Sample records for nets bridge safety

  1. Safety nets or straitjackets?

    DEFF Research Database (Denmark)

    Ilsøe, Anna


    Does regulation of working hours at national and sector level impose straitjackets, or offer safety nets to employees seeking working time flexibility? This article compares legislation and collective agreements in the metal industries of Denmark, Germany and the USA. The industry has historically...

  2. Food Safety Nets:


    Haggblade, Steven; Diallo, Boubacar; Staatz, John; Theriault, Veronique; Traoré, Abdramane


    Food and social safety nets have a history as long as human civilization. In hunter gatherer societies, food sharing is pervasive. Group members who prove unlucky in the short run, hunting or foraging, receive food from other households in anticipation of reciprocal consideration at a later time (Smith 1988). With the emergence of the first large sedentary civilizations in the Middle East, administrative systems developed specifically around food storage and distribution. The ancient Egyptian...

  3. Assuring bridge safety and serviceability in Europe (United States)


    U.S. engineers need advanced tools and protocols to better assess and assure safety and serviceability of bridges. The Federal Highway Administration, American Association of State Highway and Transportation Officials, and National Cooperative Highwa...

  4. Readmissions at a public safety net hospital.

    Directory of Open Access Journals (Sweden)

    Eri Shimizu

    Full Text Available OBJECTIVE: We aimed to determine factors related to avoidability of 30-day readmissions at our public, safety net hospital in the United States (US. METHODS: We prospectively reviewed medical records of adult internal medicine patients with scheduled and unscheduled 30-day readmissions. We also interviewed patients if they were available. An independent panel used pre-specified, objective criteria to adjudicate potential avoidability. RESULTS: Of 153 readmissions evaluated, 68% were unscheduled. Among these, 67% were unavoidable, primarily due to disease progression and development of new diagnoses. Scheduled readmissions accounted for 32% of readmissions and most (69% were clinically appropriate and unavoidable. The scheduled but avoidable readmissions (31% were attributed largely to limited resources in our healthcare system. CONCLUSIONS: Most readmissions at our public, safety net hospital were unavoidable, even among our unscheduled readmissions. Surprisingly, one-third of our overall readmissions were scheduled, the majority reflecting appropriate management strategies designed to reduce unnecessary hospital days. The scheduled but avoidable readmissions were due to constrained access to non-emergent, expensive procedures that are typically not reimbursed given our system's payor mix, a problem which likely plague other safety net systems. These findings suggest that readmissions do not necessarily reflect inadequate medical care, may reflect resource constraints that are unlikely to be addressable in systems caring for a large burden of uninsured patients, and merit individualized review.

  5. SafetyNet. Human factors safety training on the Internet

    DEFF Research Database (Denmark)

    Hauland, G.; Pedrali, M.


    This report describes user requirements to an Internet based distance learning system of human factors training, i.e. the SafetyNet prototype, within the aviation (pilots and air traffic control), maritime and medical domains. User requirements totraining have been elicited through 19 semi...

  6. A probabilistic bridge safety evaluation against floods. (United States)

    Liao, Kuo-Wei; Muto, Yasunori; Chen, Wei-Lun; Wu, Bang-Ho


    To further capture the influences of uncertain factors on river bridge safety evaluation, a probabilistic approach is adopted. Because this is a systematic and nonlinear problem, MPP-based reliability analyses are not suitable. A sampling approach such as a Monte Carlo simulation (MCS) or importance sampling is often adopted. To enhance the efficiency of the sampling approach, this study utilizes Bayesian least squares support vector machines to construct a response surface followed by an MCS, providing a more precise safety index. Although there are several factors impacting the flood-resistant reliability of a bridge, previous experiences and studies show that the reliability of the bridge itself plays a key role. Thus, the goal of this study is to analyze the system reliability of a selected bridge that includes five limit states. The random variables considered here include the water surface elevation, water velocity, local scour depth, soil property and wind load. Because the first three variables are deeply affected by river hydraulics, a probabilistic HEC-RAS-based simulation is performed to capture the uncertainties in those random variables. The accuracy and variation of our solutions are confirmed by a direct MCS to ensure the applicability of the proposed approach. The results of a numerical example indicate that the proposed approach can efficiently provide an accurate bridge safety evaluation and maintain satisfactory variation.

  7. Modeling safety requirements of an FMS using Petri-nets (United States)

    Hanna, Moheb M.; Buck, A. A.; Smith, R.


    This paper is concerned with the modelling of safety requirements using Petri nets as a tool to model and simulate a Flexible Manufacturing System (FMS). The FMS cell described comprises a pick and place robot, a multi-head drilling machine together with a vision system and illustrates how the hierarchical structure of Petri nets can be used to ensure that all fail- safe requirements are satisfied; block diagrams together with fully detailed example Petri nets are given. The work demonstrates the use of cell and robot control Petro nets together with robot subnets for the x, y and z axes and associated output nets; the control and output nets are linked together with a safety net. Individual machines are linked with the control and safety nets of an FMS at cell level. The paper also illustrates how a Petri net can act as a decision maker during image inspection and identifies the unsafe conditions that can arise within an FMS.

  8. Microfinance safety net: back to basics. (United States)

    Viola, Deborah; Shi, Qiuhu; Murthy, Padmini


    Malnutrition among families living in poorer communities has increased in the past two decades. Initiatives advocated by the World Bank include microfinance programs. Research attributing the success of these programs however, has mixed results. In this article we investigate how additional income provided by microfinance is associated with increased consumption of nondurables for households in rural villages in Bangladesh. For our purposes we compare consumption or money expensed on food, medicine, doctor fees, and smoking. Fisher's least significant difference (LSD) procedure was used to address multiple comparison issues among households. Our findings reinforce the importance of microfinance credit as a safety net. Access to additional income for poor villagers improves the consumption of basic needs as expected, regardless of how many loans are taken; consumption of "bads" remains virtually the same.

  9. Social Security: Strengthening a Vital Safety Net for Latinos (United States)

    Cruz, Jeff


    Since 1935, Social Security has provided a vital safety net for millions of Americans who cannot work because of age or disability. This safety net has been especially critical for Americans of Latino decent, who number more than 50 million or nearly one out of every six Americans. Social Security is critical to Latinos because it is much more…

  10. Dynamic Vehicle Impact for Safety Assessment of Bridges

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Nielsen, Søren R. K.; Enevoldsen, I.

    of the numerical modal parameters of the bridge are known, Only irregularities from imperfect expansion joints have been modelled as bumps at the entrance to the bridge. The results are obtained from a simulation study for different passage situations of the two heavy vehicles. Further, consequences for the safety......In this paper the dynamic amplification of vehicle load at minor highway bridges is considered for safety assessment of the load carrying capacity of bridges. The considered case is the most critical for bridges, i.e. the simultaneous passage of two heavy trucks. A short description...

  11. Advanced bridge safety initiative : FRP flexural retrofit for concrete slab bridges - task 4 deliverables. (United States)


    Concrete slab bridges are being examined as part of the MaineDOT Advanced Bridge Safety Initiative. Under Tasks : 1 3 a finite element analysis program is developed, validated and applied to twenty bridges. : Task 4 investigates and develops a no...

  12. Study on safety level of RC beam bridges under earthquake (United States)

    Zhao, Jun; Lin, Junqi; Liu, Jinlong; Li, Jia


    This study considers uncertainties in material strengths and the modeling which have important effects on structural resistance force based on reliability theory. After analyzing the destruction mechanism of a RC bridge, structural functions and the reliability were given, then the safety level of the piers of a reinforced concrete continuous girder bridge with stochastic structural parameters against earthquake was analyzed. Using response surface method to calculate the failure probabilities of bridge piers under high-level earthquake, their seismic reliability for different damage states within the design reference period were calculated applying two-stage design, which describes seismic safety level of the built bridges to some extent.

  13. Implementing ARP-Path Low Latency Bridges in NetFPGA


    Rojas Sánchez, Elisa; Naous, Jad; Ibáñez Fernández, Guillermo Agustín; Rivera, Diego; Carral Pelayo, Juan Antonio; Arco Rodríguez, José Manuel


    The demo is focused on the implementation of ARP-Path (a.k.a. FastPath) bridges, a recently proposed concept for low latency bridges. ARP-Path Bridges rely on the race between broadcast ARP Request packets, to discover the minimum latency path to the destination host. Several implementations (in Omnet++, Linux, OpenFlow, NetFPGA) have shown that ARP-Path exhibits loop-freedom, does not block links, is fully transparent to hosts and neither needs a spanning tree protocol to prevent loops nor a...

  14. Mobilizing local safety nets for enhanced adaptive capacity to ...

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


    Apr 22, 2016 ... This brief explores how the erosion of Zunde raMambo — a traditional community safety net mechanism — over time has increased the vulnerability of communities through weakened community cohesion and collective action in addressing local problems. A renewal of Zunde raMambo could help to ...

  15. Shaping forest safety nets with markets: Adaptation to climate ...

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

    Johnson Nkem


    Jun 29, 2010 ... This is likely to be worse in free market settings, especially when it diminishes the safety net ..... (1995), the cost to society of each palm tree killed through palm wine tapping ranges from 70,000 to 129,000 ... companies are involved in producing organic or alternative medicines, some of which are extracts ...

  16. Mobilizing local safety nets for enhanced adaptive capacity to ...

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

    22 avr. 2016 ... In Zimbabwe, the increased frequency of drought, flash floods, and unpredictable rainfall has added to recurrent food deficits for poor households who depend on rainfed farming on nutrient poor soils. This brief explores how the erosion of Zunde raMambo — a traditional community safety net mechanism ...

  17. New regulations on railroad bridge safety: opportunities and challenges for railroad bridge monitoring (United States)

    Moreu, Fernando; LaFave, James M.; Spencer, Billie F.


    New federal regulations now mandate North American railroad bridge owners to closely assess the structural capacity of their bridges. Consequently, railroad companies are currently looking into developing and exploring monitoring systems for specific bridges, to help them improve and develop bridge safety in order to help comply with this new rule. The first part of this paper explains the significance of the new federal law. The new rule comes from the Federal Railroad Administration (FRA), Department of Transportation (DOT), and it falls under the 49 Code of Federal Regulations (CFR), Parts 213 and 2371. It requires railroad track owners to know the safe capacity of their bridges and to additionally conduct special inspections if either weather or other exceptional conditions make them necessary to ensure safe railroad bridge operations. The second part of this paper will cover past and current studies about the viability of bridge health monitoring, and actual structural monitoring experiences for railroad bridges. Finally, lessons learned from these monitoring examples, as well as recommendations for future applications, are suggested, including wireless monitoring strategies for railroad bridges such as: campaign sensing inspections (periodic monitoring); bridge replacement observations (short term monitoring); and permanent bridge instrumentation (long term monitoring).

  18. 77 FR 21436 - Safety Zone, East River, Brooklyn Bridge Scaffolding Repair, Brooklyn, NY (United States)


    ... that a crane barge struck the scaffolding under the eastern span of the Brooklyn Bridge. As a result of... bridge, from the centerline of the bridge to the tower on the Brooklyn side. The safety zone will...

  19. Impact of Massachusetts Health Reform on Inpatient Care Use: Was the Safety-Net Experience Different Than in the Non-Safety-Net? (United States)

    Hanchate, Amresh D; McCormick, Danny; Lasser, Karen E; Feng, Chen; Manze, Meredith G; Kressin, Nancy R


    Most inpatient care for the uninsured and other vulnerable subpopulations occurs in safety-net hospitals. As insurance expansion increases the choice of hospitals for the previously uninsured, we examined if Massachusetts health reform was associated with shifts in the volume of inpatient care from safety-net to non-safety-net hospitals overall, or among other vulnerable sociodemographic (racial/ethnic minority, low socioeconomic status, high uninsured rate area) and clinical subpopulations (emergent status, diagnosis). Discharge records for adults discharged from all nonfederal acute care hospitals in Massachusetts, New Jersey, New York, and Pennsylvania 2004-2010. Using a difference-in-differences design, we compared pre-/post-reform changes in safety-net and non-safety-net hospital discharge outcomes in Massachusetts among adults 18-64 with corresponding changes in comparisons states with no reform, overall, and by subpopulations. Reform was not associated with changes in inpatient care use at safety-net and non-safety-net hospitals across all discharges or in most subpopulations examined. Demand for inpatient care at safety-net hospitals may not decrease following insurance expansion. Whether this is due to other access barriers or patient preference needs to be explored. © Health Research and Educational Trust.

  20. Participatory Approaches to Workplace Safety Management: Bridging the Gap Between Behavioral Safety and Participatory Ergonomics. (United States)

    Rost, Kristen A; Alvero, Alicia M


    Many researchers and practitioners argue the importance of end-user involvement in workplace safety management, but the research literature and practices remain fractured across orientations. The primary aim of this paper is to bridge the gap between two major participatory safety management approaches: behavioral safety and participatory ergonomics. First, an overview and brief history of participative management is presented to provide context for its application to workplace safety. Next, behavioral safety and participatory ergonomics are separately examined in terms of their origins and core elements. Finally, based on this examination, unifying elements between behavioral safety and participatory ergonomics will be presented to provide a comprehensive account of participatory safety management.

  1. Physicians' Perceptions of Volunteer Service at Safety-Net Clinics. (United States)

    Mcgeehan, Laura; Takehara, Michael A; Daroszewski, Ellen


    Volunteer physicians are crucial for the operation of safety-net clinics, which provide medical care for uninsured and underinsured populations. Thus, identifying ways to maximize the number of physicians volunteering at such clinics is an important goal. To investigate the perceptions, motivations, functions, and barriers associated with physician volunteering in four safety-net clinics in San Bernardino County, Southern California, a location of great medical need with many barriers to care. The study participants are physicians belonging to the Southern California Permanente Medical Group who use a combination of discretionary time (during regular work hours) and personal time in evening and weekend hours to volunteer their services. The experimental design incorporates a mixed methodology: an online survey of 31 physicians and follow-up interviews with 8 of them. Physicians conveyed uniformly positive perceptions of their volunteer service, and most were motivated by humanitarian or prosocial desires. Volunteering also provided a protective "escape hatch" from the pressures of the physicians' regular jobs. Physicians cited few challenges to volunteering. The most common personal barrier was a lack of time. The most common professional barriers were organizational and supply issues at the clinic, along with the patients' social, transportation, and financial challenges. The results suggest that appealing to physicians' values and faith, and highlighting the burnout-prevention qualities of volunteering, may be key to recruitment and retention of volunteer physicians who serve underserved and underinsured populations in community clinics.

  2. Physicians’ Perceptions of Volunteer Service at Safety-Net Clinics (United States)

    McGeehan, Laura; Takehara, Michael A; Daroszewski, Ellen


    Background: Volunteer physicians are crucial for the operation of safety-net clinics, which provide medical care for uninsured and underinsured populations. Thus, identifying ways to maximize the number of physicians volunteering at such clinics is an important goal. Objective: To investigate the perceptions, motivations, functions, and barriers associated with physician volunteering in four safety-net clinics in San Bernardino County, Southern California, a location of great medical need with many barriers to care. Methods: The study participants are physicians belonging to the Southern California Permanente Medical Group who use a combination of discretionary time (during regular work hours) and personal time in evening and weekend hours to volunteer their services. The experimental design incorporates a mixed methodology: an online survey of 31 physicians and follow-up interviews with 8 of them. Results: Physicians conveyed uniformly positive perceptions of their volunteer service, and most were motivated by humanitarian or prosocial desires. Volunteering also provided a protective “escape hatch” from the pressures of the physicians’ regular jobs. Physicians cited few challenges to volunteering. The most common personal barrier was a lack of time. The most common professional barriers were organizational and supply issues at the clinic, along with the patients’ social, transportation, and financial challenges. Conclusion: The results suggest that appealing to physicians’ values and faith, and highlighting the burnout-prevention qualities of volunteering, may be key to recruitment and retention of volunteer physicians who serve underserved and underinsured populations in community clinics. PMID:28241907

  3. Are Dental Schools Part of the Safety Net? (United States)

    Bailit, Howard L


    This article examines the current safety net activities of dental schools and reviews strategies by which schools could care for more poor and low-income patients. The primary data come from the annual Survey of Dental Education, a joint American Dental Education Association (ADEA) and American Dental Association (ADA) activity. The analyses use descriptive statistics and are intended to give ballpark estimates of patients treated under varying clinical scenarios. Some 107.4 million people are underserved in comparison to utilization rates for middle-income Americans. In 2013-14, pre- and postdoctoral students treated about 1,176,000 disadvantaged patients. This is an estimate; the actual value may be 25% above or below this number. The impact of potential strategies for schools to provide more care to poor and low-income patients are discussed; these are larger class size, more community-based education, a required one-year residency program, and schools' becoming part of publicly funded safety net clinics. While dental schools cannot solve the access problem, they could have a major impact if the payment and delivery strategies discussed were implemented. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  4. Computer use, language, and literacy in safety net clinic communication. (United States)

    Ratanawongsa, Neda; Barton, Jennifer L; Lyles, Courtney R; Wu, Michael; Yelin, Edward H; Martinez, Diana; Schillinger, Dean


    Patients with limited health literacy (LHL) and limited English proficiency (LEP) experience suboptimal communication and health outcomes. Electronic health record implementation in safety net clinics may affect communication with LHL and LEP patients.We investigated the associations between safety net clinician computer use and patient-provider communication for patients with LEP and LHL. We video-recorded encounters at 5 academically affiliated US public hospital clinics between English- and Spanish-speaking patients with chronic conditions and their primary and specialty care clinicians. We analyzed changes in communication behaviors (coded with the Roter Interaction Analysis System) with each additional point on a clinician computer use score, controlling for clinician type and visit length and stratified by English proficiency and health literacy status. Greater clinician computer use was associated with more biomedical statements (+12.4, P = .03) and less positive affect (-0.6, P communication. Higher clinician computer use was associated with more biomedical focus with LEP/LHL patients, and clinician verbal dominance and lower ratings with patients with adequate English proficiency and health literacy. Implementation research should explore interventions to enhance relationship-centered communication for diverse patient populations in the computer era. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  5. 77 FR 70891 - Safety Zone; Bay Bridge Construction, San Francisco Bay, San Francisco, CA (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Bay Bridge Construction, San Francisco Bay..., CA in support of the Bay Bridge Construction Safety Zone from November 1, 2012 through July 31, 2013.... 1221 et seq.). CALTRANS will sponsor the Bay Bridge Construction Safety Zone on November 1, 2012...

  6. 78 FR 37969 - Safety Zone; South Park Bridge Construction, Lower Duwamish Waterway, Seattle, WA (United States)


    ...The Coast Guard is establishing a temporary safety zone in the lower Duwamish Waterway around the South Park Bridge in Seattle, Washington for the re-construction of the bridge. The safety zone is necessary to ensure the safety of the maritime public and workers involved in the bridge construction. The safety zone will prohibit any person or vessel from entering or remaining in the safety zone unless authorized by the Captain of the Port or his Designated Representative.

  7. Modelling safety of gantry crane operations using Petri nets. (United States)

    Singh, Karmveer; Raj, Navneet; Sahu, S K; Behera, R K; Sarkar, Sobhan; Maiti, J


    Being a powerful tool in modelling industrial and service operations, Petri net (PN) has been extremely used in different domains, but its application in safety study is limited. In this study, we model the gantry crane operations used for industrial activities using generalized stochastic PNs. The complete cycle of operations of the gantry crane is split into three parts namely inspection and loading, movement of load, and unloading of load. PN models are developed for all three parts and the whole system as well. The developed PN models have captured the safety issues through reachability tree. The hazardous states are identified and how they ultimately lead to some unwanted accidents is demonstrated. The possibility of falling of load and failure of hook, sling, attachment and hoist rope are identified. Possible suggestions based on the study are presented for redesign of the system. For example, mechanical stoppage of operations in case of loosely connected load, and warning system for use of wrong buttons is tested using modified models.

  8. 78 FR 61937 - Safety Zone; Port of Galveston, Pelican Island Bridge Repair (United States)


    ... CFR Part 165 RIN 1625-AA00 Safety Zone; Port of Galveston, Pelican Island Bridge Repair AGENCY: Coast... zone in Galveston to maintain public safety during the Pelican Island Bridge Repair Project. This... Pelican Island Bridge; therefore immediate action is needed to protect public boaters and their vessels...

  9. Diabetes educators in safety-net practices: a qualitative study. (United States)

    Kahn, Linda S; Glaser, Kathryn; Fox, Chester H; Patterson, Adam


    The purpose of this study was to explore the issues and challenges faced by certified diabetes educator (CDE) trainees in providing diabetes self-management education to patients in safety-net practices. Semi-structured interviews were conducted with CDE trainees and a CDE mentor in 2 primary care practices. Transcripts were analyzed using a content-driven immersion-crystallization approach to identify major themes. Four major themes emerged from the qualitative interview data: (1) patient recruitment approaches, (2) patient barriers to attending diabetes education classes, (3) teaching challenges, and (4) CDE integration into the practices. This study underscores the need for diabetes educators and other health education professionals to be creative and flexible in delivering self-management education to patients in underserved settings. The complexity of diabetes care and the self-care responsibilities placed on the patient reinforce the need for a team approach such as that proposed in the medical home model and should include certified diabetes educators.

  10. 78 FR 71546 - Safety Zone; Belt Parkway Bridge Construction, Gerritsen Inlet, Brooklyn, NY (United States)


    ...The Coast Guard proposes to establish a safety zone on the navigable waters of Gerritsen Inlet surrounding the Belt Parkway Bridge. This proposed rule would allow the Coast Guard to prohibit all vessel traffic through the safety zone during bridge replacement operations, both planned and unforeseen, that could pose an imminent hazard to persons and vessels operating in the area. This rule is necessary to provide for the safety of life in the regulated area during the construction of the Bridge.

  11. 77 FR 1870 - Safety Zone; Matlacha Bridge Construction, Matlacha Pass, Matlacha, FL (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Matlacha Bridge Construction, Matlacha Pass... and property on navigable waters of the United States during the Matlacha Bridge construction. Persons... stage of the Matlacha Bridge construction until November 18, 2011. As a result, the Coast Guard did not...

  12. 77 FR 25080 - Safety Zones; TriMet Bridge Project, Willamette River, Portland, OR (United States)


    ... established for the TriMet Bridge construction site and are more focused in nature than the previous safety... this rule because to do so would be impracticable, since bridge construction is already underway and... bridge construction cranes. (b) Regulation. In accordance with the general regulations in 33 CFR Part 165...

  13. 77 FR 20719 - Safety Zone; Matlacha Bridge Construction, Matlacha Pass, Matlacha, FL (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Matlacha Bridge Construction, Matlacha Pass... property on navigable waters of the United States during the Matlacha Bridge construction. Persons and... navigable waters of the United States during the Matlacha Bridge construction. ] Discussion of Rule From...

  14. 77 FR 66541 - Safety Zone; Alliance Road Bridge Demolition; Black Warrior River, Locust Fork; Birmingham, AL (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Alliance Road Bridge Demolition; Black... navigable waters during the demolition of the Alliance Road Bridge (Co. Rd. 61). Entry into, transiting or... their intentions to start the process to demolish the Alliance Road Bridge on September 24, 2012...

  15. Networked collaborative pseudo-dynamic testing of a multi-span bridge based on NetSLab (United States)

    Cai, Xinjiang; Tian, Shizhu; Wang, Dapeng; Xiao, Yan


    Modern dynamic tests such as networked collaborative pseudo-dynamic testing (PDT) provide new tools to study the dynamic performance of large and complex structures. In this paper, several networked collaborative PDT systems established in China and abroad are introduced, including a detailed description of the first networked collaborative platform that involved the construction of a standardized demonstration procedure for networked collaborative PDT. The example is a multi-span bridge with RC piers retrofitted by FRP, and a networked structural laboratory (NetSLab) platform is used to link distributed laboratories located at several universities together. Substructure technology is also used in the testing. The characteristics, resource sharing and collaborative work of NetSLab are described, and the results illustrate that use of the NetSLab is feasible for studying the dynamic performance of multi-span bridge structures.

  16. The Financial Safety Net – a Necessity in a Turbulent Financial World

    Directory of Open Access Journals (Sweden)

    Peter BALOGH


    Full Text Available Over the last years we observed that whenever crisis hits, interest in guarantee arrangements rises. The current financial crisis is no exception in this respect. It turns the spotlight on the operation of the financial safety net and provides policy makers with a unique opportunity to monitor its performance and, more specifically, to identify its strengths and weaknesses. The aim of this paper is to demonstrate the need of financial safety nets in a world characterized by deep financial disruptions, describing also the main components of a well-built financial safety net

  17. Road safety performance indicators : country profiles. SafetyNet, Building the European Road Safety Observatory, Workpackage 3, Deliverable 3.7b.

    NARCIS (Netherlands)

    Riguelle, F. Eksler, V. Holló, P. Morsink, P. Gent, A. van Gitelman, V. Assum, T. & Rackliff, L.


    The EC 6th Framework Integrated Project SafetyNet aims to accelerate the availability and use of harmonised road safety data in Europe. Having such data available throughout Europe would be tremendously beneficial for road safety, since it would enable the evaluation of road safety measures, the

  18. Using a safety net and following the safety instructions could prevent half the paediatric trampoline injuries. (United States)

    Rättyä, J; Serlo, W


    The number of recreational trampolines in Finnish households has increased. There also appears to be a drastic increase in trampoline-related injuries among paediatric patients. The aim of this study was to quantify and describe trampoline-related injuries in North Finnish paediatric patients. A retrospective analysis of medical data was used in the study, covering children 16 years and younger treated for trampoline-related injuries at Oulu University Hospital over a five-month period of time from May 1 to September 30, 2005. Medical records were reviewed and additional details regarding the injuries were obtained by questionnaire. Altogether 76 patients were treated for trampoline-related injuries, which represented 13.4 % of all paediatric accidental trauma patients. In 57 accidents (86 %), there had been multiple jumpers on the trampoline. Twenty-five of the injuries (38 %) had occurred on the trampoline, in 25 cases (38 %) a child had fallen off, in 8 cases (12 %) there had been a collision with another jumper and the person had jumped onto a trampoline from a high platform in 5 incidents (8 %). Only 3 children (5 %) hurt themselves on the trampoline when jumping alone. Orthopaedic procedures requiring general anaesthesia were necessary in a total of 31 cases (41 %). The study shows that 50 % of traumas (falling off and collisions) could have been avoided by using a safety net and by jumping one at a time. The importance of following safety instructions and the need for a safety net should be emphasised to both the supervising adults and the children.



    Devin Alan Daugherty; Ernesto Escobedo


    Several safety-net hospitals have closed in the United States, but the scholarly literature does not adequately explain why. This study examines the relationship between the operational status (open or closed) of safety-net hospitals and unemployment, median household income, gross profit margin, efficiency ratio, operating margin, excess margin, and salary and benefit expenses per full-time equivalent. Study data were collected and analyzed by means of a logistic regression analysis. A signi...

  20. Possible consequences of regionally based bundled payments for diabetic amputations for safety net hospitals in Texas. (United States)

    Newhall, Karina; Stone, David; Svoboda, Ryan; Goodney, Philip


    Ongoing health reform in the United States encourages quality-based reimbursement methods such as bundled payments for surgery. The effect of such changes on high-risk procedures is unknown, especially at safety net hospitals. This study quantified the burden of diabetes-related amputation and the potential financial effect of bundled payments at safety net hospitals in Texas. We performed a cross-sectional analysis of diabetic amputation burden and charges using publically available data from Centers for Medicare and Medicaid and the Texas Department of Health from 2008 to 2012. Using hospital referral region (HRR)-level analysis, we categorized the proportion of safety net hospitals within each region as very low (0%-9%), low (10%-20%), average (20%-33%), and high (>33%) and compared amputation rates across regions using nonparametric tests of trend. We then used charge data to create reimbursement rates based on HRR to estimate financial losses. We identified 51 adult hospitals as safety nets in Texas. Regions varied in the proportion of safety net hospitals from 0% in Victoria to 65% in Harlingen. Among beneficiaries aged >65, amputation rates correlated to the proportion of safety net hospitals in each region; for example, patients in the lowest quartile of safety net had a yearly rate of 300 amputations per 100,000 beneficiaries, whereas those in the highest quartile had a yearly rate of 472 per 100,000 (P = .007). Charges for diabetic amputation-related admissions varied almost 200-fold, from $5000 to $1.4 million. Using reimbursement based on HRR to estimate a bundled payment, we noted net losses would be higher at safety net vs nonsafety net hospitals ($180 million vs $163 million), representing a per-hospital loss of $1.6 million at safety nets vs $700,000 at nonsafety nets (P amputations in Texas. Changes to traditional payment models should account for the disproportionate burden of high-risk procedures performed by these hospitals. Copyright © 2016

  1. A two-dimensional equity proposal for self-sufficiency in municipal safety-net hospitals. (United States)

    Tataw, David Besong


    This article advances a two-dimensional equity approach for self-sufficiency in municipal safety-net hospitals that will strengthen provider self-sufficiency and protect the safety-net mission of providing a dignified floor of health services to the most disadvantaged members of the society. The model responds to the failure of current delivery strategies to effectively cope with the changing market configurations in safety-net systems that have eliminated the possibility of cross-subsidization which has long been the mainstay of safety-net systems. The identified pathway to self sufficiency is made up of (1) a differential service delivery framework which includes a two-tier patient system, uniform standards of care and service levels, and the creation of a community health campus; (2) independent sector ownership; and (3) intergovernmental policy actions restricting ownership of safety-net hospitals to nonprofit entities. Although this model is explained by demonstrating potential application in safety-net hospitals, it is believed that the model is applicable in ambulatory care settings. Future work can focus on the construction of an ambulatory variation of the model and the empirical testing of the hospital and ambulatory models.

  2. 78 FR 7670 - Safety Zone; Indian Street Bridge Construction, St. Lucie Canal, Palm City, FL (United States)


    ...The Coast Guard is establishing a temporary safety zone on the St. Lucie Canal, Palm City, Florida to provide for the safety of life and vessels on a narrow waterway during bridge construction for the Indian Street Bridge. Persons and vessels are prohibited from entering, transiting through, anchoring in, or remaining within the safety zone unless authorized by the Captain of the Port Miami or a designated representative.

  3. An international network (PlaNet) to evaluate a human placental testing platform for chemicals safety testing in pregnancy. (United States)

    Brownbill, Paul; Chernyavsky, Igor; Bottalico, Barbara; Desoye, Gernot; Hansson, Stefan; Kenna, Gerry; Knudsen, Lisbeth E; Markert, Udo R; Powles-Glover, Nicola; Schneider, Henning; Leach, Lopa


    The human placenta is a critical life-support system that nourishes and protects a rapidly growing fetus; a unique organ, species specific in structure and function. We consider the pressing challenge of providing additional advice on the safety of prescription medicines and environmental exposures in pregnancy and how ex vivo and in vitro human placental models might be advanced to reproducible human placental test systems (HPTSs), refining a weight of evidence to the guidance given around compound risk assessment during pregnancy. The placental pharmacokinetics of xenobiotic transfer, dysregulated placental function in pregnancy-related pathologies and influx/efflux transporter polymorphisms are a few caveats that could be addressed by HPTSs, not the specific focus of current mammalian reproductive toxicology systems. An international consortium, "PlaNet", will bridge academia, industry and regulators to consider screen ability and standardisation issues surrounding these models, with proven reproducibility for introduction into industrial and clinical practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Running Safety of Trains under Vessel-Bridge Collision

    Directory of Open Access Journals (Sweden)

    Yongle Li


    Full Text Available To optimize the sensor placement of the health monitoring system, the dynamic behavior of the train-bridge system subjected to vessel-collision should be studied in detail firstly. This study thus focuses on the characteristics of a train-bridge system under vessel-bridge collision. The process of the vessel-bridge collision is simulated numerically with a reliable finite element model (FEM. The dynamic responses of a single car and a train crossing a cable-stayed bridge are calculated. It is shown that the collision causes significant increase of the train’s lateral acceleration, lateral wheelset force, wheel unloading rate, and derailment coefficient. The effect of the collision on the train’s vertical acceleration is much smaller. In addition, parametric studies with various train’s positions, ship tonnage, and train speed are performed. If the train is closer to the vessel-bridge collision position or the ship tonnage is larger, the train will be more dangerous. There is a relatively high probability of running danger at a low speed, resulting from longer stay of the train on the bridge. The train’s position, the ship tonnage, and the train speed must be considered when determining the most adverse conditions for the trains running on bridges under vessel-bridge collision.

  5. Stretching the safety net to serve undocumented immigrants: community responses to health needs. (United States)

    Staiti, Andrea B; Hurley, Robert E; Katz, Aaron


    A small but increasing proportion of immigrants to the United States is undocumented. Because most undocumented immigrants lack health insurance, they primarily rely on safety net providers for care. Communities with more developed safety nets and historically large numbers of immigrants appear more adept at caring for both legal and undocumented immigrants, according to Center for Studying Health System Change's (HSC) 2005 site visits to 12 nationally representative communities. Communities with less experience caring for immigrant populations and less-developed safety nets face challenges caring for this population, but many are taking steps to improve their ability to meet immigrant needs. As the number of immigrants in the U.S. grows, the need to develop community health care capacity for immigrants will intensify.

  6. Societal aspects of bridge management and safety in the Netherlands

    NARCIS (Netherlands)

    Klatter, H.E.; Vrouwenvelder, A.C.W.M.; Noortwijk, J.M. van


    The main reason for the existence of civil infrastructures is public interest. Therefore, various societal aspects should drive an infrastructure program. Civil infrastructures are long-lived as-sets. Bridges and other structures are designed for lifetimes of 50 to 100 years. A bridge can last much

  7. Child Poverty, the Great Recession, and the Social Safety Net in the United States. (United States)

    Bitler, Marianne; Hoynes, Hiliary; Kuku, Elira

    In this paper, we comprehensively examine the effects of the Great Recession on child poverty, with particular attention to the role of the social safety net in mitigating the adverse effects of shocks to earnings and income. Using a state panel data model and data for 2000 to 2014, we estimate the relationship between the business cycle and child poverty, and we examine how and to what extent the safety net is providing protection to at-risk children. We find compelling evidence that the safety net provides protection; that is, the cyclicality of after-tax-and-transfer child poverty is significantly attenuated relative to the cyclicality of private income poverty. We also find that the protective effect of the safety net is not similar across demographic groups, and that children from more disadvantaged backgrounds, such as those living with Hispanic or single heads, or particularly those living with immigrant household heads—or immigrant spouses—experience larger poverty cyclicality than those living with non- Hispanic white or married heads, or those living with native household heads with native spouses. Our findings hold across a host of choices for how to define poverty. These include measures based on absolute thresholds or more relative thresholds. They also hold for measures of resources that include not only cash and near-cash transfers net of taxes but also several measures of the value of public medical benefits.

  8. Increasing Research Capacity in a Safety Net Setting Through an Academic Clinical Partnership. (United States)

    Brooks Carthon, J Margo; Holland, Sara; Gamble, Kerry; Rothwell, Helyn; Pancir, Darcy; Ballinghoff, Jim; Aiken, Linda


    Safety net settings care for a disproportionate share of low-resource patients often have fewer resources to invest in nursing research. To address this dilemma, an academic-clinical partnership was formed in an effort to increase nursing research capacity at a safety net setting. Penn Presbyterian Medical Center and the Center for Health Outcomes and Policy Research located at the University of Pennsylvania partnered researchers and baccalaureate-prepared nurses in an 18-month research skill development program. This article describes the programmatic design, conceptual framework, resource requirements, and effect on the institutional partners and participants.

  9. Comparative Studies of Collaborative Team Depression Care Adoption in Safety Net Clinics (United States)

    Ell, Kathleen; Wu, Shinyi; Guterman, Jeffrey; Schulman, Sandra-Gross; Sklaroff, Laura; Lee, Pey-Jiuan


    Purpose: To evaluate three approaches adopting collaborative depression care model in Los Angeles County safety net clinics with predominantly Latino type 2 diabetes patients. Methods: Pre-post differences in treatment rates and symptom reductions were compared between baseline, 6-month, and 12-month follow-ups for each approach: (a) Multifaceted…

  10. Supplement: Community-based safety-nets and strategies to reduce ...

    African Journals Online (AJOL)

    Supplement: Community-based safety-nets and strategies to reduce vulnerability to drought, crop losses and market crises. NA Ngongi. Abstract. No Abstract. Journal of the Cameroon Academy of Sciences Vol. 7 (3) 2008: pp. 229-236. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...

  11. From food aid to food security: the case of the safety net policy in Ethiopia

    NARCIS (Netherlands)

    Bishop, C.; Hilhorst, D.


    Ethiopia's Productive Safety Net Programme (PSNP) is an attempt to bring food security to 5 million people by providing them with social security to close the yearly hunger gap, coupled with development projects to lift them permanently out of poverty. The programme is an example of the new policy

  12. Safety Identifying of Integral Abutment Bridges under Seismic and Thermal Loads (United States)

    Easazadeh Far, Narges; Barghian, Majid


    Integral abutment bridges (IABs) have many advantages over conventional bridges in terms of strength and maintenance cost. Due to the integrity of these structures uniform thermal and seismic loads are known important ones on the structure performance. Although all bridge design codes consider temperature and earthquake loads separately in their load combinations for conventional bridges, the thermal load is an “always on” load and, during the occurrence of an earthquake, these two important loads act on bridge simultaneously. Evaluating the safety level of IABs under combination of these loads becomes important. In this paper, the safety of IABs—designed by AASHTO LRFD bridge design code—under combination of thermal and seismic loads is studied. To fulfill this aim, first the target reliability indexes under seismic load have been calculated. Then, these analyses for the same bridge under combination of thermal and seismic loads have been repeated and the obtained reliability indexes are compared with target indexes. It is shown that, for an IAB designed by AASHTO LRFD, the indexes have been reduced under combined effects. So, the target level of safety during its design life is not provided and the code's load combination should be changed. PMID:25405232

  13. Multilevel correlates for human papillomavirus vaccination of adolescent girls attending safety net clinics. (United States)

    Tiro, Jasmin A; Pruitt, Sandi L; Bruce, Corinne M; Persaud, Donna; Lau, May; Vernon, Sally W; Morrow, Jay; Skinner, Celette Sugg


    Adolescent HPV vaccination in minority and low income populations with high cervical cancer incidence and mortality could reduce disparities. Safety-net primary care clinics are a key delivery site for improving vaccination rates in these populations. To examine prevalence of HPV initiation (≥ 1 dose), completion (receipt of dose 3 within 12 months of initiation), and receipt of 3 doses in four safety-net clinics as well as individual-, household-, and clinic-level correlates of initiation. We used multilevel modeling to investigate HPV initiation among 700 adolescent females who sought primary care in four safety-net clinics in Dallas, Texas from March 2007 to December 2009. Data were abstracted from patients' paper and electronic medical records. HPV vaccine uptake varied significantly by clinic. Across clinics, initiation was 36.6% and completion was 39.7% among those who initiated. In the total study population, only 15.7% received all three doses. In multivariate, two-level logistic regression analyses, initiation was associated with receipt of other adolescent vaccines, influenza vaccination in the year prior to data abstraction, being sexually active, and having more chart documentation (presence of health maintenance questionnaire and/or immunization record). There was no association between initiation and age, race/ethnicity, or insurance status. In four urban safety-net clinics, HPV initiation rates paralleled 2008 national rates. The correlation of HPV initiation with other adolescent vaccines underscores the importance of reviewing vaccination status at every health care visit. HPV vaccine uptake in safety-net clinics should continue to be monitored to understand impact on cervical cancer disparities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Factors shaping effective utilization of health information technology in urban safety-net clinics. (United States)

    George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard


    Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

  15. Innovation in the safety net: integrating community health centers through accountable care. (United States)

    Lewis, Valerie A; Colla, Carrie H; Schoenherr, Karen E; Shortell, Stephen M; Fisher, Elliott S


    Safety net primary care providers, including as community health centers, have long been isolated from mainstream health care providers. Current delivery system reforms such as Accountable Care Organizations (ACOs) may either reinforce the isolation of these providers or may spur new integration of safety net providers. This study examines the extent of community health center involvement in ACOs, as well as how and why ACOs are partnering with these safety net primary care providers. Mixed methods study pairing the cross-sectional National Survey of ACOs (conducted 2012 to 2013), followed by in-depth, qualitative interviews with a subset of ACOs that include community health centers (conducted 2013). One hundred and seventy-three ACOs completed the National Survey of ACOs. Executives from 18 ACOs that include health centers participated in in-depth interviews, along with leadership at eight community health centers participating in ACOs. Key survey measures include ACO organizational characteristics, care management and quality improvement capabilities. Qualitative interviews used a semi-structured interview guide. Interviews were recorded and transcribed, then coded for thematic content using NVivo software. Overall, 28% of ACOs include a community health center (CHC). ACOs with CHCs are similar to those without CHCs in organizational structure, care management and quality improvement capabilities. Qualitative results showed two major themes. First, ACOs with CHCs typically represent new relationships or formal partnerships between CHCs and other local health care providers. Second, CHCs are considered valued partners brought into ACOs to expand primary care capacity and expertise. A substantial number of ACOs include CHCs. These results suggest that rather than reinforcing segmentation of safety net providers from the broader delivery system, the ACO model may lead to the integration of safety net primary care providers.

  16. Moral Progress in the Public Safety Net: Access for Transgender and LGB Patients. (United States)

    Davis, Stephan; Berlinger, Nancy


    As a population, people who self-identify as lesbian, gay, bisexual, or transgender face significant risks to health and difficulty in obtaining medical and behavioral health care, relative to the general public. These issues are especially challenging in safety-net health care institutions, which serve a range of vulnerable populations with limited access, limited options, and significant health disparities. Safety-net hospitals, particularly public hospitals with fewer resources than academic medical centers and other nonprofit hospitals that also serve as safety nets, are under immense financial pressures. However, with the introduction in 2011 of standards for LGBT inclusion by The Joint Commission, showing progress on LGBT health care has become a compliance issue for hospitals. And because the health care community itself has contributed to LGBT health disparities through prejudice, disrespect, or inadequate knowledge that have made it difficult for LGB and especially T people to seek care or to obtain the care they need, there is a moral case for allocating scarce resources to this population: we owe them some investment in righting wrongs that the health care system itself has produced. So, where to begin in the typical safety-net hospital or clinic? Beyond staff training, which is essential and for which good models now exist, what does justice demand from a service-utilization perspective? Given the range of health care services that an LGBT person in the safety net may need or want, how should we set priorities? And what can't we promise to do for this member of our community? © 2014 by The Hastings Center.

  17. Dynamic Antenna Alignment Control in Microwave Air-Bridging for Sky-Net Mobile Communication Using Unmanned Flying Platform

    Directory of Open Access Journals (Sweden)

    Chin E. Lin


    Full Text Available This paper presents a preliminary study on establishing a mobile point-to-point (P2P microwave air-bridging (MAB between Unmanned Low Altitude Flying Platform (ULAFP and backhaul telecommunication network. The proposed Sky-Net system relays telecom signal for general mobile cellphone users via ULAFP when natural disaster sweeps off Base Transceiver Stations (BTSs. Unlike the conventional fix point microwave bridging application, the ULAFP is cruising on a predefined mission flight path to cover a wider range of service. The difficulty and challenge fall on how to maintain antenna alignment accurately in order to provide the signal strength for MAB. A dual-axis rotation mechanism with embedded controller is designed and implemented on airborne and ground units for stabilizing airborne antenna and tracking the moving ULAFP. The MAB link is established in flight tests using the proposed antenna stabilizing/tracking mechanism with correlated control method. The result supports backbone technique of the Sky-Net mobile communication and verifies the feasibility of airborne e-Cell BTS.

  18. Internet Safety and Malaysian Students: A Study of Female Undergraduates and Their Net Pals

    Directory of Open Access Journals (Sweden)

    Cheong Lee Mei, Dianne


    Full Text Available Malaysian female undergraduates are perceived as able to rationally evaluate and estimate risks towards Net pals. Friendship is secured online while deception and fraud are revealed offline. Based on what they have been informed, the female undergraduates may know their Net pals’ likes and dislikes but the invisible cyber veil does not allow them to penetrate the illusion and accurately evaluate a person’s character and personality. This study examined how Malaysian female undergraduates use the Internet, perceive risks in meeting Net pals and the safety awareness surrounding cyber friendship. Responses of 118 female undergraduates (43% from UiTM, 30% from UM, 27% from MMU to a survey indicated that Net pals were befriended through chat rooms and websites. More than half of the female undergraduates would have a face-to-face meeting with their Net pals without the knowledge of relevant parties and have done at least one potentially unsafe behaviour. If the extent and level of Internet safety awareness is known, the problem of Internet deception that might lead to potential social problems such as rape and sexual abuse can be effectively addressed.

  19. Risk Assessment for Bridges Safety Management during Operation Based on Fuzzy Clustering Algorithm

    Directory of Open Access Journals (Sweden)

    Xia Hanyu


    Full Text Available In recent years, large span and large sea-crossing bridges are built, bridges accidents caused by improper operational management occur frequently. In order to explore the better methods for risk assessment of the bridges operation departments, the method based on fuzzy clustering algorithm is selected. Then, the implementation steps of fuzzy clustering algorithm are described, the risk evaluation system is built, and Taizhou Bridge is selected as an example, the quantitation of risk factors is described. After that, the clustering algorithm based on fuzzy equivalence is calculated on MATLAB 2010a. In the last, Taizhou Bridge operation management departments are classified and sorted according to the degree of risk, and the safety situation of operation departments is analyzed.

  20. 76 FR 53827 - Safety Zone; Big Sioux River From the Military Road Bridge North Sioux City to the Confluence of... (United States)


    ... rule extends the existing temporary safety zone on the Big Sioux River from the Military Road Bridge in... Military Road Bridge in North Sioux City to the confluence of the Missouri River and extending the entire... Sioux River from the Military Road Bridge in North Sioux City, South Dakota at 42.52 degrees North, 096...

  1. The Employment Guarantee Scheme as a Social Safety Net - Poverty Dynamics and Poverty Alleviation


    Katsushi Imai


    This paper investigates the dynamic aspects of poverty and anti-poverty interventions, particularly focusing on promotional effects, i.e., the effects of helping the poor escape poverty and protective effects, i.e., the effects of preventing the non-poor from slipping into poverty. We test the effectiveness of the Employment Guarantee Scheme (EGS) in rural India as a social safety net drawing upon the ICRISAT survey data. We have carried out the econometric analysis, namely Cox Proportional H...

