistical Data Processing with R – Metadata Driven Approach

Directory of Open Access Journals (Sweden)

Rudi SELJAK

2016-06-01

Full Text Available In recent years the Statistical Office of the Republic of Slovenia has put a lot of effort into re-designing its statistical process. We replaced the classical stove-pipe oriented production system with general software solutions, based on the metadata driven approach. This means that one general program code, which is parametrized with process metadata, is used for data processing for a particular survey. Currently, the general program code is entirely based on SAS macros, but in the future we would like to explore how successfully statistical software R can be used for this approach. Paper describes the metadata driven principle for data validation, generic software solution and main issues connected with the use of statistical software R for this approach.

rCBF change in the brain of patients with major depressive disorder

International Nuclear Information System (INIS)

Sun Da; Xu Wei; Zhan Hongwei; Liu Hongbiao

2010-01-01

Purpose Major depressive disorder is a frequent emotional mood disorder. To evaluate the changes of brain blood flow in patients with depressive disorder and the correlation between rCBF and clinical feature is very important to diagnosis and treatment of this decease. Methods: Regional cerebral perfusion was investigated using SPECT in 75 patients with depressive disorders. The mean ages of the patients were 41.9 (17-74) Years old. The course of disease was different from several days to over 20 years. Results: 97.3 per cent of patients (73/75) had relative hypoperfusions in some cerebral regions. The patients had a significant decrease of rCBF in the frontal lobesbilaterally, and temporal lobes, basal ganglia, thalamus and parietal lobe. The course of disease and age of the patients had a negative correlation with the changes of rCBF. Conclusion: According to the results of our study, patients with depressive disorders had profound dysfunction of the frontal lobes bilaterally. The temporal cortices and basal ganglia were involved in most patients too. It is coincident with the results of other studies. The function of frontal lobes and temporal lobes is close relation close with affective action, attention, memory, thinking, abstraction, and other brain cognitive function. The clinical symptom of depressive disorder may be relevant with hypoperfusions of frontal lobes and temporal lobes. (authors)

Developing priority criteria for magnetic resonance imaging: results from the Western Canada Waiting List project

International Nuclear Information System (INIS)

Hadorn, D.C.

2002-01-01

The Western Canada Waiting List (WCWL) Project is a federally funded partnership of 19 organizations, including medical associations, health authorities, ministries of health and research organizations, that was created to develop tools to assist in assessing the relative urgency and priority of patients on waiting lists. The WCWL panel on magnetic resonance imaging (MRI) was 1 of 5 panels constituted under this project. The panel developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting MRI. The criteria were applied to 407 patients in the 4 western provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians' overall ratings of patients' urgency for MRI. Reliability was assessed using clinicians' ratings of 6 hypothetical paper cases. The resulting weighted criteria accounted for about two-fifths of the observed variance in overall urgency ratings (R 2 = 39.9%). The panel then modified the criteria on the basis of regression results and clinical judgment. Most of the revised criteria items showed poor inter-rater reliability, but test-retest reliability (over a 2-month interval) was relatively good. Criteria items requiring probability judgments were a challenge for clinicians. Further development and testing of the tool appears warranted, although considerable question remains concerning the utility of priority criteria for MRI and other diagnostic services. (author)

La primera escansión poética de la obra teatral Waiting for Godot

Directory of Open Access Journals (Sweden)

Elena Carolina Hewitt

2008-03-01

Full Text Available Aunque Waiting for Godot, sea claramente arte dramático escrito en prosa, mi hipótesis original es que contenga pasajes con características poéticas y rítmicas. Por lo tanto, no debemos eludir la posibilidad de realizar un análisis por escansión en Godot. La originalidad en esta hipótesis ha sido confirmada recientemente por un experto a escala internacional en Beckett. Otros estudios sin embargo, han descrito facetas puramente lingüísticas de esta obra dramática, pero hasta el momento no parece haberse llevado a cabo análisis de la métrica o examen sistemático alguno a cerca de esta faceta. En este artículo, he tratado de suplir la desatención de este aspecto efectuando mi propia y original escansión en relación a la obra dramática de Waiting for Godot, en concreto de la versión en inglés, utilizando para ello el pasaje referente a las “voces muertas”(Beckett, 1977: 62 – 63. En consecuencia, describiré las conclusiones a las que he llegado después de llevar a cabo dicho análisis de esta obra teatral, por escansión poética.

Collective neutrino oscillations and r-process nucleosynthesis in supernovae

Science.gov (United States)

Duan, Huaiyu

2012-10-01

Neutrinos can oscillate collectively in a core-collapse supernova. This phenomenon can occur much deeper inside the supernova envelope than what is predicted from the conventional matter-induced Mikheyev-Smirnov-Wolfenstein effect, and hence may have an impact on nucleosynthesis. The oscillation patterns and the r-process yields are sensitive to the details of the emitted neutrino fluxes, the sign of the neutrino mass hierarchy, the modeling of neutrino oscillations and the astrophysical conditions. The effects of collective neutrino oscillations on the r-process will be illustrated using representative late-time neutrino spectra and outflow models.

The support needs of patients waiting for publicly funded bariatric surgery - implications for health service planners.

Science.gov (United States)

Sharman, M J; Venn, A J; Jose, K A; Williams, D; Hensher, M; Palmer, A J; Wilkinson, S; Ezzy, D

2017-02-01

The objective of this study was to investigate the experience of waiting for publicly funded bariatric surgery in an Australian tertiary healthcare setting. Focus groups and individual interviews involving people waiting for or who had undergone publicly funded bariatric surgery were audio-recorded, transcribed and analysed thematically. A total of 11 women and 6 men engaged in one of six focus groups in 2014, and an additional 10 women and 9 men were interviewed in 2015. Mean age was 53 years (range 23-66); mean waiting time was 6 years (range 0-12), and mean time since surgery was 4 years (range 0-11). Waiting was commonly reported as emotionally challenging (e.g. frustrating, depressing, stressful) and often associated with weight gain (despite weight-loss attempts) and deteriorating physical health (e.g. development of new or worsening obesity-related comorbidity or decline in mobility) or psychological health (e.g. development of or worsening depression). Peer support, health and mental health counselling, integrated care and better communication about waitlist position and management (e.g. patient prioritization) were identified support needs. Even if wait times cannot be reduced, better peer and health professional supports, together with better communication from health departments, may improve the experience or outcomes of waiting and confer quality-of-life gains irrespective of weight loss. © 2016 World Obesity Federation.

Computer Simulation: A Methodology to Improve the Efficiency in the Brooke Army Medical Center Family Care Clinic (A Patient Wait Case Study)

National Research Council Canada - National Science Library

Merkie, John

2000-01-01

.... The purpose of this study was to describe the current system and to evaluate the potential impact of process/resource changes in patient wait times, access and resource utilization at the BAMC Family Care Clinic (FCC...

Mean Waiting Time and Patients' Satisfaction in GOPD, Federal ...

African Journals Online (AJOL)

Mean Waiting Time and Patients' Satisfaction in GOPD, Federal Medical Centre, Owerri. ... Journal Home > Vol 4, No 2 (2013) > ... dis-satisfaction as noted from this study should be addressed by the staff and management of the hospital.

Optimal Research and Numerical Simulation for Scheduling No-Wait Flow Shop in Steel Production

Directory of Open Access Journals (Sweden)

Huawei Yuan

2013-01-01

Full Text Available This paper considers the m-machine flow shop scheduling problem with the no-wait constraint to minimize total completion time which is the typical model in steel production. First, the asymptotic optimality of the Shortest Processing Time (SPT first rule is proven for this problem. To further evaluate the performance of the algorithm, a new lower bound with performance guarantee is designed. At the end of the paper, numerical simulations show the effectiveness of the proposed algorithm and lower bound.

The importance of patient expectations as a determinant of satisfaction with waiting times for hip and knee replacement surgery.

Science.gov (United States)

Conner-Spady, Barbara L; Sanmartin, Claudia; Johnston, Geoffrey H; McGurran, John J; Kehler, Melissa; Noseworthy, Tom W

2011-08-01

The disconfirmation model hypothesizes that satisfaction is a function of a perceived discrepancy from an initial expectation. Our objectives were: (1) to test the disconfirmation model as it applies to patient satisfaction with waiting time (WT) and (2) to build an explanatory model of the determinants of satisfaction with WT for hip and knee replacement. We mailed 1000 questionnaires to 2 random samples: patients waiting or those who had received a joint replacement within the preceding 3-12 months. We used ordinal logistic regression analysis to build an explanatory model of the determinants of satisfaction. Of the 1330 returned surveys, 1240 contained patient satisfaction data. The sample was 57% female; mean age was 70 years (SD 11). Consistent with the disconfirmation model, when their WTs were longer than expected, both waiting (OR 5.77, 95% CI 3.57-9.32) and post-surgery patients (OR 6.57, 95% CI 4.21-10.26) had greater odds of dissatisfaction, adjusting for the other variables in the model. Compared to those who waited 3 months or less, post-surgery patients who waited 6 to 12 months (OR 2.59, 95% CI 1.27-5.27) and over 12 months (OR 3.30, 95% CI 1.65-6.58) had greater odds of being dissatisfied with their waiting time. Patients who felt they were treated unfairly had greater odds of being dissatisfied (OR 4.74, 95% CI 2.60-8.62). In patients on waiting lists and post-surgery for hip and knee replacement, satisfaction with waiting times is related to fulfillment of expectations about waiting, as well as a perception of fairness. Measures to modify expectations and increase perceived fairness, such as informing patients of a realistic WT and communication during the waiting period, may increase satisfaction with WTs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Cumulative incidence for wait-list death in relation to length of queue for coronary-artery bypass grafting: a cohort study

Directory of Open Access Journals (Sweden)

Levy Adrian R

2006-08-01

Full Text Available Abstract Background In deciding where to undergo coronary-artery bypass grafting, the length of surgical wait lists is often the only information available to cardiologists and their patients. Our objective was to compare the cumulative incidence for death on the wait list according to the length of wait lists at the time of registration for the operation. Methods The study cohort included 8966 patients who registered to undergo isolated coronary-artery bypass grafting (82.4% men; 71.9% semi-urgent; 22.4% non-urgent. The patients were categorized according to wait-list clearance time at registration: either "1 month or less" or "more than 1 month". Cumulative incidence for wait-list death was compared between the groups, and the significance of difference was tested by means of regression models. Results Urgent patients never registered on a wait list with a clearance time of more than 1 month. Semi-urgent patients registered on shorter wait lists more often than non-urgent patients (79.1% vs. 44.7%. In semi-urgent and non-urgent patients, the observed proportion of wait-list deaths by 52 weeks was lower in category "1 month or less" than in category "more than 1 month" (0.8% [49 deaths] vs. 1.6% [39 deaths], P P Conclusion Long wait lists for coronary-artery bypass grafting are associated with increased probability that a patient dies before surgery. Physicians who advise patients where to undergo cardiac revascularization should consider the risk of pre-surgical death that is associated with the length of a surgical wait list.

Differential processing and attitude change following majority versus minority arguments

NARCIS (Netherlands)

DeDreu, CKW; DeVries, NK

This experiment tested the general hypothesis that majority influence induces convergent processing, which stimulates attitude change on focal issues, whereas minority influence sometimes produces divergent processing, which might stimulate change on related attitudes. Results of a numerical support

The waiting room: vector for health education? The general practitioner's point of view.

Science.gov (United States)

Gignon, Maxine; Idris, Hadjila; Manaouil, Cecile; Ganry, Oliver

2012-09-18

General practitioners (GPs) play a central role in disseminating information and most health policies are tending to develop this pivotal role of GPs in dissemination of health-related information to the public. The objective of this study was to evaluate use of the waiting room by GPs as a vector for health promotion. A cross-sectional study was conducted on a representative sample of GPs using semi-structured, face-to-face interviews. A structured grid was used to describe the documents. Quantitative and qualitative analysis was performed. Sixty GPs participated in the study. They stated that a waiting room had to be pleasant, but agreed that it was a useful vector for providing health information. The GPs stated that they distributed documents designed to improve patient care by encouraging screening, providing health education information and addressing delicate subjects more easily. However, some physicians believed that this information can sometimes make patients more anxious. A large number of documents were often available, covering a variety of topics. General practitioners intentionally use their waiting rooms to disseminate a broad range of health-related information, but without developing a clearly defined strategy. It would be interesting to correlate the topics addressed by waiting room documents with prevention practices introduced during the visit.

Patients’ Attitude towards Travelling For Breast Services versus Waiting Longer For Local Services

LENUS (Irish Health Repository)

Abd Elwahab, S

2018-05-01

Geographical access is a cornerstone of health care provision. However, prolonged waiting for breast clinic appointments in local services results in delayed diagnosis and excessive anxiety for patients. In this study, we present a patient satisfaction survey results of an initiative to offer out-patient clinic appointments for non-urgent patients referred to the breast unit in Letterkenny General Hospital (LGH), Ireland, and exceeded the recommended waiting period of 12 weeks. These patients were offered appointment in University Hospital Galway (UCHG), which is an average travel time of about 3.5-4.5 hours away from LGH. 163 patients out of 336 (48.5%) patients actively waiting more than 12 weeks for appointments in LGH accepted alternative appointments in UCHG. Despite the long travel distance for these patients, 100% of them reported high satisfaction and 97.3% said they would accept further UCHG appointments if a similar situation of prolonged waiting in LGH arises. None of these patients were diagnosed with cancer, and only one had a benign lumpectomy. This study showed that if offered alternative appointments, just under half of the patients would accept. The initiative provides a feasible solution for long waiters, and the survey shows that patients’ satisfaction remains high despite long travel.

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

Directory of Open Access Journals (Sweden)

Hourvash Akbari Haghighinejad

2016-01-01

Full Text Available Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14 was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity. The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the numberwaiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

Implementation of Organ Culture storage of donor corneas: a 3 year study of its impact on the corneal transplant wait list at the Lions New South Wales Eye Bank.

