WorldWideScience

Sample records for primary aluminum guidelines

  1. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna

    2009-01-01

    OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p ...: Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed....

  2. EPRI PWR primary water chemistry guidelines revision

    International Nuclear Information System (INIS)

    McElrath, Joel; Fruzzetti, Keith

    2014-01-01

    EPRI periodically updates the PWR Primary Water Chemistry Guidelines as new information becomes available and as required by NEI 97-06 (Steam Generator Program Guidelines) and NEI 03-08 (Guideline for the Management of Materials Issues). The last revision of the PWR water chemistry guidelines identified an optimum primary water chemistry program based on then-current understanding of research and field information. This new revision provides further details with regard to primary water stress corrosion cracking (PWSCC), fuel integrity, and shutdown dose rates. A committee of industry experts, including utility specialists, nuclear steam supply system (NSSS) and fuel vendor representatives, Institute of Nuclear Power Operations (INPO) representatives, consultants, and EPRI staff collaborated in reviewing the available data on primary water chemistry, reactor water coolant system materials issues, fuel integrity and performance issues, and radiation dose rate issues. From the data, the committee updated the water chemistry guidelines that all PWR nuclear plants should adopt. The committee revised guidance with regard to optimization to reflect industry experience gained since the publication of Revision 6. Among the changes, the technical information regarding the impact of zinc injection on PWSCC initiation and dose rate reduction has been updated to reflect the current level of knowledge within the industry. Similarly, industry experience with elevated lithium concentrations with regard to fuel performance and radiation dose rates has been updated to reflect data collected to date. Recognizing that each nuclear plant owner has a unique set of design, operating, and corporate concerns, the guidelines committee has retained a method for plant-specific optimization. Revision 7 of the Pressurized Water Reactor Primary Water Chemistry Guidelines provides guidance for PWR primary systems of all manufacture and design. The guidelines continue to emphasize plant

  3. Guideline for primary care management of headache in adults

    Science.gov (United States)

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. Quality of evidence A comprehensive search was conducted for relevant guidelines and systematic reviews published between January 2000 and May 2011. The guidelines were critically appraised using the AGREE (Appraisal of Guidelines for Research and Evaluation) tool, and the 6 highest-quality guidelines were used as seed guidelines for the guideline adaptation process. Main message A multidisciplinary guideline development group of primary care providers and other specialists crafted 91 specific recommendations using a consensus process. The recommendations cover diagnosis, investigation, and management of migraine, tension-type, medication-overuse, and cluster headache. Conclusion A clinical practice guideline for the Canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidence-informed care for patients with headache. PMID:26273080

  4. GHG emissions from primary aluminum production in China: Regional disparity and policy implications

    International Nuclear Information System (INIS)

    Hao, Han; Geng, Yong; Hang, Wen

    2016-01-01

    Highlights: • GHG emissions from primary aluminum production in China were accounted. • The impact of regional disparity of power generation was considered for this study. • GHG emissions factor of China’s primary aluminum production was 16.5 t CO_2e/t Al ingot in 2013. • Total GHG emissions from China’s primary aluminum production were 421 mt CO_2e in 2013. - Abstract: China is the world-leading primary aluminum production country, which contributed to over half of global production in 2014. Primary aluminum production is power-intensive, for which power generation has substantial impact on overall Greenhouse Gas (GHG) emissions. In this study, we explore the impact of regional disparity of China’s power generation system on GHG emissions for the sector of primary aluminum production. Our analysis reveals that the national GHG emissions factor (GEF) of China’s primary aluminum production was 16.5 t CO_2e/t Al ingot in 2013, with province-level GEFs ranging from 8.2 to 21.7 t CO_2e/t Al ingot. There is a high coincidence of provinces with high aluminum productions and high GEFs. Total GHG emissions from China’s primary aluminum production were 421 mt CO_2e in 2013, approximately accounting for 4% of China’s total GHG emissions. Under the 2020 scenario, GEF shows a 13.2% reduction compared to the 2013 level, but total GHG emissions will increase to 551 mt CO_2e. Based on our analysis, we recommend that the government should further promote energy efficiency improvement, facilitate aluminum industry redistribution with low-carbon consideration, promote secondary aluminum production, and improve aluminum industry data reporting and disclosure.

  5. CO_2 emission trends of China's primary aluminum industry: A scenario analysis using system dynamics model

    International Nuclear Information System (INIS)

    Li, Qiang; Zhang, Wenjuan; Li, Huiquan; He, Peng

    2017-01-01

    China announced its promise on CO_2 emission peak. When and what level of CO_2 emission peak China's primary aluminum industry will reach is in suspense. In this paper, a system dynamic model is established, with five subsystems of economy development, primary aluminum production, secondary aluminum production, CO_2 emission intensity and policies making involved. The model is applied to examine potential CO_2 emission trends of China's primary aluminum industry in next fifteen years with three scenarios of “no new policies”, “13th five-year plan” and “additional policies”. Simulation results imply that: merely relying on rapid expansion of domestic scarps recycling and reuse could not mitigate CO_2 emission continuously. Combination of energy-saving technology application and electrolytic technology innovation, as well as promoting hydropower utilization in primary aluminum industry are necessary for long term low-carbon development. From a global prospective, enhancing international cooperation on new primary aluminum capacity construction in other countries, especially with rich low-carbon energy, could bring about essential CO_2 emission for both China's and global primary aluminum industry. - Highlights: • A system dynamic model is established for future CO_2 emission trend of China's primary aluminum industry. • Three potential policy scenarios are simulated. • The impacts of potential policies implication on the CO_2 emission trend are discussed.

  6. The Practice Guidelines for Primary Care of Acute Abdomen 2015.

    Science.gov (United States)

    Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

    2016-01-01

    Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.

  7. Heart failure guidelines and prescribing in primary care across Europe

    Directory of Open Access Journals (Sweden)

    Hobbs FD Richard

    2005-08-01

    Full Text Available Abstract Background Major international differences in heart failure treatment have been repeatedly described, but the reasons for these differences remain unclear. National guideline recommendations might be a relevant factor. This study, therefore, explored variation of heart failure guideline recommendations in Europe. Methods Treatment recommendations of 14 national guidelines published after 1994 were analyzed in relation to the heart failure treatment guideline of the European Society of Cardiology. To test potential relations between recommendations and prescribing, national prescribing patterns as obtained by a European study in primary care (IMPROVEMENT-HF were related to selected recommendations in those countries. Results Besides the 14 national guidelines used by primary care physicians in the countries contacted, the European guideline was used in four countries, and separate guidelines for specialists and primary care were available in another four countries. Two countries indicated that no guideline was used up to 2000. Comprehensiveness of the guidelines varied with respect to length, literature included and evidence ratings. Relevant differences in treatment recommendations were seen only in drug classes where evidence had changed recently (β-blockers and spironolactone. The relation between recommendation and prescribing for selected recommendations was inconsistent among countries. Conclusion Differences in guideline recommendations are not sufficient to explain variation of prescribing among countries, thus other factors must be considered.

  8. 76 FR 76259 - National Emissions Standards for Hazardous Air Pollutants: Primary Aluminum Reduction Plants

    Science.gov (United States)

    2011-12-06

    ... Emissions From Maleic Anhydride Plants, Ethylbenzene/Styrene Plants, Benzene Storage Vessels, Benzene...). The rule is applicable to facilities with affected sources associated with the production of aluminum... are subject to the requirements of this NESHAP: 14 primary aluminum production plants and one carbon...

  9. Primary Aluminum Reduction Industry - National Emission Standards for Hazardous Air Pollutants (NESHAP)

    Science.gov (United States)

    National emission standards for each new or existing potline, paste production operation, and anode bake furnace associated with a primary aluminum reduction plant. Includes rule history, implementation information and additional resources.

  10. Practice Guidelines for Primary Care of Acute Abdomen 2015.

    Science.gov (United States)

    Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

    2016-01-01

    Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine, in collaboration with four other medical societies, launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines (all clinical questions and recommendations were shown in supplementary information). A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on nine subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  11. Hypertension guideline implementation: experiences of Finnish primary care nurses

    DEFF Research Database (Denmark)

    Alanen, Seija; Ijäs, Jarja; Kaila, Minna

    2008-01-01

    RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses. METHOD: We assessed the style of implementation and adoption of the national...... Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as 'disseminators' (n = 13) or 'implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers...... were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors. RESULTS: Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion...

  12. Final Technical Report Microwave Assisted Electrolyte Cell for Primary Aluminum Production

    Energy Technology Data Exchange (ETDEWEB)

    Xiaodi Huang; J.Y. Hwang

    2007-04-18

    This research addresses the high priority research need for developing inert anode and wetted cathode technology, as defined in the Aluminum Industry Technology Roadmap and Inert Anode Roadmap, with the performance targets: a) significantly reducing the energy intensity of aluminum production, b) ultimately eliminating anode-related CO2 emissions, and c) reducing aluminum production costs. This research intended to develop a new electrometallurgical extraction technology by introducing microwave irradiation into the current electrolytic cells for primary aluminum production. This technology aimed at accelerating the alumina electrolysis reduction rate and lowering the aluminum production temperature, coupled with the uses of nickel based superalloy inert anode, nickel based superalloy wetted cathode, and modified salt electrolyte. Michigan Technological University, collaborating with Cober Electronic and Century Aluminum, conducted bench-scale research for evaluation of this technology. This research included three sub-topics: a) fluoride microwave absorption; b) microwave assisted electrolytic cell design and fabrication; and c) aluminum electrowinning tests using the microwave assisted electrolytic cell. This research concludes that the typically used fluoride compound for aluminum electrowinning is not a good microwave absorbing material at room temperature. However, it becomes an excellent microwave absorbing material above 550°C. The electrowinning tests did not show benefit to introduce microwave irradiation into the electrolytic cell. The experiments revealed that the nickel-based superalloy is not suitable for use as a cathode material; although it wets with molten aluminum, it causes severe reaction with molten aluminum. In the anode experiments, the chosen superalloy did not meet corrosion resistance requirements. A nicked based alloy without iron content could be further investigated.

  13. [Interdisciplinary AWMF guideline for the diagnostics of primary immunodeficiency].

    Science.gov (United States)

    Farmand, S; Baumann, U; von Bernuth, H; Borte, M; Foerster-Waldl, E; Franke, K; Habermehl, P; Kapaun, P; Klock, G; Liese, J; Marks, R; Müller, R; Nebe, T; Niehues, T; Schuster, V; Warnatz, K; Witte, T; Ehl, S; Schulze, I

    2011-11-01

    Primary immunodeficiencies are potentially life-threatening diseases. Over the last years, the clinical phenotype and the molecular basis of an increasing number of immunological defects have been characterized. However, in daily practice primary immunodeficiencies are still often diagnosed too late. Considering that an early diagnosis may reduce morbidity and mortality of affected patients, an interdisciplinary guideline for the diagnosis of primary immunodeficiencies was developed on behalf of the Arbeitsgemeinschaft Pädiatrische Immunologie (API) and the Deutsche Gesellschaft für Immunologie (DGfI). The guideline is based on expert opinion and on knowledge from other guidelines and recommendations from Germany and other countries, supplemented by data from studies that support the postulated key messages (level of evidence III). With the contribution of 20 representatives, belonging to 14 different medical societies and associations, a consensus-based guideline with a representative group of developers and a structured consensus process was created (S2k). Under the moderation of a representative of the Association of the Scientific Medical Societies in Germany (AWMF) the nominal group process took place in April 2011. The postulated key messages were discussed and voted on following a structured consensus procedure. In particular, modified warning signs for primary immunodeficiencies were formulated and immunological emergency situations were defined. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    Tsima BM

    2016-08-01

    Full Text Available Billy M Tsima,1 Vincent Setlhare,1 Oathokwa Nkomazana2 1Department of Family Medicine and Public Health, 2Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana Background: Botswana’s health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers.Methods: The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list.Results: Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed.Conclusion: The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better

  15. Guideline-related barriers to optimal prescription of oral anticoagulants in primary care

    NARCIS (Netherlands)

    Beukenhorst, A. L.; Arts, D. L.; Lucassen, W.; Jager, K. J.; van der Veer, S. N.

    2016-01-01

    Guidelines provide recommendations for antithrombotic treatment to prevent stroke in people with atrial fibrillation, but oral anticoagulant prescriptions in Dutch primary care are often discordant with these recommendations. Suboptimal guideline features (i.e. format and content) have been

  16. Energy conservation in the primary aluminum and chlor-alkali industries

    Energy Technology Data Exchange (ETDEWEB)

    1980-10-01

    The primary aluminum and chlor-alkali industries together use nearly 13% of the electrical energy consumed by US industry. As part of its mission to promote energy conservation in basic US industries, the DOE surveys the present technological status of the major electrochemical industries and evaluates promising technological innovations that may lead to reduced energy requirements. This study provides technical and economic analyses in support of a government program of research and development in advanced electrolytic technology. This program is intended to supplement the development efforts directed toward energy savings by private industry. Sections II and III of this report cover aluminum and chlorine production processes only, since these two industries represent over 90% of the electrical energy requirements of all electrolytic industries in the United States. Section IV examines barriers to accelerated research and development by the electrolytic industries, and makes suggestions for government actions to overcome these barriers.

  17. Attitudes toward guidelines in Finnish primary care nursing: a questionnaire survey

    DEFF Research Database (Denmark)

    Seija, Alanen; Kaila, Minna; Välimäki, Marita

    2009-01-01

    to be shaped by perceptions of others, which makes the role of organizational implementation interventions interesting. AIMS: This article describes primary care nurses' attitudes toward guidelines among Finnish primary care nurses and the associations between attitudes, implementation interventions...... more positively and that guidelines were more easily available. Further, nurses who were familiar or very familiar with the guidelines had more positive attitudes toward them. Attitudes were also associated with self-reported guideline use. CONCLUSIONS: The evidence-based guidelines were accepted...... as a reliable source of advice in patient care in Finnish primary care. It seems that implementation interventions improve attitudes toward guidelines and enhance guideline use. These interventions might also be important from another point of view; they presumably improve familiarity with guidelines, which...

  18. Exposure to fluoride in smelter workers in a primary aluminum industry in India.

    Science.gov (United States)

    Susheela, A K; Mondal, N K; Singh, A

    2013-04-01

    Fluoride is used increasingly in a variety of industries in India. Emission of fluoride dust and fumes from the smelters of primary aluminum producing industries is dissipated in the work environment and poses occupational health hazards. To study the prevalence of health complaints and its association with fluoride level in body fluids of smelter workers in a primary aluminum producing industry. In an aluminum industry, health status of 462 smelter workers, 60 supervisors working in the smelter unit, 62 non-smelter workers (control group 1) and 30 administration staff (control group 2) were assessed between 2007 and 2009. Their health complaints were recorded and categorized into 4 groups: 1) gastro-intestinal complaints; 2) non-skeletal manifestations; 3) skeletal symptoms; and (4) respiratory problems. Fluoride level in body fluids, nails, and drinking water was tested by an ion selective electrode; hemoglobin level was tested using HemoCue. The total complaints reported by study groups were significantly higher than the control groups. Smelter workers had a significantly (pworkers; the nail fluoride content was also higher in smelter workers than non-smelter workers (pworkers with higher hemoglobin level had a significantly (pworkers were consuming water with high fluoride concentrations. A high percentage of participants was using substances with high fluoride contents. Industrial emission of fluoride is not the only important sources of fluoride exposure--consumption of substance with high levels of fluoride is another important route of entry of fluoride into the body. Measurement of hemoglobin provides a reliable indicator for monitoring the health status of employees at risk of fluorosis.

  19. Exposure to Fluoride in Smelter Workers in a Primary Aluminum Industry in India

    Directory of Open Access Journals (Sweden)

    AK Susheela

    2013-04-01

    Full Text Available Background: Fluoride is used increasingly in a variety of industries in India. Emission of fluoride dust and fumes from the smelters of primary aluminum producing industries is dissipated in the work environment and poses occupational health hazards. Objective: To study the prevalence of health complaints and its association with fluoride level in body fluids of smelter workers in a primary aluminum producing industry. Methods: In an aluminum industry, health status of 462 smelter workers, 60 supervisors working in the smelter unit, 62 non-smelter workers (control group 1 and 30 administration staff (control group 2 were assessed between 2007 and 2009. Their health complaints were recorded and categorized into 4 groups: 1 gastro-intestinal complaints; 2 non-skeletal manifestations; 3 skeletal symptoms; and (4 respiratory problems. Fluoride level in body fluids, nails, and drinking water was tested by an ion selective electrode; hemoglobin level was tested using HemoCue. Results: The total complaints reported by study groups were significantly higher than the control groups. Smelter workers had a significantly (p<0.001 higher urinary and serum fluoride level than non-smelter workers; the nail fluoride content was also higher in smelter workers than non-smelter workers (p<0.001. The smelter workers with higher hemoglobin level had a significantly (p<0.001 lower urinary fluoride concentration and complained less frequently of health problems. Only 1.4% of the smelter workers were consuming water with high fluoride concentrations. A high percentage of participants was using substances with high fluoride contents. Conclusions: Industrial emission of fluoride is not the only important sources of fluoride exposure—consumption of substance with high levels of fluoride is another important route of entry of fluoride into the body. Measurement of hemoglobin provides a reliable indicator for monitoring the health status of employees at risk of fluorosis.

  20. [The unbearable lightness of aluminum: the social and environmental impacts of Brazil's insertion in the primary aluminum global market].

    Science.gov (United States)

    Henriques, Alen Batista; Porto, Marcelo Firpo Souza

    2013-11-01

    This article assesses aluminum production in Brazil and its social, environmental and public health impacts. The effects of the aluminum production chain challenge the idea of sustainable growth affirmed by business groups that operate in the sector. This article upholds the theory that the insertion of Brazil in the global aluminum market is part of a new configuration of the International Division of Labor (IDL), the polluting economic and highly energy dependent activities of which - as is the case of aluminum - have been moving to peripheral nations or emerging countries. The laws in such countries are less stringent, and similarly the environmental movements and the claims of the affected populations in the territories prejudiced in their rights to health, a healthy environment and culture are less influential. The competitiveness of this commodity is guaranteed in the international market, from the production of external factors such as environmental damage, deforestation, emissions of greenhouse gases and scenarios of environmental injustice. This includes undertakings in the construction of hydroelectric dams that expose traditional communities to situations involving the loss of their territories.

  1. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists and primary-care providers

    NARCIS (Netherlands)

    Spiegel, B. M. R.; Farid, M.; van Oijen, M. G. H.; Laine, L.; Howden, C. W.; Esrailian, E.

    2009-01-01

    Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). We

  2. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists and primary-care providers.

    NARCIS (Netherlands)

    Spiegel, B.M.; Farid, M.; Oijen, M.G.H. van; Laine, L.; Howden, C.W.; Esrailian, E.

    2009-01-01

    BACKGROUND: Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. AIM: To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers

  3. Primary and secondary creep in aluminum alloys as a solid state transformation

    Science.gov (United States)

    Fernández, R.; Bruno, G.; González-Doncel, G.

    2016-08-01

    Despite the massive literature and the efforts devoted to understand the creep behavior of aluminum alloys, a full description of this phenomenon on the basis of microstructural parameters and experimental conditions is, at present, still missing. The analysis of creep is typically carried out in terms of the so-called steady or secondary creep regime. The present work offers an alternative view of the creep behavior based on the Orowan dislocation dynamics. Our approach considers primary and secondary creep together as solid state isothermal transformations, similar to recrystallization or precipitation phenomena. In this frame, it is shown that the Johnson-Mehl-Avrami-Kolmogorov equation, typically used to analyze these transformations, can also be employed to explain creep deformation. The description is fully compatible with present (empirical) models of steady state creep. We used creep curves of commercially pure Al and ingot AA6061 alloy at different temperatures and stresses to validate the proposed model.

  4. Quality Primary Care and Family Planning Services for LGBT Clients: A Comprehensive Review of Clinical Guidelines.

    Science.gov (United States)

    Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N

    2018-04-01

    LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.

  5. BWR water chemistry guidelines and PWR primary water chemistry guidelines in Japan – Purpose and technical background

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Hirotaka, E-mail: kawamuh@criepi.denken.or.jp [Central Research Institute of Electric Power Industry (Japan); Hirano, Hideo [Central Research Institute of Electric Power Industry (Japan); Katsumura, Yousuke [University of Tokyo (Japan); Uchida, Shunsuke [Tohoku University (Japan); Mizuno, Takayuki [Mie University (Japan); Kitajima, Hideaki; Tsuzuki, Yasuo [Japan Nuclear Safety Institute (Japan); Terachi, Takumi [Institute of Nuclear Safety System, Inc. (Japan); Nagase, Makoto; Usui, Naoshi [Hitachi-GE Nuclear Energy, Ltd. (Japan); Takagi, Junichi; Urata, Hidehiro [Toshiba Corporation (Japan); Shoda, Yasuhiko; Nishimura, Takao [Mitsubishi Heavy Industry, Ltd. (Japan)

    2016-12-01

    Highlights: • Framework of BWR/PWR water chemistry Guidelines in Japan are presented. • Guideline necessity, definitions, philosophy and technical background are mentioned. • Some guideline settings for control parameters and recommendations are explaines. • Chemistry strategy is also mentioned. - Abstract: After 40 years of light water reactor (LWR) operations in Japan, the sustainable development of water chemistry technologies has aimed to ensure the highest coolant system component integrity and fuel reliability performance for maintaining LWRs in the world; additionally, it aimed to achieve an excellent dose rate reduction. Although reasonable control and diagnostic parameters are utilized by each boiling water reactor (BWR) and pressurized water reactor (PWR) owner, it is recognized that specific values are not shared among everyone involved. To ensure the reliability of BWR and PWR operation and maintenance, relevant members of the Atomic Energy Society of Japan (AESJ) decided to establish guidelines for water chemistry. The Japanese BWR and PWR water chemistry guidelines provide strategies to improve material and fuel reliability performance as well as to reduce dosing rates. The guidelines also provide reasonable “control values”, “diagnostic values” and “action levels” for multiple parameters, and they stipulate responses when these levels are exceeded. Specifically, “conditioning parameters” are adopted in the Japanese PWR primary water chemistry guidelines. Good practices for operational conditions are also discussed with reference to long-term experience. This paper presents the purpose, technical background and framework of the preliminary water chemistry guidelines for Japanese BWRs and PWRs. It is expected that the guidelines will be helpful as an introduction to achieve safety and reliability during operations.

  6. Guidelines for Reporting Quantitative Methods and Results in Primary Research

    Science.gov (United States)

    Norris, John M.; Plonsky, Luke; Ross, Steven J.; Schoonen, Rob

    2015-01-01

    Adequate reporting of quantitative research about language learning involves careful consideration of the logic, rationale, and actions underlying both study designs and the ways in which data are analyzed. These guidelines, commissioned and vetted by the board of directors of "Language Learning," outline the basic expectations for…

  7. Utilization of standard treatment guidelines (STG) at primary health ...

    African Journals Online (AJOL)

    Objective: Standard Treatment Guideline (STG) is an essential structural resource component for quality of care in health facilities. In Tanzania less information is available on STG availability, prescriber's awareness and adherence to its use in line with WHO recommendations. Methods: A cross sectional descriptive study ...

  8. Guidelines for kangaroo care in district hospitals and primary health ...

    African Journals Online (AJOL)

    Babies with a weight of between 1.5 kg and 1.6 kg are started with ... to provide guidelines for managing babies with insufficient weight gain, and to provide guidance for ... Gender, birth weight and gestational age at birth also did not have a ...

  9. Clinical findings confirm national guidelines regarding primary gastroscopy for upper gastrointestinal symptoms

    DEFF Research Database (Denmark)

    Rolff, Hans Christian; Simonsen, Louise Rolighed; Rosenberg, Jacob

    2011-01-01

    This study describes unsedated transnasal oesophagogastroduodenoscopy (UT-OGD) in the office setting. Evaluation of national guidelines regarding primary endoscopy for the investigation of upper gastrointestinal (GI) symptoms was also a focus of this study....