  2. Reducing Poverty and Investing in People : The New Role of Safety Nets in Africa


    Monchuk, Victoria


    For two decades, Africa’s strong economic growth has paved the way for poverty reduction. Nevertheless, high chronic poverty levels persist, and the gap between income groups in terms of human capital and access to basic services is growing. Also, poor households are vulnerable to frequent shocks. By providing regular, reliable support to poor households and helping them invest in productive activities, targeted interventions such as safety nets help reduce persistent poverty, reverse the tre...

  3. Study protocol for "Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET)": a pragmatic trial comparing implementation strategies. (United States)

    Gold, Rachel; Hollombe, Celine; Bunce, Arwen; Nelson, Christine; Davis, James V; Cowburn, Stuart; Perrin, Nancy; DeVoe, Jennifer; Mossman, Ned; Boles, Bruce; Horberg, Michael; Dearing, James W; Jaworski, Victoria; Cohen, Deborah; Smith, David


    Little research has directly compared the effectiveness of implementation strategies in any setting, and we know of no prior trials directly comparing how effectively different combinations of strategies support implementation in community health centers. This paper outlines the protocol of the Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET), a trial designed to compare the effectiveness of several common strategies for supporting implementation of an intervention and explore contextual factors that impact the strategies' effectiveness in the community health center setting. This cluster-randomized trial compares how three increasingly hands-on implementation strategies support adoption of an evidence-based diabetes quality improvement intervention in 29 community health centers, managed by 12 healthcare organizations. The strategies are as follows: (arm 1) a toolkit, presented in paper and electronic form, which includes a training webinar; (arm 2) toolkit plus in-person training with a focus on practice change and change management strategies; and (arm 3) toolkit, in-person training, plus practice facilitation with on-site visits. We use a mixed methods approach to data collection and analysis: (i) baseline surveys on study clinic characteristics, to explore how these characteristics impact the clinics' ability to implement the tools and the effectiveness of each implementation strategy; (ii) quantitative data on change in rates of guideline-concordant prescribing; and (iii) qualitative data on the "how" and "why" underlying the quantitative results. The outcomes of interest are clinic-level results, categorized using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, within an interrupted time-series design with segmented regression models. This pragmatic trial will compare how well each implementation strategy works in "real-world" practices. Having a better understanding of how different

  4. Integral urban project and safety. Building barriers or bridges?

    CSIR Research Space (South Africa)

    Landman, K


    Full Text Available Planning and design measures can be utilised successfully to enhance feelings of safety in areas where people feel vulnerable. The study of the relationship between crime and the physical environment has resulted in various theoretical approaches...

  5. The North Carolina Healthcare Safety Net, 2005: fragments of a lifeline serving the uninsured. (United States)

    Silberman, Pam; Odom, Carmen Hooker; Smith, Sherwood; Dubay, Kristen L; Thompson, Kristie Weisner


    North Carolina is in the midst of a quiet, but growing healthcare crisis. The number of uninsured residents is rising at an alarming rate--and a faster rate than in most other states. Almost one of every five (20%) non-elderly North Carolinians have no health insurance, which means a sizeable portion of our population has unmet healthcare needs. As healthcare costs continue to increase, North Carolina is likely to continue seeing increased numbers of uninsured. Until we can dramatically reduce the volume of the uninsured, there will be a continuing and growing need for governmental, private sector, and voluntary healthcare providers to serve this population. In this issue of the Journal, we have attempted to draw attention to the volume and variety of services, programs, and organizations involved in meeting this important healthcare need among our state's most vulnerable populations. The organizations involved in rendering these services, and the private physicians and other healthcare professionals who give of their time and talents to meet these needs, are stretched to their limits in most communities. The Task Force has recommended several concrete steps that would shore up safety net organizations' and individual providers' capacity/ability to meet these needs. Some of these steps will require rather straightforward changes in regulations and laws governing the provision of healthcare services. Others will require appropriation of funds to augment the public, private, and voluntary support now given through these safety net provider organizations in support of their efforts to serve the uninsured. While some effort needs to be made to bring these issues to the attention of the state's Congressional delegation in Washington, DC, many of these problems should not have to wait for federal action. The needs are great, and the demands for service are increasing among those organizations and professionals who have assumed these responsibilities in counties and

  6. Bridges

    NARCIS (Netherlands)

    Zant, W.


    We estimate to what extent bridges in Mozambique lead to transport cost reductions and attribute these reductions to key determinants, in particular road distance, road quality and crossing borders. For identification we exploit the introduction of a road bridge over the Zambezi river, in August

  7. 76 FR 25278 - Safety Zone; TriMet Bridge Project, Willamette River; Portland, OR (United States)


    ..., which will then become highlighted in blue. In the ``Document Type'' drop down menu select ``Proposed..., will be starting construction of the new Portland-Milwaukie Light Rail Bridge on July 1, 2011 (with in... traffic. The rule will only limit entry into certain areas of the river for safety; the other section of...

  8. 76 FR 53054 - Safety Zone; TriMet Bridge Project, Willamette River; Portland, OR (United States)


    ... 2011 through October 2014. The project includes the construction of four piers, two on land and two... safety zone during the construction of the TriMet Bridge on the Willamette River, in Portland, OR. This... close proximity to cranes and overhead work associated with this construction project. During the...

  9. Low-Value Medical Services in the Safety-Net Population. (United States)

    Barnett, Michael L; Linder, Jeffrey A; Clark, Cheryl R; Sommers, Benjamin D


    National patterns of low-value and high-value care delivered to patients without insurance or with Medicaid could inform public policy but have not been previously examined. To measure rates of low-value care and high-value care received by patients without insurance or with Medicaid, compared with privately insured patients, and provided by safety-net physicians vs non-safety-net physicians. This multiyear cross-sectional observational study included all patients ages 18 to 64 years from the National Ambulatory Medical Care Survey (2005-2013) and the National Hospital Ambulatory Medical Care Survey (2005-2011) eligible for any of the 21 previously defined low-value or high-value care measures. All measures were analyzed with multivariable logistic regression and adjusted for patient and physician characteristics. Comparison of patients by insurance status (uninsured/Medicaid vs privately insured) and safety-net physicians (seeing >25% uninsured/Medicaid patients) vs non-safety-net physicians (seeing 1%-10%). Delivery of 9 low-value or 12 high-value care measures, based on previous research definitions, and composite measures for any high-value or low-value care delivery during an office visit. Overall, 193 062 office visits were eligible for at least 1 measure. Mean (95% CI) age for privately insured patients (n = 94 707) was 44.7 (44.5-44.9) years; patients on Medicaid (n = 45 123), 39.8 (39.3-40.3) years; and uninsured patients (n = 19 530), 41.9 (41.5-42.4) years. Overall, low-value and high-value care was delivered in 19.4% (95% CI, 18.5%-20.2%) and 33.4% (95% CI, 32.4%-34.3%) of eligible encounters, respectively. Rates of low-value and high-value care delivery were similar across insurance types for the majority of services examined. Among Medicaid patients, adjusted rates of use were no different for 6 of 9 low-value and 9 of 12 high-value services compared with privately insured beneficiaries, whereas among the uninsured, rates were no

  10. Patient Experience of Chronic Illness Care and Medical Home Transformation in Safety Net Clinics. (United States)

    Tung, Elizabeth L; Gao, Yue; Peek, Monica E; Nocon, Robert S; Gunter, Kathryn E; Lee, Sang Mee; Chin, Marshall H


    To examine the relationship between medical home transformation and patient experience of chronic illness care. Thirteen safety net clinics located in five states enrolled in the Safety Net Medical Home Initiative. Repeated cross-sectional surveys of randomly selected adult patients were completed at baseline (n = 303) and postintervention (n = 271). Questions from the Patient Assessment of Chronic Illness Care (PACIC) (100-point scale) were used to capture patient experience of chronic illness care. Generalized estimating equation methods were used to (i) estimate how differential improvement in patient-centered medical home (PCMH) capability affected differences in modified PACIC scores between baseline and postintervention, and (ii) to examine cross-sectional associations between PCMH capability and modified PACIC scores for patients at completion of the intervention. In adjusted analyses, high PCMH improvement (above median) was only marginally associated with a larger increase in total modified PACIC score (adjusted β = 7.7, 95 percent confidence interval [CI]: -1.1 to 16.5). At completion of the intervention, a 10-point higher PCMH capability score was associated with an 8.9-point higher total modified PACIC score (95 percent CI: 3.1-14.7) and higher scores in four of five subdomains (patient activation, delivery system design, contextual care, and follow-up/coordination). We report that sustained, 5-year medical home transformation may be associated with modest improvement in patient experience of chronic illness care for vulnerable populations in safety net clinics. © Health Research and Educational Trust.

  11. Patient portal readiness among postpartum patients in a safety net setting. (United States)

    Wieland, Daryl; Gibeau, Anne; Dewey, Caitlin; Roshto, Melanie; Frankel, Hilary


    Maternity patients interact with the healthcare system over an approximately ten-month interval, requiring multiple visits, acquiring pregnancy-specific education, and sharing health information among providers. Many features of a web-based patient portal could help pregnant women manage their interactions with the healthcare system; however, it is unclear whether pregnant women in safety-net settings have the resources, skills or interest required for portal adoption. In this study of postpartum patients in a safety net hospital, we aimed to: (1) determine if patients have the technical resources and skills to access a portal, (2) gain insight into their interest in health information, and (3) identify the perceived utility of portal features and potential barriers to adoption. We developed a structured questionnaire to collect demographics from postpartum patients and measure use of technology and the internet, self-reported literacy, interest in health information, awareness of portal functions, and perceived barriers to use. The questionnaire was administered in person to women in an inpatient setting. Of the 100 participants surveyed, 95% reported routine internet use and 56% used it to search for health information. Most participants had never heard of a patient portal, yet 92% believed that the portal functions were important. The two most appealing functions were to check results and manage appointments. Most participants in this study have the required resources such as a device and familiarity with the internet to access a patient portal including an interest in interacting with a healthcare institution via electronic means. Pregnancy is a critical episode of care where active engagement with the healthcare system can influence outcomes. Healthcare systems and portal developers should consider ways to tailor a portal to address the specific health needs of a maternity population including those in a safety net setting.

  12. In a safety net population HPV4 vaccine adherence worsens as BMI increases.

    Directory of Open Access Journals (Sweden)

    Diane M Harper

    Full Text Available Obesity adversely inhibits antibody response to vaccination. Three doses of HPV4 may or may not provide adequate long term protection against HPV 16/18 in obese females. The aim of this study was to determine whether adherence to HPV4 vaccination in a safety net population was reduced with increasing body mass index (BMI.We designed a historical prospective study evaluating the number and dates of HPV4 dosing that occurred from July 1, 2006 through October 1, 2009 by the demographic characteristics of the 10-26 year old recipient females. The defined dosing intervals were adapted from the literature and obesity categories were defined by the WHO.1240 females with BMI measurements received at least one dose of HPV4; 38% were obese (class I, II and III and 25% were overweight. Females with normal BMI received on-time triplet dosing significantly more often than did the obese class II and III females (30% vs. 18%, p<0.001. Obese class II/III females have a significant 45% less chance of completing the on-time triplet HPV4 series than normal women (OR = 0.55, 95% CI: 0.37, 0.83. Pregnancy history has a significant influence on BMI and HPV4 dosing compliance in this safety net population where 71% had been gravid. Hispanic females were less likely to complete HPV4 dosing regardless of BMI (aOR = 0.39, 95% CI: 0.16, 0.95.Obesity, as well as gravidity and Hispanic race, are risk factors for lack of HPV4 vaccine adherence among young females in a safety net population.

  13. CEDRIC: a computerized chronic disease management system for urban, safety net clinics. (United States)

    Ogunyemi, Omolola; Mukherjee, Sukrit; Ani, Chizobam; Hindman, David; George, Sheba; Ilapakurthi, Ramarao; Verma, Mary; Dayrit, Melvin


    To meet the challenge of improving health care quality in urban, medically underserved areas of the US that have a predominance of chronic diseases such as diabetes, we have developed a new information system called CEDRIC for managing chronic diseases. CEDRIC was developed in collaboration with clinicians at an urban safety net clinic, using a community-participatory partnered research approach, with a view to addressing the particular needs of urban clinics with a high physician turnover and large uninsured/underinsured patient population. The pilot implementation focuses on diabetes management. In this paper, we describe the system's architecture and features.

  14. Targeting International Food Aid Programmes: The Case of Productive Safety Net Programme in Tigray, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hossein Azadi


    Full Text Available Ethiopia has experienced more than five major droughts in the past three decades, leading to high dependency on international food aids. Nevertheless, studies indicate that asset depletion has not been prevented; neither did food insecurity diminish. Since 2004/5, the Productive Safety Net Programme (PSNP has been implemented to improve food security in Tigray, Northern Ethiopia. Critics point out that the implementation of food aid programmes can have negative impacts as well as positive outcomes for local communities. Accordingly, this survey study aimed to analyse the distribution and allocation of food aids in the Productive Safety Net Programme (PSNP in Tigray. Results of 479 interviews revealed that targeting different households in the PSNP has been considerably linked to socio-demographic attributes among which age and size of family were decisive factors to receive food aids. Furthermore, older households with smaller family size received more direct support. Inequality between genders was another major finding of this study. When combined with the marital status, there was also a big difference in the percentage of married or unmarried women receiving food aids. These findings could provide fundamental information for policy intervention to correct food security programmes at household level and reduce hunger. Given that, socio-demographic factors can help to identify particular and usually different requirements, vulnerabilities and coping strategies of the members of the food aid programme, so that they can be much more addressed when an emergency happens.

  15. Vaccine adverse events in a safety net healthcare system and a managed care organization. (United States)

    Narwaney, Komal J; Breslin, Kristin; Ross, Colleen A; Shoup, Jo Ann; Wain, Kris F; Weintraub, Eric S; McNeil, Michael M; Hambidge, Simon J


    The Institute of Medicine, in a 2013 report, recommended that the Vaccine Safety Datalink (VSD) expand collaborations to include more diversity in the study population. Kaiser Permanente Colorado (KPCO), an established VSD site, partnered with Denver Health (DH), an integrated safety net healthcare system, to demonstrate the feasibility of integrating DH data within the VSD. Prior to incorporating the data, we examined the identification of specific vaccine associated adverse events (VAEs) in these two distinct healthcare systems. We conducted retrospective cohort analyses within KPCO and DH to compare select VAEs between the two populations. We examined the following associations between January 1, 2004 and December 31, 2013: Measles, Mumps, and Rubella (MMR) vaccine and febrile seizures in children 2years and younger, intussusception after rotavirus vaccine in infants 4-34weeks, syncope after adolescent vaccines (Tetanus, Diphtheria, acellular Pertussis; Meningococcal and Human Papillomavirus) in adolescents 13-17years and medically attended local reactions after pneumococcal polysaccharide (PPSV23) vaccine in adults 65years and older. Both sites used similar data procurement methods and chart review processes. For seizures after MMR vaccine (KPCO - 3.15vs. DH - 2.97/10,000 doses) and syncope after all adolescent vaccines (KPCO - 3.0vs. DH - 2.37/10,000 doses), the chart confirmed rates were comparable at the two sites. However, for medically attended local reactions after PPSV23, there were differences in chart confirmed rates between the sites (KPCO - 31.65vs. DH - 14.90/10,000 doses). For intussusception after rotavirus vaccine, the number of cases was too low to make a valid comparison (KPCO - 0vs. DH - 0.13/10,000 doses). We demonstrated that data on important targeted VAEs can be captured at DH and rates appear similar to those at KPCO. Work is ongoing on the optimal approach to assimilate DH data as a potential safety net healthcare system in the VSD

  16. 77 FR 35900 - Safety Zone; Gilmerton Bridge Center Span Float-in, Elizabeth River; Norfolk, Portsmouth, and... (United States)


    ...The Coast Guard proposes establishing a safety zone on the navigable waters of the Elizabeth River in Norfolk, Portsmouth, and Chesapeake, VA. This action is necessary to provide for the safety of life on navigable waters during the Gilmerton Bridge Center Span Float- in and bridge construction of span placement. This action is intended to restrict vessel traffic movement to protect mariners from the hazards associated with the float-in and span placement.

  17. 77 FR 73541 - Safety Zone: Gilmerton Bridge Center Span Float-in, Elizabeth River; Norfolk, Portsmouth, and... (United States)


    ...The Coast Guard will establish a temporary safety zone on the navigable waters of the Elizabeth River in Norfolk, Portsmouth, and Chesapeake, VA. This action is necessary to provide for the safety of life on navigable waters during the Gilmerton Bridge Center Span Float- in and bridge construction of span placement. This action is intended to restrict vessel traffic movement to protect mariners from the hazards associated with the float-in and span placement.

  18. NPOESS C3S Expandability: SafetyNetTM and McMurdo Improvements (United States)

    Jamilkowski, M. L.; Paciaroni, J.; Pela, F.


    The National Oceanic & Atmospheric Administration (NOAA), Department of Defense (DoD), and National Aeronautics & Space Administration (NASA) are jointly acquiring the next-generation weather & environmental satellite system; the National Polar-orbiting Operational Environmental Satellite System (NPOESS). NPOESS replaces the current NOAA Polar-orbiting Operational Environmental Satellites (POES) and Dod's Defense Meteorological Satellite Program (DMSP). The NPOESS satellites carry a suite of sensors that collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The command & telemetry portion of NPOESS is the Command, Control and Communications Segment (C3S), developed by Raytheon Intelligence & Information Systems. C3S is responsible for managing the overall NPOESS mission from control and status of the space and ground assets to ensuring delivery of timely, high quality data from the Space Segment (SS) to the Interface Data Processing Segment (IDPS) for processing. In addition, the C3S provides the globally distributed ground assets necessary to collect and transport mission, telemetry, and command data between the satellites and the processing locations. The C3S provides all functions required for day-to-day commanding & state-of-health monitoring of the NPP & NPOESS satellites, and delivery of Stored Mission Data (SMD) to each US Weather Central Interface Data Processor (IDP) for data products development and transfer to System subscribers. The C3S also monitors and reports system-wide health and status & data communications with external systems and between NPOESS segments. Two crucial elements of NPOESS C3S expandability are SafetyNetTM and communications improvements to McMurdo Station, Antarctica. SafetyNetTM is a key feature of NPOESS and a vital element of the C3S and Northrop Grumman Aerospace Systems patented data collection architecture. The centerpiece of SafetyNetTM is the system of

  19. Patient-Centered Medical Home Intervention at an Internal Medicine Resident Safety-Net Clinic (United States)

    Hochman, Michael E.; Asch, Steven; Jibilian, Arek; Chaudry, Bharat; Ben-Ari, Ron; Hsieh, Eric; Berumen, Margaret; Mokhtari, Shahrod; Raad, Mohamad; Hicks, Elisabeth; Sanford, Crystal; Aguirre, Norma; Tseng, Chi-hong; Vangala, Sitaram; Mangione, Carol M.; Goldstein, David A.


    IMPORTANCE The patient-centered medical home (PCMH) model holds promise for improving primary care delivery, but it has not been adequately tested in teaching settings. DESIGN, SETTING, AND PARTICIPANTS We implemented an intervention guided by PCMH principles at a safety-net teaching clinic with resident physician providers. Two similar clinics served as controls. MAIN OUTCOMES AND MEASURES Using a cross-sectional design, we measured the effect on patient and resident satisfaction using the Consumer Assessment of Healthcare Providers and Systems survey and a validated teaching clinic survey, respectively. Both surveys were conducted at baseline and 1 year after the intervention. We also measured the effect on emergency department and hospital utilization. RESULTS Following implementation of our intervention, the clinic’s score on the National Committee for Quality Assurance’s PCMH certification tool improved from 35 to 53 of 100 possible points, although our clinic did not achieve all must-pass elements to qualify as a PCMH. During the 1-year study period, 4676 patients were exposed to the intervention; 39.9% of these used at least 1 program component. Compared with baseline, patient-reported access and overall satisfaction improved to a greater extent in the intervention clinic, and the composite satisfaction rating increased from 48% to 65% in the intervention clinic vs from 50% to 59% in the control sites (P = .04). The improvements were particularly notable for questions relating to access. For example, satisfaction with urgent appointment scheduling increased from 12% to 53% in the intervention clinic vs from 14% to 18% in the control clinics (P < .001). Resident satisfaction also improved in the intervention clinic: the composite satisfaction score increased from 39% to 51% in the intervention clinic vs a decrease from 46%to 42% in the control clinics (P = .01). Emergency department utilization did not differ significantly between the intervention and

  20. Application of Petri nets to reliability prediction of occupant safety systems with partial detection and repair

    Energy Technology Data Exchange (ETDEWEB)

    Kleyner, Andre, E-mail: [Delphi Corporation, Electronics and Safety Division, P.O. Box 9005, M.S. CTC 2E, Kokomo, IN 46904 (United States); Volovoi, Vitali, E-mail: vitali.volovoi@ae.gatech.ed [School of Aerospace Engineering, Georgia Institute of Technology, Atlanta, GA 30332 (United States)


    This paper presents an application of stochastic Petri nets (SPN) to calculate the availability of safety critical on-demand systems. Traditional methods of estimating system reliability include standards-based or field return-based reliability prediction methods. These methods do not take into account the effect of fault-detection capability and penalize the addition of detection circuitry due to the higher parts count. Therefore, calculating system availability, which can be linked to the system's probability of failure on demand (P{sub fd}), can be a better alternative to reliability prediction. The process of estimating the P{sub fd} of a safety system can be further complicated by the presence of system imperfections such as partial-fault detection by users and untimely or uncompleted repairs. Additionally, most system failures cannot be represented by Poisson process Markov chain methods, which are commonly utilized for the purposes of estimating P{sub fd}, as these methods are not well-suited for the analysis of non-Poisson failures. This paper suggests a methodology and presents a case study of SPN modeling adequately handling most of the above problems. The model will be illustrated with a case study of an automotive electronics airbag controller as an example of a safety critical on-demand system.

  1. Is Informal Employment a Safety Net in Times of Crisis? Evidence from Serbia

    Directory of Open Access Journals (Sweden)

    Anna Jaskova


    Full Text Available This paper deals with the analysis of movements and causes of the informal employment in Serbia from the period of 1990s until the present time. Based on the results of the survey, it is not possible to confirm the assumption that informal employment rises in the years of economic crises and falls during economic recovery. Since informal employment can have the same trend as formal employment i.e. to fall in the times of crisis, it cannot be the safety net for those who are formally unemployed. Economic growth, however, cannot secure the decrease in absolute nor relative level of informal employment. Inadequate economic policies and labour market institutions can countermand the positive impact of economic growth on the labour formalisation. Therefore, the creation of proper labour market policies and institutional environment should be the central goals for policymakers in both economic crisis as well as economic growth periods.

  2. Factors associated with cervical cancer screening in a safety net population. (United States)

    Heberer, Meredith A; Komenaka, Ian K; Nodora, Jesse N; Hsu, Chiu-Hsieh; Gandhi, Sonal G; Welch, Lauren E; Bouton, Marcia E; Aristizabal, Paula; Weiss, Barry D; Martinez, Maria Elena


    To identify factors associated with Papanicolaou-smear (Pap-smear) cervical cancer screening rates in a safety net population. From January 2012 to May 2013, the use of Pap-smear was determined for all patients seen at the breast clinic in a safety net hospital. Health literacy assessment was performed using the validated Newest Vital Sign. The records of patients were reviewed to determine if they had undergone Pap-smears for cervical cancer screening. Sociodemographic information was collected included age, education, monthly income, race/ethnicity, employment, insurance status, and primary care provider of the patient. Logistic regression analysis was then performed to determine factors associated with utilization of Pap-smears. Crude and adjusted odds ratios derived from multivariate logistic regression models were calculated as well as the associated 95%CIs and P-values. Overall, 39% had Pap-smears in the prior 15 mo, 1377 consecutive women were seen during the study period and their records were reviewed. Significantly more patients with adequate health literacy underwent Pap-smears as compared to those with limited health literacy (59% vs 34%, P < 0.0001). In multivariate analysis, patients with adequate health literacy, younger patients, and those with later age of first live birth were more likely to undergo Pap-smears. Patients whose primary care providers were gynecologists were also significantly more likely to have Pap-smears compared to other specialties (P < 0.0001). Patients younger than 21 years or older than 65 years underwent screening less frequently (11% and 11%, respectively) than those 21-64 years (41%, P < 0.0001). Race, ethnicity, language, and insurance status were not associated with Pap-smear screening rates. Patient health literacy and primary care physician were associated with Pap-smear utilization. Development of interventions to target low health literacy populations could improve cervical cancer screening.

  3. Internet access and online cancer information seeking among Latino immigrants from safety net clinics. (United States)

    Selsky, Claire; Luta, George; Noone, Anne-Michelle; Huerta, Elmer E; Mandelblatt, Jeanne S


    Internet use is widespread, but little is known about Internet use for cancer information among Latinos, especially those who rely on safety net clinics. The authors investigated access to and intended use of the Internet for cancer information among low income, immigrant Latinos predominately from Central and South America. A cross-sectional study of 1,273 Latinos 21 years and older attending safety net clinics or health fairs was conducted from June 2007 to November 2008. The authors used logistic regression models to evaluate associations of age, acculturation, psychosocial factors and other covariates with Internet access and intended use of the Internet for cancer information among those with access. Of the sample, 44% reported Internet access. Higher information self-efficacy and greater trust in the Internet were independently associated with Internet access (p = .05 and p access, 53.8% reported they intended to seek cancer help online if they needed information. Those with younger age and higher acculturation, education and self-efficacy had higher odds of intended Internet use for cancer information, considering covariates. In addition, those with high (vs. low) perceived risk of cancer (OR = 1.76; 95% CI [1.14, 2.73]; p = .01) and higher levels of trust in online health information (OR = 1.47 per one-point increase; 95% [CI 1.19, 1.82]; p = .0004) were more likely to intend to seek cancer information online. These findings that Internet access is fairly high in the immigrant Latino population and that the Internet is a trusted source of cancer information suggest that the Internet may be a channel for cancer control interventions.

  4. From striving to thriving: systems thinking, strategy, and the performance of safety net hospitals. (United States)

    Clark, Jonathan; Singer, Sara; Kane, Nancy; Valentine, Melissa


    Safety net hospitals (SNH) have, on average, experienced declining financial margins and faced an elevated risk of closure over the past decade. Despite these challenges, not all SNHs are weakening and some are prospering. These higher-performing SNHs provide substantial care to safety net populations and produce sustainable financial returns. Drawing on the alternative structural positioning and resource-based views, we explore strategic management as a source of performance differences across SNHs. We employ a mixed-method design, blending quantitative and qualitative data and analysis. We measure financial performance using hospital operating margin and quantitatively evaluate its relationship with a limited set of well-defined structural positions. We further evaluate these structures and also explore the internal resources of SNHs based on nine in-depth case studies developed from site visits and extensive interviews. Quantitative results suggest that structural positions alone are not related to performance. Comparative case studies suggest that higher-performing SNH differ in four respects: (1) coordinating patient flow across the care continuum, (2) engaging in partnerships with other providers, (3) managing scope of services, and (4) investing in human capital. On the basis of these findings, we propose a model of strategic action related to systems thinking--the ability to see wholes and interrelationships rather than individual parts alone. Our exploratory findings suggest the need to move beyond generic strategies alone and acknowledge the importance of underlying managerial capabilities. Specifically, our findings suggest that effective strategy is a function of both the internal resources (e.g., managers' systems-thinking capability) and structural positions (e.g., partnerships) of organizations. From this perspective, framing resources and positioning as distinct alternatives misses the nuances of how strategic advantage is actually achieved.

  5. Safety barriers for motorways : shoulder and bridge safety barriers and impact attenuators surveyed and assessed.

    NARCIS (Netherlands)

    Schoon, C.C. Heijer, T. Pol, W.H.M. van de & Jordaan, D.J.R.


    The various types and practical qualities of deformable and non-deformable safety barriers are listed. The main conclusions drawn from tests based on several safety criteria are : various types of deformable barriers (steel guide rails) perform well when hit by cars; various types of deformable

  6. Vaccines and Internet: characteristics of the vaccine safety net web sites and suggested improvements. (United States)

    Martínez-Mora, Marta; Alvarez-Pasquín, María José; Rodríguez-Salvanés, Francisco


    The Internet contains a large amount of useful information on many subjects, but also information of doubtful quality. To help identify Web sites on vaccine safety that fulfil good practice, the Global Advisory Committee on Vaccine Safety of the World Health Organization (WHO) has published criteria to which sites should adhere and a listing of Web sites that fulfil them. There are no studies describing the common attributes of these sites. To examine the attributes, design characteristics and resources of Web sites belonging to the Vaccine Safety Net (VSN) of the WHO. A cross-sectional, descriptive observational study using an evaluation questionnaire was carried out applied to the VSN web sites listed in March-April 2007. Twenty-six Web sites accredited by the VSN by April 2007 were analysed. With respect to design and quality, all sites contained information about the site manager. Postal and Email addresses were available for 84.6% of the sites. About privacy and personal data processing, 73.1% of sites specified the data protection procedure used and stated that data were not sold or passed third parties. The most-used language was English (76.9%). 96.3% of sites had links to other pro-vaccination sites and 19.2% provided the addresses of vaccination centres. 63.6% of webs were aimed at general public and health care workers but there was no clear separation of documents or different entry routes. With respect to information on vaccine safety, 84.6% of sites had information on adverse effects. In the general information section, 92.3% of sites had a new developments section. Some sites had multiple sources of financing and in 57% of sites, the financing was public. The most-important plus factors found were the transparency of financing, the lack of links to the pharmaceutical industry, the transparency of site management and responsibility and the proven scientific quality and constant updating of contents.

  7. Bridging the Divide between Safety and Risk Management for your Project or Program (United States)

    Lutomski, Mike


    This presentation will bridge the divide between these separate but overlapping disciplines and help explain how to use Risk Management as an effective management decision support tool that includes safety. Risk Management is an over arching communication tool used by management to prioritize and effectively mitigate potential problems before they concur. Risk Management encompasses every kind of potential problem that can occur on a program or project. Some of these are safety issues such as hazards that have a specific likelihood and consequence that need to be controlled and included to show an integrated picture of accepted) mitigated, and residual risk. Integrating safety and other assurance disciplines is paramount to accurately representing a program s or projects risk posture. Risk is made up of several components such as technical) cost, schedule, or supportability. Safety should also be a consideration for every risk. The safety component can also have an impact on the technical, cost, and schedule aspect of a given risk. The current formats used for communication of safety and risk issues are not consistent or integrated. The presentation will explore the history of these disciplines, current work to integrate them, and suggestions for integration for the future.

  8. NPOESS C3S Expandability: SafetyNet(TM) and McMurdo Improvements (United States)

    Paciaroni, J.; Jamilkowski, M. L.


    The National Oceanic & Atmospheric Administration (NOAA), Department of Defense (DoD), and National Aeronautics and Space Administration (NASA) are jointly acquiring the next-generation weather and environmental satellite system; the National Polar-orbiting Operational Environmental Satellite System (NPOESS). NPOESS replaces the current Polar-orbiting Operational Environmental Satellites (POES) managed by NOAA and the Defense Meteorological Satellite Program (DMSP) managed by the DoD. The NPOESS satellites carry a suite of sensors that collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The command and telemetry portion of NPOESS is the Command, Control and Communications Segment (C3S), developed by Raytheon Intelligence & Information Systems. C3S is responsible for managing the overall NPOESS mission from control and status of the space and ground assets to ensuring delivery of timely, high quality data from the Space Segment (SS) to the Interface Data Processing Segment (IDPS) for processing. In addition, the C3S provides the globally distributed ground assets necessary to collect and transport mission, telemetry, and command data between the satellites and the processing locations. The C3S provides all functions required for day-to-day commanding and state-of-health monitoring of the NPP and NPOESS satellites, and delivery of Stored Mission Data (SMD) to each U.S. Weather Central Interface Data Processor (IDP) for data products development and transfer to System subscribers. The C3S also monitors and reports system-wide health and status and data communications with external systems and between the NPOESS segments. Two crucial elements of NPOESS C3S expandability are SafetyNet(TM) and communications improvements to McMurdo Station, Antarctica. ‘SafetyNet(TM)’ is a key feature of the National Polar-orbiting Operational Environmental Satellite System (NPOESS), vital element of the C3S

  9. Assessing Patient Activation among High-Need, High-Cost Patients in Urban Safety Net Care Settings. (United States)

    Napoles, Tessa M; Burke, Nancy J; Shim, Janet K; Davis, Elizabeth; Moskowitz, David; Yen, Irene H


    We sought to examine the literature using the Patient Activation Measure (PAM) or the Patient Enablement Instrument (PEI) with high-need, high-cost (HNHC) patients receiving care in urban safety net settings. Urban safety net care management programs serve low-income, racially/ethnically diverse patients living with multiple chronic conditions. Although many care management programs track patient progress with the PAM or the PEI, it is not clear whether the PAM or the PEI is an effective and appropriate tool for HNHC patients receiving care in urban safety net settings in the United States. We searched PubMed, EMBASE, Web of Science, and PsycINFO for articles published between 2004 and 2015 that used the PAM and between 1998 and 2015 that used the PEI. The search was limited to English-language articles conducted in the United States and published in peer-reviewed journals. To assess the utility of the PAM and the PEI in urban safety net care settings, we defined a HNHC patient sample as racially/ethnically diverse, low socioeconomic status (SES), and multimorbid. One hundred fourteen articles used the PAM. All articles using the PEI were conducted outside the U.S. and therefore were excluded. Nine PAM studies (8%) included participants similar to those receiving care in urban safety net settings, three of which were longitudinal. Two of the three longitudinal studies reported positive changes following interventions. Our results indicate that research on patient activation is not commonly conducted on racially and ethnically diverse, low SES, and multimorbid patients; therefore, there are few opportunities to assess the appropriateness of the PAM in such populations. Investigators expressed concerns with the potential unreliability and inappropriate nature of the PAM on multimorbid, older, and low-literacy patients. Thus, the PAM may not be able to accurately assess patient progress among HNHC patients receiving care in urban safety net settings. Assessing

  10. Evaluation of Policy Implementation at Norm Strategy Criteria Procedure Safety Management System that Influence the Safety Culture in Building Construction, Housing, Waterworks, Road and Bridge Project in Indonesia


    Yusuf Latief; Rossy Armyn Machfudiyanto; Brain Harryanto; Cahyadi Santoso


    Unideal Safety culture in Indonesia requires an evaluation of policy implementation refers to the construction safety regulation, Ministry Regulation 05/PRT/2014. Out of Norms, Standards, Procedures and Criteria (NSPK), we only have Norms and Procedure. As for Standard and Criteria are still being planned. This research on building, housing, water resource, roads and bridges construction at the Ministry of General Works and Housing resulted in having significant relation between safety policy...

  11. Risk exposure data : recommendations for collection and exploitation. SafetyNet, Building the European Road Safety Observatory, Workpackage 2, Deliverable 2.5.

    NARCIS (Netherlands)

    Duchamp, G. Treny, V. Hemdorff, S. Haddak, M. Holló, P. Cardoso, J. Papadimitriou, E. Yannis, G. Chaziris, A. Bijleveld, F. Bjørnskau, T. & Leiner, T.


    The present deliverable, as the last of work package 2 of SafetyNet dealing with risk exposure data, is the conclusion of four years work. In the light of the progress made from the State of the art to the common framework, including the practical case of the pilot study, its aim is to give

  12. Estimation real number of road accident casualties. SafetyNet, Building the European Road Safety Observatory, Deliverable D.1.15 : final report on task 1.5.

    NARCIS (Netherlands)

    Broughton, J. Amoros, E. Bos, N.M. Evgenikos, P. Hoeglinger, S. Holló, P. Pérez, C. & Tecl, J.


    The objective of Task 1.5 of the SafetyNet IP has been to estimate the actual numbers of road accident casualties in Europe from the CARE database by addressing two issues: • the under-reporting in national accident databases and • the differences between countries of the definitions used to

  13. Numerical Analysis of a Train-Bridge System Subjected to Earthquake and Running Safety Evaluation of Moving Train

    Directory of Open Access Journals (Sweden)

    Xun Yang


    Full Text Available This paper investigates the dynamic response of a train-bridge system subjected to earthquakes, and the running safety indices of the train on the bridge under earthquake are studied. Taking a long span cable-stayed bridge across the Huangpu River as an example, a full three-dimensional finite element model of the train-bridge system was established, in which the soil-bridge and rail-train interactions were considered. Parallel computing based on contact balance was utilized to deal with this large-scale numerical simulation problem. The dynamic nonlinear analysis was performed on a Hummingbird supercomputer using the finite element code LS-DYNA 971. The results show that the acceleration responses of the train subjected to an earthquake are much greater than the ones without earthquake input, and the running safety of a moving train is affected by both the earthquake intensity and the running speed of the train. The running safety of the moving train can be evaluated by the threshold curve between earthquake intensity and train speed. The proposed modeling strategies and the simulated results can give a reference prediction of the dynamic behaviour of the train-bridge subjected to an earthquake.

  14. Mobile phone use patterns and preferences in safety net office-based buprenorphine patients. (United States)

    Tofighi, Babak; Grossman, Ellie; Buirkle, Emily; McNeely, Jennifer; Gourevitch, Marc; Lee, Joshua D


    Integrating mobile phone technologies in addiction treatment is of increasing importance and may optimize patient engagement with their care and enhance the delivery of existing treatment strategies. Few studies have evaluated mobile phone and text message (TM) use patterns in persons enrolled in addiction treatment, and none have assessed the use in safety net, office-based buprenorphine practices. A 28-item, quantitative and qualitative semistructured survey was administered to opiate-dependent adults in an urban, publicly funded, office-based buprenorphine program. Survey domains included demographic characteristics, mobile phone and TM use patterns, and preferences pertaining to their recovery. Surveyors approached 73 of the 155 eligible subjects (47%); 71 respondents completed the survey. Nearly all participants reported mobile phone ownership (93%) and TM use (93%), and most reported "very much" or "somewhat" comfort sending TM (79%). Text message contact with 12-step group sponsors, friends, family members, and counselors was also described (32%). Nearly all preferred having their providers' mobile phone number (94%), and alerting the clinic via TM in the event of a potential relapse to receive both supportive TM and a phone call from their buprenorphine provider was also well received (62%). Mobile phone and TM use patterns and preferences among this sample of office-based buprenorphine participants highlight the potential of adopting patient-centered mobile phone-based interventions in this treatment setting.

  15. The use of open source electronic health records within the federal safety net. (United States)

    Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri


    To conduct a federally funded study that examines the acquisition, implementation and operation of open source electronic health records (EHR) within safety net medical settings, such as federally qualified health centers (FQHC). The study was conducted by the National Opinion Research Center (NORC) at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to West Virginia, California and Arizona FQHC that were currently using an open source EHR. Five of the six sites that were chosen as part of the study found a number of advantages in the use of their open source EHR system, such as utilizing a large community of users and developers to modify their EHR to fit the needs of their provider and patient communities, and lower acquisition and implementation costs as compared to a commercial system. Despite these advantages, many of the informants and site visit participants felt that widespread dissemination and use of open source was restrained due to a negative connotation regarding this type of software. In addition, a number of participants stated that there is a necessary level of technical acumen needed within the FQHC to make an open source EHR effective. An open source EHR provides advantages for FQHC that have limited resources to acquire and implement an EHR, but additional study is needed to evaluate its overall effectiveness.

  16. Safety-net Hospitals Face More Barriers Yet Use Fewer Strategies to Reduce Readmissions. (United States)

    Figueroa, Jose F; Joynt, Karen E; Zhou, Xiner; Orav, Endel J; Jha, Ashish K


    US hospitals that care for vulnerable populations, "safety-net hospitals" (SNHs), are more likely to incur penalties under the Hospital Readmissions Reduction Program, which penalizes hospitals with higher-than-expected readmissions. Understanding whether SNHs face unique barriers to reducing readmissions or whether they underuse readmission-prevention strategies is important. We surveyed leadership at 1600 US acute care hospitals, of whom 980 participated, between June 2013 and January 2014. Responses on 28 questions on readmission-related barriers and strategies were compared between SNHs and non-SNHs, adjusting for nonresponse and sampling strategy. We further compared responses between high-performing SNHs and low-performing SNHs. We achieved a 62% response rate. SNHs were more likely to report patient-related barriers, including lack of transportation, homelessness, and language barriers compared with non-SNHs (P-valuesbarriers, SNHs were less likely to use e-tools to share discharge summaries (70.1% vs. 73.7%, Pbarriers to reducing readmissions, SNHs were less likely to use readmission-reduction strategies. This combination of higher barriers and lower use of strategies may explain why SNHs have higher rates of readmissions and penalties under the Hospital Readmissions Reduction Program.

  17. Advanced bridge safety initiative : recommended practices for live load testing of existing flat-slab concrete bridges - task 5. (United States)


    Current AASHTO provisions for load rating flat-slab concrete bridges use the equivalent strip : width method, which is regarded as overly conservative compared to more advanced analysis : methods and field live load testing. It has been shown that li...

  18. Promoting HPV Vaccination in Safety-Net Clinics: A Randomized Trial. (United States)

    Tiro, Jasmin A; Sanders, Joanne M; Pruitt, Sandi L; Stevens, Clare Frey; Skinner, Celette Sugg; Bishop, Wendy P; Fuller, Sobha; Persaud, Donna


    Evaluate effects of a multicomponent intervention (human papillomavirus [HPV] vaccine-specific brochure and recalls) on HPV vaccination and secondarily examine if race/ethnicity moderates effects. Unvaccinated girls aged 11 to 18 years attending 4 safety-net pediatric clinics and their parent/guardian (n = 814 dyads) were randomized to (1) active comparison (general adolescent vaccine brochure), or (2) intervention consisting of a HPV vaccine-specific brochure, telephone recalls to parents who declined, and recalls to patients overdue for doses 2 and 3. HPV 1-dose and 3-dose coverages were assessed via electronic health records 12 months after randomization. Multivariate logistic regressions estimated adjusted odds and marginal predicted vaccine coverage by study arm and race/ethnicity. Intent-to-treat analyses found no main effect of the HPV vaccine-specific brochure on 1-dose coverage (42.0% vs 40.6%); however, secondary analyses found race/ethnicity was a significant moderator such that the intervention was effective only for Hispanic individuals (adjusted odds ratio [AOR] 1.43; 95% confidence interval [CI] 1.02-2.02), and not effective for black individuals (AOR 0.64; 95% CI 0.41-1.13). Recalls to parents who declined the vaccine during the index visit were not effective, but recalls to patients overdue for doses 2 and 3 were effective at increasing 3-dose coverage regardless of race/ethnicity (AOR 1.99; 95% CI 1.16-3.45). Educational materials describing only the HPV vaccine were effective for Hispanic but not black individuals. Future research should test mechanisms that may mediate intervention effects for different racial/ethnic groups, such as different informational needs or vaccine schemas (experiences, beliefs, norms). Copyright © 2015 by the American Academy of Pediatrics.

  19. The influence of perceived neighborhood disorder on smoking cessation among urban safety net hospital patients. (United States)

    Ma, Ping; Businelle, Michael S; Balis, David S; Kendzor, Darla E


    Although research has shown that objective neighborhood characteristics are associated with health behaviors including smoking, little is known about the influence of perceived neighborhood characteristics on a smoking cessation attempt. Participants (N=139) enrolled in a Dallas safety-net hospital smoking cessation program were followed from 1 week pre-quit through 4 weeks post-quit. Logistic regression analyses were conducted to evaluate the impact of perceived neighborhood order and disorder on the likelihood of achieving biochemically verified point prevalence and continuous smoking abstinence 4 weeks following a scheduled quit attempt. Analyses were adjusted for demographic characteristics, cigarettes per day, intervention group, and pharmacological treatment. Participants were primarily non-White (72.7%) and female (56.8%) with a mean age of 52.5 (SD=3.7) years. Most reported an annual household income of ≤$25,000 (86.3%). Logistic regression analyses indicated that greater neighborhood physical (p=.048) and social order (p=.039) were associated with a greater likelihood of achieving point prevalence smoking abstinence at 4 weeks post-quit. Greater perceived physical (p=.035) and social disorder (p=.039) and total neighborhood disorder (p=.014), were associated with a reduced likelihood of achieving point prevalence abstinence. Social disorder (p=.040) was associated with a reduced likelihood of achieving continuous abstinence at 4 weeks post-quit, while social order (p=.020) was associated with an increased likelihood of continuous abstinence. Perceptions of neighborhood order and disorder were associated with the likelihood of smoking cessation among socioeconomically disadvantaged smokers making a quit attempt. Findings highlight the need to address perceptions of the neighborhood environment among disadvantaged smokers seeking treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Factors associated with surgical management in an underinsured, safety net population. (United States)

    Winton, Lisa M; Nodora, Jesse N; Martinez, Maria Elena; Hsu, Chiu-Hsieh; Djenic, Brano; Bouton, Marcia E; Aristizabal, Paula; Ferguson, Elizabeth M; Weiss, Barry D; Komenaka, Ian K


    Few studies include significant numbers of racial and ethnic minority patients. The current study was performed to examine factors that affect breast cancer operations in an underinsured population. We performed a retrospective review of all breast cancer patients from January 2010 to May 2012. Patients with American Joint Committee on Cancer clinical stage 0-IIIA breast cancer underwent evaluation for type of operation: breast conservation, mastectomy alone, and reconstruction after mastectomy. The population included 403 patients with mean age 53 years. Twelve of the 50 patients (24%) diagnosed at stage IIIB presented with synchronous metastatic disease. Of the remaining patients, only 2 presented with metastatic disease (0.6%). The initial operation was 65% breast conservation, 26% mastectomy alone, and 10% reconstruction after mastectomy. Multivariate analysis revealed that Hispanic ethnicity (odds ratio [OR], 0.38; 95% CI, 0.19-0.73; P = .004), presentation with palpable mass (OR, 0.34; 95% CI, 0.13-0.90; P = .03), preoperative chemotherapy (OR, 0.25; 95% CI, 0.10-0.62; P = .003) were associated with a lesser likelihood of mastectomy. Multivariate analysis of factors associated with reconstruction after mastectomy showed that operation with Breast surgical oncologist (OR, 18.4; 95% CI, 2.18-155.14; P < .001) and adequate health literacy (OR, 3.13; 95% CI, 0.95-10.30; P = .06) were associated with reconstruction. The majority of safety net patients can undergo breast conservation despite delayed presentation and poor use of screening mammography. Preoperative chemotherapy increased the likelihood of breast conservation. Routine systemic workup in patients with operable breast cancer is not indicated. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Pragmatic trial of an intervention to increase human papillomavirus vaccination in safety-net clinics

    Directory of Open Access Journals (Sweden)

    Maureen Sanderson


    Full Text Available Abstract Background Human papillomavirus (HPV infection has been causally linked to six cancers, and many disproportionately affect minorties. This study reports on the development and effectiveness of an intervention aimed at increasing HPV vaccine uptake among African American and Hispanic pediatric patients in safety-net clinics. Methods Formative research, community engagement, and theory guided development of the intervention. A clustered, non-randomized controlled pragmatic trial was conducted in four clinics providing healthcare for the underserved in Tennessee, U.S., with two intervention sites and two usual care sites. Patients aged 9-18 years (N = 408 and their mothers (N = 305 enrolled, with children clustered within families. The intervention consisted of two provider/staff training sessions and provision of patient education materials, consisting of a video/flyer promoting HPV vaccine. Medical records were reviewed before/after the initial visit and after 12 months. Results At the initial visit, provision of patient education materials and provider recommendation were higher at intervention sites versus usual care sites, and receipt of HPV vaccine was higher at intervention sites (45.4% versus 32.9% but not significantly after adjusting for patient’s age and mother’s education. Provider recommendation, but not education materials, increased the likelihood of vaccine receipt at the initial visit, although over one-third of intervention mothers cited the flyer/video as motivating vaccination. Completion of the 3-dose series at follow-up was lower in the intervention arm. Conclusions Future interventions should combine patient education, intensive provider/staff education, and patient reminders. Research should compare patient education focusing on HPV vaccine only versus all adolescent vaccines. Trial registration Retrospectively registered with NCT02808832 , 9/12/16

  2. From social network to safety net: Dementia-friendly communities in rural northern Ontario. (United States)

    Wiersma, Elaine C; Denton, Alison


    Dementia-friendly communities, as communities that enable people with dementia to remain involved and active and have control over their lives for as long as possible, centrally involve social support and social networks for people living with dementia. The purpose of this research was to explore and understand the context of dementia in rural northern communities in Ontario with an emphasis on understanding how dementia friendly the communities were. Using qualitative methods, interviews were conducted with a total of 71 participants, including 37 health service providers, 15 care partners, 2 people living with dementia and 17 other community members such as local business owners, volunteers, local leaders, friends and neighbours. The strong social networks and informal social support that were available to people living with dementia, and the strong commitment by community members, families and health care providers to support people with dementia, were considered a significant asset to the community. A culture of care and looking out for each other contributed to the social support provided. In particular, the familiarity with others provided a supportive community environment. People with dementia were looked out for by community members, and continued to remain connected in their communities. The social support provided in these communities demonstrated that although fragile, this type of support offered somewhat of a safety net for individuals living with dementia. This work provides important insights into the landscape of dementia in rural northern Ontario communities, and the strong social supports that sustain people with dementia remaining in the communities. © The Author(s) 2013.