Science.gov (United States)

Devasahayam, Raj; Georges, Pierre; Hodge, Christopher; Treloggen, Jane; Cooper, Simon; Petsoglou, Con; Sutton, Gerard; Zhu, Meidong

2016-09-01

Organ Culture corneal storage offers an extended storage time and increased donor pool and tissue assessment opportunities. In September 2011, the Lions New South Wales Eye Bank (LNSWEB) moved from hypothermic storage to Organ Culture corneal storage. This study evaluates the impact of implementation of Organ Culture on donor eye retrieval and the corneal transplant waiting list over a 3 year period in NSW, Australia. Retrospective review of the LNSWEB data from September 2011 to August 2014. Tissue collection, waiting list and tissue utilization data were recorded. The data from September 2008 to August 2011 for Optisol-GS storage was used for comparison. The annual donor and cornea collection rate increased 35 % and 44 % respectively with Organ Culture compared to Optisol-GS storage. The utilization rate of corneal tissue increased from 73.4 % with hypothermic storage to 77.2 % with Organ Culture storage. The transplant wait list decreased by 77.3 % from September 2011 to August 2014 and correlated with the increased rate of corneal transplantation (r = -0.9381, p banks. The practical benefits of the extended storage time and increased donor assessment opportunities have directly led to an increase in corneal utilization rate and a significant decrease in recipient wait list time.

Change in hearing during 'wait and scan' management of patients with vestibular schwannoma

DEFF Research Database (Denmark)

Stangerup, Sven-Eric; Caye-Thomasen, P.; Tos, M.

2008-01-01

: At the time of diagnosis, 334 patients (53 per cent) had good hearing and speech discrimination of better than 70 per cent; at the end of the 10-year observation period, this latter percentage was 31 per cent. In 17 per cent of the patients, speech discrimination at diagnosis was 100 per cent; of these, 88......Aim: To evaluate hearing changes during 'wait and scan' management of patients with vestibular schwannoma. Subjects: Over a 10-year period, 636 patients have prospectively been allocated to 'wait and scan' management, with annual magnetic resonance scanning and audiological examination. Results...... surgery and of radiation therapy with those of 'wait and scan' management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth Udgivelsesdato: 2008/7...

Determinants of Patient Waiting Time in the General Outpatient ...

African Journals Online (AJOL)

obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both .... Simple random sampling was done for the first two patients to get the starting ... record clerks (12% [9/76]), and jumping of queue by patients.

Waiting for the Leaf; Warten auf den Leaf

Energy Technology Data Exchange (ETDEWEB)

Wilms, Jan

2012-01-15

Nissan will be the first manufacturer to launch an electric vehicle of the VW Golf category in the German market. With a mileage of about 170 km and a roomy passenger compartment, the Leaf promises much comfort. In the US market, it was launched two years ago. Was it worth while waiting for?.

U.S. tells CERN to wait for support

CERN Multimedia

Mervis, J

1995-01-01

The US has put off CERN's request for a $300 million contribution to help build the Large Hadron Collider. Department of Energy officials asserted that such a decision must wait until after the budget is finalized. House Science Committee Chairman Robert Walker also claimed it was too early to make a decision.

Differential processing and attitude change following majority versus minority arguments

NARCIS (Netherlands)

de Dreu, C.K.W.; van de Vliert, E.

1996-01-01

Tested the hypothesis that majority (MAJ) influence induces convergent processing, which stimulates attitude change (AC) on focal issues (FISs), whereas minority (MIN) influence produces divergent processing, which might stimulate change on related attitudes. Ss were 86 high school students. Results

Trends and patterns in inter-firm R&D networks in the global computer industry: a historical analysis of major developments during the period 1970-1999.

NARCIS (Netherlands)

Cloodt, M.M.A.H.; Hagedoorn, J.; Roijakkers, A.H.W.M.

2006-01-01

We present a historical analysis of major trends in inter-firm R&D partnering in the international computer industry during the period 1970-1999. We first discuss different modes of R&D cooperation in the context of the overall growth patterns in R&D partnerships. We also examine major changes in

Financial cost to institutions on patients waiting for gall bladder disease surgery.

Science.gov (United States)

Waqas, Ahmed; Qasmi, Shahzad Ahmed; Kiani, Faran; Raza, Ahmed; Khan, Khizar Ishtiaque; Manzoor, Shazia

2014-01-01

The aim of this study was to determine the financial costs to institution on patients waiting for gall bladder disease surgery and suggest measures to reduce them. This multi-centre prospective descriptive survey was performed on all patients who underwent an elective cholecystectomy by three consultants at secondary care hospitals in Pakistan between Jan 2010 to Jan 2012. Data was collected on demographics, the duration of mean waiting time, specific indications and nature of disease for including the patients in the waiting list, details of emergency re-admissions while awaiting surgery, investigations done, treatment given and expenditures incurred on them during these episodes. A total of 185 patients underwent elective open cholecystectomy. The indications for listing the patients for surgery were biliary colic in 128 patients (69%), acute cholecystitis in 43 patients (23%), obstructive jaundice in 8 patients (4.5%) and acute pancreatitis in 6 patients (3.2%). 146 (78.9%) and 39 (21.1%) of patients were listed as outdoor electives and indoor emergencies respectively. Of the 185 patients, 54 patients (29.2%) were re-admitted. Financial costs in Pakistani rupees per episode of readmission were 23050 per episode in total and total money spent on all readmissions was Rs. 17,05,700/-. Financial costs on health care institutions due to readmissions in patients waiting for gall bladder disease surgery are high. Identifying patients at risk for these readmissions and offering them early laparoscopic cholecystectomy is very important.

Petri Net-Based R&D Process Modeling and Optimization for Composite Materials

Directory of Open Access Journals (Sweden)

Xiaomei Hu

2013-01-01

Full Text Available Considering the current R&D process for new composite materials involves some complex details, such as formula design, specimen/sample production, materials/sample test, assessment, materials/sample feedback from customers, and mass production, the workflow model of Petri net-based R&D process for new composite materials’ is proposed. By analyzing the time property of the whole Petri net, the optimized model for new composite materials R&D workflow is further proposed. By analyzing the experiment data and application in some materials R&D enterprise, it is demonstrated that the workflow optimization model shortens the period of R&D on new materials for 15%, definitely improving the R&D efficiency. This indicates the feasibility and availability of the model.

Neutrino-induced charged-current reaction rates for r-process nuclei

CERN Document Server

Langanke, K

2001-01-01

Neutrino-induced reactions play an important role during and after the r-process if it occurs in an environment with extreme neutrino fluxes, as in the neutrino-driven wind model or neutron star mergers. The neutrino reactions can excite the daughter nucleus above the neutron threshold, which is quite low for r-process nuclei. Thus the daughter nucleus will decay by emission of one or several neutrons. We have calculated the relevant total (nu sub e , e sup -) cross sections as well as the partial neutron spallation cross sections for r-process nuclei with neutron numbers N=41-135 and proton numbers Z=21-82. The supernova neutrino spectrum is described by a Fermi-Dirac distribution with various temperature parameters between T=2.8 MeV and T=10 MeV and with the degeneracy parameters alpha=0 and alpha=3. Our calculations of the nuclear response are based on the random phase approximation and consider allowed as well as forbidden transitions.

Adsorption of Chrysoidine R by using fly ash in batch process

International Nuclear Information System (INIS)

Matheswaran, Manickam; Karunanithi, Thirugnanam

2007-01-01

This investigation deals with effective utilization of fly ash as adsorbent for the removal of Chrysoidine R from the aqueous solution. The fly ash is a major byproduct generated in coal-based thermal power plants and has good potential for use as an adsorbent. A series of experiments were carried out in a batch adsorption technique to obtain the effect of process variables viz. contact time, pH (2, 4, 6 and 8) initial concentration of the dye (400, 600, 800 and 1000 mg L -1 ), amount of the adsorbent (125, 250, 375 and 500 mg L -1 ), and temperature (303, 313, 323 and 333 K) on adsorption. The concentration of dye was determined by spectrophotometer. The results showed that as the amount of the adsorbent was increased, the percentage of dye removal increased accordingly; higher adsorption percentage was observed at lower concentration of chrysoidine. The adsorption data were analyzed using Langmuir and Freundlich isotherms. The adsorption was found to obey pseudo-first order kinetics. An intra particle diffusion model was used to fit the experimental data. The thermodynamic parameters such as standard change in free energy, enthalpy and entropy of adsorption have been calculated. Adsorption of Chrysoidine R on fly ash was found to be an exothermic reaction

(n,γ) (γ,n) unstability in the r process of nucleosynthesis

International Nuclear Information System (INIS)

Duarte, S.J.B.

1977-01-01

The equilibrium approximation for capture and neutron photoemission reactions within r process of nucleosynthesis is analysed. This analysis is considered for whole range of neutron density and temperature which enable the ocurrence of the process. In this way it is necessary to know capture and photo-emission rates for approximately 2000 nuclei. The detailed balance is used in rate relation of above-mencioned reactions, and its application, under temperature, and its application, under temperature conditions and neutron density is discussed. The others nuclear parameters used in face of the nuclei involved in r process are far away of the β stability line. The temperature conditions and neutron density are presented from the point where the equilirbium approximation is not applicable. The procedure to be used in the application of the obtained results in dynamical models of r process is also presented. (M.C.K.) [pt

Assessment of Patient Satisfaction with Pharmaceutical Community Services in R. Macedonia

Directory of Open Access Journals (Sweden)

Zoran Sterjev

2011-06-01

Full Text Available Measuring and analyzing patients’ satisfaction with pharmacist’s consultation is a relatively new development which is enforced by the new demands of society. High number of variables, such as their state of health, socio-demographic variables (age, sex, and cultural level, characteristics of their healthcare provider (affective care, quantity of information, technical expertise, etc, or waiting time are related to patients’ satisfaction. At present, in R.Macedonia, there are 834 community pharmacies, which accounts for pharmacy vs. population ratio of 1:2500. The pharmacies are situated in 8 different regions (the Vardar region, Pelagonia, North-East, South-West, Polog, East and South East. The present cross-sectional descriptive study based on interview data was carried out in order to ascertain patients’ satisfaction from their experience with the cumulative quality of pharmaceutical services. A total of 651 patients of both sexes (59,3% male and 39,1% female were included in the study. The results from our analysis showed the influence of different factors in the process of choosing pharmacy: distance, medicines price, well-stocked with medicines, professional advice by the employees in the pharmacy, hygiene in pharmacies, the privacy they offer, waiting time, possibility for private conversation with professionals.

Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach

Science.gov (United States)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2017-04-01

Emergency department (ED) is the main unit of a hospital that provides emergency treatment. Operating 24 hours a day with limited number of resources invites more problems to the current chaotic situation in some hospitals in Malaysia. Delays in getting treatments that caused patients to wait for a long period of time are among the frequent complaints against government hospitals. Therefore, the ED management needs a model that can be used to examine and understand resource capacity which can assist the hospital managers to reduce patients waiting time. Simulation model was developed based on 24 hours data collection. The model developed using Arena simulation replicates the actual ED's operations of a public hospital in Selangor, Malaysia. The OptQuest optimization in Arena is used to find the possible combinations of a number of resources that can minimize patients waiting time while increasing the number of patients served. The simulation model was modified for improvement based on results from OptQuest. The improvement model significantly improves ED's efficiency with an average of 32% reduction in average patients waiting times and 25% increase in the total number of patients served.

Primordial Black Holes and r-Process Nucleosynthesis.

Science.gov (United States)

Fuller, George M; Kusenko, Alexander; Takhistov, Volodymyr

2017-08-11

We show that some or all of the inventory of r-process nucleosynthesis can be produced in interactions of primordial black holes (PBHs) with neutron stars (NSs) if PBHs with masses 10^{-14}  M_{⊙}process and the accompanying decompression and decay of nuclear matter can produce electromagnetic transients, such as a kilonova-type afterglow and fast radio bursts. These transients are not accompanied by significant gravitational radiation or neutrinos, allowing such events to be differentiated from compact object mergers occurring within the distance sensitivity limits of gravitational-wave observatories. The PBH-NS destruction scenario is consistent with pulsar and NS statistics, the dark-matter content, and spatial distributions in the Galaxy and ultrafaint dwarfs, as well as with the r-process content and evolution histories in these sites. Ejected matter is heated by beta decay, which leads to emission of positrons in an amount consistent with the observed 511-keV line from the Galactic center.

Quality Improvement Cycles that Reduced Waiting Times at ...

African Journals Online (AJOL)

It was decided to undertake quality improvement (QI) cycles to analyse and improve the situation, using waiting time as a measure of improvement. Methods: A QI team was chosen to conduct two QI cycles. The allocated time for QI cycle 1 was from May to August 2006 and for QI cycle 2 from September to December 2006.

Impact of co-located general practitioner (GP) clinics and patient choice on duration of wait in the emergency department.

Science.gov (United States)

Sharma, Anurag; Inder, Brett

2011-08-01

To empirically model the determinants of duration of wait of emergency (triage category 2) patients in an emergency department (ED) focusing on two questions: (i) What is the effect of enhancing the degree of choice for non-urgent (triage category 5) patients on duration of wait for emergency (category 2) patients in EDs; and (ii) What is the effect of co-located GP clinics on duration of wait for emergency patients in EDs? The answers to these questions will help in understanding the effectiveness of demand management strategies, which are identified as one of the solutions to ED crowding. The duration of wait for each patient (difference between arrival time and time first seen by treating doctor) was modelled as a function of input factors (degree of choice, patient characteristics, weekend admission, metro/regional hospital, concentration of emergency (category 2) patients in hospital service area), throughput factors (availability of doctors and nurses) and output factor (hospital bed capacity). The unit of analysis was a patient episode and the model was estimated using a survival regression technique. The degree of choice for non-urgent (category 5) patients has a non-linear effect: more choice for non-urgent patients is associated with longer waits for emergency patients at lower values and shorter waits at higher values of degree of choice. Thus more choice of EDs for non-urgent patients is related to a longer wait for emergency (category 2) patients in EDs. The waiting time for emergency patients in hospital campuses with co-located GP clinics was 19% lower (1.5 min less) on average than for those waiting in campuses without co-located GP clinics. These findings suggest that diverting non-urgent (category 5) patients to an alternative model of care (co-located GP clinics) is a more effective demand management strategy and will reduce ED crowding.

Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

Science.gov (United States)

Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

2008-01-01

BACKGROUND: Monitoring wait times and defining targets for care have been advocated to improve health care delivery related to cancer, heart, diagnostic imaging, joint replacements and sight restoration. There are few data on access to care for digestive diseases, although they pose a greater economic burden than cancer or heart disease in Canada. The present study compared wait times for specialist gastroenterology care with recent, evidence-based, consensus-defined benchmark wait times for a range of digestive diseases. METHODS: Total wait times from primary care referral to investigation were measured for seven digestive disease indications by using the Practice Audit in Gastroenterology program, and were benchmarked against consensus recommendations. RESULTS: Total wait times for 1903 patients who were undergoing investigation exceeded targets for those with probable cancer (median 26 days [25th to 75th percentiles eight to 56 days] versus target of two weeks); probable inflammatory bowel disease (101 days [35 to 209 days] versus two weeks); documented iron deficiency anemia (71 days [19 to 142 days] versus two months); positive fecal occult blood test (73 days [36 to 148 days] versus two months); dyspepsia with alarm symptoms (60 days [23 to 140 days] versus two months); refractory dyspepsia without alarm symptoms (126 days [42 to 225 days] versus two months); and chronic constipation and diarrhea (141 days [68 to 264 days] versus two months). A minority of patients were seen within target times: probable cancer (33% [95% CI 20% to 47%]); probable inflammatory bowel disease (12% [95% CI 1% to 23%]); iron deficiency anemia (46% [95% CI 37% to 55%]); positive occult blood test (41% [95% CI 28% to 54%]); dyspepsia with alarm symptoms (51% [95% CI 41% to 60%]); refractory dyspepsia without alarm symptoms (33% [95% CI 19% to 47%]); and chronic constipation and diarrhea (21% [95% CI 14% to 29%]). DISCUSSION: Total wait times for the seven indications exceeded the

A comparative analysis of three of ERDA's major R and D programs

International Nuclear Information System (INIS)

Weyant, J.P.

1978-01-01

The benefits attributable to alternative energy R and D programs should be evaluated in terms of how well the technologies contribute as integral elements of the total United States energy system. Thus, the present model simulates the dynamics of the evolution of the total energy system by requiring both existing and new technologies to compete for introduction on a cost-competitive basis that considers the time phasing of (1) retirement of energy conversion facilities, (2) growth in end-use demands, and (3) escalation of the costs of extracting depleting domestic energy resources. This approach contrasts with a static model used by the Energy Research and Development Administration, wherein assumptions must be made for each future year of interest for (1) maximum capacity constraints for alternative types of conversion facilities and (2) the cost of energy resources. The present model is used to compare the relative consequences and merits of the technology products from the following three of ERDA's major energy R and D programs: (1) the liquid-metal fast breeder reactor (LMFBR), (2) synthetic fuels derived from coal and oil shale, and (3) improved efficiencies for end-use devices (e.g. space heaters). (author)

R and D contract management systems in the USA (Attachment); Beikoku ni okeru R and D contract kanri system (tenpu shiryohen)

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-02-01

Presented herein is the attachment for 'R and D contract management systems in the USA'. The major contents include regulations governing the R and D contracts, procedures for the R and D contracts, financial procedures for the R and D contracts, procedures for the alternative R and D contracts, financial management of the R and D contracts, and activities for the management of the contract processes by electronic systems. (NEDO)

Outsourcing R&D Modules of a New Developing Technology

DEFF Research Database (Denmark)

Pedersen, Jørgen Lindgaard; Perunovic, Zoran

2004-01-01

The paper explores some of the dimensions of the R&D processes: modularity, uncertainty and outsourcing. Ways to divide R&D effort into modules and to argue, either in direction of its modularity, or interdependency, are presented. Further on, uncertainties are segmented into the majors and minors......, and reasons to outsource R&D modules, in the light of these uncertainties, have been investigated. The R&D process has been observed from insulin technologies development over time....

The R-process: supernovae and other sources of the heaviest elements

International Nuclear Information System (INIS)

Thielemann, F.-K.; Moceli, D.; Panov, I.

2007-01-01

Rapid neutron capture in stellar explosions is responsible for the heaviest elements in nature, up to Th, U and beyond. This nucleosynthesis process, the r-process, is unique in the sense that a combination of nuclear physics far from stability (masses, half-lives, neutron-capture and photodisintegration, neutron-induced and beta-delayed fission and last but not least neutrino-nucleus interactions) is intimately linked to ejecta from astrophysical explosions (core collapse supernovae or other neutron star related events). The astrophysics and nuclear physics involved still harbor many uncertainties, either in the extrapolation of nuclear properties far beyond present experimental explorations or in the modeling of multidimensional, general relativistic (neutrino-radiation) hydrodynamics with rotation and possibly required magnetic fields. Observational clues about the working of the r-process are mostly obtained from solar abundances and from the abundance evolution of the heaviest elements as a function of galactic age, as witnessed in old extremely metal-poor stars. They contain information whether the r-process is identical for all stellar events, how abundance features develop with galactic time and whether the frequency of r-process events is comparable to that of average core collapse supernovae - producing oxygen through titanium, as well as iron-group nuclei. The theoretical modeling of the r-process has advanced from simple approaches, where the use of static neutron densities and temperatures can aid to test the influence of nuclear properties far from stability on abundance features, to more realistic expansions with a given entropy, global neutron/proton ratio and expansion timescales, as expected from explosive astrophysical events. The direct modeling in astrophysical events such as supernovae still faces the problem whether the required conditions can be met. (author)

Duration of the first steps of the human rRNA processing

Czech Academy of Sciences Publication Activity Database

Popov, A.; Smirnov, E.; Kováčik, L.; Raška, O.; Hagen, G.; Stixová, Lenka; Raška, I.

2013-01-01

Roč. 4, č. 2 (2013), s. 134-141 ISSN 1949-1034 R&D Projects: GA ČR(CZ) GBP302/12/G157; GA MŠk(CZ) EE2.3.30.0030 Grant - others:GA ČR(CZ) GAP302/12/1885 Institutional research plan: CEZ:AV0Z50040702 Institutional support: RVO:68081707 Keywords : rRNA processing * cleavage * half-life time Subject RIV: BO - Biophysics Impact factor: 3.148, year: 2013

Telephone-Based Physical Activity Counseling for Major Depression in People with Multiple Sclerosis

Science.gov (United States)

Bombardier, Charles H.; Ehde, Dawn M.; Gibbons, Laura E.; Wadhwani, Roini; Sullivan, Mark D.; Rosenberg, Dori E.; Kraft, George H.

2013-01-01

Objective: Physical activity represents a promising treatment for major depressive disorder (MDD) in people with multiple sclerosis (MS). We conducted a single-blind, two-arm randomized controlled trial comparing a 12-week physical activity counseling intervention delivered primarily by telephone (n = 44) to a wait-list control group (N = 48).…

Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000

Directory of Open Access Journals (Sweden)

Hayden Robert

2005-03-01

Full Text Available Abstract Background In British Columbia, Canada, all necessary medical services are funded publicly. Concerned with growing wait lists in the mid-1990s, the provincial government started providing extra funding for coronary artery bypass grafting (CABG operations annually. Although aimed at improving access, it is not known whether supplementary funding changed the time that patients spent on wait lists for CABG. We sought to determine whether the period of registration on wait lists had an effect on time to isolated CABG and whether the period effect was similar across priority groups. Methods Using records from a population-based registry, we studied the wait-list time before and after supplementary funding became available. We compared the number of weeks from registration to surgery for equal proportions of patients in synthetic cohorts defined by five registration periods in the 1990s. Results Overall, 9,231 patients spent a total of 137,126 person-weeks on the wait lists. The time to surgery increased by the middle of the decade, and decreased toward the end of the decade. Relative to the 1991–92 registration period, the conditional weekly probabilities of undergoing surgery were 30% lower among patients registered on the wait lists in 1995–96, hazard ratio (HR = 0.70 (0.65–0.76, and 23% lower in 1997–98 patients, HR = 0.77 (0.71–0.83, while there were no differences with 1999–2000 patients, HR = 0.94 (0.88–1.02, after adjusting for priority group at registration, comorbidity, age and sex. We found that the effect of registration period was different across priority groups. Conclusion Our results provide evidence that time to CABG shortened after supplementary funding was provided on an annual basis to tertiary care hospitals within a single publicly funded health system. One plausible explanation is that these hospitals had capacity to increase the number of operations. At the same time, the effect was not uniform across

Mandatory weight loss during the wait for bariatric surgery.

Science.gov (United States)

Glenn, Nicole M; Raine, Kim D; Spence, John C

2015-01-01

Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies. © The Author(s) 2014.

Maternity waiting homes in Southern Lao PDR: the unique 'silk home'.

Science.gov (United States)

Eckermann, Elizabeth; Deodato, Giovanni

2008-10-01

The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People's Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.

Waiting Time from Diagnosis to Treatment has no Impact on Survival in Patients with Esophageal Cancer

NARCIS (Netherlands)

Visser, E.; Leeftink, Anne Greetje; van Rossum, P.S.N.; Siesling, Sabine; van Hillegersberg, R.; Ruurda, J.P.

2016-01-01

Background Waiting time from diagnosis to treatment has emerged as an important quality indicator in cancer care. This study was designed to determine the impact of waiting time on long-term outcome of patients with esophageal cancer who are treated with neoadjuvant therapy followed by surgery or

Patient perceptions regarding physician reimbursements, wait times, and out-of-pocket payments for anterior cruciate ligament reconstruction in Ontario.

Science.gov (United States)

Memon, Muzammil; Ginsberg, Lydia; de Sa, Darren; Nashed, Andrew; Simunovic, Nicole; Phillips, Mark; Denkers, Matthew; Ogilvie, Rick; Peterson, Devin; Ayeni, Olufemi R

2017-12-01

Currently, there is a lack of knowledge regarding patient perceptions surrounding physician reimbursements, appropriate wait times, and out-of-pocket payment options for anterior cruciate ligament reconstruction (ACLR). Our objective was to determine the current state of these perceptions in an Ontario setting. A survey was developed and pretested to address patient perceptions about physician reimbursements, appropriate wait times, and out-of-pocket payment options for ACLR using a focus group of experts and by reviewing prior surveys. The survey was administered to patients in a waiting room setting. Two hundred and fifty completed surveys were obtained (79.9% response rate). Participants responded that an appropriate physician reimbursement for ACLR was $1000.00 and that the Ontario Health Insurance Plan (OHIP) reimbursed physicians $700.00 for ACLR. Seventy-four percent of participants responded that the OHIP reimbursement of $615.20 for the procedure was either lower or much lower than what they considered to be an appropriate reimbursement for ACLR. Over 90% of participants responded that an ACLR should occur within 90 days of injury. Thirty-five percent of participants were willing to pay $750.00 out-of-pocket to have an ACLR done sooner, while 16.4% of participants were willing to pay $2500.00 out-of-pocket to travel outside of Canada for expedited surgery. This survey study demonstrates that patients' estimates of both appropriate and actual physician reimbursements were greater than the current reimbursement for ACLR. Further, the majority of individuals report that the surgical fee for ACLR is lower than what they consider to be an appropriate amount of compensation for the procedure. Additionally, nearly all respondents believe that a ruptured ACL should be reconstructed within 90 days of injury. Consequently, a number of patients are willing to pay out-of-pocket for expedited surgery either in Canada or abroad. However, patients' preferences for

Radiation processing in the U.S.S.R.

Science.gov (United States)

Pikaev, A. K.

The present paper is a short review of the modern status of radiation processing in the U.S.S.R. Data on ionizing radiation sources used in radiation processing are reported. The main directions of the development of this field of technology: radiation modification of materials, radiation curing of coatings, radiation-chemical methods of synthesis, radiation sterilization of medical products, radiation treatment of food, application of ionizing radiation for the solution of ecological problems etc. -are considered.

Experience of being a low priority patient during waiting time at an emergency department

Directory of Open Access Journals (Sweden)

Adolfsson A

2012-01-01

Full Text Available Ingrid Dahlen1,2, Lars Westin1, Annsofie Adolfsson11School of Life Sciences, University of Skövde, Skövde, Sweden; 2Emergency Department, Skaraborg Hospital, Skövde, SwedenBackground: Work in the emergency department is characterized by fast and efficient medical efforts to save lives, but can also involve a long waiting time for patients. Patients are given a priority rating upon their arrival in the clinic based on the seriousness of their problem, and nursing care for lower priority patients is given a lower prioritization. Regardless of their medical prioritization, all patients have a right to expect good nursing care while they are waiting. The purpose of this study was to illustrate the experience of the low prioritized patient during their waiting time in the emergency department.Methods: A phenomenological hermeneutic research method was used to analyze an interview transcript. Data collection consisted of narrative interviews. The interviewees were 14 patients who had waited more than three hours for surgical, orthopedic, or other medical care.Results: The findings resulted in four different themes, ie, being dependent on care, being exposed, being vulnerable, and being secure. Lower priority patients are not paid as much attention by nursing staff. Patients reported feeling powerless, insulted, and humiliated when their care was delayed without their understanding what was happening to them. Not understanding results in exposure that violates self-esteem.Conclusion: The goal of the health care provider must be to minimize and prevent suffering, prevent feelings of vulnerability, and to create conditions for optimal patient well being.Keywords: emergency department, patients, waiting times, nursing staff

R and D contract management systems in the USA (Attachment); Beikoku ni okeru R and D contract kanri system (tenpu shiryohen)

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-02-01

Presented herein is the attachment for 'R and D contract management systems in the USA'. The major contents include regulations governing the R and D contracts, procedures for the R and D contracts, financial procedures for the R and D contracts, procedures for the alternative R and D contracts, financial management of the R and D contracts, and activities for the management of the contract processes by electronic systems. (NEDO)

Two facets of patience in young children: Waiting with and without an explicit reward.

Science.gov (United States)

Barragan-Jason, Gladys; Atance, Cristina; Kopp, Leia; Hopfensitz, Astrid

2018-07-01

Patience, or the ability to tolerate delay, is typically studied using delay of gratification (DoG) tasks. However, among other factors (e.g., type of reward), the use of a reward to test patience is affected by an individual's motivation to obtain the reward (e.g., degree of preference for the small vs. large reward). In addition, DoG tasks do not assess the extent to which an individual can wait in the absence of an explicit reward-or what we term "patience as a virtue." Accordingly, the current study used a new measure of patience-the "pure waiting paradigm"-in which 3- to 5-year-old children waited 3 min with nothing to do and with no explicit reward. We then examined the relation between performance on this task (as assessed by children's spontaneous patient behaviors) and performance on two DoG tasks (candy and video rewards). Significant correlations were found between DoG performance and patient behaviors in the pure waiting paradigm, especially when controlling for motivation. These results and methodology show for the first time a direct link between patience as a virtue and DoG performance and also provide new insights about the study of patience in children. Copyright © 2018 Elsevier Inc. All rights reserved.

Blood pressure self-measurement in the obstetric waiting room

DEFF Research Database (Denmark)

Wagner, Stefan; Kamper, Christina H.; Toftegaard, Thomas Skjødeberg

2013-01-01

a reliable blood pressure reading. Results: We found that the patients did not adhere to given instructions when performing blood pressure self-measurement in the waiting room. None of the 81 patients adhered to all six inves- tigated recommendations, while around a quarter adhered to five out of six...