  10. Barriers to Primary Care Clinician Adherence to Clinical Guidelines for the Management of Low Back Pain

    DEFF Research Database (Denmark)

    Slade, Susan C; Kent, Peter; Patel, Shilpa

    2016-01-01

    and qualitative methods had been used for both data collection and analysis. We searched major databases up to July 2014. Pairs of reviewers independently screened titles and abstracts, extracted data, appraised method quality using the CASP checklist, conducted thematic analysis and synthesized the results......INTRODUCTION: Despite the availability of evidence-based guidelines for the management of low back pain that contain consistent messages, large evidence-practice gaps in primary care remain. OBJECTIVES: To perform a systematic review and meta-synthesis of qualitative studies that have explored...... primary care clinicians' perceptions and beliefs about guidelines for low back pain, including perceived enablers and barriers to guideline adherence. METHODS: Studies investigatingperceptions and beliefs about low back pain guidelines were included if participants were primary care clinicians...

  11. WEB-BASED APPLICATIONS FOR GUIDELINE IMPLEMENTATION IN PRIMARY CARE

    Directory of Open Access Journals (Sweden)

    Matteo Capobussi

    2013-01-01

    Full Text Available Efforts in developing guidelines have to be supported by investments on their application. Medical software may have a role in these initiatives. Two computer programs have been developed: one regarding chronic kidney disease and one about chronic pain management. For six months their use by 104 general practitioners was monitored. At study conclusion, a questionnaire of 13 multiple choice questions was emailed to all participating doctors. To evaluate the clinical benefits for the patients, a GP regularly used the CKD program and provided patients’ outcomes and clinical data. The application recorded 108 accesses during 66 work sessions. In the clinical outcomes section of this study, 7 patients out of 21 were diagnosed with CKD. Our study shows a need for programs of the “expert systems” kind: sources devoted to a narrow field of competence, accessed only when needed, in a way that resembles traditional specialist consultation.

  12. Design Guideline for Primary Heat Exchanger in a Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sunil; Seo, Kyoung-Woo; Kim, Seong-Hoon; Chi, Dae-Young; Park, Cheol [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    In this paper, analytical study is conducted to track the variation of the PCS outlet temperature in conditions of the constant core power and constant SCS inlet temperature. The PCS circulates demineralized water to remove the heat generated in reactor core. The heat is transferred to the cold water of the SCS through the primary heat exchanger. In JRTR, Plate-type Heat Exchanger (PHE) was used as the primary heat exchanger. The cooling tower automatically sets the SCS inlet temperature constant by fan speed control. The flow rate of SCS is adjusted to be identical with the PCS flow rate. To design the PHE, the inlet and outlet temperatures and the flow rates for both systems should be determined. The flow rate has the allowable band for the safe operation from the lower limit to upper limit resulting in different temperature distribution in the PHE. Specially, the PCS outlet temperature which is the core inlet temperature is used for a safety parameter for the reactor shutdown. Therefore, we need to figure out which limit for the flow rate should be used from the conservative point of view. At 200 kg/s of PCS and SCS flow rates, the inlet and outlet temperatures are 41.3℃and 34℃, respectively. With increase of the flow rate, both of PCS inlet and outlet temperatures decrease to 33.6℃ and 39.9℃. This result means the low limit of the allowable flow band should be used for the conservative design of primary heat exchanger. If the upper limit of the allowable flow band is used, the PCS outlet temperature which is the safety parameter used for the reactor shutdown increases with decrease of the flow rate.

  13. Design Guideline for Primary Heat Exchanger in a Research Reactor

    International Nuclear Information System (INIS)

    Lee, Sunil; Seo, Kyoung-Woo; Kim, Seong-Hoon; Chi, Dae-Young; Park, Cheol

    2016-01-01

    In this paper, analytical study is conducted to track the variation of the PCS outlet temperature in conditions of the constant core power and constant SCS inlet temperature. The PCS circulates demineralized water to remove the heat generated in reactor core. The heat is transferred to the cold water of the SCS through the primary heat exchanger. In JRTR, Plate-type Heat Exchanger (PHE) was used as the primary heat exchanger. The cooling tower automatically sets the SCS inlet temperature constant by fan speed control. The flow rate of SCS is adjusted to be identical with the PCS flow rate. To design the PHE, the inlet and outlet temperatures and the flow rates for both systems should be determined. The flow rate has the allowable band for the safe operation from the lower limit to upper limit resulting in different temperature distribution in the PHE. Specially, the PCS outlet temperature which is the core inlet temperature is used for a safety parameter for the reactor shutdown. Therefore, we need to figure out which limit for the flow rate should be used from the conservative point of view. At 200 kg/s of PCS and SCS flow rates, the inlet and outlet temperatures are 41.3℃and 34℃, respectively. With increase of the flow rate, both of PCS inlet and outlet temperatures decrease to 33.6℃ and 39.9℃. This result means the low limit of the allowable flow band should be used for the conservative design of primary heat exchanger. If the upper limit of the allowable flow band is used, the PCS outlet temperature which is the safety parameter used for the reactor shutdown increases with decrease of the flow rate

  14. Multiple linear regression models for predicting chronic aluminum toxicity to freshwater aquatic organisms and developing water quality guidelines.

    Science.gov (United States)

    DeForest, David K; Brix, Kevin V; Tear, Lucinda M; Adams, William J

    2018-01-01

    The bioavailability of aluminum (Al) to freshwater aquatic organisms varies as a function of several water chemistry parameters, including pH, dissolved organic carbon (DOC), and water hardness. We evaluated the ability of multiple linear regression (MLR) models to predict chronic Al toxicity to a green alga (Pseudokirchneriella subcapitata), a cladoceran (Ceriodaphnia dubia), and a fish (Pimephales promelas) as a function of varying DOC, pH, and hardness conditions. The MLR models predicted toxicity values that were within a factor of 2 of observed values in 100% of the cases for P. subcapitata (10 and 20% effective concentrations [EC10s and EC20s]), 91% of the cases for C. dubia (EC10s and EC20s), and 95% (EC10s) and 91% (EC20s) of the cases for P. promelas. The MLR models were then applied to all species with Al toxicity data to derive species and genus sensitivity distributions that could be adjusted as a function of varying DOC, pH, and hardness conditions (the P. subcapitata model was applied to algae and macrophytes, the C. dubia model was applied to invertebrates, and the P. promelas model was applied to fish). Hazardous concentrations to 5% of the species or genera were then derived in 2 ways: 1) fitting a log-normal distribution to species-mean EC10s for all species (following the European Union methodology), and 2) fitting a triangular distribution to genus-mean EC20s for animals only (following the US Environmental Protection Agency methodology). Overall, MLR-based models provide a viable approach for deriving Al water quality guidelines that vary as a function of DOC, pH, and hardness conditions and are a significant improvement over bioavailability corrections based on single parameters. Environ Toxicol Chem 2018;37:80-90. © 2017 SETAC. © 2017 SETAC.

  15. Toddler Developmental Delays After Extensive Hospitalization: Primary Care Practitioner Guidelines.

    Science.gov (United States)

    Lehner, Dana C; Sadler, Lois S

    2015-01-01

    This review investigated developmental delays toddlers may encounter after a lengthy pediatric hospitalization (30 days or greater). Physical, motor, cognitive, and psychosocial development of children aged 1 to 3 years was reviewed to raise awareness of factors associated with developmental delay after extensive hospitalization. Findings from the literature suggest that neonatal and pediatric intensive care unit (NICU/PICU) graduates are most at risk for developmental delays, but even non-critical hospital stays interrupt development to some extent. Primary care practitioners (PCPs) may be able to minimize risk for delays through the use of formal developmental screening tests and parent report surveys. References and resources are described for developmental assessment to help clinicians recognize delays and to educate families about optimal toddler development interventions. Pediatric PCPs play a leading role in coordinating health and developmental services for the young child following an extensive hospital stay.

  16. Guidelines on radiology standards for primary dental care

    International Nuclear Information System (INIS)

    1994-01-01

    A Joint Working Party (JWP) on patient dose reduction in diagnostic radiology was established between the Royal College of Radiologists (RCR) and the National Radiological Protection Board (NRPB) towards the end of 1988. JWP identified a large potential for patient dose reduction on a national scale, and a report of its findings was published in 1990. This guidance was only generally applicable to dental radiology and in 1992 a further joint venture between RCR and NRPB resulted in the formation of a Working Party (WP) to consider all aspects of dental radiology applicable to primary dental care. Dental radiology is one of the largest single groups of radiographic examination performed, although the effective dose per radiograph is small. This means that individual risks from dental radiology are low, but WP has identified a significant potential for reduction in the collective dose and for improvements in the diagnostic quality of radiographs. The WP recommendations cover all aspects of dental radiology: training and examination regimes for dentists and staff, patient selection and clinical justification for radiography, diagnostic interpretation, equipment and procedural aspects, and finally the question of quality assurance in dental radiology. The economic impact of the many recommendations by WP has been considered in some detail. The benefits and cost of each recommendation either have been assigned a monetary value or have been assessed more qualitatively. The conclusion is that there is a strong economic justification for implementation of the full package of recommendations. (Author)

  17. VGB primary and secondary side water chemistry guidelines for PWR plants

    International Nuclear Information System (INIS)

    Neder, H.; Wolter, D.; Staudt, U.

    2007-01-01

    The recent revision of the VGB Water Chemistry Guidelines was issued in 2005 and published in the second half of 2006. These guidelines are based on the primary and secondary side operating chemistry experience with all Siemens designed pressurized water reactors gained since the beginning of the 1980s. These guidelines cover For the primary side chemistry Modified lithium boron chemistry, Zinc chemistry for dose rate reduction, Enriched boric acid (EBA) chemistry for high duty core design For the secondary side chemistry High all-volatile treatment (AVT) chemistry (high pH operation) Oxygen injection in the secondary side Especially for the secondary side chemistry, compared with the water chemistry guidelines of other organizations worldwide, these Guidelines are less stringent, providing more operational flexibility to the plant operation, and can be applied for all new designs of steam generators with egg-crates or broached hole tube supports and with I 690TT or I 800 tubing materials. This paper gives an overview of the 2006 revision of the VGB Water Chemistry Guidelines for PWR plants and describes the fundamental goals of water chemistry operation strategies. In addition, the reasons for the selected control parameters and action levels, to achieve an adequate plant performance, are presented based on the operating experience. (orig.)

  18. Measurement of tritium activity in the aluminum pipe of JRR-2 heavy water primary cooling system using imaging plate

    International Nuclear Information System (INIS)

    Motoishi, Shoji; Kobayashi, Katsutoshi

    2000-12-01

    JRR-2 is the heavy water cooling type nuclear reactor, which has been operated for 36 years (1960-1976) and in the process of decommissioning at present. For this reason, evaluation of tritium quantity permeated into the pipe and apparatus of the primary coolant heavy water circulating system is important. In the Radioisotope Production Division, activity of tritium in aluminum pipe was measured with imaging plate (IP), liquid scintillation analyzer and high purity germanium detector (HPGe). After acrylic paints was applied for the region except for tritium contamination on the surface of aluminum pipe, only the oxidized contaminated part was dissolved by 1.5%(1.21M) HF for 3 minutes, and measured with IP. As a result, the tritium was found to permeate in the depth of 25 μm. Moreover, 90% of it was found to be distributed within 7 μm. (author)

  19. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.; Smolders, M.; Laurant, M.G.H.; Meer, K. de; Spreeuwenberg, P.; Marwijk, H.W.J. van; Penninx, B.W.J.H.; Bensing, J.M.

    2010-01-01

    OBJECTIVE: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. DESIGN: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). PARTICIPANTS: Seven hundred and

  20. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.; Smolders, M.; Laurant, M.G.H.; van der Meer, K; Spreeuwenberg, P.; van Marwijk, H.W.J.; Penninx, B.W.J.H.; Bensing, J.M.

    2010-01-01

    Objective: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Design: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Participants: Seven hundred and

  1. Patient Factors Associated with Guideline-concordant Treatment of Anxiety and Depression in Primary Care

    NARCIS (Netherlands)

    Prins, Marijn A.; Verhaak, Peter F. M.; Smolders, Mirrian; Laurant, Miranda G. H.; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.; Bensing, Jozien M.

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current

  2. Prescription non-conformities in primary care settings: How useful are guidelines

    Directory of Open Access Journals (Sweden)

    Fahad A Al-Hussein

    2008-01-01

    Conclusions: Conformity to prescribing guidelines is quite low in spite of the significant input of resources by the parent organization. This burden on work flow, utilization of time and service delivery needs to be studied and addressed by ensuring that there are periodic audits in the work routines of primary health care, and a feedback given to the care providers.

  3. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    Science.gov (United States)

    Prins, Marijn A; Verhaak, Peter F M; Smolders, Mirrian; Laurant, Miranda G H; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W J; Penninx, Brenda W J H; Bensing, Jozien M

    2010-07-01

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p depression than clinical need factors. Initiatives to improve GPs' communication skills around mental health issues, and to improve recognition of people suffering from anxiety disorders, could increase the number of patients receiving treatment for depression and anxiety in primary care.

  4. Atrial fibrillation in a primary care population: how close to NICE guidelines are we?

    LENUS (Irish Health Repository)

    Loo, Bryan

    2009-06-01

    The National Institute for Health and Clinical Excellence (NICE) guidelines for the management of atrial fibrillation were published in June 2006. It was anticipated that they would potentially lead to increased demand for echocardiography (ECHO), increased access to secondary care services (for example for cardioversion), and require additional resources for monitoring anticoagulation. A primary care survey was therefore initiated in South Devon, in advance of publication of the guidelines as a snapshot of existing practice, to determine any additional resources and education required to meet the new standards. The main aim was to determine what proportion of patients were managed exclusively in primary care, how frequently patients were investigated by ECHO and whether anticoagulation was being appropriately targeted at patients at high risk of thromboembolic events.

  5. The use of guideline recommended beta-blocker therapy in primary prevention implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Ruwald, Anne Christine; Gislason, Gunnar Hilmar; Vinther, Michael

    2017-01-01

    Aims: We aimed to examine the use of guideline recommended beta-blocker therapy prior to and after primary prevention implantable cardioverter defibrillator (ICD) implantation in a 'real-life' setting. Methods and results: From the Danish Pacemaker and ICD Registry we identified all 1st-time prim......Aims: We aimed to examine the use of guideline recommended beta-blocker therapy prior to and after primary prevention implantable cardioverter defibrillator (ICD) implantation in a 'real-life' setting. Methods and results: From the Danish Pacemaker and ICD Registry we identified all 1st......-time primary prevention ICD and cardiac resynchronization therapy defibrillator (CRT-D) implantations in Denmark from 2007-12 (n = 2935). Use of beta-blocker, type and dose was acquired through the Danish Prescription Registry. According to guideline recommendations, we defined target daily doses as ≥50 mg...... carvedilol and ≥200 mg metoprolol. Prior to implantation 2427 of 2935 (83%) patients received beta-blocker therapy, with 2166 patients (89%) having initiated treatment 3 months or more prior to implantation. The majority of patients was prescribed carvedilol (52%) or metoprolol (41%). Patients on carvedilol...

  6. Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

    2012-10-01

    Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

  7. Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

    2012-01-01

    Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (Pabsenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

  8. Chronic Kidney Disease Guideline Implementation in Primary Care: A Qualitative Report from the TRANSLATE CKD Study.

    Science.gov (United States)

    Vest, Bonnie M; York, Trevor R M; Sand, Jessica; Fox, Chester H; Kahn, Linda S

    2015-01-01

    Primary care physicians (PCPs) are optimally situated to identify and manage early stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national, mixed-methods, cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. As part of the mixed-methods process evaluation, semistructured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the 4 domains of Normalization Process Theory (NPT). Identified themes illuminated the complex work undertaken to manage CKD in primary care practices. Barriers to guideline implementation were identified in each of the 4 NPT domains, including (1) lack of knowledge and understanding around CKD (coherence), (2) difficulties engaging providers and patients in CKD management (cognitive participation), (3) limited time and competing demands (collective action), and (4) challenges obtaining and using data to monitor progress (reflexive monitoring). Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. © Copyright 2015 by the American Board of Family Medicine.

  9. Awareness of hypertension guidelines in primary care: results of a regionwide survey in Italy.

    Science.gov (United States)

    Cuspidi, C; Michev, I; Meani, S; Severgnini, B; Sala, C; Salerno, M; Valerio, C; Bertazzoli, G; Leonetti, G; Magrini, F; Zanchetti, A

    2003-08-01

    Unsatisfactory blood pressure (BP) control so often described in treated hypertensive populations is also explained by insufficient physicians' awareness of experts' guidelines. We assessed awareness of current recommendations about hypertension management in a general practice setting, using the World Health Organization/International Society of Hypertension (WHO/ISH) 1999 guidelines as reference. In a regionwide survey, a total of 5133 physicians (three-quarters of all active general practitioners in Lombardy, a region of north-western Italy) were contacted by letter and received a multiple choice 10-item questionnaire. Data on physicians' demographic characteristics, information on hypertension prevalence and their perception of BP control among their patients were also requested in an additional form. The number of answers in agreement with WHO/ISH guidelines was used as an awareness measure. This was considered adequate if correct answers to six out of 10 questions, including an appropriate definition of hypertension, were provided. Of the 1256 returned questionnaires (a 24.5% response rate), 1162 were suitable for analysis. The mean score of correct answers was 5.3 points and only 20.1% of the study population correctly answered at least six of the questions (including that on the definition of hypertension in the elderly). Guidelines awareness was negatively related to increase in physicians' age and duration of clinical practice and by the male gender. Finally, the physicians reported a high rate of achieved BP control, and those who were considered to have achieved highest rates (>75%) of control in their patients had a lower rate of adequate knowledge than those who reported less-successful therapeutic results (18 vs 25%, P<0.01), suggesting that they ignored or disregarded the goal BP recommended by the guidelines. This large regional survey shows that a sufficient degree of guidelines awareness is present in a minority of primary-care physicians in the

  10. Smartphone Application of Primary Care Guidelines used in Education of Medical Students

    Science.gov (United States)

    Waldmann, Uta-Maria; Weckbecker, Klaus

    2013-01-01

    Background and Objective: The guidelines of the German College of General Practitioners and Family Physicians (DEGAM) on frequent and important reasons for encounter in Primary Care play a central role in the teaching of Family Medicine. They were edited by the authors into an app for mobile phones, making them available at all times to General Practitioners and medical students. This study examines the issue: how useful do students consider this application within their learning process in Family Medicine? Method: The short versions of the 15 DEGAM guidelines were processed as a web app (for all smartphone software systems) including offline utilisation, and offered to students in the Family Medicine course, during clinical attachments in General Practice, on elective compulsory courses or for their final year rotation in General Practice. The evaluation was made with a structured survey using the feedback function of the Moodle learning management system [http://www.elearning-allgemeinmedizin.de] with Likert scales and free-text comments. Results: Feedback for evaluation came from 14 (25%) of the student testers from the Family Medicine course (9), the clinical attachment in General Practice (1), the final year rotation in General Practice (1) and elective compulsory courses (4). Students rated the app as an additional benefit to the printed/pdf-form. They use it frequently and successfully during waiting periods and before, during, or after lectures. In addition to general interest and a desire to become acquainted with the guidelines and to learn, the app is consulted with regard to general (theoretical) questions, rather than in connection with contact with patients. Interest in and knowledge of the guidelines is stimulated by the app, and on the whole the application can be said to be well suited to the needs of this user group. Discussion: The students evaluated the guidelines app positively: as a modern way of familiarising them with the guidelines and

  11. Evaluation of diabetes care management in primary clinics based on the guidelines of American Diabetes Association.

    Science.gov (United States)

    Albarrak, Ahmed Ismail; Mohammed, Rafiuddin; Assery, Bushra; Allam, Dalya; Morit, Sarah Al; Saleh, Reem Al; Zare'a, Reem

    2018-01-01

    There is a rapid increase in the incidence of diabetes mellitus in Saudi Arabia. Diabetes management is an essential constituent to prevent prognosis of diabetes complications. The main objective of this study was to assess diabetes care in primary clinics based on the guidelines of American Diabetes Association (ADA). A retrospective study at King Khaled University Hospitals, Riyadh, Saudi Arabia. A total of 200 patients were randomly selected from the databases of primary care clinics. An evaluation checklist was created based on the ADA treatment guidelines such as medical history, physical examination, laboratory evaluation, and referrals. The result showed that elements achieving the ADA targets for overall care were medical history (44.9%), physical examination (59.6%), laboratory evaluation (36.3%), and referrals (19.3%). The other subelement indicators such as referral to diabetes self-management education clinics (10%), dental examination (2%), HbA1c regular monitoring (33.5%), and blood pressure determination (100%) were documented with adherence to ADA standards. Diabetes management standards are an essential element in the success of the management plan. Most of the elements examined are not in full compliance with the ADA standard. Continues monitoring and self-review are recommended.

  12. Are primary care practitioners in Barbados following hypertension guidelines? - a chart audit

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2010-11-01

    Full Text Available Abstract Background About 55% of the population 40 to 80 years of age in Barbados is hypertensive. The quality of hypertension primary care compared to available practice guidelines is uncertain. Findings Charts of hypertensive and diabetic patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all hypertensive patients ≥ 40 years of age were then selected and processes of care and blood pressure (BP maintenance 343 charts of hypertensive patients (170 public, and 173 private were audited. Patients had the following characteristics: mean age 64 years, female gender 63%, mean duration of diagnosis 9.1 years, and diabetes diagnosed 58%. Patients had an average of 4.7 clinic visits per year, 70% were prescribed a thiazide diuretic, 42% a calcium channel blocker, 40% an angiotensin receptor blocker, and 19% a beta blocker. Public patients compared to private patients were more likely to be female (73% vs. 52%, p Conclusions Improvements are needed in following guidelines for basic interventions such as body mass assessment, accurate BP measurement, use of thiazide diuretics and lifestyle advice. BP control is inadequate.

  13. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists and primary-care providers.

    Science.gov (United States)

    Spiegel, B M R; Farid, M; van Oijen, M G H; Laine, L; Howden, C W; Esrailian, E

    2009-04-15

    Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). We administered a vignette survey to elicit knowledge and beliefs about dyspepsia including a set of 16 best practices, to three groups: (i) dyspepsia experts; (ii) community gastroenterologists and (iii) PCPs. The expert, community gastroenterologist and PCP groups endorsed 75%, 73% and 57% of best practices respectively. Gastroenterologists were more likely to adhere with guidelines than PCPs (P guideline adherence (P = 0.04). Gastroenterologists are more likely than PCPs to comply with best practices in dyspepsia, although compliance remains incomplete in both groups. PCPs harbour more concerns regarding long-term PPI use and these concerns may affect therapeutic decision making. This suggests that best practices have not been uniformly adopted and persistent guideline-practice disconnects should be addressed.

  14. ACC/AHA guidelines superior to ESC/EAS guidelines for primary prevention with statins in non-diabetic Europeans

    DEFF Research Database (Denmark)

    Mortensen, Martin Bødtker; Nordestgaard, Børge G; Afzal, Shoaib

    2017-01-01

    Aim We compared the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and the 2016 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines on prevention of atherosclerotic cardiovascular disease (ASCVD) using different risk prediction models [US......-calibrated around decision thresholds for statin therapy. For a Class I recommendation, 42% of individuals qualified for statins using the ACC/AHA guidelines vs. 6% with the ESC/EAS guidelines. Using ACC/AHA- vs. ESC/EAS-defined statin eligibility led to a substantial gain in sensitivity (+62% for any ASCVD and+76......% for fatal ASCVD) with a smaller loss in specificity (-35% for any ASCVD and -36% for fatal ASCVD). Similar differences between the ACC/AHA and ESC/EAS guidelines were found for men and women separately, and for Class IIa recommendations. The sensitivity and specificity of a US-PCE risk of 5% were similar...

  15. Impact of the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention on adherence to national obesity clinical practice guidelines in a primary care centre.