  3. Mobile health and patient engagement in the safety net: a survey of community health centers and clinics. (United States)

    Broderick, Andrew; Haque, Farshid


    Patient-centered technologies have emerged as a way to actively engage patients in care. The reach and potential of cell phones to engage diverse patient populations is great. Evidence of their effectiveness in improving health-related outcomes is limited. Researchers conducted an online survey of community health centers and clinics to assess if and how health care providers in the safety net use cell phones to support patient engagement. The findings indicate that the use of cell phones in patient care is at an early stage of deployment across the safety net. Organizations identify chronic disease management as an area where cell phones offer considerable potential to effectively engage patients. To promote widespread adoption and use, technical assistance to support the implementation and management of interventions, evidence-based or best practice models that highlight successful implementation strategies in care delivery, and the introduction of new payment or reimbursement policies will be essential.

  4. Advanced bridge safety initiative, task 3 : slab bridge load rating using AASHTO methodology and finite element analysis - an analysis of 20 bridges. (United States)


    Current AASHTO provisions for the conventional load rating of flat slab bridges rely on the equivalent strip method : of analysis for determining live load effects, this is generally regarded as overly conservative by many professional : engineers. A...

  5. Biospecimen Sharing Among Hispanic Women in a Safety-Net Clinic: Implications for the Precision Medicine Initiative


    Nodora, Jesse N.; Komenaka, Ian K.; Bouton, Marcia E; Ohno-Machado, Lucila; Schwab, Richard; Kim, Hyeon-eui; Farcas, Claudiu; Perez, Giovanna; Elena Martinez, Maria


    Biospecimen donation is key to the Precision Medicine Initiative, which pioneers a model for accelerating biomedical research through individualized care. Personalized medicine should be made available to medically underserved populations, including the large and growing US Hispanic population. We present results of a study of 140 Hispanic women who underwent a breast biopsy at a safety-net hospital and were randomly assigned to receive information and request for consent for biospecimen and ...

  6. Translating self-persuasion into an adolescent HPV vaccine promotion intervention for parents attending safety-net clinics. (United States)

    Baldwin, Austin S; Denman, Deanna C; Sala, Margarita; Marks, Emily G; Shay, L Aubree; Fuller, Sobha; Persaud, Donna; Lee, Simon Craddock; Skinner, Celette Sugg; Wiebe, Deborah J; Tiro, Jasmin A


    Self-persuasion is an effective behavior change strategy, but has not been translated for low-income, less educated, uninsured populations attending safety-net clinics or to promote human papillomavirus (HPV) vaccination. We developed a tablet-based application (in English and Spanish) to elicit parental self-persuasion for adolescent HPV vaccination and evaluated its feasibility in a safety-net population. Parents (N=45) of age-eligible adolescents used the self-persuasion application. Then, during cognitive interviews, staff gathered quantitative and qualitative feedback on the self-persuasion tasks including parental decision stage. The self-persuasion tasks were rated as easy to complete and helpful. We identified six question prompts rated as uniformly helpful, not difficult to answer, and generated non-redundant responses from participants. Among the 33 parents with unvaccinated adolescents, 27 (81.8%) reported deciding to get their adolescent vaccinated after completing the self-persuasion tasks. The self-persuasion application was feasible and resulted in a change in parents' decision stage. Future studies can now test the efficacy of the tablet-based application on HPV vaccination. The self-persuasion application facilitates verbalization of reasons for HPV vaccination in low literacy, safety-net settings. This self-administered application has the potential to be more easily incorporated into clinical practice than other patient education approaches. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Incentivizing primary care providers to innovate: building medical homes in the post-Katrina New Orleans safety net. (United States)

    Rittenhouse, Diane R; Schmidt, Laura A; Wu, Kevin J; Wiley, James


    To evaluate safety-net clinics' responses to a novel community-wide Patient-Centered Medical Home (PCMH) financial incentive program in post-Katrina New Orleans. Between June 2008 and June 2010, we studied 50 primary care clinics in New Orleans receiving federal funds to expand services and improve care delivery. Multiwave, longitudinal, observational study of a local safety-net primary care system. Clinic-level data from a semiannual survey of clinic leaders (89.3 percent response rate), augmented by administrative records. Overall, 62 percent of the clinics responded to financial incentives by achieving PCMH recognition from the National Committee on Quality Assurance (NCQA). Higher patient volume, higher baseline PCMH scores, and type of ownership were significant predictors of achieving NCQA recognition. The steepest increase in adoption of PCMH processes occurred among clinics achieving the highest, Level 3, NCQA recognition. Following NCQA recognition, 88.9 percent stabilized or increased their use of PCMH processes, although several specific PCMH processes had very low rates of adoption overall. Findings demonstrate that widespread PCMH implementation is possible in a safety-net environment when external financial incentives are aligned with the goal of practice innovation. © Health Research and Educational Trust.

  8. Towards a Usability and Error "Safety Net": A Multi-Phased Multi-Method Approach to Ensuring System Usability and Safety. (United States)

    Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth


    The usability and safety of health information systems have become major issues in the design and implementation of useful healthcare IT. In this paper we describe a multi-phased multi-method approach to integrating usability engineering methods into system testing to ensure both usability and safety of healthcare IT upon widespread deployment. The approach involves usability testing followed by clinical simulation (conducted in-situ) and "near-live" recording of user interactions with systems. At key stages in this process, usability problems are identified and rectified forming a usability and technology-induced error "safety net" that catches different types of usability and safety problems prior to releasing systems widely in healthcare settings.

  9. Provision of clinical pharmacy services in two safety net provider settings.

    Directory of Open Access Journals (Sweden)

    Connor SE


    free clinic and the community health center. Conclusion: A clinical pharmacy services model provides a role for the pharmacist in an interdisciplinary team (beyond the traditional dispensing role to identify medication related problems in the drug therapy of patients who utilize safety-net provider health care services.

  10. Access to care after Massachusetts' health care reform: a safety net hospital patient survey. (United States)

    McCormick, Danny; Sayah, Assaad; Lokko, Hermione; Woolhandler, Steffie; Nardin, Rachel


    Massachusetts' health care reform substantially decreased the percentage of uninsured residents. However, less is known about how reform affected access to care, especially according to insurance type. To assess access to care in Massachusetts after implementation of health care reform, based on insurance status and type. We surveyed a convenience sample of 431 patients presenting to the Emergency Department of Massachusetts' second largest safety net hospital between July 25, 2009 and March 20, 2010. Demographic and clinical characteristics, insurance coverage, measures of access to care and cost-related barriers to care. Patients with Commonwealth Care and Medicaid, the two forms of insurance most often newly-acquired under the reform, reported similar or higher utilization of and access to outpatient visits and rates of having a usual source of care, compared with the privately insured. Compared with the privately insured, a significantly higher proportion of patients with Medicaid or Commonwealth Care Type 1 (minimal cost sharing) reported delaying or not getting dental care (42.2 % vs. 27.1 %) or medication (30.0 % vs. 7.0 %) due to cost; those with Medicaid also experienced cost-related barriers to seeing a specialist (14.6 % vs. 3.5 %) or getting recommended tests (15.6 % vs. 5.9 %). Those with Commonwealth Care Types 2 and 3 (greater cost sharing) reported significantly more cost-related barriers to obtaining care than the privately insured (45.0 % vs. 16.0 %), to seeing a primary care doctor (25.0 % vs. 6.0 %) or dental provider (58.3 % vs. 27.1 %), and to obtaining medication (20.8 % vs. 7.0 %). No differences in cost-related barriers to preventive care were found between the privately and publicly insured. Access to care improved less than access to insurance following Massachusetts' health care reform. Many newly insured residents obtained Medicaid or state subsidized private insurance; cost-related barriers to access were worse for these patients than

  11. 78 FR 4331 - Safety Zone; Sellwood Bridge Move; Willamette River, Portland, OR (United States)


    ..., Oregon, while it is being relocated 66 feet downriver as part of the new Sellwood Bridge construction.... The bridge construction contractor was constrained by the completion of the temporary structures and...


    Directory of Open Access Journals (Sweden)

    Boris Azinović


    Full Text Available In the paper the seismic response of precast balcony cantilever structural elements for prevention of thermal bridges was analysed. This solution has been developed in seismic non-prone areas with the main purpose of eliminating a thermal bridge at the point where the balcony is fixed to the building. The solution has been specially made to withstand vertical static loading, not accounting for eventual vertical seismic loads in the case of transferring the solution to more active seismic zones. This paper deals with the seismic analysis of existent precast cantilever elements exposed to vertical accelerations and has proven that some elements in the case of lifting are not sufficient from the safety point of view. The results of the main research results obtained by numerous seismic analyses can be summarized as follows: 1 the insertion of a precast load-bearing thermal insulation element increases the flexibility of RC fixed base cantilevers and therefore limits their length to 300–400 cm, 2 vertical seismic loads can result in the cantilever uplift, which means that tensile stresses could appear also at the bottom of the cross-section 3 precast elements, that appear on the Slovenian market to this day, do not have the appropriate steel reinforcement in the bottom part of the cross-section. For this reason, the possibility of damage is considerably higher for precast cantilever structural elements than for RC fixed base cantilevers. Statistically calculated probability of cantilever uplift for Ljubljana, which would result in severe damage, is relatively low (3% in the 50-year life span. However, the calculated value is greater than the maximum acceptable level of seismic risk for collapse. One of the possible solutions to prevent the negative influences of cantilever uplift is to consider the proper reinforcement also at the bottom of the precast elements' crosssection, or by other measures preventing uplift.

  13. National Use of Safety-Net Clinics for Primary Care among Adults with Non-Medicaid Insurance in the United States.

    Directory of Open Access Journals (Sweden)

    Oanh Kieu Nguyen

    Full Text Available To describe the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare.Cross-sectional analysis using the 2006-2010 National Ambulatory Medical Care Surveys, annual probability samples of outpatient visits in the U.S. We estimated national prevalence of safety-net visits using weighted percentages to account for the complex survey design. We conducted bivariate and multivariate logistic regression analyses to examine characteristics associated with safety-net clinic use.More than one-third (35.0% of all primary care safety-net clinic visits were among adults with non-Medicaid primary insurance, representing 6,642,000 annual visits nationally. The strongest predictors of safety-net use among non-Medicaid insured adults were: being from a high-poverty neighborhood (AOR 9.53, 95% CI 4.65-19.53, being dually eligible for Medicare and Medicaid (AOR 2.13, 95% CI 1.38-3.30, and being black (AOR 1.97, 95% CI 1.06-3.66 or Hispanic (AOR 2.28, 95% CI 1.32-3.93. Compared to non-safety-net users, non-Medicaid insured adults who used safety-net clinics had a higher prevalence of diabetes (23.5% vs. 15.0%, p<0.001, hypertension (49.4% vs. 36.0%, p<0.001, multimorbidity (≥2 chronic conditions; 53.5% vs. 40.9%, p<0.001 and polypharmacy (≥4 medications; 48.8% vs. 34.0%, p<0.001. Nearly one-third (28.9% of Medicare beneficiaries in the safety-net were dual eligibles, compared to only 6.8% of Medicare beneficiaries in non-safety-net clinics (p<0.001.Safety net clinics are important primary care delivery sites for non-Medicaid insured minority and low-income populations with a high burden of chronic illness. The critical role of safety-net clinics in care delivery is likely to persist despite expanded insurance coverage under the Affordable Care Act.

  14. Sustainability of bridge foundations using electrical resistivity imaging and induced polarization to support transportation safety. (United States)


    As of September 2007, there were 67,240 U.S. bridges in the National Bridge Inventory classified as having unknown : foundations (FHWA 2008). The bridges spanning rivers are of critical importance due to the risks of potential scour. In fact, it is :...

  15. 75 FR 21990 - Safety Zone; Extended Debris Removal in the Lake Champlain Bridge Construction Zone (Between... (United States)


    ... Champlain Bridge Construction Zone (Between Vermont and New York), Crown Point, NY AGENCY: Coast Guard, DHS... navigable waters immediately surrounding the Lake Champlain Bridge construction zone between Chimney Point... to the north and south of the Lake Champlain Bridge construction site. The Captain of the Port may...

  16. NaNet: a configurable NIC bridging the gap between HPC and real-time HEP GPU computing (United States)

    Lonardo, A.; Ameli, F.; Ammendola, R.; Biagioni, A.; Cotta Ramusino, A.; Fiorini, M.; Frezza, O.; Lamanna, G.; Lo Cicero, F.; Martinelli, M.; Neri, I.; Paolucci, P. S.; Pastorelli, E.; Pontisso, L.; Rossetti, D.; Simeone, F.; Simula, F.; Sozzi, M.; Tosoratto, L.; Vicini, P.


    NaNet is a FPGA-based PCIe Network Interface Card (NIC) design with GPUDirect and Remote Direct Memory Access (RDMA) capabilities featuring a configurable and extensible set of network channels. The design currently supports both standard—Gbe (1000BASE-T) and 10GbE (10Base-R)—and custom—34 Gbps APElink and 2.5 Gbps deterministic latency KM3link—channels, but its modularity allows for straightforward inclusion of other link technologies. The GPUDirect feature combined with a transport layer offload module and a data stream processing stage makes NaNet a low-latency NIC suitable for real-time GPU processing. In this paper we describe the NaNet architecture and its performances, exhibiting two of its use cases: the GPU-based low-level trigger for the RICH detector in the NA62 experiment at CERN and the on-/off-shore data transport system for the KM3NeT-IT underwater neutrino telescope.

  17. National Use of Safety-Net Clinics for Primary Care among Adults with Non-Medicaid Insurance in the United States. (United States)

    Nguyen, Oanh Kieu; Makam, Anil N; Halm, Ethan A


    To describe the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare). Cross-sectional analysis using the 2006-2010 National Ambulatory Medical Care Surveys, annual probability samples of outpatient visits in the U.S. We estimated national prevalence of safety-net visits using weighted percentages to account for the complex survey design. We conducted bivariate and multivariate logistic regression analyses to examine characteristics associated with safety-net clinic use. More than one-third (35.0%) of all primary care safety-net clinic visits were among adults with non-Medicaid primary insurance, representing 6,642,000 annual visits nationally. The strongest predictors of safety-net use among non-Medicaid insured adults were: being from a high-poverty neighborhood (AOR 9.53, 95% CI 4.65-19.53), being dually eligible for Medicare and Medicaid (AOR 2.13, 95% CI 1.38-3.30), and being black (AOR 1.97, 95% CI 1.06-3.66) or Hispanic (AOR 2.28, 95% CI 1.32-3.93). Compared to non-safety-net users, non-Medicaid insured adults who used safety-net clinics had a higher prevalence of diabetes (23.5% vs. 15.0%, pclinics (pclinics are important primary care delivery sites for non-Medicaid insured minority and low-income populations with a high burden of chronic illness. The critical role of safety-net clinics in care delivery is likely to persist despite expanded insurance coverage under the Affordable Care Act.

  18. The risks of opioid treatment: Perspectives of primary care practitioners and patients from safety-net clinics. (United States)

    Hurstak, Emily E; Kushel, Margot; Chang, Jamie; Ceasar, Rachel; Zamora, Kara; Miaskowski, Christine; Knight, Kelly


    Patients with a history of substance use are more likely than those without substance use to experience chronic noncancer pain (CNCP), to be prescribed opioids, and to experience opioid misuse or overdose. Primary care practitioners (PCPs) in safety-net settings care for low-income patients with CNCP and substance use, usually without specialist consultation. To inform communication related to opioid risk, we explored PCPs' and patients' perceptions of the risks of chronic opioid therapy. We conducted semistructured interviews with 23 PCPs and 46 of their patients, who had a history of CNCP and substance use. We recruited from 6 safety-net health care settings in the San Francisco Bay Area. We transcribed interviews verbatim and analyzed transcripts using grounded theory methodology. (1) PCPs feared harming patients and the community by opioid prescribing. PCPs emphasized fear of opioid overdose. (2) Patients did not highlight concerns about the adverse health consequences of opioids, except for addiction. (3) Both patients and PCPs were concerned about PCPs' medicolegal risks related to opioid prescribing. (4) Patients reported feeling stigmatized by policies aimed at reducing opioid misuse. We identified differences in how clinicians and patients perceive opioid risk. To improve the informed consent process for opioid therapy, patients and PCPs need to have a shared understanding of the risks of opioids and engage in discussions that promote patient autonomy and safety. As clinics implement opioid prescribing policies, clinicians must develop effective communication strategies in order to educate patients about opioid risks and decrease patients' experiences of stigma and discrimination.

  19. Proximity to safety-net clinics and HPV vaccine uptake among low-income, ethnic minority girls. (United States)

    Tsui, Jennifer; Singhal, Rita; Rodriguez, Hector P; Gee, Gilbert C; Glenn, Beth A; Bastani, Roshan


    Human Papillomavirus (HPV) vaccine uptake remains low. Although publicly funded programs provide free or low cost vaccines to low-income children, barriers aside from cost may prevent disadvantaged girls from getting vaccinated. Prior studies have shown distance to health care as a potential barrier to utilizing pediatric preventive services. This study examines whether HPV vaccines are geographically accessible for low-income girls in Los Angeles County and whether proximity to safety-net clinics is associated with vaccine initiation. Interviews were conducted in multiple languages with largely immigrant, low-income mothers of girls ages 9 to 18 via a county health hotline to assess uptake and correlates of uptake. Addresses of respondents and safety-net clinics that provide the HPV vaccine for free or low cost were geo-coded and linked to create measures of geographic proximity. Logistic regression models were estimated for each proximity measure on HPV vaccine initiation while controlling for other factors. On average, 83% of the 468 girls had at least one clinic within 3-miles of their residence. The average travel time on public transportation to the nearest clinic among all girls was 21min. Average proximity to clinics differed significantly by race/ethnicity. Latinas had both the shortest travel distances (2.2 miles) and public transportation times (16min) compared to other racial/ethnic groups. The overall HPV vaccine initiation rate was 25%. Increased proximity to the nearest clinic was not significantly associated with initiation. By contrast, daughter's age and insurance status were significantly associated with increased uptake. This study is among the first to examine geographic access to HPV vaccines for underserved girls. Although the majority of girls live in close proximity to safety-net vaccination services, rates of initiation were low. Expanding clinic outreach in this urban area is likely more important than increasing geographic access to the

  20. Rethinking the therapeutic misconception: social justice, patient advocacy, and cancer clinical trial recruitment in the US safety net. (United States)

    Burke, Nancy J


    Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. In the course of two years of ethnographic fieldwork in a safety net hospital, I conducted clinic observations (n=150 clinic days) and in-depth in-person qualitative interviews with patients (n=37) and providers (n=15). I used standard qualitative methods to organize and code resulting fieldnote and interview data. Findings suggest that TM is limited in relevance for the interdisciplinary context of cancer clinical trial recruitment in the safety net setting. Ethnographic data show the value of the discussions that happen prior to the informed consent, those that introduce the idea of participation in research. These preliminary discussions are elemental especially when recruiting underserved and vulnerable patients for clinical trial participation who are often unfamiliar with medical research and how it relates to medical care. Data also highlight the multiple actors involved in research discussions and the ethics of social justice and patient advocacy they mobilize, suggesting that class, inequality, and dependency influence the forms of ethical engagements in public hospital settings. On the ground ethics of social justice and patient advocacy are more relevant than TM as guiding ethical principles in the context of

  1. Catalyzing Implementation of Evidence-Based Interventions in Safety Net Settings: A Clinical-Community Partnership in South Los Angeles. (United States)

    Payán, Denise D; Sloane, David C; Illum, Jacqueline; Vargas, Roberto B; Lee, Donzella; Galloway-Gilliam, Lark; Lewis, LaVonna B


    This study is a process evaluation of a clinical-community partnership that implemented evidence-based interventions in clinical safety net settings. Adoption and implementation of evidence-based interventions in these settings can help reduce health disparities by improving the quality of clinical preventive services in health care settings with underserved populations. A clinical-community partnership model is a possible avenue to catalyze adoption and implementation of interventions amid organizational barriers to change. Three Federally Qualified Health Centers in South Los Angeles participated in a partnership led by a local community-based organization (CBO) to implement hypertension interventions. Qualitative research methods were used to evaluate intervention selection and implementation processes between January 2014 and June 2015. Data collection tools included a key participant interview guide, health care provider interview guide, and protocol for taking meeting minutes. This case study demonstrates how a CBO acted as an external facilitator and employed a collaborative partnership model to catalyze implementation of evidence-based interventions in safety net settings. The study phases observed included initiation, planning, and implementation. Three emergent categories of organizational facilitators and barriers were identified (personnel capacity, professional development capacity, and technological capacity). Key participants and health care providers expressed a high level of satisfaction with the collaborative and the interventions, respectively. The CBO's role as a facilitator and catalyst is a replicable model to promote intervention adoption and implementation in safety net settings. Key lessons learned are provided for researchers and practitioners interested in partnering with Federally Qualified Health Centers to implement health promotion interventions.

  2. The experience of primary care providers with an integrated mental health care program in safety-net clinics. (United States)

    Bentham, Wayne D; Ratzliff, Anna; Harrison, David; Chan, Ya-Fen; Vannoy, Steven; Unützer, Jürgen


    Primary care providers participating in a statewide implementation of an integrated mental health care program for "safety-net" patients in primary care clinics were surveyed to elicit their experiences and level of satisfaction. Quantitative analyses were performed to identify respondent characteristics and satisfaction with the program. Qualitative analyses were done to identify common themes in response to the question "How could psychiatric consultation [in the program] be improved?" Primary care providers were generally satisfied with the integrated mental health care program and raised several concerns that suggest important principles for successful future implementations of these types of programs.

  3. Internet access and patient portal readiness among patients in a group of inner-city safety-net practices. (United States)

    Sanders, Mechelle R; Winters, Paul; Fortuna, Robert J; Mendoza, Michael; Berliant, Marc; Clark, Linda; Fiscella, Kevin


    The use of online personal health records (PHRs) threatens to transform the digital divide to a health care divide among the underserved. Little is known about underserved patients' ability to access online PHRs. We examined these factors among patients within safety-net practices. Among respondents (N = 654), only 12% had no experience of using a computer, and most were interested in using it to communicate with their provider. Age, sex, and race were not associated with interest in PHRs. A majority of patients have access to the Internet and are interested in using a PHR to manage their care, but they are not prepared.

  4. Early-Warning Method of Train Running Safety of a High-Speed Railway Bridge Based on Transverse Vibration Monitoring

    Directory of Open Access Journals (Sweden)

    You-Liang Ding


    Full Text Available Making use of long-term transverse vibration monitoring data of DaShengGuan Bridge, the early-warning method of train running safety of the high-speed railway bridge is established by adopting principal component analysis (PCA method. Firstly, the root mean square (RMS of the transverse acceleration of the main girder is used as the monitoring parameter for the train running safety. The correlation model between the RMS values measured from different positions is further adopted as the evaluating model for the train running safety. Finally, the effects of the environmental changes on the evaluating model are eliminated using the PCA method and the warning index for the train running safety is further constructed. The analysis results show that the correlation between the RMS values of the accelerations from different measuring positions on the main girder can be analyzed by a quadratic polynomial fitting model. The PCA method can effectively remove the environmental effects on the quadratic polynomial fitting model. The proposed warning method provides a good capability for detecting the abnormal changes of the measured transverse accelerations and hence it is suitable for early-warning of the train running safety.

  5. Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

    Directory of Open Access Journals (Sweden)

    Ken Russell Coelho


    Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

  6. Biospecimen Sharing Among Hispanic Women in a Safety-Net Clinic: Implications for the Precision Medicine Initiative. (United States)

    Nodora, Jesse N; Komenaka, Ian K; Bouton, Marcia E; Ohno-Machado, Lucila; Schwab, Richard; Kim, Hyeon-Eui; Farcas, Claudiu; Perez, Giovanna; Elena Martinez, Maria


    Biospecimen donation is key to the Precision Medicine Initiative, which pioneers a model for accelerating biomedical research through individualized care. Personalized medicine should be made available to medically underserved populations, including the large and growing US Hispanic population. We present results of a study of 140 Hispanic women who underwent a breast biopsy at a safety-net hospital and were randomly assigned to receive information and request for consent for biospecimen and data sharing by the patient's physician or a research assistant. Consent rates were high (97.1% and 92.9% in the physician and research assistant arms, respectively) and not different between groups (relative risk [RR] = 1.05, 95% confidence interval [CI] = 0.96 to 1.10). Consistent with a small but growing literature, we show that perceptions of Hispanics' unwillingness to participate in biospecimen sharing for research are not supported by data. Safety-net clinics and hospitals offer untapped possibilities for enhancing participation of underserved populations in the exciting Precision Medicine Initiative. © The Author 2016. Published by Oxford University Press.

  7. High priority for hepatitis C screening in safety net hospitals: Results from a prospective cohort of 4582 hospitalized baby boomers. (United States)

    Turner, Barbara J; Taylor, Barbara S; Hanson, Joshua; Liang, Yuanyuan; Veerapaneni, Poornachand; Villarreal, Roberto; Perez, Mary; Hernandez, Ludivina; Sandhu, Jasdeep; Fiebelkorn, Kristin


    Low-income populations are disproportionately affected by hepatitis C virus (HCV) infection. Thus, implementing baby boomer screening (born 1945-1965) for HCV may be a high priority for safety net hospitals. We report the prevalence and predictors of HCV infection and advanced fibrosis or cirrhosis based on the Fibrosis-4 score plus imaging for a baby boomer cohort admitted to a safety net hospital over a 21-month interval with >9 months of follow-up. Anti-HCV antibody testing was performed for 4582, or 90%, of all never-screened patients, of whom 312 (6.7%) tested positive. Adjusted odds ratios of testing anti-HCV-positive were 2.66 for men versus women (Pbaby boomers were diagnosed with chronic HCV, nearly twice the rate in the community; one-third had noninvasive testing that indicated advanced fibrosis or cirrhosis, which was significantly more likely for Hispanics, those of older age, those with obesity, those with alcohol abuse/dependence, and those who lacked insurance. © 2015 by the American Association for the Study of Liver Diseases.

  8. Buffering the Uneven Impact of the Affordable Care Act: Immigrant-serving Safety-net Providers in New Mexico. (United States)

    Getrich, Christina M; García, Jacqueline M; Solares, Angélica; Kano, Miria


    We conducted a study in early 2014 to document how the initial implementation of the Affordable Care Act (ACA) affected health care provision to different categories of immigrants from the perspective of health care providers in New Mexico. Though ACA navigators led enrollment, a range of providers nevertheless became involved by necessity, expressing concern about how immigrants were faring in the newly configured health care environment and taking on advocacy roles. Providers described interpreting shifting eligibility and coverage, attending to vulnerable under/uninsured patients, and negotiating new bureaucratic barriers for insured patients. Findings suggest that, like past efforts, this recent reform to the fragmented health care system has perpetuated a condition in which safety-net clinics and providers are left to buffer a widening gap for immigrant patients. With possible changes to the ACA ahead, safety-net providers' critical buffering roles will likely become more crucial, underscoring the necessity of examining their experiences with past reforms. © 2017 by the American Anthropological Association.

  9. WE-G-BRA-02: SafetyNet: Automating Radiotherapy QA with An Event Driven Framework

    Energy Technology Data Exchange (ETDEWEB)

    Hadley, S; Kessler, M [The University of Michigan, Ann Arbor, MI (United States); Litzenberg, D [Univ Michigan, Ann Arbor, MI (United States); Lee, C; Irrer, J; Chen, X; Acosta, E; Weyburne, G; Lam, K; Younge, K; Matuszak, M [University of Michigan, Ann Arbor, MI (United States); Keranen, W [Varian Medical Systems, Palo Alto, CA (United States); Covington, E [University of Michigan Hospital and Health System, Ann Arbor, MI (United States); Moran, J [Univ Michigan Medical Center, Ann Arbor, MI (United States)


    Purpose: Quality assurance is an essential task in radiotherapy that often requires many manual tasks. We investigate the use of an event driven framework in conjunction with software agents to automate QA and eliminate wait times. Methods: An in house developed subscription-publication service, EventNet, was added to the Aria OIS to be a message broker for critical events occurring in the OIS and software agents. Software agents operate without user intervention and perform critical QA steps. The results of the QA are documented and the resulting event is generated and passed back to EventNet. Users can subscribe to those events and receive messages based on custom filters designed to send passing or failing results to physicists or dosimetrists. Agents were developed to expedite the following QA tasks: Plan Revision, Plan 2nd Check, SRS Winston-Lutz isocenter, Treatment History Audit, Treatment Machine Configuration. Results: Plan approval in the Aria OIS was used as the event trigger for plan revision QA and Plan 2nd check agents. The agents pulled the plan data, executed the prescribed QA, stored the results and updated EventNet for publication. The Winston Lutz agent reduced QA time from 20 minutes to 4 minutes and provided a more accurate quantitative estimate of radiation isocenter. The Treatment Machine Configuration agent automatically reports any changes to the Treatment machine or HDR unit configuration. The agents are reliable, act immediately, and execute each task identically every time. Conclusion: An event driven framework has inverted the data chase in our radiotherapy QA process. Rather than have dosimetrists and physicists push data to QA software and pull results back into the OIS, the software agents perform these steps immediately upon receiving the sentinel events from EventNet. Mr Keranen is an employee of Varian Medical Systems. Dr. Moran’s institution receives research support for her effort for a linear accelerator QA project from

  10. Road safety performance indicators : country comparisons. SafetyNet, Building the European Road Safety Observatory, Workpackage 3, Deliverable 3.7a.

    NARCIS (Netherlands)

    Auerbach-Hafen, K. Riguelle, F. Eksler, V. Haddak, M. Holló, P. Arsenio, E. Cardoso, J. Vieira Gomes, S. Rapadimitriou, E. Amelink, M. Goldenbeld, C. Mathijssen, R. Louwerse, R. Morsink, P. Schoon, C. Gent, A. van Houwing, S. Vis, M. Gitelman, V. Hakkert, S. Assum, T. page, M. & Rackliff, L.


    This report compares the safety performance of 27 European countries – the25 EU member states, Norway and Switzerland. The comparison is done for seven road safety related areas: alcohol and drugs, speeds, protective systems, daytime running lights, vehicles (passive safety), roads, and trauma

  11. Peer review of the National Transportation Safety Board structural analysis of the I-35W bridge collapse.

    Energy Technology Data Exchange (ETDEWEB)

    Gwinn, Kenneth West; Redmond, James Michael; Wellman, Gerald William


    The Engineering Sciences Center at Sandia National Laboratories provided an independent peer review of the structural analysis supporting the National Transportation Safety Board investigation of the August 1, 2007 collapse of the I-35W Bridge in Minneapolis. The purpose of the review was to provide an impartial critique of the analysis approach, assumptions, solution techniques, and conclusions. Subsequent to reviewing numerous supporting documents, a SNL team of staff and management visited NTSB to participate in analysis briefings, discussions with investigators, and examination of critical elements of the bridge wreckage. This report summarizes the opinion of the review team that the NTSB analysis effort was appropriate and provides compelling supporting evidence for the NTSB probable cause conclusion.

  12. 76 FR 32313 - Safety Zone; Chelsea St. Bridge Demolition, Chelsea River, Chelsea, MA (United States)


    ... delivery vital to New England, namely petroleum products (e.g. heating oil and gasoline). If the bridge construction project is held up or off schedule it would have serious ramifications to the waterway...

  13. Becoming Baby-Friendly and Transforming Maternity Care in a Safety-Net Hospital on the Texas-Mexico Border. (United States)

    Eganhouse, Deborah J; Gutierrez, Leticia; Cuellar, Lorena; Velasquez, Cecilia


    Nurse leaders used the Centers for Disease Control and Prevention's survey on Maternity Practices in Infant Nutrition and Care, as well as Baby-Friendly Hospital Initiative guidelines, to transform maternity care in a safety-net hospital with more than 3,500 births annually. Implementing evidence-based guidelines to support breastfeeding was essential for a vulnerable population characterized by minimal prenatal care and high rates of diabetes, hypertension, obesity, and poverty. Research showing the importance of breastfeeding in protecting against these factors guided extensive changes in our maternity care model. The nursing and medical teams changed long-held practices that separated women from their newborns and observed substantial improvements in breastfeeding initiation and exclusive breastfeeding rates at discharge. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  14. A safety-net antibiotic prescription for otitis media: the effects of a PBRN study on patients and practitioners. (United States)

    Siegel, Robert M; Bien, James; Lichtenstein, Philip; Davis, James; Khoury, Jane C; Knight, Jamie E; Kiely, Michele; Bernier, Jeralyn


    Pediatricians can decrease antibiotic use by treating acute otitis media (AOM) with a safety-net antibiotic prescription (SNAP). This study assessed whether the practitioners of the Practice-Based Research Network who participated in the study continued to use the SNAP and report a 60-day follow-up of the study patients. Charts were reviewed of study patients for 60 days following study enrollment. A survey on antibiotic use for AOM was mailed to the 17 study practitioners (SP) and 30 randomly selected community pediatricians (CP). Eight of the SP used the SNAP more than 20 times over the year following the study vs 1 of the CP. Sixty-two percent of patients never received antibiotics. The recurrence/relapse rate was greater in children younger than 2 years old compared to those older, 34% vs 10%. Practitioners who participate in a Practice-Based Research Network study are more likely to use a study intervention than others.

  15. Implementation of routine screening for Lynch syndrome in university and safety-net health system settings: successes and challenges. (United States)

    Marquez, Evelyn; Geng, Zhuo; Pass, Sarah; Summerour, Pia; Robinson, Linda; Sarode, Venetia; Gupta, Samir


    Routine screening for evidence of DNA mismatch repair abnormalities can identify colorectal cancer patients with Lynch syndrome, but impact in usual care settings requires study. After implementing routine screening at our university and safety-net health systems as usual practice, our aims were to determine outcomes, including screening process quality. We conducted a retrospective cohort study from 1 May 2010 to 1 May 2011. Screening included reflexive immunohistochemistry to evaluate DNA mismatch repair protein expression for patients with colorectal cancer aged ≤70 years, with a cancer genetics team following up results. Screening outcomes, as well as challenges to a high-quality screening process were evaluated. We included 129 patients (mean age 56 years, 36% female); 100 had immunohistochemistry screening completed. Twelve patients had abnormal immunohistochemistry: four with definite Lynch syndrome, four with probable Lynch syndrome, and three without Lynch syndrome; one patient had an incomplete work-up. Lynch syndrome was confirmed for 6/13 asymptomatic relatives tested. Screening process quality was optimal for 77.5% of patients. Barriers to optimal quality screening included ensuring reflexive immunohistochemistry completion, complete follow-up of abnormal immunohistochemistry, and timely incorporation of results into clinical decision making. Usual care implementation of routine screening for Lynch syndrome can result in significant rates of detection, even in a largely safety-net setting. To optimize implementation, challenges to high-quality Lynch syndrome screening, such as ensuring reflexive screening completion and clinically indicated genetic testing and follow-up for abnormal screens, must be identified and addressed.

  16. Home closure as a weapon in the Dutch war on drugs: Does judicial review function as a safety net? (United States)

    Bruijn, L Michelle; Vols, Michel; Brouwer, Jan G


    A widespread sense of a failing criminal justice system and increased feelings of insecurity changed the response to crime into a culture of control, which is characterized by policies that punish and exclude. In the Netherlands, these influences can be witnessed in the war on drugs where local authorities use their administrative power to close homes involved in drug-related crime. Citizens can invoke judicial review over these administrative interferences by claiming that such closure results in an unfair balance between purposes, means and consequences. This paper assesses whether judicial review functions as a safety net against losing one's home due to drug-related crime. We used doctrinal legal research methods to examine the "law in the books" and empirical legal research methods to analyse the "law in action". We used a survey to investigate how often the drug-related closure power was used in 2015, and we statistically analysed all published case law of Dutch lower courts between 2007 and 2016. The scope of the closure power broadened over the years and our data show that local authorities fiercely make use of this instrument. In 41.4% of the cases, citizens are successful in fighting the closure. While scholarly literature indicates that judicial courts function as safeguards by questioning the proportionality of administrative action, raising a proportionality defence does not necessarily result in a more favourable outcome for citizens. In fact, raising a proportionality defence makes it more likely to result in dismissal of the appeal. The stretched scope of the drug-related closure power together with the relatively low success rate of citizens who fight the loss of their home and a seemingly meaningless proportionality check show no sign of a safety net against the loss of one's home at the suit of a local authority. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Participation of low-income women in genetic cancer risk assessment and BRCA 1/2 testing: the experience of a safety-net institution


    Komenaka, Ian K.; Nodora, Jesse N.; Madlensky, Lisa; Lisa M. Winton; Heberer, Meredith A.; Schwab, Richard B; Weitzel, Jeffrey N.; Martinez, Maria Elena


    Some communities and populations lack access to genetic cancer risk assessment (GCRA) and testing. This is particularly evident in safety-net institutions, which serve a large segment of low-income, uninsured individuals. We describe the experience of a safety-net clinic with limited resources in providing GCRA and BRCA1/2 testing. We compared the proportion and characteristics of high-risk women who were offered and underwent GCRA and genetic testing. We also provide a description of the mut...

  18. Road safety performance indicators : updated country comparisons. SafetyNet, Building the European Road Safety Observatory, Workpackage 3, Deliverable 3.11a.

    NARCIS (Netherlands)

    Riguelle, F. Eksler, V. Holló, P. Vis, M. Gitelman, V. Assum, T. & Rackliff, L.


    This report presents an overview of recent figures of chosen safety performance indicators of 29 European countries – the 27 EU member states, complemented with Norway and Switzerland. The comparison is done for five road safety performance indicators in the following areas: alcohol and drugs,

  19. Advanced bridge safety initiative : phase 2, task 2 - effects of curb and railing inclusion on rating factors of reinforced concrete flat slab bridges using finite element analysis. (United States)


    The Maine Department of Transportation (Maine DOT) owns a number of existing reinforced concrete slab : bridges that utilize the standard Maine concrete bridge rail. At issue is the additional stiffening and strengthening : that the curb and this rai...

  20. Safeguard: Progress and Test Results for a Reliable Independent On-Board Safety Net for UAS (United States)

    Young, Steven D.; Dill, Evan T.; Hayhurst, Kelly J.; Gilabert, Russell V.


    As demands increase to use unmanned aircraft systems (UAS) for a broad spectrum of commercial applications, regulatory authorities are examining how to safely integrate them without compromising safety or disrupting traditional airspace operations. For small UAS, several operational rules have been established; e.g., do not operate beyond visual line-of-sight, do not fly within five miles of a commercial airport, do not fly above 400 feet above ground level. Enforcing these rules is challenging for UAS, as evidenced by the number of incident reports received by the Federal Aviation Administration (FAA). This paper reviews the development of an onboard system - Safeguard - designed to monitor and enforce conformance to a set of operational rules defined prior to flight (e.g., geospatial stay-out or stay-in regions, speed limits, and altitude constraints). Unlike typical geofencing or geo-limitation functions, Safeguard operates independently of the off-the-shelf UAS autopilot and is designed in a way that can be realized by a small set of verifiable functions to simplify compliance with existing standards for safety-critical systems (e.g. for spacecraft and manned commercial transportation aircraft systems). A framework is described that decouples the system from any other devices on the UAS as well as introduces complementary positioning source(s) for applications that require integrity and availability beyond what can be provided by the Global Positioning System (GPS). This paper summarizes the progress and test results for Safeguard research and development since presentation of the design concept at the 35th Digital Avionics Systems Conference (DASC '16). Significant accomplishments include completion of software verification and validation in accordance with NASA standards for spacecraft systems (to Class B), development of improved hardware prototypes, development of a simulation platform that allows for hardware-in-the-loop testing and fast-time Monte Carlo

  1. Falling through the Safety Net: Latinos and the Declining Effectiveness of Anti-Poverty Programs in the 1980s. Public Policy Report 1. (United States)

    Brischetto, Robert R.; Leonard, Paul A.

    This report provides data and discusses trends in the demography and economics of Latinos. It was compiled in response to a request from Latino leaders for information on the needs of their constituents. In general the trends show that Latinos are falling through the safety net that government agencies are supposed to provide. Changes in the…

  2. 78 FR 13747 - Safety Advisory 2013-01; Passing Stop Signals Protecting Movable Bridges (United States)


    ... notice recommends that track owners and railroads: (1) Evaluate the design and construction of existing... and seating the bridge and then moving the slide lock rails into the locked position. Once the slide lock rails were fully engaged, a signal to proceed would be displayed. Following the derailment, the...

  3. Observing the work of an urban safety-net psychiatric emergency room: managing the unmanageable. (United States)

    Lincoln, Alisa K; White, Andrew; Aldsworth, Casandra; Johnson, Peggy; Strunin, Lee


    Staff in the psychiatric emergency room (PER) have demanding jobs requiring a complex balance between the needs and safety of the individual and the community, systemic resources, and job responsibilities while providing timely, effective care. Little research exists concerning day-to-day work activities of PER staff, their interaction, and their perceptions of their work. This study explored the work of PER staff and the organisational context of the PER work setting. Observations of staff were conducted in the public spaces of a public urban PER using two observational techniques. The first was designed to measure the types of work activities staff engaged in and the time spent in these work activities (work task data). The second technique was the gathering of observational data by a peripheral-member-researcher (participant observation data). Analyses were conducted of both the work task and participant observation data. Results indicate that most PER staff time is spent in administrative and phone tasks, while less than a third is spent on direct clinical work. Four important issues for PER work were identified: a workload that is unmanageable, managing the unmanageable, bogus referrals and dumping and insurance problems. The PER remains the front-line of the medical and social service systems. Work done in these settings is of critical importance; however little attention is paid to the content and nature of the work. Our study demonstrates that staff of the PER face challenges on many levels as they struggle with the task of working with people presenting in psychiatric and social crisis.

  4. 47 CFR 80.1007 - Bridge-to-bridge radiotelephone installation. (United States)


    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Bridge-to-bridge radiotelephone installation. 80.1007 Section 80.1007 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND... Bridge-to-Bridge Act § 80.1007 Bridge-to-bridge radiotelephone installation. Use of the bridge-to-bridge...

  5. Shrinking the Public Safety Net or Helping the Poor Play by the Rules? The Changes in the State-Level Policies That Affected Low-Income Families with Children in the Welfare Reform Era: 1994-2002 (United States)

    Aratani, Yumiko; Lu, Hsien-Hen; Aber, J. Lawrence


    Despite the claimed success of the 1996 Welfare Reform, little research using multivariate regression has examined changes in multiple public safety-net programs. Thus, we still do not know whether public safety-net programs for the poor have shrunk or increased nationwide, along with the sharp declines in cash assistance. Using state-level data…

  6. The Economic Impact of Productive Safety Net Program on Poverty: Microeconometrics Analysis, Tigrai National Regional State, Ethiopia

    Directory of Open Access Journals (Sweden)

    Yibrah Hagos Gebresilassie


    Full Text Available This paper aims at evaluating the impact of productive safety net program on poverty using primary data from randomly selected 600 households in central zone of Tigrai National Regional State, Ethiopia. Propensity Score Matching and Foster-Greer-Thorbecke were used to evaluate impact of the program and poverty, respectively. The paper revealed that the program has positive and significant effect on consumption, livestock holdings, and productive assets. Moreover, impact of the program on total consumption expenditure per adult equivalent was found to be positive and significant. Using total poverty line, poverty rate was lowest among program participants (30.33% than non-participants (31.1%. Highest poverty rate was found among households headed by women (38.42% while households headed by men (23.1%. The study also revealed that the program has positive and significant effect on poverty reduction and protecting productive assets. Finally, it was recommended that female headed program participants based programs should be provided to help boost their agricultural output and reduce endemic poverty.