Waiting in the queue on Hotelling’s Main Street

NARCIS (Netherlands)

Peters, H.J.M.; Schröder, M.J.W.; Vermeulen, A.J.

2015-01-01

We consider a variant of Hotelling’s location model that was proposed by Kohlberg (1983): when choosing a firm, consumers take travel time and also (expected) waiting time, which again depends on the number of consumers choosing that firm, into consideration. If we assume that firms are symmetric,

Long gamma-ray burst as a production site of r-process elements

International Nuclear Information System (INIS)

Nakamrua, Ko; Harikae, Seiji; Kajino, Toshitaka; Mathews, Grant J.

2012-01-01

We simulated the r-process nucleosynthesis in and around a high entropy jet from a long gamma-ray burst (GRB). Our simulation is based on the collapsar scenario for long GRBs and on relativistic magnetohydrodynamic simulations (Harikae et al. 2009, 2010) including ray-tracing neutrino transport, which describe the development of the black hole accretion disk and the heating of the funnel region to produce a relativistic jet. The time evolution of the jet was then extended to later phase via axi-symmetric special relativistic hydrodynamic simulation to follow the temperature, entropy, electron fraction, and density evolution for representative test particles. The evolution of nuclear abundances from nucleons to heavy nuclei for representative test particle trajectories was solved in a large nuclear reaction network including more than 5000 isotopes. We show that a robust r-process successfully occurs within the collapsar jet outflow and that sufficient mass is ejected within the flow to account for the observed r-process abundance distribution along with the large dispersion in r-process elements observed in metal-poor halo stars.

The experience of adults who choose watchful waiting or active surveillance as an approach to medical treatment: a qualitative systematic review.

Science.gov (United States)

Rittenmeyer, Leslie; Huffman, Dolores; Alagna, Michael; Moore, Ellen

2016-02-01

"Watchful waiting" or "active surveillance" is an alternative approach in the medical management of certain diseases. Most often considered appropriate as an approach to treatment for low-risk prostate cancer, it is also found in the literature in breast cancer surveillance, urinary lithiasis, lymphocytic leukemia, depression and small renal tumors. This systematic review sought to:Identify and synthesize the best available international evidence on the experience of adults who choose watchful waiting or active surveillance as an approach to medical treatment. To this end the questions addressed in this review were:1. How do patients who have chosen watchful waiting or active surveillance describe the process of coming to the decision?2. What were the factors that influenced their decision to choose?3. How do patients who have chosen watchful waiting or active surveillance describe the experience? Male or female patients, 18 years or older, who experience the phenomenon of choosing or not choosing watchful waiting or active surveillance as a treatment approach.The phenomena of interest were accounts of the experiences of adult patients who choose watchful waiting or active surveillance as an approach to medical treatment.This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and critical theory. Mixed method studies with narrative description and patient voice were also considered. Grey literature such as research reports and dissertations were also included. The search strategy aimed to find both published and unpublished studies through electronic databases, reference lists, and the World Wide Web. Extensive searches were undertaken of relevant databases to include CINAHL, PubMed, SCOPUS and PsycINFO. A three-step search strategy was used in each component of the review. Studies were limited to English language papers. The search considered papers

Development of crystal texture in R-lean RFeCoNbB (R = Nd, Pr) alloy during melt spinning processes

International Nuclear Information System (INIS)

Li, Wei; Li, Lanlan; Liu, Yanguo; Zhang, Xiangyi

2012-01-01

Highlights: ► We study the texture development during the melt spinning processes of R-lean alloys. ► A strong (0 0 l) texture parallel to the ribbon plane for (Nd,Pr) 2 Fe 14 B is obtained. ► The texture for R 2 Fe 14 B crystals can develop by a seeding effect of α-Fe texture. ► The anisotropic nanocomposite magnet yields M r = 0.78M s and large (BH) max = 25.2 MGOe. - Abstract: The formation of crystal texture of R 2 Fe 14 B nanocrystals in R–Fe–B (R = rare earth) alloys with low R content ( 2 Fe 14 B nanocrystals during the melt spinning processes of Nd 3.6 Pr 5.4 Fe 80 Co 3 NbB 7 by effectively employing the seeding effect of α-Fe nanocrystal texture. The (Nd,Pr) 2 Fe 14 B nanocrystals produced from the R-lean alloy at a wheel speed of 18 m/s show a strong (0 0 l) texture parallel to the ribbon plane, which yields a high remanence M r = 0.78M s and a large energy product (BH) max = 25.2 MGOe for the α-Fe/(Nd,Pr) 2 Fe 14 B nanocomposite ribbons. The present study provides a promising approach to prepare anisotropic nanocomposite magnets from R-lean alloys.

The use of the waiting list in a fair selection of patients for nursing home care

NARCIS (Netherlands)

Meiland, F. J.; Danse, J. A.; Hoos, A. M.; Wendte, J. F.; Gunning-Schepers, L. J.

1996-01-01

When health care resources are scarce, waiting lists may be used as a distribution measure in order to enhance the fair allocation of resources through selection of patients. In this study, the structure and use of a waiting list for a fair selection of patients for nursing home admission was

Reducing Bottlenecks to Improve the Efficiency of the Lung Cancer Care Delivery Process: A Process Engineering Modeling Approach to Patient-Centered Care.

Science.gov (United States)

Ju, Feng; Lee, Hyo Kyung; Yu, Xinhua; Faris, Nicholas R; Rugless, Fedoria; Jiang, Shan; Li, Jingshan; Osarogiagbon, Raymond U

2017-12-01

The process of lung cancer care from initial lesion detection to treatment is complex, involving multiple steps, each introducing the potential for substantial delays. Identifying the steps with the greatest delays enables a focused effort to improve the timeliness of care-delivery, without sacrificing quality. We retrospectively reviewed clinical events from initial detection, through histologic diagnosis, radiologic and invasive staging, and medical clearance, to surgery for all patients who had an attempted resection of a suspected lung cancer in a community healthcare system. We used a computer process modeling approach to evaluate delays in care delivery, in order to identify potential 'bottlenecks' in waiting time, the reduction of which could produce greater care efficiency. We also conducted 'what-if' analyses to predict the relative impact of simulated changes in the care delivery process to determine the most efficient pathways to surgery. The waiting time between radiologic lesion detection and diagnostic biopsy, and the waiting time from radiologic staging to surgery were the two most critical bottlenecks impeding efficient care delivery (more than 3 times larger compared to reducing other waiting times). Additionally, instituting surgical consultation prior to cardiac consultation for medical clearance and decreasing the waiting time between CT scans and diagnostic biopsies, were potentially the most impactful measures to reduce care delays before surgery. Rigorous computer simulation modeling, using clinical data, can provide useful information to identify areas for improving the efficiency of care delivery by process engineering, for patients who receive surgery for lung cancer.

Waiting to Drive (A Minute of Health with CDC)

Centers for Disease Control (CDC) Podcasts

2015-04-09

Over the past 10 years, the number of fatal motor-vehicle crashes involving teenage drivers has declined by more than 50 percent. This podcast discusses the trend of teens waiting until they are older to drive.  Created: 4/9/2015 by MMWR.   Date Released: 4/9/2015.

Factors affecting medication-order processing time.

Science.gov (United States)

Beaman, M A; Kotzan, J A

1982-11-01

The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

Stress, psychological distress, and coping in patients on the waiting list for lung transplantation : an exploratory study

NARCIS (Netherlands)

Vermeulen, KM; Bosma, OH; van der Bij, W; Koeter, GH; TenVergert, EM

Little information is available in literature on quality of life, stress and coping during the period patients are waiting for lung transplantation. This study explored potential stressful events that patients experience during the waiting period assessed the level of anxiety and depression and

Wait time management strategies for total joint replacement surgery: sustainability and unintended consequences.

Science.gov (United States)

Pomey, Marie-Pascale; Clavel, Nathalie; Amar, Claudia; Sabogale-Olarte, Juan Carlos; Sanmartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2017-09-07

In Canada, long waiting times for core specialized services have consistently been identified as a key barrier to access. Governments and organizations have responded with strategies for better access management, notably for total joint replacement (TJR) of the hip and knee. While wait time management strategies (WTMS) are promising, the factors which influence their sustainable implementation at the organizational level are understudied. Consequently, this study examined organizational and systemic factors that made it possible to sustain waiting times for TJR within federally established limits and for at least 18 months or more. The research design is a multiple case study of WTMS implementation. Five cases were selected across five Canadian provinces. Three success levels were pre-defined: 1) the WTMS maintained compliance with requirements for more than 18 months; 2) the WTMS met requirements for 18 months but could not sustain the level thereafter; 3) the WTMS never met requirements. For each case, we collected documents and interviewed key informants. We analyzed systemic and organizational factors, with particular attention to governance and leadership, culture, resources, methods, and tools. We found that successful organizations had specific characteristics: 1) management of the whole care continuum, 2) strong clinical leadership; 3) dedicated committees to coordinate and sustain strategy; 4) a culture based on trust and innovation. All strategies led to relatively similar unintended consequences. The main negative consequence was an initial increase in waiting times for TJR and the main positive consequence was operational enhancement of other areas of specialization based on the TJR model. This study highlights important differences in factors which help to achieve and sustain waiting times. To be sustainable, a WTMS needs to generate greater synergies between contextual-level strategy (provincial or regional) and organizational objectives and

Lung cancer care trajectory at a Canadian centre: an evaluation of how wait times affect clinical outcomes.

Science.gov (United States)

Kasymjanova, G; Small, D; Cohen, V; Jagoe, R T; Batist, G; Sateren, W; Ernst, P; Pepe, C; Sakr, L; Agulnik, J

2017-10-01

Lung cancer continues to be one of the most common cancers in Canada, with approximately 28,400 new cases diagnosed each year. Although timely care can contribute substantially to quality of life for patients, it remains unclear whether it also improves patient outcomes. In this work, we used a set of quality indicators that aim to describe the quality of care in lung cancer patients. We assessed adherence with existing guidelines for timeliness of lung cancer care and concordance with existing standards of treatment, and we examined the association between timeliness of care and lung cancer survival. Patients with lung cancer diagnosed between 2010 and 2015 were identified from the Pulmonary Division Lung Cancer Registry at our centre. We demonstrated that the interdisciplinary pulmonary oncology service successfully treated most of its patients within the recommended wait times. However, there is still work to be done to decrease variation in wait time. Our results demonstrate a significant association between wait time and survival, supporting the need for clinicians to optimize the patient care trajectory. It would be helpful for Canadian clinicians treating patients with lung cancer to have wait time guidelines for all treatment modalities, together with standard definitions for all time intervals. Any reductions in wait times should be balanced against the need for thorough investigation before initiating treatment. We believe that our unique model of care leads to an acceleration of diagnostic steps. Avoiding any delay associated with referral to a medical oncologist for treatment could be an acceptable strategy with respect to reducing wait time.

THE INFLUENCE OF WAITING TIME SATISFACTION ON CUSTOMER LOYALTY TOWARDS MULTI-STAGE SERVICES IN A FULL-SERVICE RESTAURANT: EVIDENCE FROM INDIA

Directory of Open Access Journals (Sweden)

A. Mittal

2016-06-01

Full Text Available Research shows waiting time in services is an important source of service evaluation by the customer. In fact, time is one component of the total 'cost' that the customer bears and cost is a core component of the perceived cost-benefit equation that the customer uses to evaluate her or his sustained patronage of a particular service. In most services, customers consider waiting as a waste of time. However, from the customer perspective, in the case of a full-service restaurant, waiting is expected and sometimes desirable also. Prior research, mainly in the west, suggests that when customers think that a wait for service is too long, they become less satisfied with overall service quality. Based on a research setting in a full-scale restaurant in India, this paper seeks answers to two research questions: First, what are the determinants of overall waiting-time satisfaction and second, what is the influence of waiting-time satisfaction on customer loyalty.

No-Wait Job Shop Scheduling, a Constraint Propagation Approach

NARCIS (Netherlands)

Lennartz, P.M.

2006-01-01

Multi-machine scheduling problems have earned themselves a reputation of intractability. In this thesis we try to solve a special kind of these problems, the so-called no-wait job shop problems. In an instance of this problem-class we are given a number of operations that are to be executed on a

Economic evaluation of Internet-based problem-solving guided self-help treatment in comparison with enhanced usual care for depressed outpatients waiting for face-to-face treatment

DEFF Research Database (Denmark)

Kolovos, Spyros; Kenter, Robin M F; Bosmans, Judith E

2016-01-01

at outpatient clinics. METHODS: An economic evaluation was performed alongside a randomized controlled trial with 12 months follow-up. Outcomes were improvement in depressive symptom severity (measured by CES-D), response to treatment and Quality-Adjusted Life-Years (QALYs). Statistical uncertainty around cost......BACKGROUND: Previous studies have demonstrated the effectiveness of Internet-based interventions for depression in comparison with usual care. However, evidence on the cost-effectiveness of these interventions when delivered in outpatient clinics is lacking. The aim of this study was to estimate...... the cost-effectiveness of an Internet-based problem-solving guided self-help intervention in comparison with enhanced usual care for outpatients on a waiting list for face-to-face treatment for major depression. After the waiting list period, participants from both groups received the same treatment...

Waiting for total knee replacement surgery: factors associated with pain, stiffness, function and quality of life

Directory of Open Access Journals (Sweden)

Dionne Clermont E

2009-05-01

Full Text Available Abstract Background Recent evidences show that education and rehabilitation while waiting for knee replacement have positive effects on the patients' health status. Identification of factors associated with worse pain, function and health-related quality of life (HRQoL while waiting for surgery could help develop pre-surgery rehabilitation interventions that target specifically these factors and prioritize patients that may benefit the most from them. The objectives of this study were to measure pain, stiffness, function and HRQoL in patients at enrolment on waiting lists for knee replacement and to identify demographic, clinical, socioeconomic and psychosocial characteristics associated with these outcomes. Methods This study is part of a broader study measuring the effects of pre-surgery wait in patients scheduled for knee replacement. From 02/2006 to 09/2007, 197 patients newly scheduled for total knee replacement were recruited from the waiting lists of three university hospitals in Quebec City, Canada. Pain, stiffness and function were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC and HRQoL was measured with the SF-36 Health Survey. Stepwise multiple regression analysis was used to assess the strength of the associations between the independent variables and the WOMAC and SF-36 scores. Results The scores of all eight HRQoL physical and mental domains of the SF-36 were significantly lower than aged matched Canadian normative data (p Conclusion Patients waiting for knee replacement have poor function and HRQoL. Characteristics that were found to be associated with these outcomes could help develop pre-surgery rehabilitation program and prioritize patients that may benefit the most from them. Such programs could include interventions to reduce psychological distress, therapeutic exercises targeting both knees and weight loss management.