    Science.gov (United States)

    Barnes, Emily R; Theeke, Laurie A; Mallow, Jennifer

    2015-04-01

    Obesity is significantly underdiagnosed and undertreated in primary care settings. The purpose of this clinical practice change project was to increase provider adherence to national clinical practice guidelines for the diagnosis and treatment of obesity in adults. Based upon the National Institutes of Health guidelines for the diagnosis and treatment of obesity, a clinical change project was implemented. Guided by the theory of planned behaviour, the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention includes education sessions, additional provider resources for patient education, a provider reminder system and provider feedback. Primary care providers did not significantly increase on documentation of diagnosis and planned management of obesity for patients with body mass index (BMI) greater than or equal to 30. Medical assistants increased recording of height, weight and BMI in the patient record by 13%, which was significant. Documentation of accurate BMI should lead to diagnosis of appropriate weight category and subsequent care planning. Future studies will examine barriers to adherence to clinical practice guidelines for obesity. Interventions are needed that include inter-professional team members and may be more successful if delivered separately from routine primary care visits. © 2015 John Wiley & Sons, Ltd.

  16. Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline

    Directory of Open Access Journals (Sweden)

    Silvina Arrossi

    2017-10-01

    Full Text Available Purpose: To provide resource-stratified (four tiers, evidence-based recommendations on the primary prevention of cervical cancer globally. Methods: The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group for one round of formal ratings. Results: Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. Recommendations: In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus–related cancers and diseases. Basic settings: vaccinating boys is not recommended

  17. Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline.

    Science.gov (United States)

    Arrossi, Silvina; Temin, Sarah; Garland, Suzanne; Eckert, Linda O'Neal; Bhatla, Neerja; Castellsagué, Xavier; Alkaff, Sharifa Ezat; Felder, Tamika; Hammouda, Doudja; Konno, Ryo; Lopes, Gilberto; Mugisha, Emmanuel; Murillo, Rául; Scarinci, Isabel C; Stanley, Margaret; Tsu, Vivien; Wheeler, Cosette M; Adewole, Isaac Folorunso; de Sanjosé, Silvia

    2017-10-01

    To provide resource-stratified (four tiers), evidence-based recommendations on the primary prevention of cervical cancer globally. The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group) for one round of formal ratings. Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus-related cancers and diseases. Basic settings: vaccinating boys is not recommended. It is the view of the American Society of Clinical Oncology that

  18. WHO 2009 GUIDELINES FOR ANTI-RETROVIRAL THERAPHY: ITS IMPLICATION FOR PRIMARY CARE PHYSICIAN

    Directory of Open Access Journals (Sweden)

    KOH KC

    2010-01-01

    Full Text Available -The HIV epidemic in Malaysia is slowing down but has now spread to spouses and sexual partners of traditional at risk populations, via heterosexual transmission. -The WHO 2009 guideline advocates starting HAART at CD4 level of 350 cells/mm3, marking a significant departure from starting at CD4 level of 200 cells/mm3 previously. -The WHO 2009 guideline recommended replacing stavudine with either zidovudine or tenofovir as part of the first line HAART regimen due to the former’s adverse effects. -Early detection of HIV infection and earlier initiation of HAART translates into better quality of life and lower risk of Tuberculosis co-infection. -Earlier detection of HIV infection requires picking up on subtle signs of the infection as well as employing a host of available diagnostic tests in cases where HIV infection is strongly suspected. -HIV test should be offered as a part of a routine health check screening. This facilitates early detection of HIV infection and early referral to the hospital for further management. -Collaboration and communications with non-governmental organizations involved in care of HIV infected people can be a good mean of providing support and counselling to newly diagnosed HIV infected individuals. -Asymptomatic undiagnosed HIV infected patients may pose a risk for disease transmission to health care workers in the primary care setting. Steps must be taken to minimize the risk of transmission and easy access to post-exposure prophylaxis. -The primary care physician should be well versed with the many possible drug interactions between HAART and other commonly used medications for other illnesses in order to avoid potentially fatal adverse reactions or treatment failure in patients taking HAART.

  19. 75 FR 66798 - Ormet Primary Aluminum Corporation Including On-Site Temporary Workers, Hannibal, OH; Notice of...

    Science.gov (United States)

    2010-10-29

    ... supplied additional information regarding overall United States production, consumption, and importation of... and obtained current aggregate data on aluminum production and imports through 2009 which was not..., reaching a level well over 100 percent in 2009. This increased reliance on aggregate imports of aluminum...

  20. Falling on stony ground? A qualitative study of implementation of clinical guidelines' prescribing recommendations in primary care.

    Science.gov (United States)

    Rashidian, Arash; Eccles, Martin P; Russell, Ian

    2008-02-01

    We aimed to explore key themes for the implementation of guidelines' prescribing recommendations. We interviewed a purposeful sample of 25 participants in British primary care in late 2000 and early 2001. Thirteen were academics in primary care and 12 were non-academic GPs. We asked about implementation of guidelines for five conditions (asthma, coronary heart disease prevention, depression, epilepsy, menorrhagia) ensuring variation in complexity, role of prescribing in patient management, GP role in prescribing and GP awareness of guidelines. We used the Theory of Planned Behaviour to design the study and the framework method for the analysis. Seven themes explain implementation of prescribing recommendations in primary care: credibility of content, credibility of source, presentation, influential people, organisational factors, disease characteristics, and dissemination strategy. Change in recommendations may hinder implementation. This is important since the development of evidence-based guidelines requires change in recommendations. Practitioners do not have a universal view or a common understanding of valid 'evidence'. Credibility is improved if national bodies develop primary care guidelines with less input from secondary care and industry, and with simple and systematic presentation. Dissemination should target GPs' perceived needs, improve ownership and get things right in the first implementation attempt. Enforcement strategies should not be used routinely. GPs were critical of guidelines' development, relevance and implementation. Guidelines should be clear about changes they propose. Future studies should quantify the relationship between evidence base of recommendations and implementation, and between change in recommendations and implementation. Small but important costs and side effects of implementing guidelines should be measured in evaluative studies.

  1. 3D microstructural evolution of primary recrystallization and grain growth in cold rolled single-phase aluminum alloys

    Science.gov (United States)

    Adam, Khaled; Zöllner, Dana; Field, David P.

    2018-04-01

    Modeling the microstructural evolution during recrystallization is a powerful tool for the profound understanding of alloy behavior and for use in optimizing engineering properties through annealing. In particular, the mechanical properties of metallic alloys are highly dependent upon evolved microstructure and texture from the softening process. In the present work, a Monte Carlo (MC) Potts model was used to model the primary recrystallization and grain growth in cold rolled single-phase Al alloy. The microstructural representation of two kinds of dislocation densities, statistically stored dislocations and geometrically necessary dislocations were quantified based on the ViscoPlastic Fast Fourier transform method. This representation was then introduced into the MC Potts model to identify the favorable sites for nucleation where orientation gradients and entanglements of dislocations are high. Additionally, in situ observations of non-isothermal microstructure evolution for single-phase aluminum alloy 1100 were made to validate the simulation. The influence of the texture inhomogeneity is analyzed from a theoretical point of view using an orientation distribution function for deformed and evolved texture.

  2. Management of pelvic inflammatory disease by primary care physicians. A comparison with Centers for Disease Control and Prevention guidelines.

    Science.gov (United States)

    Hessol, N A; Priddy, F H; Bolan, G; Baumrind, N; Vittinghoff, E; Reingold, A L; Padian, N S

    1996-01-01

    The Centers for Disease Control and Prevention published recommendations for clinicians on the management of pelvic inflammatory disease, but it is unknown if providers are aware of the guidelines or follow them. To compare pelvic inflammatory disease screening, diagnosis, treatment, and reporting practices among primary care physicians with the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. A weighted random sample of California primary care physicians surveyed in November 1992 and January 1993. Of the 1,165 physicians surveyed, 553 (48%) returned completed questionnaires. Among respondents, 302 (55%) reported having treated a case of pelvic inflammatory disease during the last 12 months, and of these, 52% answered that they were unsure of or do not follow the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. Pediatricians and those with more years since residency were less likely to deviate from the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease, and family practitioners were more likely to deviate from the guidelines. Pelvic inflammatory disease is commonly encountered by primary care physicians in California. Training and experience were important predictors of compliance with the Centers for Disease Control and Prevention recommendations; however, substantial divergence from the guidelines occurs.

  3. The use of clinical practice guidelines in primary care: professional mindlines and control mechanisms.

    Science.gov (United States)

    Gené-Badia, Joan; Gallo, Pedro; Caïs, Jordi; Sánchez, Emília; Carrion, Carme; Arroyo, Liliana; Aymerich, Marta

    2016-01-01

    To identify the relevant barriers and enablers perceived by primary care professionals in implementing the recommendations of clinical practice guidelines (CPG). Two focus groups were conducted with primary care physicians and nurses in Catalonia (Spain) between October and December 2012. Thirty-nine health professionals were selected based on their knowledge and daily use of CPG. Finally, eight general practitioners and eight nurses were included in the discussion groups. Participants were asked to share their views and beliefs on the accessibility of CPG, their knowledge and use of these documents, the content and format of CPG, dissemination strategy, training, professional-patient relationship, and the use of CPG by the management structure. We recorded and transcribed the content verbatim and analysed the data using qualitative analysis techniques. Physicians believed that, overall, CPG were of little practical use and frequently referred to them as a largely bureaucratic management control instrument that threatened their professional autonomy. In contrast, nurses believed that CPG were rather helpful tools in their day-to-day practice, although they would like them to be more sensitive to the current role of nurses. Both groups believed that CPG did not provide a response to most of the decisions they faced in the primary care setting. Compliance with CPG recommendations would be improved if these documents were brief, non-compulsory, not cost-containment oriented, more based on nursing care models, sensitive to the specific needs of primary care patients, and integrated into the computer workstation. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Safety and immunogenicity of a primary series of Sabin-IPV with and without aluminum hydroxide in infants.

    Science.gov (United States)

    Verdijk, Pauline; Rots, Nynke Y; van Oijen, Monique G C T; Weldon, William C; Oberste, M Steven; Okayasu, Hiromasa; Sutter, Roland W; Bakker, Wilfried A M

    2014-09-03

    An inactivated poliovirus vaccine (IPV) based on attenuated poliovirus strains (Sabin-1, -2 and -3) was developed for technology transfer to manufacturers in low- and middle-income countries in the context of the global polio eradication initiative. Safety and immunogenicity of Sabin-IPV (sIPV) was evaluated in a double-blind, randomized, controlled, dose-escalation trial in the target population. Healthy infants (n=20/group) aged 56-63 days, received a primary series of three intramuscular injections with low-, middle- or high-dose sIPV with or without aluminum hydroxide or with the conventional IPV based on wild poliovirus strains (wIPV). Virus-neutralizing titers against both Sabin and wild poliovirus strains were determined before and 28 days after three vaccinations. The incidence of local and systemic reactions was comparable with the wIPV. Seroconversion rates after three vaccinations were 100% for type 2 and type 3 polioviruses (both Sabin and wild strains) and 95-100% for type 1 polioviruses. Median titers were high in all groups. Titers were well above the log2(titer) correlated with protection (=3) for all groups. Median titers for Sabin-2 were 9.3 (range 6.8-11.5) in the low-dose sIPV group, 9.2 (range 6.8-10.2) in the low-dose adjuvanted sIPV group and 9.8 (range 5.5-15.0) in the wIPV group, Median titers against MEF-1 (wild poliovirus type 2) were 8.2 (range 4.8-10.8) in the low-dose sIPV group, 7.3 (range 4.5-10.2) in the low-dose adjuvanted Sabin-IPV group and 10.3 (range 8.5-17.0) in the wIPV group. For all poliovirus types the median titers increased with increasing dose levels. sIPV and sIPV adjuvanted with aluminum hydroxide were immunogenic and safe at all dose levels, and comparable with the wIPV. EudraCTnr: 2011-003792-11, NCT01709071. Copyright © 2014. Published by Elsevier Ltd.

  5. Translating sickle cell guidelines into practice for primary care providers with Project ECHO

    Directory of Open Access Journals (Sweden)

    Lisa M. Shook

    2016-11-01

    Full Text Available Background: Approximately 100,000 persons with sickle cell disease (SCD live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. Methods: STORM investigators hypothesized that Project ECHO® methodology could be replicated to create a low-cost, high-impact intervention to train PCPs in evidence-based care for pediatric and young adult patients with SCD in the Midwest, called STORM TeleECHO. This approach utilizes video technology for monthly telementoring clinics consisting of didactic and case-based presentations focused on the National Heart, Lung and Blood Institute (NHLBI evidence-based guidelines for SCD. Results: Network leads in each of the STORM states assisted with developing the curriculum and are recruiting providers for monthly clinics. To assess STORM TeleECHO feasibility and acceptability, monthly attendance and satisfaction data are collected. Changes in self-reported knowledge, comfort, and practice patterns will be compared with pre-participation, and 6 and 12 months after participation. Conclusions: STORM TeleECHO has the potential to increase implementation of the NHLBI evidence-based guidelines, especially increased use of hydroxyurea, resulting in improvements in the quality of care and outcomes for children and young adults with SCD. This model could be replicated in other pediatric chronic illness conditions to improve PCP knowledge and confidence in delivering evidence-based care.

  6. Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study

    NARCIS (Netherlands)

    Teunissen, E.; Gravenhorst, K.; Dowrick, C.; Weel-Baumgarten, E.M. van; Driessen Mareeuw, F.A. van den; Brun, T. de; Burns, N.; Lionis, C.; Mair, F.S.; O'Donnell, C.; O'Reilly-de Brún, M.P.; Papadakaki, M.; Saridaki, A.; Spiegel, W.; Weel, C. van; Muijsenbergh, M.E.T.C. van den; Macfarlane, A.

    2017-01-01

    BACKGROUND: Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this

  7. Guidelines for integrating population education into primary education and literacy programmes.

    Science.gov (United States)

    1989-01-01

    In recent seminars and workshops in the Asia and Pacific region the integration of population education into primary schools and literacy programs were the main topics. In most of the countries in this area separate courses in population education appear to be unfeasible for primary and secondary schools. In the nonformal area experience has indicated that population education acquires more meaning and relevance if it is integrated into an ongoing development program. The integration approach requires knowledge of the contents of the accommodating subjects or programs and knowledge of the contents of the accommodating subjects or programs and knowledge of the contents of population education. Guidelines suggested include the following steps in developing an integrated curriculum and instructional materials. First determine the needs, characteristics and other background information needed on the target group. Next prioritize the problems and needs of the target group, and formulate educational objectives from the identified needs and problems. Next determine and sequence the curriculum contents and then determine specific population education objectives and contents for integration, and what specific materials have to be developed. Then identify the specific type of format of materials to be developed, and write the first draft of the material. Also prepare illustrations and other art and graphic materials. Then the draft material should be reviewed and translated into the language of the target audience if needed. The materials should then be pretested, or field tested, using a sample of the intended users. To make sure the materials are reaching the target groups and being used effectively, a user's guide should be prepared and teachers and facilitators, as well as supervisors, should be prepared on the use of the material. In addition, a distribution and utilization plan should be prepared. Nonformal education materials can be distributed through libraries

  8. Guidelines on the use of space maintainers following premature loss of primary teeth.

    Science.gov (United States)

    Brothwell, D J

    1997-11-01

    To formulate evidence-based guidelines on the appropriate use of space maintaining appliances to prevent or reduce the severity of malocclusion in the permanent dentition following the premature loss of primary teeth. Placement of lingual arch, palatal arch, band-loop, crown-loop, and intra-alveolar space maintainers. Reduced prevalence or severity of space loss in the primary or mixed dentition, reduced prevalence or severity of malocclusion in the permanent dentition measured as significant changes in: crowding, ectopic eruption, impacted teeth, Angle's class II or III occlusion, crossbite, deep overbite, deep overjet, or midline shift. Articles published from 1966 to 1996, located though Medline searches. Only clinical trials, cohort studies, case-control studies, or large case series were considered. Relevant clinical findings were evaluated and categorized using evidence-based methods and values established by the Canadian Task Force on the Periodic Health Examination. A recommendation was developed for the use of space maintainers. The potential benefits of using space maintaining appliances include reduced prevalence or severity of: crowding, ectopic eruption, tooth impaction, crossbite, excessive overbite and overjet, and poor molar relationship. Other advantages include the potential for considerable cost savings by reducing the need for future orthodontic treatment. The potential disadvantages of using space maintaining appliances include soft tissue impingement, interference with eruption of adjacent teeth, pain, plaque accumulation, caries, and broken, dislodged or lost appliances. There is poor evidence to recommend for or against the use of space maintainers to prevent or reduce the severity of malocclusion in the permanent dentition (see Table 1, Recommendation C) Decisions regarding the use of space maintainers must therefore be guided by factors other than scientific evidence.

  9. [Quality and compliance with Clinical Practice Guidelines of Chronic Noncommunicable Diseases in primary care].

    Science.gov (United States)

    Poblano-Verástegui, Ofelia; Vieyra-Romero, Waldo I; Galván-García, Ángel F; Fernández-Elorriaga, María; Rodríguez-Martínez, Antonia I; Saturno-Hernández, Pedro J

    2017-01-01

    To assess the quality and compliance of clinical practice guidelines (CPG) applicable to chronic non-communicable diseases (CNCD) in primary healthcare (CS), and views of staff on the barriers, facilitators and their use. 18 valued CPG with AGREEII, 3 are selected to develop indicators and assess compliance using lot quality acceptance sample (LQAS, standard 75 / 95% threshold 40 / 75% respectively, α:0. 05, β:0. 10) on 5 CS. 70 professionals surveyed about knowledge and use of CPG. Average quality of the CPG was 57.2%; low rating in domains: "Applicability" (<25%), "Stakeholder involvement" (43.5%) and "Rigour of development" (55.0%). Compliance in CS ranges from 39 to 53.4%. Professionals show uneven knowledge of CPG; 44 to 45% (according to CPG), they declare that they are not used, they identify as main barriers the lack of training, and their difficult accessibility and management. The quality and implementation of evaluated CPG is deficient constituting an opportunity of improvement in health services.

  10. Chronic hepatitis B management based on standard guidelines in community primary care and specialty clinics.

    Science.gov (United States)

    Ku, Kevin C; Li, Jiayi; Ha, Nghi B; Martin, Marina; Nguyen, Vincent G; Nguyen, Mindie H

    2013-12-01

    Prior studies have underlined the need for increased screening and awareness of chronic hepatitis B (CHB), especially in certain high-risk populations. However, few studies have examined the patterns of evaluation and management of CHB between primary care physicians (PCP) and specialists according to commonly-used professional guidelines. Our goal was to examine whether necessary laboratory parameters used to determine disease status and eligibility for antiviral therapy were performed by PCPs and specialists. We conducted a retrospective study of 253 treatment-naïve CHB patients who were evaluated by PCP only (n=63) or by specialists (n=190) for CHB at a community multispecialty medical center between March 2007 and June 2009. Criteria for CHB management and treatment eligibility were based on the American Association for the Study of Liver Diseases 2007 guideline and the US Panel 2006 algorithm. Required parameters for optimal evaluation for CHB included hepatitis B e antigen (HBeAg), HBV DNA, and alanine aminotransferase (ALT). Preferred antiviral agents for CHB included pegylated interferon, adefovir, and entecavir. The majority of patients were Asians (90%) and (54%) with a mean age of 43±11.6 years. Compared to PCPs, specialists were more likely to order laboratory testing for ALT (94 vs. 86%, P=0.05), HBeAg (67 vs. 41%, P<0.0001) and HBV DNA (83 vs. 52%, P<0.0001). The proportion of patients having all three laboratory parameters was significantly higher among those evaluated by specialists compared to PCP (62 vs. 33%, P<0.0001). A total of 55 patients were initiated on antiviral treatment (n=47 by specialists and n=6 by PCPs). Lamivudine was prescribed more often by PCPs than specialists (33 vs. 2%, P=0.05). Preferred agents were used 96% of the time by specialists compared to 67% of those treated by PCPs (P=0.05). Patients evaluated by specialists for CHB are more likely to undergo more complete laboratory evaluation and, if eligible, are also more

  11. Evaluating the Impact and Cost-Effectiveness of Statin Use Guidelines for Primary Prevention of Coronary Heart Disease and Stroke.

    Science.gov (United States)

    Heller, David J; Coxson, Pamela G; Penko, Joanne; Pletcher, Mark J; Goldman, Lee; Odden, Michelle C; Kazi, Dhruv S; Bibbins-Domingo, Kirsten

    2017-09-19

    Statins are effective in the primary prevention of atherosclerotic cardiovascular disease. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline expands recommended statin use, but its cost-effectiveness has not been compared with other guidelines. We used the Cardiovascular Disease Policy Model to estimate the cost-effectiveness of the ACC/AHA guideline relative to current use, Adult Treatment Panel III guidelines, and universal statin use in all men 45 to 74 years of age and women 55 to 74 years of age over a 10-year horizon from 2016 to 2025. Sensitivity analyses varied costs, risks, and benefits. Main outcomes were incremental cost-effectiveness ratios and numbers needed to treat for 10 years per quality-adjusted life-year gained. Each approach produces substantial benefits and net cost savings relative to the status quo. Full adherence to the Adult Treatment Panel III guideline would result in 8.8 million more statin users than the status quo, at a number needed to treat for 10 years per quality-adjusted life-year gained of 35. The ACC/AHA guideline would potentially result in up to 12.3 million more statin users than the Adult Treatment Panel III guideline, with a marginal number needed to treat for 10 years per quality-adjusted life-year gained of 68. Moderate-intensity statin use in all men 45 to 74 years of age and women 55 to 74 years of age would result in 28.9 million more statin users than the ACC/AHA guideline, with a marginal number needed to treat for 10 years per quality-adjusted life-year gained of 108. In all cases, benefits would be greater in men than women. Results vary moderately with different risk thresholds for instituting statins and statin toxicity estimates but depend greatly on the disutility caused by daily medication use (pill burden). At a population level, the ACC/AHA guideline for expanded statin use for primary prevention is projected to treat more people, to save more lives, and to cost less

  12. Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol

    Directory of Open Access Journals (Sweden)

    Eva Comin

    2013-03-01

    Full Text Available Background The electronic medical records software of the Catalan Institute of Health has recently incorporated an electronic version of clinical practice guidelines (e-CPGs. This study aims to assess the impact of the implementation of e-CPGs on the diagnosis, treatment, control and management of hypercholesterolaemia, diabetes mellitus type 2 and hypertension.Methods Eligible study participants are those aged 35–74 years assigned to family practitioners (FPs of the Catalan Institute of Health. Routinely collected data from electronic primary care registries covering 80% of the Catalan population will be analysed using two approaches: (1 a cross-sectional study to describe the characteristics of the sample before e-CPG implementation; (2 a controlled before-and-after study with 1-year follow-up to ascertain the effect of e-CPG implementation. Patients of FPs who regularly use the e-CPGs will constitute the intervention group; the control group will comprise patients assigned to FPs not regularly using the e-CPG. The outcomes are: (1 suspected and confirmed diagnoses, (2 control of clinical variables, (3 requests for tests and (4 proportions of patients with adequate drug prescriptions.Results This protocol should represent a reproducible process to assess the impact of the implementation of e-CPGs. We anticipate reporting results in late 2013.Conclusion This project will assess the effectiveness of e-CPGs to improve clinical decisions and healthcare procedures in the three disorders analysed. The results will shed light on the use of evidence-based medicine to improve clinical practice of FPs.

  13. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism.