  7. URBAN-NET: A Network-based Infrastructure Monitoring and Analysis System for Emergency Management and Public Safety

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sangkeun (Matt) [ORNL; Chen, Liangzhe [ORNL; Duan, Sisi [ORNL; Chinthavali, Supriya [ORNL; Shankar, Mallikarjun (Arjun) [ORNL; Prakash, B. Aditya [Virginia Tech, Blacksburg, VA


    Abstract Critical Infrastructures (CIs) such as energy, water, and transportation are complex networks that are crucial for sustaining day-to-day commodity flows vital to national security, economic stability, and public safety. The nature of these CIs is such that failures caused by an extreme weather event or a man-made incident can trigger widespread cascading failures, sending ripple effects at regional or even national scales. To minimize such effects, it is critical for emergency responders to identify existing or potential vulnerabilities within CIs during such stressor events in a systematic and quantifiable manner and take appropriate mitigating actions. We present here a novel critical infrastructure monitoring and analysis system named URBAN-NET. The system includes a software stack and tools for monitoring CIs, pre-processing data, interconnecting multiple CI datasets as a heterogeneous network, identifying vulnerabilities through graph-based topological analysis, and predicting consequences based on what-if simulations along with visualization. As a proof-of-concept, we present several case studies to show the capabilities of our system. We also discuss remaining challenges and future work.

  8. Work Disability Among Native-born and Foreign-born Americans: On Origins, Health, and Social Safety Nets. (United States)

    Engelman, Michal; Kestenbaum, Bert M; Zuelsdorff, Megan L; Mehta, Neil K; Lauderdale, Diane S


    Public debates about both immigration policy and social safety net programs are increasingly contentious. However, little research has explored differences in health within America's diverse population of foreign-born workers, and the effect of these workers on public benefit programs is not well understood. We investigate differences in work disability by nativity and origins and describe the mix of health problems associated with receiving Social Security Disability Insurance benefits. Our analysis draws on two large national data sources-the American Community Survey and comprehensive administrative records from the Social Security Administration-to determine the prevalence and incidence of work disability between 2001 and 2010. In sharp contrast to prior research, we find that foreign-born adults are substantially less likely than native-born Americans to report work disability, to be insured for work disability benefits, and to apply for those benefits. Overall and across origins, the foreign-born also have a lower incidence of disability benefit award. Persons from Africa, Northern Europe, Canada, and parts of Asia have the lowest work disability benefit prevalence rates among the foreign-born; persons from Southern Europe, Western Europe, the former Soviet Union, and the Caribbean have the highest rates.

  9. 49 CFR Appendix A to Part 237 - Supplemental Statement of Agency Policy on the Safety of Railroad Bridges (United States)


    ... traffic levels. 7. Underwater inspections of railroad bridges. (a) Inspections of bridges should include... communication between an inspector and an engineer who performs an analysis of a bridge. (c) An inspection... bridge evaluation depends on the quality of the communication between them. Review of inspection reports...

  10. Hardware safety net

    National Research Council Canada - National Science Library

    Mario Apicella


      Voom Technologies' PCI card, ISIR (Instant Save Instant Restore), works with ATA disk drives and promises to quickly revive a computer impaired by a virus, damaging update, corrupted configuration file, or other software illness...

  11. Without a Safety Net

    DEFF Research Database (Denmark)

    Nielsen, Mette Lykke; Gørlich, Anne; Grytnes, Regine


    ‘Precarisation’ is one of the concepts that has become important in efforts to explain how neoliberal politics and changed economic conditions produce new forms of marginalization and increased insecurity. The aim of this article is to examine how subjectivity is produced among young Danish emplo...

  12. Radar: Human Safety Net (United States)

    Ritz, John M.


    Radar is a technology that can be used to detect distant objects not visible to the human eye. A predecessor of radar, called the telemobiloscope, was first used to detect ships in the fog in 1904 off the German coast. Many scientists have worked on the development and refinement of radar (Hertz with electromagnetic waves; Popov with determining…

  13. Cultivating engaged leadership through a learning collaborative: lessons from primary care renewal in Oregon safety net clinics. (United States)

    McMullen, Carmit K; Schneider, Jennifer; Firemark, Alison; Davis, James; Spofford, Mark


    The aim of this study was to explore how learning collaboratives cultivate leadership skills that are essential for implementing patient-centered medical homes (PCMHs). We conducted an ethnographic evaluation of a payor-incentivized PCMH implementation in Oregon safety net clinics, known as Primary Care Renewal. Analyses primarily drew on in-depth interviews with organizational leaders who were involved in the initiative. We solicited perspectives on the history, barriers, facilitators, and other noteworthy factors related to the implementation of PCMH. We reviewed and summarized transcripts and created and applied a coding dictionary to identify emergent leadership themes. We reviewed field notes from clinic site visits and observations of learning collaborative activities for additional information on the role of engaged leadership. Interview data suggested that organizations followed a similar, sequential process of Primary Care Renewal implementation having 2 phases-inspiration and implementation-and that leaders needed and learned different leadership skills in each phase. Leaders reported that collaborative learning opportunities were critical for developing engaged leadership skills during the inspiration phase of transformation. Facilitative and modeling aspects of engaged leadership were most important for codesigning a vision and plan for change. Adaptive leadership skills became more important during the implementation phase, when specific operational and management skills were needed to foster standardization and spread of the Primary Care Renewal initiative throughout participating clinics. The PCMH has received much attention as a way to reorganize and potentially improve primary care. Documenting steps and stages for cultivating leaders with the vision and skills to transform their organizations into PCMHs may offer a useful roadmap to other organizations considering a similar transformation.

  14. Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system. (United States)

    Kahn, Ben; Freeland, Zachary; Gopal, Purva; Agrawal, Deepak; Mayorga, Christian A; Mithani, Rozina; Skinner, Celette Sugg; Halm, Ethan A; Singal, Amit G


    Appropriate surveillance intervals for colorectal cancer (CRC) screening is one of the Centers for Medicare and Medicaid Services 2014 physician quality reporting system measures. Appropriateness of surveillance intervals will continue to be monitored closely, particularly as reimbursements become tied to quality measures. Quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. We conducted a retrospective cohort study of patients who had colonoscopy with polypectomy at a safety-net health system between June 2011 and December 2013. Surveillance recommendations shorter and longer than guideline recommendations were defined as potential overuse and underuse. We used multivariate logistic regression to identify correlates of guideline-concordant surveillance recommendations, overuse, and underuse. Among 1,822 patients with polypectomy, 1,329 had ≥1 adenoma. Surveillance interval recommendations were guideline-concordant in 1,410 (77.4%) patients, potential overuse in 263 (14.4%), potential underuse in 85 (4.7%), and missing in 64 (3.5%) patients. Predictors of guideline-concordant recommendations in multivariate analyses included age >65 years (OR 1.36, 95% CI 1.02-1.80), incomplete resection (OR 3.58, 95% CI 1.41-9.09), and good/excellent prep quality (OR 2.22, 95% CI 1.72-2.86). Underuse recommendations were more likely in patients with ≥3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, ≥3 adenomas, age >65, or Hispanic ethnicity. Surveillance recommendations are not concordant with guidelines in one of four cases. Interventions to improve prep quality and guideline concordance of surveillance recommendations can improve cost-effectiveness of CRC screening.

  15. Collaborative health literate depression care among predominantly Hispanic patients with coronary heart disease in safety net care. (United States)

    Ell, Kathleen; Oh, Hyunsung; Lee, Pey-Jiuan; Guterman, Jeffrey


    To determine whether evidence-based socioculturally health literate-adapted collaborative depression care improves depression care, depressive symptoms, and quality of life among predominantly Hispanic patients with coronary heart disease. The 12-month trial included 97 patients with coronary heart disease (79% of eligible patients) who met the depression criteria assessed by the Patient Health Questionnaire-9. Patients were recruited from 3 safety net clinics and offered depression team care by a bilingual clinical social worker and community patient navigator, a consulting psychiatrist, and a primary care physician. The team provided problem-solving therapy (PST) or pharmacotherapy or both, telephone symptom monitoring and behavioral activation, and patient resource navigation support. Recruited patients were given patient and family member health literacy-adapted educational and community resource materials in Spanish or English. Overall, depression treatment was 74% (PST, 55%; PST plus antidepressant medications, 18%; and antidepressant medications alone, 2%). Nearly half of the patients showed a 50% reduction of the Symptom Checklist-20 (49% at 6 mo and 48% at 12 mo) and of Patient Health Questionnaire-9 score with 47% of patients at 6 months and 43% at 12 months. The 50% improvement in Patient Health Questionnaire and Symptom Checklist-20 score reduction did not vary significantly between patients who received PST or antidepressant only or those who received PST plus antidepressant. The quality of life Short-Form Health Survey SF-12, the Minnesota Living with Heart Failure questionnaire, and the Sheehan Disability Scale outcomes also improved significantly. Socioculturally literacy-adapted collaborative depression care was accepted by patients with coronary heart disease and improved depression care and symptoms, quality of life, and functional outcomes among predominantly Hispanic patients with heart disease. Copyright © 2014 The Academy of Psychosomatic

  16. Improving healthcare empowerment through breast cancer patient navigation: a mixed methods evaluation in a safety-net setting. (United States)

    Gabitova, Guzyal; Burke, Nancy J


    Breast cancer mortality rates in the U.S. remain relatively high, particularly among ethnic minorities and low-income populations. Unequal access to quality care, lower follow up rates, and poor treatment adherence contribute to rising disparities among these groups. Healthcare empowerment (HCE) is theorized to improve patient outcomes through collaboration with providers and improving understanding of and compliance with treatment. Patient navigation is a health care organizational intervention that essentially improves healthcare empowerment by providing informational, emotional, and psychosocial support. Patient navigators address barriers to care through multilingual coordination of treatment and incorporation of access to community services, support, and education into the continuum of cancer care. Utilizing survey and qualitative methods, we evaluated the patient navigation program in a Northern California safety-net hospital Breast Clinic by assessing its impact on patients' experiences with cancer care and providers' perspectives on the program. We conducted qualitative interviews with 16 patients and 4 service providers, conducted approximately 66 hours of clinic observations, and received feedback through the self-administered survey from 66 patients. The role of the patient navigator at the Breast Clinic included providing administrative assistance, psychosocial support, improved knowledge, better understanding of treatment process, and ensuring better communication between patients and providers. As such, patient navigators facilitated improved collaboration between patients and providers and understanding of interdisciplinary care processes. The survey results suggested that the majority of patients across all ethnic backgrounds and age groups were highly satisfied with the program and had a positive perception of their navigator. Interviews with patients and providers highlighted the roles of a navigator in ensuring continuity of care, improving

  17. A public-professional web-bridge for vaccines and vaccination: user concerns about vaccine safety. (United States)

    García-Basteiro, Alberto L; Alvarez-Pasquín, María-José; Mena, Guillermo; Llupià, Anna; Aldea, Marta; Sequera, Victor-Guillermo; Sanz, Sergi; Tuells, Jose; Navarro-Alonso, José-Antonio; de Arísteguí, Javier; Bayas, José-María

    2012-05-28 (, a website founded by the Spanish Association of Vaccinology offers a personalized service called Ask the Expert, which answers any questions posed by the public or health professionals about vaccines and vaccination. The aim of this study was to analyze the factors associated with questions on vaccination safety and determine the characteristics of questioners and the type of question asked during the period 2008-2010. A total of 1341 questions were finally included in the analysis. Of those, 30% were related to vaccine safety. Questions about pregnant women had 5.01 higher odds of asking about safety (95% CI 2.82-8.93) than people not belonging to any risk group. Older questioners (>50 years) were less likely to ask about vaccine safety compared to younger questioners (OR: 0.44, 95% CI 0.25-0.76). Questions made after vaccination or related to influenza (including H1N1) or travel vaccines were also associated with a higher likelihood of asking about vaccine safety. These results identify risk groups (pregnant women), population groups (older people) and some vaccines (travel and influenza vaccines, including H1N1) where greater efforts to provide improved, more-tailored vaccine information in general and on the Internet are required. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Nets for social safety: an analysis of the growth and changing composition of social security programmes in the fisheries sector of Kerala State, India


    Kurien, John; Paul, Antonyto


    Nets for Social Safety is a first –of –its-kind study, specially commissioned by the International Collective in Support of Fishworkers, to focus on the growth and changing composition of social security provisions in the fisheries sector of Kerala, a small coastal State in southwest India. John Kurien and Antonyto Paul, the authors of the study, enumerate the achievements and problems confronted by a developing maritime State in trying to ensure that a section of its population, which a...

  19. Participation of low-income women in genetic cancer risk assessment and BRCA 1/2 testing: the experience of a safety-net institution. (United States)

    Komenaka, Ian K; Nodora, Jesse N; Madlensky, Lisa; Winton, Lisa M; Heberer, Meredith A; Schwab, Richard B; Weitzel, Jeffrey N; Martinez, Maria Elena


    Some communities and populations lack access to genetic cancer risk assessment (GCRA) and testing. This is particularly evident in safety-net institutions, which serve a large segment of low-income, uninsured individuals. We describe the experience of a safety-net clinic with limited resources in providing GCRA and BRCA1/2 testing. We compared the proportion and characteristics of high-risk women who were offered and underwent GCRA and genetic testing. We also provide a description of the mutation profile for affected women. All 125 patients who were offered GCRA accepted to undergo GCRA. Of these, 72 % had a breast cancer diagnosis, 70 % were Hispanic, 52.8 % were non-English speakers, and 66 % did not have health insurance. Eighty four (67 %) were offered genetic testing and 81 (96 %) agreed. Hispanic women, those with no medical insurance, and those with a family history of breast cancer were significantly more likely to undergo testing (p > 0.01). Twelve of 81 (15 %) patients were found to have deleterious mutations, seven BRCA1, and five BRCA2. Our experience shows that it is possible to offer GCRA and genetic testing even in the setting of limited resources for these services. This is important given that a large majority of the low-income women in our study agreed to undergo counseling and testing. Our experience could serve as a model for similar low-resource safety-net health settings.

  20. Advanced bridge safety initiative, task 1 : development of improved analytical load rating procedures for flat-slab concrete bridges - a thesis and guidelines. (United States)


    Current AASHTO provisions for the conventional load rating of flat slab bridges rely on the equivalent strip method : of analysis for determining live load effects, this is generally regarded as overly conservative by many professional : engineers. A...

  1. Simulation of crash tests for high impact levels of a new bridge safety barrier (United States)

    Drozda, Jiří; Rotter, Tomáš


    The purpose is to show the opportunity of a non-linear dynamic impact simulation and to explain the possibility of using finite element method (FEM) for developing new designs of safety barriers. The main challenge is to determine the means to create and validate the finite element (FE) model. The results of accurate impact simulations can help to reduce necessary costs for developing of a new safety barrier. The introductory part deals with the creation of the FE model, which includes the newly-designed safety barrier and focuses on the application of an experimental modal analysis (EMA). The FE model has been created in ANSYS Workbench and is formed from shell and solid elements. The experimental modal analysis, which was performed on a real pattern, was employed for measuring the modal frequencies and shapes. After performing the EMA, the FE mesh was calibrated after comparing the measured modal frequencies with the calculated ones. The last part describes the process of the numerical non-linear dynamic impact simulation in LS-DYNA. This simulation was validated after comparing the measured ASI index with the calculated ones. The aim of the study is to improve professional public knowledge about dynamic non-linear impact simulations. This should ideally lead to safer, more accurate and profitable designs.

  2. Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa. (United States)

    Steenkamp, L; Goosen, A; Venter, D; Beeforth, M


    The HIV prevalence in South Africa among students at higher education institutions (HEIs) in 2008 was reported to be 3.4%, with the highest HIV prevalence found in the Eastern Cape Province. Students at these facilities are also increasingly affected by socio-economic constraints that may impact on food security. Little is known about the impact of food insecurity on HIV-infected students in HEIs in South Africa. The purpose of this paper is to describe food insecurity and the nutritional status among HIV-infected students on the Nelson Mandela Metropolitan University campuses in South Africa, as well as current initiatives to strengthen the safety nets for food-insecure students. This descriptive, cross-sectional survey was conducted among a convenience sample of known HIV-infected, registered students (n = 63), older than 18 years of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme. Ethical approval for the study was obtained from the Research Ethics Committee (NMMU) and participants were included in the sample after providing written, informed consent. Findings indicate that food insecurity was common with more than 60% of the sample reporting food insecurity at the household level during the previous month. Of the sample, 51% were classified as being either overweight or obese. Although food insecurity did not contribute to weight loss in our sample, food-insecure students were more likely to consume inadequate amounts of vitamins and minerals, especially antioxidants that are important in supporting the immune system. Food insecurity has been identified as affecting the majority of HIV-infected students in this study, especially regarding their difficulty in accessing nutritious foods. As overweight and obesity also seem to threaten the health and future well-being of the students, appropriate management of the overweight individuals and those with obesity should be instituted in order to prevent the development

  3. Affordability of health care under publicly subsidized insurance after Massachusetts health care reform: a qualitative study of safety net patients. (United States)

    Zallman, Leah; Nardin, Rachel; Malowney, Monica; Sayah, Assaad; McCormick, Danny


    The Affordable Care Act (ACA) and the 2006 Massachusetts (MA) health reform law, on which the ACA was based, aimed to improve the affordability of care largely by expanding publicly sponsored insurances. Both laws also aimed to promote consumer understanding of how to acquire, maintain and use these public plans. A prior study found an association between the level of cost-sharing required in these plans and the affordability of care. Preparatory to a quantitative study we conducted this qualitative study that aimed to examine (1) whether cost sharing levels built into the public insurance types that formed the backbone of the MA health reform led to unaffordability of care and if so, (2) how insurances with higher cost sharing levels led to unaffordability of care in this context. We interviewed 12 consumers obtaining the most commonly obtained insurances under MA health reform (Medicaid and Commonwealth Care) at a safety net hospital emergency department. We purposefully interviewed a stratified sample of higher and low cost sharing recipients. We used a combination of inductive and deductive codes to analyze the data according to degree of cost-sharing required by different insurance types. We found that higher cost sharing plans led to unaffordability of care, as evidenced by unmet medical needs, difficulty affording basic non-medical needs due to expenditures on medical care, and reliance on non-insurance resources to pay for care. Participants described two principal mechanisms by which higher cost sharing led to unaffordability of care: (1) cost sharing above what their incomes allowed and (2) poor understanding of how to effectively acquire, maintain and utilize insurance new public plans. Further efforts to investigate the relationship between perceived affordability of care and understanding of insurance for the insurance types obtained under MA health reform may be warranted. A potential focus for further work may be quantitative investigation of how the

  4. Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa

    Directory of Open Access Journals (Sweden)

    L. Steenkamp


    Full Text Available The HIV prevalence in South Africa among students at higher education institutions (HEIs in 2008 was reported to be 3.4%, with the highest HIV prevalence found in the Eastern Cape Province. Students at these facilities are also increasingly affected by socio-economic constraints that may impact on food security. Little is known about the impact of food insecurity on HIV-infected students in HEIs in South Africa. The purpose of this paper is to describe food insecurity and the nutritional status among HIV-infected students on the Nelson Mandela Metropolitan University campuses in South Africa, as well as current initiatives to strengthen the safety nets for food-insecure students. This descriptive, cross-sectional survey was conducted among a convenience sample of known HIV-infected, registered students (n = 63, older than 18 years of age and managed as part of the Campus Health Service antiretroviral therapy (ART programme. Ethical approval for the study was obtained from the Research Ethics Committee (NMMU and participants were included in the sample after providing written, informed consent. Findings indicate that food insecurity was common with more than 60% of the sample reporting food insecurity at the household level during the previous month. Of the sample, 51% were classified as being either overweight or obese. Although food insecurity did not contribute to weight loss in our sample, food-insecure students were more likely to consume inadequate amounts of vitamins and minerals, especially antioxidants that are important in supporting the immune system. Food insecurity has been identified as affecting the majority of HIV-infected students in this study, especially regarding their difficulty in accessing nutritious foods. As overweight and obesity also seem to threaten the health and future well-being of the students, appropriate management of the overweight individuals and those with obesity should be instituted in order to prevent

  5. 76 FR 38013 - Safety Zone; Big Sioux River From the Military Road Bridge North Sioux City to the Confluence of... (United States)


    ... navigation on the Big Sioux River from the Military Road Bridge in North Sioux City, South Dakota to the... Road Bridge in North Sioux City, SD at 42.52 degrees North, 096.48 West longitude to the confluence of... Sioux River from the Military Road Bridge in North Sioux City, SD at 42.52 degrees North, 096.48 West...

  6. Cable Supported Bridges

    DEFF Research Database (Denmark)

    Gimsing, Niels Jørgen

    Cable supported bridges in the form of suspension bridges and cable-stayed bridges are distinguished by their ability to overcome large spans.The book concentrates on the synthesis of cable supported bridges, covering both design and construction aspects. The analytical part covers simple methods...... to quantify the different structural configurations and allows a preliminary optimization of the main structure.Included are the most recent advances in structural design, corrosion protection of cables, aerodynamic safety, and erection procedures....

  7. Water safety plans: bridges and barriers to implementation in North Carolina. (United States)

    Amjad, Urooj Quezon; Luh, Jeanne; Baum, Rachel; Bartram, Jamie


    First developed by the World Health Organization, and now used in several countries, water safety plans (WSPs) are a multi-step, preventive process for managing drinking water hazards. While the beneficial impacts of WSPs have been documented in diverse countries, how to successfully implement WSPs in the United States remains a challenge. We examine the willingness and ability of water utility leaders to implement WSPs in the US state of North Carolina. Our findings show that water utilities have more of a reactive than preventive organizational culture, that implementation requires prioritization of time and resources, perceived comparative advantage to other hazard management plans, leadership in implementation, and identification of how WSPs can be embedded in existing work practices. Future research could focus on whether WSP implementation provides benefits such as decreases in operational costs, and improved organization of records and communication.

  8. Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness. (United States)

    Ferranti, Jeffrey M; Langman, Matthew K; Tanaka, David; McCall, Jonathan; Ahmad, Asif


    Healthcare is increasingly dependent upon information technology (IT), but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality, and financial effectiveness. Moreover, hospitals have lagged in adopting thoughtful analytic approaches that would allow operational leaders and providers to capitalize upon existing data stores. In this manuscript, we propose a fundamental re-evaluation of strategic IT investments in healthcare, with the goal of increasing efficiency, reducing costs, and improving outcomes through the targeted application of health analytics. We also present three case studies that illustrate the use of health analytics to leverage pre-existing data resources to support improvements in patient safety and quality of care, to increase the accuracy of billing and collection, and support emerging health issues. We believe that such active investment in health analytics will prove essential to realizing the full promise of investments in electronic clinical systems.

  9. Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record. (United States)

    Benkert, R; Dennehy, P; White, J; Hamilton, A; Tanner, C; Pohl, J M


    In this new era after the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the literature on lessons learned with electronic health record (EHR) implementation needs to be revisited. Our objective was to describe what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics, specifically feasibility of data retrieval, measurements over time, quality of data, and how our teams used this data. A cross-sectional study was conducted from October 2008 to October 2012 in four safety-net clinics located in the Midwest and Western United States. A data warehouse that stores data from across the U.S was utilized for data extraction from patients with diabetes or hypertension diagnoses and at least two office visits per year. Standard quality measures were collected over a period of two to four years. All sites were engaged in a partnership model with the IT staff and a shared learning process to enhance the use of the quality metrics. While use of the algorithms was feasible across sites, challenges occurred when attempting to use the query results for research purposes. There was wide variation of both process and outcome results by individual centers. Composite calculations balanced out the differences seen in the individual measures. Despite using consistent quality definitions, the differences across centers had an impact on numerators and denominators. All sites agreed to a partnership model of EHR implementation, and each center utilized the available resources of the partnership for Center-specific quality initiatives. Utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care delivery models.

  10. Understanding the critical role of social work in safety net medical settings: framework for research and practice in the emergency department. (United States)

    Moore, Megan; Ekman, Eve; Shumway, Martha


    Social workers in Emergency Departments (ED) provide counseling, community resource linkage, and discharge planning. The ED is a critical intervention point for patients with multiple unmet medical, psychological, and social needs, and little or no other contact with service providers. In part because of its role as a medical safety net for underserved populations, use of the ED has steadily increased over time. There is limited research examining the utility of social services in the ED. This article provides a brief history of hospital social work and a literature review of ED social work research with the goal of advancing current research and practice agendas.

  11. 47 CFR 80.331 - Bridge-to-bridge communication procedure. (United States)


    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Bridge-to-bridge communication procedure. 80..., Alarm, Urgency and Safety Procedures § 80.331 Bridge-to-bridge communication procedure. (a) Vessels subject to the Bridge-to-Bridge Act transmitting on the designated navigational frequency must conduct...

  12. 77 FR 44544 - Safety Zone; Gilmerton Bridge Center Span Float-In, Elizabeth River; Norfolk, Portsmouth, and... (United States)


    ...The Coast Guard is withdrawing its proposed rule concerning the Gilmerton Bridge Center Span Float-in and bridge construction of span placement. The original proposal had a start date of July 31, 2012, and must be rescheduled to start on September 5, 2012, due to unforeseen circumstances with span lift construction.

  13. The health of safety net hospitals following Massachusetts health care reform: changes in volume, revenue, costs, and operating margins from 2006 to 2009. (United States)

    Mohan, Arun; Grant, Jennifer; Batalden, Maren; McCormick, Danny


    Massachusetts health care reform, designed to expand coverage and access to care for vulnerable populations, serves as the model for national health reform in the United States that will be implemented in 2014. Yet, little is known about how the reform may have affected the demand for and the financial performance of safety net hospitals (SNH), the primary source of care for such populations before the reform. Using a quasi-experimental design that included all acute care hospitals in the state, we calculated changes in mean inpatient and outpatient volumes, revenue, and operating margins at SNH from the pre-reform (Fiscal Year 2006) to the post-reform (Fiscal Year 2009) period. We contrasted these changes with contemporaneous changes occurring among non-safety net hospitals (NSNH) using a difference-in-differences approach. We found that SNH in Massachusetts continue to play a disproportionately large role in caring for disadvantaged patients after reform, but that their financial performance has declined considerably compared with NSNH. Ongoing reform efforts in the United States should account for continued SNH demand among the most vulnerable patients and should be designed so as not to undermine the financial stability of SNH that meet this demand.

  14. An international network (PlaNet) to evaluate a human placental testing platform for chemicals safety testing in pregnancy

    DEFF Research Database (Denmark)

    Brownbill, Paul; Chernyavsky, Igor; Bottalico, Barbara


    in pregnancy and how ex vivo and in vitro human placental models might be advanced to reproducible human placental test systems (HPTSs), refining a weight of evidence to the guidance given around compound risk assessment during pregnancy. The placental pharmacokinetics of xenobiotic transfer, dysregulated...... placental function in pregnancy-related pathologies and influx/efflux transporter polymorphisms are a few caveats that could be addressed by HPTSs, not the specific focus of current mammalian reproductive toxicology systems. An international consortium, “PlaNet”, will bridge academia, industry...

  15. Barriers and Facilitators to Online Portal Use Among Patients and Caregivers in a Safety Net Health Care System: A Qualitative Study. (United States)

    Tieu, Lina; Sarkar, Urmimala; Schillinger, Dean; Ralston, James D; Ratanawongsa, Neda; Pasick, Rena; Lyles, Courtney R


    Patient portals have the potential to support self-management for chronic diseases and improve health outcomes. With the rapid rise in adoption of patient portals spurred by meaningful use incentives among safety net health systems (a health system or hospital providing a significant level of care to low-income, uninsured, and vulnerable populations), it is important to understand the readiness and willingness of patients and caregivers in safety net settings to access their personal health records online. To explore patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital, a safety net hospital. We conducted 16 in-depth interviews with chronic disease patients and caregivers who expressed interest in using the Internet to manage their health. Discussions focused on health care experiences, technology use, and interest in using an online portal to manage health tasks. We used open coding to categorize all the barriers and facilitators to portal use, followed by a second round of coding that compared the categories to previously published findings. In secondary analyses, we also examined specific barriers among 2 subgroups: those with limited health literacy and caregivers. We interviewed 11 patients and 5 caregivers. Patients were predominantly male (82%, 9/11) and African American (45%, 5/11). All patients had been diagnosed with diabetes and the majority had limited health literacy (73%, 8/11). The majority of caregivers were female (80%, 4/5), African American (60%, 3/5), caregivers of individuals with diabetes (60%, 3/5), and had adequate health literacy (60%, 3/5). A total of 88% (14/16) of participants reported interest in using the portal after viewing a prototype. Major perceived barriers included security concerns, lack of technical skills/interest, and preference for in-person communication. Facilitators to portal use included convenience, health monitoring, and improvements in patient

  16. Impact of Social Determinants of Health on Patients with Complex Diabetes Who Are Served by National Safety-Net Health Centers. (United States)

    Li, Vivian; McBurnie, Mary Ann; Simon, Melissa; Crawford, Phil; Leo, Michael; Rachman, Fred; Cottrell, Erika; Dant, Lydia; Oneha, Mary; Chang Weir, Rosy


    Recent research demonstrates an increased need to understand the contribution of social determinants of health (SDHs) in shaping an individual's health status and outcomes. We studied patients with diabetes in safety-net centers and evaluated associations of their disease complexity, demographic characteristics, comorbidities, insurance status, and primary language with their HbA1c level over time. Adult patients with diabetes with at least 3 distinct primary care visits between January 1, 2006, and December 31, 2013, were identified in the CHARN data warehouse. These patients were categorized into 4 groups: those without a diagnosis of cardiovascular disease (CVD) or depression; those with CVD but not depression; those with depression but not CVD; and those with CVD and depression. Charlson score; demographic characteristics such as age, sex, and race/ethnicity; and SDHs such as primary language and insurance status were used as predictors. The outcome measure was HbA1c. Hypothesis testing was conducted using 3-level hierarchical linear models. Baseline HbA1c differed significantly across the 4 diabetes groups and by race/ethnicity. The amount of HbA1c change over time differed by insurance status. Patients who were continuously insured tended to have lower baseline HbA1c and a smaller increase. Chinese-speaking patients tended to have lower baseline HbA1c but a larger increase over time compared with English speakers. There were various unexpected associations: compared with the diabetes-only group, mean HbA1c tended to be lower among the other more complex groups at baseline; women tended to have lower measures at baseline; older age and higher Charlson scores were associated with lower HbA1c. There is still unexplained variability relating to both baseline HbA1c values and change over time in the model. SDHs, such as insurance status and primary language, are associated with HbA1c, and results suggest that these relationships vary with disease status among

  17. Can We Do That Here? Establishing the Scope of Surgical Practice at a New Safety-Net Community Hospital Through a Transparent, Collaborative Review of Physician Privileges. (United States)

    O'Neill, Sean M; Seresinghe, Sarah; Sharma, Arun; Russell, Tara A; Crawford, L'Orangerie; Frencher, Stanley K


    Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms. Staff privileging decisions were initially based only on physicians' training and experience, but this resulted in several cases that tested the boundaries of what a small community hospital was prepared to handle. A collaborative, transparent process to review physician privileges was developed. This began with physician-only review of procedure lists, followed by a larger, multidisciplinary group to assess system-level factors. Specific questions were used to guide discussion, and unanimous approval from all stakeholders was required to include a procedure. An initial list of 558 procedures across 11 specialties was reduced to 321 (57.5%). No new cases that fall outside these new boundaries have arisen. An inclusive process was crucial for obtaining buy-in and establishing cultural norms. Arranging transfer agreements remains a significant challenge. Accumulation of institutional experience continues through regular performance reviews. As this hospital's capabilities mature, a blueprint has been established for expanding surgical scope of practice based explicitly on system-level factors. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  18. Technology-facilitated depression care management among predominantly Latino diabetes patients within a public safety net care system: comparative effectiveness trial design. (United States)

    Wu, Shinyi; Ell, Kathleen; Gross-Schulman, Sandra G; Sklaroff, Laura Myerchin; Katon, Wayne J; Nezu, Art M; Lee, Pey-Jiuan; Vidyanti, Irene; Chou, Chih-Ping; Guterman, Jeffrey J


    Health disparities in minority populations are well recognized. Hispanics and Latinos constitute the largest ethnic minority group in the United States; a significant proportion receives their care via a safety net. The prevalence of diabetes mellitus and comorbid depression is high among this group, but the uptake of evidence-based collaborative depression care management has been suboptimal. The study design and baseline characteristics of the enrolled sample in the Diabetes-Depression Care-management Adoption Trial (DCAT) establishes a quasi-experimental comparative effectiveness research clinical trial aimed at accelerating the adoption of collaborative depression care in safety net clinics. The study was conducted in collaboration with the Los Angeles County Department of Health Services at eight county-operated clinics. DCAT has enrolled 1406 low-income, predominantly Hispanic/Latino patients with diabetes to test a translational model of depression care management. This three-group study compares usual care with a collaborative care team support model and a technology-facilitated depression care model that provides automated telephonic depression screening and monitoring tailored to patient conditions and preferences. Call results are integrated into a diabetes disease management registry that delivers provider notifications, generates tasks, and issues critical alerts. All subjects receive comprehensive assessments at baseline, 6, 12, and 18 months by independent English-Spanish bilingual interviewers. Study outcomes include depression outcomes, treatment adherence, satisfaction, acceptance of assessment and monitoring technology, social and economic stress reduction, diabetes self-care management, health care utilization, and care management model cost and cost-effectiveness comparisons. DCAT's goal is to optimize depression screening, treatment, follow-up, outcomes, and cost savings to reduce health disparities. Copyright © 2013 Elsevier Inc. All rights

  19. Sub-optimal Testing and Awareness of HCV and HBV Among High Risk Individuals at an Underserved Safety-Net Hospital. (United States)

    Wong, Robert J; Campbell, Brendan; Liu, Benny; Baden, Rachel; Bhuket, Taft


    Sub-optimal screening for chronic hepatitis C virus (HCV) and chronic hepatitis B virus (HBV) among high risk groups delays diagnosis and treatment. We aimed to evaluate overall rates of HCV and HBV screening and patient knowledge of their testing result. Adults age ≥18 years undergoing elective outpatient endoscopy at a large, urban safety-net hospital from July 2015 to July 2016 were prospectively evaluated to determine rates of HCV and HBV testing, the results of those completed tests, and patient knowledge of test results among high risk individuals (as determined by U.S. Preventative Services Task Force). Among 1125 patients (52.3% male, 70.4% foreign-born), 66.5% were high risk for chronic HCV; only 30.9% received prior testing. 14.7% had positive chronic HCV infection. Patients born in the 1945-1965 cohort were more likely to have received prior HCV testing compared to those born outside of this cohort (32.7 vs. 16.9%, p = 0.01). Among patients who received HCV screening, 29.3% were aware of test results. Overall, 61.6% were high risk for chronic HBV; only 25.1% received prior testing. 4.1% were positive for chronic HBV. Compared to Caucasians, Asians (19.0 vs. 44.4%, p HBV testing. Among patients who received prior HBV screening, 18.4% were aware of test results. Less than one-third of high risk patients received HCV and HBV screening among an ethnically diverse safety-net population. Equally low rates of patient knowledge of testing results were observed.

  20. The equivalency between logic Petri workflow nets and workflow nets. (United States)

    Wang, Jing; Yu, ShuXia; Du, YuYue


    Logic Petri nets (LPNs) can describe and analyze batch processing functions and passing value indeterminacy in cooperative systems. Logic Petri workflow nets (LPWNs) are proposed based on LPNs in this paper. Process mining is regarded as an important bridge between modeling and analysis of data mining and business process. Workflow nets (WF-nets) are the extension to Petri nets (PNs), and have successfully been used to process mining. Some shortcomings cannot be avoided in process mining, such as duplicate tasks, invisible tasks, and the noise of logs. The online shop in electronic commerce in this paper is modeled to prove the equivalence between LPWNs and WF-nets, and advantages of LPWNs are presented.

  1. Ensuring Patient Safety by using Colored Petri Net Simulation in the Design of Heterogeneous, Multi-Vendor, Integrated, Life-Critical Wireless (802.x) Patient Care Device Networks. (United States)

    Sloane, Elliot; Gehlot, Vijay


    Hospitals and manufacturers are designing and deploying the IEEE 802.x wireless technologies in medical devices to promote patient mobility and flexible facility use. There is little information, however, on the reliability or ultimate safety of connecting multiple wireless life-critical medical devices from multiple vendors using commercial 802.11a, 802.11b, 802.11g or pre-802.11n devices. It is believed that 802.11-type devices can introduce unintended life-threatening risks unless delivery of critical patient alarms to central monitoring systems and/or clinical personnel is assured by proper use of 802.11e Quality of Service (QoS) methods. Petri net tools can be used to simulate all possible states and transitions between devices and/or systems in a wireless device network, and can identify failure modes in advance. Colored Petri Net (CPN) tools are ideal, in fact, as they allow tracking and controlling each message in a network based on pre-selected criteria. This paper describes a research project using CPN to simulate and validate alarm integrity in a small multi-modality wireless patient monitoring system. A 20-monitor wireless patient monitoring network is created in two versions: one with non-prioritized 802.x CSM protocols and the second with simulated Quality of Service (QoS) capabilities similar to 802.11e (i.e., the second network allows message priority management.) In the standard 802.x network, dangerous heart arrhythmia and pulse oximetry alarms could not be reliably and rapidly communicated, but the second network's QoS priority management reduced that risk significantly.

  2. Patient engagement at the margins: Health care providers' assessments of engagement and the structural determinants of health in the safety-net. (United States)

    Fleming, Mark D; Shim, Janet K; Yen, Irene H; Thompson-Lastad, Ariana; Rubin, Sara; Van Natta, Meredith; Burke, Nancy J


    Increasing "patient engagement" has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement. We investigate how health care providers describe engagement for high cost patients-the "super-utilizers" of the health care system-who often face complex challenges related to socioeconomic marginalization including poverty, housing insecurity, exposure to violence and trauma, cognitive and mental health issues, and substance use. The health care providers in our study faced institutional pressure to assess patient engagement and to direct care towards engaged patients. However, providers considered such assessments to be highly challenging and oftentimes inaccurate, particularly because they understood low patient engagement to be the result of difficult socioeconomic conditions. Providers tried to navigate the demand to assess patient engagement in care by looking for explicit positive and negative indicators of engagement, while also being sensitive to more subtle and intuitive signs of engagement for marginalized patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

    Directory of Open Access Journals (Sweden)

    Hansel Tookes

    Full Text Available Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs. Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs. 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9% died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million.Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.

  4. The Community Health Applied Research Network (CHARN) Data Warehouse: a Resource for Patient-Centered Outcomes Research and Quality Improvement in Underserved, Safety Net Populations. (United States)

    Laws, Reesa; Gillespie, Suzanne; Puro, Jon; Van Rompaey, Stephan; Quach, Thu; Carroll, Joseph; Weir, Rosy Chang; Crawford, Phil; Grasso, Chris; Kaleba, Erin; McBurnie, Mary Ann


    The Community Health Applied Research Network, funded by the Health Resources and Services Administration, is a research network comprising 18 Community Health Centers organized into four Research Nodes (each including an academic partner) and a data coordinating center. The network represents more than 500,000 diverse safety net patients across 11 states. The primary objective of this paper is to describe the development and implementation process of the CHARN data warehouse. The methods involved regulatory and governance development and approval, development of content and structure of the warehouse and processes for extracting the data locally, performing validation, and finally submitting data to the data coordinating center. Version 1 of the warehouse has been developed. Tables have been added, the population and the years of electronic health records (EHR) have been expanded for Version 2. It is feasible to create a national, centralized data warehouse with multiple Community Health Center partners using different EHR systems. It is essential to allow sufficient time: (1) to develop collaborative, trusting relationships among new partners with varied technology, backgrounds, expertise, and interests; (2) to complete institutional, business, and regulatory review processes; (3) to identify and address technical challenges associated with diverse data environments, practices, and resources; and (4) to provide continuing data quality assessments to ensure data accuracy.

  5. Decreasing Turnaround Time and Increasing Patient Satisfaction in a Safety Net Hospital-Based Pediatrics Clinic Using Lean Six Sigma Methodologies. (United States)

    Jayasinha, Yasangi


    Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic. Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction. A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%. We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.

  6. Predictors of psychological distress among cancer patients receiving care at a safety-net institution: the role of younger age and psychosocial problems. (United States)

    Acquati, Chiara; Kayser, Karen


    The present study examined prevalence and predictors of psychological distress among cancer patients receiving care at a safety-net institution during the first year of implementation of a distress screening protocol. Differences between screened and unscreened patients were also analyzed. Data on 182 breast and lung cancer patients who were treated at a NCI-designated Academic Comprehensive Cancer Center (ACAD) were abstracted from the patients' medical charts for a period of 1 year. Among the patients screened for distress, 66.2% reported a score higher than 4 (the established cut-off for distress) on the Distress Thermometer. Results from multiple regression analysis indicated that younger age, practical, and emotional problems were significant predictors of higher self-reported scores of psychological distress. There were no significant differences on socio-demographic and clinical variables between patients screened and those who were not screened. However, patients who were receiving more than one treatment modality were more likely to be screened. The occurrence of psychological distress in this setting was higher than the percentages reported in other similar studies. Furthermore, younger cancer patients and those presenting psychosocial problems were at risk for higher distress, which requires referral to psychosocial providers and the implementation of services able to meet these areas of need.

  7. Race/Ethnicity, Primary Language, and Income Are Not Demographic Drivers of Mortality in Breast Cancer Patients at a Diverse Safety Net Academic Medical Center

    Directory of Open Access Journals (Sweden)

    Divya A. Parikh


    Full Text Available Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center. Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code, and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012. Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28–4.37, p=0.006, age > 70 years (OR = 3.88, CI = 1.13–11.48, p=0.014, and AJCC stage IV (OR = 171.81, CI = 59.99–492.06, p<0.0001. Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.

  8. Net Locality

    DEFF Research Database (Denmark)

    de Souza e Silva, Adriana Araujo; Gordon, Eric

    Provides an introduction to the new theory of Net Locality and the profound effect on individuals and societies when everything is located or locatable. Describes net locality as an emerging form of location awareness central to all aspects of digital media, from mobile phones, to Google Maps...... of emerging technologies, from GeoCities to GPS, Wi-Fi, Wiki Me, and Google Android....

  9. Net Neutrality

    DEFF Research Database (Denmark)

    Savin, Andrej


    Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else.......Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else....

  10. Railroad Bridges (United States)

    Department of Homeland Security — Bridges-Rail in the United States According to The National Bridge Inspection Standards published in the Code of Federal Regulations (23 CFR 650.3), a bridge isA...

  11. Myocardial Bridge (United States)

    ... Sudden Cardiac Arrest Valve Disease Vulnerable Plaque Myocardial Bridge Related terms: myocardium, coronary arteries, myocardial ischemia Your ... surface of the heart. What is a myocardial bridge? A myocardial bridge is a band of heart ...

  12. 47 CFR 80.309 - Watch required by the Bridge-to-Bridge Act. (United States)


    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Watch required by the Bridge-to-Bridge Act. 80... Safety Watches § 80.309 Watch required by the Bridge-to-Bridge Act. In addition to the watch requirement contained in § 80.148, all vessels subject to the Bridge-to-Bridge Act must keep a watch on the designated...

  13. Existing Steel Railway Bridges Evaluation

    Directory of Open Access Journals (Sweden)

    Vičan Josef


    Full Text Available The article describes general principles and basis of evaluation of existing railway bridges based on the concept of load-carrying capacity determination. Compared to the design of a new bridge, the modified reliability level for existing bridges evaluation should be considered due to implementation of the additional data related to bridge condition and behaviour obtained from regular inspections. Based on those data respecting the bridge remaining lifetime, a modification of partial safety factors for actions and materials could be respected in the bridge evaluation process. A great attention is also paid to the specific problems of determination of load-caring capacity of steel railway bridges in service. Recommendation for global analysis and methodology for existing steel bridge superstructure load-carrying capacity determination are described too.

  14. Bridging the divide between fire safety research and fighting fire safely: How do we convey research innovation to contribute more effectively to wildland firefighter safety? (United States)

    Theodore Ted Adams; Bret W. Butler; Sara Brown; Vita Wright; Anne Black


    Creating a safe workplace for wildland firefighters has long been at the centre of discussion for researchers and practitioners. The goal of wildland fire safety research has been to protect operational firefighters, yet its contributions often fall short of potential because much is getting lost in the translation of peer-reviewed results to potential and intended...

  15. Understanding the linkages between social safety nets and childhood violence: a review of the evidence from low- and middle-income countries. (United States)

    Peterman, Amber; Neijhoft, Anastasia Naomi; Cook, Sarah; Palermo, Tia M


    As many as one billion children experience violence every year, and household- and community-level poverty are among the risk factors for child protection violations. Social safety nets (SSNs) are a main policy tool to address poverty and vulnerability, and there is substantial evidence demonstrating positive effects on children's health and human capital. This paper reviews evidence and develops a framework to understand linkages between non-contributory SSNs and the experience of childhood emotional, physical and sexual violence in low- and middle-income countries. We catalogue 14 rigorous impact evaluations, 11 of which are completed, analysing 57 unique impacts on diverse violence indicators. Among these impacts, approximately one in five represent statistically significant protective effects on childhood violence. Promising evidence relates to sexual violence among female adolescents in Africa, while there is less clear evidence of significant impacts in other parts of the developing world, and on young child measures, including violent discipline. Further, few studies are set up to meaningfully unpack mechanisms between SSNs and childhood violence; however, those most commonly hypothesized operate at the household level (through increases in economic security and reductions in poverty-related stress), the interpersonal level (improved parental behaviours, caregiving practices, improved psychosocial well-being) and at the child-level (protective education and decreases in problem or risky behaviours). It is important to emphasize that traditional SSNs are never designed with violence prevention as primary objectives, and thus should not be considered as standalone interventions to reduce risks for childhood violence. However, SSNs, particularly within integrated protection systems, appear to have potential to reduce violence risk. Linkages between SSNs and childhood violence are understudied, and investments should be made to close this evidence gap. © The

  16. A Quasi-experimental Evaluation of Performance Improvement Teams in the Safety-Net: A Labor-Management Partnership Model for Engaging Frontline Staff. (United States)

    Laing, Brian Yoshio; Dixit, Ravi K; Berry, Sandra H; Steers, W Neil; Brook, Robert H


    Unit-based teams (UBTs), initially developed by Kaiser Permanente and affiliated unions, are natural work groups of clinicians, managers, and frontline staff who work collaboratively to identify areas for improvement and implement solutions. We evaluated the UBT model implemented by the Los Angeles County Department of Health Services in partnership with its union to engage frontline staff in improving patient care. We conducted a quasi-experimental study, comparing surveys at baseline and 6 months, among personnel in 10 clinics who received UBT training to personnel in 5 control clinics. We also interviewed staff from 5 clinics that received UBT training and 3 control clinics. We conducted 330 surveys and 38 individual, semi-structured interviews with staff at an outpatient facility in South Los Angeles. Each UBT leader received an 8-hour training in basic performance improvement methods, and each UBT was assigned a team "coach." Our outcome measure was 6-month change in the "adaptive reserve" score, the units' self-reported ability to make and sustain change. We analyzed transcripts of the interviews to find common themes regarding the UBT intervention. The survey response rate was 63% (158/252) at baseline and 75% (172/231) at 6 months. There was a significant difference-in-change in adaptive reserve between UBTs and non-UBTs at 6 months (+0.11 vs -0.13; P = .02). Nine of the 10 UBTs reported increases in adaptive reserve and 8 UBTs reported decreased no-show rates or patient length of stay in clinic. Staff overwhelmingly felt the UBTs were a positive intervention because it allowed all levels of staff to have a voice in improvement. Our results indicate that partnership between management and unions to engage frontline staff in teams may be a useful tool to improve delivery of health care in a safety-net setting.