Guided online or face-to-face cognitive behavioral treatment for insomnia: A randomized wait-list controlled trial

NARCIS (Netherlands)

Lancee, J.; van Straten, A.; Morina, N.; Kaldo, V.; Kamphuis, J.H.

2016-01-01

Study Objectives: To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition. Methods: A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were

Waiting-time approximations in multi-queue systems with cyclic service

NARCIS (Netherlands)

Boxma, O.J.; Meister, B.W.

1987-01-01

This study is devoted to mean waiting-time approximations in a single-server multi-queue model with cyclic service and zero switching times of the server between consecutive queues. Two different service disciplines are considered: exhaustive service and (ordinary cyclic) nonexhaustive service. For

Study of the 17Ne Coulomb dissociation process and its role for the rp process of nucleosynthesis

Energy Technology Data Exchange (ETDEWEB)

Marganiec, Justyna [TU Darmstadt (Germany); EMMI, GSI Darmstadt (Germany); Wamers, Felix [EMMI, GSI Darmstadt (Germany); TU Darmstadt (Germany); GSI Darmstadt (Germany); FIAS, Frankfurt am Main (Germany); Aumann, Thomas [TU Darmstadt (Germany); GSI Darmstadt (Germany); Egorova, Irina [BLTP JINR Dubna (Russian Federation); Grigorenko, Leonid [FLNR JINR Dubna (Russian Federation); RRC KI, Moscow (Russian Federation); Heil, Michael [GSI Darmstadt (Germany); Perfenova, Yuliya [FLNR JINR Dubna (Russian Federation); INP, Moscow (Russian Federation); Plag, Ralf [GSI Darmstadt (Germany); Goethe-Universitaet, Frankfurt am Main (Germany); Collaboration: R3B-Collaboration

2014-07-01

The study of {sup 17}Ne Coulomb dissociation process gives us a possibility to study the time-reversed reaction {sup 15}O(2p,γ){sup 17}Ne, with the detailed balance theorem. This reaction could serve as a bypass of {sup 15}O waiting point during the rp process, and move the initial CNO material towards heavier nuclei. The two-proton capture can proceed sequentially or directly from the three-body continuum. And the reaction rate can be enhanced by a few orders of magnitude by taking the three-body continuum into account. The Coulomb dissociation method is the one way to experimentally determine the three-body radiative capture cross section, which is needed to verify theoretical calculations, and which was not experimentally determined yet. The experiment has been performed at the LAND/R3B setup at GSI.

Experience of being a low priority patient during waiting time at an emergency department.

Science.gov (United States)

Dahlen, Ingrid; Westin, Lars; Adolfsson, Annsofie

2012-01-01

Work in the emergency department is characterized by fast and efficient medical efforts to save lives, but can also involve a long waiting time for patients. Patients are given a priority rating upon their arrival in the clinic based on the seriousness of their problem, and nursing care for lower priority patients is given a lower prioritization. Regardless of their medical prioritization, all patients have a right to expect good nursing care while they are waiting. The purpose of this study was to illustrate the experience of the low prioritized patient during their waiting time in the emergency department. A phenomenological hermeneutic research method was used to analyze an interview transcript. Data collection consisted of narrative interviews. The interviewees were 14 patients who had waited more than three hours for surgical, orthopedic, or other medical care. The findings resulted in four different themes, ie, being dependent on care, being exposed, being vulnerable, and being secure. Lower priority patients are not paid as much attention by nursing staff. Patients reported feeling powerless, insulted, and humiliated when their care was delayed without their understanding what was happening to them. Not understanding results in exposure that violates self-esteem. The goal of the health care provider must be to minimize and prevent suffering, prevent feelings of vulnerability, and to create conditions for optimal patient well being.

A Novel Strategy of Carbon Capture and Sequestration by rHLPD Processing

Directory of Open Access Journals (Sweden)

Richard Eric Riman

2016-01-01

Full Text Available Monoethanolamine (MEA scrubbing is an energy intensive process for Carbon Capture and Sequestration (CCS due to the regeneration of amine in stripping towers at high temperature (100-120 ºC and the subsequent pressurization of CO2 for geologic sequestration. In this paper, we introduce a novel method, reactive hydrothermal liquid phase densification (rHLPD, which is able to solidify (densify monolithic materials without using high temperature kilns. Then we integrate MEA-based CCS processing and mineral carbonation by using rHLPD technology. This integration is designated as rHLPD-Carbon Sequestration (rHLPD-CS process. Our results show that the CO2 captured in the MEA-CO2 solution was sequestered by the mineral (wollastonite CaSiO3 carbonation at a low operating temperature (60 ºC and simultaneously monolithic materials with a compressive strength of ~121 MPa were formed. This suggests that the use of rHLPD-CS technology eliminates the energy consumed for CO2-MEA stripping and CO2 compression and also sequesters CO2 to form value-added products, which have a potential to be utilized as construction and infrastructure materials. In contrast to the high energy requirements and excessive greenhouse gas emissions from conventional Portland cement manufacturing, our calculations show that the integration of rHLPD and CS technologies provides a low energy alternative to production of traditional cementitious binding materials.

Waiting Time Increases Risk of Attrition in Gambling Disorder Treatment

DEFF Research Database (Denmark)

Linnet, Jakob; Pedersen, Anders Sune

2014-01-01

Attrition is a well known problem in psychotherapeutic treatment. Patients with addiction have high attrition rates, and it is therefore important to identify factors that can improve completion rates in addiction. Here, we investigated the influence of waiting time as a predictor of treatment...

Vibrant Energy Aware Spray and Wait Routing in Delay Tolerant Network

Directory of Open Access Journals (Sweden)

Viren G. Patel

2013-01-01

Full Text Available Delay tolerant networks (DTN are wireless networks where disconnections arise often due to the mobility of nodes, failures of energy, the low density of nodes, or when the network extends over long distances. In these situations, traditional routing protocols that have been developed for mobile ad hoc networks prove to be unsuccessful to the scope of transmitting messages between nodes. The Spray and Wait routing may achieve low routing and energy efficiency due to the blindness in the spray phase. To deal with this situation, we propose an opportunistic routing with enclosed message copies, called the Vibrant Energy aware Spray and Wait (VESW, which utilizes the information about vibrancy of node and remaining energy to allocate the number of copies between the corresponding pair nodes in the spray phase.

Waiting for a kidney transplant: the experience of patients with end-stage renal disease in South Korea.

Science.gov (United States)

Chong, Hye Jin; Kim, Hyun Kyung; Kim, Sung Reul; Lee, Sik

2016-04-01

To explore the experiences of Korean patients with end-stage renal disease awaiting kidney transplantation. The need for kidney transplantation has increased worldwide, while the number of kidney donors has not increased commensurately. This mismatch is a serious issue in South Korea. Prolonged waits for transplantation may cause physical and psychosocial issues and lead to poor outcomes. Nevertheless, the experience of waiting for kidney transplantation in South Korea has never been explored in depth. A qualitative descriptive design was used. The participants were eight patients diagnosed with end-stage renal disease on the waiting list for kidney transplantation in South Korea. Data were collected through individual in-depth interviews. All conversations during interviews were recorded and transcribed verbatim. Transcribed data were analysed using conventional content analysis. The experience of waiting for kidney transplantation consisted of six categories: (1) the light at the end of the tunnel, (2) being on call without any promise, (3) a tough tug of war between excitement and frustration, (4) doubts in the complexity, (5) A companion on the hard journey and (6) getting ready for D-day. Kidney transplantation candidates experience psychosocial difficulties and concerns while waiting for long periods of time without any assurance of resolution. Systematic education and psychosocial support from health care professionals and family members help patients get through what they describe as a difficult journey. Comprehensive management programs for kidney transplantation candidates are needed. Health care professionals need to recognise the psychosocial concerns of patients awaiting kidney transplantation. Clinicians should provide patients with information and support throughout the waiting period. © 2016 John Wiley & Sons Ltd.

Evaluating outcomes of the emergency nurse practitioner role in a major urban emergency department, Melbourne, Australia.

Science.gov (United States)

Jennings, Natasha; O'Reilly, Gerard; Lee, Geraldine; Cameron, Peter; Free, Belinda; Bailey, Michael

2008-04-01

The aim of this study was to evaluate the impact of the introduction of Emergency Nurse Practitioner Candidates (ENPC) on waiting times and length of stay of patients presenting to a major urban Emergency Department (ED) in Melbourne, Australia. As part of a Victorian state funded initiative to improve patient outcomes, the role of the Emergency Nurse Practitioner has been developed. The integration and implementation of this role, is not only new to the Alfred Emergency and Trauma Centre but to EDs in Melbourne, Australia, with aims of providing holistic and comprehensive care for patients. A retrospective case series of all patients with common ED diagnostic subgroups were included. The ENPC group (n = 572) included all patients managed by the ENPC and the Traditional Model (TM) group (n = 2584) included all patients managed by the traditional medical ED model of care. Outcome measures included waiting times and length of stay. Statistically significant differences were evident between the two groups in waiting times and length of stay in the ED. The overall median waiting time for emergency patients to be seen by the ENPC was less than for the TM group [median (IQR): ENPC 12 (5.5-28) minutes; TM 31 (11.5-76) minutes (Wilcoxon p times for ENPC shifts vs. non-ENPC shifts revealed significant differences [median (IQR): ENPC rostered 24 (9-52) minutes; ENPC not rostered 33 (13-80.5) minutes (Wilcoxon p Melbourne, Australia were associated with significantly reduced waiting times and length of stay for emergency patients. Emergency Nurse Practitioners should be considered as a potential long term strategy to manage increased service demands on EDs. Relevance to clinical practice. This study is the first in Australia with a significant sample size to vigorously compare ENPC waiting times and length of stay outcomes with the TM model of care in the ED. The study suggests that ENPCs can have a favourable impact on patient outcomes with regard to waiting times and length

Cultural differences and process adaptation in international R&D project management

DEFF Research Database (Denmark)

Li, Xing; Li, J. Z.

2009-01-01

In the era of globalization, Western companies have started to explore China as a source of technology. Yet, Western R&D project management processes in China are frequently facing many problems. Some of the problems can be conceptualized by analyzing a number of known cultural contrasts between ...... project success. At the same time, lessons and recommendations on the adaptability to Chinese style business and management interactions will be drawn from the case study for international companies that locate R&D projects in China.......In the era of globalization, Western companies have started to explore China as a source of technology. Yet, Western R&D project management processes in China are frequently facing many problems. Some of the problems can be conceptualized by analyzing a number of known cultural contrasts between...

Workshop: Waiting for the top quark

International Nuclear Information System (INIS)

Anon.

1991-01-01

The world of elementary particle physics is eagerly waiting for the top quark, probably the final element of the 'periodic table' of elementary particle constituents. This table consists of two families of weakly interacting particles (leptons) - one series carrying electric charge; the other being electrically neutral - together with a family of quarks carrying electric charge 2/3 (up, charm, top) and a family of charge -1/3 quarks (down, strange, beauty). It was then not surprising that the 1990 Theory Workshop at the DESY Laboratory in Hamburg in October, devoted this time to 'top physics', attracted some 200 physicists, substantially more than previous workshops in the series

Learning to wait: A laboratory investigation

Science.gov (United States)

Oprea, R.; Friedman, D.; Anderson, S.T.

2009-01-01

Human subjects decide when to sink a fixed cost C to seize an irreversible investment opportunity whose value V is governed by Brownian motion. The optimal policy is to invest when V first crosses a threshold V* = (1 + w*) C, where the wait option premium w* depends on drift, volatility, and expiration hazard parameters. Subjects in the Low w* treatment on average invest at values quite close to optimum. Subjects in the two Medium and the High w* treatments invested at values below optimum, but with the predicted ordering, and values approached the optimum by the last block of 20 periods. ?? 2009 The Review of Economic Studies Limited.

Psychosocial and Patient Education Needs of Prostate Cancers Selecting Watchful Waiting

National Research Council Canada - National Science Library

Knight, Sara J; Latini, David M

2006-01-01

... of this approach to disease management. We propose to gather data from prostate cancer patients selecting watchful waiting in lieu of an active treatment for their cancer in order to understand the psychosocial and symptom management...

Waiting Time Policies in the Health Care Sector. What Works?

DEFF Research Database (Denmark)

Christiansen, Terkel; Bech, Mickael

2013-01-01

times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

Science.gov (United States)

Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

2011-10-01

This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

Assessing the impact of a waiting time survey on reducing waiting times in urban primary care clinics in Cape Town, South Africa

Directory of Open Access Journals (Sweden)

Johann Daniels

2017-09-01

Full Text Available A waiting time survey (WTS conducted in several clinics in Cape Town, South Africa provided recommendations on how to shorten waiting times (WT. A follow-up study was conducted to assess whether WT had reduced. Using a stratified sample of 22 clinics, a before and after study design assessed changes in WT. The WT was measured and perceptions of clinic managers were elicited, about the previous survey’s recommendations. The overall median WT decreased by 21 minutes (95%CI: 11.77- 30.23, a 28% decrease from the previous WTS. Although no specific factor was associated with decreases in WT, implementation of recommendations to reduce WT was 2.67 times (95%CI: 1.33-5.40 more likely amongst those who received written recommendations and 2.3 times (95%CI: 1.28- 4.19 more likely amongst managers with 5 or more years’ experience. The decrease in WT found demonstrates the utility of a WTS in busy urban clinics in developing country contexts. Experienced facility managers who timeously receive customised reports of their clinic’s performance are more likely to implement changes that positively impact on reducing WT.

Patient deaths blamed on long waits at the Phoenix VA

Directory of Open Access Journals (Sweden)

Robbins RA

2014-04-01

Full Text Available No abstract available. Article truncated at 150 words. This morning the lead article in the Arizona Republic was a report blaming as many as 40 deaths at the Phoenix VA on long waits (1. Yesterday, Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, held a hearing titled “A Continued Assessment of Delays in VA Medical Care and Preventable Veteran Deaths.” “It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care,” Miller announced to a stunned audience. The committee has spent months investigating patient-care scandals and allegations at VA facilities in Pittsburgh, Atlanta, Miami and other cities. said that dozens of VA hospital patients in Phoenix may have died while awaiting medical care. He went on to say that staff investigators have evidence that the Phoenix VA Health Care System keeps two sets of records to conceal prolonged waits that patients must endure for ...