    Science.gov (United States)

    Wilhelm, Scott M; Wang, Tracy S; Ruan, Daniel T; Lee, James A; Asa, Sylvia L; Duh, Quan-Yang; Doherty, Gerard M; Herrera, Miguel F; Pasieka, Janice L; Perrier, Nancy D; Silverberg, Shonni J; Solórzano, Carmen C; Sturgeon, Cord; Tublin, Mitchell E; Udelsman, Robert; Carty, Sally E

    2016-10-01

    Primary hyperparathyroidism (pHPT) is a common clinical problem for which the only definitive management is surgery. Surgical management has evolved considerably during the last several decades. To develop evidence-based guidelines to enhance the appropriate, safe, and effective practice of parathyroidectomy. A multidisciplinary panel used PubMed to review the medical literature from January 1, 1985, to July 1, 2015. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Initial evaluation should include 25-hydroxyvitamin D measurement, 24-hour urine calcium measurement, dual-energy x-ray absorptiometry, and supplementation for vitamin D deficiency. Parathyroidectomy is indicated for all symptomatic patients, should be considered for most asymptomatic patients, and is more cost-effective than observation or pharmacologic therapy. Cervical ultrasonography or other high-resolution imaging is recommended for operative planning. Patients with nonlocalizing imaging remain surgical candidates. Preoperative parathyroid biopsy should be avoided. Surgeons who perform a high volume of operations have better outcomes. The possibility of multigland disease should be routinely considered. Both focused, image-guided surgery (minimally invasive parathyroidectomy) and bilateral exploration are appropriate operations that achieve high cure rates. For minimally invasive parathyroidectomy, intraoperative parathyroid hormone monitoring via a reliable protocol is recommended. Minimally invasive parathyroidectomy is not routinely recommended for known or suspected multigland disease. Ex vivo aspiration of resected parathyroid tissue may be used to confirm parathyroid tissue intraoperatively. Clinically relevant thyroid disease should be assessed preoperatively and managed during parathyroidectomy. Devascularized normal parathyroid tissue should be autotransplanted. Patients should be observed

  14. Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Martín-Iglesias Susana

    2011-12-01

    Full Text Available Abstract Background The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be based upon the training of health professionals. Following the recommendations of a breastfeeding guide can modify the practice of health professionals and improve results with respect to exclusively or predominatly breastfed children at 6 months of age. Method/Design This study involves a community based cluster randomized trial in primary healthcare centres in Leganés (Madrid, Spain. The project aims to determine whether the use of an implementation strategy (including training session, information distribution, opinion leader of a breastfeeding guideline in primary care is more effective than usual diffusion. The number of patients required will be 240 (120 in each arm. It will be included all the mothers of infants born during the study period (6 months who come to the health centre on the first visit of the child care programme and who give their consent to participate. The main outcome variable is the exclusive o predominant breastfeeding at 6 moths of age.. Main effectiveness will be analyzed by comparing the percentage of infants with exclusive or predominant breastfeeding at 6 months between the intervention group and the control group. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion Strategies need to be found which facilitate the giving of effective advice on breastfeeding by professionals and which provide support to women during the breastfeeding period. By applying the guide

  15. Do Economic Evaluations in Primary Care Prevention and the Management of Hypertension Conform to Good Practice Guidelines? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Maria Cristina Peñaloza Ramos MA

    2016-09-01

    Full Text Available Background: Results of previous research have identified the need for further investigation into the compliance with good practice guidelines for current decision-analytic modeling (DAM. Objective: To identify the extent to which recent model-based economic evaluations of interventions focused on lowering the blood pressure (BP of patients with hypertension conform to published guidelines for DAM in health care using a five-dimension framework developed to assess compliance to DAM guidelines. Methods: A systematic review of English language articles was undertaken to identify published model-based economic evaluations that examined interventions aimed at lowering BP. The review covered the period January 2000 to March 2015 and included the following electronic bibliographic databases: EMBASE and Medline via Ovid interface and the Centre for Reviews and Dissemination’s (CRD NHS-EED. Data were extracted based on different components of good practice across five dimensions utilizing a framework to assess compliance to DAM guidelines. Results: Thirteen articles were included in this review. The review found limited compliance to good practice DAM guidelines, which was most frequently justified by the lack of data. Conclusions: The assessment of structural uncertainty cannot yet be considered common practice in primary prevention and management of hypertension, and researchers seem to face difficulties with identifying sources of structural uncertainty and then handling them correctly. Additional guidelines are needed to aid researchers in identifying and managing sources of potential structural uncertainty. Adherence to guidelines is not always possible and it does pose challenges, in particular when there are limitations due to data availability that restrict, for example, a validation process.

  16. World Federation of Societies of Biological Psychiatry guidelines for the pharmacological treatment of dementias in primary care

    DEFF Research Database (Denmark)

    Ihl, Ralf; Bunevicius, Robertas; Frölich, Lutz

    2015-01-01

    OBJECTIVE: To define a practice guideline for biological treatment of dementias for general practitioners in primary care. METHODS: This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the Biological treatment of Alzheimer's disease...... and other dementias for treatment in primary care ( Ihl et al. 2011 ). The recommendations were developed by a task force of international experts in the field and are based on randomized controlled studies. RESULTS: Anti-dementia medications neither cure, nor arrest, or alter the course of the disease....... The type of dementia, the individual symptom constellation and the tolerability and evidence for efficacy should determine what medications should be used. In treating neuropsychiatric symptoms, psychosocial intervention should be the treatment of first choice. For neuropsychiatric symptoms, medications...

  17. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia - a short version for primary care.

    Science.gov (United States)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthøj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

    2017-06-01

    Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this publication is to offer relevant evidence-based recommendations for the biological treatment of schizophrenia in primary care. This publication is a short and practice-oriented summary of Parts I-III of the World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. The recommendations were developed by the authors and consented by a task force of international experts. Guideline recommendations are based on randomized-controlled trials and supplemented with non-randomized trials and meta-analyses where necessary. Antipsychotics of different chemical classes are the first-line pharmacological treatments for schizophrenia. Specific circumstances (e.g., suicidality, depression, substance dependence) may need additional treatment options. The pharmacological and non-pharmacological management of side effects is of crucial importance for the long-term treatment in all settings of the healthcare system. This summary of the three available evidence-based guidelines has the potential to support clinical decisions and can improve treatment of schizophrenia in primary care settings.

  18. The aluminum smelting process.

    Science.gov (United States)

    Kvande, Halvor

    2014-05-01

    This introduction to the industrial primary aluminum production process presents a short description of the electrolytic reduction technology, the history of aluminum, and the importance of this metal and its production process to modern society. Aluminum's special qualities have enabled advances in technologies coupled with energy and cost savings. Aircraft capabilities have been greatly enhanced, and increases in size and capacity are made possible by advances in aluminum technology. The metal's flexibility for shaping and extruding has led to architectural advances in energy-saving building construction. The high strength-to-weight ratio has meant a substantial reduction in energy consumption for trucks and other vehicles. The aluminum industry is therefore a pivotal one for ecological sustainability and strategic for technological development.

  19. Prevention of Glucocorticoid-Induced Osteoporosis: Clinical audit to evaluate the implementation of National Osteoporosis Guideline Group 2017 guidelines in a primary care setting.

    Science.gov (United States)

    Carter, Matthew

    2018-04-12

    Treatment with glucocorticoids is the leading cause of drug-induced osteoporosis. National Osteoporosis Guideline Group (NOGG) 2017 guidelines advise a case-finding strategy for patients at risk. The aims of the audit were to evaluate the implementation of the NOGG 2017 guidelines for patients receiving long-term glucocorticoid therapy in a suburban general practice, to instigate changes to ensure 90% of patients are investigated and treated appropriately, and to evaluate impact at a 6-mo re-audit. Reporting Analysis and Intelligence Delivering Results (RAIDR) is a health-care intelligence tool accessing primary care clinical data. Using RAIDR, data on relevant osteoporotic risk factors were combined to produce FRAX scores for patients who had been prescribed glucocorticoids 3 or more times in the past 12 months. FRAX data were displayed in a NOGG guidance graph for major osteoporotic fracture probability. Patients were assessed as high, intermediate, or low risk. High- and intermediate-risk patients above the NOGG threshold were recommended to start bisphosphonates; these patients were sent a prescription for alendronate and a letter of explanation. There were no intermediate patients below the NOGG threshold. Low-risk patients were recommended to have lifestyle advice; a leaflet was produced and sent to these patients. Initial results showed that only 25% of patients recommended to be on bisphosphonates were taking them. Steps were taken to educate the general practitioners in the FRAX tool and NOGG guidelines; the chronic obstructive pulmonary disease annual template was amended to aid adherence by alerting the nurse to the number of glucocorticoid courses prescribed, with additional boxes for prescribing alendronate and printing the lifestyle leaflet; and 2-monthly RAIDR searches by the practice pharmacist were started. A re-audit 6 mo later showed improvement to 92%. This audit showed that education, reminders, and simple computer prompts can greatly improve

  20. Developing Guidelines to Enhance Students Desirable Characteristics for Schools under the Office of Udornthani Primary Education Service Area 1

    Directory of Open Access Journals (Sweden)

    Aroonsiri Janlon

    2017-09-01

    Full Text Available The purposes of this research were 1 to study the elements and indicators students desirable characteristics for schools ; 2 to study the present condition and the desirable of students desirable characteristics for schools ; and 3 to develop guidelines to enhance students desirable characteristics for schools under the office of Udornthani primary education service area 1. Research and development. Method was divided into three phases for the purposes of research. The samples were 296 teachers and school administrators, using stratified random sampling. Instruments used were questionnaire, assessment elements and indicators, interview form and assessment guidelines. Data were analyzed using mean, standard devitation and modified priority needs index. Research findings were as follows: 1. There were 3 elements of students desirable characteristics for schools consisted of discipline, learning and commitment to work. Discipline consisted of four indicators, learning consisted of indicators and commitment to work consisted of two indicators. 2. The current situation of students desirable characteristics for schools under the office of Udornthani primary education service area 1, overall at a high level, considering each element, discipline was the highest, followed by learning and the lowest was commitment to work as well. In desirable situation the same relults on the current situation. 3. Guidelines to enhance students desirable characteristics for schools under the office of Udornthani primary education service area 1 consisted of 7 guidelines: 1 the policy clearly ; 2 providing specialized committees ; 3 creating a common understanding ; 4 targeting clearly ; 5 the environmental moral ; 6 supervision, monitoring and evaluation ; and 7 creating a network of parents and the community.

  1. Aluminum Hydroxide

    Science.gov (United States)

    Aluminum hydroxide is used for the relief of heartburn, sour stomach, and peptic ulcer pain and to ... Aluminum hydroxide comes as a capsule, a tablet, and an oral liquid and suspension. The dose and ...

  2. Implementation of Mandatory Nutritional Guidelines in South Australian Primary School Canteens: A Qualitative Study

    Science.gov (United States)

    Abery, Elizabeth; Drummond, Claire

    2014-01-01

    Primary schools are identified as being in a primary position to offer nutrition education. Moreover, primary schools can offer an environment which is conducive to the promotion of healthy eating while influencing eating behaviours of children to benefit their health, well-being and academic development and performance. School canteens are one…

  3. Diagnostic Yield of Chromosomal Microarray Analysis in an Autism Primary Care Practice: Which Guidelines to Implement?

    Science.gov (United States)

    McGrew, Susan G.; Peters, Brittany R.; Crittendon, Julie A.; Veenstra-VanderWeele, Jeremy

    2012-01-01

    Genetic testing is recommended for patients with ASD; however specific recommendations vary by specialty. American Academy of Pediatrics and American Academy of Neurology guidelines recommend G-banded karyotype and Fragile X DNA. The American College of Medical Genetics recommends Chromosomal Microarray Analysis (CMA). We determined the yield of…

  4. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy

    DEFF Research Database (Denmark)

    Muraro, A; Halken, S; Arshad, S H

    2014-01-01

    Food allergy can have significant effects on morbidity and quality of life and can be costly in terms of medical visits and treatments. There is therefore considerable interest in generating efficient approaches that may reduce the risk of developing food allergy. This guideline has been prepared...

  5. Age-specific antibiotic prescribing and adherence to guidelines in pediatric patients in primary care.

    NARCIS (Netherlands)

    Ivanovska, V.; Hek, K.; Mantel-Teeuwisse, A.K.; Leufkens, H.G.M.; Dijk, L. van

    2018-01-01

    Background: Most antibiotics in children are used to treat viral and self-limiting conditions. This study aims to compare physicians' adherence to guidelines on antibiotic prescribing in fever and in ear and respiratory infections to children in different age groups in the Netherlands. Methods: Data

  6. EAACI Food Allergy and Anaphylaxis Guidelines. Primary prevention of food allergy

    NARCIS (Netherlands)

    Muraro, A.; Halken, S.; Arshad, S. H.; Beyer, K.; Dubois, A. E. J.; Du Toit, G.; Eigenmann, P. A.; Grimshaw, K. E. C.; Hoest, A.; Lack, G.; O'Mahony, L.; Papadopoulos, N. G.; Panesar, S.; Prescott, S.; Roberts, G.; de Silva, D.; Venter, C.; Verhasselt, V.; Akdis, A. C.; Sheikh, A.

    Food allergy can have significant effects on morbidity and quality of life and can be costly in terms of medical visits and treatments. There is therefore considerable interest in generating efficient approaches that may reduce the risk of developing food allergy. This guideline has been prepared by

  7. Translation of clinical practice guidelines for childhood obesity prevention in primary care mobilizes a rural Midwest community.

    Science.gov (United States)

    Gibson, S Jo

    2016-03-01

    The purpose of this project was to implement clinic system changes that support evidence-based guidelines for childhood obesity prevention. Adherence rates for prevention and screening of children in a rural Midwest primary care setting were used to measure the success of the program. Retrospective chart reviews reflected gaps in current practice and documentation. An evidence-based toolkit for childhood obesity prevention was used to implement clinic system changes for the identified gaps. The quality improvement approach proved to be effective in translating knowledge of obesity prevention guidelines into rural clinic practices with significant improvements in documentation of prevention measures that may positively impact the childhood obesity epidemic. Primary care providers, including nurse practitioners (NPs), are at the forefront of diagnosing, educating, and counseling children and families on obesity prevention and need appropriate resources and tools to deliver premier care. The program successfully demonstrated how barriers to practice, even with the unique challenges in a rural setting, can be overcome. NPs fulfill a pivotal primary care role and can provide leadership that may positively impact obesity prevention in their communities. ©2015 American Association of Nurse Practitioners.

  8. Communication between secondary and primary care following self-harm: are National Institute of Clinical Excellence (NICE guidelines being met?

    Directory of Open Access Journals (Sweden)

    Jordan Rita

    2008-10-01

    Full Text Available Abstract Background Most patients contact their general practitioner (GP following presentation to an Emergency Department (ED after a self-harm incident, and strategies to help GPs manage these patients include efficient communication between services. The aim of this study was to assess the standard of documentation and communication to primary care from secondary care as recommended by the National Institute of Clinical Excellence (NICE guidelines on the short-term management of people who self-harm. Methods An audit of medical records (ED and Psychiatric on people aged 16 years and over who had presented to the ED following self-harm, benchmarked according to government guidelines, was performed. Data were collected over a 4-week period at a general teaching hospital. Results We collected data on 93 consecutive episodes of self-harm; 62% of episodes were communicated to primary care, 58% of these communications were within 24 h and most within 3 days. Patient identifying details and follow-up arrangements were specified in most cases. Communication via psychiatric staff was most detailed. ED clinicians provided few communications and were of limited content. Communication with the patient's GP was not made in half of those cases seen by a mental health specialist. Conclusion Government guidelines are only partially being met. Reliance on communication by ED staff would leave a substantial proportion of patients discharged from the ED with no or minimal communication to primary care. Psychiatric services need to improve the rate of communication to the patient's GP following assessment A national sample of National Health Service (NHS trusts would establish if this is a problem elsewhere.

  9. Which Clinical Guidelines Should Be Implemented for Management of Osteopenia in Primary Care? A Clin-IQ

    Directory of Open Access Journals (Sweden)

    Turia Hollingsworth

    2014-11-01

    Full Text Available Literature review was conducted to determine clinical guidelines for osteopenia management of immunocompetent patients in the primary care setting. It was concluded that pharmacological treatment should be offered to patients with osteopenia if they are considered high risk, which can be determined by utilizing the World Health Organization Fracture Risk Assessment Tool (FRAX® to evaluate 10-year risk. Patients with a calculated hip fracture probability of at least 3% or those with probability of 20% or more for all osteoporotic fractures may be offered bisphosphonate therapy.

  10. Evidence-based practice guideline of Chinese herbal medicine for primary open-angle glaucoma (qingfeng -neizhang).

    Science.gov (United States)

    Yang, Yingxin; Ma, Qiu-Yan; Yang, Yue; He, Yu-Peng; Ma, Chao-Ting; Li, Qiang; Jin, Ming; Chen, Wei

    2018-03-01

    Primary open angle glaucoma (POAG) is a chronic, progressive optic neuropathy. The aim was to develop an evidence-based clinical practice guideline of Chinese herbal medicine (CHM) for POAG with focus on Chinese medicine pattern differentiation and treatment as well as approved herbal proprietary medicine. The guideline development group involved in various pieces of expertise in contents and methods. Authors searched electronic databases include CNKI, VIP, Sino-Med, Wanfang data, PubMed, the Cochrane Library, EMBASE, as well as checked China State Food and Drug Administration (SFDA) from the inception of these databases to June 30, 2015. Systematic reviews and randomized controlled trials of Chinese herbal medicine treating adults with POAG were evaluated. Risk of bias tool in the Cochrane Handbook and evidence strength developed by the GRADE group were applied for the evaluation, and recommendations were based on the findings incorporating evidence strength. After several rounds of Expert consensus, the final guideline was endorsed by relevant professional committees. CHM treatment principle and formulae based on pattern differentiation together with approved patent herbal medicines are the main treatments for POAG, and the diagnosis and treatment focusing on blood related patterns is the major domain. CHM therapy alone or combined with other conventional treatment reported in clinical studies together with Expert consensus were recommended for clinical practice.

  11. Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial.

    Science.gov (United States)

    Tello-Bernabé, Eugenia; Sanz-Cuesta, Teresa; del Cura-González, Isabel; de Santiago-Hernando, María L; Jurado-Sueiro, Montserrat; Fernández-Girón, Mercedes; García-de Blas, Francisca; Pensado-Freire, Higinio; Góngora-Maldonado, Francisco; de la Puente-Chamorro, María J; Rodríguez-Pasamontes, Carmen; Martín-Iglesias, Susana

    2011-12-01

    Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs) have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low. This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain). The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back) of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion. The number of patients required is 296 (148 in each arm), all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). They are chosen by consecutive sampling. The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D), and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care patients receive. ISRCTN: ISRCTN83365316.

  12. Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Tello-Bernabé Eugenia

    2011-12-01

    Full Text Available Abstract Background Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low. Method/design This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain. The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion. The number of patients required is 296 (148 in each arm, all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV. They are chosen by consecutive sampling. The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D, and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care

  13. Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility

    Directory of Open Access Journals (Sweden)

    Kramer Lena

    2011-11-01

    Full Text Available Abstract Background Most guidelines concentrate on investigations, treatment, and monitoring instead of patient history and clinical examination. We developed a guideline that dealt with the different aetiologies of chest pain by emphasizing the patient's history and physical signs. The objective of this study was to evaluate the guideline's acceptance and feasibility in the context of a practice test. Methods The evaluation study was nested in a diagnostic cross-sectional study with 56 General Practitioners (GPs and 862 consecutively recruited patients with chest pain. The evaluation of the guideline was conducted in a mixed method design on a sub-sample of 17 GPs and 282 patients. Physicians' evaluation of the guideline was assessed via standardized questionnaires and case record forms. Additionally, practice nursing staff and selected patients were asked for their evaluation of specific guideline modules. Quantitative data was analyzed descriptively for frequencies, means, and standard deviations. In addition, two focus groups with a total of 10 GPs were held to gain further insights in the guideline implementation process. The data analysis and interpretation followed the standards of the qualitative content analysis. Results The overall evaluation of the GPs participating in the evaluation study regarding the recommendations made in the chest pain guideline was positive. A total of 14 GPs were convinced that there was a need for this kind of guideline and perceived the guideline recommendations as useful. While the long version was partially criticized for a perceived lack of clarity, the short version of the chest pain guideline and the heart score were especially appreciated by the GPs. However, change of clinical behaviour as consequence of the guideline was inconsistent. While on a concrete patient related level, GPs indicated to have behaved as the guideline recommended, the feedback on a more general level was heterogeneous. Several

  14. The management of hypercholesterolemia in patients with coronary artery disease: guidelines for primary care.

    Science.gov (United States)

    Vogel, R A

    1998-01-01

    More than 10 million individuals in the United States currently have symptomatic coronary artery disease (CAD). Asymptomatic CAD is even more prevalent. CAD in the United States is responsible for approximately 1.5 million myocardial infarctions, 500,000 deaths, and a total economic burden in excess of $120 billion annually. Fortunately, CAD is preventable in many individuals. Our understanding of CAD has steadily progressed throughout the 20th century, and now several lines of evidence support the importance of cholesterol in both the genesis and management of coronary atherosclerosis. Following identification of the presence of cholesterol in atheromas, Anitschkov early this century demonstrated that atherosclerotic lesions can be induced in susceptible animals by high-saturated-fat and cholesterol diets. These lesions regressed when low-fat and cholesterol diets were resumed. In the 1970s and 1980s, findings from the landmark Framingham Heart, Seven Countries, and Multiple Risk Factor Intervention Trial studies firmly established that hypercholesterolemia was a major risk factor for cardiovascular morbidity and mortality. During the 1980s and 1990s, 21 of 22 angiographic trials demonstrated reduced progression of coronary and/or carotid artery disease using lifestyle, drug, and surgical means for reducing cholesterol. The later trials commonly employed hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), reflecting increasing clinical use of these drugs. In 1988, the Adult Treatment Panel of the National Cholesterol Education Program (NCEP) published guidelines on testing and treating hypercholesterolemic patients, which outlined a more aggressive approach to cholesterol lowering than was currently in practice. Since 1994, five large cardiovascular event trials and a large angiographic trial have shown that aggressive cholesterol lowering reduces both cardiac morbidity and mortality, largely substantiating the NCEP guidelines. Although important

  15. The use of clinical practice guidelines in primary care: professional mindlines and control mechanisms

    Directory of Open Access Journals (Sweden)

    Joan Gené-Badia

    2016-09-01

    Conclusions: Compliance with CPG recommendations would be improved if these documents were brief, non-compulsory, not cost-containment oriented, more based on nursing care models, sensitive to the specific needs of primary care patients, and integrated into the computer workstation.

  16. Cognitive functions in primary central nervous system lymphoma: Literature review and assessment guidelines

    NARCIS (Netherlands)

    D.D. Correa; L. Maron; H. Harder (Helena); M. Klein (Martin); C.L. Armstrong; P. Calabrese; J.E.C. Bromberg (Jacolien); L.E. Abrey (Lauren); T.T. Batchelor (Tracy); D. Schiff (David)

    2007-01-01

    textabstractBackground: Treatment-related neurotoxicity has been recognized as a significant problem in patients with primary central nervous system lymphoma (PCNSL) as effective treatment has increased survival rates. There is, however, a paucity of research on cognitive functions in this

  17. Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community

    NARCIS (Netherlands)

    van Bijnen, E.M.E.; Paget, W.J.; den Heijer, C.D.J.; Stobberingh, E.E.; Bruggeman, C.A.; Schellevis, F.G.

    2014-01-01

    Background: Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. Methods:

  18. Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community.

    NARCIS (Netherlands)

    Bijnen, E.M.E. van; Paget, W.J.; Heijer, C.D.J. den; Stobberingh, E.E.; Bruggeman, C.A.; Schellevis, F.G.