  17. RESTful NET

    CERN Document Server

    Flanders, Jon


    RESTful .NET is the first book that teaches Windows developers to build RESTful web services using the latest Microsoft tools. Written by Windows Communication Foundation (WFC) expert Jon Flanders, this hands-on tutorial demonstrates how you can use WCF and other components of the .NET 3.5 Framework to build, deploy and use REST-based web services in a variety of application scenarios. RESTful architecture offers a simpler approach to building web services than SOAP, SOA, and the cumbersome WS- stack. And WCF has proven to be a flexible technology for building distributed systems not necessa

  18. SAFETY

    CERN Multimedia

    Niels Dupont


    CERN Safety rules and Radiation Protection at CMS The CERN Safety rules are defined by the Occupational Health & Safety and Environmental Protection Unit (HSE Unit), CERN’s institutional authority and central Safety organ attached to the Director General. In particular the Radiation Protection group (DGS-RP1) ensures that personnel on the CERN sites and the public are protected from potentially harmful effects of ionising radiation linked to CERN activities. The RP Group fulfils its mandate in collaboration with the CERN departments owning or operating sources of ionising radiation and having the responsibility for Radiation Safety of these sources. The specific responsibilities concerning "Radiation Safety" and "Radiation Protection" are delegated as follows: Radiation Safety is the responsibility of every CERN Department owning radiation sources or using radiation sources put at its disposition. These Departments are in charge of implementing the requi...

  19. Fiscal 1997 survey report. Subtask 3 (hydrogen utilization worldwide clean system technology) (WE-NET) (total system conceptual design/safety measures/evaluation technology); 1997 nendo seika hokokusho. Suiso riyo kokusai clean energy system gijutsu (WE-NET) subtask 3 zentai system gainen sekkei - anzen taisaku hyoka gijutsu

    Energy Technology Data Exchange (ETDEWEB)



    Concerning the study of safety measures in WE-NET, the paper described the fiscal 1997 results. For drawing up a policy for safety design, technology of preserving hydrogen at high temperature/pressure, continuing collecting information on existing plants (liquid hydrogen, LNG). Investigating manuals of NASA and NASDA and also referring to people`s opinions at chemical plants, etc., the study entered into the setting-up of the safety policy and design standards. Examples of anomalies/accidents were extracted, and classification/arrangement were commenced of the measures for anomalies of detection/prevention/protection. Toward the diffusion of hydrogen and the enhancement and unification of explosion/fire simulation models, the extraction of problems has been almost finished. The second mini work shop on safety was held in the U.S., and exchanges of information were made among researchers of each country. All agreed on the importance of collecting data as the base of safety standards. As to safety measures in various tests using combustor evaluation experimental facilities, experimental equipment for materials under liquid hydrogen and experimental equipment of thermal insulation under liquid hydrogen, problems were extracted between researchers and people concerned with safety measures, and the measures to solve them were studied. 18 refs., 31 figs., 10 tabs.

  20. Petri Nets

    Indian Academy of Sciences (India)

    Associate Professor of. Computer Science and. Automation at the Indian. Institute of Science,. Bangalore. His research interests are broadly in the areas of stochastic modeling and scheduling methodologies for future factories; and object oriented modeling. GENERAL I ARTICLE. Petri Nets. 1. Overview and Foundations.

  1. Petri Nets

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 4; Issue 8. Petri Nets - Overview and Foundations. Y Narahari. General Article Volume 4 Issue 8 August 1999 pp ... Author Affiliations. Y Narahari1. Department ot Computer Science and Automation, Indian Institute of Science, Bangalore 560 012, India.

  2. Why is it so hard to implement change? A qualitative examination of barriers and facilitators to distribution of naloxone for overdose prevention in a safety net environment. (United States)

    Drainoni, Mari-Lynn; Koppelman, Elisa A; Feldman, James A; Walley, Alexander Y; Mitchell, Patricia M; Ellison, Jacqueline; Bernstein, Edward


    The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose. The aims of this study were to examine acceptance and uptake of the policy and assess facilitators and barriers to implementation. After obtaining pre-post data on naloxone distribution, we conducted a qualitative study. The PARiHS framework steered development of the qualitative guide. We used theoretical sampling in order to include the range of types of emergency department staff (50 total). The constant comparative method was initially used to code the transcripts and identify themes; the themes that emerged from the coding were then mapped back to the evidence, context and facilitation constructs of the PARiHS framework. Acceptance of the policy was good but uptake was low. Primary themes related to facilitators included: real-world driven intervention with philosophical, clinician and leadership support; basic education and training efforts; availability of resources; and ability to leave the ED with the naloxone kit in hand. Barriers fell into five general categories: protocol and policy; workflow and logistical; patient-related; staff roles and responsibilities; and education and training. The actual implementation of a new innovation in healthcare delivery is largely driven by factors beyond acceptance. Despite support and resources, implementation was challenging, with low uptake. While the potential of this innovation is unknown, understanding the experience is important to improve uptake

  3. Bridge characterization and structural health monitoring: a suspension bridge case study


    Houel, Adrien; Orcesi, André; LECONTE, Renaud


    Detecting and assessing the severity of structural damage is one major objective when monitoring a bridge. In particular, when some degradation phenomena threaten the bridge safety, the goal can be to assess monitoring critical components, which allows checking a safety threshold is not reached until some repair/rehabilitation actions are performed. This paper describes an overall monitoring-based decision process, illustrated with the case of a suspension bridge in France, the Teil Bridge ne...

  4. Myocardial Bridging

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan


    Full Text Available Abstract Myocardial bridging is rare. Myocardial bridges are most commonly localized in the middle segment of the left anterior descending coronary artery. The anatomic features of the bridges vary significantly. Alterations of the endothelial morphology and the vasoactive agents impact on the progression of atherosclerosis of myocardial bridging. Patients may present with chest pain, myocardial infarction, arrhythmia and even sudden death. Patients who respond poorly to the medical treatment with β-blockers warrant a surgical intervention. Myotomy is a preferred surgical procedure for the symptomatic patients. Coronary stent deployment has been in limited use due to the unsatisfactory long-term results.

  5. Heavy Vehicles on Minor Highway Bridges

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Nielsen, Søren R. K.; Enevoldsen, I.

    of heavier trucks moving at larger speeds, and partly because the authorities want to permit transportation of special heavy goods at a larger part of the road net. These needs will in many cases cause the strengthening of the bridges becomes necessary. In order to keep the expenses of such strengthening......Vibration of a bridge structure due to the passage of vehicles is an important consideration in the design of bridges. Further, a common problem in bridge engineering practice in these years is the upgrading of minor highway bridges (=5-20 m) to carry heavier loads partly due to a tendency...... the numerical models for the mathematical models of the vehicles and the bridge from which the load amplification factors can be estimated assuming that the dynamic parameters of the vehicles and the modal parameters of the bridge are known....

  6. Development of finite element models to predict dynamic bridge response. (United States)


    Dynamic response has long been recognized as one of the significant factors affecting the service life and safety of bridge structures. Even though considerable research, both analytical and experimental, has been devoted to dynamic bridge behavior, ...

  7. Bridge Management Systems

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    In this paper bridge management systems are discussed with special emphasis on management systems for reinforced concrete bridges. Management systems for prestressed concrete bridges, steel bridges, or composite bridges can be developed in a similar way....


    CERN Multimedia

    C. Schaefer and N. Dupont


      “Safety is the highest priority”: this statement from CERN is endorsed by the CMS management. An interpretation of this statement may bring you to the conclusion that you should stop working in order to avoid risks. If the safety is the priority, work is not! This would be a misunderstanding and misinterpretation. One should understand that “working safely” or “operating safely” is the priority at CERN. CERN personnel are exposed to different hazards on many levels on a daily basis. However, risk analyses and assessments are done in order to limit the number and the gravity of accidents. For example, this process takes place each time you cross the road. The hazard is the moving vehicle, the stake is you and the risk might be the risk of collision between both. The same principle has to be applied during our daily work. In particular, keeping in mind the general principles of prevention defined in the late 1980s. These principles wer...


    CERN Document Server

    M. Plagge, C. Schaefer and N. Dupont


    Fire Safety – Essential for a particle detector The CMS detector is a marvel of high technology, one of the most precise particle measurement devices we have built until now. Of course it has to be protected from external and internal incidents like the ones that can occur from fires. Due to the fire load, the permanent availability of oxygen and the presence of various ignition sources mostly based on electricity this has to be addressed. Starting from the beam pipe towards the magnet coil, the detector is protected by flooding it with pure gaseous nitrogen during operation. The outer shell of CMS, namely the yoke and the muon chambers are then covered by an emergency inertion system also based on nitrogen. To ensure maximum fire safety, all materials used comply with the CERN regulations IS 23 and IS 41 with only a few exceptions. Every piece of the 30-tonne polyethylene shielding is high-density material, borated, boxed within steel and coated with intumescent (a paint that creates a thick co...

  10. National Bridge Inventory (NBI) Bridges (United States)

    Department of Homeland Security — The NBI is a collection of information (database) describing the more than 600,000 of the Nation's bridges located on public roads, including Interstate Highways,...

  11. Building Bridges

    DEFF Research Database (Denmark)

    The report Building Bridges adresses the questions why, how and for whom academic audience research has public value, from the different points of view of the four working groups in the COST Action IS0906 Transforming Audiences, Transforming Societies – “New Media Genres, Media Literacy and Trust...... in the Media”, “Audience Interactivity and Participation”, “The Role of Media and ICT Use for Evolving Social Relationships” and “Audience Transformations and Social Integration”. Building Bridges is the result of an ongoing dialogue between the Action and non-academic stakeholders in the field of audience...

  12. Bridged graphite oxide materials (United States)

    Herrera-Alonso, Margarita (Inventor); McAllister, Michael J. (Inventor); Aksay, Ilhan A. (Inventor); Prud'homme, Robert K. (Inventor)


    Bridged graphite oxide material comprising graphite sheets bridged by at least one diamine bridging group. The bridged graphite oxide material may be incorporated in polymer composites or used in adsorption media.

  13. Injuries sustained after falls from bridges across the United States-Mexico border at El Paso. (United States)

    McLean, Susan F; Tyroch, Alan H


    To compare demographics and motivations for falls from bridges at the United States-Mexico border and in El Paso County, Texas, and to analyze injuries and injury patterns to support intentionality and to provide treatment recommendations. A retrospective observational review was conducted of hospital admissions to a trauma center after falls from bridges from 1995 to 2009. Statistical methods used were chi-square testing, T-test for means comparison, univariate correlations, and regression analysis. Of the 97 evaluated patients, 81.4% fell from U.S.-Mexico border bridges, including one patient who fell from a railway bridge; 74.7% of those falling from border bridges had a non-U.S. address, contrasting with 22.2% of those who fell within the United States. Falls over the border were associated with more immigration-related motivations and fewer suicide attempts. Injuries included lower extremities in 76 (78.4%) and thoracolumbar spine in 27 (27.8%) patients; 16 patients with a thoracolumbar spine fracture (59.3%) also had a lower extremity injury. Mean hospital length of stay was 7.2 days. Mean injury severity score was 8.45 (range 1-43). Age, injury severity score, and pelvic fracture increased the hospital length of stay. Patients fell while emigrating-immigrating based on residence and motivating factors. A dyad of lower extremity and thoracolumbar spine injuries coincided in 59.3% of those with a thoracolumbar spine injury; thoracolumbar spine imaging of patients evaluated after falls from bridges is recommended. Proposed prevention strategies include posting signs on bridges and installing catch-net safety barriers.

  14. Evaluation of fleet management techniques for timber highway bridges (United States)

    Brent M. Phares; Travis K. Hosteng; Justin Dahlberg; Michael A. Ritter


    The general condition of the nation's bridges presents a complex management issue when considering cost, safety, and time. Consequently, the management of those bridges can become an overwhelming task. The need for a management system that is specific to rural systems may help to improve the management of this significant number of bridges. Although individual...

  15. NA-NET numerical analysis net

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, J. [Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science]|[Oak Ridge National Lab., TN (United States); Rosener, B. [Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science


    This report describes a facility called NA-NET created to allow numerical analysts (na) an easy method of communicating with one another. The main advantage of the NA-NET is uniformity of addressing. All mail is addressed to the Internet host ```` at Oak Ridge National Laboratory. Hence, members of the NA-NET do not need to remember complicated addresses or even where a member is currently located. As long as moving members change their e-mail address in the NA-NET everything works smoothly. The NA-NET system is currently located at Oak Ridge National Laboratory. It is running on the same machine that serves netlib. Netlib is a separate facility that distributes mathematical software via electronic mail. For more information on netlib consult, or send the one-line message ``send index`` to netlib{at} The following report describes the current NA-NET system from both a user`s perspective and from an implementation perspective. Currently, there are over 2100 members in the NA-NET. An average of 110 mail messages pass through this facility daily.

  16. NA-NET numerical analysis net

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, J. (Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science Oak Ridge National Lab., TN (United States)); Rosener, B. (Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science)


    This report describes a facility called NA-NET created to allow numerical analysts (na) an easy method of communicating with one another. The main advantage of the NA-NET is uniformity of addressing. All mail is addressed to the Internet host'' at Oak Ridge National Laboratory. Hence, members of the NA-NET do not need to remember complicated addresses or even where a member is currently located. As long as moving members change their e-mail address in the NA-NET everything works smoothly. The NA-NET system is currently located at Oak Ridge National Laboratory. It is running on the same machine that serves netlib. Netlib is a separate facility that distributes mathematical software via electronic mail. For more information on netlib consult, or send the one-line message send index'' to netlib{at} The following report describes the current NA-NET system from both a user's perspective and from an implementation perspective. Currently, there are over 2100 members in the NA-NET. An average of 110 mail messages pass through this facility daily.

  17. Mathematical bridges

    CERN Document Server

    Andreescu, Titu; Tetiva, Marian


    Building bridges between classical results and contemporary nonstandard problems, Mathematical Bridges embraces important topics in analysis and algebra from a problem-solving perspective. Blending old and new techniques, tactics and strategies used in solving challenging mathematical problems, readers will discover numerous genuine mathematical gems throughout that will heighten their appreciation of the inherent beauty of mathematics. Most of the problems are original to the authors and are intertwined in a well-motivated exposition driven by representative examples. The book is structured to assist the reader in formulating and proving conjectures, as well as devising solutions to important mathematical problems by making connections between various concepts and ideas from different areas of mathematics. Instructors and educators teaching problem-solving courses or organizing mathematics clubs, as well as motivated mathematics students from high school juniors to college seniors, will find Mathematical Bri...

  18. Salt-bridge energetics in halophilic proteins.

    Directory of Open Access Journals (Sweden)

    Arnab Nayek

    Full Text Available Halophilic proteins have greater abundance of acidic over basic and very low bulky hydrophobic residues. Classical electrostatic stabilization was suggested as the key determinant for halophilic adaptation of protein. However, contribution of specific electrostatic interactions (i.e. salt-bridges to overall stability of halophilic proteins is yet to be understood. To understand this, we use Adaptive-Poison-Boltzmann-Solver Methods along with our home-built automation to workout net as well as associated component energy terms such as desolvation energy, bridge energy and background energy for 275 salt-bridges from 20 extremely halophilic proteins. We then perform extensive statistical analysis on general and energetic attributes on these salt-bridges. On average, 8 salt-bridges per 150 residues protein were observed which is almost twice than earlier report. Overall contributions of salt-bridges are -3.0 kcal mol-1. Majority (78% of salt-bridges in our dataset are stable and conserved in nature. Although, average contributions of component energy terms are equal, their individual details vary greatly from one another indicating their sensitivity to local micro-environment. Notably, 35% of salt-bridges in our database are buried and stable. Greater desolvation penalty of these buried salt-bridges are counteracted by stable network salt-bridges apart from favorable equal contributions of bridge and background terms. Recruitment of extensive network salt-bridges (46% with a net contribution of -5.0 kcal mol-1 per salt-bridge, seems to be a halophilic design wherein favorable average contribution of background term (-10 kcal mol-1 exceeds than that of bridge term (-7 kcal mol-1. Interiors of proteins from halophiles are seen to possess relatively higher abundance of charge and polar side chains than that of mesophiles which seems to be satisfied by cooperative network salt-bridges. Overall, our theoretical analyses provide insight into halophilic

  19. Comparison of the effects of conditional food and cash transfers of the Ethiopian Productive Safety Net Program on household food security and dietary diversity in the face of rising food prices: ways forward for a more nutrition-sensitive program. (United States)

    Baye, Kaleab; Retta, Negussie; Abuye, Cherinet


    In light of the continuing rise in food prices during and after the 2008 world food crisis, whether food and cash transfers are equally effective in improving food security and diet quality is debatable. To compare the effects of conditional food and cash transfers of the Ethiopian Productive Safety Net Program (PSNP) on household food security and dietary diversity. Data on household dietary diversity, child anthropometry, food security, and preference of transfer modalities (food, cash, or mixed) were generated from a cross-sectional survey of 195 PSNP beneficiary households (67 receiving food and 128 receiving cash) in Hawella Tulla District, Sidama, southern Ethiopia. Most beneficiaries (96%) reported food shortages, and 47% reported food shortages that exceeded 3 months. Households receiving cash had better household dietary diversity scores (p = .02) and higher consumption of oils and fats (p = .003) and vitamin A-rich foods (p = .002). Compared with households receiving food, households receiving cash were more affected by increases in food prices that forced them to reduce their number of daily meals (p food (82%) preferred to continue receiving food, households receiving cash (56%) preferred a mix of food and cash. Households receiving cash had better household dietary diversity than households receiving food, a result suggesting that cash transfers may be more effective. However, the continuing rise infood prices may offset these benefits unless cash transfers are index-linked to food price fluctuations.

  20. Application of bridge continuous shape measurement system based on optical fiber sensing technology in bridge post-seismic detection (United States)

    Yang, Yan; Liu, Fang; Fu, Jinghua; Yang, Dandan


    Bridge shape is the important indicator to estimate the safety of the bridge. A bridge shape measurement system based on fiber optic gyroscope is builded up to survey the continuous shape of bridge. This measurement system comprises angular velocity sensor, linear velocity sensor, position sensor and etc. The bridge shape survey using the leveling measurement and bridge continuous shape measurement system was carried out after the earthquake. By comparing the data before and after the earthquake, the numerical values of the two method were similar. The experimental results show that the proposed system is an effective measurement method.

  1. Net Ecosystem Carbon Flux (United States)

    U.S. Geological Survey, Department of the Interior — Net Ecosystem Carbon Flux is defined as the year-over-year change in Total Ecosystem Carbon Stock, or the net rate of carbon exchange between an ecosystem and the...

  2. Probabilistic FE analysis of a cable stayed composite bridge

    NARCIS (Netherlands)

    Boer, A. de; Waarts, P.H.


    This paper describes the design of a new cable stayed composite bridge near Kampen in the Netherlands. In the design process, the safety of bridges is insured by means of partial safety factors for both strength and load parameters. As a result it is generally accepted that the structure as a whole

  3. Bridging the Gap: A Framework and Strategies for Integrating the Quality and Safety Mission of Teaching Hospitals and Graduate Medical Education. (United States)

    Tess, Anjala; Vidyarthi, Arpana; Yang, Julius; Myers, Jennifer S


    Integrating the quality and safety mission of teaching hospitals and graduate medical education (GME) is a necessary step to provide the next generation of physicians with the knowledge, skills, and attitudes they need to participate in health system improvement. Although many teaching hospital and health system leaders have made substantial efforts to improve the quality of patient care, few have fully included residents and fellows, who deliver a large portion of that care, in their efforts. Despite expectations related to the engagement of these trainees in health care quality improvement and patient safety outlined by the Accreditation Council for Graduate Medical Education in the Clinical Learning Environment Review program, a structure for approaching this integration has not been described.In this article, the authors present a framework that they hope will assist teaching hospitals in integrating residents and fellows into their quality and safety efforts and in fostering a positive clinical learning environment for education and patient care. The authors define the six essential elements of this framework-organizational culture, teaching hospital-GME alignment, infrastructure, curricular resources, faculty development, and interprofessional collaboration. They then describe the organizational characteristics required for each element and offer concrete strategies to achieve integration. This framework is meant to be a starting point for the development of robust national models of infrastructure, alignment, and collaboration between GME and health care quality and safety leaders at teaching hospitals.

  4. Professional Enterprise NET

    CERN Document Server

    Arking, Jon


    Comprehensive coverage to help experienced .NET developers create flexible, extensible enterprise application code If you're an experienced Microsoft .NET developer, you'll find in this book a road map to the latest enterprise development methodologies. It covers the tools you will use in addition to Visual Studio, including Spring.NET and nUnit, and applies to development with ASP.NET, C#, VB, Office (VBA), and database. You will find comprehensive coverage of the tools and practices that professional .NET developers need to master in order to build enterprise more flexible, testable, and ext

  5. Inclusive Growth: More than Safety Nets

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


    caused that crisis and remain responsible for persistent deprivation continue to exist. 2. The need to find policies that ... debate, including questions of definition, and global challenges to address inclusive growth effectively. 4 Earlier origins of the ... debates, often with (youth) unemployment as a key concern. 12 According to ...

  6. New Principal Coaching as a Safety Net (United States)

    Celoria, Davide; Roberson, Ingrid


    This study examines new principal coaching as an induction process and explores the emotional dimensions of educational leadership. Twelve principal coaches and new principals--six of each--participated in this qualitative study that employed emergent coding (Creswell, 2008; Denzin, 2005; Glaser & Strauss, 1998; Spradley, 1979). The major…

  7. Vulnerability and Safety Nets in Lao PDR


    Lindelow, Magnus; Fenton, Nina


    Lao PDR has experienced high levels of economic growth in recent years and the incidence of poverty has fallen dramatically since the 1990s. Yet, this report shows that Lao households continue to be highly vulnerable to regular seasonal fluctuations, as well as agricultural shocks and natural disasters. The report also highlights the importance of health shocks, injury and death for household ...

  8. Bridge resource program. (United States)


    The mission of Rutgers Universitys Center for Advanced Infrastructure and Transportation (CAIT) Bridge Resource Program (BRP) is to provide bridge engineering support to the New Jersey Department of Transportation (NJDOT)s Bridge Engineering an...

  9. Design of the Violence and Stress Assessment (ViStA) study: a randomized controlled trial of care management for PTSD among predominantly Latino patients in safety net health centers. (United States)

    Meredith, Lisa S; Eisenman, David P; Green, Bonnie L; Kaltman, Stacey; Wong, Eunice C; Han, Bing; Cassells, Andrea; Tobin, Jonathan N


    Posttraumatic stress disorder (PTSD) is a common problem in primary care. Although effective treatments are available, little is known about whether such treatments are effective within the context of Federally Qualified Health Centers (FQHCs) that serve as national "safety nets" for providing primary care for low income and underinsured patients. The Violence and Stress Assessment (ViStA) study is the first randomized controlled trial (RCT) to test the impact of a care management intervention for treating PTSD in FQHCs. To develop a PTSD management intervention appropriate for lower resource FQHCs and the predominantly Latino patients they serve, formative work was conducted through a collaborative effort between researchers and an FQHC practice-based research network. This article describes how FQHC stakeholders were convened to review, assess, and prioritize evidence-based strategies for addressing patient, clinician, and system-level barriers to care. This multi-component care management intervention incorporates diagnosis with feedback, patient education and activation; navigation and linkage to community resources; clinician education and medication guidance; and structured cross-disciplinary communication and continuity of care, all facilitated by care managers with FQHC experience. We also describe the evaluation design of this five-year RCT and the characteristics of the 404 English or Spanish speaking patients enrolled in the study and randomized to either the intervention or to usual care. Patients are assessed at baseline, six months, and 12 months to examine intervention effectiveness on PTSD, other mental health symptoms, health-related quality-of-life, health care service use; and perceived barriers to care and satisfaction with care. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. WaveNet (United States)


    Coastal Inlets Research Program WaveNet WaveNet is a web-based, Graphical-User-Interface ( GUI ) data management tool developed for Corps coastal...generates tabular and graphical information for project planning and design documents. The WaveNet is a web-based GUI designed to provide users with from different sources, and employs a combination of Fortran, Python and Matlab codes to process and analyze data for USACE applications

  11. Coloured Petri Nets

    DEFF Research Database (Denmark)

    Jensen, Kurt


    This paper describes how Coloured Petri Nets (CP-nets) have been developed — from being a promising theoretical model to being a full-fledged language for the design, specification, simulation, validation and implementation of large software systems (and other systems in which human beings and...... use of CP-nets — because it means that the function representation and the translations (which are a bit mathematically complex) no longer are parts of the basic definition of CP-nets. Instead they are parts of the invariant method (which anyway demands considerable mathematical skills...

  12. Game Coloured Petri Nets

    DEFF Research Database (Denmark)

    Westergaard, Michael


    This paper introduces the notion of game coloured Petri nets. This allows the modeler to explicitly model what parts of the model comprise the modeled system and what parts are the environment of the modeled system. We give the formal definition of game coloured Petri nets, a means of reachability...... analysis of this net class, and an application of game coloured Petri nets to automatically generate easy-to-understand visualizations of the model by exploiting the knowledge that some parts of the model are not interesting from a visualization perspective (i.e. they are part of the environment...

  13. Programming NET Web Services

    CERN Document Server

    Ferrara, Alex


    Web services are poised to become a key technology for a wide range of Internet-enabled applications, spanning everything from straight B2B systems to mobile devices and proprietary in-house software. While there are several tools and platforms that can be used for building web services, developers are finding a powerful tool in Microsoft's .NET Framework and Visual Studio .NET. Designed from scratch to support the development of web services, the .NET Framework simplifies the process--programmers find that tasks that took an hour using the SOAP Toolkit take just minutes. Programming .NET

  14. Annotating Coloured Petri Nets

    DEFF Research Database (Denmark)

    Lindstrøm, Bo; Wells, Lisa Marie


    -net. An example of such auxiliary information is a counter which is associated with a token to be able to do performance analysis. Modifying colour sets and arc inscriptions in a CP-net to support a specific use may lead to creation of several slightly different CP-nets – only to support the different uses...... a method which makes it possible to associate auxiliary information, called annotations, with tokens without modifying the colour sets of the CP-net. Annotations are pieces of information that are not essential for determining the behaviour of the system being modelled, but are rather added to support...

  15. Optimum Maintenance Strategies for Highway Bridges

    DEFF Research Database (Denmark)

    Frangopol, Dan M.; Thoft-Christensen, Palle; Das, Parag C.

    As bridges become older and maintenance costs become higher, transportation agencies are facing challenges related to implementation of optimal bridge management programs based on life cycle cost considerations. A reliability-based approach is necessary to find optimal solutions based on minimum...... expected life-cycle costs or maximum life-cycle benefits. This is because many maintenance activities can be associated with significant costs, but their effects on bridge safety can be minor. In this paper, the program of an investigation on optimum maintenance strategies for different bridge types...... is described. The end result of this investigation will be a general reliability-based framework to be used by the UK Highways Agency in order to plan optimal strategies for the maintenance of its bridge network so as to optimize whole-life costs....

  16. Robustness and health monitoring of existing bridges


    Casas Rius, Joan Ramon


    The paper shows how the robustness concept, mainly developed and thought for the design of new structures, and the monitoring by suitable sensors based on fiber optics can also play a relevant role in the safety and management of existing bridges. A new approach of robustness more related to the long-term and service life of bridges is presented and its advantages in the decision-making process during the management of existing bridges are highlighted and afterwards applied on a real brid...

  17. Beyond net deficits: new priorities for an aquacultural geography

    NARCIS (Netherlands)

    Belton, B.; Bush, S.R.


    Geographers first identified aquaculture as an important field of study during the 1990s, pointing to a ‘net deficit’ in geographical knowledge about the activity. This paper examines how far geographers have come in bridging this knowledge deficit in the last 20 years. While increasing attention

  18. Net zero water

    CSIR Research Space (South Africa)

    Lindeque, M


    Full Text Available Is it possible to develop a building that uses a net zero amount of water? In recent years it has become evident that it is possible to have buildings that use a net zero amount of electricity. This is possible when the building is taken off...

  19. SolNet

    DEFF Research Database (Denmark)

    Jordan, Ulrike; Vajen, Klaus; Bales, Chris


    SolNet, founded in 2006, is the first coordinated International PhD education program on Solar Thermal Engineering. The SolNet network is coordinated by the Institute of Thermal Engineering at Kassel University, Germany. The network offers PhD courses on solar heating and cooling, conference...

  20. Kunstige neurale net

    DEFF Research Database (Denmark)

    Hørning, Annette


    Artiklen beskæftiger sig med muligheden for at anvende kunstige neurale net i forbindelse med datamatisk procession af naturligt sprog, specielt automatisk talegenkendelse.......Artiklen beskæftiger sig med muligheden for at anvende kunstige neurale net i forbindelse med datamatisk procession af naturligt sprog, specielt automatisk talegenkendelse....

  1. Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED). (United States)

    Towfighi, Amytis; Cheng, Eric M; Ayala-Rivera, Monica; McCreath, Heather; Sanossian, Nerses; Dutta, Tara; Mehta, Bijal; Bryg, Robert; Rao, Neal; Song, Shlee; Razmara, Ali; Ramirez, Magaly; Sivers-Teixeira, Theresa; Tran, Jamie; Mojarro-Huang, Elizabeth; Montoya, Ana; Corrales, Marilyn; Martinez, Beatrice; Willis, Phyllis; Macias, Mireya; Ibrahim, Nancy; Wu, Shinyi; Wacksman, Jeremy; Haber, Hilary; Richards, Adam; Barry, Frances; Hill, Valerie; Mittman, Brian; Cunningham, William; Liu, Honghu; Ganz, David A; Factor, Diane; Vickrey, Barbara G


    Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diverse population. In this single-blind randomized controlled trial, 516 adults (≥40 years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90 days are being enrolled at five sites within the Los Angeles County safety-net setting and randomized 1:1 to intervention vs usual care. Participants are excluded if they do not speak English, Spanish, Cantonese, Mandarin, or Korean or if they are unable to consent. The intervention includes a minimum of three clinic visits in the healthcare setting, three home visits, and Chronic Disease Self-Management Program group workshops in community venues. The primary outcome is blood pressure (BP) control (systolic BP control of other vascular risk factors including lipids and hemoglobin A1c, (3) inflammation (C reactive protein [CRP]), (4) medication adherence, (5) lifestyle factors (smoking, diet, and physical activity), (6) estimated relative reduction in risk for recurrent stroke or myocardial

  2. Efficacy, Safety and Cost of Insecticide Treated Wall Lining, Insecticide Treated Bed Nets and Indoor Wall Wash with Lime for Visceral Leishmaniasis Vector Control in the Indian Sub-continent: A Multi-country Cluster Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Dinesh Mondal


    Full Text Available We investigated the efficacy, safety and cost of lime wash of household walls plus treatment of sand fly breeding places with bleach (i.e. environmental management or EM, insecticide impregnated durable wall lining (DWL, and bed net impregnation with slow release insecticide (ITN for sand fly control in the Indian sub-continent.This multi-country cluster randomized controlled trial had 24 clusters in each three sites with eight clusters per high, medium or low sand fly density stratum. Every cluster included 45-50 households. Five households from each cluster were randomly selected for entomological measurements including sand fly density and mortality at one, three, nine and twelve months post intervention. Household interviews were conducted for socioeconomic information and intervention acceptability assessment. Cost for each intervention was calculated. There was a control group without intervention.Sand fly mortality [mean and 95%CI] ranged from 84% (81%-87% at one month to 74% (71%-78% at 12 months for DWL, 75% (71%-79% at one month to 49% (43%-55% at twelve months for ITN, and 44% (34%-53% at one month to 22% (14%-29% at twelve months for EM. Adjusted intervention effect on sand fly density measured by incidence rate ratio ranged from 0.28 (0.23-0.34 at one month to 0.62 (0.51-0.75 at 12 months for DWL; 0.72 (0.62-0.85 at one month to 1.02 (0.86-1.22 at 12 months for ITN; and 0.89 (0.76-1.03 at one months to 1.49 (1.26-1.74 at 12 months for EM. Household acceptance of EM was 74% compared to 94% for both DWL and ITN. Operational cost per household in USD was about 5, 8, and 2 for EM, DWL and ITN, respectively. Minimal adverse reactions were reported for EM and ITN while 36% of households with DWL reported transient itching.DWL is the most effective, durable and acceptable control method followed by ITN. The Visceral Leishmaniasis (VL Elimination Program in the Indian sub-continent should consider DWL and ITN for sand fly control in

  3. Pro NET Best Practices

    CERN Document Server

    Ritchie, Stephen D


    Pro .NET Best Practices is a practical reference to the best practices that you can apply to your .NET projects today. You will learn standards, techniques, and conventions that are sharply focused, realistic and helpful for achieving results, steering clear of unproven, idealistic, and impractical recommendations. Pro .NET Best Practices covers a broad range of practices and principles that development experts agree are the right ways to develop software, which includes continuous integration, automated testing, automated deployment, and code analysis. Whether the solution is from a free and

  4. Getting to Net Zero

    Energy Technology Data Exchange (ETDEWEB)


    The technology necessary to build net zero energy buildings (NZEBs) is ready and available today, however, building to net zero energy performance levels can be challenging. Energy efficiency measures, onsite energy generation resources, load matching and grid interaction, climatic factors, and local policies vary from location to location and require unique methods of constructing NZEBs. It is recommended that Components start looking into how to construct and operate NZEBs now as there is a learning curve to net zero construction and FY 2020 is just around the corner.

  5. Instant Lucene.NET

    CERN Document Server

    Heydt, Michael


    Filled with practical, step-by-step instructions and clear explanations for the most important and useful tasks. A step-by-step guide that helps you to index, search, and retrieve unstructured data with the help of Lucene.NET.Instant Lucene.NET How-to is essential for developers new to Lucene and Lucene.NET who are looking to get an immediate foundational understanding of how to use the library in their application. It's assumed you have programming experience in C# already, but not that you have experience with search techniques such as information retrieval theory (although there will be a l


    Directory of Open Access Journals (Sweden)

    Liviu Mihai SIMA


    Full Text Available This paper presents a solution for the railway bridges monitoring based on the use of already existing equipments in the railway installations and some new equipments based on photo-elements, as well. This kind of equipments can function in continue and discontinuous regime, means of them tracking down if the bridge piles suffered movements by different reasons. This aspect can put in danger the safety of the circulation on that bridge.

  7. Common pathologies in RC bridge structures: a statistical analysis


    Santos, J.; Nunes, C.; Fernandes, C.; Varum, H.


    One of the main tasks in bridge engineering is to maintain the existing bridge stock according to current and predicted traffic and safety requirements. Bridges deterioration commonly occurs due to a wide variety of pathological factors, with origin in, for example: unexpected traffic loads, vehicle impacts, environmental factors, earth movements, chloride attack, carbonation effect, lack of maintenance, de-icing salts, degradation of the drainage systems, pavement quality. Consid...

  8. Net Zero Energy Buildings

    DEFF Research Database (Denmark)

    Marszal, Anna Joanna; Bourrelle, Julien S.; Musall, Eike


    and identify possible renewable energy supply options which may be considered in calculations. Finally, the gap between the methodology proposed by each organisation and their respective national building code is assessed; providing an overview of the possible changes building codes will need to undergo......The international cooperation project IEA SHC Task 40 / ECBCS Annex 52 “Towards Net Zero Energy Solar Buildings”, attempts to develop a common understanding and to set up the basis for an international definition framework of Net Zero Energy Buildings (Net ZEBs). The understanding of such buildings...... parameters used in the calculations are discussed and the various renewable supply options considered in the methodologies are summarised graphically. Thus, the paper helps to understand different existing approaches to calculate energy balance in Net ZEBs, highlights the importance of variables selection...

  9. PhysioNet (United States)

    U.S. Department of Health & Human Services — The PhysioNet Resource is intended to stimulate current research and new investigations in the study of complex biomedical and physiologic signals. It offers free...

  10. NetSig

    DEFF Research Database (Denmark)

    Horn, Heiko; Lawrence, Michael S; Chouinard, Candace R


    Methods that integrate molecular network information and tumor genome data could complement gene-based statistical tests to identify likely new cancer genes; but such approaches are challenging to validate at scale, and their predictive value remains unclear. We developed a robust statistic (Net......Sig) that integrates protein interaction networks with data from 4,742 tumor exomes. NetSig can accurately classify known driver genes in 60% of tested tumor types and predicts 62 new driver candidates. Using a quantitative experimental framework to determine in vivo tumorigenic potential in mice, we found that Net......Sig candidates induce tumors at rates that are comparable to those of known oncogenes and are ten-fold higher than those of random genes. By reanalyzing nine tumor-inducing NetSig candidates in 242 patients with oncogene-negative lung adenocarcinomas, we find that two (AKT2 and TFDP2) are significantly amplified...

  11. TideNet (United States)


    query tide data sources in a desired geographic region of USA and its territories (Figure 1). Users can select a tide data source through the Google Map data sources according to the desired geographic region. It uses the Google Map interface to display data from different sources. Recent...Coastal Inlets Research Program TideNet The TideNet is a web-based Graphical User Interface (GUI) that provides users with GIS mapping tools to

  12. Building Neural Net Software


    Neto, João Pedro; Costa, José Félix


    In a recent paper [Neto et al. 97] we showed that programming languages can be translated on recurrent (analog, rational weighted) neural nets. The goal was not efficiency but simplicity. Indeed we used a number-theoretic approach to machine programming, where (integer) numbers were coded in a unary fashion, introducing a exponential slow down in the computations, with respect to a two-symbol tape Turing machine. Implementation of programming languages in neural nets turns to be not only theo...

  13. Interaction Nets in Russian


    Salikhmetov, Anton


    Draft translation to Russian of Chapter 7, Interaction-Based Models of Computation, from Models of Computation: An Introduction to Computability Theory by Maribel Fernandez. "In this chapter, we study interaction nets, a model of computation that can be seen as a representative of a class of models based on the notion of 'computation as interaction'. Interaction nets are a graphical model of computation devised by Yves Lafont in 1990 as a generalisation of the proof structures of linear logic...

  14. Programming NET 35

    CERN Document Server

    Liberty, Jesse


    Bestselling author Jesse Liberty and industry expert Alex Horovitz uncover the common threads that unite the .NET 3.5 technologies, so you can benefit from the best practices and architectural patterns baked into the new Microsoft frameworks. The book offers a Grand Tour" of .NET 3.5 that describes how the principal technologies can be used together, with Ajax, to build modern n-tier and service-oriented applications. "

  15. Bridging consent: from toll bridges to lift bridges?

    Directory of Open Access Journals (Sweden)

    Knoppers Bartha


    Full Text Available Abstract Background The ability to share human biological samples, associated data and results across disease-specific and population-based human research biobanks is becoming increasingly important for research into disease development and translation. Although informed consent often does not anticipate such cross-domain sharing, it is important to examine its plausibility. The purpose of this study was to explore the feasibility of bridging consent between disease-specific and population-based research. Comparative analyses of 1 current ethical and legal frameworks governing consent and 2 informed consent models found in disease-specific and population-based research were conducted. Discussion Ethical and legal frameworks governing consent dissuade cross-domain data sharing. Paradoxically, analysis of consent models for disease-specific and population-based research reveals such a high degree of similarity that bridging consent could be possible if additional information regarding bridging was incorporated into consent forms. We submit that bridging of consent could be supported if current trends endorsing a new interpretation of consent are adopted. To illustrate this we sketch potential bridging consent scenarios. Summary A bridging consent, respectful of the spirit of initial consent, is feasible and would require only small changes to the content of consents currently being used. Under a bridging consent approach, the initial data and samples collection can serve an identified research project as well as contribute to the creation of a resource for a range of other projects.

  16. Field evaluation of thermographic bridge concrete inspection techniques. (United States)


    The goal of this research is to develop new technologies for the condition assessment of concrete to help ensure bridge safety and improve the effectiveness of maintenance and repair. : The objectives of the research are to: : Quantify the capabi...

  17. Bridge vehicle impact assessment. (United States)


    Bridges in New York State have been experiencing close to 200 bridge hits a year. These : accidents are attributed to numerous factors including: improperly stored equipment on trucks; : violation of vehicle posting signs; illegal commercial vehicles...

  18. Movable bridge maintenance monitoring. (United States)


    Movable bridges have particular maintenance issues, which cost considerably more than those of fixed bridges, : mostly because of the complex interaction of the mechanical, electrical and structural components. In order to track : maintenance and ope...

  19. Enhancing supply vessel safety

    Energy Technology Data Exchange (ETDEWEB)



    A supply-vessel bridge installation consists of a navigating bridge and a control position aft, from which operators control the ship when close to rigs or platforms, and operate winches and other loading equipment. The international Convention for Safety of I Ale at Sea (SOLAS) does not regulate the layout, so design varies to a large degree, often causing an imperfect working environment. As for other types of ships, more than half the offshore service vessel accidents at sea are caused by bridge system failures. A majority can be traced back to technical design, and operational errors. The research and development project NAUT-OSV is a response to the offshore industry's safety concerns. Analysis of 24 incidents involving contact or collision between supply vessels and offshore installations owned or operated by Norwegian companies indicated that failures in the bridge system were often the cause.

  20. Bridge Crossing Simulator (United States)


    support the durability testing of Military Bridging and Gap Crossing Equipment. 15. SUBJECT TERMS Bridge Crossing Simulator Trilateral Design... Trilateral Design and Test Code for Military Bridging and Gap Crossing Equipment (TDTC) 1* is derived based on the number of samples the test bridge...Automotive and Armaments Command TARDEC U.S. Army Tank-Automotive Research, Development and Engineering Center TDTC Trilateral Design and Test Code

  1. Principles of Bridge Reliability

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle; Nowak, Andrzej S.

    The paper gives a brief introduction to the basic principles of structural reliability theory and its application to bridge engineering. Fundamental concepts like failure probability and reliability index are introduced. Ultimate as well as serviceability limit states for bridges are formulated......, and as an example the reliability profile and a sensitivity analyses for a corroded reinforced concrete bridge is shown....

  2. Post-earthquake bridge inspection guidelines. (United States)


    This report presents a course of action that can be used by New York States Department of Transportation : (NYSDOT) to respond to an earthquake that may have damaged bridges, so that the highway system can be : assessed for safety and functionalit...

  3. Timber bridge evaluation : a global nondestructive approach using impact generated FRFs (United States)

    Angus Morison; C.D. Van Karsen; H.A. Evensen; J.B. Ligon; J.R. Erickson; R.J. Ross; J.W. Forsman


    Bridges require periodic inspections to ensure the safety of those using the structure. A visual inspection has historically been the most common form of investigation for timber bridges. This poses many problems when inspecting bridge timbers since often the damage is internal, leaving no visible signs of decay on the surface. Localized nondestructive evaluation (NDE...

  4. Plans for crash-tested bridge railings for longitudinal wood decks (United States)

    M. A. Ritter; R. K. Faller; P. D. Hilbrich Lee; B. T. Rosson; S. R. Duwadi


    In the past decade, bridge railing design criteria have moved away from static-load design and have focused on full-scale crash testing as a more appropriate and reliable means of evaluating bridge railings. The five bridge railing plans presented reflect the results of a cooperative research project between the Midwest Roadside Safety Facility, University of Nebraska...

  5. Using expert opinion to quantify accuracy and reliability of nondestructive evaluation on bridges. (United States)


    Bridge inspection is an important phase in bridge management. In 2009, a joint American Society of Civil : Engineers Structural Engineering Institute and AASHTO Ad-Hoc group was created to identify the issues : in bridge safety and to study current b...

  6. La plataforma .NET


    Fornas Estrada, Miquel


    L'aparició de la plataforma .NET Framework ha suposat un canvi molt important en la forma de crear i distribuir aplicacions, degut a que incorpora una sèrie d'innovacions tècniques i productives que simplifiquen molt les tasques necessàries per desenvolupar un projecte. La aparición de la plataforma. NET Framework ha supuesto un cambio muy importante en la forma de crear y distribuir aplicaciones, debido a que incorpora una serie de innovaciones técnicas y productivas que simplifican mucho...

  7. Biological Petri Nets

    CERN Document Server

    Wingender, E


    It was suggested some years ago that Petri nets might be well suited to modeling metabolic networks, overcoming some of the limitations encountered by the use of systems employing ODEs (ordinary differential equations). Much work has been done since then which confirms this and demonstrates the usefulness of this concept for systems biology. Petri net technology is not only intuitively understood by scientists trained in the life sciences, it also has a robust mathematical foundation and provides the required degree of flexibility. As a result it appears to be a very promising approach to mode

  8. Controlling porosity in bridged polysilsesquioxanes through elimination reactions

    Energy Technology Data Exchange (ETDEWEB)

    McClain, M.D.; Loy, D.A. [Sandia National Labs., Albuquerque, NM (United States); Prabakar, S. [Univ. of New Mexico, Albuquerque, NM (United States). Advanced Materials Lab.


    The retro Diels-Alder reaction was used to modify porosity in hydrocarbon-bridged polysilsesquioxane gels. Microporous polysilsesquioxanes incorporating a thermally labile Diels-Alder adduct as the hydrocarbon bridging group were prepared by sol-gel polymerization of trans-2,3-bis(triethoxysilyl)norbornene. Upon heating the 2,3-norbornenylene-bridges polymers at temperatures above 250 C, the norbornenylene-bridging group underwent a retro Diels-Alder reaction losing cyclopentadiene and leaving behind a ethenylene-bridged polysilsesquioxane. Less than theoretical quantities of cyclopentadiene were volatilized indicating that some of the diene was either reacting with the silanol and olefinic rich material or undergoing oligomerization. Both scanning electron microscopy and nitrogen sorption porosimetry revealed net coarsening of pores (and reduction of surface area) in the materials with thermolysis.