Neurocognitive Effects of Repetitive Transcranial Magnetic Stimulation (rTMS in Adolescents with Major Depressive Disorder (MDD

Directory of Open Access Journals (Sweden)

Christopher A Wall

2013-12-01

Full Text Available Objectives: It is estimated that 30% to 40% of adolescents with major depressive disorder (MDD do not receive full benefit from current antidepressant therapies. Repetitive transcranial magnetic stimulation (rTMS is a novel therapy approved by the US FDA to treat adults with MDD. Research suggests rTMS is not associated with adverse neurocognitive effects in adult populations; however, there is no documentation of its neurocognitive effects in adolescents. This is a secondary post hoc analysis of neurocognitive outcome in adolescents who were treated with open label rTMS in two separate studies. Methods: Eighteen patients (mean age, 16.2 ± 1.1 years; 11 females, 7 males with MDD who failed to adequately respond to at least 1 antidepressant agent were enrolled in the studies. Fourteen patients completed all 30 rTMS treatments (5 days/week, 120% of motor threshold, 10 Hz, 3,000 stimulations per session applied to the left dorsolateral prefrontal cortex (L-DLPFC. Depression was rated using the Children’s Depression Rating Scale-Revised (CDRS-R. Neurocognitive evaluation was performed at baseline and after completion of 30 rTMS treatments with the Children’s Auditory Verbal Learning Test (CAVLT and Delis-Kaplan Executive Function System (DKEFS Trail Making Test. Results: Over the course of 30 rTMS treatments, adolescents showed a substantial decrease in depression severity and a statistically significant improvement in memory and delayed verbal recall. Other learning and memory indices and executive function remained intact. Neither participants nor their family members reported clinically meaningful changes in neurocognitive function. Conclusion: These preliminary findings suggest rTMS does not adversely impact neurocognitive functioning in adolescents and may provide subtle enhancement of verbal memory as measured by the CAVLT. Further controlled investigations are warranted to confirm and extend these findings.

A Novel Strategy for Carbon Capture and Sequestration by rHLPD Processing

Energy Technology Data Exchange (ETDEWEB)

Li, Qinghua; Gupta, Surojit; Tang, Ling; Quinn, Sean [Department of Material Science and Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ (United States); Atakan, Vahit [Solidia Technologies, Inc., Piscataway, NJ (United States); Riman, Richard E., E-mail: riman@rci.rutgers.edu [Department of Material Science and Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ (United States)

2016-01-22

Monoethanolamine (MEA) scrubbing is an energy-intensive process for carbon capture and sequestration (CCS) due to the regeneration of amine in stripping towers at high temperature (100–120°C) and the subsequent pressurization of CO{sub 2} for geological sequestration. In this paper, we introduce a novel method, reactive hydrothermal liquid phase densification (rHLPD), which is able to solidify (densify) monolithic materials without using high temperature kilns. Then, we integrate MEA-based CCS processing and mineral carbonation by using rHLPD technology. This integration is designated as rHLPD-carbon sequestration (rHLPD-CS) process. Our results show that the CO{sub 2} captured in the MEA-CO{sub 2} solution was sequestered by the mineral (wollastonite CaSiO{sub 3}) carbonation at a low operating temperature (60°C) and simultaneously monolithic materials with a compressive strength of ~121 MPa were formed. This suggests that the use of rHLPD-CS technology eliminates the energy consumed for CO{sub 2}-MEA stripping and CO{sub 2} compression and also sequesters CO{sub 2} to form value-added products, which have a potential to be utilized as construction and infrastructure materials. In contrast to the high energy requirements and excessive greenhouse gas emissions from conventional Portland cement manufacturing, our calculations show that the integration of rHLPD and CS technologies provides a low energy alternative to production of traditional cementitious-binding materials.

Complete Element Abundances of Nine Stars in the r-process Galaxy Reticulum II

Science.gov (United States)

Ji, Alexander P.; Frebel, Anna; Simon, Joshua D.; Chiti, Anirudh

2016-10-01

We present chemical abundances derived from high-resolution Magellan/Magellan Inamori Kyocera Echelle spectra of the nine brightest known red giant members of the ultra-faint dwarf galaxy Reticulum II (Ret II). These stars span the full metallicity range of Ret II (-3.5 contaminated known r-process pattern. The abundances of lighter elements up to the iron peak are otherwise similar to abundances of stars in the halo and in other ultra-faint dwarf galaxies. However, the scatter in abundance ratios is large enough to suggest that inhomogeneous metal mixing is required to explain the chemical evolution of this galaxy. The presence of low amounts of neutron-capture elements in other ultra-faint dwarf galaxies may imply the existence of additional r-process sites besides the source of r-process elements in Ret II. Galaxies like Ret II may be the original birth sites of r-process enhanced stars now found in the halo. This paper includes data gathered with the 6.5 m Magellan Telescopes located at Las Campanas Observatory, Chile.

The tyranny of distance: maternity waiting homes and access to birthing facilities in rural Timor-Leste.

Science.gov (United States)

Wild, Kayli; Barclay, Lesley; Kelly, Paul; Martins, Nelson

2012-02-01

To examine the impact of maternity waiting homes on the use of facility-based birthing services for women in two remote districts of Timor-Leste. A before-and-after study design was used to compare the number of facility-based births in women who lived at different distances (0-5, 6-25, 26-50 and > 50 km) from the health centre before and after implementation of maternity waiting homes. Routine data were collected from health centre records at the end of 2007; they included 249 births in Same, Manufahi district, and 1986 births in Lospalos, Lautem district. Population data were used to estimate the percentage of women in each distance category who were accessing facility-based care. Most facility-based births in Same (80%) and Lospalos (62%) were among women who lived within 5 km of the health centre. There was no significant increase in the number of facility-based births among women in more remote areas following implementation of the maternity waiting homes. The percentage of births in the population that occurred in a health facility was low for both Manufahi district (9%) and Lautem district (17%), and use decreased markedly as distance between a woman's residence and the health facilities increased. The maternity waiting homes in Timor-Leste did not improve access to facility-based delivery for women in remote areas. The methods for distance analysis presented in this paper provide a framework that could be used by other countries seeking to evaluate maternity waiting homes.

The Sit-and-Wait Hypothesis in Bacterial Pathogens: A Theoretical Study of Durability and Virulence

Directory of Open Access Journals (Sweden)

Liang Wang

2017-11-01

Full Text Available The intriguing sit-and-wait hypothesis predicts that bacterial durability in the external environment is positively correlated with their virulence. Since its first proposal in 1987, the hypothesis has been spurring debates in terms of its validity in the field of bacterial virulence. As a special case of the vector-borne transmission versus virulence tradeoff, where vector is now replaced by environmental longevity, there are only sporadic studies over the last three decades showing that environmental durability is possibly linked with virulence. However, no systematic study of these works is currently available and epidemiological analysis has not been updated for the sit-and-wait hypothesis since the publication of Walther and Ewald’s (2004 review. In this article, we put experimental evidence, epidemiological data and theoretical analysis together to support the sit-and-wait hypothesis. According to the epidemiological data in terms of gain and loss of virulence (+/- and durability (+/- phenotypes, we classify bacteria into four groups, which are: sit-and-wait pathogens (++, vector-borne pathogens (+-, obligate-intracellular bacteria (--, and free-living bacteria (-+. After that, we dive into the abundant bacterial proteomic data with the assistance of bioinformatics techniques in order to investigate the two factors at molecular level thanks to the fast development of high-throughput sequencing technology. Sequences of durability-related genes sourced from Gene Ontology and UniProt databases and virulence factors collected from Virulence Factor Database are used to search 20 corresponding bacterial proteomes in batch mode for homologous sequences via the HMMER software package. Statistical analysis only identified a modest, and not statistically significant correlation between mortality and survival time for eight non-vector-borne bacteria with sit-and-wait potentials. Meanwhile, through between-group comparisons, bacteria with higher

Realistic fission models, new beta-decay half-lives and the r-process in neutron star mergers

International Nuclear Information System (INIS)

Shibagaki, S.; Kajino, T.; Chiba, S.; Lorusso, G.; Nishimura, S.; Mathews, G. J.

2014-01-01

Almost half of heavy nuclei beyond iron are considered to be produced by rapid neutron capture process (r-process). This process occurs in the neutron-rich environment such as core-collapse supernovae or neutron star mergers, but the main production site is still unknown. In the r-process of neutron star mergers, nuclear fission reactions play an important role. Also beta-decay half-lives of magic nuclei are crucial for the r-process. We have carried out r-process nucleosynthesis calculations based upon new theoretical estimates of fission fragment distributions and new beta-decay half-lives for N=82 nuclei measured at RIBF-RIKEN. We investigate the effect of nuclear fission on abundance patterns in the matter ejected from neutron star mergers with two different fission fragment mass distributions. We also discuss how the new experimental beta-decay half-lives affect the r-process

Change of tumor target volume during waiting time for intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Chen Bo; Yi Junlin; Gao Li; Xu Guozhen; Huang Xiaodong; Zhang Zhong; Luo Jingwei; Li Suyan

2007-01-01

Objective: To determine the influence of change in tumor target volume of nasopharyngeal carcinoma (NPC) while waiting for intensity modulated radiation therapy (IMRT). Methods: From March 2005 to December 2005, 31 patients with nasopharyngeal carcinoma received IMRT as the initial treatment at the Cancer Hospital of Chinese Academic of Medical Sciences. The original simulation CT scan was acquired before IMRT planning. A second CT scan was acquired before the start of radiotherapy. Wait- ing time was defined as the duration between CT simulation and start of radiotherapy. CT-CT fusion was used to minimize the error of delineation between the first tumor target volume (GTV) and the second tumor target volume (sGTV). Tumor target volume was calculated by treatment planning system. T test was carried out to analyse the difference between GTV and sGTV. Pearson correlation and multivariate linear regression was used to analyse the influence factor of the change betweent GTV and sGTV. Results: Median waiting time was 18 days (range, 9-27 days). There were significant differences between GTV and sGTV of both primary tumor (P=0.009) and metastatic lymphoma (P=0.005 ). Both Pearson correlation and multivariate linear regression showed that the change of primary tumor target volume had significant correlation with the first tumor target volume but had no significant correlation with the waiting time, sex, age, T stage and N stage (1992 Chinese Fuzhou Staging Classification). Conclusions: Within the range of the waiting time ob- served in our study, large volume primary tumor would have had a significant increase in volume, but whether the therapeutic effect would be influenced or not would need to be proved by study of large number of cases. Patients with large volume tumor should be considered to reduce the influence of waiting time by enlarging gross target volume and clinical targe volume and by neoadjuveant chemotherapy. For avoiding the unnecessary high-dose to normal

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

OpenAIRE

Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

2016-01-01

Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emerg...

[Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

Science.gov (United States)

Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

2015-12-01

Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Continuous time random walk model with asymptotical probability density of waiting times via inverse Mittag-Leffler function

Science.gov (United States)

Liang, Yingjie; Chen, Wen

2018-04-01

The mean squared displacement (MSD) of the traditional ultraslow diffusion is a logarithmic function of time. Recently, the continuous time random walk model is employed to characterize this ultraslow diffusion dynamics by connecting the heavy-tailed logarithmic function and its variation as the asymptotical waiting time density. In this study we investigate the limiting waiting time density of a general ultraslow diffusion model via the inverse Mittag-Leffler function, whose special case includes the traditional logarithmic ultraslow diffusion model. The MSD of the general ultraslow diffusion model is analytically derived as an inverse Mittag-Leffler function, and is observed to increase even more slowly than that of the logarithmic function model. The occurrence of very long waiting time in the case of the inverse Mittag-Leffler function has the largest probability compared with the power law model and the logarithmic function model. The Monte Carlo simulations of one dimensional sample path of a single particle are also performed. The results show that the inverse Mittag-Leffler waiting time density is effective in depicting the general ultraslow random motion.

Hospital competition, GP fundholders and waiting times in the UK internal market: the case of elective surgery.

Science.gov (United States)

Xavier, Ana

2003-03-01

In this paper I model the demand for and supply of elective surgery using a modified Hotelling framework in which time, money, and distance are determinants of the demand for hospital care. Hospitals compete with each other in terms of the waiting time and consequently treat a certain number of patients. The basic model of hospital competition is then extended to incorporate the general practitioner (GP) fundholding scheme whereby the GPs are allocated a budget with which to buy care for their patients. Waiting time increases when production of care becomes more expensive, when the benefit obtained from treatment increases, when the unit cost of distance decreases, and when the importance given to time as a performance indicator decreases. The higher the money price the lower the waiting time. Finally, the money price paid by the GP fundholders is greater than that paid by the Health Authorities and greater than the hospitals marginal cost of production. As a consequence, fundholding patients pay a zero time price while non-fundholding patients experiment a positive waiting time.

Solution-Processed rGO/AgNPs/rGO Sandwich Structure as a Hole Extraction Layer for Polymer Solar Cells

Directory of Open Access Journals (Sweden)

Quang Trung Tran

2015-01-01

Full Text Available We found that inserting silver nanoparticles (AgNPs between two layers of reduced grapheme oxide (rGO has an effect on tailoring the work function of rGO. The utilization of rGO/AgNPs/rGO sandwich structure as the hole extraction layer in polymer solar cells is demonstrated. Solution-processable fabrication of this sandwich structure at the ITO/active layer interface facilitates the extraction of hole from active layer into ITO anode because of lowering the barrier level alignment at the interface. It results in an improvement of the short circuit current density and the overall photovoltaic performance.

Potential impact of enhanced practice efficiency on endoscopy waiting times.

LENUS (Irish Health Repository)

Harewood, G C

2009-06-01

With the growing demand on endoscopy services, optimising practice efficiency has assumed increasing importance. Prior research has identified practice changes, which increase the efficiency in endoscopy. In this study, the potential impact of these practice changes on the current and projected future endoscopy waiting times at our institution was assessed.

High-dose chemoradiotherapy and watchful waiting for distal rectal cancer

DEFF Research Database (Denmark)

Appelt, Ane L; Pløen, John; Harling, Henrik

2015-01-01

-dose radiotherapy with concomitant chemotherapy followed by observation (watchful waiting) was successful for non-surgical management of low rectal cancer. METHODS: Patients with primary, resectable, T2 or T3, N0-N1 adenocarcinoma in the lower 6 cm of the rectum were given chemoradiotherapy (60 Gy in 30 fractions...