    2014-01-01

    Background: Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. Methods:

  19. Diagnosis and management of von Willebrand disease: guidelines for primary care.

    Science.gov (United States)

    Yawn, Barbara; Nichols, William L; Rick, Margaret E

    2009-12-01

    Von Willebrand disease is an inherited condition characterized by deficiency of von Willebrand factor, which is essential in hemostasis. The National Heart, Lung, and Blood Institute has released new evidence-based guidelines for the diagnosis and management of the disease. There are three major subtypes of von Willebrand disease, classified as partial quantitative deficiency (low levels) of von Willebrand factor (type 1), qualitative deficiency (type 2), or virtually complete deficiency (type 3). Diagnosis is usually made by reviewing the patient's personal and family history of bleeding and by clinical evaluation for more common reasons for bleeding, supplemented with laboratory tests. Assessment may be used to determine bleeding risk before surgery and other invasive procedures, and to diagnose reasons for unexplained hemorrhaging. Von Willebrand factor levels of 30 IU per dL or lower are required for the definite diagnosis of inherited von Willebrand disease. Persons with levels of 30 to 50 IU per dL may not have the disease, but may need agents to increase von Willebrand factor levels during invasive procedures or childbirth. Treatment is tailored to the subtype of the disease: increasing plasma concentration of von Willebrand factor by releasing endogenous stores with desmopressin or replacing nonexistent or ineffective von Willebrand factor by using human plasma-derived, viral-inactivated concentrates; treatment is often combined with hemostatic agents that have mechanisms other than increasing von Willebrand factor. Regular prophylaxis is seldom required, and treatment is initiated before planned invasive procedures or in response to bleeding.

  20. Competencies and Training Guidelines for Behavioral Health Providers in Pediatric Primary Care.

    Science.gov (United States)

    Njoroge, Wanjiku F M; Williamson, Ariel A; Mautone, Jennifer A; Robins, Paul M; Benton, Tami D

    2017-10-01

    This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. An existing and successful integrated care training model, currently implemented at Children's Hospital of Philadelphia, is described. This model and the training competencies are discussed in the context of recommendations for future work and training. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Assessment of secondary aluminum reserves of nations

    DEFF Research Database (Denmark)

    Maung, Kyaw Nyunt; Yoshida, Tomoharu; Liu, Gang

    2017-01-01

    aluminum resources are accumulated in landfill sites. Understanding the sizes of primary and secondary aluminum reserves enables us to extend knowledge of efficient raw material sourcing from a narrow perspective of primary reserves alone to a broader perspective of both primary and secondary reserves...

  2. [Basic guidelines for detecting sedentarism and recommendations for physical activity in primary care].

    Science.gov (United States)

    Crespo-Salgado, Juan José; Delgado-Martín, José Luis; Blanco-Iglesias, Orlando; Aldecoa-Landesa, Susana

    2015-03-01

    The detection of physical inactivity in adults, using simple and useful tools is primary objective in both public health and in clinical settings, since this risk factor is one of the major causes of non-communicable disease in the world, and is very prevalent in developed societies such as in Spain. Two validated instruments are described that are simple and useful for detecting and/or monitoring physical inactivity in adults: (i)the international physical activity questionnaire in its short version, and (ii)the pedometer to measure the number of steps taken in a day. Increased levels of physical activity are important for the primary prevention of some chronic diseases (coronary heart disease, type2 diabetes, osteoporosis, colon cancer) and to improve the quality of life. Medical personnel must determine the motivation level and the availability of patients and their families to change their behavior towards physical activity. Moderate-intensity physical activities have hardly any contraindications and the risks are few. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  3. The feasibility of implementing food-based dietary guidelines in the South African primary-school curriculum.

    Science.gov (United States)

    Nguyen, Kim A; de Villiers, Anniza; Fourie, Jean M; Bourne, Lesley T; Hendricks, Michael K

    2015-01-01

    To explore the perceptions of educators from the Western Cape Province about the feasibility of implementing South African food-based dietary guidelines (FBDG) in the national curriculum of primary schools. Combined quantitative and qualitative methods. We report on the quantitative component. Twelve public primary schools of different socio-economic status in three education districts of the Western Cape: Metro Central, Metro East and Cape Winelands. Educators (n 256) participated in the self-completed questionnaire survey. Educators assessed that FBDG were appropriate to South African schoolchildren (94%), could be used as an education tool (97%) and fill gaps in the current curriculum about healthy dietary habits (91%). Besides Life Orientation, FBDG could be taught in other learning areas from grades 3 to 7 (9-13 years old). Important barriers to implementing FBDG in the curriculum were educators' workload (61%), insufficient time (46%), learners' disadvantaged background (43%) and educators' lack of knowledge (33%). Other approaches to teach children about FBDG included linking these to the National School Nutrition Programme (82%), school tuck shops (79%), parent meetings (75%), school nutrition policy (73%) and school assembly (57%). Educators in high-income schools perceived that learners' lifestyle was significantly worse (P school assembly were the best means to teach pupils about FBDG (P school curriculum is seen as important together with optimizing the school physical environment. Key factors required for successful implementation in the curriculum are sufficient educational materials, adequate time allocation and appropriate educator training.

  4. The combined effect of titanic carbide and aluminum phosphide on the refinement of primary silicon in Al-50Si alloy

    Energy Technology Data Exchange (ETDEWEB)

    Dai Hongshang [Key Lab. of Liquid Structure and Heredity of Materials, Ministry of Education, Shandong Univ., Jinan (China); Liu Xiangfa [Key Lab. of Liquid Structure and Heredity of Materials, Ministry of Education, Shandong Univ., Jinan (China); Shandong Binzhou Bohai Piston Co., Ltd., Binzhou, SD (China)

    2008-12-15

    Two refinement methods for Al-50Si alloy are presented in this article: one way is using a newly developed Si-20P alloy at 1573 K: another technique is using the Si-20P alloy in company with Al-TiO{sub 2}-C mixture powder at 1473 K. Compared to the first method, the second one not only has better refinement effect on primary Si but also lower refinement temperature. These results are due to the combined effect of TiC and AlP on the refinement process, and the duplex TiC/AlP nucleus of primary silicon has been demonstrated using electron probe micro-analysis. Moreover, the reaction of Al-TiO{sub 2}-C mixture powder with increasing temperature was investigated using differential scanning calorimetry, which shows that the TiC particles are produced at about 1473 K. AlP particles combine with the in-situ TiC particles in the melt, which is the main reason for the formation of a duplex nucleus, and the disregistry between TiC and AlP in low-index planes is also discussed. (orig.)

  5. Contribution of free play towards physical activity guidelines for New Zealand primary school children aged 7-9 years.

    Science.gov (United States)

    McGall, S E; McGuigan, M R; Nottle, C

    2011-02-01

    the objectives of this study were to investigate children's physical activity patterns to gain comparisons between home and school and to determine whether the current physical activity guidelines of 60 min of moderate to vigorous physical activity (MVPA) daily were being met. participants were recruited from two New Zealand primary schools (60 children, mean age (SD) 8.3 (0.7) years). Physical activity was measured for seven consecutive days using Actigraph accelerometers. Total activity and average counts were determined for school playtime, after school and weekends. Differences between average counts for these intervals were compared using the t statistic. Time and percentage of time spent were categorised into the activity thresholds: sedentary (5200). Total activity for each day was also determined. no child met the recommended 60 min of MVPA daily during the investigation. Compared to school playtime, activity counts were lower by 36% (CI 25% to 45.5%, p<0.001, effect size (ES)=-1.29) after school, 50.1% (CI 37% to 60.5%, p<0.001, ES=-2.01) on Saturday and 57.4% (CI 46.3% to 66.3%, p<0.001, ES=-2.47) on Sunday. Mean results showed children spent 91-96% of their time engaged in light or sedentary activities. Even during school playtime, where the children were most active, only 8 of 80 min were spent engaged in MVPA. this study found activity levels were considerably lower than the recommended guidelines, and children were more active during school playtime compared to after school and weekends.

  6. Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study.

    Science.gov (United States)

    Teunissen, E; Gravenhorst, K; Dowrick, C; Van Weel-Baumgarten, E; Van den Driessen Mareeuw, F; de Brún, T; Burns, N; Lionis, C; Mair, F S; O'Donnell, C; O'Reilly-de Brún, M; Papadakaki, M; Saridaki, A; Spiegel, W; Van Weel, C; Van den Muijsenbergh, M; MacFarlane, A

    2017-02-10

    Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice. We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers' fieldwork reports, were coded and thematically analysed by each team using NPT. In all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants' needs. Implementation of interpreter services was difficult mainly because of financial and other

  7. Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.

    Science.gov (United States)

    Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

    2014-10-01

    In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.

  8. A consensus-based guideline defining clinical target volume for primary disease in external beam radiotherapy for intact uterine cervical cancer

    International Nuclear Information System (INIS)

    Toita, Takafumi; Ohno, Tatsuya; Kaneyasu, Yuko

    2011-01-01

    The objective of this study was to develop a consensus-based guideline to define clinical target volume for primary disease (clinical target volume primary) in external beam radiotherapy for intact uterine cervical cancer. The working subgroup of the Japan Clinical Oncology Group (JCOG) Radiation Therapy Study Group began developing a guideline for primary clinical target volume in November 2009. The group consisted of 10 radiation oncologists and 2 gynecologic oncologists. The process started with comparing the contouring on computed tomographic images of actual cervical cancer cases among the members. This was followed by a comprehensive literature review that included primary research articles and textbooks as well as information on surgical procedures. Extensive discussion occurred in face-to-face meetings (three occasions) and frequent e-mail communications until a consensus was reached. The working subgroup reached a consensus on the definition for the clinical target volume primary. The clinical target volume primary consists of the gross tumor volume, uterine cervix, uterine corpus, parametrium, vagina and ovaries. Definitions for these component structures were determined. Anatomical boundaries in all directions were defined for the parametrium. Examples delineating these boundaries were prepared for the posterior border of the parametrium for various clinical situations (id est (i.e.) central tumor bulk, degree of parametrial involvement). A consensus-based guideline defining the clinical target volume primary was developed for external beam radiotherapy for intact uterine cervical cancer. This guideline will serve as a template for radiotherapy protocols in future clinical trials. It may also be used in actual clinical practice in the setting of highly precise external beam radiotherapy, including intensity-modulated radiotherapy. (author)

  9. Antibiotic prescribing for acute lower respiratory tract infections (LRTI) - guideline adherence in the German primary care setting: An analysis of routine data.

    Science.gov (United States)

    Kraus, Eva Maria; Pelzl, Steffen; Szecsenyi, Joachim; Laux, Gunter

    2017-01-01

    Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care. Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine. Antibiotics were prescribed in 41% of consultations. General practitioners' decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73%) and acute bronchitis (78%) were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28%) were not congruent to the guidelines. Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs.

  10. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Oyun Chimeddamba

    2016-04-01

    Full Text Available (1 Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2 Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3 Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4 Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines.

  11. Guidelines on acute gastroenteritis in children : a critical appraisal of their quality and applicability in primary care Epidemiology and research methodology in primary care

    NARCIS (Netherlands)

    van den Berg, Jose; Berger, Marjolein Y.

    2011-01-01

    Background: Reasons for poor guideline adherence in acute gastroenteritis (AGE) in children in high-income countries are unclear, but may be due to inconsistency between guideline recommendations, lack of evidence, and lack of generalizability of the recommendations to general practice. The aim of

  12. Barriers to implementing the "2008 Mexican Clinical Practice Guideline recommendations for the management of hip and knee osteoarthritis" in primary healthcare practice.

    Science.gov (United States)

    Loyola-Sanchez, Adalberto; Richardson, Julie; Pelaez-Ballestas, Ingris; Sánchez, José Guadalupe; González, Martha Alicia; Sánchez-Cruz, Juan; Jiménez-Baez, María Valeria; Nolasco-Alonso, Nancy; Alvarado, Idolina; Rodríguez-Amado, Jacqueline; Alvarez-Nemegyei, José; Wilson, Mike G

    2014-01-01

    To evaluate the implementability of the "2008 Mexican Clinical Practice Guideline for the management of hip and knee osteoarthritis at the primary level of care" within primary healthcare of three Mexican regions using the Guideline Implementability Appraisal methodology version 2 (GLIA.v2). Six family physicians, representing the South, North, and Central Mexico, and one Mexican physiatrist evaluated the 45 recommendations stated by the Mexican guideline. The GLIA.v2 methodology includes the execution of qualitative and semi-quantitative techniques. Reviewers' agreement was between moderate to near complete in most cases. Sixty-nine percent of the recommendations were considered difficult to implement within clinical practice. Eight recommendations did not have an appropriate format. Only 6 recommendations were judged as able to be consistently applied to clinical practice. Barriers related to the context of one or more institutions/regions were identified in 25 recommendations. These barriers are related to health providers/patients' beliefs, processes of care within each institution, and availability of some treatments recommended by the guideline. The guideline presented problems of conciseness and clarity that negatively affect its application within the Mexican primary healthcare context. We identified individual, organizational and system characteristics, which are common to the 3 institutions/regions studied and constitute barriers for implementing the guideline to clinical practice. It is recommended that the 2008-Mexican-CPG-OA be thoroughly revised and restructured to improve the clarity of the actions implied by each recommendation. We propose some strategies to accomplish this and to overcome some of the identified regional/institutional barriers. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  13. Validation of the 2014 European Society of Cardiology guidelines risk prediction model for the primary prevention of sudden cardiac death in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Vriesendorp, Pieter A; Schinkel, Arend F L; Liebregts, Max; Theuns, Dominic A M J; van Cleemput, Johan; Ten Cate, Folkert J; Willems, Rik; Michels, Michelle

    2015-08-01

    The recently released 2014 European Society of Cardiology guidelines of hypertrophic cardiomyopathy (HCM) use a new clinical risk prediction model for sudden cardiac death (SCD), based on the HCM Risk-SCD study. Our study is the first external and independent validation of this new risk prediction model. The study population consisted of a consecutive cohort of 706 patients with HCM without prior SCD event, from 2 tertiary referral centers. The primary end point was a composite of SCD and appropriate implantable cardioverter-defibrillator therapy, identical to the HCM Risk-SCD end point. The 5-year SCD risk was calculated using the HCM Risk-SCD formula. Receiver operating characteristic curves and C-statistics were calculated for the 2014 European Society of Cardiology guidelines, and risk stratification methods of the 2003 American College of Cardiology/European Society of Cardiology guidelines and 2011 American College of Cardiology Foundation/American Heart Association guidelines. During follow-up of 7.7±5.3 years, SCD occurred in 42 (5.9%) of 706 patients (ages 49±16 years; 34% women). The C-statistic of the new model was 0.69 (95% CI, 0.57-0.82; P=0.008), which performed significantly better than the conventional risk factor models based on the 2003 guidelines (C-statistic of 0.55: 95% CI, 0.47-0.63; P=0.3), and 2011 guidelines (C-statistic of 0.60: 95% CI, 0.50-0.70; P=0.07). The HCM Risk-SCD model improves the risk stratification of patients with HCM for primary prevention of SCD, and calculating an individual risk estimate contributes to the clinical decision-making process. Improved risk stratification is important for the decision making before implantable cardioverter-defibrillator implantation for the primary prevention of SCD. © 2015 American Heart Association, Inc.

  14. Development of a meta-algorithm for guiding primary care encounters for patients with multimorbidity using evidence-based and case-based guideline development methodology.

    Science.gov (United States)

    Muche-Borowski, Cathleen; Lühmann, Dagmar; Schäfer, Ingmar; Mundt, Rebekka; Wagner, Hans-Otto; Scherer, Martin

    2017-06-22

    The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures. Primary care. The meta-algorithm was developed in six steps:1. Designing 10 case vignettes of patients with multimorbidity (common, epidemiologically confirmed disease patterns and/or particularly challenging health care needs) in a multidisciplinary workshop.2. Based on the main diagnoses, a systematic guideline synopsis of evidence-based and consensus-based clinical practice guidelines was prepared. The recommendations were prioritised according to the clinical and psychosocial characteristics of the case vignettes.3. Case vignettes along with the respective guideline recommendations were validated and specifically commented on by an external panel of practicing general practitioners (GPs).4. Guideline recommendations and experts' opinions were summarised as case specific management recommendations (N-of-one guidelines).5. Healthcare preferences of patients with multimorbidity were elicited from a systematic literature review and supplemented with information from qualitative interviews.6. All N-of-one guidelines were analysed using pattern recognition to identify common decision nodes and care elements. These elements were put together to form a generic meta-algorithm. The resulting meta-algorithm reflects the logic of a GP's encounter of a patient with multimorbidity regarding decision-making situations, communication needs and priorities. It can be filled with the complex problems of individual patients and hereby offer guidance to the practitioner. Contrary to simple, symptom-oriented algorithms, the meta

  15. Practice guidelines in the context of primary care, learning and usability in the physicians' decision-making process--a qualitative study.

    Science.gov (United States)

    Ingemansson, Maria; Bastholm-Rahmner, Pia; Kiessling, Anna

    2014-08-20

    Decision-making is central for general practitioners (GP). Practice guidelines are important tools in this process but implementation of them in the complex context of primary care is a challenge. The purpose of this study was to explore how GPs approach, learn from and use practice guidelines in their day-to-day decision-making process in primary care. A qualitative approach using focus-group interviews was chosen in order to provide in-depth information. The participants were 22 GPs with a median of seven years of experience in primary care, representing seven primary healthcare centres in Stockholm, Sweden in 2011. The interviews focused on how the GPs use guidelines in their decision-making, factors that influence their decision how to approach these guidelines, and how they could encourage the learning process in routine practice.Data were analysed by qualitative content analysis. Meaning units were condensed and grouped in categories. After interpreting the content in the categories, themes were created. Three themes were conceptualized. The first theme emphasized to use guidelines by interactive contextualized dialogues. The categories underpinning this theme: 1. Feedback by peer-learning 2. Feedback by collaboration, mutual learning, and equality between specialties, identified important ways to achieve this learning dialogue. Confidence was central in the second theme, learning that establishes confidence to provide high quality care. Three aspects of confidence were identified in the categories of this theme: 1. Confidence by confirmation, 2. Confidence by reliability and 3. Confidence by evaluation of own results. In the third theme, learning by use of relevant evidence in the decision-making process, we identified two categories: 1. Design and lay-out visualizing the evidence 2. Accessibility adapted to the clinical decision-making process as prerequisites for using the practice guidelines. Decision-making in primary care is a dual process that involves

  16. Guidelines on acute gastroenteritis in children: A critical appraisal of their quality and applicability in primary care

    NARCIS (Netherlands)

    J. van den Berg (José); M.Y. Berger (Marjolein)

    2011-01-01

    textabstractBackground: Reasons for poor guideline adherence in acute gastroenteritis (AGE) in children in high-income countries are unclear, but may be due to inconsistency between guideline recommendations, lack of evidence, and lack of generalizability of the recommendations to general practice.

  17. The relative influence of secondary versus primary prevention using the national cholesterol education program adult treatment panel II guidelines

    NARCIS (Netherlands)

    Goldman, L; Coxson, P; Hunink, MGM; Goldman, PA; Tosteson, ANA; Mittleman, M; Williams, L; Weinstein, MC

    OBJECTIVES This study was undertaken to project the population-wide effect of full implementation of the Adult Treatment Panel (ATP) II guidelines of the National Cholesterol Education Program (NCEP). BACKGROUND The ATP II has proposed guidelines for cholesterol reduction, but the long-term

  18. A survey of the management of urinary tract infection in children in primary care and comparison with the NICE guidelines.

    LENUS (Irish Health Repository)

    Kennedy, Kieran M

    2010-01-01

    BACKGROUND: The aim of this study was to establish current practices amongst general practitioners in the West of Ireland with regard to the investigation, diagnosis and management of urinary tract infection (UTI) in children and to evaluate these practices against recently published guidelines from the National Institute for Health and Clinical Excellence (NICE). METHODS: A postal survey was performed using a questionnaire that included short clinical scenarios. All general practices in a single health region were sent a questionnaire, cover letter and SAE. Systematic postal and telephone contact was made with non-responders. The data was analysed using SPSS version 15. RESULTS: Sixty-nine general practitioners were included in the study and 50 (72%) responded to the questionnaire. All respondents agreed that it is important to consider diagnosis of UTI in all children with unexplained fever. Doctors accurately identified relevant risk factors for UTI in the majority (87%) of cases. In collecting urine samples from a one year old child, 80% of respondents recommended the use of a urine collection bag and the remaining 20% recommended collection of a clean catch sample. Respondents differed greatly in their practice with regard to detailed investigation and specialist referral after a first episode of UTI. Co-amoxiclav was the most frequently used antibiotic for the treatment of cystitis, with most doctors prescribing a five day course. CONCLUSIONS: In general, this study reveals a high level of clinical knowledge amongst doctors treating children with UTI in primary care in the catchment area of County Mayo. However, it also demonstrates wide variation in practice with regard to detailed investigation and specialist referral. The common practice of prescribing long courses of antibiotics when treating lower urinary tract infection is at variance with NICE\\'s recommendation of a three day course of antibiotics for cystitis in children over three months of age when

  19. Multi-faceted implementation strategy to increase use of a clinical guideline for the diagnosis of deep venous thrombosis in primary care.

    Science.gov (United States)

    Kingma, Anna E C; van Stel, Henk F; Oudega, Ruud; Moons, Karel G M; Geersing, Geert-Jan

    2017-08-01

    A clinical decision rule (CDR), combined with a negative D-dimer test, can safely rule out deep venous thrombosis (DVT) in primary care. This strategy is recommended by guidelines, yet uptake by GPs is low. To evaluate a multi-faceted implementation strategy aimed at increased use of the guideline recommended CDR plus D-dimer test in primary care patients with suspected DVT. This multi-faceted implementation strategy consisted of educational outreach visits, financial reimbursements and periodical newsletters. 217 Dutch GPs (implementation group) received this strategy and included patients. Effectiveness was measured through the following patient-level outcomes: (i) proportion of non-referred patients, (ii) proportion of missed DVT cases within this group and (iii) the proportion of patients in whom the guideline was applied incorrectly. Implementation outcomes ('acceptability', 'feasibility', 'fidelity' and 'sustainability') were assessed with an online questionnaire. Patient-level outcomes were compared with those of patients included by 450 GPs, uninformed about the study's purposes providing information about usual care. 336 (54%) of 619 analyzable implementation group patients were not referred, missing 6 [1.8% (95% confidence interval 0.7% to 3.9%)] DVT cases. Incorrect guideline use was observed in 199 patients (32%). Self-reported acceptability, feasibility and expected sustainability were high. Guideline use increased from 42% to an expected continuation of use of 91%. Only 32 usual care GPs included 62 patients, making formal comparison unreliable. This multi-faceted implementation strategy safely reduced patient referral to secondary care, despite frequently incorrect application of the guideline and resulted in high acceptability, feasibility and expected sustainability. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. 40 CFR 440.20 - Applicability; description of the aluminum ore subcategory.

    Science.gov (United States)

    2010-07-01

    ... subpart B are applicable to discharges from facilities engaged in the mining of bauxite as an aluminum ore. ... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORE MINING AND DRESSING POINT SOURCE CATEGORY Aluminum Ore...

  1. Guidelines on acute gastroenteritis in children: a critical appraisal of their quality and applicability in primary care

    Directory of Open Access Journals (Sweden)

    van den Berg José

    2011-12-01

    Full Text Available Abstract Background Reasons for poor guideline adherence in acute gastroenteritis (AGE in children in high-income countries are unclear, but may be due to inconsistency between guideline recommendations, lack of evidence, and lack of generalizability of the recommendations to general practice. The aim of this study was to assess the quality of international guidelines on AGE in children and investigate the generalizability of the recommendations to general practice. Methods Guidelines were retrieved from websites of professional medical organisations and websites of institutes involved in guideline development. In addition, a systematic search of the literature was performed. Articles were selected if they were a guideline, consensus statement or care protocol. Results Eight guidelines met the inclusion criteria, the quality of the guidelines varied. 242 recommendations on diagnosis and management were found, of which 138 (57% were based on evidence. There is a large variety in the classification of symptoms to different categories of dehydration. No signs are generalizable to general practice. It is consistently recommended to use hypo-osmolar ORS, however, the recommendations on ORS-dosage are not evidence based and are inconsistent. One of 14 evidence based recommendations on therapy of AGE is based on outpatient research and is therefore generalizable to general practice. Conclusions The present study shows considerable variation in the quality of guidelines on AGE in children, as well as inconsistencies between the recommendations. It remains unclear how to asses the extent of dehydration and determine the preferred treatment or referral of a young child with AGE presenting in general practice.