  9. Petri Nets-Applications

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 4; Issue 9. Petri Nets - Applications. Y Narahari. General Article Volume 4 Issue 9 September 1999 pp 44-52. Fulltext. Click here to view fulltext PDF. Permanent link: Author Affiliations. Y Narahari ...

  10. Coloured Petri Nets

    CERN Document Server

    Jensen, Kurt


    Coloured Petri Nets (CPN) is a graphical language for modelling and validating concurrent and distributed systems, and other systems in which concurrency plays a major role. This book introduces the constructs of the CPN modelling language and presents the related analysis methods. It provides a comprehensive road map for the practical use of CPN.

  11. Boom Booom Net Radio

    DEFF Research Database (Denmark)

    Grimshaw, Mark Nicholas; Yong, Louisa; Dobie, Ian


    of an existing Internet radio station; Boom Booom Net Radio. Whilst necessity dictates some use of technology-related terminology, wherever possible we have endeavoured to keep such jargon to a minimum and to either explain it in the text or to provide further explanation in the appended glossary....

  12. Game Theory .net. (United States)

    Shor, Mikhael


    States making game theory relevant and accessible to students is challenging. Describes the primary goal of is to provide interactive teaching tools. Indicates the site strives to unite educators from economics, political and computer science, and ecology by providing a repository of lecture notes and tests for courses using…

  13. Coloured Petri Nets

    DEFF Research Database (Denmark)

    Jensen, Kurt; Kristensen, Lars Michael

    Coloured Petri Nets (CPN) is a graphical language for modelling and validating concurrent and distributed systems, and other systems in which concurrency plays a major role. The development of such systems is particularly challenging because of inherent intricacies like possible nondeterminism...

  14. 75 FR 41281 - Bridge Safety Standards (United States)


    ... goods, automobiles, grain, coal, hazardous materials, and passengers is transported on the nation's rail... Engineering and Technology (ABET)'' is obsolete in that the organization has changed its name to ABET, Inc. AAR further notes that ABET Inc. only accredits engineering education programs in the United States...

  15. Deck forms for bridge construction safety. (United States)


    Because I-girders have inherently weak torsion resistance, cross-frames and/or diaphragms are placed at close : spacing intervals to minimize the susceptibility of individual girders to instability during construction. A recent : increase in fatigue ...

  16. Efficacy and safety of LAS41008 (dimethyl fumarate) in adults with moderate-to-severe chronic plaque psoriasis: a randomized, double-blind, Fumaderm®- and placebo-controlled trial (BRIDGE). (United States)

    Mrowietz, U; Szepietowski, J C; Loewe, R; van de Kerkhof, P; Lamarca, R; Ocker, W G; Tebbs, V M; Pau-Charles, I


    Fumaric acid esters (FAEs) are recommended in international guidelines for induction and long-term treatment of adults with moderate-to-severe chronic plaque psoriasis. The fixed combination Fumaderm ® is approved in Germany, with dimethyl fumarate (DMF) being the main active ingredient. To assess the efficacy and safety of a new formulation of DMF (LAS41008), compared with placebo and Fumaderm ® , in adults with moderate-to-severe chronic plaque psoriasis. In this phase III, double-blind, placebo-controlled, noninferiority trial (BRIDGE, NCT01726933, EudraCT 2012-000055-13), patients were randomized to receive LAS41008, Fumaderm ® or placebo (2 : 2 : 1) for 16 weeks, uptitrating to a maximum daily DMF dose of 720 mg, depending upon individual response. The coprimary end points were the percentage of patients achieving ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) and the percentage achieving a score of 'clear' or 'almost clear' in the Physician's Global Assessment (PGA) at week 16. In total, 671 patients were randomized and included in the full analysis set (n = 267, LAS41008; n = 273, Fumaderm ® ; n = 131, placebo). At week 16, 37·5% of patients treated with LAS41008 achieved PASI 75, compared with 15·3% receiving placebo (superiority for LAS41008 vs. placebo: P < 0·001) and 40·3% receiving Fumaderm ® (noninferiority for LAS41008 vs. Fumaderm ® : P < 0·001). Overall, 33% of patients treated with LAS41008 were 'clear' or 'almost clear' in the PGA at week 16, compared with 13·0% receiving placebo (P < 0·0001; LAS41008 superiority vs. placebo) and 37·4% receiving Fumaderm ® . Most treatment-related adverse events were classed as 'mild' in severity. LAS41008 (DMF) is effective in the treatment of adults with moderate-to-severe chronic plaque psoriasis. © 2016 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

  17. Crash test and evaluation of the TxDOT T631 bridge rail. (United States)


    In August 2010, Midwest Roadside Safety Facility (MwRSF) developed and crash tested a low-cost, energy-absorbing bridge rail for the Manual for Assessing Safety Hardware (MASH) TL-3 applications. This low-cost bridge rail was designed to be compatibl...

  18. [Composite (etched) bridge]. (United States)

    de Kloet, H J; van Pelt, A W


    An adhesive or resin-bonded bridge is a tooth saving construction for the replacement of a lost tooth, especially when the abutment teeth are relatively sound. In this article an overview is presented of the different types of resin-bonded bridges, their advantages and disadvantages and their indications. The direct methods are very suited for the immediate replacement of a lost anterior tooth. The all composite adhesive bridge has a survival rate that is surprisingly good.

  19. Net technical assessment


    Wegmann, David G.


    Approved for public release; distribution is unlimited. The present and near term military balance of power between the U.S. and the Soviet Union can be expressed in a variety of net assessments. One can examine the strategic nuclear balance, the conventional balance in Europe, the maritime balance, and many others. Such assessments are essential not only for policy making but for arms control purposes and future force structure planning. However, to project the future military balance, on...

  20. Influence of Blasting Vibration on Young Concrete Bridge: A Case Study of Yesanhe Super Large Bridge

    Directory of Open Access Journals (Sweden)

    Ming Chen


    Full Text Available Influence of blasting vibration on young concrete structure is an important issue in the field of hydropower engineering, transportation, and so forth. Based on influence of blasting excavation on concrete pouring progress of box girder in nearby Yesanhe Super Large Bridge, which is located in Hubei Province of China, a method combining field test and numerical simulation is used to study influence of blasting vibration on young concrete super large bridge. The results show that blasting excavation of nearby Yesanhe Hydropower Station induced vibration response on Yesanhe Bridge and peak particle velocity (PPV on the bridge was quite small under test conditions. Monitoring data and numerical simulation both indicate that PPV of box girder is 1 to 4 times larger than that of pier foundation; with the extension of bridge cantilever casting section, velocity amplification factors of different parts of the box girder have different changes and duration of vibration in vertical direction increases. Three days after concrete pouring, the impact of concrete ageing on PPV and damage distribution of the bridge is not obvious. When vibration velocity of pier foundation is within 2 cm/s, the maximum tensile and compressive stress of box girder concrete are less than the tensile and compressive strength of concrete, so that blasting vibration unlikely gives impact on the safety of bridge.

  1. Bridging the Gap

    DEFF Research Database (Denmark)

    Kramer Overgaard, Majken; Broeng, Jes; Jensen, Monika Luniewska

    Bridging the Gap (BtG) is a 2-year project funded by The Danish Industry Foundation. The goal of Bridging the Gap has been to create a new innovation model which will increase the rate at which Danish universities can spinout new technology ventures.......Bridging the Gap (BtG) is a 2-year project funded by The Danish Industry Foundation. The goal of Bridging the Gap has been to create a new innovation model which will increase the rate at which Danish universities can spinout new technology ventures....

  2. Using WordNet for Building WordNets

    CERN Document Server

    Farreres, X; Farreres, Xavier; Rodriguez, Horacio; Rigau, German


    This paper summarises a set of methodologies and techniques for the fast construction of multilingual WordNets. The English WordNet is used in this approach as a backbone for Catalan and Spanish WordNets and as a lexical knowledge resource for several subtasks.

  3. Bridge health monitoring metrics : updating the bridge deficiency algorithm. (United States)


    As part of its bridge management system, the Alabama Department of Transportation (ALDOT) must decide how best to spend its bridge replacement funds. In making these decisions, ALDOT managers currently use a deficiency algorithm to rank bridges that ...

  4. Proof nets for lingusitic analysis

    NARCIS (Netherlands)

    Moot, R.C.A.


    This book investigates the possible linguistic applications of proof nets, redundancy free representations of proofs, which were introduced by Girard for linear logic. We will adapt the notion of proof net to allow the formulation of a proof net calculus which is soundand complete for the

  5. Teaching Tennis for Net Success. (United States)

    Young, Bryce


    A program for teaching tennis to beginners, NET (Net Easy Teaching) is described. The program addresses three common needs shared by tennis students: active involvement in hitting the ball, clearing the net, and positive reinforcement. A sample lesson plan is included. (IAH)

  6. Net4Care Ecosystem Website

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Hansen, Klaus Marius; Rasmussen, Morten


    is a tele-monitoring scenario in which Net4Care clients are deployed in a gateway in private homes. Medical devices then connect to these gateways and transmit their observations to a Net4Care server. In turn the Net4Care server creates valid clinical HL7 documents, stores them in a national XDS repository...

  7. Covered Bridge Security Manual (United States)

    Brett Phares; Terry Wipf; Ryan Sievers; Travis Hosteng


    The design, construction, and use of covered timber bridges is all but a lost art in these days of pre-stressed concrete, high-performance steel, and the significant growth both in the volume and size of vehicles. Furthermore, many of the existing covered timber bridges are preserved only because of their status on the National Registry of Historic Places or the...

  8. Bridges Expansion Joints


    Sergey W. Kozlachkow


    The survey is concerned with the expansion joints, used in bridge constructions to compensate medium and significant operational linear and spatial displacements between adjacent spans or between bridge span and pier. The analysis of design features of these types of expansion joints, their advantages and disadvantages, based on operational experience justified the necessity to design constructions, meeting the modern demands imposed to expansion joints.

  9. Students design composite bridges

    NARCIS (Netherlands)

    Stark, J.W.B.; Galjaard, J.C.; Brekelmans, J.W.P.M.


    The paper gives an overview of recent research on steel-concrete composite bridge design by students of Delft University of Technology doing their master's thesis. Primary objective of this research was to find possibilities for application of steel-concrete composite bridges in the Netherlands,

  10. Bridge the Gap

    DEFF Research Database (Denmark)

    Marselis, Randi Lorenz


    This article focuses on photo projects organised for teenage refugees by the Society for Humanistic Photography (Berlin, Germany). These projects, named Bridge the Gap I (2015), and Bridge the Gap II (2016), were carried out in Berlin and brought together teenagers with refugee and German...

  11. Virtual Bridge Design Challenge (United States)

    Mitts, Charles R.


    This design/problem-solving activity challenges students to design a replacement bridge for one that has been designated as either structurally deficient or functionally obsolete. The Aycock MS Technology/STEM Magnet Program Virtual Bridge Design Challenge is an authentic introduction to the engineering design process. It is a socially relevant…

  12. Linguistic Barriers and Bridges

    DEFF Research Database (Denmark)

    Thuesen, Frederik


    The influence of language on social capital in low-skill and ethnically diverse workplaces has thus far received very limited attention within the sociology of work. As the ethnically diverse workplace is an important social space for the construction of social relations bridging different social...... communication related to collaboration and ‘small talk’ may provide linguistic bridges to social capital formation....

  13. Master Robotic Net

    Directory of Open Access Journals (Sweden)

    Vladimir Lipunov


    Full Text Available The main goal of the MASTER-Net project is to produce a unique fast sky survey with all sky observed over a single night down to a limiting magnitude of 19-20. Such a survey will make it possible to address a number of fundamental problems: search for dark energy via the discovery and photometry of supernovae (including SNIa, search for exoplanets, microlensing effects, discovery of minor bodies in the Solar System, and space-junk monitoring. All MASTER telescopes can be guided by alerts, and we plan to observe prompt optical emission from gamma-ray bursts synchronously in several filters and in several polarization planes.

  14. Art/Net/Work

    DEFF Research Database (Denmark)

    Andersen, Christian Ulrik; Lindstrøm, Hanne


    The seminar Art|Net|Work deals with two important changes in our culture. On one side, the network has become essential in the latest technological development. The Internet has entered a new phase, Web 2.0, including the occurrence of as ‘Wiki’s’, ‘Peer-2-Peer’ distribution, user controlled...... the praxis of the artist. We see different kinds of interventions and activism (including ‘hacktivism’) using the network as a way of questioning the invisible rules that govern public and semi-public spaces. Who ‘owns’ them? What kind of social relationships do they generate? On what principle...

  15. Long Span Bridges in Scandinavia

    DEFF Research Database (Denmark)

    Gimsing, Niels Jørgen


    is found in Scandinavia - the 1210 m span of the Höga Kusten Bridge in Sweden.The Kvarnsund Bridge in Norway was at the completion in 1991 the longest cable-stayed bridge in the world, and the span of 530 m is still thge longest for cable-stayed bridges in concrete. The Øresund Bridge with its sapn of 490...... m is the longest among cable-stayed bridges for both road and railway traffic....

  16. Sustainable Bridge Infrastructure Procurement

    DEFF Research Database (Denmark)

    Safi, Mohammed; Du, Guangli; Simonsson, Peter


    The lack of a flexible but systematic approach for integrating lifecycle aspects into bridge investment decisions is a major obstacle hindering the procurement of sustainable bridge infrastructures. This paper addresses this obstacle by introducing a holistic approach that agencies could use to p...... to procure the most “sustainable” (lifecycle-efficient) bridge through a fair design-build (D-B) tendering process, considering all the main aspects: life-cycle cost (LCC), service life-span, aesthetic demands and environmental impacts (LCA).......The lack of a flexible but systematic approach for integrating lifecycle aspects into bridge investment decisions is a major obstacle hindering the procurement of sustainable bridge infrastructures. This paper addresses this obstacle by introducing a holistic approach that agencies could use...

  17. expansions to and an introduction to (United States)

    Martin, John; Rosa, Bruce A.; Ozersky, Philip; Hallsworth-Pepin, Kymberlie; Zhang, Xu; Bhonagiri-Palsikar, Veena; Tyagi, Rahul; Wang, Qi; Choi, Young-Jun; Gao, Xin; McNulty, Samantha N.; Brindley, Paul J.; Mitreva, Makedonka

    2015-01-01 ( is the new moniker for a collection of databases: and Within this collection we provide services and resources for parasitic roundworms (nematodes) and flatworms (trematodes), collectively known as helminths. For over a decade we have provided resources for studying nematodes via our veteran site ( In this article, (i) we provide an update on the expansions of that hosts omics data from 84 species and provides advanced search tools to the broad scientific community so that data can be mined in a useful and user-friendly manner and (ii) we introduce, a site dedicated to the dissemination of data from flukes, flatworm parasites of the class Trematoda, phylum Platyhelminthes. is an independent component of and currently hosts data from 16 species, with information ranging from genomic, functional genomic data, enzymatic pathway utilization to microbiome changes associated with helminth infections. The databases’ interface, with a sophisticated query engine as a backbone, is intended to allow users to search for multi-factorial combinations of species’ omics properties. This report describes updates to since its last description in NAR, 2012, and also introduces and presents its new sibling site, PMID:25392426


    Directory of Open Access Journals (Sweden)

    Evelia Schettini


    Full Text Available The aim of this paper was to investigate the radiometric properties of coloured nets used to protect a peach cultivation. The modifications of the solar spectral distribution, mainly in the R and FR wavelength band, influence plant photomorphogenesis by means of the phytochrome and cryptochrome. The phytochrome response is characterized in terms of radiation rate in the red wavelengths (R, 600-700 nm to that in the farred radiation (FR, 700-800 nm, i.e. the R/FR ratio. The effects of the blue radiation (B, 400-500 nm is investigated by the ratio between the blue radiation and the far-red radiation, i.e. the B/FR ratio. A BLUE net, a RED net, a YELLOW net, a PEARL net, a GREY net and a NEUTRAL net were tested in Bari (Italy, latitude 41° 05’ N. Peach trees were located in pots inside the greenhouses and in open field. The growth of the trees cultivated in open field was lower in comparison to the growth of the trees grown under the nets. The RED, PEARL, YELLOW and GREY nets increased the growth of the trees more than the other nets. The nets positively influenced the fruit characteristics, such as fruit weight and flesh firmness.

  19. Toward an Egyptian Bridge Management System

    Directory of Open Access Journals (Sweden)

    Ahmed M. Saleh


    Full Text Available A prototype bridge management system for concrete bridges in Egypt (EBRMS is built and tested. The proposed system has the ability to record different inventory data, has tools for condition rating, priority ranking and cost optimization at both bridge and network levels. Condition rating is based on the type, extent, and severity of defects and urgency of intervention, all based on observations made during the inspections. It also takes into account the importance of the deteriorated elements. Priority ranking is evaluated on the basis of a knowledge-base stored in the system. It is calculated using four parameters: condition rating; remaining service life; safety index; and impact of the structure on the network. The developed framework of EBRMS consists of three main modules: database and inspections, condition rating and decision making modules. Details of each of the system capabilities are based on the published research work, mainly on the BRIME project. Testing and verification of the proposed scheme are carried out using a virtual bridge network and available published data as the knowledge base. Twelve actual bridges of different types (slab and beam, box girder and slab types at different locations and under varying service conditions are assumed in the virtual network. Various scenarios of damage states, imposed policies and budget constraints were assumed for testing and validation. All results were reasonable and within acceptable domain.

  20. Safety performance indicators for the road network.

    NARCIS (Netherlands)

    Weijermars, W. Gitelman, V. Papadimitriou, E. Lima De & Azevedo, C.


    Within the 6th FP European project SafetyNet, a team has worked on the development of Safety Performance Indicators (SPIs) on seven road safety related areas. These SPIs reflect the operational conditions of the road traffic system that influence the system's safety performance. SPIs were developed

  1. 75 FR 754 - Safety Zone and Regulated Navigation Area, Chicago Sanitary and Ship Canal, Romeoville, IL (United States)


    ... south of the Romeo Road Bridge) and mile marker 297.5 (approximately 1.3 miles northeast of the Romeo Road Bridge). It also places a safety zone over a smaller portion of these same waters. The RNA and... Romeo Road Bridge) and mile marker 297.5 (approximately 1.3 miles northeast of the Romeo Road Bridge...

  2. Design of wireless synchronous structural monitoring system for large bridges (United States)

    Liu, Zhiqiang; Liu, Wei; Li, Na; Yu, Yan; Mao, Xingquan; Yang, Zhitao


    Large bridges play a significant role in the development of both the urban traffic condition and the social economy. It is of high importance to monitor the operational bridges and to assess their security from the perspective of people's life and property safety. In this paper, a wireless bridge structure monitoring system was developed and DMTS synchronization algorithm (based on the one-way synchronization mechanism of the sender) which can meet the system requirement was proposed. Then the deck vibration test of a bridge in Xiamen was carried out. The study shows that the wireless sensing system has the advantage of high accuracy, and the feature of easy operation, good instantaneity, and low overhead costs, which has a good application prospect in the field of structure monitoring and condition assessment of the bridges.

  3. Bridge technology report

    CERN Document Server


    Please note this is a Short Discount publication. As LANs have proliferated, new technologies and system concepts have come to the fore. One of the key issues is how to interconnect networks. One means of interconnection is to use a 'bridge'. Other competing technologies are repeaters, routers, and gateways. Bridges permit traffic isolation, connect network segments together and operate at the MAC layer. Further, because they operate at the MAC layer, they can handle a variety of protocols such as TCP/IP, SNA, and X.25. This report focuses on the specific technology of bridging two netw

  4. Sustainable Bridge Infrastructure Procurement

    DEFF Research Database (Denmark)

    Safi, Mohammed; Du, Guangli; Simonsson, Peter


    The lack of a flexible but systematic approach for integrating lifecycle aspects into bridge investment decisions is a major obstacle hindering the procurement of sustainable bridge infrastructures. This paper addresses this obstacle by introducing a holistic approach that agencies could use to p...... to procure the most “sustainable” (lifecycle-efficient) bridge through a fair design-build (D-B) tendering process, considering all the main aspects: life-cycle cost (LCC), service life-span, aesthetic demands and environmental impacts (LCA)....

  5. Coloured Petri Nets

    DEFF Research Database (Denmark)

    Jensen, Kurt; Kristensen, Lars Michael

    studies that illustrate the practical use of CPN modelling and validation for design, specification, simulation, verification and implementation in various application domains. Their presentation primarily aims at readers interested in the practical use of CPN. Thus all concepts and constructs are first......Coloured Petri Nets (CPN) is a graphical language for modelling and validating concurrent and distributed systems, and other systems in which concurrency plays a major role. The development of such systems is particularly challenging because of inherent intricacies like possible nondeterminism...... and the immense number of possible execution sequences. In this textbook, Jensen and Kristensen introduce the constructs of the CPN modelling language and present the related analysis methods in detail. They also provide a comprehensive road map for the practical use of CPN by showcasing selected industrial case...

  6. Is this bridge safe? Evaluation of Audiovisual Cues for a Walk on a Small Bridge Over a Canyon

    DEFF Research Database (Denmark)

    Sikström, Erik; Nilsson, Niels Chr.; Götzen, Amalia De


    This paper presents two within-subjects studies (n=23) exploring how different combinations of visual and auditory feedback influence perceived realism, virtual self-perception and the experience of safety during walks on a virtual platform suspended over a canyon. In the first study, the frequency...... footsteps without creaking sounds. Moreover, the frequency factor of the frequency controls for footsteps was also manipulated between trails, but the visual appearance of the bridge was limited to the model of the old broken bridge....

  7. The Cultural Bridge Model. (United States)

    West, Edith A.


    Offers a cultural bridge model that would enhance the health care of the American Indian population. Suggests that transcultural nursing should transcend the realm of thought and become an integrated part of daily practice. (Author)

  8. Bridged Race Population Estimates (United States)

    U.S. Department of Health & Human Services — Population estimates from "bridging" the 31 race categories used in Census 2000, as specified in the 1997 Office of Management and Budget (OMB) race and ethnicity...

  9. State's First Bridge (United States)

    US Fish and Wildlife Service, Department of the Interior — Article with details on the state's first bridge that crossed the Noxubee River adjacent to the Noxubee National Wildlife Refuge Boundary. Details also included...

  10. Innovation and knowledge generation in cooperation nets: challenges for regulations in the nuclear safety area in Brazil; Inovacao e geracao de conhecimento nas redes de cooperacao: desafios para a regulacao na area de seguranca nuclear no Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Staude, Fabio


    The importance of inter-organisational cooperation within the innovation process has been increasingly recognized. In fact, all organisations, at some point, need to look to external sources for inputs to the process of building up technological competence. In this sense, through a detailed case study, this thesis examine theoretical and empirically how collaborative initiatives have supported the Brazilian nuclear regulatory body in the development and implementation of innovations, in order to verify the positive relationship between the collaboration and the organisational innovation performance. Emphasizing the importance of both internal sources of knowledge and external participation, the study encompasses documentary analysis, a preliminary survey and semi-structured interviews with the regulatory body employers in charge of controlling medical and research facilities and activities involving radiation sources. The thesis demonstrates that innovations developed and implemented in the Brazilian nuclear safety and security area are associated with collaborative initiatives, in order to improve the organizational capability to fulfill safety obligations, providing some important implications for regulatory body managers concerned with the management of innovation. The findings also identified actors with a significant degree of influence in the innovation process. The result reveals that the support provided by these actors has a significant influence on the innovation performance of the Brazilian nuclear regulatory body, suggesting that Brazil should adopt more interactive models of innovation and knowledge transfer. In addition, the findings show that these key actors can play a very distinctive role in the context of sectoral systems of innovation information regime. (author)

  11. Forward Affect Bridge. (United States)

    Bonshtein, Udi; Torem, Moshe


    This article presents a modification of the affect bridge technique. The Forward Affect Bridge enables practitioners to create and maintain hope when it is missing. Hope is relevant for diminishing avoidance and being involved with necessary activities. The main idea is to build up a positive atmosphere in the here and now (relying on rapport), to amplify it, and to project it forward. By using clinical vignettes, the authors illustrate these techniques.

  12. Bridges Expansion Joints

    Directory of Open Access Journals (Sweden)

    Sergey W. Kozlachkow


    Full Text Available The survey is concerned with the expansion joints, used in bridge constructions to compensate medium and significant operational linear and spatial displacements between adjacent spans or between bridge span and pier. The analysis of design features of these types of expansion joints, their advantages and disadvantages, based on operational experience justified the necessity to design constructions, meeting the modern demands imposed to expansion joints.

  13. Oxygen safety (United States)

    COPD - oxygen safety; Chronic obstructive pulmonary disease - oxygen safety; Chronic obstructive airways disease - oxygen safety; Emphysema - oxygen safety; Heart failure - oxygen-safety; Palliative care - oxygen safety; Hospice - oxygen safety

  14. 46 CFR 69.71 - Change of net tonnage. (United States)


    ... the International Convention for the Safety of Life at Sea (SOLAS) or other international agreement... the load line assigned under the International Convention on Load Lines, SOLAS or other international... MEASUREMENT OF VESSELS Convention Measurement System § 69.71 Change of net tonnage. (a) When a vessel is...

  15. Net Balanced Floorplanning Based on Elastic Energy Model

    DEFF Research Database (Denmark)

    Liu, Wei; Nannarelli, Alberto


    with balanced net delays to increase the safety margins of the design. In this paper, we investigate the properties of floorplanning based on the elastic energy model. The B*-tree, which is based on an ordered binary tree, is used for circuit representation and the elastic energy is used as the cost function...

  16. CifNet network multi-well data management system (United States)

    Li, Ning; Wang, Mingchao; Cui, Jian; Wang, Jianqiang; Wang, Caizhi


    The CifNet network multi-well data management system is developed for 100MB or 1000MB local network environments which are used in Chinese oil industry. The kernel techniques of CifNet system include: 1, establishing a high efficient and low cost network multi-well data management architecture based on the General Logging Curve Theory and the Cif data format; 2, implementing efficient visit and transmission of multi-well data in C/S local network based on TCP/IP protocol; 3, ensuring the safety of multi-well data in store, visit and application based on Unix operating system security. By using CifNet system, the researcher in office or at home can visit curves of any borehole in any working area of any oilfield. The application foreground of CifNet system is also commented.

  17. Observing Bridge Dynamic Deflection in Green Time by Information Technology (United States)

    Yu, Chengxin; Zhang, Guojian; Zhao, Yongqian; Chen, Mingzhi


    As traditional surveying methods are limited to observe bridge dynamic deflection; information technology is adopted to observe bridge dynamic deflection in Green time. Information technology used in this study means that we use digital cameras to photograph the bridge in red time as a zero image. Then, a series of successive images are photographed in green time. Deformation point targets are identified and located by Hough transform. With reference to the control points, the deformation values of these deformation points are obtained by differencing the successive images with a zero image, respectively. Results show that the average measurement accuracies of C0 are 0.46 pixels, 0.51 pixels and 0.74 pixels in X, Z and comprehensive direction. The average measurement accuracies of C1 are 0.43 pixels, 0.43 pixels and 0.67 pixels in X, Z and comprehensive direction in these tests. The maximal bridge deflection is 44.16mm, which is less than 75mm (Bridge deflection tolerance value). Information technology in this paper can monitor bridge dynamic deflection and depict deflection trend curves of the bridge in real time. It can provide data support for the site decisions to the bridge structure safety.

  18. 75 FR 52463 - Safety Zone; Raccoon Creek, Bridgeport, NJ (United States)


    ... life and property on navigable waters while contractors replace steel I-beams. This safety zone is... plans on replacing steel I-beams used to support the Route 130 Bridge spanning the Raccoon Creek in... temporary safety zone is for all navigable waters within 400 yards on either side of the Route 130 Bridge...

  19. Numerical analysis of dynamic response of vehicle–bridge coupled system on long-span continuous girder bridge

    Directory of Open Access Journals (Sweden)

    Lipeng An


    Full Text Available To systematically study the vehicle–bridge coupled dynamic response and its change rule with different parameters, a vehicle model with seven degrees of freedom was built and the total potential energy of vehicle space vibration system was deduced. Considering the stimulation of road roughness, the dynamic response equation of vehicle–bridge coupled system was established in accordance with the elastic system principle of total potential energy with stationary value and the “set-in-right-position” rule. On the basis of the self-compiled Fortran program and bridge engineering, the dynamic response of long-span continuous girder bridge under vehicle load was studied. This study also included the calculation of vehicle impact coefficient, evaluation of vibration comfort, and analysis of dynamic response parameters. Results show the impact coefficient changes with lane number and is larger than the value calculated by the “general code for design of highway bridges and culverts (China”. The Dieckmann index of bridge vibration is also related to lane number, and the vibration comfort evaluation is good in normal conditions. The relevant conclusions from parametric analyses have practical significance to dynamic design and daily operation of long-span continuous girder bridges in expressways. Safety and comfort are expected to improve significantly with further control of the vibration of vehicle–bridge system.

  20. Linear Logic on Petri Nets

    DEFF Research Database (Denmark)

    Engberg, Uffe Henrik; Winskel, Glynn

    This article shows how individual Petri nets form models of Girard's intuitionistic linear logic. It explores questions of expressiveness and completeness of linear logic with respect to this interpretation. An aim is to use Petri nets to give an understanding of linear logic and give some apprai...

  1. Reference Guide Microsoft.NET

    NARCIS (Netherlands)

    Zee M van der; Verspaij GJ; Rosbergen S; IMP; NMD


    Developers, administrators and managers can get more understanding of the .NET technology with this report. They can also make better choices how to use this technology. The report describes the results and conclusions of a study of the usability for the RIVM of this new generation .NET development

  2. Net neutrality and audiovisual services

    NARCIS (Netherlands)

    van Eijk, N.; Nikoltchev, S.


    Net neutrality is high on the European agenda. New regulations for the communication sector provide a legal framework for net neutrality and need to be implemented on both a European and a national level. The key element is not just about blocking or slowing down traffic across communication

  3. A Small Universal Petri Net

    Directory of Open Access Journals (Sweden)

    Dmitry A. Zaitsev


    Full Text Available A universal deterministic inhibitor Petri net with 14 places, 29 transitions and 138 arcs was constructed via simulation of Neary and Woods' weakly universal Turing machine with 2 states and 4 symbols; the total time complexity is exponential in the running time of their weak machine. To simulate the blank words of the weakly universal Turing machine, a couple of dedicated transitions insert their codes when reaching edges of the working zone. To complete a chain of a given Petri net encoding to be executed by the universal Petri net, a translation of a bi-tag system into a Turing machine was constructed. The constructed Petri net is universal in the standard sense; a weaker form of universality for Petri nets was not introduced in this work.

  4. Structural evaluation of a prestressed concrete bridge under an alkali-silica reaction; Evaluacion estructural de un puente de hormigon pretensado afectado por una reaccion alcali-silice

    Energy Technology Data Exchange (ETDEWEB)

    Carpintero Garcia, I.; Bermudez Adriozola, B.


    The Central Laboratory of Structures and Materials (CEDEX) was commissioned by the National Department of Highways to evaluate the safety conditions of one bridge built on 1997, which is part of the net of the Spanish National Highways. Even at the first inspection many cracks were detected in the concrete deck, associated with expansion concrete processes. This examination revealed that concrete deterioration was not associated with any reinforcement corrosion process; in fact, there were no symptoms of this pathology all along the bridge. for that reason the internal chemical reactions were considered as the most probable cause for the expansion of concrete, as no symptoms of deterioration due to external attack were found. In order to check the origin of concrete expansion, some tests were carried out on concrete samples drilled on the decks. Results of these tests show that there had been internal reactions in concrete mass which explains its expansion and the appearance of those cracks observed. Further more, some other activities were also carried out on site to estimate the importance of the structural damages, as topographic levelling and dynamic testing of the decks. Also the mechanical properties of concrete probes were tested at laboratory. This article shows the main results obtained on the study carried on to determine the cause and significance of the structural damages of the bridge. (Author) 3 refs.

  5. Fiber reinforced polymer composites for bridge structures

    Directory of Open Access Journals (Sweden)

    Alexandra CANTORIU


    Full Text Available Rapid advances in construction materials technology have led to the emergence of new materials with special properties, aiming at safety, economy and functionality of bridges structures. A class of structural materials which was originally developed many years ago, but recently caught the attention of engineers involved in the construction of bridges is fiber reinforced polymer composites. This paper provides an overview of fiber reinforced polymer composites used in bridge structures including types, properties, applications and future trends. The results of this study have revealed that this class of materials presents outstanding properties such as high specific strength, high fatigue and environmental resistance, lightweight, stiffness, magnetic transparency, highly cost-effective, and quick assembly, but in the same time high initial costs, lack of data on long-term field performance, low fire resistance. Fiber reinforced polymer composites were widely used in construction of different bridge structures such as: deck and tower, I-beams, tendons, cable stands and proved to be materials for future in this field.

  6. Landslide stabilization measures for a bridge crossing

    Energy Technology Data Exchange (ETDEWEB)

    Prince, B.S.; Walter, D.J.; McRoberts, E.C. [AMEC Earth and Environmental Ltd., Edmonton, AB (Canada)


    A primary road was financed and constructed in 2003 by CNRL to provide access to its Horizon oil sands mine in northern Alberta. The road included a two lane, 50 metre high, 262 metre long bridge over the MacKay River near the town of Fort MacKay. The site of the bridge crossing was constrained by requirements that it bypass Aboriginal territory. The only available crossing site was near a river valley slope that had previously undergone deep-seated slope failure. The roadway design accounted for the possibility that future slope failures could occur at the bridge site. In response to safety concerns, the design assumed that valley slopes were in a near-failure state and remedial measures were taken to stabilize the slope. This paper discussed the specific geotechnical issues concerning the bridge abutments and the proposed methodology for dealing with them in a timely manner that would not affect the overall project schedule for the multi-billion dollar project. Risks were identified along with the requirements for long term monitoring. Back-analysis of the south valley slopes and an examination of weak clay materials in the north and south slopes indicated that slope stabilization measures would not be needed on the northern slope. However, a shear key and mechanically stabilized earth (MSE) wall was needed to stabilize the south valley slope. 3 refs., 1 tab., 7 figs.

  7. 9 CFR 442.2 - Definitions and procedures for determining net weight compliance. (United States)


    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Definitions and procedures for determining net weight compliance. 442.2 Section 442.2 Animals and Animal Products FOOD SAFETY AND INSPECTION... Standards and Technology (NIST) Handbook 133, “Checking the Net Contents of Packaged Goods,” Fourth Edition...

  8. 78 FR 59237 - Regulated Navigation Area-Weymouth Fore River, Fore River Bridge Construction, Weymouth and... (United States)


    ...The Coast Guard is establishing a temporary regulated navigation area (RNA) on the navigable waters of Weymouth Fore River in the vicinity of the Fore River Bridge (Mile 3.5) between Weymouth and Quincy, MA. This rule will place temporary speed, wake, and entry restrictions on vessels during bridge replacement operations. This rule is necessary to provide for the safety of life in the vicinity of the Fore River Bridge during its construction.

  9. Active Control of Suspension Bridges

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    In this paper some recent research on active control of very long suspension bridges, is presented. The presentation is based on research work at Aalborg University, Denmark. The active control system is based on movable flaps attached to the bridge girder. Wind load on bridges with or without...... flaps attached to the girder is briefly presented. A simple active control system is discussed. Results from wind tunnel experiments with a bridge section show that flaps can be used effectively to control bridge girder vibrations. Flutter conditions for suspension bridges with and without flaps...

  10. The Effect of Deck Width Addition Toward Stability of Cable Stayed Bridge: Case Study of Siak Sri Indrapura Bridge, Riau

    Directory of Open Access Journals (Sweden)

    Supriyadi Bambang


    Full Text Available An aeroelastic interaction always take places in long-span bridge, i.e. the dynamic relationship between wind forces (aerodynamic and bridge structural motion (dynamics. Wind forces may lead to serviceability and safety problems, and may even cause instability of the whole bridge structure due to the flexibility nature of long span bridge structures.The slimer girder plate will make the structure more unstable as can be seen from the occurrence of lateral deformation. This paper presents the results analysis of cable stayed bridge that has total span of 640 m, two planes configuration of harp-typed hanger cable, the A shape pylons span along 320 m (main span,and side span of 160m. Structural analysis was conducted to determine the optimum ratio between width and spans of cable stayed bridge. The bridge was modeled with various width of 7 to 22 m. Structural modelling was conducted using SAP2000 software to analyze the structural stability of cable stayed bridge under wind load at speed of 35 m/s.The influence of wind loads to the cable stayed bridge stability can be seen based on the bridge deck deformation at the Y-axis (U2, in which for the width of the bridge deck of 7 m, 8 m, 9 m and 10 m, the deformation of U2 are 0.26 m; 0.17 m; 0.12 m and 0.10 m, respectively. Meanwhile, for bridge’s width of 11-22 m, the value of U2 axis deformation is relatively constant between 0.08 m to 0.07 m. This finding suggests that the ratio between width and length of bridge greatly affect the stability of the cable stayed bridge. Cable-stayed bridge, especially for concrete bridge, with two plain system having optimum ratio of width and length show no sign of an aerodynamic instability when fulfills the requirements of B ≥ L / 3.

  11. Istanbul Bridge Conference 2014

    CERN Document Server

    Gülkan, Polat; Mahmoud, Khaled


      The book includes peer-reviewed contributions selected from presentations given at the Istanbul Bridge Conference 2014, held from August 11 – 13 in Istanbul, Turkey. It reports on the current challenges in bridge engineering faced by professionals around the globe, giving a special emphasis to recently developed techniques, innovations and opportunities. The book covers key topics in the field, including modeling and analysis methods; construction and erection techniques; design for extreme events and condition assessment and structural health monitoring. There is a balanced presentation of theory, research and practice. This book, which provides the readers with a comprehensive and timely reference guide on current practices in bridge engineering, is intended for professionals, academic researchers and students alike.

  12. Bridging the Gap

    DEFF Research Database (Denmark)

    Dahlberg, Rasmus


    The fixed link between Denmark and Sweden connects two busy cities and a large international airport with many of its travelers and employees. 18,000 vehicles and 160 passenger trains transport each day more than 70,000 people across the combined road and rail Øresund Bridge and through the Øresund...... Tunnel, approximately 25,000 of them critical to the regional work market. Even though the risk analysis states that the likelihood of a long-term closure (100C days) is very low Danish and Swedish transport authorities have demanded that the infrastructure operator conducts a survey of the preparedness...... in its final report to the Danish and Swedish transport authorities while drawing upon experiences from two recent comparable cases of infrastructure disruptions: The Champlain Bridge (2009) and the Forth Road Bridge (2015)....

  13. Development of bridge girder movement criteria for accelerated bridge construction. (United States)


    End diaphragms connect multiple girders to form a bridge superstructure system for effective resistance to earthquake loads. Concrete : girder bridges that include end diaphragms consistently proved to perform well during previous earthquake events. ...

  14. High-level Petri Nets

    DEFF Research Database (Denmark)

    High-level Petri nets are now widely used in both theoretical analysis and practical modelling of concurrent systems. The main reason for the success of this class of net models is that they make it possible to obtain much more succinct and manageable descriptions than can be obtained by means...... of low-level Petri nets - while, on the other hand, they still offer a wide range of analysis methods and tools. The step from low-level nets to high-level nets can be compared to the step from assembly languages to modern programming languages with an elaborated type concept. In low-level nets...... there is only one kind of token and this means that the state of a place is described by an integer (and in many cases even by a boolean). In high-level nets each token can carry a complex information/data - which, e.g., may describe the entire state of a process or a data base. Today most practical...

  15. Plans for crash-tested wood bridge railings for concrete decks (United States)

    Michael A. Ritter; Ronald K. Faller; Barry T. Rosson; Paula D. Hilbrich Lee; Sheila Rimal. Duwadi


    As part of a continuing cooperative research between the Midwest Roadside Safety Facility (MwRSF); the USDA Forest Service, Forest Products Laboratory (FPL); and the Federal Highway Administration (FHWA), several crashworthy wood bridge railings and approach railing transitions have been adapted for use on concrete bridge decks. These railings meet testing and...

  16. Pro asynchronous programming with .NET

    CERN Document Server

    Blewett, Richard; Ltd, Rock Solid Knowledge


    Pro Asynchronous Programming with .NET teaches the essential skill of asynchronous programming in .NET. It answers critical questions in .NET application development, such as: how do I keep my program responding at all times to keep my users happy how do I make the most of the available hardware how can I improve performanceIn the modern world, users expect more and more from their applications and devices, and multi-core hardware has the potential to provide it. But it takes carefully crafted code to turn that potential into responsive, scalable applications.With Pro Asynchronous Programming

  17. Conformal Nets II: Conformal Blocks (United States)

    Bartels, Arthur; Douglas, Christopher L.; Henriques, André


    Conformal nets provide a mathematical formalism for conformal field theory. Associated to a conformal net with finite index, we give a construction of the `bundle of conformal blocks', a representation of the mapping class groupoid of closed topological surfaces into the category of finite-dimensional projective Hilbert spaces. We also construct infinite-dimensional spaces of conformal blocks for topological surfaces with smooth boundary. We prove that the conformal blocks satisfy a factorization formula for gluing surfaces along circles, and an analogous formula for gluing surfaces along intervals. We use this interval factorization property to give a new proof of the modularity of the category of representations of a conformal net.

  18. The strength of liquid bridges in random granular materials. (United States)

    Grof, Zdenek; Lawrence, Christopher J; Stepánek, Frantisek


    The strength of capillary bridges in randomly packed granular media was analyzed by means of computer simulations. A novel simulation method, based on the tracking of moving interfaces, has been implemented and used for determining the equilibrium shape of capillary bridges in a granular medium under a range of liquid saturations and solid-phase geometry. The net force acting on each grain due to the capillary bridges was evaluated, as well as the aggregate force acting between two wet granular media during their separation in the normal directions. The simulation results are consistent with previous experimental observations and reveal interesting phenomena such as the existence of a maximum in the tensile strength of a wet granular medium as function of liquid saturation.

  19. Frozen soil lateral resistance for the seismic design of highway bridge foundations : [summary]. (United States)


    With recent seismic activity and earthquakes in Alaska and throughout the Pacific Rim, seismic design is becoming an increasingly important public safety concern for : highway bridge designers. Hoping to generate knowledge that can improve the seismi...

  20. Bridge-Vehicle Impact Assessment (United States)


    Bridges in New York State have been experiencing close to 200 bridge hits a year. These : accidents are attributed to numerous factors including: improperly stored equipment on trucks; : violation of vehicle posting signs; illegal commercial vehicles...

  1. Colorado statewide historic bridge inventory. (United States)


    The purpose of the Colorado statewide historic bridge inventory was to document and evaluate the National : Register of Historic Places eligibility all on-system highway bridges and grade separation structures built in : Colorado between 1959 and 196...

  2. Strengthening bridges using composite materials. (United States)


    The objective of this research project is to outline methodologies for using Fiber Reinforced Polymer (FRP) composites to strengthen and rehabilitate reinforced concrete bridge elements. : Infrastructure deterioration and bridge strengthening techniq...

  3. Virginia Bridge Information Systems Laboratory. (United States)


    This report presents the results of applied data mining of legacy bridge databases, focusing on the Pontis and : National Bridge Inventory databases maintained by the Virginia Department of Transportation (VDOT). Data : analysis was performed using a...

  4. Uncontrolled concrete bridge parapet cracking. (United States)


    The Ohio Department of Transportation has recently identified the problem of wide-spread premature cracking of concrete bridge : parapets throughout its District 12 region (Northeast Ohio). Many of the bridge decks that contain these prematurely crac...

  5. A New Practical Method to Simulate Flood-Induced Bridge Pier Scour—A Case Study of Mingchu Bridge Piers on the Cho-Shui River

    Directory of Open Access Journals (Sweden)

    Jian-Hao Hong


    Full Text Available The evolution of bridge pier scour is very important for bridge safety warning and assessment. During typhoon seasons in Taiwan, the torrential river flow often causes scour monitoring instruments to fail in their attempt to measure the temporal variations of pier scour depths. To better understand the scouring phenomenon during a large flood event, this study proposes a fast and reliable method for bridge pier scour simulation. The proposed method consists of two main components: (1 a robust finite-volume hydraulic model that simulates the flow depth and velocities; and (2 two scour depth computation algorithms that predict the temporal development of the general and local scour depths. The greatest advantage of this method is that it is very straight-forward and reliable, giving bridge managers sufficient time to make an informed decision for bridge safety warning. Only a few hydraulic flow conditions near the bridge are necessary to simulate the scour depth evolution. Moreover, the method can be applied for both general and local scour simulations. To demonstrate the accuracy of the proposed method, field data collected using the “numbered-brick” method were performed at the Mingchu Bridge, which is located along an incised channel reach of the Cho-Shui River in Taiwan. The simulated water levels and total scour depths are in good agreements with the field data. Finally, to help bridge authorities responsible for making a decision towards bridge scour warning, a bridge safety curve (scoured bed level-discharge relationship is proposed. Based on the results of two flood events, the study shows that the proposed method can quickly and accurately simulate the bridge pier scour.

  6. Common practices in assessing conditions of concrete bridges

    Directory of Open Access Journals (Sweden)

    Alsharqawi Mohammed


    Full Text Available Bridge condition assessment is an essential step in bridge management. To ensure safety and serviceability of bridge infrastructure, accurate condition assessment is needed to provide basis for bridge Maintenance, Repair, and Replacement (MRR decisions. In Canada and the United States, visual inspection is the common practice to evaluate a bridge condition. Meanwhile, this practice is limited to detect surface defects and external flaws. For subsurface defects, Non-Destructive Testing and Evaluation (NDT&E technologies are being used to supplement visual inspection. This paper reviews the common practices in assessing concrete bridges’ conditions and discusses the limitations of available condition assessment models. Further, this research studies six NDT&E techniques and establishes a set of selection criteria which is utilized to compare each technique in terms of providing the best inspection results. Based on the comparison, it is found that Ground Penetrating Radar (GPR appears to be the most appropriate NDT&E techniques for inspection of concrete bridges. Thus, this paper recommends integrating GPR technology with the dominant visual inspection practice in order to establish a more accurate overall bridge condition rating system where surface and subsurface defects are assessed.

  7. Petri Net Tool Overview 1986

    DEFF Research Database (Denmark)

    Jensen, Kurt; Feldbrugge, Frits


    This paper provides an overview of the characteristics of all currently available net based tools. It is a compilation of information provided by tool authors or contact persons. A concise one page overview is provided as well....