ADAPTATION OF JOHNSON SEQUENCING ALGORITHM FOR JOB SCHEDULING TO MINIMISE THE AVERAGE WAITING TIME IN CLOUD COMPUTING ENVIRONMENT

Directory of Open Access Journals (Sweden)

SOUVIK PAL

2016-09-01

Full Text Available Cloud computing is an emerging paradigm of Internet-centric business computing where Cloud Service Providers (CSPs are providing services to the customer according to their needs. The key perception behind cloud computing is on-demand sharing of resources available in the resource pool provided by CSP, which implies new emerging business model. The resources are provisioned when jobs arrive. The job scheduling and minimization of waiting time are the challenging issue in cloud computing. When a large number of jobs are requested, they have to wait for getting allocated to the servers which in turn may increase the queue length and also waiting time. This paper includes system design for implementation which is concerned with Johnson Scheduling Algorithm that provides the optimal sequence. With that sequence, service times can be obtained. The waiting time and queue length can be reduced using queuing model with multi-server and finite capacity which improves the job scheduling model.

Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

Science.gov (United States)

Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

2014-01-01

Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

Data Processing Languages for Business Intelligence. SQL vs. R

Directory of Open Access Journals (Sweden)

Marin FOTACHE

2016-01-01

Full Text Available As data centric approach, Business Intelligence (BI deals with the storage, integration, processing, exploration and analysis of information gathered from multiple sources in various formats and volumes. BI systems are generally synonymous to costly, complex platforms that require vast organizational resources. But there is also an-other face of BI, that of a pool of data sources, applications, services developed at different times using different technologies. This is “democratic” BI or, in some cases, “fragmented”, “patched” (or “chaotic” BI. Fragmentation creates not only integration problems, but also supports BI agility as new modules can be quickly developed. Among various languages and tools that cover large extents of BI activities, SQL and R are instrumental for both BI platform developers and BI users. SQL and R address both monolithic and democratic BI. This paper compares essential data processing features of two languages, identifying similarities and differences among them and also their strengths and limits.

Passenger arrival and waiting time distributions dependent on train service frequency and station characteristics: A smart card data analysis

DEFF Research Database (Denmark)

Ingvardson, Jesper Bláfoss; Nielsen, Otto Anker; Raveau, Sebastián

2018-01-01

Waiting time at public transport stops is perceived by passengers to be more onerous than in-vehicle time, hence it strongly influences the attractiveness and use of public transport. Transport models traditionally assume that average waiting times are half the service headway by assuming random...... Copenhagen Area covering metro, suburban, and regional rail stations thereby giving a range of service headways from 2 to 60 min. It was shown that the proposed mixture distribution is superior to other distributions proposed in the literature. This can improve waiting time estimations in public transport...

Prospective evaluation through questionnaires of the emotional status of cancer patients in the waiting rooms of a department of oncology

OpenAIRE

Roberta Resega; Sheila Piva; Annalisa Bramati; Christian Lurati; Nicla La Verde; Marco Riva; Marina Chiara Garassino; Anna Moretti; Claudio Mencacci; Valter Torri; Gabriella Farina; Maria Chiara Dazzani

2016-01-01

Objective: The aim of this study is to better identify the prevailing emotions and feelings of cancer patients during their stay in waiting rooms in a department of oncology. Methods: In July 2014, patients in the waiting rooms of our Department of Oncology were asked to fill out dedicated questionnaires. Patients had to choose sentences that best described their feelings, thoughts and experiences; this part was differentiated according to the waiting rooms (Consultation Rooms versus Day H...

Major ion chemistry of the Son River, India: Weathering processes ...

Indian Academy of Sciences (India)

Major ion chemistry of the Son River, India: Weathering processes, dissolved fluxes and water quality assessment. Chinmaya Maharana, Sandeep Kumar Gautam,. Abhay Kumar Singh and Jayant K Tripathi. J. Earth Syst. Sci. 124(6) cO Indian Academy of Sciences. Supplementary data ...

Does postoperative 'M' technique (R) massage with or without mandarin oil reduce infants' distress after major craniofacial surgery?

NARCIS (Netherlands)

de Jong, Marjan; Lucas, Cees; Bredero, Hansje; van Adrichem, Leon; Tibboel, Dick; van Dijk, Monique

2012-01-01

de jong m., lucas c., bredero h., van adrichem l., tibboel d. & van dijk m. (2011) Does postoperative M technique (R) massage with or without mandarin oil reduce infants distress after major craniofacial surgery? Journal of Advanced Nursing68(6), 17481757. Abstract Aim. This article is a report of a

Shell-model calculations of beta-decay rates for s- and r-process nucleosyntheses

International Nuclear Information System (INIS)

Takahashi, K.; Mathews, G.J.; Bloom, S.D.

1985-01-01

Examples of large-basis shell-model calculations of Gamow-Teller β-decay properties of specific interest in the astrophysical s- and r- processes are presented. Numerical results are given for: (1) the GT-matrix elements for the excited state decays of the unstable s-process nucleus 99 Tc; and (2) the GT-strength function for the neutron-rich nucleus 130 Cd, which lies on the r-process path. The results are discussed in conjunction with the astrophysics problems. 23 refs., 3 figs

On the Fractional Poisson Process and the Discretized Stable Subordinator

Directory of Open Access Journals (Sweden)

Rudolf Gorenflo

2015-08-01

Full Text Available We consider the renewal counting number process N = N(t as a forward march over the non-negative integers with independent identically distributed waiting times. We embed the values of the counting numbers N in a “pseudo-spatial” non-negative half-line x ≥ 0 and observe that for physical time likewise we have t ≥ 0. Thus we apply the Laplace transform with respect to both variables x and t. Applying then a modification of the Montroll-Weiss-Cox formalism of continuous time random walk we obtain the essential characteristics of a renewal process in the transform domain and, if we are lucky, also in the physical domain. The process t = t(N of accumulation of waiting times is inverse to the counting number process, in honour of the Danish mathematician and telecommunication engineer A.K. Erlang we call it the Erlang process. It yields the probability of exactly n renewal events in the interval (0; t]. We apply our Laplace-Laplace formalism to the fractional Poisson process whose waiting times are of Mittag-Leffler type and to a renewal process whose waiting times are of Wright type. The process of Mittag-Leffler type includes as a limiting case the classical Poisson process, the process of Wright type represents the discretized stable subordinator and a re-scaled version of it was used in our method of parametric subordination of time-space fractional diffusion processes. Properly rescaling the counting number process N(t and the Erlang process t(N yields as diffusion limits the inverse stable and the stable subordinator, respectively.

Hip and knee arthroplasty waiting list – how accurate and fair?

African Journals Online (AJOL)

access by hospital managers and provincial planners. ... interaction of administration and clinical staff. ... Resource-intensive procedures require the use of patient waiting lists in an attempt to increase fairness ... These deficiencies have prompted the introduction of a scoring-based prioritisation system incorporating clinical,.

TractoR: Magnetic Resonance Imaging and Tractography with R

Directory of Open Access Journals (Sweden)

Chris A. Clark

2011-10-01

Full Text Available Statistical techniques play a major role in contemporary methods for analyzing magnetic resonance imaging (MRI data. In addition to the central role that classical statistical methods play in research using MRI, statistical modeling and machine learning techniques are key to many modern data analysis pipelines. Applications for these techniques cover a broad spectrum of research, including many preclinical and clinical studies, and in some cases these methods are working their way into widespread routine use. In this manuscript we describe a software tool called TractoR (for “Tractography with R”, a collection of packages for the R language and environment, along with additional infrastructure for straightforwardly performing common image processing tasks. TractoR provides general purpose functions for reading, writing and manipulating MR images, as well as more specific code for fitting signal models to diffusion MRI data and performing tractography, a technique for visualizing neural connectivity.

Emergency Department Waiting Times (EDWaT): A Patient Flow Management and Quality of Care Rating mHealth Application.

Science.gov (United States)

Househ, Mowafa; Yunus, Faisel

2014-01-01

Saudi hospital emergency departments (ED) have suffered from long waiting times, which have led to a delay in emergency patient care. The increase in the population of Saudi Arabia is likely to further stretch the healthcare services due to overcrowding leading to decreased healthcare quality, long patient waits, patient dissatisfaction, ambulance diversions, decreased physician productivity, and increased frustration among medical staff. This will ultimately put patients at risk for poor health outcomes. Time is of the essence in emergencies and to get to an ED that has the shortest waiting time can mean life or death for a patient, especially in cases of stroke and myocardial infarction. In this paper, we present our work on the development of a mHealth Application - EDWaT - that will: provide patient flow information to the emergency medical services staff, help in quick routing of patients to the nearest hospital, and provide an opportunity for patients to review and rate the quality of care received at an ED, which will then be forwarded to ED services administrators. The quality ratings will help patients to choose between two EDs with the same waiting time and distance from their location. We anticipate that the use of EDWaT will help improve ED wait times and the quality of care provision in Saudi hospitals EDs.

A modelling framework for mitigating customers' waiting time at a vehicle inspection centre

Science.gov (United States)

Ahmad, Norazura; Abidin, Norhaslinda Zainal; Ilyas, Khibtiyah; Abduljabbar, Waleed Khalid

2017-11-01

In Malaysia, an agency that is entrusted by the Government to perform mandatory vehicle inspection for public, commercial and private vehicles, receive many customers daily. Often complaints of problems received from the customers are associated with waiting time that leads to lost of business and dissatisfied customers. To address this issue, we propose a framework for modelling a vehicle inspection system using an integration of simulation and optimization approaches. The strengths of simulation and optimization are reviewed briefly that is hoped to reveal the synergy between the established methods in determining an appropriate customer's waiting time for inspection at a vehicle inspection centre. Relevant concepts and preliminary results are also presented and discussed in this paper.

Deficient neural activity subserving decision-making during reward waiting time in intertemporal choice in adult attention-deficit hyperactivity disorder.

Science.gov (United States)

Todokoro, Ayako; Tanaka, Saori C; Kawakubo, Yuki; Yahata, Noriaki; Ishii-Takahashi, Ayaka; Nishimura, Yukika; Kano, Yukiko; Ohtake, Fumio; Kasai, Kiyoto

2018-04-24

Impulsivity, which significantly affects social adaptation, is an important target behavioral characteristic in interventions for attention-deficit hyperactivity disorder (ADHD). Typically, people are willing to wait longer to acquire greater rewards. Impulsivity in ADHD may be associated with brain dysfunction in decision-making involving waiting behavior under such situations. We tested the hypothesis that brain circuitry during a period of waiting (i.e., prior to the acquisition of reward) is altered in adults with ADHD. The participants included 14 medication-free adults with ADHD and 16 healthy controls matched for age, sex, IQ, and handedness. The behavioral task had participants choose between a delayed, larger monetary reward and an immediate, smaller monetary reward, where the reward waiting time actually occurred during functional magnetic resonance imaging measurement. We tested for group differences in the contrast values of blood-oxygen-level dependent signals associated with the length of waiting time, calculated using the parametric modulation method. While the two groups did not differ in the time discounting rate, the delay-sensitive contrast values were significantly lower in the caudate and visual cortex in individuals with ADHD. The higher impulsivity scores were significantly associated with lower delay-sensitive contrast values in the caudate and visual cortex. These results suggest that deficient neural activity affects decision-making involving reward waiting time during intertemporal choice tasks, and provide an explanation for the basis of impulsivity in adult ADHD. © 2018 The Author. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology.

Global process industry initiatives to reduce major accident hazards

Energy Technology Data Exchange (ETDEWEB)

Pitblado, Robin [DNV Energy Houston, TX (United States). SHE Risk Management; Pontes, Jose [DNV Energy Rio de Janeiro, RJ (Brazil). Americas Region; Oliveira, Luiz [DNV Energy Rio de Janeiro, RJ (Brazil)

2008-07-01

Since 2000, disasters at Texas City, Toulouse, Antwerp, Buncefield, P-36 and several near total loss events offshore in Norway have highlighted that major accident process safety is still a serious issue. Hopes that Process Safety Management or Safety Case regulations would solve these issues have not proven true. The Baker Panel recommended to BP several actions mainly around leadership, incentives, metrics, safety culture and more effective implementation of PSM systems. In Europe, an approach built around mechanical integrity and safety barriers, especially relating to technical safety systems, is being widely adopted. DNV has carried out a global survey of process industry initiatives, by interview and by literature review, for both upstream and downstream activities, to identify what the industry itself is planning to implement to enhance process safety in the next 5 - 10 years. This shows that an approach combining Baker Panel and EU barrier approaches and some nuclear industry real-time risk management approaches might be the best means to achieve a factor of 3-4 improvement in process safety. (author)

A study on the impact of prioritising emergency department arrivals on the patient waiting time.

Science.gov (United States)

Van Bockstal, Ellen; Maenhout, Broos

2018-05-03

In the past decade, the crowding of the emergency department has gained considerable attention of researchers as the number of medical service providers is typically insufficient to fulfil the demand for emergency care. In this paper, we solve the stochastic emergency department workforce planning problem and consider the planning of nurses and physicians simultaneously for a real-life case study in Belgium. We study the patient arrival pattern of the emergency department in depth and consider different patient acuity classes by disaggregating the arrival pattern. We determine the personnel staffing requirements and the design of the shifts based on the patient arrival rates per acuity class such that the resource staffing cost and the weighted patient waiting time are minimised. In order to solve this multi-objective optimisation problem, we construct a Pareto set of optimal solutions via the -constraints method. For a particular staffing composition, the proposed model minimises the patient waiting time subject to upper bounds on the staffing size using the Sample Average Approximation Method. In our computational experiments, we discern the impact of prioritising the emergency department arrivals. Triaging results in lower patient waiting times for higher priority acuity classes and to a higher waiting time for the lowest priority class, which does not require immediate care. Moreover, we perform a sensitivity analysis to verify the impact of the arrival and service pattern characteristics, the prioritisation weights between different acuity classes and the incorporated shift flexibility in the model.

Relativistic QRPA calculation of β-decay rates of r-process nuclei

International Nuclear Information System (INIS)

Marketin, T.; Paar, N.; Niksic, T.

2009-01-01

The rapid neutron-capture process (r-process) is responsible for the creation of many nuclei heavier than iron. To describe the r-process, precise data is needed on a large number of neutron-rich nuclei, most of which are not experimentally reachable. One crucial parameter in modeling the nucleosynthesis are the half-lives of the nuclei through which the r-process runs. Therefore, it is of great importance to develop a reliable predictive model which can be applied to the decay of exotic nuclei. A fully self-consistent calculation of β-decay rates is presented, based on a microscopic theoretical framework. Nuclear ground state is determined using the Relativistic Hartree-Bogoliubov (RHB) model with density-dependent meson-nucleon coupling constants. Momentum dependent terms are also included to improve the density of single-particle states around the Fermi level via an increase of the effective nucleon mass [1]. Transition rates are calculated within the proton-neutron relativistic quasiparticle RPA using the same interaction that was used in the RHB equations. In this way no additional parameters are introduced in the RPA calculation. Weak interaction rates are calculated using the current-current formalism previously employed in the study of other astrophysically significant weak processes [2,3], which systematically includes the contributions of forbidden transitions. This theoretical framework will be utilized to study the contributions of forbidden transitions to the total decay rate in several mass regions. We will compare the calculated half-lives for several isotopic chains with previous calculations and experimental data and discuss possible improvements to the model.(author)

No More Waits and Delays: Streamlining Workflow to Decrease Patient Time of Stay for Image-guided Musculoskeletal Procedures.