  2. Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: qualitative comparative case study in primary care.

    Science.gov (United States)

    Wiener-Ogilvie, Sharon; Huby, Guro; Pinnock, Hilary; Gillies, John; Sheikh, Aziz

    2008-06-04

    Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice. Qualitative comparative case study using nine in-depth interviews and 2 focus groups with general practitioners and practice nurses, involved in delivering asthma care. Participants were purposively recruited from practices in a Scottish health board with high and low compliance with the BTS-SIGN asthma guideline. There was a marked difference in the way respondents from practices with high compliance and respondents from practices with low compliance spoke about the value of guidelines and the challenges of implementing them. On both accounts, the former were more positive than the latter and were able to be more specific about the strategies they used to overcome barriers to implementation. We explored the reason for this difference in response and identified practice organisation, centring on delegation of work to nurses, as a factor mediating the practice's level of compliance. Effective delegation was underpinned by organisation of asthma work among practice members who have the appropriate level of skills and knowledge, know and understand each others' work and responsibilities, communicate well among themselves and trust each others' skills. It was the combination of these factors which made for successful delegation and guideline implementation, not any one factor in isolation. In our sample of practices, teamwork and organisation of care within practices appeared to impact on guideline implementation and further larger studies are needed to explore this issue further. Isolated interventions such as measures to improve staff's knowledge or increased clinical resource and time, which are

  3. Prevention of mother-to-child transmission of HIV guidelines: Nurses’ views at four primary healthcare facilities in the Limpopo Province

    Directory of Open Access Journals (Sweden)

    Barbara A. Hanrahan

    2017-06-01

    Full Text Available Background: When new guidelines for existing programmes are introduced, it is often the clinicians tasked with the execution of the guidelines who bear the brunt of the changes. Frequently their opinions are not sought. In this study, the researcher interviewed registered nurses working in the field of the prevention of mother-to-child transmission (PMTCT of human immunodeficiency virus (HIV to gain an understanding of their perspectives on the changes introduced to the guidelines. The guideline changes in 2014 were to move from the World Health Organization (WHO Option B to Option B + which prescribes lifelong antiretroviral therapy (ART for all HIV-positive pregnant women regardless of CD4 cell count. Objective: To determine what the registered nurses’ perspectives are on the PMTCT programme as implemented at four PHC facilities in the Limpopo Province. Method: For this qualitative investigation, a descriptive research design was implemented. The data were collected during semi-structured interviews with nurses from four primary healthcare facilities in the Limpopo Province of South Africa. Data were analysed using thematic analysis. Results: Challenges preventing effective implementation (e.g. increased workloads, viz. staff shortages; poor planning of training; equipment and medication shortages and long lead times; poor patient education were identified. Conclusion: In spite of the successes of the PMTCT programme, considerable challenges still prevail; lack of patient education, poor facilities management and staff shortages could potentially influence the implementation of the PMTCT guidelines negatively.

  4. Immunogenicity of aluminum-adsorbed hepatitis A vaccine (Havrix®) administered as a third dose after primary doses of Japanese aluminum-free hepatitis A vaccine (Aimmugen®) for Japanese travelers to endemic countries.

    Science.gov (United States)

    Fukushima, Shinji; Kiyohara, Tomoko; Ishii, Koji; Nakano, Takashi; Hamada, Atsuo

    2017-11-07

    Hepatitis A vaccination is recommended for travelers to endemic countries. Several inactivated aluminum-adsorbed hepatitis A vaccines are available worldwide, but only one licensed hepatitis A vaccine is available in Japan. This vaccine is a lyophilized inactivated aluminum-free hepatitis A vaccine (Aimmugen®). The standard schedule of Aimmugen® is three doses (at 0, 2-4 weeks, and 6 months). Japanese people will go abroad after receiving 2 doses of Aimmugen®. Some long-term travelers will receive the third dose of hepatitis A vaccine at their destination, at 6-24 months after 2 doses of Aimmugen®. Aimmugen® is not available in countries other than Japan. They receive inactivated aluminum-adsorbed hepatitis A vaccine instead of a third dose of Aimmugen®. This study was undertaken to determine whether the booster vaccination with an aluminum-adsorbed hepatitis A vaccine is effective following two doses of Aimmugen®. Subjects were healthy Japanese adults aged 20 years or older who had received two doses of Aimmugen®. Subjects received a booster dose of Havrix®1440 intramuscularly as the third dose. Serology samples for hepatitis A virus antibody titers were taken 4-6 weeks later. Anti-hepatitis A virus antibody titers were measured by an inhibition enzyme-linked immunosorbent assay. Subjects were 20 healthy Japanese adults, 6 men and 14 women. The mean age ± standard deviation was 37.2 ± 13.3. The seroprotection rate (SPR, anti-hepatitis A virus antibody titer ≥10 mIU/mL) was 85% at enrollment, and increased to 100% after vaccination with Havrix®. The geometric mean anti-hepatitis A virus antibody titer increased from 39.8 mIU/mL to 2938.2 mIU/mL. The three scheduled doses consisting of two doses of Aimmugen® plus a third dose with Havrix® is more immunogenic than using only two doses of Aimmugen®. The vaccination with Havrix® could be allowed to be used instead of a third dose of Aimmugen®. (UMIN000009351). Copyright © 2017 Elsevier Ltd. All

  5. Meta-regression analyses to explain statistical heterogeneity in a systematic review of strategies for guideline implementation in primary health care.

    Directory of Open Access Journals (Sweden)

    Susanne Unverzagt

    Full Text Available This study is an in-depth-analysis to explain statistical heterogeneity in a systematic review of implementation strategies to improve guideline adherence of primary care physicians in the treatment of patients with cardiovascular diseases. The systematic review included randomized controlled trials from a systematic search in MEDLINE, EMBASE, CENTRAL, conference proceedings and registers of ongoing studies. Implementation strategies were shown to be effective with substantial heterogeneity of treatment effects across all investigated strategies. Primary aim of this study was to explain different effects of eligible trials and to identify methodological and clinical effect modifiers. Random effects meta-regression models were used to simultaneously assess the influence of multimodal implementation strategies and effect modifiers on physician adherence. Effect modifiers included the staff responsible for implementation, level of prevention and definition pf the primary outcome, unit of randomization, duration of follow-up and risk of bias. Six clinical and methodological factors were investigated as potential effect modifiers of the efficacy of different implementation strategies on guideline adherence in primary care practices on the basis of information from 75 eligible trials. Five effect modifiers were able to explain a substantial amount of statistical heterogeneity. Physician adherence was improved by 62% (95% confidence interval (95% CI 29 to 104% or 29% (95% CI 5 to 60% in trials where other non-medical professionals or nurses were included in the implementation process. Improvement of physician adherence was more successful in primary and secondary prevention of cardiovascular diseases by around 30% (30%; 95% CI -2 to 71% and 31%; 95% CI 9 to 57%, respectively compared to tertiary prevention. This study aimed to identify effect modifiers of implementation strategies on physician adherence. Especially the cooperation of different health

  6. Diabetes and hypertension guidelines and the primary health care practitioner in Barbados: knowledge, attitudes, practices and barriers-a focus group study

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2010-12-01

    Full Text Available Abstract Background Audits have shown numerous deficiencies in the quality of hypertension and diabetes primary care in Barbados, despite distribution of regional guidelines. This study aimed to evaluate the knowledge, attitudes and practices, and the barriers faced by primary care practitioners in Barbados concerning the recommendations of available diabetes and hypertension guidelines. Methods Focus groups using a moderator's manual were conducted at all 8 public sector polyclinics, and 5 sessions were held for private practitioners. Results Polyclinic sessions were attended by 63 persons (17 physicians, 34 nurses, 3 dieticians, 3 podiatrists, 5 pharmacists, and 1 other, and private sector sessions by 20 persons (12 physicians, 1 nurse, 3 dieticians, 2 podiatrists and 2 pharmacists. Practitioners generally thought they gave a good quality of care. Commonwealth Caribbean Medical Research Council 1995 diabetes and 1998 hypertension guidelines, and the Ministry of Health 2001 diabetes protocol had been seen by 38%, 32% and 78% respectively of polyclinic practitioners, 67%, 83%, and 33% of private physicians, and 25%, 0% and 38% of non-physician private practitioners. Current guidelines were considered by some to be outdated, unavailable, difficult to remember and lacking in advice to tackle barriers. Practitioners thought that guidelines should be circulated widely, promoted with repeated educational sessions, and kept short. Patient oriented versions of the guidelines were welcomed. Patient factors causing barriers to ideal outcome included denial and fear of stigma; financial resources to access an appropriate diet, exercise and monitoring equipment; confusion over medication regimens, not valuing free medication, belief in alternative medicines, and being unable to change habits. System barriers included lack of access to blood investigations, clinic equipment and medication; the lack of human resources in polyclinics; and an uncoordinated

  7. Diabetes and hypertension guidelines and the primary health care practitioner in Barbados: knowledge, attitudes, practices and barriers--a focus group study.

    Science.gov (United States)

    Adams, O Peter; Carter, Anne O

    2010-12-03

    Audits have shown numerous deficiencies in the quality of hypertension and diabetes primary care in Barbados, despite distribution of regional guidelines. This study aimed to evaluate the knowledge, attitudes and practices, and the barriers faced by primary care practitioners in Barbados concerning the recommendations of available diabetes and hypertension guidelines. Focus groups using a moderator's manual were conducted at all 8 public sector polyclinics, and 5 sessions were held for private practitioners. Polyclinic sessions were attended by 63 persons (17 physicians, 34 nurses, 3 dieticians, 3 podiatrists, 5 pharmacists, and 1 other), and private sector sessions by 20 persons (12 physicians, 1 nurse, 3 dieticians, 2 podiatrists and 2 pharmacists). Practitioners generally thought they gave a good quality of care. Commonwealth Caribbean Medical Research Council 1995 diabetes and 1998 hypertension guidelines, and the Ministry of Health 2001 diabetes protocol had been seen by 38%, 32% and 78% respectively of polyclinic practitioners, 67%, 83%, and 33% of private physicians, and 25%, 0% and 38% of non-physician private practitioners. Current guidelines were considered by some to be outdated, unavailable, difficult to remember and lacking in advice to tackle barriers. Practitioners thought that guidelines should be circulated widely, promoted with repeated educational sessions, and kept short. Patient oriented versions of the guidelines were welcomed. Patient factors causing barriers to ideal outcome included denial and fear of stigma; financial resources to access an appropriate diet, exercise and monitoring equipment; confusion over medication regimens, not valuing free medication, belief in alternative medicines, and being unable to change habits. System barriers included lack of access to blood investigations, clinic equipment and medication; the lack of human resources in polyclinics; and an uncoordinated team approach. Patients faced cultural barriers with

  8. Network Meta-analysis for Clinical Practice Guidelines: A Case Study on First-Line Medical Therapies for Primary Open-Angle Glaucoma

    Science.gov (United States)

    Rouse, Benjamin; Cipriani, Andrea; Shi, Qiyuan; Coleman, Anne L.; Dickersin, Kay; Li, Tianjing

    2016-01-01

    Background Network meta-analysis compares multiple treatment options for the same condition and may be useful for developing clinical practice guidelines. Purpose To compare treatment recommendations for first-line medical therapy for primary open angle-glaucoma (POAG) from major updates of American Academy of Ophthalmology (AAO) guidelines with the evidence available at the time, using network meta-analysis. Data Sources MEDLINE, Embase, and the Cochrane Library were searched on 11 March 2014 for randomized, controlled trials (RCTs) of glaucoma monotherapies compared with placebo, vehicle, or no treatment or other monotherapies. The AAO Web site was searched in August 2014 to identify AAO POAG guidelines. Study Selection Eligible RCTs were selected by 2 independent reviewers, and guidelines were selected by 1 person. Data Extraction One person abstracted recommendations from guidelines and a second person verified. Two people independently abstracted data from included RCTs. Data Synthesis Guidelines were grouped together on the basis of literature search dates, and RCTs that existed at 1991, 1995, 1999, 2004, and 2009 were analyzed. The outcome of interest was intraocular pressure (IOP) at 3 months. Only the latest guideline made a specific recommendation: prostaglandins. Network meta-analyses showed that all treatments were superior to placebo in decreasing IOP at 3 months. The mean reductions (95% credible intervals [CrIs]) for the highest-ranking class compared with placebo were as follows: 1991: β-blockers, 4.01 (CrI, 0.48 to 7.43); 1995: α2-adrenergic agonists, 5.64 (CrI, 1.73 to 9.50); 1999: prostaglandins, 5.43 (CrI, 3.38 to 7.38); 2004: prostaglandins, 4.75 (CrI, 3.11 to 6.44); 2009: prostaglandins, 4.58 (CrI, 2.94 to 6.24). Limitation When comparisons are informed by a small number of studies, the treatment effects and rankings may not be stable. Conclusion For timely recommendations when multiple treatment options are available, guidelines developers

  9. Enhancing system-wide implementation of opioid prescribing guidelines in primary care: protocol for a stepped-wedge quality improvement project.

    Science.gov (United States)

    Zgierska, Aleksandra E; Vidaver, Regina M; Smith, Paul; Ales, Mary W; Nisbet, Kate; Boss, Deanne; Tuan, Wen-Jan; Hahn, David L

    2018-06-05

    Systematic implementation of guidelines for opioid therapy management in chronic non-cancer pain can reduce opioid-related harms. However, implementation of guideline-recommended practices in routine care is subpar. The goal of this quality improvement (QI) project is to assess whether a clinic-tailored QI intervention improves the implementation of a health system-wide, guideline-driven policy on opioid prescribing in primary care. This manuscript describes the protocol for this QI project. A health system with 28 primary care clinics caring for approximately 294,000 primary care patients developed and implemented a guideline-driven policy on long-term opioid therapy in adults with opioid-treated chronic non-cancer pain (estimated N = 3980). The policy provided multiple recommendations, including the universal use of treatment agreements, urine drug testing, depression and opioid misuse risk screening, and standardized documentation of the chronic pain diagnosis and treatment plan. The project team drew upon existing guidelines, feedback from end-users, experts and health system leadership to develop a robust QI intervention, targeting clinic-level implementation of policy-directed practices. The resulting multi-pronged QI intervention included clinic-wide and individual clinician-level educational interventions. The QI intervention will augment the health system's "routine rollout" method, consisting of a single educational presentation to clinicians in group settings and a separate presentation for staff. A stepped-wedge design will enable 9 primary care clinics to receive the intervention and assessment of within-clinic and between-clinic changes in adherence to the policy items measured by clinic-level electronic health record-based measures and process measures of the experience with the intervention. Developing methods for a health system-tailored QI intervention required a multi-step process to incorporate end-user feedback and account for the needs of

  10. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia–a short version for primary care

    DEFF Research Database (Denmark)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas

    2017-01-01

    Objective: Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this ......Objective: Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose...... of this publication is to offer relevant evidence-based recommendations for the biological treatment of schizophrenia in primary care. Methods: This publication is a short and practice-oriented summary of Parts I–III of the World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological...

  11. Applied Electrochemistry of Aluminum

    DEFF Research Database (Denmark)

    Li, Qingfeng; Qiu, Zhuxian

    Electrochemistry of aluminum is of special importance from both theoretical and technological point of view. It covers a wide range of electrolyte systems from molten fluoride melts at around 1000oC to room temperature molten salts, from aqueous to various organic media and from liquid to solid...... electrolytes. The book is an updated review of the technological advances in the fields of electrolytic production and refining of metals, electroplating, anodizing and other electrochemical surface treatments, primary and secondary batteries, electrolytic capacitors; corrosion and protection and others....

  12. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers.

    Science.gov (United States)

    Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

    2017-01-01

    Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM. A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323) who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p culture was the most predominant (mean =41.13; standard deviation [SD] =8.92), followed by hierarchical (mean =33.14; SD=5.96), while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51), followed by clan/group (mean =29.73; SD =8.37). Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research should preferably mix quantitative and qualitative approaches and explore the use of more sensitive instruments to measure such a complex construct and its effects on guideline adherence in small-sized clinics.

  13. Changing attitudes to infection management in primary care: a controlled trial of active versus passive guideline implementation strategies.

    Science.gov (United States)

    Onion, C W; Bartzokas, C A

    1998-04-01

    When attempting to implement evidence-based medicine, such as through clinical guidelines, we often rely on passive educational tactics, for example didactic lectures and bulletins. These methods involve the recipient in relatively superficial processing of information, and any consequent attitude changes can be expected to be short-lived. However, active methods, such as practice-based discussion, should involve recipients in deep processing, with more enduring attitude changes. In this experiment, the aim was to assess the efficacy of an active strategy at promoting deep processing and its effectiveness, relative to a typical passive method, at changing attitudes between groups of GPs over 12 months across an English Health District. All 191 GPs operating from 69 practices in the Wirral Health District of Northwest England were assigned, with minimization of known confounding variables, to three experimental groups: active, passive and control. The groups were shown to have similar learning styles. The objective of the study was to impart knowledge of best management of infections as captured in a series of locally developed clinical guidelines. The passive group GPs were given a copy of the guidelines and were invited to an hour-long lecture event. The GPs in the deep group were given a copy of the guidelines and were invited to engage in an hour-long discussion about the guideline content at their own premises. The control group received neither the guidelines nor any educational contact regarding them. Three months before and 12 months after the interventions, all GPs were sent a postal questionnaire on their preferred empirical antibiotic for 10 common bacterial infections. The responses were compared in order to ascertain whether increased knowledge of best clinical practice was evident in each group. Seventy-five per cent (144/191) of GPs responded to the pre-intervention questionnaire, 62 % (119/191) post-intervention. Thirty-four per cent (22/64) of GPs

  14. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care.

    Science.gov (United States)

    Quanbeck, Andrew; Brown, Randall T; Zgierska, Aleksandra E; Jacobson, Nora; Robinson, James M; Johnson, Roberta A; Deyo, Brienna M; Madden, Lynn; Tuan, Wen-Jan; Alagoz, Esra

    2018-01-25

    This paper reports on the feasibility, acceptability, and effectiveness of an innovative implementation strategy named "systems consultation" aimed at improving adherence to clinical guidelines for opioid prescribing in primary care. While clinical guidelines for opioid prescribing have been developed, they have not been widely implemented, even as opioid abuse reaches epidemic levels. We tested a blended implementation strategy consisting of several discrete implementation strategies, including audit and feedback, academic detailing, and external facilitation. The study compares four intervention clinics to four control clinics in a randomized matched-pairs design. Each systems consultant aided clinics on implementing the guidelines during a 6-month intervention consisting of monthly site visits and teleconferences/videoconferences. The mixed-methods evaluation employs the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Quantitative outcomes are compared using time series analysis. Qualitative methods included focus groups, structured interviews, and ethnographic field techniques. Seven clinics were randomly approached to recruit four intervention clinics. Each clinic designated a project team consisting of six to eight staff members, each with at least one prescriber. Attendance at intervention meetings was 83%. More than 80% of staff respondents agreed or strongly agreed with the statements: "I am more familiar with guidelines for safe opioid prescribing" and "My clinic's workflow for opioid prescribing is easier." At 6 months, statistically significant improvements were noted in intervention clinics in the percentage of patients with mental health screens, treatment agreements, urine drug tests, and opioid-benzodiazepine co-prescribing. At 12 months, morphine-equivalent daily dose was significantly reduced in intervention clinics compared to controls. The cost to deliver the strategy was $7345 per clinic. Adaptations were

  15. Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: Qualitative comparative case study in primary care

    Directory of Open Access Journals (Sweden)

    Gillies John

    2008-06-01

    Full Text Available Abstract Background Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice. Methods Qualitative comparative case study using nine in-depth interviews and 2 focus groups with general practitioners and practice nurses, involved in delivering asthma care. Participants were purposively recruited from practices in a Scottish health board with high and low compliance with the BTS-SIGN asthma guideline. Results There was a marked difference in the way respondents from practices with high compliance and respondents from practices with low compliance spoke about the value of guidelines and the challenges of implementing them. On both accounts, the former were more positive than the latter and were able to be more specific about the strategies they used to overcome barriers to implementation. We explored the reason for this difference in response and identified practice organisation, centring on delegation of work to nurses, as a factor mediating the practice's level of compliance. Effective delegation was underpinned by organisation of asthma work among practice members who have the appropriate level of skills and knowledge, know and understand each others' work and responsibilities, communicate well among themselves and trust each others' skills. It was the combination of these factors which made for successful delegation and guideline implementation, not any one factor in isolation. Conclusion In our sample of practices, teamwork and organisation of care within practices appeared to impact on guideline implementation and further larger studies are needed to explore this issue further. Isolated interventions such as measures to improve staff

  16. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Radwan M

    2017-08-01

    Full Text Available Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA by using the competing values framework (CVF and examining its influence on the adherence to the Clinical Practice Guideline (CPG for DM.Methods: A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323 who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. Results: The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA. In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92, followed by hierarchical (mean =33.14; SD=5.96, while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51, followed by clan/group (mean =29.73; SD =8.37. Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Conclusion: Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research

  17. Implementation of a guideline for low back pain management in primary care: a cost-effectiveness analysis.

    Science.gov (United States)

    Becker, Annette; Held, Heiko; Redaelli, Marcus; Chenot, Jean F; Leonhardt, Corinna; Keller, Stefan; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Basler, Heinz-Dieter; Kochen, Michael M; Donner-Banzhoff, Norbert; Strauch, Konstantin

    2012-04-15

    Cost-effectiveness analysis alongside a cluster randomized controlled trial. To study the cost-effectiveness of 2 low back pain guideline implementation (GI) strategies. Several evidence-based guidelines on management of low back pain have been published. However, there is still no consensus on the effective implementation strategy. Especially studies on the economic impact of different implementation strategies are lacking. This analysis was performed alongside a cluster randomized controlled trial on the effectiveness of 2 GI strategies (physician education alone [GI] or physician education in combination with motivational counseling [MC] by practice nurses)--both compared with the postal dissemination of the guideline (control group, C). Sociodemographic data, pain characteristics, and cost data were collected by interview at baseline and after 6 and 12 months. low back pain-related health care costs were valued for 2004 from the societal perspective. For the cost analysis, 1322 patients from 126 general practices were included. Both interventions showed lower direct and indirect costs as well as better patient outcomes during follow-up compared with controls. In addition, both intervention arms showed superiority of cost-effectiveness to C. The effects attenuated when adjusting for differences of health care utilization prior to patient recruitment and for clustering of data. Trends in cost-effectiveness are visible but need to be confirmed in future studies. Researchers performing cost-evaluation studies should test for baseline imbalances of health care utilization data instead of judging on the randomization success by reviewing non-cost parameters like clinical data alone.

  18. Implementing the European guidelines for cardiovascular disease prevention in the primary care setting in Cyprus: Lessons learned from a health care services study

    Directory of Open Access Journals (Sweden)

    Philalithis Anastasios

    2008-07-01

    Full Text Available Abstract Background Recent guidelines recommend assessment and treatment of the overall risk for cardiovascular disease (CVD through management of multiple risk factors in patients at high absolute risk. The aim of our study was to assess the level of cardiovascular risk in patients with known risk factors for CVD by applying the SCORE risk function and to study the implications of European guidelines on the use of treatment and goal attainment for blood pressure (BP and lipids in the primary care of Cyprus. Methods Retrospective chart review of 1101 randomly selected patients with type 2 diabetes mellitus (DM2, or hypertension or hyperlipidemia in four primary care health centres. The SCORE risk function for high-risk regions was used to calculate 10-year risk of cardiovascular fatal event. Most recent values of BP and lipids were used to assess goal attainment to international standards. Most updated medications lists were used to compare proportions of current with recommended antihypertensive and lipid-lowering drug (LLD users according to European guidelines. Results Implementation of the SCORE risk model labelled overall 39.7% (53.6% of men, 31.3% of women of the study population as high risk individuals (CVD, DM2 or SCORE ≥5%. The SCORE risk chart was not applicable in 563 patients (51.1% due to missing data in the patient records, mostly on smoking habits. The LDL-C goal was achieved in 28.6%, 19.5% and 20.9% of patients with established CVD, DM2 (no CVD and SCORE ≥5%, respectively. BP targets were achieved in 55.4%, 5.6% and 41.9% respectively for the above groups. There was under prescription of antihypertensive drugs, LLD and aspirin for all three high risk groups. Conclusion This study demonstrated suboptimal control and under-treatment of patients with cardiovascular risk factors in the primary care in Cyprus. Improvement of documentation of clinical information in the medical records as well as GPs training for implementation

  19. 40 CFR 464.10 - Applicability; description of the aluminum casting subcategory.