  8. Understanding Net Zero Energy Buildings

    DEFF Research Database (Denmark)

    Salom, Jaume; Widén, Joakim; Candanedo, José


    Although several alternative definitions exist, a Net-Zero Energy Building (Net ZEB) can be succinctly described as a grid-connected building that generates as much energy as it uses over a year. The “net-zero” balance is attained by applying energy conservation and efficiency measures...... and by incorporating renewable energy systems. While based on annual balances, a complete description of a Net ZEB requires examining the system at smaller time-scales. This assessment should address: (a) the relationship between power generation and building loads and (b) the resulting interaction with the power grid....... This paper presents and categorizes quantitative indicators suitable to describe both aspects of the building’s performance. These indicators, named LMGI - Load Matching and Grid Interaction indicators, are easily quantifiable and could complement the output variables of existing building simulation tools...

  9. PolicyNet Publication System (United States)

    Social Security Administration — The PolicyNet Publication System project will merge the Oracle-based Policy Repository (POMS) and the SQL-Server CAMP system (MSOM) into a new system with an Oracle...

  10. KM3NeT

    CERN Multimedia

    KM3NeT is a large scale next-generation neutrino telescope located in the deep waters of the Mediterranean Sea, optimized for the discovery of galactic neutrino sources emitting in the TeV energy region.

  11. Net Neutrality: Background and Issues

    National Research Council Canada - National Science Library

    Gilroy, Angele A


    .... The move to place restrictions on the owners of the networks that compose and provide access to the Internet, to ensure equal access and nondiscriminatory treatment, is referred to as "net neutrality...

  12. Building a Straw Bridge (United States)

    Teaching Science, 2015


    This project is for a team of students (groups of two or three are ideal) to design and construct a model of a single-span bridge, using plastic drinking straws as the building material. All steps of the design, construction, testing and critiquing stages should be recorded by students in a journal. Students may like to include labelled diagrams,…

  13. Bridge the Gap. (United States)

    Klein, Mel; Cufaude, Jeffrey B.


    This document consists of two paired articles: the first, "Preparing Faculty Out of Class Experiences," by Mel Klein, and the second, "Help Advisers Be More Than Ghost Signatures," by Jeffrey B. Calfaude. Each article shares insights on how faculty advisers "bridge the gap" between students and faculty. When faculty members are asked to advise…

  14. Bridging the gap (United States)


    Astronomy is flourishing in China, with impressive achievements in instrument design and construction matched by a higher international research profile. Yet there remains a mismatch between the facilities available and those needed to progress. Sue Bowler wonders how the country will bridge the gap.

  15. Quantum Bidding in Bridge

    Directory of Open Access Journals (Sweden)

    Sadiq Muhammad


    Full Text Available Quantum methods allow us to reduce communication complexity of some computational tasks, with several separated partners, beyond classical constraints. Nevertheless, experimental demonstrations of this have thus far been limited to some abstract problems, far away from real-life tasks. We show here, and demonstrate experimentally, that the power of reduction of communication complexity can be harnessed to gain an advantage in a famous, immensely popular, card game—bridge. The essence of a winning strategy in bridge is efficient communication between the partners. The rules of the game allow only a specific form of communication, of very low complexity (effectively, one has strong limitations on the number of exchanged bits. Surprisingly, our quantum technique does not violate the existing rules of the game (as there is no increase in information flow. We show that our quantum bridge auction corresponds to a biased nonlocal Clauser-Horne-Shimony-Holt game, which is equivalent to a 2→1 quantum random access code. Thus, our experiment is also a realization of such protocols. However, this correspondence is not complete, which enables the bridge players to have efficient strategies regardless of the quality of their detectors.

  16. Bridge over troubled water?

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Nannestad, Peter; Svendsen, Gert Tinggaard


    The problem of integrating non-Western immigrants into Western welfare states is the focus of this paper. To address this issue, we suggest a social capital approach in which we apply the conceptual pair of bridging social capital (BR), which connects an individual to the broader social structure...

  17. Bridging the Gap? (United States)

    Salter, Colin


    The political context of the conversion of the Historic Tramway Bridge, adjacent to Sandon Point in Bulli (NSW, Australia), and how this was exploited to serve predetermined ends, illustrates that technologies can be designed to have particular social (and political) effects. Through reflection on this relatively small engineering project, this…

  18. Petri Nets in Cryptographic Protocols

    DEFF Research Database (Denmark)

    Crazzolara, Federico; Winskel, Glynn


    A process language for security protocols is presented together with a semantics in terms of sets of events. The denotation of process is a set of events, and as each event specifies a set of pre and postconditions, this denotation can be viewed as a Petri net. By means of an example we illustrate...... how the Petri-net semantics can be used to prove security properties....

  19. The Economics of Net Neutrality


    Hahn, Robert W.; Wallsten, Scott


    This essay examines the economics of "net neutrality" and broadband Internet access. We argue that mandating net neutrality would be likely to reduce economic welfare. Instead, the government should focus on creating competition in the broadband market by liberalizing more spectrum and reducing entry barriers created by certain local regulations. In cases where a broadband provider can exercise market power the government should use its antitrust enforcement authority to police anticompetitiv...

  20. Wind Resistant Design of Bridges in Japan Developments and Practices

    CERN Document Server

    Fujino, Yozo; Tanaka, Hiroshi


    For long-span bridges, wind action is a dominant factor in their safety and serviceability. A large number of long-span bridges have been built in Japan over the past 30 years, and tremendous amounts of research and technical development have been accomplished in wind resistant design. This book is a compilation of the results of active research and development. Wind resistant design standards generated in Japan are described in the first few chapters. Then comes information such as design wind speed, structural damping, wind tunnel tests, and analyses, which provide the basis of the design standards. Wind-induced vibrations and their control of girders, towers, cables, and other features are explained with examples of field measurements. Comprehensive listings of Japanese experience in vibration control are also presented. Because achieving particularly dynamic safety against wind is still not an easy task, these data and information will be valuable assets for the wind-engineering and bridge-engineering com...

  1. 77 FR 1407 - Regulated Navigation Area; Memorial Bridge Construction, Piscataqua River, Portsmouth, NH (United States)


    ...The United States Coast Guard is establishing a regulated navigation area (RNA) on the navigable waters of the Piscataqua River under and surrounding the Memorial Bridge between Portsmouth, NH and Kittery, ME. This temporary interim rule is necessary to provide for the safety of life on the navigable waters during bridge demolition and replacement construction operations. This rule implements certain safety measures, including speed restrictions and the temporary suspension of vessel traffic during construction operations that could be hazardous to nearby vessels.

  2. Revised Rules for Concrete Bridges

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle; Jensen, F. M.; Middleton, C.

    This paper is based on research performed for the Highway Agency, London, UK under the project DPU/9/44 "Revision of Bridge Assessment Rules Based on Whole Life Performance: Concrete Bridges" It contains details of a methodology which can be used to generate Whole Life (WL) reliability profiles....... These WL reliability profiles may be used to establish revised rules for Concrete Bridges....

  3. 26 CFR 1.904(f)-3 - Allocation of net operating losses and net capital losses. (United States)


    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Allocation of net operating losses and net....904(f)-3 Allocation of net operating losses and net capital losses. For rules relating to the allocation of net operating losses and net capital losses, see § 1.904(g)-3T. ...

  4. 29 CFR 4204.13 - Net income and net tangible assets tests. (United States)


    ... 29 Labor 9 2010-07-01 2010-07-01 false Net income and net tangible assets tests. 4204.13 Section....13 Net income and net tangible assets tests. (a) General. The criteria under this section are that either— (1) Net income test. The purchaser's average net income after taxes for its three most recent...

  5. New technique of railway bridges in Hokuriku Shinkansen; Hokuriku Shinkansen tetsudokyo no gijutsu

    Energy Technology Data Exchange (ETDEWEB)

    Miyabayashi, H. [Japan Railway Construction Public Corp., Tokyo (Japan)


    This paper presents new technologies of the railway bridges in Hokuriku Shinkansen. Hokuriku Shinkansen of 117km between Takasaki and Nagano is a part of Shinkansen connecting Tokyo with Nagano by nearly 1.5 hours. Its construction is in promotion under severe financial condition, and cost reduction is an essential target. Among the concrete bridges in this section, Kirizumigawa bridge, a prestressed concrete strutted 3-span continuous beam bridge, adopted a lowering erection method for its slant pier. In this method featured by high safety and profitability, the rib component of a concrete arch bridge is vertically erected on a arch support, and installed by swinging it toward the central span. In addition, a cantilever method was adopted to keep the scenery of a national park. Daini Chikumagawa bridge with the longest span of 133.9m among concrete railway bridges is the first cable-stayed prestressed concrete bridge in Shinkansen. Yashiro Minami and Kita bridges of 105m and 90m in central span are the extradosed bridges which were adopted as optimum structure for lowering the beam height of meddle-sized railway bridges. 3 refs., 12 figs., 2 tabs.

  6. 77 FR 14276 - Regulated Navigation Area; Little Bay Bridge Construction, Little Bay, Portsmouth, NH (United States)


    ...The Coast Guard is establishing a regulated navigation area (RNA) on the navigable waters of Little Bay in the Piscataqua River under and surrounding the Little Bay and General Sullivan Bridges in order to facilitate construction of the Little Bay Bridge between Newington, NH and Dover, NH. This temporary interim rule is necessary to provide for the safety of life on the navigable waters during bridge construction operations that could pose an imminent hazard to vessels operating in the area. This rule implements certain safety measures, including speed restrictions and the temporary suspension of vessel traffic during construction operations.

  7. 76 FR 57910 - Regulated Navigation Area; Route 24 Bridge Construction, Tiverton and Portsmouth, RI (United States)


    ...The Coast Guard is establishing a regulated navigation area (RNA) on the navigable waters of the Sakonnet River under and surrounding construction of the new Route 24 bridge that crosses the Sakonnet River between Tiverton and Portsmouth, Rhode Island. This rule implements certain safety measures including establishment of a temporary channel beneath the bridge, speed restrictions, and suspension of all vessel traffic within the RNA during construction operations that could pose an imminent hazard to vessels operating in the area. This rule is necessary to provide for the safety of life on the navigable waters during construction of the Route 24 bridge over the main channel of the Sakonnet River.

  8. High-speed railway bridge dynamic measurement based on GB-InSAR technology (United States)

    Liu, Miao; Ding, Ke-liang; Liu, Xianglei; Song, Zichao


    It is an important task to evaluate the safety during the life of bridges using the corresponding vibration parameters. With the advantages of non-contact and high accuracy, the new remote measurement technology of GB-InSAR is suitable to make dynamic measurement for bridges to acquire the vibration parameters. Three key technologies, including stepped frequency-continuous wave technique, synthetic aperture radar and interferometric measurement technique, are introduced in this paper. The GB-InSAR is applied for a high-speed railway bridge to measure of dynamic characteristics with the train passing which can be used to analyze the safety of the monitored bridge. The test results shown that it is an reliable non-contact technique for GB-InSAR to acquire the dynamic vibration parameter for the high-speed railway bridges.

  9. Bridge the Gap

    DEFF Research Database (Denmark)

    Marselis, Randi Lorenz


    This article focuses on photo projects organised for teenage refugees by the Society for Humanistic Photography (Berlin, Germany). These projects, named Bridge the Gap I (2015), and Bridge the Gap II (2016), were carried out in Berlin and brought together teenagers with refugee and German-majorit...... was produced – and sometimes not produced - within the projects. The importance of memory work in the context of refugee resettlement is often overlooked, but is particularly relevant when cultural encounters are organised in museums and exhibition galleries.......-majority backgrounds to experiment with digital photography and create joint exhibitions. Drawing on concepts from memory studies, such as travelling memory and multidirectional memory, the author examines the projects as interventions in German and Berlin memory cultures, and examines how multidirectional memory...

  10. A deformation analysis method of stepwise regression for bridge deflection prediction (United States)

    Shen, Yueqian; Zeng, Ying; Zhu, Lei; Huang, Teng


    Large-scale bridges are among the most important infrastructures whose safe conditions concern people's daily activities and life safety. Monitoring of large-scale bridges is crucial since deformation might have occurred. How to obtain the deformation information and then judge the safe conditions are the key and difficult problems in bridge deformation monitoring field. Deflection is the important index for evaluation of bridge safety. This paper proposes a forecasting modeling of stepwise regression analysis. Based on the deflection monitoring data of Yangtze River Bridge, the main factors influenced deflection deformation is chiefly studied. Authors use the monitoring data to forecast the deformation value of a bridge deflection at different time from the perspective of non-bridge structure, and compared to the forecasting of gray relational analysis based on linear regression. The result show that the accuracy and reliability of stepwise regression analysis is high, which provides the scientific basis to the bridge operation management. And above all, the ideas of this research provide and effective method for bridge deformation analysis.

  11. Bridging Classroom Language Ethnography


    Grenfell, Michael James


    PUBLISHED Paper #5: Bridging Classroom Language Ethnography, New Literacy Studies and Bourdieu?s Social Philosophy: Principles and Practice The purpose of this paper is to analyze and synthesize the various ways that classroom language ethnography, NLS, and Bourdieu?s social philosophy, were integrated. The goal of the analysis and synthesis is to provide a fresh perspective and fruitful insights on literacy in all its manifestations that provides the foundations for a more robust...

  12. Artisanal fishing net float loss and a proposal for a float design solution

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Chaves


    Full Text Available Abstract Plastic floats from fishing nets are commonly found washed up on beaches in southern Brazil. They are usually broken and show signs of having been repaired. Characteristics of floats and interviews with fishermen suggest two main causes of float loss. First, collisions between active gear, bottom trawl nets for shrimp, and passive gear, drift nets for fish, destroy nets and release fragments of them, including floats. Second, the difficulty with which floats are inserted on the float rope of the nets when they are used near the surface. Floats are inserted to replace damaged or lost floats, or they may be removed if it is desired that the nets be used in deeper waters. Floats may thus be poorly fixed to the cables and lost. Here a new float design that offers greater safety in use and for the replacement of floats is described and tested.

  13. TimeNET Optimization Environment

    Directory of Open Access Journals (Sweden)

    Christoph Bodenstein


    Full Text Available In this paper a novel tool for simulation-based optimization and design-space exploration of Stochastic Colored Petri nets (SCPN is introduced. The working title of this tool is TimeNET Optimization Environment (TOE. Targeted users of this tool are people modeling complex systems with SCPNs in TimeNET who want to find parameter sets that are optimal for a certain performance measure (fitness function. It allows users to create and simulate sets of SCPNs and to run different optimization algorithms based on parameter variation. The development of this tool was motivated by the need to automate and speed up tests of heuristic optimization algorithms to be applied for SCPN optimization. A result caching mechanism is used to avoid recalculations.

  14. Bridging the Health Data Divide. (United States)

    Celi, Leo Anthony; Davidzon, Guido; Johnson, Alistair Ew; Komorowski, Matthieu; Marshall, Dominic C; Nair, Sunil S; Phillips, Colin T; Pollard, Tom J; Raffa, Jesse D; Salciccioli, Justin D; Salgueiro, Francisco Muge; Stone, David J


    Fundamental quality, safety, and cost problems have not been resolved by the increasing digitization of health care. This digitization has progressed alongside the presence of a persistent divide between clinicians, the domain experts, and the technical experts, such as data scientists. The disconnect between clinicians and data scientists translates into a waste of research and health care resources, slow uptake of innovations, and poorer outcomes than are desirable and achievable. The divide can be narrowed by creating a culture of collaboration between these two disciplines, exemplified by events such as datathons. However, in order to more fully and meaningfully bridge the divide, the infrastructure of medical education, publication, and funding processes must evolve to support and enhance a learning health care system. ©Leo Anthony Celi, Guido Davidzon, Alistair EW Johnson, Matthieu Komorowski, Dominic C Marshall, Sunil S Nair, Colin T Phillips, Tom J Pollard, Jesse D Raffa, Justin D Salciccioli, Francisco Muge Salgueiro, David J Stone. Originally published in the Journal of Medical Internet Research (, 20.12.2016.

  15. Cable-stayed PC bridge with inclined main tower. Hachinohe port island bridge; Keisha shuto to yusuru 2 keikan renzoku PC shachokyo. Hachinoheko port island renrakykyo (kasho)

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, A. [Hachinohe Institute of Technology, Aomori (Japan)


    The design and construction of the inclined main bridge, which is being constructed at the mouth of the Hachinohe Harbor (in Japan), are outlined in this paper. This connecting bridge has an overall length of 265.56 m, and consists of the main bridge member of asymmetric 2 cable-stayed PC bridge and the 3 cable-stayed PC box member bridge. An asymmetric design was employed for the main bridge frame to ensure the access space for small ships passing between bridge girders, easy maintenance and service, improved economy, and excellent view. The main tower is a single-pillar reinforced concrete structure with an inclination of 15{degree} and 47 m in height. Forty-eight diagonal cables are arranged so that 12 cable trains are connected to the main tower on the right and left sides respectively, and the back-stay cable structure is used for each upper 3 cable trains to improve safety against the earthquake. The main beam is made by a prestressed concrete structure with inverse trapezoidal 3-chamber frame section. This structure is superior in increasing the safety against wind. Steel tube sheet-pile well is selected for the bridge pier base, and debris layer is selected as a support layer for the base. For the construction of the lower bridge section, sand conversion through predrilling of rubble-mound and debris layer was executed. The underwater non-separative concrete and embedded type frame are used around the bridge piers and its surrounding. For the construction of the upper bridge section, steel frames are used inside the main tower to ensure the construction precision. 7 figs.

  16. Implementing NetScaler VPX

    CERN Document Server

    Sandbu, Marius


    An easy-to-follow guide with detailed step-by step-instructions on how to implement the different key components in NetScaler, with real-world examples and sample scenarios.If you are a Citrix or network administrator who needs to implement NetScaler in your virtual environment to gain an insight on its functionality, this book is ideal for you. A basic understanding of networking and familiarity with some of the different Citrix products such as XenApp or XenDesktop is a prerequisite.

  17. Net4Care PHMR Library

    DEFF Research Database (Denmark)


    The Net4Care PHMR library contains a) A GreenCDA approach for constructing a data object representing a PHMR document: SimpleClinicalDocument, and b) A Builder which can produce a XML document representing a valid Danish PHMR (following the MedCom profile) document from the SimpleClinicalDocument......The Net4Care PHMR library contains a) A GreenCDA approach for constructing a data object representing a PHMR document: SimpleClinicalDocument, and b) A Builder which can produce a XML document representing a valid Danish PHMR (following the MedCom profile) document from the Simple...

  18. Pro DLR in NET 4

    CERN Document Server

    Wu, Chaur


    Microsoft's Dynamic Language Runtime (DLR) is a platform for running dynamic languages such as Ruby and Python on an equal footing with compiled languages such as C#. Furthermore, the runtime is the foundation for many useful software design and architecture techniques you can apply as you develop your .NET applications. Pro DLR in .NET 4 introduces you to the DLR, showing how you can use it to write software that combines dynamic and static languages, letting you choose the right tool for the job. You will learn the core DLR components such as LINQ expressions, call sites, binders, and dynami

  19. Hierarchies in Coloured Petri Nets

    DEFF Research Database (Denmark)

    Huber, Peter; Jensen, Kurt; Shapiro, Robert M.


    The paper shows how to extend Coloured Petri Nets with a hierarchy concept. The paper proposes five different hierarchy constructs, which allow the analyst to structure large CP-nets as a set of interrelated subnets (called pages). The paper discusses the properties of the proposed hierarchy...... constructs, and it illustrates them by means of two examples. The hierarchy constructs can be used for theoretical considerations, but their main use is to describe and analyse large real-world systems. All of the hierarchy constructs are supported by the editing and analysis facilities in the CPN Palette...

  20. Development of road safety performance indicators for the European countries.

    NARCIS (Netherlands)

    Gitelman, V. Vis, M. Weijermars, W. & Hakkert, S.


    Safety performance indicators (SPIs) are measures reflecting the operational conditions of the road traffic system that influence the system’s safety performance. Within the EU funded SafetyNet project, SPIs were developed for seven road safety-related areas: alcohol and drugs; speed; protective

  1. Recent Research and Applications of Numerical Simulation for Dynamic Response of Long-Span Bridges Subjected to Multiple Loads

    Directory of Open Access Journals (Sweden)

    Zhiwei Chen


    Full Text Available Many long-span bridges have been built throughout the world in recent years but they are often subject to multiple types of dynamic loads, especially those located in wind-prone regions and carrying both trains and road vehicles. To ensure the safety and functionality of these bridges, dynamic responses of long-span bridges are often required for bridge assessment. Given that there are several limitations for the assessment based on field measurement of dynamic responses, a promising approach is based on numerical simulation technologies. This paper provides a detailed review of key issues involved in dynamic response analysis of long-span multiload bridges based on numerical simulation technologies, including dynamic interactions between running trains and bridge, between running road vehicles and bridge, and between wind and bridge, and in the wind-vehicle-bridge coupled system. Then a comprehensive review is conducted for engineering applications of newly developed numerical simulation technologies to safety assessment of long-span bridges, such as assessment of fatigue damage and assessment under extreme events. Finally, the existing problems and promising research efforts for the numerical simulation technologies and their applications to assessment of long-span multiload bridges are explored.

  2. Durban Dahira: A Safety Net and Transnational Junction for ...

    African Journals Online (AJOL)

    The paper further propounds that the Muridiyya brotherhood to which all the participants in the study belonged provides training, guidance and solidarity structure well-adjusted to crisis and change situations. The paper equally reveals how the Durban dahira provides Senegalese Mouride migrants with an avenue to ...

  3. productive safety nets program and household level graduation in ...

    African Journals Online (AJOL)



    Oct 29, 2012 ... iron sheets and who can meet his food gaps better than others. The district food security expert also stated that 4,200 birr per household per year from all resources ... 0.2 equine and 0.63 calves. In addition to this, the food gap was also investigated and all of them consume less than 6 months from their.

  4. Bio-diversity: an effective safety net against environmental pollution

    Energy Technology Data Exchange (ETDEWEB)

    Swaminathan, M.S


    Biodiversity is the feedstock for the biotechnology industry. Hence, the conservation, enhancement and sustainable and equitable use of biodiversity should be accorded high priority in all national environment protection programmes. Lichens serve as useful indicators of environmental health. Similarly, several blue green algae help to sequester salt from water. There is need for the more widespread use of such biomonitoring and bioremediation agents. Bioprospecting research designed to identify novel metabolites must be rooted in the principle of equity in sharing benefits with the holders of traditional knowledge. There is need for greater vigil against alien invasive species, since with growing world trade in food grains and other agricultural commodities, there is an increasing possibility of introducing new pests, weeds and harmful micro-organisms. Finally, biological scientists should place emphasis on their ethical responsibility for the consequences of their research, since otherwise bioterrorism could become a major threat to human security. - The age of biological diversity serves as an impetus for the future of biotechnology.

  5. Weathering Natural Disasters with a Net of Safety (United States)

    Berson, Ilene R.; Berson, Michael J.


    Faster and more efficient coverage on television and the Internet is increasingly exposing children to traumatic images of natural devastation both at home and abroad. Natural disasters, such as the wildfires in California or the trauma caused by Hurricane Katrina in New Orleans, have become commonplace. Catastrophic events like these serve as…

  6. Bio-diversity: an effective safety net against environmental pollution. (United States)

    Swaminathan, M S


    Biodiversity is the feedstock for the biotechnology industry. Hence, the conservation, enhancement and sustainable and equitable use of biodiversity should be accorded high priority in all national environment protection programmes. Lichens serve as useful indicators of environmental health. Similarly, several blue green algae help to sequester salt from water. There is need for the more widespread use of such biomonitoring and bioremediation agents. Bioprospecting research designed to identify novel metabolites must be rooted in the principle of equity in sharing benefits with the holders of traditional knowledge. There is need for greater vigil against alien invasive species, since with growing world trade in food grains and other agricultural commodities, there is an increasing possibility of introducing new pests, weeds and harmful micro-organisms. Finally, biological scientists should place emphasis on their ethical responsibility for the consequences of their research, since otherwise bioterrorism could become a major threat to human security.

  7. A Safety Net for the Internet: Protecting Our Children. (United States)

    Armagh, Daniel


    Addresses the need to educate children about the dangers of exchanges with strangers on the Internet. Discusses child pornography and exploitative "support groups"; chat room risks; the need for parents to protect their children; and cyberfilters. Suggests protective measures for parents. (AEF)

  8. Integrated Monitoring System for Durability Assessment of Concrete Bridges

    Directory of Open Access Journals (Sweden)

    Cristian-Claudiu Comisu


    Full Text Available An ageing and deteriorating bridge stock presents the bridge owners with the growing challenge of maintaining the structures at a satisfactory level of safety, performance and aesthetic appearance within the allocated budgets. This task calls for optimized bridge management based on efficient methods of selecting technical and economical optimal maintenance and rehabilitation strategies. One of the crucial points in the assessment of the current condition and future development and performance. Selecting the optimal maintenance and rehabilitation strategy within the actual budget is a key point in bridge management for which an accurate assessment of performance and deterioration rate is necessary. For this assessment, the use of integrated monitoring system has several advantages compared to the traditional approach of scattered visual inspections combined with occasional on site testing with portable equipment and laboratory testing of collected samples. For this reason, attention is more focusing on the development of permanent integrated monitoring system for durability assessment of concrete bridges. It is estimated that with the implementation of such integrated monitoring systems, it should be possible to reduce the operating costs of inspections and maintenance by 25% and the operator of the structures will be able to take protective actions before damaging processes start. This paper indentifies the main bridge owner requirements to integrated monitoring systems and outlines how monitoring systems may be used for performance and deterioration rate assessment to establish a better basis for selecting the optimal maintenance and rehabilitation strategy.

  9. Construction of stiffening girder for Akashi straits bridge. Installation with use of latest bridging technology; Akashi kaikyo ohashi hoko keta kasetsu koji. Saishin kakyo gijutsu wo kushishite kasetsu

    Energy Technology Data Exchange (ETDEWEB)

    Oe, S. [Honshu-Shikoku Bridge Authority, Tokyo (Japan)


    The Akashi straits bridge is the Kobe-Naruto route of the bridge connecting Honshu and Shikoku; the bridge links Kobe in Hyogo prefecture with Awaji Island and, when completed, it will be a 3-span 2-hinge suspension bridge with the longest center effective span in the world. This report centers on the outline of the construction of stiffening girders for the Akashi straits bridge and especially on the characteristics of the engineering method newly employed. As the method of installing the stiffening girders, an overhang installation of face bars was employed which was a time-tested method. As the installing direction of the side spans, it was decided to install them from the anchorage to the tower. At the beginning, six large block installations were performed. A special balance was developed for the installation of short hanger parts for the purpose of enhancing safety and reduction in the process. A rubber-tired transporting truck was adopted for transporting members of framework on the bridge. GPS survey was used as a method for surveying the configuration. The subject engineering method was based on the construction of suspension bridge stiffening trusses in the past Honshu-Shikoku connecting bridge and reinforced with the improvements as above. Since the bridge is in the middle of construction, a subsequent report will hopefully be made on the actual results of the installation and the spanning after the closure. 8 figs., 2 tabs.

  10. Direct field measurement of the dynamic amplification in a bridge (United States)

    Carey, Ciarán; OBrien, Eugene J.; Malekjafarian, Abdollah; Lydon, Myra; Taylor, Su


    In this paper, the level of dynamics, as described by the Assessment Dynamic Ratio (ADR), is measured directly through a field test on a bridge in the United Kingdom. The bridge was instrumented using fiber optic strain sensors and piezo-polymer weigh-in-motion sensors were installed in the pavement on the approach road. Field measurements of static and static-plus-dynamic strains were taken over 45 days. The results show that, while dynamic amplification is large for many loading events, these tend not to be the critical events. ADR, the allowance that should be made for dynamics in an assessment of safety, is small.

  11. Bridging Experience With Eptifibatide After Stent Implantation. (United States)

    Barra, Megan E; Fanikos, John; Gerhard-Herman, Marie D; Bhatt, Deepak L


    Patients who have undergone intracoronary stent implantation often require surgery within the first year after the procedure. Planned or emergent surgical intervention requires interruption of antiplatelet therapy and is associated with an increased risk of stent thrombosis. Eptifibatide, an intravenous glycoprotein IIb/IIIa inhibitor (GPIIb/IIIa), can be considered for antiplatelet bridging of high-risk patients in the periprocedural period. The aim of this report is to describe the management of antiplatelet therapy and outcomes of patients who were bridged with eptifibatide perioperatively within 1 year of intracoronary stent implantation. We performed a retrospective analysis of patients identified through the hospital's computer system consecutively from January 1, 2011 to December 31, 2014. We included 18 patients who were bridged from an oral P2Y12-receptor antagonist with eptifibatide before surgery. Outcome measures were the incidence of thromboembolic events or stent thrombosis within 30 days of surgery and death within 90 days of hospital discharge. Safety measures were the incidence of thrombolysis in myocardial infarction major, minor, or minimal bleeding. Of the 18 patients assessed, no patients experienced thromboembolic events or stent thrombosis. There was one major bleeding event and one minimal bleeding event postoperatively. Antiplatelet therapy management was highly variable in the perioperative period with 72.2% receiving the recommended GPIIb/IIIa loading dose, 50% of patients not continuing aspirin throughout the surgery, 27.8% of patients stopping antiplatelet therapy less than 5 days before surgery, and 50% not receiving a loading dose of an oral P2Y12-receptor antagonist postoperatively. Within a limited sample size, bridging with an intravenous GPIIb/IIIa inhibitor appeared feasible. Further study is needed on the optimal strategy to manage patients with recent stenting who need surgical procedures.

  12. D.NET case study

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


    developing products, marketing tools and building capacity of the grass root telecentre workers. D.Net recognized that it had several ideas worth developing into small interventions that would make big differences, but resource constraints were a barrier for scaling-up these initiatives. More demands, limited resources.

  13. Surgery for GEP-NETs

    DEFF Research Database (Denmark)

    Knigge, Ulrich; Hansen, Carsten Palnæs


    Surgery is the only treatment that may cure the patient with gastroentero-pancreatic (GEP) neuroendocrine tumours (NET) and neuroendocrine carcinomas (NEC) and should always be considered as first line treatment if R0/R1 resection can be achieved. The surgical and interventional procedures for GEP...

  14. Net Neutrality in the Netherlands

    NARCIS (Netherlands)

    van Eijk, N.


    The Netherlands is among the first countries that have put specific net neutrality standards in place. The decision to implement specific regulation was influenced by at least three factors. The first was the prevailing social and academic debate, partly due to developments in the United States. The

  15. Complexity Metrics for Workflow Nets

    DEFF Research Database (Denmark)

    Lassen, Kristian Bisgaard; van der Aalst, Wil M.P.


    Process modeling languages such as EPCs, BPMN, flow charts, UML activity diagrams, Petri nets, etc.\\ are used to model business processes and to configure process-aware information systems. It is known that users have problems understanding these diagrams. In fact, even process engineers and system...

  16. Simulation of multivariate diffusion bridges

    DEFF Research Database (Denmark)

    Bladt, Mogens; Finch, Samuel; Sørensen, Michael

    We propose simple methods for multivariate diffusion bridge simulation, which plays a fundamental role in simulation-based likelihood and Bayesian inference for stochastic differential equations. By a novel application of classical coupling methods, the new approach generalizes a previously...... proposed simulation method for one-dimensional bridges to the mulit-variate setting. First a method of simulating approzimate, but often very accurate, diffusion bridges is proposed. These approximate bridges are used as proposal for easily implementable MCMC algorithms that produce exact diffusion bridges....... The new method is much more generally applicable than previous methods. Another advantage is that the new method works well for diffusion bridges in long intervals because the computational complexity of the method is linear in the length of the interval. In a simulation study the new method performs well...

  17. Morphological aspects of myocardial bridges

    Directory of Open Access Journals (Sweden)

    Almira Lujinović


    Full Text Available Although some myocardial bridges can be asymptomatic, their presence often causes coronary disease either through direct compression of the “tunnel” segment or through stimulation and accelerated development of atherosclerosis in the segment proximally to the myocardial bridge. The studied material contained 30 human hearts received from the Department of Anatomy. The hearts were preserved 3 to 5 days in 10% formalin solution. Thereafter, the fatty tissue was removed and arterial blood vessels prepared by careful dissection with special reference to the presence of the myocardial bridges. Length and thickness of the bridges were measured by the precise electronic caliper. The angle between the myocardial bridge fibre axis and other axis of the crossed blood vessel was measured by a goniometer. The presence of the bridges was confirmed in 53.33% of the researched material, most frequently (43.33% above the anterior interventricular branch. The mean length of the bridges was 14.64±9.03 mm and the mean thickness was 1.23±1.32 mm. Myocardial bridge fibres pass over the descending blood vessel at the angle of 10-90 degrees. The results obtained on a limited sample suggest that the muscular index of myocardial bridge is the highest for bridges located on RIA, but that the difference is not significant in relation to bridges located on other branches. The results obtained suggest that bridges located on other branches, not only those on RIA, could have a great contractive power and, consequently, a great compressive force, which would be exerted on the wall of a crossed blood vessel.


    Directory of Open Access Journals (Sweden)

    M. I. Kazakevych


    Full Text Available The major concepts of the elaboration and realization of the bridge construction monitoring systemic approach are presented in this paper. The main peculiarity of the bridge monitoring modern aspect is pointed out here, namely, the transition from the demands of providing the reliability to the demands of providing the whole complex of the structure consumer qualities. The criteria of diagnostics of the bridge exploitation reliability as the fundamental aim of monitoring are formulated here.

  19. Bridging the Gap. (United States)

    Webb, Michele


    The view from the top of Hoover Dam looking south over the Colorado River was breathtaking! My friend and I stood there in silence, taking it all in. I had visited Hoover Dam on many occasions, but this visit was the first time I had seen the arch bridge that carries US Route 93 over the river and joins Nevada and Arizona states. It was a beautiful day, the temperature was perfect, and there was a slight breeze coming from Lake Mead behind us as we took in the view.

  20. Bridging the Emissions Gap


    Blok, K.


    The analyses in Chapters 2 and 3 of this report concluded that the emissions gap in 2020 will likely be between 8 and 13 GtCO2e. The chapters also estimated the difference between BaU emissions in 2020 and the emissions level consistent with a “likely” chance of staying within the 2°C target to be 14 GtCO2e. This chapter explores the potential for bridging this gap using a sector policy approach. Firstly, the chapter provides a summary and update of the estimated emission reduction potential ...

  1. Bridging biometrics and forensics (United States)

    Yan, Yanjun; Osadciw, Lisa Ann


    This paper is a survey on biometrics and forensics, especially on the techniques and applications of face recognition in forensics. This paper describes the differences and connections between biometrics and forensics, and bridges each other by formulating the conditions when biometrics can be applied in forensics. Under these conditions, face recognition, as a non-intrusive and non-contact biometrics, is discussed in detail as an illustration of applying biometrics in forensics. The discussion on face recognition covers different approaches, feature extractions, and decision procedures. The advantages and limitations of biometrics in forensic applications are also addressed.

  2. 33 CFR 115.40 - Bridge repairs. (United States)


    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which do...

  3. Comprehensive evaluation of fracture critical bridges. (United States)


    Two-girder steel bridges are classified as fracture critical bridges based on the definition given in the AASHTO LRFD Bridge Design Specifications. In a fracture critical bridge a failure of a tension member leads to collapse of the bridge. However, ...

  4. Caught in the Net: Perineuronal Nets and Addiction

    Directory of Open Access Journals (Sweden)

    Megan Slaker


    Full Text Available Exposure to drugs of abuse induces plasticity in the brain and creates persistent drug-related memories. These changes in plasticity and persistent drug memories are believed to produce aberrant motivation and reinforcement contributing to addiction. Most studies have explored the effect drugs of abuse have on pre- and postsynaptic cells and astrocytes; however, more recently, attention has shifted to explore the effect these drugs have on the extracellular matrix (ECM. Within the ECM are unique structures arranged in a net-like manner, surrounding a subset of neurons called perineuronal nets (PNNs. This review focuses on drug-induced changes in PNNs, the molecules that regulate PNNs, and the expression of PNNs within brain circuitry mediating motivation, reward, and reinforcement as it pertains to addiction.

  5. Hydraulic and sediment characteristics at the North Channel Bridge, Jamaica Bay, New York (United States)

    Staubitz, W.W.; Wolcott, S.W.


    Data were collected during the spring of 1984 in the vicinity of North Channel Bridge in Jamaica Bay, New York to define the hydraulic regime and the physical characteristics and chemical quality of bottom sediments. The data were used in a semiquantitative analysis to predict the effects of bridge replacement and the attendant resuspension of bottom sediments, on the hydraulics and quality of water and bottom sediments. The bay-bottom configuration at the bridge site was defined, and continuous tidal stage and tidal velocity data were collected for about a month. In addition, eight bottom-sediment samples were collected near the bridge and analyzed. Results of the hydraulic analysis show that the proposed bridge should not have any measurable effect on the net water transport at the bridge cross section. The sediment data indicate that bottom sediments are relatively unpolluted in the vicinity of the bridge. Seventy-five percent of the resuspended bottom sediments will probably settle within 186 m of the bridge during an average ebb tide. Metals and nutrients released from the sediments to the water column are expected to be diluted far below detection limits. The extra oxygen demand exerted by the resuspended bottom sediments is also expected to be far less than ambient biochemical oxygen demand of the water column. (USGS)

  6. Research on the Key Technology of Hinge Joint Diseases Treatment without Traffic Interruption for Plate Girder Bridge


    Xun Jingchuan; Xiang Hongwei; Peng Jingrong


    The plate girder bridge accounts for a large proportion of bridge types for its advantages of simple structure and convenience in construction. However, during the service stage, it is easy to suffer the hinge joint diseases, which badly weaken the integral rigidity of superstructure and affect the operation safety of the bridge. This paper presents a treatment technology for hinge joint diseases without interrupting traffic, and the main operation steps and key points of the technology are s...

  7. Army Net Zero Prove Out. Army Net Zero Training Report (United States)


    sensors were strategically placed throughout the installation by magnetically attaching them to water main valve stems. The sensors check sound...Recycle Wrap  Substitutes for Packaging Materials  Re-Use of Textiles and Linens  Setting Printers to Double-Sided Printing Net Zero Waste...can effectively achieve source reduction. Clean and Re-Use Shop Rags - Shop rags represent a large textile waste stream at many installations. As a

  8. Army Net Zero Prove Out. Net Zero Waste Best Practices (United States)


    Anaerobic Digesters – Although anaerobic digestion is not a new technology and has been used on a large-scale basis in wastewater treatment , and has been used on a large-scale basis in wastewater treatment , the use of the technology should be demonstrated with other...approaches can be used for cardboard and cellulose -based packaging materials. This approach is in line with the Net Zero Waste hierarchy in terms of

  9. Environmental life cycle assessment comparison between two bridge types: reinforced concrete bridge and steel composite bridge

    DEFF Research Database (Denmark)

    Du, Guangli; Karoumi, Raid


    The concept of sustainable construction has attracted an increased attention. Bridge infrastructures and their belonged construction activities consume considerable material and energy, which is responsible for large environmental burdens. However, the environmental assessment of bridges has...... not been integrated into the decision-making process. This paper presents a systematic LCA method for quantifying the environmental impacts for bridges. The comparison study is performed between a reinforced concrete bridge and a steel bridge as an alternative design, with several key maintenance and EOL...... scenarios outlined. LCA study is performed with the ReCiPe methodology with life cycle inventories data from public database. Five selected mid-point level impact categories and the energy consumption are presented. The result shows that the steel bridge has a better environmental performance due...

  10. The Art World's Concept of Negative Space Applied to System Safety Management (United States)

    Goodin, Ronnie


    Tools from several different disciplines can improve system safety management. This paper relates the Art World with our system safety world showing useful art schools of thought applied to system safety management; developing an art theory- system safety bridge. This bridge is then used to demonstrate relations with risk management, the legal system, personnel management and basic management (establishing priorities.) One goal of this presentation/paper is simply to be a fun diversion from the many technical topics presented during the conference.

  11. 47 CFR 80.163 - Operator requirements of the Bridge-to-Bridge Act. (United States)


    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Operator requirements of the Bridge-to-Bridge... Requirements § 80.163 Operator requirements of the Bridge-to-Bridge Act. Each ship subject to the Bridge-to-Bridge Act must have on board a radio operator who holds a restricted radiotelephone operator permit or...

  12. Field performance of timber bridges. 7, Connell Lake stress-laminated deck bridge (United States)

    L. E. Hislop; M. A. Ritter

    The Connell Lake bridge was constructed in early 1991 on the Tongass National Forest, Alaska, as a demonstration bridge under the Timber Bridge Initiative. The bridge is a stress-laminated deck structure with an approximate 36-ft length and 18-ft width and is the first known stress-laminated timber bridge constructed in Alaska. Performance of the bridge was monitored...

  13. HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity (United States)

    National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Productivity (NPP) portion of the Human Appropriation of Net Primary...

  14. Hydrodynamic characteristics of plane netting used for aquaculture net cages in uniform current

    National Research Council Canada - National Science Library



      The hydrodynamic characteristics of polyethylene (PE) netting and chain link wire netting with different types of twine diameter and mesh size for aquaculture net cages were examined by experiments in a flume tank...

  15. Seepage study of the Sevier River Basin above Sevier Bridge Reservoir, Utah, 1988 (United States)

    Sandberg, George W.; Smith, Cynthia J.


    A seepage study was done during 1988 on selected reaches of the Sevier River in Utah above Sevier Bridge Reservoir, the East Fork Sevier River in Black Canyon and Kingston Canyon, Long-East Bench and McEwen Canals in the upper Sevier River basin, and the San Pitch River in Sanpete Valley to determine gain or loss of flow from seepage. A net gain occurred in all of the reaches except Kingston Canyon on the East Fork Sevier River, which had a net loss. In the upper Sevier River basin, the Sevier River between Hatch and Circleville Canyon had a net gain of about 125 cubic feet per second; Long-East Bench Canal had a net gain of about 0.7 cubic foot per second; McEwen Canal had a net gain of about 0.9 cubic foot per second; the East Fork Sevier River in Black Canyon had a net gain of about 3.0 cubic feet per second; and the East Fork Sevier River in Kingston Canyon had a net loss of about 8.0 cubic feet per second. In central Sevier Valley, both the south and the north sections had large gains. The net gain for both sections, combined, was about 213 cubic feet per second for August 1988 and about 230 cubic feet per second for October 1988. The reach of the San Pitch River studied had a net gain of about 23.4 cubic feet per second.

  16. Implementation of a bridge management system in the municipal environment

    CSIR Research Space (South Africa)

    Nordengen, Paul A


    Full Text Available 2005/07/27 69.87 57.94 4 QL-88_01B Humewood Bridge (East Structure) 2005/08/30 63.63 64.41 5 QK-81_03B 6th Avenue Walmer Footbridge 2005/06/10 52.89 70.33 6 QE-83_01B Boswell Algoa Ramps 2005/07/27 75.53 71.59 7 QG-83_08B Pell Street I/C (North... 3. QL-89_01B - Hobie Pier 4. QJ-82_01B - Albany Road footbridge 5. QJ-85_01B - Baakens River bridge (West) 6. QJ-85_02B - Baakens River bridge (East) Common problems relating to road user safety that were identified are the following: 1...

  17. Isolated unit tests in .Net


    Haukilehto, Tero


    In this thesis isolation in unit testing is studied to get a precise picture of the isolation frameworks available for .Net environment. At the beginning testing is discussed in theory with the benefits and the problems it may have been linked with. The theory includes software development in general in connection with testing. Theory of isolation is also described before the actual isolation frameworks are represented. Common frameworks are described in more detail and comparable informa...

  18. Design of piles for integral abutment bridges. (United States)


    More and more, integral abutment bridges are being used in place : of the more traditional bridge designs with expansion releases. In : this study, states which use integral abutment bridges were surveyed : to determine their current practice in the ...

  19. Developing deterioration models for Nebraska bridges. (United States)


    Nebraska Bridge Management System (NBMS) was developed in 1999 to assist in optimizing budget allocation for : the maintenance, rehabilitation and replacement needs of highway bridges. This requires the prediction of bridge : deterioration to calcula...

  20. Monitoring bridge scour using fiber optic sensors. (United States)


    The scouring process excavates and carries away materials from the bed and banks of streams, and from : around the piers and abutments of bridges. Scour undermines bridges and may cause bridge failures due to : structural instability. In the last 30 ...

  1. Faster bridge construction using precast substructures : brief. (United States)


    Bridge replacement often requires road closures and detours that frustrate road users. It remains a key goal of Wisconsin DOT to reduce construction-related road use interruptions. This will be a challenge with bridges: Bridge inspections in 2007 ide...

  2. The violin bridge as filter. (United States)

    Bissinger, George


    The violin bridge filter role was investigated using modal and acoustic measurements on 12 quality-rated violins combined with systematic bridge rocking frequency f(rock) and wing mass decrements deltam on four bridges for two other violins. No isolated bridge resonances were observed; bridge motions were complex (including a "squat" mode near 0.8 kHz) except for low frequency rigid body pivot motions, all more or less resembling rocking motion at higher frequencies. A conspicuous broad peak near 2.3 kHz in bridge driving point mobility (labeled BH) was seen for good and bad violins. Similar structure was seen in averaged bridge, bridge feet, corpus mobilities and averaged radiativity. No correlation between violin quality and BH driving point, averaged corpus mobility magnitude, or radiativity was found. Increasing averaged-over-f(rock) deltam(g) from 0 to 0.12 generally increased radiativity across the spectrum. Decreasing averaged-over-deltam f(rock) from 3.6 to 2.6 kHz produced consistent decreases in radiativity between 3 and 4.2 kHz, but only few-percent decreases in BH frequency. The lowest f(rock) values were accompanied by significantly reduced radiation from the Helmholtz A0 mode near 280 Hz; this, combined with reduced high frequency output, created overall radiativity profiles quite similar to "bad" violins among the quality-rated violins.

  3. Crashworthy railing for timber bridges (United States)

    Michael A. Ritter; Ronald K. Faller; Sheila Rimal. Duwadi


    Bridge railing systems in the United States have historically beers designed based on static load criteria given in the American Association of State Highway and Transportation 0fficials (AASHTO) Standard Specifications for Highway Bridges. In the past decade, full-scale vehicle crash testing has been recognized as a more appropriate and reliable method of evaluating...

  4. Fatigue tests on aluminium bridges

    NARCIS (Netherlands)

    Maljaars, J.; Soetens, F.; Straalen, IJ.J. van


    Traffic bridges are subjected to variable loads and should therefore be checked on fatigue. Especially low weight materials, like aluminium, are sensitive to fatigue, because the variable load is a substantial part of the total load. This paper shows the structural design of an aluminium bridge

  5. Steel-soil composite bridge

    DEFF Research Database (Denmark)

    Du, Guangli; Pettersson, Lars; Karoumi, Raid


    viability, while their environmental performance is overlooked. Today’s designers are urged to seek new design options to reduce the environmental burdens. Sweden owns more than 24574 bridges and most of them are short spans. Among them, the slab frame bridge (CFB) is a common solution. Soil steel composite...