Science.gov (United States)

Cheung, Yvonne Y; Goodman, Eric M; Osunkoya, Tomiwa O

2016-01-01

Long wait times limit our ability to provide the right care at the right time and are commonly products of inefficient workflow. In 2013, the demand for musculoskeletal (MSK) procedures increased beyond our department's ability to provide efficient and timely service. We initiated a quality improvement (QI) project to increase efficiency and decrease patient time of stay. Our project team included three MSK radiologists, one senior resident, one technologist, one administrative assistant/scheduler, and the lead technologist. We adopted and followed the Lean Six Sigma DMAIC (define, measure, analyze, improve, and control) approach. The team used tools such as voice of the customer (VOC), along with affinity and SIPOC (supplier, input, process, output, customer) diagrams, to understand the current process, identify our customers, and develop a project charter in the define stage. During the measure stage, the team collected data, created a detailed process map, and identified wastes with the value stream mapping technique. Within the analyze phase, a fishbone diagram helped the team to identify critical root causes for long wait times. Scatter plots revealed relationships among time variables. Team brainstorming sessions generated improvement ideas, and selected ideas were piloted via plan, do, study, act (PDSA) cycles. The control phase continued to enable the team to monitor progress using box plots and scheduled reviews. Our project successfully decreased patient time of stay. The highly structured and logical Lean Six Sigma approach was easy to follow and provided a clear course of action with positive results. (©)RSNA, 2016.

A Methodology for Collective Evaluation and Selection of Industrial R&D Projects

OpenAIRE

Muhittin Oral; Ossama Kettani; Pascal Lang

1991-01-01

This paper proposes a methodology for evaluating and selecting R&D projects in a collective decision setting, especially useful at sectorial and national levels. It consists of two major phases: Evaluation and Selection. The evaluation process repeatedly uses mathematical programming models to determine the "relative values" of a given R&D project from the viewpoint of the other R&D projects. The selection process of R&D projects is based on these "relative values" and is done through a model...

Increases in heart rate and serum cortisol concentrations in healthy dogs are positively correlated with an indoor waiting-room environment.

Science.gov (United States)

Perego, Roberta; Proverbio, Daniela; Spada, Eva

2014-03-01

Few studies have investigated the effect of veterinary clinical procedures on the welfare of dogs, with specific emphasis on the veterinary practice environment. Clinicopathologic variables have also not been assessed in these potentially stressful situations. Similar to human clinical studies, the veterinary clinical waiting room could present a significant stress factor for dogs. The present study was designed to investigate the effect of waiting-room environment on serum cortisol and glucose alterations as well as heart rate in privately owned healthy dogs. The clinical trial included 24 healthy dogs that were divided into 2 groups: the clinical waiting-room group (A) and the control group (B) that waited outside in a garden. During the entire experiment, 18 dogs (9 dogs per group) were monitored with a human heart rate monitor fastened around the chest. After 20 minutes of waiting, blood samples were collected from all of the dogs (24 dogs) to determine serum cortisol concentration. Serum cortisol concentration and mean, maximum, and minimum heart rate were significantly higher in group A compared with group B, but there was no statistical difference in serum glucose concentrations between the 2 study groups. Results of this study suggest that the waiting room is a potentially stressful situation for dogs in clinical veterinary practice, when compared with a garden, based on the assessment of adrenal cortex function and heart rate evaluation. © 2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

R-process nucleosynthesis: a dynamical model

Energy Technology Data Exchange (ETDEWEB)

Hillebrandt, W; Takahashi, K [Technische Hochschule Darmstadt (Germany, F.R.). Inst. fuer Kernphysik; Kodama, T [Centro Brasileiro de Pesquisas Fisicas, Rio de Janeiro

1976-10-01

The synthesis of heavy and neutron-rich elements (with the mass number A > approximately 70) is reconsidered in the framework of a dynamical supernova model. The synthesis equation for the rapid neutron-capture (or, the r-) process and the hydrodynamical equations for the supernova explosion are solved simultaneously. Improved systematics of nuclear parameters are used, and the energy release due to ..beta..-decays as well as the energy loss due to neutrinos is taken into account. It is shown that the observed solar-system abundance curve can be reproduced fairly well by assuming only one supernova event on a time-scale of the order of 1 s. However there are still some discrepancies which may be explained by uncertainties in the nuclear data used.

Space - A unique environment for process modeling R&D

Science.gov (United States)

Overfelt, Tony

1991-01-01

Process modeling, the application of advanced computational techniques to simulate real processes as they occur in regular use, e.g., welding, casting and semiconductor crystal growth, is discussed. Using the low-gravity environment of space will accelerate the technical validation of the procedures and enable extremely accurate determinations of the many necessary thermophysical properties. Attention is given to NASA's centers for the commercial development of space; joint ventures of universities, industries, and goverment agencies to study the unique attributes of space that offer potential for applied R&D and eventual commercial exploitation.

Enabling Web-Based Analysis of CUAHSI HIS Hydrologic Data Using R and Web Processing Services

Science.gov (United States)

Ames, D. P.; Kadlec, J.; Bayles, M.; Seul, M.; Hooper, R. P.; Cummings, B.

2015-12-01

The CUAHSI Hydrologic Information System (CUAHSI HIS) provides open access to a large number of hydrological time series observation and modeled data from many parts of the world. Several software tools have been designed to simplify searching and access to the CUAHSI HIS datasets. These software tools include: Desktop client software (HydroDesktop, HydroExcel), developer libraries (WaterML R Package, OWSLib, ulmo), and the new interactive search website, http://data.cuahsi.org. An issue with using the time series data from CUAHSI HIS for further analysis by hydrologists (for example for verification of hydrological and snowpack models) is the large heterogeneity of the time series data. The time series may be regular or irregular, contain missing data, have different time support, and be recorded in different units. R is a widely used computational environment for statistical analysis of time series and spatio-temporal data that can be used to assess fitness and perform scientific analyses on observation data. R includes the ability to record a data analysis in the form of a reusable script. The R script together with the input time series dataset can be shared with other users, making the analysis more reproducible. The major goal of this study is to examine the use of R as a Web Processing Service for transforming time series data from the CUAHSI HIS and sharing the results on the Internet within HydroShare. HydroShare is an online data repository and social network for sharing large hydrological data sets such as time series, raster datasets, and multi-dimensional data. It can be used as a permanent cloud storage space for saving the time series analysis results. We examine the issues associated with running R scripts online: including code validation, saving of outputs, reporting progress, and provenance management. An explicit goal is that the script which is run locally should produce exactly the same results as the script run on the Internet. Our design can

Developing Third Year Thai Major Students’ Researching Skill Using Coaching and Mentoring Process

Directory of Open Access Journals (Sweden)

Wimonrat Soonthornrojana

2016-12-01

Full Text Available The purposes of the study were (1 to develop third year Thai major students’ researching skill according to the criterion of 80 percent, and (2 to study third and fourth year Thai major students’ satisfaction in Coaching and Mentoring process. 95 participants were selected using purposive sampling from third year Thai major students. Five research instruments were used in this study ; (1 classroom research comprehension tests, (2 outline evaluation forms, lesson plan evaluation forms and achievement tests, teaching performance evaluation forms and research report evaluation forms, (3 research behavioral observation forms for third year Thai major students, (4 third year Thai major students interview forms, and (5 satisfaction questionnaire. Statistics used in the study were percentage average, and standard deviation. The result showed third year Thai major students who had taken research course using Coaching and Mentoring process scored 80% in researching skill according to the criterion and had positive satisfaction with average value of 4.54 or 90.79%. Moreover, the result found that fourth year students had positive satisfaction in counseling third year students with average value of 4.73 or 96.38%.

A Study to Determine Patient Waiting Time at the Outpatient Pharmacy at Wilford Hall USAF Medical Center

Science.gov (United States)

1988-06-01

at Wilford Hall USAF Medical Center significantly reduced the patient wait time at the main outpatient pharmacy. Satellite pharmacies have been ).’l...PRESENTING TO WINDOW 1, 19 MAR 88. 47 C:. A’.’E-:A: -ESCRIRTIONS PER PATIENT ...........48 H. WILFORD HALL MEDICAL CENTER OUTPATIENT QUESTIONNAIRE...that wait times at tne outpatient pharmacy were excessive. It was this concern that motivated the Medical Center Administrator to request that patient

A prospective study on the impact of waiting times for radiotherapy ...

African Journals Online (AJOL)

Background: Radiotherapy plays a vital role in the management of cervical cancer. However, because of high patient load and limited resources, waiting lists are unacceptably long. This is a highly curable malignancy that often occurs in economically active, relatively young women. The impact of treatment delays on society ...

R and D thermochemical I-S process at JAERI

International Nuclear Information System (INIS)

Onuki, K.; Kubo, S.; Nakajima, H.; Higashi, S.; Kasahara, S.; Ishiyama, S.; Okuda, H.

2004-01-01

The Japan Atomic Energy Research Institute (JAERI) has conducted a study on the thermochemical water-splitting process of the iodine-sulfur family (IS process). In the IS process, water will react with iodine and sulfur dioxide to produce hydrogen iodide and sulfuric acid, which are then decomposed thermally to produce hydrogen and oxygen. High temperature nuclear heat, mainly supplied by a High Temperature Gas-cooled Reactor (HTGR), is used to drive the endothermic decomposition of sulfuric acid. JAERI has demonstrated the feasibility of the water-splitting hydrogen production process by carrying out laboratory-scale experiments in which combined operation of fundamental reactions and separations using the IS process was performed continuously. At present, the hydrogen production test is continuing, using a scaled-up glass apparatus. Corrosion-resistant materials for constructing a large-scale plant and process improvements by introducing advanced separation techniques, such as membrane separation, are under study. Future R and D items are discussed based on the present activities. (author)

PATENTS, R&D, AND MARKET STRUCTURE IN THE U.S. FOOD PROCESSING INDUSTRY

OpenAIRE

Gopinath, Munisamy; Vasavada, Utpal

1999-01-01

This study investigates the effects of market structure and research and development (R&D) on the innovation activities of firms. Fixed and random effects count data models are estimated with firm-level data for the U.S. food processing industry. Results show a positive association between patents and R&D, and patents and market structure, suggesting that firms which exhibit noncompetitive behavior are likely to develop new products and processes. Significant intra-industry spillovers of know...

Major disruption process in tokamak

International Nuclear Information System (INIS)

Kurita, Gen-ichi; Azumi, Masafumi; Tuda, Takashi; Takizuka, Tomonori; Tsunematsu, Toshihide; Tokuda, Shinji; Itoh, Kimitaka; Takeda, Tatsuoki

1981-11-01

The major disruption in a cylindrical tokamak is investigated by using the multi-helicity code, and the destabilization of the 3/2 mode by the mode coupling with the 2/1 mode is confirmed. The evolution of the magnetic field topology caused by the major disruption is studied in detail. The effect of the internal disruption on the 2/1 magnetic island width is also studied. The 2/1 magnetic island is not enhanced by the flattening of the q-profile due to the internal disruption. (author)

Mobile Technology Waiting for the 3G Rush

Institute of Scientific and Technical Information of China (English)

HAYET SELLAMI

2006-01-01

@@ China is potentially the biggest third generation (3G) mobile market in the world, and everyone is eager to grab a piece of the pie. Foreign carriers are still not allowed to apply for licences since China's decision regarding licensing and adoption of 3G mobile services is still pending, but the waiting list is long. Both Chinese officials and industry executives have stated that they want 3G in place in time for the August 2008 Olympic Games held in Beijing. This tight deadline leaves no room for failure.

Patients\\' response to waiting time in an out-patient pharmacy in ...

African Journals Online (AJOL)

Purpose: To identify the dispensing procedure at a pharmacy, investigate the possible operational problems that may lead to excessive patient waiting times as prescriptions are filled and to examine patient disposition to perceived delays at the pharmacy. Methods: The study was carried out in a 574-bed university teaching ...

Variance to mean ratio, R(t), for poisson processes on phylogenetic trees.

Science.gov (United States)

Goldman, N

1994-09-01

The ratio of expected variance to mean, R(t), of numbers of DNA base substitutions for contemporary sequences related by a "star" phylogeny is widely seen as a measure of the adherence of the sequences' evolution to a Poisson process with a molecular clock, as predicted by the "neutral theory" of molecular evolution under certain conditions. A number of estimators of R(t) have been proposed, all predicted to have mean 1 and distributions based on the chi 2. Various genes have previously been analyzed and found to have values of R(t) far in excess of 1, calling into question important aspects of the neutral theory. In this paper, I use Monte Carlo simulation to show that the previously suggested means and distributions of estimators of R(t) are highly inaccurate. The analysis is applied to star phylogenies and to general phylogenetic trees, and well-known gene sequences are reanalyzed. For star phylogenies the results show that Kimura's estimators ("The Neutral Theory of Molecular Evolution," Cambridge Univ. Press, Cambridge, 1983) are unsatisfactory for statistical testing of R(t), but confirm the accuracy of Bulmer's correction factor (Genetics 123: 615-619, 1989). For all three nonstar phylogenies studied, attained values of all three estimators of R(t), although larger than 1, are within their true confidence limits under simple Poisson process models. This shows that lineage effects can be responsible for high estimates of R(t), restoring some limited confidence in the molecular clock and showing that the distinction between lineage and molecular clock effects is vital.(ABSTRACT TRUNCATED AT 250 WORDS)

Pyro-processes and the wastes

International Nuclear Information System (INIS)

Kurata, Masaki; Tokiwai, Moriyasu; Inoue, Tadashi; Nishimura, Tomohiro

2000-01-01

Reprocessing using pyrometallurgical processes is generally considered to have economical benefits comparing with conventional aqueous processes because of the combination of simpler process and equipments, less criticality, and more compact facilities. On the other hand, the pyrometallurgical processes must generate peculiar wastes and R and D on those wastes is slightly inferior, as compared with the main processes. In this paper, process flows of major pyrometallurgical processes are firstly summarized and, then, the present R and D condition on the wastes are shown. (author)