    Science.gov (United States)

    2010-07-01

    ... aluminum casting subcategory. 464.10 Section 464.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS METAL MOLDING AND CASTING POINT SOURCE CATEGORY Aluminum Casting Subcategory § 464.10 Applicability; description of the aluminum casting subcategory. The...

  20. Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

    Science.gov (United States)

    van Avendonk, Mariëlle J P; Mensink, Paul A J S; Drenthen, A J M Ton; van Binsbergen, Jaap J

    2012-04-01

    The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines. But in the field of nutrition and other lifestyle-related interventions, there are many direct and indirect interfaces for over- as well as undernutrition. The Dutch College of General Practitioners (NHG) published the Practice Guideline Obesity in adults and children to lead GPs in this process and to bridge the gap with public health. The same applies for the recently published National Primary Care Cooperation Agreement Undernutrition on the collaboration of primary care workers to enhance awareness and early intervention in case of nutritional impairment. This article goes into the background as well as the content of these two NHG products and the implications for daily practice. An attempt is made to connect primary care and public health in this matter. Particularly in the case of obesity, a close relationship with public health is of vital importance.

  1. 77 FR 13585 - Electricity Subsector Cybersecurity Risk Management Process Guideline

    Science.gov (United States)

    2012-03-07

    ... DEPARTMENT OF ENERGY Electricity Subsector Cybersecurity Risk Management Process Guideline AGENCY... Electricity Subsector Cybersecurity Risk Management Process guideline. The guideline describes a risk... Cybersecurity Risk Management Process Guideline. The primary goal of this guideline is to describe a risk...

  2. Development of Guidelines for Mentoring Internal Supervision for the Schools under Roi-Et Office of Primary Education Service Area 2

    Directory of Open Access Journals (Sweden)

    Natchana Sahunil

    2017-06-01

    Full Text Available The research aimed to 1 study the factors and indicators of mentoring internal supervision for schools, 2 study the current state and the desirable state of mentoring internal supervision for schools, and 3 study the guidelines on the operation of mentoring internal supervision for the schools under Roi-Et Office of Primary Education Service Area 2. The research was divided into 3 phases. In phase 1 the informants comprised 5 certified experts. In phase 2 the sample comprised 488 government teachers under Roi-Et Office of Primary Education Service Area 2, btained through multi-stage random sampling. In phase 3 the informants comprised school directors, school deputy directors and supervisor teachers under Roi-Et Office of Primary Education Service Area 2, totally 9 persons. The research instruments onsisted of 1 a questionnaire having the discrimination from 0.34 to 0.79 and the total reliability of 0.87, 2 a structured interview form, and 3 a suitability and feasibility assessment form for the guidelines on the operation of mentoring internal supervision. The analysis of data employed percentage, the mean and standard deviation. The results are as follows: 1. There are 4 factors of the guidelines on mentoring internal supervision for schools. They are: preparation of mentoring supervision, with 12 indicators ; management of mentoring supervision, with 12 indicators ; operation of mentoring supervision, with 14 indicators ; and evaluation of mentoring supervision, with 10 indicators, all of which had been evaluated by the experts as, on the whole, very suitable. 2. The current state of the mentoring internal supervision for schools, on the whole and factor by factor, was in the moderate level in every factor. Meanwhile, the desirable state of mentoring internal supervision for schools, on the whole, was in the high level. When considered factor by factor, the factor with the highest mean is management of mentoring supervision. The factor with

  3. Energy analysis of hydrogen and electricity production from aluminum-based processes

    International Nuclear Information System (INIS)

    Wang, Huizhi; Leung, Dennis Y.C.; Leung, Michael K.H.

    2012-01-01

    The aluminum energy conversion processes have been characterized to be carbon-free and sustainable. However, their applications are restrained by aluminum production capacity as aluminum is never found as a free metal on the earth. This study gives an assessment of typical aluminum-based energy processes in terms of overall energy efficiency and cost. Moreover, characteristics associated with different processes are identified. Results in this study indicate the route from which aluminum is produced can be a key factor in determining the efficiency and costs. Besides, the aluminum–air battery provides a more energy-efficient manner for the conversion of energy stored in primary aluminum and recovered aluminum from products compared to aluminum-based hydrogen production, whereas the aluminum-based hydrogen production gives a more energy-efficient way of utilizing energy stored in secondary aluminum or even scrap aluminum.

  4. Should the gap be filled between guidelines and actual practice for management of low back pain in primary care? The Quebec experience.

    Science.gov (United States)

    Rossignol, M; Abenhaim, L; Bonvalot, Y; Gobeille, D; Shrier, I

    1996-12-15

    A prospective cohort study. To describe health services utilization for low back pain in the province of Quebec, Canada, and to compare it with North American guidelines. The Quebec Task Force and the Agency for Health Care Planning and Research (United States) published guidelines for the management of low back pain in 1987 and 1994, respectively. A cohort of 2147 adults with low back pain identified at the Quebec Worker's Compensation Board were selected randomly and observed over 2 years' time for their health care utilization profile. During the study period, 57.8% of the workers still under active care 7 weeks after their back injury had not yet been referred to a specialist. Specialized imaging techniques were obtained by 4.5% of the patients, with a delay of 7 weeks or more in 66% of them. Surgery was performed on 1.6% of the patients. The presence of an initial specific diagnosis and proximity to a university hospital significantly increased utilization rate and reduced the delays. Health services utilization for back pain in Quebec was equal or lower to what currently is practiced elsewhere, but access to specialists was not meeting the current recommendations. This would represent a 12% net increase in new specialist contacts and a quicker access in 39% who saw a specialist. Before such an effort can be considered, health care planners will need a better definition of the role of the specialist consultation in the guidelines and scientific evidence specifically addressing their benefit in primary care, especially in the absence of a specific diagnosis.

  5. Lead exposure from aluminum cookware in Cameroon

    International Nuclear Information System (INIS)

    Weidenhamer, Jeffrey D.; Kobunski, Peter A.; Kuepouo, Gilbert; Corbin, Rebecca W.; Gottesfeld, Perry

    2014-01-01

    Blood lead levels have decreased following the removal of lead from gasoline in most of the world. However, numerous recent studies provide evidence that elevated blood lead levels persist in many low and middle-income countries around the world at much higher prevalence than in the more developed countries. One potential source of lead exposure that has not been widely investigated is the leaching of lead from artisanal aluminum cookware, which is commonly used in the developing world. Twenty-nine samples of aluminum cookware and utensils manufactured by local artisans in Cameroon were collected and analyzed for their potential to release lead during cooking. Source materials for this cookware included scrap metal such as engine parts, radiators, cans, and construction materials. The lead content of this cookware is relatively low (< 1000 ppm by X-ray fluorescence), however significant amounts of lead, as well as aluminum and cadmium were released from many of the samples using dilute acetic acid extractions at boiling and ambient temperatures. Potential exposures to lead per serving were estimated to be as high as 260 μg, indicating that such cookware can pose a serious health hazard. We conclude that lead, aluminum and cadmium can migrate from this aluminum cookware during cooking and enter food at levels exceeding recommended public health guidelines. Our results support the need to regulate lead content of materials used to manufacture these pots. Artisanal aluminum cookware may be a major contributor to lead poisoning throughout the developing world. Testing of aluminum cookware in other developing countries is warranted. - Highlights: • Cookware is manufactured in Cameroon from scrap aluminum including car parts. • Twenty-nine cookware samples were evaluated for their potential to leach lead. • Boiling extractions to simulate the effects of cooking released significant lead. • Potential lead exposures per serving are estimated as high as 260 μg.

  6. Lead exposure from aluminum cookware in Cameroon

    Energy Technology Data Exchange (ETDEWEB)

    Weidenhamer, Jeffrey D.; Kobunski, Peter A. [Department of Chemistry, Geology and Physics, 401 College Ave., Ashland University, Ashland, OH 44805 (United States); Kuepouo, Gilbert [Research and Education Centre for Development (CREPD), Yaounde (Cameroon); Corbin, Rebecca W. [Department of Chemistry, Geology and Physics, 401 College Ave., Ashland University, Ashland, OH 44805 (United States); Gottesfeld, Perry, E-mail: pgottesfeld@okinternational.org [Occupational Knowledge International, San Francisco, CA (United States)

    2014-10-15

    Blood lead levels have decreased following the removal of lead from gasoline in most of the world. However, numerous recent studies provide evidence that elevated blood lead levels persist in many low and middle-income countries around the world at much higher prevalence than in the more developed countries. One potential source of lead exposure that has not been widely investigated is the leaching of lead from artisanal aluminum cookware, which is commonly used in the developing world. Twenty-nine samples of aluminum cookware and utensils manufactured by local artisans in Cameroon were collected and analyzed for their potential to release lead during cooking. Source materials for this cookware included scrap metal such as engine parts, radiators, cans, and construction materials. The lead content of this cookware is relatively low (< 1000 ppm by X-ray fluorescence), however significant amounts of lead, as well as aluminum and cadmium were released from many of the samples using dilute acetic acid extractions at boiling and ambient temperatures. Potential exposures to lead per serving were estimated to be as high as 260 μg, indicating that such cookware can pose a serious health hazard. We conclude that lead, aluminum and cadmium can migrate from this aluminum cookware during cooking and enter food at levels exceeding recommended public health guidelines. Our results support the need to regulate lead content of materials used to manufacture these pots. Artisanal aluminum cookware may be a major contributor to lead poisoning throughout the developing world. Testing of aluminum cookware in other developing countries is warranted. - Highlights: • Cookware is manufactured in Cameroon from scrap aluminum including car parts. • Twenty-nine cookware samples were evaluated for their potential to leach lead. • Boiling extractions to simulate the effects of cooking released significant lead. • Potential lead exposures per serving are estimated as high as 260 μg.

  7. Implementing core NICE guidelines for osteoarthritis in primary care with a model consultation (MOSAICS): a cluster randomised controlled trial.

    Science.gov (United States)

    Dziedzic, K S; Healey, E L; Porcheret, M; Afolabi, E K; Lewis, M; Morden, A; Jinks, C; McHugh, G A; Ryan, S; Finney, A; Main, C; Edwards, J J; Paskins, Z; Pushpa-Rajah, A; Hay, E M

    2018-01-01

    To determine the effectiveness of a model osteoarthritis consultation, compared with usual care, on physical function and uptake of National Institute for Health and Care Excellence (NICE) osteoarthritis recommendations, in adults ≥45 years consulting with peripheral joint pain in UK general practice. Two-arm cluster-randomised controlled trial with baseline health survey. Eight general practices in England. 525 adults ≥45 years consulting for peripheral joint pain, amongst 28,443 population survey recipients. Four intervention practices delivered the model osteoarthritis consultation to patients consulting with peripheral joint pain; four control practices continued usual care. The primary clinical outcome of the trial was the SF-12 physical component score (PCS) at 6 months; the main secondary outcome was uptake of NICE core recommendations by 6 months, measured by osteoarthritis quality indicators. A Linear Mixed Model was used to analyse clinical outcome data (SF-12 PCS). Differences in quality indicator outcomes were assessed using logistic regression. 525 eligible participants were enrolled (mean age 67.3 years, SD 10.5; 59.6% female): 288 from intervention and 237 from control practices. There were no statistically significant differences in SF-12 PCS: mean difference at the 6-month primary endpoint was -0.37 (95% CI -2.32, 1.57). Uptake of core NICE recommendations by 6 months was statistically significantly higher in the intervention arm compared with control: e.g., increased written exercise information, 20.5% (7.9, 28.3). Whilst uptake of core NICE recommendations was increased, there was no evidence of benefit of this intervention, as delivered in this pragmatic randomised trial, on the primary outcome of physical functioning at 6 months. ISRCTN06984617. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Implementing international osteoarthritis treatment guidelines in primary health care: study protocol for the SAMBA stepped wedge cluster randomized controlled trial.

    Science.gov (United States)

    Østerås, Nina; van Bodegom-Vos, Leti; Dziedzic, Krysia; Moseng, Tuva; Aas, Eline; Andreassen, Øyvor; Mdala, Ibrahim; Natvig, Bård; Røtterud, Jan Harald; Schjervheim, Unni-Berit; Vlieland, Thea Vliet; Hagen, Kåre Birger

    2015-12-02

    Previous research indicates that people with osteoarthritis (OA) are not receiving the recommended and optimal treatment. Based on international treatment recommendations for hip and knee OA and previous research, the SAMBA model for integrated OA care in Norwegian primary health care has been developed. The model includes physiotherapist (PT) led patient OA education sessions and an exercise programme lasting 8-12 weeks. This study aims to assess the effectiveness, feasibility, and costs of a tailored strategy to implement the SAMBA model. A cluster randomized controlled trial with stepped wedge design including an effect, process, and cost evaluation will be conducted in six municipalities (clusters) in Norway. The municipalities will be randomized for time of crossover from current usual care to the implementation of the SAMBA model by a tailored strategy. The tailored strategy includes interactive workshops for general practitioners (GPs) and PTs in primary care covering the SAMBA model for integrated OA care, educational material, educational outreach visits, feedback, and reminder material. Outcomes will be measured at the patient, GP, and PT levels using self-report, semi-structured interviews, and register based data. The primary outcome measure is patient-reported quality of care (OsteoArthritis Quality Indicator questionnaire) at 6-month follow-up. Secondary outcomes include referrals to PT, imaging, and referrals to the orthopaedic surgeon as well as participants' treatment satisfaction, symptoms, physical activity level, body weight, and self-reported and measured lower limb function. The actual exposure to the tailor made implementation strategy and user experiences will be measured in a process evaluation. In the economic evaluation, the difference in costs of usual OA care and the SAMBA model for integrated OA care will be compared with the difference in health outcomes and reported by the incremental cost-effectiveness ratio (ICER). The results

  9. Are primary care practitioners in Barbados following diabetes guidelines? - a chart audit with comparison between public and private care sectors

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2011-06-01

    Full Text Available Abstract Background Over 19% of the population ≥ 40 years of age in Barbados are diabetic. The quality of diabetes primary care is uncertain. Findings Charts of diabetic and hypertensive patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all diabetic patients ≥ 40 years of age were then selected. Processes of care, and quality targets for blood pressure (BP, fasting blood glucose (FBG and glycosylated haemoglobin (HbA1c were documented. 252 charts of diabetic patients (125 public and 127 private were audited. Patients had the following characteristics: mean age 64 years, female gender 61%, mean duration of diagnosis 9 years, and hypertension diagnosed 78%. Patients had an average of 4.7 clinic visits per year, 66% were prescribed metformin, 68% a sulphonylurea, 25% a statin, 21% insulin, 15% aspirin and 12% a glucosidase inhibitor. Public patients compared to private patients were more likely to be female (77% vs. 46%, p Conclusions Interventions such as body mass assessment, lifestyle advice, screening for retinopathy, monitoring blood glucose control, and achieving BP and glycaemic targets need improvement.

  10. ALUMINUM BOX BUNDLING PRESS

    Directory of Open Access Journals (Sweden)

    Iosif DUMITRESCU

    2015-05-01

    Full Text Available In municipal solid waste, aluminum is the main nonferrous metal, approximately 80- 85% of the total nonferrous metals. The income per ton gained from aluminum recuperation is 20 times higher than from glass, steel boxes or paper recuperation. The object of this paper is the design of a 300 kN press for aluminum box bundling.

  11. Characterization of ultrafine aluminum nanoparticles

    International Nuclear Information System (INIS)

    Sandstrom, Mary M.; Jorgensen, Betty S.; Mang, Joseph T.; Smith, Bettina L.; Son, Steven F.

    2004-01-01

    Aluminum nanopowders with particle sizes ranging from ∼25 nm to 80 nm were characterized by a variety of methods. We present and compare the results from common powder characterization techniques including transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM), BET gas adsorption surface area analysis, thermogravimetric analysis (TGA), photon correlation spectroscopy (PCS), and low angle laser light scattering (LALLS). Aluminum nanoparticles consist of an aluminum core with an aluminum oxide coating. HRTEM measurements of both the particle diameter and oxide layer thickness tend to be larger than those obtained from BET and TGA. LALLS measurements show a large degree of particle agglomeration in solution; therefore, primary particle sizes could not be determined. Furthermore, results from small-angle scattering techniques (SAS), including small-angle neutron (SANS) and x-ray (SAXS) scattering are presented and show excellent agreement with the BET, TGA, and HRTEM. The suite of analytical techniques presented in this paper can be used as a powerful tool in the characterization of many types of nanosized powders.

  12. Aluminum as anode for energy storage and conversion: a review

    Science.gov (United States)

    Li, Qingfeng; Bjerrum, Niels J.

    Aluminum has long attracted attention as a potential battery anode because of its high theoretical voltage and specific energy. The protective oxide layer on the aluminum surface is however detrimental to the battery performance, contributing to failure to achieve the reversible potential and causing the delayed activation of the anode. By developing aluminum alloys as anodes and solution additives to electrolytes, a variety of aluminum batteries have been extensively investigated for various applications. From molten salt and other non-aqueous electrolytes, aluminum can be electrodeposited and therefore be suitable for developing rechargable batteries. Considerable efforts have been made to develop secondary aluminum batteries of high power density. In the present paper, these research activities are reviewed, including aqueous electrolyte primary batteries, aluminum-air batteries and molten salt secondary batteries.

  13. Graphene-aluminum nanocomposites

    International Nuclear Information System (INIS)

    Bartolucci, Stephen F.; Paras, Joseph; Rafiee, Mohammad A.; Rafiee, Javad; Lee, Sabrina; Kapoor, Deepak; Koratkar, Nikhil

    2011-01-01

    Highlights: → We investigated the mechanical properties of aluminum and aluminum nanocomposites. → Graphene composite had lower strength and hardness compared to nanotube reinforcement. → Processing causes aluminum carbide formation at graphene defects. → The carbides in between grains is a source of weakness and lowers tensile strength. - Abstract: Composites of graphene platelets and powdered aluminum were made using ball milling, hot isostatic pressing and extrusion. The mechanical properties and microstructure were studied using hardness and tensile tests, as well as electron microscopy, X-ray diffraction and differential scanning calorimetry. Compared to the pure aluminum and multi-walled carbon nanotube composites, the graphene-aluminum composite showed decreased strength and hardness. This is explained in the context of enhanced aluminum carbide formation with the graphene filler.

  14. Problems and Guidelines of Strategy Implementation in Basic Educational Institutions under the Supervision of KhonKaen Primary Educational Service Area Office 4

    Directory of Open Access Journals (Sweden)

    Sasiwan Tonkanya

    2016-09-01

    Full Text Available The research aimed to 1 study problems of strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4 ; and 2 propose the guidelines for strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4. The study was carried out in 2 phases. In phase 1, it focused on the study and analysis of the strategic implementation problems and phase 2 studied the best practice schools. The informants for the interview in phase 1 comprised 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools. They were selected by the use of purposive sampling technique. The population in the study of the strategic implementation problems in basic educational institutions in phase 1 consisted of 543 school administrators and teachers who were involved in strategy implementation from 181 schools under Khonkaen Primary Educational Service Area Office 4 in academic year 2014. The study samples were 217 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools under Khonkaen Primary Educational Service Area Office 4. The samples were selected by the use of stratified sampling technique. The informants of the phase 2 study were 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized best practice schools obtained from purposive sampling technique. The research instruments used for data collection consisted of 2 sets of questionnaires. The Set 1 questionnaire was the 5-point Likert scale on the levels of the problems in implementation with item discrimination at 0.60 – 1.00 and reliability of the whole questionnaire at .9359. The questionnaire contained 3 parts with 65 items. The Set 2 questionnaire comprised 2 parts with 10 items regarding

  15. Curriculum Guidelines for Periodontics.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)

  16. Primary and secondary cutaneous CD30(+) lymphoproliferative disorders : a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment

    NARCIS (Netherlands)

    Bekkenk, MW; Geelen, FAMJ; Vader, PCV; Heule, F; Geerts, ML; van Vloten, WA; Meijer, CJLM; Willemze, R

    2000-01-01

    To evaluate our diagnostic and therapeutic guidelines, clinical and long-term follow-up data of 219 patients with primary or secondary cutaneous CD30(+) lympho proliferative disorders were evaluated. The study group included 118 patients with lymphomatoid papulosis (LyP; group 1), 79 patients with

  17. Primary and secondary cutaneous CD30(+) lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment

    NARCIS (Netherlands)

    Bekkenk, M. W.; Geelen, F. A.; van Voorst Vader, P. C.; Heule, F.; Geerts, M. L.; van Vloten, W. A.; Meijer, C. J.; Willemze, R.

    2000-01-01

    To evaluate our diagnostic and therapeutic guidelines, clinical and long-term follow-up data of 219 patients with primary or secondary cutaneous CD30(+) lymphoproliferative disorders were evaluated. The study group included 118 patients with lymphomatoid papulosis (LyP; group 1), 79 patients with

  18. BONDING ALUMINUM METALS

    Science.gov (United States)

    Noland, R.A.; Walker, D.E.

    1961-06-13

    A process is given for bonding aluminum to aluminum. Silicon powder is applied to at least one of the two surfaces of the two elements to be bonded, the two elements are assembled and rubbed against each other at room temperature whereby any oxide film is ruptured by the silicon crystals in the interface; thereafter heat and pressure are applied whereby an aluminum-silicon alloy is formed, squeezed out from the interface together with any oxide film, and the elements are bonded.

  19. Aluminum powder metallurgy processing

    Energy Technology Data Exchange (ETDEWEB)

    Flumerfelt, J.F.

    1999-02-12

    The objective of this dissertation is to explore the hypothesis that there is a strong linkage between gas atomization processing conditions, as-atomized aluminum powder characteristics, and the consolidation methodology required to make components from aluminum powder. The hypothesis was tested with pure aluminum powders produced by commercial air atomization, commercial inert gas atomization, and gas atomization reaction synthesis (GARS). A comparison of the GARS aluminum powders with the commercial aluminum powders showed the former to exhibit superior powder characteristics. The powders were compared in terms of size and shape, bulk chemistry, surface oxide chemistry and structure, and oxide film thickness. Minimum explosive concentration measurements assessed the dependence of explosibility hazard on surface area, oxide film thickness, and gas atomization processing conditions. The GARS aluminum powders were exposed to different relative humidity levels, demonstrating the effect of atmospheric conditions on post-atomization processing conditions. The GARS aluminum powders were exposed to different relative humidity levels, demonstrating the effect of atmospheric conditions on post-atomization oxidation of aluminum powder. An Al-Ti-Y GARS alloy exposed in ambient air at different temperatures revealed the effect of reactive alloy elements on post-atomization powder oxidation. The pure aluminum powders were consolidated by two different routes, a conventional consolidation process for fabricating aerospace components with aluminum powder and a proposed alternative. The consolidation procedures were compared by evaluating the consolidated microstructures and the corresponding mechanical properties. A low temperature solid state sintering experiment demonstrated that tap densified GARS aluminum powders can form sintering necks between contacting powder particles, unlike the total resistance to sintering of commercial air atomization aluminum powder.

  20. Anodizing Aluminum with Frills.

    Science.gov (United States)

    Doeltz, Anne E.; And Others

    1983-01-01

    "Anodizing Aluminum" (previously reported in this journal) describes a vivid/relevant laboratory experience for general chemistry students explaining the anodizing of aluminum in sulfuric acid and constrasting it to electroplating. Additions to this procedure and the experiment in which they are used are discussed. Reactions involved are…

  1. Nurses' experiences of guideline implementation

    DEFF Research Database (Denmark)

    Alanen, Seija; Välimäki, Marita; Kaila, Minna

    2009-01-01

    AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation. DESIGN: Qualitative interview. METHODS: Data were generated by four focus group interviews involving nurses working in out-patient services in primary...... to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines...