  6. Vulnerability of bridges to fire

    DEFF Research Database (Denmark)

    Giuliani, Luisa; Crosti, C.; Gentili, F.


    Even if recent effort in developing methodology and measures for design structures against fire and explosions has been mostly focused on buildings, bridges can also be very sensitive to those actions, as witnesses by some recent bridge accidents, which caused major economic losses and also endan...

  7. Crossing borders via mental bridges

    DEFF Research Database (Denmark)

    Keil, Dirk

    administration, and in specific on the attempt to initiate and promote cross-border regional integration via the building of mental bridges between Danish and German parts of the Femern Belt Region. Here one of the first projects aiming primarily at building mental bridges in the Femern Belt Region...

  8. Strength and fatigue of three glass fiber reinforced composite bridge decks with mechanical deck to stringer connections. (United States)


    Replacement of the steel grating deck on the lift span of the Morrison Bridge in Portland, OR, will utilize glass : fiber reinforced polymer (FRP) panels to address ongoing maintenance issues of the deteriorated existing deck, improve driver : safety...

  9. Acoustic emission safety monitoring of intermodal transportation infrastructure. (United States)


    Safety and integrity of the national transportation infrastructure are of paramount importance and highway bridges are critical components of the highway system network. This network provides an immense contribution to the industry productivity and e...

  10. Event hierarchies in DanNet

    DEFF Research Database (Denmark)

    Pedersen, Bolette Sandford; Nimb, Sanni


    Artiklen omhandler udarbejdelsen af et verbumshierarki i det leksikalsk-semantiske ordnet, DanNet.......Artiklen omhandler udarbejdelsen af et verbumshierarki i det leksikalsk-semantiske ordnet, DanNet....

  11. The Uniframe .Net Web Service Discovery Service

    National Research Council Canada - National Science Library

    Berbeco, Robert W


    Microsoft .NET allows the creation of distributed systems in a seamless manner Within NET small, discrete applications, referred to as Web services, are utilized to connect to each other or larger applications...

  12. Long Term RadNet Quality Data (United States)

    U.S. Environmental Protection Agency — This RadNet Quality Data Asset includes all data since initiation and when ERAMS was expanded to become RadNet, name changed to reflect new mission. This includes...

  13. Integrated system of structural health monitoring and intelligent management for a cable-stayed bridge. (United States)

    Chen, Bin; Wang, Xu; Sun, Dezhang; Xie, Xu


    It is essential to construct structural health monitoring systems for large important bridges. Zhijiang Bridge is a cable-stayed bridge that was built recently over the Hangzhou Qiantang River (the largest river in Zhejiang Province). The length of Zhijiang Bridge is 478 m, which comprises an arched twin-tower space and a twin-cable plane structure. As an example, the present study describes the integrated system of structural health monitoring and intelligent management for Zhijiang Bridge, which comprises an information acquisition system, data management system, evaluation and decision-making system, and application service system. The monitoring components include the working environment of the bridge and various factors that affect bridge safety, such as the stress and strain of the main bridge structure, vibration, cable force, temperature, and wind speed. In addition, the integrated system includes a forecasting and decision-making module for real-time online evaluation, which provides warnings and makes decisions based on the monitoring information. From this, the monitoring information, evaluation results, maintenance decisions, and warning information can be input simultaneously into the bridge monitoring center and traffic emergency center to share the monitoring data, thereby facilitating evaluations and decision making using the system.

  14. Integrated System of Structural Health Monitoring and Intelligent Management for a Cable-Stayed Bridge

    Directory of Open Access Journals (Sweden)

    Bin Chen


    Full Text Available It is essential to construct structural health monitoring systems for large important bridges. Zhijiang Bridge is a cable-stayed bridge that was built recently over the Hangzhou Qiantang River (the largest river in Zhejiang Province. The length of Zhijiang Bridge is 478 m, which comprises an arched twin-tower space and a twin-cable plane structure. As an example, the present study describes the integrated system of structural health monitoring and intelligent management for Zhijiang Bridge, which comprises an information acquisition system, data management system, evaluation and decision-making system, and application service system. The monitoring components include the working environment of the bridge and various factors that affect bridge safety, such as the stress and strain of the main bridge structure, vibration, cable force, temperature, and wind speed. In addition, the integrated system includes a forecasting and decision-making module for real-time online evaluation, which provides warnings and makes decisions based on the monitoring information. From this, the monitoring information, evaluation results, maintenance decisions, and warning information can be input simultaneously into the bridge monitoring center and traffic emergency center to share the monitoring data, thereby facilitating evaluations and decision making using the system.

  15. Electrothermally Tunable Bridge Resonator

    KAUST Repository

    Hajjaj, Amal Z.


    This paper demonstrates experimentally, theoretically, and numerically a wide-range tunability of an in-plane clamped-clamped microbeam, bridge, and resonator compressed by a force due to electrothermal actuation. We demonstrate that a single resonator can be operated at a wide range of frequencies. The microbeam is actuated electrothermally, by passing a DC current through it. We show that when increasing the electrothermal voltage, the compressive stress inside the microbeam increases, which leads eventually to its buckling. Before buckling, the fundamental frequency decreases until it drops to very low values, almost to zero. After buckling, the fundamental frequency increases, which is shown to be as high as twice the original resonance frequency. Analytical results based on the Galerkin discretization of the Euler Bernoulli beam theory are generated and compared to the experimental data and to simulation results of a multi-physics finite-element model. A good agreement is found among all the results.

  16. Bridging the Evaluation Gap

    Directory of Open Access Journals (Sweden)

    Paul Wouters


    Full Text Available Paul Wouters’ essay is concerned with bridging the gap between what we value in our academic work and how we are assessed in formal evaluation exercises. He reflects on the recent evaluation of his own center, and reminds us that it is productive to see evaluations not as the (obviously impossible attempt to produce a true representation of past work, but rather as the exploration and performance of “who one wants to be.” Reflecting on why STS should do more than just play along to survive in the indicator game, he suggests that our field should contribute to changing its very rules. In this endeavor, the attitude and sensibilities developed in our field may be more important than any specific theoretical concepts or methodologies.

  17. Design without thermal bridges

    Directory of Open Access Journals (Sweden)

    Maltseva Irina


    Full Text Available The main focus of the article is on the quality design and implementation of the thermal insulation of buildings. Shells of buildings consist not only of conventional structures (wall, roof, ceiling, but also of edges, corners, joints and places of disruption of the outer thermal insulation shell integrity (due to through passage of pipelines, ventilation ducts and etc.. In all these places, heat losses are generally increased in comparison with conventional surfaces. Some of them are easily taken into account by calculation, using a special method proposed by the authors. Other thermal bridges due to unfavorable structural details can be avoided by observing the rules and recommendations that are classified and discussed in detail in this article.

  18. Looking Beyond the Bridge

    DEFF Research Database (Denmark)

    Jahn, Elke; Rosholm, Michael

    We perform a comprehensive analysis of the stepping-stone effect of temporary agency employment on unemployed workers. Using the timing-of-events approach, we not only investigate whether agency employment is a bridge into regular employment but also analyze its effect on post-unemployment wages...... and job stability for unemployed Danish workers. We find evidence of large positive treatment effects, particularly for immigrants. There is also some indication that higher treatment intensity increases the likelihood of leav-ing unemployment for regular jobs. Our results show that agency employment...... is even more effective in tight labor markets, where firms use agency employment primarily to screen po-tential candidates for permanent posts. Finally, our results suggest that agency employment may improve subsequent match quality in terms of wages and job duration....

  19. PsychoNet: a psycholinguistc commonsense ontology


    Mohtasseb, Haytham; Ahmed, Amr


    Ontologies have been widely accepted as the most advanced knowledge representation model. This paper introduces PsychoNet, a new knowledgebase that forms the link between psycholinguistic taxonomy, existing in LIWC, and its semantic textual representation in the form of commonsense semantic ontology, represented by ConceptNet. The integration of LIWC and ConceptNet and the added functionalities facilitate employing ConceptNet in psycholinguistic studies. Furthermore, it simplifies utilization...

  20. Experimental evaluation and field implementation of FRP bridge deck modules

    Directory of Open Access Journals (Sweden)

    Woraphot Prachasaree


    Full Text Available Construction of highway bridge decks using fiber reinforced polymer (FRP composite deck and superstructuremodules in lieu of concrete decks has proven to be feasible. However, FRP’s are not widely accepted yet despite theirbenefits such as non-corrosiveness, higher strength to weight ratio, and better fatigue resistance than conventional materials.Lack of wider usage of FRP material is mainly attributed to the absence of: 1 standardized test procedures, 2 designspecifications, and 3 construction procedures. The higher initial cost is also inhibiting bridge engineers in selecting FRPmodules as highway bridge super structural systems.Implementation of FRP composites technology for highway bridge decks leads to higher safety and lower life cyclecosts. Significant ongoing research and development of FRP deck modules as illustrated herein, has proven to enhancedeck module properties in developing FRP modules with enhanced structural performance.Prodeck 4 is one such multicellular deck that was recently developed, and extensively evaluated for static and fatigueloads, and its response results are presented herein. From rigorous testing, it was concluded that Prodeck 4 could resistAASHTO HS 25 loading with maximum stringer spacing of 48 inches. This led to construction of two bridges (one in Ohioand other in West Virginia using Prodeck 4 as decking.

  1. 78 FR 72451 - Net Investment Income Tax (United States)


    ... Revenue Service 26 CFR Part 1 RIN 1545-BL74 Net Investment Income Tax AGENCY: Internal Revenue Service...). These regulations provide guidance on the computation of net investment income. The regulations affect... lesser of: (A) The individual's net investment income for such taxable year, or (B) the excess (if any...

  2. 47 CFR 69.302 - Net investment. (United States)


    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Net investment. 69.302 Section 69.302... Apportionment of Net Investment § 69.302 Net investment. (a) Investment in Accounts 2001, 1220 and Class B Rural...) Investment in Accounts 2002, 2003 and to the extent such inclusions are allowed by this Commission, Account...

  3. 47 CFR 65.450 - Net income. (United States)


    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Net income. 65.450 Section 65.450... OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Exchange Carriers § 65.450 Net income. (a) Net income shall consist of all revenues derived from the provision of interstate telecommunications services...

  4. 47 CFR 65.500 - Net income. (United States)


    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Net income. 65.500 Section 65.500... OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Interexchange Carriers § 65.500 Net income. The net income methodology specified in § 65.450 shall be utilized by all interexchange carriers that are...

  5. NetBeans IDE 8 cookbook

    CERN Document Server

    Salter, David


    If you're a Java developer of any level using NetBeans and want to learn how to get the most out of NetBeans, then this book is for you. Learning how to utilize NetBeans will provide a firm foundation for your Java application development.

  6. Characterizing behavioural congruences for Petri nets

    DEFF Research Database (Denmark)

    Nielsen, Mogens; Priese, Lutz; Sassone, Vladimiro


    We exploit a notion of interface for Petri nets in order to design a set of net combinators. For such a calculus of nets, we focus on the behavioural congruences arising from four simple notions of behaviour, viz., traces, maximal traces, step, and maximal step traces, and from the corresponding...

  7. 27 CFR 4.37 - Net contents. (United States)


    ... the volume of wine within the container, except that the following tolerances shall be allowed: (1... THE TREASURY LIQUORS LABELING AND ADVERTISING OF WINE Labeling Requirements for Wine § 4.37 Net contents. (a) Statement of net contents. The net contents of wine for which a standard of fill is...

  8. NET 40 Generics Beginner's Guide

    CERN Document Server

    Mukherjee, Sudipta


    This is a concise, practical guide that will help you learn Generics in .NET, with lots of real world and fun-to-build examples and clear explanations. It is packed with screenshots to aid your understanding of the process. This book is aimed at beginners in Generics. It assumes some working knowledge of C# , but it isn't mandatory. The following would get the most use out of the book: Newbie C# developers struggling with Generics. Experienced C++ and Java Programmers who are migrating to C# and looking for an alternative to other generic frameworks like STL and JCF would find this book handy.

  9. The Net Reclassification Index (NRI)

    DEFF Research Database (Denmark)

    Pepe, Margaret S.; Fan, Jing; Feng, Ziding


    The Net Reclassification Index (NRI) is a very popular measure for evaluating the improvement in prediction performance gained by adding a marker to a set of baseline predictors. However, the statistical properties of this novel measure have not been explored in depth. We demonstrate the alarming...... marker is proven to erroneously yield a positive NRI. Some insight into this phenomenon is provided. Since large values for the NRI statistic may simply be due to use of poorly fitting risk models, we suggest caution in using the NRI as the basis for marker evaluation. Other measures of prediction...

  10. Bridge Creek IMW database - Bridge Creek Restoration and Monitoring Project (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The incised and degraded habitat of Bridge Creek is thought to be limiting a population of ESA-listed steelhead (Oncorhynchus mykiss). A logical restoration approach...

  11. Compilation of accelerated bridge construction (ABC) bridges : final report. (United States)


    Development of accelerated bridge construction (ABC) technologies has been occurring across the country, many times in : isolation. Although FHWA and others have worked to facilitate communication between these efforts, there was not a : comprehensiv...

  12. Research on the Key Technology of Hinge Joint Diseases Treatment without Traffic Interruption for Plate Girder Bridge

    Directory of Open Access Journals (Sweden)

    Xun Jingchuan


    Full Text Available The plate girder bridge accounts for a large proportion of bridge types for its advantages of simple structure and convenience in construction. However, during the service stage, it is easy to suffer the hinge joint diseases, which badly weaken the integral rigidity of superstructure and affect the operation safety of the bridge. This paper presents a treatment technology for hinge joint diseases without interrupting traffic, and the main operation steps and key points of the technology are summarized. Through an example of the reinforcement of a plate girder bridge, the deformation data before and after the reinforcement is measured and compared, which verifies the effectiveness of the method.

  13. Thermal bridges of modern windows

    DEFF Research Database (Denmark)

    Hansen, Ernst Jan de Place; Møller, Eva B.; Nielsen, Anker


    With its focus on reduced energy consumption, contemporary housing construction requires a highly insulated and airtight building envelope with as few thermal bridges as possible.Windows must be carefully designed, as thermal bridges can lead to surface condensation or mold growth, even...... if the window has an U-factor of 1 W/(m2·K) or lower. This paper describes the development of modern, energy efficient Danish windows with reduced thermal bridges. It focuses on materials, geometry, and sealing of window panes based on a literature review. Examples of modern windows are presented. Experience...

  14. Reliability Assessment of Concrete Bridges

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle; Middleton, C. R.

    This paper is partly based on research performed for the Highways Agency, London, UK under the project DPU/9/44 "Revision of Bridge Assessment Rules Based on Whole Life Performance: concrete bridges". It contains the details of a methodology which can be used to generate Whole Life (WL) reliability...... profiles. These WL reliability profiles may be used to establish revised rules for concrete bridges. This paper is to some extend based on Thoft-Christensen et. al. [1996], Thoft-Christensen [1996] et. al. and Thoft-Christensen [1996]....

  15. Complex Testing of the Bridges

    Directory of Open Access Journals (Sweden)

    Savić Adrijana


    Full Text Available This article describes the process of examining bridges. AB road bridge, founded on the columns by the Karpoš system and damaged due to erosive action of the river, is given as an example. The first tests of the bridge are conducted on the impact load of V 300, because of the appearance of longitudinal cracks. The results of the columns testing are presented in this paper, as well as the rehabilitation measures thus increasing the load capacity of the column.

  16. Bridge management system for the Western Cape provincial government, South Africa: implementation and utilization

    CSIR Research Space (South Africa)

    Nell, AJ


    Full Text Available Examples of structural repairs a) repairs to culvert wing walls, abutment walls as well as deck slab, b) replacement of existing steel bridge handrails with precast concrete rails, c) repairs to bridge abutment by means of externally reinforced concrete... general problem of reinforcement corrosion. New precast reinforced concrete railings were proposed in instances were vandalism had occurred; • Bearings were generally in a good condition; • Selected road safety elements were also identified for repair...

  17. Reliability Assessment of Long Span Suspension Bridges Subjected to Dead Loads


    Antonsen, Kristin


    In the present study the influence of standardized safety factors in large and heavy structures, where the major loading arises from self-weight of the structure itself, is considered. For this purpose, a reliability analysis of the Hardanger Bridge is performed. The loading is assumed to originate from the self-weight of the bridge deck, hangers and main cables only, i.e. all other loads are neglected. The reliability analysis is performed by comparing axial loading and resistance capaci...

  18. Deterministic and Probabilistic Analysis of NPP Communication Bridge Resistance Due to Extreme Loads

    Directory of Open Access Journals (Sweden)

    Králik Juraj


    Full Text Available This paper presents the experiences from the deterministic and probability analysis of the reliability of communication bridge structure resistance due to extreme loads - wind and earthquake. On the example of the steel bridge between two NPP buildings is considered the efficiency of the bracing systems. The advantages and disadvantages of the deterministic and probabilistic analysis of the structure resistance are discussed. The advantages of the utilization the LHS method to analyze the safety and reliability of the structures is presented


    Directory of Open Access Journals (Sweden)

    Elisabeta Mihaela CIORTEA


    Full Text Available Purpose of the paper is to analyze the Petri net model, to describe the transport process, part of amanufacturing system and its dynamics.A hibrid Petri net model is built to describe the dinamics of the transport process manufacturingsystem. Mathematical formulation of the dinamycs processes a detailed description. Based on this model, theanalysis of the transport process is designed to be able to execute a production plan and resolve any conflictsthat may arise in the system.In the analysis dinamics known two stages: in the continuous variables are discrete hybrid system in thehibrid discrete variables are used as safety control with very well defined responsibilities.In terms of the chosen model, analyze transport process is designed to help execute a production planand resolve conflicts that may arise in the process, and then the ones in the system

  20. A bridge monitoring tool based on bridge and vehicle accelerations


    Hester, David; González, Arturo


    Previous research on damage detection based on the response of a structure to a moving load has reported decay in accuracy with increasing load speed. Using a 3D vehicle – bridge interaction model, this paper shows that the area under the filtered acceleration response of the bridge increases with increasing damage, even at highway load speeds. Once a datum reading is established, the area under subsequent readings can be monitored and compared with the baseline reading, if an increase is obs...

  1. Drug Safety (United States)

    ... over-the-counter drug. The FDA evaluates the safety of a drug by looking at Side effects ... clinical trials The FDA also monitors a drug's safety after approval. For you, drug safety means buying ...

  2. 75 FR 22228 - Regulated Navigation Area; Lake Champlain Bridge Construction Zone, NY and VT (United States)


    ...The Coast Guard is establishing a regulated navigation area around the construction zone of the Lake Champlain Bridge between Crown Point, New York and Chimney Point, Vermont. This temporary interim rule places speed restrictions on all vessels transiting the navigable waters of Lake Champlain in the vicinity of the bridge construction. In addition, this rule provides for the temporary suspension of all vessel traffic within the regulated navigation area during certain periods of construction. This rule is necessary to provide for the safety of life on the navigable waters within this regulated area during the construction of the Lake Champlain Bridge.

  3. Long-Term Structural Health Monitoring System for a High-Speed Railway Bridge Structure. (United States)

    Ding, You-Liang; Wang, Gao-Xin; Sun, Peng; Wu, Lai-Yi; Yue, Qing


    Nanjing Dashengguan Bridge, which serves as the shared corridor crossing Yangtze River for both Beijing-Shanghai high-speed railway and Shanghai-Wuhan-Chengdu railway, is the first 6-track high-speed railway bridge with the longest span throughout the world. In order to ensure safety and detect the performance deterioration during the long-time service of the bridge, a Structural Health Monitoring (SHM) system has been implemented on this bridge by the application of modern techniques in sensing, testing, computing, and network communication. The SHM system includes various sensors as well as corresponding data acquisition and transmission equipment for automatic data collection. Furthermore, an evaluation system of structural safety has been developed for the real-time condition assessment of this bridge. The mathematical correlation models describing the overall structural behavior of the bridge can be obtained with the support of the health monitoring system, which includes cross-correlation models for accelerations, correlation models between temperature and static strains of steel truss arch, and correlation models between temperature and longitudinal displacements of piers. Some evaluation results using the mean value control chart based on mathematical correlation models are presented in this paper to show the effectiveness of this SHM system in detecting the bridge's abnormal behaviors under the varying environmental conditions such as high-speed trains and environmental temperature.

  4. Long-Term Structural Health Monitoring System for a High-Speed Railway Bridge Structure (United States)

    Wu, Lai-Yi


    Nanjing Dashengguan Bridge, which serves as the shared corridor crossing Yangtze River for both Beijing-Shanghai high-speed railway and Shanghai-Wuhan-Chengdu railway, is the first 6-track high-speed railway bridge with the longest span throughout the world. In order to ensure safety and detect the performance deterioration during the long-time service of the bridge, a Structural Health Monitoring (SHM) system has been implemented on this bridge by the application of modern techniques in sensing, testing, computing, and network communication. The SHM system includes various sensors as well as corresponding data acquisition and transmission equipment for automatic data collection. Furthermore, an evaluation system of structural safety has been developed for the real-time condition assessment of this bridge. The mathematical correlation models describing the overall structural behavior of the bridge can be obtained with the support of the health monitoring system, which includes cross-correlation models for accelerations, correlation models between temperature and static strains of steel truss arch, and correlation models between temperature and longitudinal displacements of piers. Some evaluation results using the mean value control chart based on mathematical correlation models are presented in this paper to show the effectiveness of this SHM system in detecting the bridge's abnormal behaviors under the varying environmental conditions such as high-speed trains and environmental temperature. PMID:26451387

  5. Opening Electrical Contacts: The Transition from the Molten Metal Bridge to the Electric Arc (United States)

    Slade, Paul G.

    This paper presents a comprehensive explanation of the formation of the electric arc between opening contacts in a current carrying electric circuit. As the contacts begin to open a molten metal bridge forms between them. The rupture of this bridge and the initial formation of the electric arc are studied in both atmospheric air and vacuum using experiments to determine the direction of metal transfer between the contacts as a function of time after the rupture of the molten metal bridge. High speed streak photography is also used to show the rupture of the molten metal bridge and the initial formation of the electric arc. Analysis of these data show that a very high-pressure, high-temperature metal vapor zone exists between the contacts after the rupture of the molten metal bridge. Under this condition a pseudo-arc forms where current is carried by metal ions and an anomalous, high net transfer of metal to the cathodic contact occurs. The pressure in this region decreases rapidly and there is a transition to the usual electric arc, which still operates in the metal vapor. In this arc the current is now mostly carried by electrons. The data shows that there is still a net transfer of metal to the cathode, but now its volume is a function of the arcing time.

  6. The stories of two bridges in Ghana

    DEFF Research Database (Denmark)

    Andreasen, Jørgen


    Public participation in bridge building was promoted by un habitat in the village of Mankrong. The neighbouring village did not participate in the construction of their bridge. The first flooding washed the second bridge down while the "participative bridge" stood up....

  7. Heavy Vehicles on Minor Highway Bridges

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Nielsen, Søren R. K.; Enevoldsen, I.

    Vibration of a bridge structure due to the passage of vehicles is an important consideration in the design of bridges. Further, a common problem in bridge engineering practice in these years is the upgrading of minor highway bridges (=5-20 m) to carry heavier loads partly due to a tendency of hea...

  8. Interstate-35 bridge instrumentation renaissance. (United States)


    An updated, accelerometer-based, sensor and data acquisition system was installed and verified on the I-35 Walnut Creek Bridge in Purcell, Oklahoma. The data collection system also includes a microwave communication system to move sensor and video da...

  9. Caltrans bridge inspection aerial robot. (United States)


    The California Department of Transportation (Caltrans) project resulted in the development of a twin-motor, : single duct, electric-powered Aerobot designed of carrying video cameras up to 200 feet in elevation to enable : close inspection of bridges...

  10. Energy harvesting on highway bridges. (United States)


    A concept for harvesting energy from the traffic-induced loadings on a highway bridge using piezoelectric : materials to generate electricity was explored through the prototype stage. A total of sixteen lead-zirconate : titanate (PZT) Type 5A piezoel...

  11. Milton-Madison Bridge Project


    Hetrick, Kevin; Bunselmeier, Jason


    INDOT will provide a brief introduction to the Madison Milton Ohio River Bridge Project, discuss the project development process, the design/build procurement and the construction during this presentation.

  12. Preventative maintenance program for bridges. (United States)


    The Kentucky Transportation Cabinets (KYTC) bridge inventory is rapidly aging. As such, the Cabinet : needs to identify and implement relevant preventative maintenance (PM) actions to extend the useful : service lives of those structures. Maintena...

  13. Bridge Aesthetics and Structural Honesty

    DEFF Research Database (Denmark)

    Gimsing, Niels Jørgen


    In bridges the overall form must be chosen with due respect to the transmission of forces if efficient structures shall be created, The design must therefore be governed by experienced structural engineers - in some cases assisted by aesthetic advisers on specific issues. Some basic requirements ...... decisive for choosing the form of trusses, arches and cable-stayed bridges are outlined, and several examples show bridges designed without giving priority to the structural aspects.......In bridges the overall form must be chosen with due respect to the transmission of forces if efficient structures shall be created, The design must therefore be governed by experienced structural engineers - in some cases assisted by aesthetic advisers on specific issues. Some basic requirements...

  14. GFRP reinforced concrete bridge decks. (United States)


    This report investigates the application of glass fiber reinforced polymer (GFRP) rebars in concrete bridge decks as a potential replacement or supplement to conventional steel rebars. Tests were conducted to determine the material properties of the ...

  15. We Must Be Bridge Builders. (United States)

    Andringa, Robert C.


    Higher education, and trustees in particular, must be "bridge builders" among academe, government, and business communities. Trustees must also be the mediators and a reconciling force when the public and independent campuses lose sight of their common cause. (MLW)

  16. VEXAG's Venus Bridge Focus Group (United States)

    Cutts, J. A.


    VEXAG’s Venus Bridge Focus Group is investigating whether viable Venus missions can be conducted within a $200M cost-cap. Progress reports on mission concept studies of combined in situ and orbiter missions will be presented.

  17. Growth of human cells on a non-woven silk fibroin net: a potential for use in tissue engineering. (United States)

    Unger, Ronald E; Wolf, Michael; Peters, Kirsten; Motta, Antonella; Migliaresi, Claudio; James Kirkpatrick, C


    We have examined a novel biomaterial consisting of a non-woven fibroin net produced from silk (Bombyx mori) cocoons for its ability to support the growth of human cells. Various human cells of different tissue and cell types (endothelial, epithelial, fibroblast, glial, keratinocyte, osteoblast) were examined for adherence and growth on the nets by confocal laser microscopy after staining of the cells with calcein-AM and by electron microscopy. All the cells readily adhered and spread over the individual fibers of the nets. Most of the cells were able to grow and survive on the nets for at least 7 weeks and growth not only covered the individual fibers of the net but generally bridged the gaps between individual fibers forming tissue-like structures. Scanning electron microscopic examination of the nets demonstrated a tight association of individual cells with the fibers and nets examined after removal of cells showed no evidence that the growth of cells in any way changed the structure of the fibers. Thus, silk fibroin nets are highly human cell-compatible and should be a useful new scaffolding biomaterial applicable for a wide range of target tissues in addition to supporting endothelial cells required for the vascularization of the newly formed tissue.

  18. Development of inspection robots for bridge cables. (United States)

    Yun, Hae-Bum; Kim, Se-Hoon; Wu, Liuliu; Lee, Jong-Jae


    This paper presents the bridge cable inspection robot developed in Korea. Two types of the cable inspection robots were developed for cable-suspension bridges and cable-stayed bridge. The design of the robot system and performance of the NDT techniques associated with the cable inspection robot are discussed. A review on recent advances in emerging robot-based inspection technologies for bridge cables and current bridge cable inspection methods is also presented.

  19. Development of Inspection Robots for Bridge Cables

    Directory of Open Access Journals (Sweden)

    Hae-Bum Yun


    Full Text Available This paper presents the bridge cable inspection robot developed in Korea. Two types of the cable inspection robots were developed for cable-suspension bridges and cable-stayed bridge. The design of the robot system and performance of the NDT techniques associated with the cable inspection robot are discussed. A review on recent advances in emerging robot-based inspection technologies for bridge cables and current bridge cable inspection methods is also presented.

  20. -Net Approach to Sensor -Coverage

    Directory of Open Access Journals (Sweden)

    Fusco Giordano


    Full Text Available Wireless sensors rely on battery power, and in many applications it is difficult or prohibitive to replace them. Hence, in order to prolongate the system's lifetime, some sensors can be kept inactive while others perform all the tasks. In this paper, we study the -coverage problem of activating the minimum number of sensors to ensure that every point in the area is covered by at least sensors. This ensures higher fault tolerance, robustness, and improves many operations, among which position detection and intrusion detection. The -coverage problem is trivially NP-complete, and hence we can only provide approximation algorithms. In this paper, we present an algorithm based on an extension of the classical -net technique. This method gives an -approximation, where is the number of sensors in an optimal solution. We do not make any particular assumption on the shape of the areas covered by each sensor, besides that they must be closed, connected, and without holes.

  1. Consideration on extradosed prestressed concrete road bridge; Dorokyo ni okeru daihenshin PC keburu kyo

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, A.; Honma, A. [Japan Highway Public Corp., Tokyo (Japan)


    The details of the investigation on the Odawara Blue Way Bridge for which extradosed type is employed are provided, and a report is made about the situation of the study on the future construction of the 2nd Tomei-Meishin Expressway. The extradosed PC bridge is considered to have intermediate structural characteristics of those of the conventional beam bridge and PC cable stayed bridge, and is expected to be applied to bridges having approximately from 100 to 200m span. The features of the extradosed PC bridge is outlined. Approximately 1/35 beam height on the intermediate support and 1/10 main tower height against the center span are considered to be proper. PC steel products can be used efficiently because stress fluctuation of diagonals and the load sharing rate of the diagonal member are less than those of the PC cable stayed bridge and safety factor similar to that of general internal cable can be adopted. Construction works for the main tower and the diagonal member are easy due to low height of the main tower, and the bridge is advantageous also in the maintenance control because no beam is required. 5 refs., 8 figs., 2 tabs.

  2. NETS - Danish participation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Alsen, S. (Grontmij - Carl Bro, Glostrup (Denmark)); Theel, C. (Baltic Sea Solutions, Holeby (Denmark))


    Within the NICe-funded project 'Nordic Environmental Technology Solutions (NETS)' a new type of networking at the Nordic level was organized in order to jointly exploit the rapidly growing market potential in the environmental technology sector. The project aimed at increased and professionalized commercialization of Nordic Cleantech in energy and water business segments through 1) closer cooperation and joint marketing activities, 2) a website, 3) cleantech product information via brochures and publications 4) and participating in relevant trade fairs and other industry events. Facilitating business-to-business activities was another core task for the NETS project partners from Norway, Sweden, Finland and Denmark with the aim to encourage total solutions for combined Cleantech system offers. The project has achieved to establish a Cleantech register of 600 Nordic Cleantech companies, a network of 86 member enterprises, produced several publications and brochures for direct technology promotion and a website for direct access to company profiles and contact data. The project partners have attended 14 relevant international Cleantech trade fairs and conferences and facilitated business-to-business contacts added by capacity building offers through two company workshops. The future challenge for the project partners and Nordic Cleantech will be to coordinate the numerous efforts within the Nordic countries in order to reach concerted action and binding of member companies for reliable services, an improved visibility and knowledge exchange. With Cleantech's growing market influence and public awareness, the need to develop total solutions is increasing likewise. Marketing efforts should be encouraged cross-sectional and cross-border among the various levels of involved actors from both the public and the private sector. (au)

  3. The NordiNet® International Outcome Study and NovoNet® ANSWER Program®

    DEFF Research Database (Denmark)

    Höybye, Charlotte; Sävendahl, Lars; Christesen, Henrik Thybo


    the opportunity to assess long-term treatment outcomes and the clinical factors and variables affecting those outcomes, in patients receiving GH therapy in routine clinical practice. DESIGN: The NordiNet® International Outcome Study (IOS) and the American Norditropin® Studies: Web Enabled Research (ANSWER Program...... will provide valid insights into the effectiveness and safety of GH treatment across a diverse and large patient population treated in accordance with real-world clinical practice and following the Good Pharmacoepidemiological Practice and STrengthening the Reporting of OBservational studies in Epidemiology...

  4. 33 CFR 118.100 - Retroreflective panels on bridge piers. (United States)


    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Retroreflective panels on bridge... SECURITY BRIDGES BRIDGE LIGHTING AND OTHER SIGNALS § 118.100 Retroreflective panels on bridge piers. The... 12 inches square. (c) To mark bridge piers or channel sides on bridges not required to have bridge...

  5. Application and Theory of Petri Nets

    DEFF Research Database (Denmark)

    This volume contains the proceedings of the 13th International Conference onApplication and Theory of Petri Nets, held in Sheffield, England, in June 1992. The aim of the Petri net conferences is to create a forum for discussing progress in the application and theory of Petri nets. Typically....... Balbo and W. Reisig, 18 submitted papers, and seven project papers. The submitted papers and project presentations were selectedby the programme committee and a panel of referees from a large number of submissions....

  6. Are You Neutral About Net Neutrality (United States)


    Information Resources Management College National Defense University Are You Neutral About Net Neutrality ? A presentation for Systems & uses Verizon FiOS for phone, TV, and internet service 3 Agenda Net Neutrality —Through 2 Lenses Who Are the Players & What Are They Saying...Medical Treatment Mini-Case Studies Updates Closing Thoughts 4 Working Definitions of Net Neutrality "Network Neutrality" is the concept that

  7. Texture Based Image Analysis With Neural Nets (United States)

    Ilovici, Irina S.; Ong, Hoo-Tee; Ostrander, Kim E.


    In this paper, we combine direct image statistics and spatial frequency domain techniques with a neural net model to analyze texture based images. The resultant optimal texture features obtained from the direct and transformed image form the exemplar pattern of the neural net. The proposed approach introduces an automated texture analysis applied to metallography for determining the cooling rate and mechanical working of the materials. The results suggest that the proposed method enhances the practical applications of neural nets and texture extraction features.

  8. Factors associated with mosquito net use by individuals in households owning nets in Ethiopia

    Directory of Open Access Journals (Sweden)

    Graves Patricia M


    Full Text Available Abstract Background Ownership of insecticidal mosquito nets has dramatically increased in Ethiopia since 2006, but the proportion of persons with access to such nets who use them has declined. It is important to understand individual level net use factors in the context of the home to modify programmes so as to maximize net use. Methods Generalized linear latent and mixed models (GLLAMM were used to investigate net use using individual level data from people living in net-owning households from two surveys in Ethiopia: baseline 2006 included 12,678 individuals from 2,468 households and a sub-sample of the Malaria Indicator Survey (MIS in 2007 included 14,663 individuals from 3,353 households. Individual factors (age, sex, pregnancy; net factors (condition, age, net density; household factors (number of rooms [2006] or sleeping spaces [2007], IRS, women's knowledge and school attendance [2007 only], wealth, altitude; and cluster level factors (rural or urban were investigated in univariate and multi-variable models for each survey. Results In 2006, increased net use was associated with: age 25-49 years (adjusted (a OR = 1.4, 95% confidence interval (CI 1.2-1.7 compared to children U5; female gender (aOR = 1.4; 95% CI 1.2-1.5; fewer nets with holes (Ptrend = 0.002; and increasing net density (Ptrend [all nets in HH good] = 1.6; 95% CI 1.2-2.1; increasing net density (Ptrend [per additional space] = 0.6, 95% CI 0.5-0.7; more old nets (aOR [all nets in HH older than 12 months] = 0.5; 95% CI 0.3-0.7; and increasing household altitude (Ptrend Conclusion In both surveys, net use was more likely by women, if nets had fewer holes and were at higher net per person density within households. School-age children and young adults were much less likely to use a net. Increasing availability of nets within households (i.e. increasing net density, and improving net condition while focusing on education and promotion of net use, especially in school-age children

  9. Pro Agile NET Development with Scrum

    CERN Document Server

    Blankenship, Jerrel; Millett, Scott


    Pro Agile .NET Development with SCRUM guides you through a real-world ASP.NET project and shows how agile methodology is put into practice. There is plenty of literature on the theory behind agile methodologies, but no book on the market takes the concepts of agile practices and applies these in a practical manner to an end-to-end ASP.NET project, especially the estimating, requirements and management aspects of a project. Pro Agile .NET Development with SCRUM takes you through the initial stages of a project - gathering requirements and setting up an environment - through to the development a

  10. Pro ASP.NET MVC 4

    CERN Document Server

    Freeman, Adam


    The ASP.NET MVC 4 Framework is the latest evolution of Microsoft's ASP.NET web platform. It provides a high-productivity programming model that promotes cleaner code architecture, test-driven development, and powerful extensibility, combined with all the benefits of ASP.NET. ASP.NET MVC 4 contains a number of significant advances over previous versions. New mobile and desktop templates (employing adaptive rendering) are included together with support for jQuery Mobile for the first time. New display modes allow your application to select views based on the browser that's making the request whi

  11. Professional Visual Basic 2010 and .NET 4

    CERN Document Server

    Sheldon, Bill; Sharkey, Kent


    Intermediate and advanced coverage of Visual Basic 2010 and .NET 4 for professional developers. If you've already covered the basics and want to dive deep into VB and .NET topics that professional programmers use most, this is your book. You'll find a quick review of introductory topics-always helpful-before the author team of experts moves you quickly into such topics as data access with ADO.NET, Language Integrated Query (LINQ), security, ASP.NET web programming with Visual Basic, Windows workflow, threading, and more. You'll explore all the new features of Visual Basic 2010 as well as all t

  12. NASA Net Zero Energy Buildings Roadmap

    Energy Technology Data Exchange (ETDEWEB)

    Pless, S.; Scheib, J.; Torcellini, P.; Hendron, B.; Slovensky, M.


    In preparation for the time-phased net zero energy requirement for new federal buildings starting in 2020, set forth in Executive Order 13514, NASA requested that the National Renewable Energy Laboratory (NREL) to develop a roadmap for NASA's compliance. NASA detailed a Statement of Work that requested information on strategic, organizational, and tactical aspects of net zero energy buildings. In response, this document presents a high-level approach to net zero energy planning, design, construction, and operations, based on NREL's first-hand experience procuring net zero energy construction, and based on NREL and other industry research on net zero energy feasibility. The strategic approach to net zero energy starts with an interpretation of the executive order language relating to net zero energy. Specifically, this roadmap defines a net zero energy acquisition process as one that sets an aggressive energy use intensity goal for the building in project planning, meets the reduced demand goal through energy efficiency strategies and technologies, then adds renewable energy in a prioritized manner, using building-associated, emission- free sources first, to offset the annual energy use required at the building; the net zero energy process extends through the life of the building, requiring a balance of energy use and production in each calendar year.

  13. Towards a Standard for Modular Petri Nets

    DEFF Research Database (Denmark)

    Kindler, Ekkart; Petrucci, Laure


    When designing complex systems, mechanisms for structuring, composing, and reusing system components are crucial. Today, there are many approaches for equipping Petri nets with such mechanisms. In the context of defining a standard interchange format for Petri nets, modular PNML was defined....... Moreover, we present and discuss some more advanced features of modular Petri nets that could be included in the standard. This way, we provide a formal foundation and a basis for a discussion of features to be included in the upcoming standard of a module concept for Petri nets in general and for high...

  14. Experiments and simulation of a net closing mechanism for tether-net capture of space debris (United States)

    Sharf, Inna; Thomsen, Benjamin; Botta, Eleonora M.; Misra, Arun K.


    This research addresses the design and testing of a debris containment system for use in a tether-net approach to space debris removal. The tether-net active debris removal involves the ejection of a net from a spacecraft by applying impulses to masses on the net, subsequent expansion of the net, the envelopment and capture of the debris target, and the de-orbiting of the debris via a tether to the chaser spacecraft. To ensure a debris removal mission's success, it is important that the debris be successfully captured and then, secured within the net. To this end, we present a concept for a net closing mechanism, which we believe will permit consistently successful debris capture via a simple and unobtrusive design. This net closing system functions by extending the main tether connecting the chaser spacecraft and the net vertex to the perimeter and around the perimeter of the net, allowing the tether to actuate closure of the net in a manner similar to a cinch cord. A particular embodiment of the design in a laboratory test-bed is described: the test-bed itself is comprised of a scaled-down tether-net, a supporting frame and a mock-up debris. Experiments conducted with the facility demonstrate the practicality of the net closing system. A model of the net closure concept has been integrated into the previously developed dynamics simulator of the chaser/tether-net/debris system. Simulations under tether tensioning conditions demonstrate the effectiveness of the closure concept for debris containment, in the gravity-free environment of space, for a realistic debris target. The on-ground experimental test-bed is also used to showcase its utility for validating the dynamics simulation of the net deployment, and a full-scale automated setup would make possible a range of validation studies of other aspects of a tether-net debris capture mission.

  15. Introduction to the Delaware River Port Authority's Smart Bridges initiative (United States)

    Box, Robert A.; McCullough, Patrick J.; Bistline, Robert S.


    The Delaware River Port Authority, whose mission is to manage, plan and construct transportation facilities and provide transportation services to maximize the safe and efficient movement of people and freight within the Delaware River Valley, located in southwestern Pennsylvania and southern New Jersey, is a self-financing, bi-state Authority, formed by a compact between the Commonwealth of Pennsylvania and the State of New Jersey and approved by the Congress of the United States. The Delaware River Port Authority is firmly committed to the strategic and integrated use of advanced transportation technology to improve traffic flow, operational efficiency and safety on DRPA's four bridges. To this end, the Delaware River Port Authority has initiated a program, appropriately named 'Smart Bridges.' The Delaware River Port Authority has recognized that this type of program is essential to the advancement of the DRPA's mission as an efficient, customer- friendly transportation and regional development agency. Under the Smart Bridges program the Delaware River Port Authority is introducing new technology into its aging infrastructure and transportation systems to ensure that the facilities continue to serve the region into the 21st century and beyond. Initiatives introduced under this program include EZ Pass, video surveillance systems, computerized traffic control systems and partnering with local universities to investigate the application of various innovative technologies to assist in the maintenance of the bridge facilities.

  16. HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity (United States)

    National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Product (NPP) portion of the HANPP Collection represents a map identifying...

  17. Price smarter on the Net. (United States)

    Baker, W; Marn, M; Zawada, C


    Companies generally have set prices on the Internet in two ways. Many start-ups have offered untenably low prices in a rush to capture first-mover advantage. Many incumbents have simply charged the same prices on-line as they do off-line. Either way, companies are missing a big opportunity. The fundamental value of the Internet lies not in lowering prices or making them consistent but in optimizing them. After all, if it's easy for customers to compare prices on the Internet, it's also easy for companies to track customers' behavior and adjust prices accordingly. The Net lets companies optimize prices in three ways. First, it lets them set and announce prices with greater precision. Different prices can be tested easily, and customers' responses can be collected instantly. Companies can set the most profitable prices, and they can tap into previously hidden customer demand. Second, because it's so easy to change prices on the Internet, companies can adjust prices in response to even small fluctuations in market conditions, customer demand, or competitors' behavior. Third, companies can use the clickstream data and purchase histories that it collects through the Internet to segment customers quickly. Then it can offer segment-specific prices or promotions immediately. By taking full advantage of the unique possibilities afforded by the Internet to set prices with precision, adapt to changing circumstances quickly, and segment customers accurately, companies can get their pricing right. It's one of the ultimate drivers of e-business success.

  18. Constraint Ornstein-Uhlenbeck bridges (United States)

    Mazzolo, Alain


    In this paper, we study the Ornstein-Uhlenbeck bridge process (i.e., the Ornstein-Uhlenbeck process conditioned to start and end at fixed points) constraints to have a fixed area under its path. We present both anticipative (in this case, we need the knowledge of the future of the path) and non-anticipative versions of the stochastic process. We obtain the anticipative description thanks to the theory of generalized Gaussian bridges while the non-anticipative representation comes from the theory of stochastic control. For this last representation, a stochastic differential equation is derived which leads to an effective Langevin equation. Finally, we extend our theoretical findings to linear bridge processes.

  19. - Integrated safety concepts and reliability. Proceedings; - Integrierte Sicherheitskonzepte und Zuverlaessigkeit. Tagungsband

    Energy Technology Data Exchange (ETDEWEB)



    The proceedings volume of the two days Meeting titled:'' - Integrated Safety Concepts and Reliability'' which has been held on the 5th and 6th April 2005 in Leipzig, includes the ten contributions presented. The subjects were as follows: safety and reliability in modern vehicles; e-safty activities of European Commission; advanced safety technology for enhanced road safety; safety systems - sometimes less may be more - analysis related to markets with limited purchasing power like in Czech Republic; modern design of the truck driver's workplace and supporting technologies for road safety; risk management and car safety; concepts of driver assistance - state of affairs and outlook; to err (while driving) is human - which technical systems can help?; Safety Net: developing the European Road Safety Observatory; consumer safety ratings and their effect on car safety. The manuscripts are available in the form of reproduced overhead foils. (AKF)

  20. Long-Term Structural Health Monitoring System for a High-Speed Railway Bridge Structure

    Directory of Open Access Journals (Sweden)

    You-Liang Ding


    Full Text Available Nanjing Dashengguan Bridge, which serves as the shared corridor crossing Yangtze River for both Beijing-Shanghai high-speed railway and Shanghai-Wuhan-Chengdu railway, is the first 6-track high-speed railway bridge with the longest span throughout the world. In order to ensure safety and detect the performance deterioration during the long-time service of the bridge, a Structural Health Monitoring (SHM system has been implemented on this bridge by the application of modern techniques in sensing, testing, computing, and network communication. The SHM system includes various sensors as well as corresponding data acquisition and transmission equipment for automatic data collection. Furthermore, an evaluation system of structural safety has been developed for the real-time condition assessment of this bridge. The mathematical correlation models describing the overall structural behavior of the bridge can be obtained with the support of the health monitoring system, which includes cross-correlation models for accelerations, correlation models between temperature and static strains of steel truss arch, and correlation models between temperature and longitudinal displacements of piers. Some evaluation results using the mean value control chart based on mathematical correlation models are presented in this paper to show the effectiveness of this SHM system in detecting the bridge’s abnormal behaviors under the varying environmental conditions such as high-speed trains and environmental temperature.