  2. Is the Aluminum Hypothesis Dead?

    Science.gov (United States)

    2014-01-01

    The Aluminum Hypothesis, the idea that aluminum exposure is involved in the etiology of Alzheimer disease, dates back to a 1965 demonstration that aluminum causes neurofibrillary tangles in the brains of rabbits. Initially the focus of intensive research, the Aluminum Hypothesis has gradually been abandoned by most researchers. Yet, despite this current indifference, the Aluminum Hypothesis continues to attract the attention of a small group of scientists and aluminum continues to be viewed with concern by some of the public. This review article discusses reasons that mainstream science has largely abandoned the Aluminum Hypothesis and explores a possible reason for some in the general public continuing to view aluminum with mistrust. PMID:24806729

  3. Anodized aluminum on LDEF

    Science.gov (United States)

    Golden, Johnny L.

    1993-01-01

    A compilation of reported analyses and results obtained for anodized aluminum flown on the Long Duration Exposure Facility (LDEF) was prepared. Chromic acid, sulfuric acid, and dyed sulfuric acid anodized surfaces were exposed to the space environment. The vast majority of the anodized surface on LDEF was chromic acid anodize because of its selection as a thermal control coating for use on the spacecraft primary structure, trays, tray clamps, and space end thermal covers. Reports indicate that the chromic acid anodize was stable in solar absorptance and thermal emittance, but that contamination effects caused increases in absorptance on surfaces exposed to low atomic oxygen fluences. There were some discrepancies, however, in that some chromic acid anodized specimens exhibited significant increases in absorptance. Sulfuric acid anodized surfaces also appeared stable, although very little surface area was available for evaluation. One type of dyed sulfuric acid anodize was assessed as an optical baffle coating and was observed to have improved infrared absorptance characteristics with exposure on LDEF.

  4. From Invisibility to Visibility: A Policy Archaeology of the Introduction of Anti-Transphobic and Anti-Homophobic Bullying Guidelines into the Irish Primary Education System

    Science.gov (United States)

    Bailey, Susan

    2017-01-01

    In September 2013, the Department of Education and Skills introduced revised anti-bullying guidelines which made it compulsory for all schools to ensure that their individual anti-bullying policies include a clause on identity-based bullying, specifically referencing transphobic and homophobic bullying. The introduction of these guidelines would…

  5. Barriers and enablers for the development and implementation of allied health clinical practice guidelines in South African primary healthcare settings: a qualitative study.

    Science.gov (United States)

    Dizon, J M; Grimmer, K; Louw, Q; Machingaidze, S; Parker, H; Pillen, H

    2017-09-15

    The South African allied health (AH) primary healthcare (PHC) workforce is challenged with the complex rehabilitation needs of escalating patient numbers. The application of evidence-based care using clinical practice guidelines (CPGs) is one way to make efficient and effective use of resources. Although CPGs are common for AH in high-income countries, there is limited understanding of how to do this in low- to middle-income countries. This paper describes barriers and enablers for AH CPG uptake in South African PHC. Semi-structured individual interviews were undertaken with 25 South African AH managers, policymakers, clinicians and academics to explore perspectives on CPGs. Interviews were conducted by researcher dyads, one being familiar with South African AH PHC practice and the other with CPG expertise. Rigour and transparency of data collection was ensured. Interview transcripts were analysed by structuring content into codes, categories and themes. Exemplar quotations were extracted to support themes. CPGs were generally perceived to be relevant to assist AH providers to address the challenges of consistently providing evidence-based care in South African PHC settings. CPGs were considered to be tools for managing clinical, social and economic complexities of AH PHC practice, particularly if CPG recommendations were contextusalised. CPG uptake was one way to deal with increasing pressures to make efficient use of scarce financial resources, and to demonstrate professional legitimacy. Themes comprised organisational infrastructures and capacities for CPG uptake, interactions between AH actors and interaction with broader political structures, the nature of AH evidence in CPGs, and effectively implementing CPGs into practice. CPGs contextualised to local circumstances offer South African PHC AH services with an efficient vehicle for putting evidence into practice. There are challenges to doing this, related to local barriers such as geography, AH training

  6. Quality Guidelines

    Science.gov (United States)

    ... this page: https://medlineplus.gov/criteria.html MedlinePlus Quality Guidelines To use the sharing features on this ... materials must also meet our existing quality guidelines. Quality, authority and accuracy of health content The organization's ...

  7. Applying STOPP Guidelines in Primary Care Through Electronic Medical Record Decision Support: Randomized Control Trial Highlighting the Importance of Data Quality.

    Science.gov (United States)

    Price, Morgan; Davies, Iryna; Rusk, Raymond; Lesperance, Mary; Weber, Jens

    2017-06-15

    Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices. Phase 1: In the randomized controlled trial, 40 fully automated STOPP rules were implemented as EMR alerts during a 16-week intervention period. The control group did not receive the 40 STOPP rules (but received other alerts). Participants were recruited through the OSCAR EMR user group mailing list and in person at user group meetings. Results were assessed by querying EMR data PIPs. EMR data quality probes were included. Phase 2: physicians were invited to participate in 1-hour semi-structured interviews to discuss the results. In the EMR, 40 STOPP rules were successfully implemented. Phase 1: A total of 28 physicians from 8 practices were recruited (16 in intervention and 12 in control groups). The calculated PIP rate was 2.6% (138/5308) (control) and 4.11% (768/18,668) (intervention) at baseline. No change in PIPs was observed through the intervention (P=.80). Data quality probes generally showed low use of problem list and medication list. Phase 2: A total of 5 physicians participated. All the participants felt that they were aware of the alerts but commented on workflow and presentation challenges. The calculated PIP rate was markedly less than the expected rate found in literature (2.6% and 4.0% vs 20% in literature). Data quality probes highlighted issues related to completeness of data in areas of the EMR used for PIP reporting and by the decision support such as problem and medication lists. Users also highlighted areas for better integration of STOPP guidelines with

  8. Technological, Economic, and Environmental Optimization of Aluminum Recycling

    Science.gov (United States)

    Ioana, Adrian; Semenescu, Augustin

    2013-08-01

    The four strategic directions (referring to the entire life cycle of aluminum) are as follows: production, primary use, recycling, and reuse. Thus, in this work, the following are analyzed and optimized: reducing greenhouse gas emissions from aluminum production, increasing energy efficiency in aluminum production, maximizing used-product collection, recycling, and reusing. According to the energetic balance at the gaseous environment level, the conductive transfer model is also analyzed through the finished elements method. Several principles of modeling and optimization are presented and analyzed: the principle of analogy, the principle of concepts, and the principle of hierarchization. Based on these principles, an original diagram model is designed together with the corresponding logic diagram. This article also presents and analyzes the main benefits of aluminum recycling and reuse. Recycling and reuse of aluminum have the main advantage that it requires only about 5% of energy consumed to produce it from bauxite. The aluminum recycling and production process causes the emission of pollutants such as dioxides and furans, hydrogen chloride, and particulate matter. To control these emissions, aluminum recyclers are required to comply with the National Emission Standards for Hazardous Air Pollutants for Secondary Aluminum Production. The results of technological, economic, and ecological optimization of aluminum recycling are based on the criteria function's evaluation in the modeling system.

  9. Advances in aluminum anodizing

    Science.gov (United States)

    Dale, K. H.

    1969-01-01

    White anodize is applied to aluminum alloy surfaces by specific surface preparation, anodizing, pigmentation, and sealing techniques. The development techniques resulted in alloys, which are used in space vehicles, with good reflectance values and excellent corrosive resistance.

  10. Corrosion Inhibitors for Aluminum.

    Science.gov (United States)

    Muller, Bodo

    1995-01-01

    Describes a simple and reliable test method used to investigate the corrosion-inhibiting effects of various chelating agents on aluminum pigments in aqueous alkaline media. The experiments that are presented require no complicated or expensive electronic equipment. (DDR)

  11. Corrosion Protection of Aluminum

    Science.gov (United States)

    Dalrymple, R. S.; Nelson, W. B.

    1963-07-01

    Treatment of aluminum-base metal surfaces in an autoclave with an aqueous chromic acid solution of 0.5 to 3% by weight and of pH below 2 for 20 to 50 hrs at 160 to 180 deg C produces an extremely corrosion-resistant aluminum oxidechromium film on the surface. A chromic acid concentration of 1 to 2% and a pH of about 1 are preferred.

  12. 78 FR 38102 - Passenger Vessels Accessibility Guidelines

    Science.gov (United States)

    2013-06-25

    ... Costs and Benefits The primary estimates of the costs and benefits of the proposed guidelines are shown... quantify the benefits of the proposed guidelines due to the nature of the benefits. The proposed guidelines..., transportation, public accommodation, and leisure. The proposed guidelines would enable these individuals to...

  13. Membrane Purification Cell for Aluminum Recycling

    Energy Technology Data Exchange (ETDEWEB)

    David DeYoung; James Wiswall; Cong Wang

    2011-11-29

    Recycling mixed aluminum scrap usually requires adding primary aluminum to the scrap stream as a diluent to reduce the concentration of non-aluminum constituents used in aluminum alloys. Since primary aluminum production requires approximately 10 times more energy than melting scrap, the bulk of the energy and carbon dioxide emissions for recycling are associated with using primary aluminum as a diluent. Eliminating the need for using primary aluminum as a diluent would dramatically reduce energy requirements, decrease carbon dioxide emissions, and increase scrap utilization in recycling. Electrorefining can be used to extract pure aluminum from mixed scrap. Some example applications include producing primary grade aluminum from specific scrap streams such as consumer packaging and mixed alloy saw chips, and recycling multi-alloy products such as brazing sheet. Electrorefining can also be used to extract valuable alloying elements such as Li from Al-Li mixed scrap. This project was aimed at developing an electrorefining process for purifying aluminum to reduce energy consumption and emissions by 75% compared to conventional technology. An electrolytic molten aluminum purification process, utilizing a horizontal membrane cell anode, was designed, constructed, operated and validated. The electrorefining technology could also be used to produce ultra-high purity aluminum for advanced materials applications. The technical objectives for this project were to: - Validate the membrane cell concept with a lab-scale electrorefining cell; - Determine if previously identified voltage increase issue for chloride electrolytes holds for a fluoride-based electrolyte system; - Assess the probability that voltage change issues can be solved; and - Conduct a market and economic analysis to assess commercial feasibility. The process was tested using three different binary alloy compositions (Al-2.0 wt.% Cu, Al-4.7 wt.% Si, Al-0.6 wt.% Fe) and a brazing sheet scrap composition (Al-2

  14. Aluminum industry options paper

    International Nuclear Information System (INIS)

    1999-10-01

    In 1990, Canada's producers of aluminum (third largest in the world) emitted 10 million tonnes of carbon dioxide and equivalent, corresponding to 6.4 tonnes of greenhouse gas intensity per tonne of aluminum. In 2000, the projection is that on a business-as-usual (BAU) basis Canadian producers now producing 60 per cent more aluminum than in 1990, will emit 10.7 million tonnes of carbon dioxide and equivalent, corresponding to a GHG intensity of 4.2 tonnes per tonne of aluminum. This improvement is due to production being based largely on hydro-electricity, and partly because in general, Canadian plants are modern, with technology that is relatively GHG-friendly. The Aluminum Association of Canada estimates that based on anticipated production, and under a BAU scenario, GHG emissions from aluminum production will rise by 18 per cent by 2010 and by 30 per cent by 2020. GHG emissions could be reduced below the BAU forecast first, by new control and monitoring systems at some operations at a cost of $4.5 to 7.5 million per smelter. These systems could reduce carbon dioxide equivalent emissions by 0.8 million tonnes per year. A second alternative would require installation of breaker feeders which would further reduce perfluorocarbon (PFC) emissions by 0.9 million tonnes of carbon dioxide equivalent. Cost of the breakers feeders would be in the order of $200 million per smelter. The third option calls for the the shutting down of some of the smelters with older technology by 2015. In this scenario GHG emissions would be reduced by 2010 by 0.8 million tonnes per year of carbon dioxide equivalent. However, the cost in this case would be about $1.36 billion. The industry would support measures that would encourage the first two sets of actions, which would produce GHG emissions from aluminum production in Canada of about 10.2 million tonnes per year of carbon dioxide equivalent, or about two per cent above 1990 levels with double the aluminum production of 1990. Credit for

  15. Mesoporous aluminum phosphite

    International Nuclear Information System (INIS)

    El Haskouri, Jamal; Perez-Cabero, Monica; Guillem, Carmen; Latorre, Julio; Beltran, Aurelio; Beltran, Daniel; Amoros, Pedro

    2009-01-01

    High surface area pure mesoporous aluminum-phosphorus oxide-based derivatives have been synthesized through an S + I - surfactant-assisted cooperative mechanism by means of a one-pot preparative procedure from aqueous solution and starting from aluminum atrane complexes and phosphoric and/or phosphorous acids. A soft chemical extraction procedure allows opening the pore system of the parent as-prepared materials by exchanging the surfactant without mesostructure collapse. The nature of the pore wall can be modulated from mesoporous aluminum phosphate (ALPO) up to total incorporation of phosphite entities (mesoporous aluminum phosphite), which results in a gradual evolution of the acidic properties of the final materials. While phosphate groups in ALPO act as network building blocks (bridging Al atoms), the phosphite entities become basically attached to the pore surface, what gives practically empty channels. The mesoporous nature of the final materials is confirmed by X-ray diffraction (XRD), transmission electron microscopy (TEM) and N 2 adsorption-desorption isotherms. The materials present regular unimodal pore systems whose order decreases as the phosphite content increases. NMR spectroscopic results confirm the incorporation of oxo-phosphorus entities to the framework of these materials and also provide us useful information concerning the mechanism through which they are formed. - Abstract: TEM image of the mesoporous aluminum phosphite showing the hexagonal disordered pore array that is generated by using surfactant micelles as template. Also a scheme emphasizing the presence of an alumina-rich core and an ALPO-like pore surface is presented.

  16. [Revised practice guideline 'Anaemia in midwifery practice'

    NARCIS (Netherlands)

    Beentjes, M.; Jans, S.M.P.J.

    2012-01-01

    The practice guideline of the Royal Dutch Organization of Midwives 'Anaemia in primary care midwifery practice' published in 2000, has recently been revised. The revised guideline takes physiological haemodilution during pregnancy into consideration and provides gestation specific reference values

  17. Legal duties, professional obligations or notional guidelines? Screening, treatment and referral of domestic violence cases in primary health care settings in South Africa.

    Science.gov (United States)

    Artz, Lillian; Meer, Talia; Aschman, Gray

    2018-06-18

    Since 2013, approximately 4400 women have been murdered by their partners in South Africa. This is five times higher than the per capita global average. Domestic violence is known to be cyclical, endemic and frequently involves multiple victims. It also becomes progressively more dangerous over time and may lead to fatalities. In 2012, the Health Professions Council of South Africa released a domestic violence protocol for emergency service providers. This protocol, or screening guidelines, includes assessing future risk to domestic violence, providing physical and psychosocial care, documentation of evidence of abuse and informing patients of their rights and the services available to them. The extent to which these guidelines have been circulated and implemented, particularly by general health care practitioners (HCPs), is unknown. We review international treaties to which South Africa is a signatory, as well as national legislation and policies that reinforce the right to care for victims of domestic violence, to delineate the implication of these laws and policies for HCPs. We reviewed literature and analysed national and international legislation and policies. The 'norms' contained in existing guidelines and currently practiced in an ad hoc manner are not only compatible with existing statutory duties of HCPs but are in fact a natural extension of them. Proactive interventions such as the use of guidelines for working with victims of domestic violence enable suspected cases of domestic violence to be systematically identified, appropriately managed, properly referred, and should be adopted by all South African HCPs.

  18. Curricular Guidelines for Neuroanatomy.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Presented are the curricular guidelines for Neuroanatomy developed by the Section on Anatomical Sciences of the American Association of Dental Schools for use by individual educational institutions as curriculum development aids. Included are recommendations for primary educational goals, prerequisites, scope, content, behavioral objectives,…

  19. Regeneration of aluminum hydride

    Science.gov (United States)

    Graetz, Jason Allan; Reilly, James J; Wegrzyn, James E

    2012-09-18

    The present invention provides methods and materials for the formation of hydrogen storage alanes, AlH.sub.x, where x is greater than 0 and less than or equal to 6 at reduced H.sub.2 pressures and temperatures. The methods rely upon reduction of the change in free energy of the reaction between aluminum and molecular H.sub.2. The change in free energy is reduced by lowering the entropy change during the reaction by providing aluminum in a state of high entropy, and by increasing the magnitude of the change in enthalpy of the reaction or combinations thereof.

  20. Regeneration of aluminum hydride

    Science.gov (United States)

    Graetz, Jason Allan; Reilly, James J.

    2009-04-21

    The present invention provides methods and materials for the formation of hydrogen storage alanes, AlH.sub.x, where x is greater than 0 and less than or equal to 6 at reduced H.sub.2 pressures and temperatures. The methods rely upon reduction of the change in free energy of the reaction between aluminum and molecular H.sub.2. The change in free energy is reduced by lowering the entropy change during the reaction by providing aluminum in a state of high entropy, by increasing the magnitude of the change in enthalpy of the reaction or combinations thereof.

  1. Strategies for Primary Prevention of Coronary Heart Disease Based on Risk Stratification by the ACC/AHA Lipid Guidelines, ATP III Guidelines, Coronary Calcium Scoring, and C-Reactive Protein, and a Global Treat-All Strategy: A Comparative--Effectiveness Modeling Study.

    Directory of Open Access Journals (Sweden)

    Benjamin Z Galper

    Full Text Available Several approaches have been proposed for risk-stratification and primary prevention of coronary heart disease (CHD, but their comparative and cost-effectiveness is unknown.We constructed a state-transition microsimulation model to compare multiple approaches to the primary prevention of CHD in a simulated cohort of men aged 45-75 and women 55-75. Risk-stratification strategies included the 2013 American College of Cardiology/American Heart Association (ACC/AHA guidelines on the treatment of blood cholesterol, the Adult Treatment Panel (ATP III guidelines, and approaches based on coronary artery calcium (CAC scoring and C-reactive protein (CRP. Additionally we assessed a treat-all strategy in which all individuals were prescribed either moderate-dose or high-dose statins and all males received low-dose aspirin. Outcome measures included CHD events, costs, medication-related side effects, radiation-attributable cancers, and quality-adjusted-life-years (QALYs over a 30-year timeframe.Treat-all with high-dose statins dominated all other strategies for both men and women, gaining 15.7 million QALYs, preventing 7.3 million myocardial infarctions, and saving over $238 billion, compared to the status quo, far outweighing its associated adverse events including bleeding, hepatitis, myopathy, and new-onset diabetes. ACC/AHA guidelines were more cost-effective than ATP III guidelines for both men and women despite placing 8.7 million more people on statins. For women at low CHD risk, treat-all with high-dose statins was more likely to cause a statin-related adverse event than to prevent a CHD event.Despite leading to a greater proportion of the population placed on statin therapy, the ACC/AHA guidelines are more cost-effective than ATP III. Even so, at generic prices, treating all men and women with statins and all men with low-dose aspirin appears to be more cost-effective than all risk-stratification approaches for the primary prevention of CHD

  2. Strategies for Primary Prevention of Coronary Heart Disease Based on Risk Stratification by the ACC/AHA Lipid Guidelines, ATP III Guidelines, Coronary Calcium Scoring, and C-Reactive Protein, and a Global Treat-All Strategy: A Comparative--Effectiveness Modeling Study

    Science.gov (United States)

    Galper, Benjamin Z.; Wang, Y. Claire; Einstein, Andrew J.

    2015-01-01

    Background Several approaches have been proposed for risk-stratification and primary prevention of coronary heart disease (CHD), but their comparative and cost-effectiveness is unknown. Methods We constructed a state-transition microsimulation model to compare multiple approaches to the primary prevention of CHD in a simulated cohort of men aged 45–75 and women 55–75. Risk-stratification strategies included the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on the treatment of blood cholesterol, the Adult Treatment Panel (ATP) III guidelines, and approaches based on coronary artery calcium (CAC) scoring and C-reactive protein (CRP). Additionally we assessed a treat-all strategy in which all individuals were prescribed either moderate-dose or high-dose statins and all males received low-dose aspirin. Outcome measures included CHD events, costs, medication-related side effects, radiation-attributable cancers, and quality-adjusted-life-years (QALYs) over a 30-year timeframe. Results Treat-all with high-dose statins dominated all other strategies for both men and women, gaining 15.7 million QALYs, preventing 7.3 million myocardial infarctions, and saving over $238 billion, compared to the status quo, far outweighing its associated adverse events including bleeding, hepatitis, myopathy, and new-onset diabetes. ACC/AHA guidelines were more cost-effective than ATP III guidelines for both men and women despite placing 8.7 million more people on statins. For women at low CHD risk, treat-all with high-dose statins was more likely to cause a statin-related adverse event than to prevent a CHD event. Conclusions Despite leading to a greater proportion of the population placed on statin therapy, the ACC/AHA guidelines are more cost-effective than ATP III. Even so, at generic prices, treating all men and women with statins and all men with low-dose aspirin appears to be more cost-effective than all risk-stratification approaches for the

  3. Aluminum Hydroxide and Magnesium Hydroxide

    Science.gov (United States)

    Aluminum Hydroxide, Magnesium Hydroxide are antacids used together to relieve heartburn, acid indigestion, and upset stomach. They ... They combine with stomach acid and neutralize it. Aluminum Hydroxide, Magnesium Hydroxide are available without a prescription. ...

  4. Role of iron and aluminum coagulant metal residuals and lead release from drinking water pipe materials.

    Science.gov (United States)

    Knowles, Alisha D; Nguyen, Caroline K; Edwards, Marc A; Stoddart, Amina; McIlwain, Brad; Gagnon, Graham A

    2015-01-01

    Bench-scale experiments investigated the role of iron and aluminum residuals in lead release in a low alkalinity and high (> 0.5) chloride-to-sulfate mass ratio (CSMR) in water. Lead leaching was examined for two lead-bearing plumbing materials, including harvested lead pipe and new lead: tin solder, after exposure to water with simulated aluminum sulfate, polyaluminum chloride and ferric sulfate coagulation treatments with 1-25-μM levels of iron or aluminum residuals in the water. The release of lead from systems with harvested lead pipe was highly correlated with levels of residual aluminum or iron present in samples (R(2) = 0.66-0.88), consistent with sorption of lead onto the aluminum and iron hydroxides during stagnation. The results indicate that aluminum and iron coagulant residuals, at levels complying with recommended guidelines, can sometimes play a significant role in lead mobilization from premise plumbing.

  5. Electrically conductive anodized aluminum coatings

    Science.gov (United States)

    Alwitt, Robert S. (Inventor); Liu, Yanming (Inventor)

    2001-01-01

    A process for producing anodized aluminum with enhanced electrical conductivity, comprising anodic oxidation of aluminum alloy substrate, electrolytic deposition of a small amount of metal into the pores of the anodized aluminum, and electrolytic anodic deposition of an electrically conductive oxide, including manganese dioxide, into the pores containing the metal deposit; and the product produced by the process.

  6. Preventive evidence into practice (PEP study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Harris Mark F

    2013-01-01

    Full Text Available Abstract Background There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession. Methods We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20% and increased adherence to guideline recommendations for: the management of CVD and diabetes risk factors (by 20%; and lifestyle and physiological risk factors of patients at risk (by 5%. Thirty-two general practices will be randomised in a 1:1 allocation to receive either the intervention or continue with usual care, after stratification by state. The intervention will be delivered through: small group education; audit of patient records to determine preventive care; and practice facilitation visits adapted to the needs of the practices. Outcome data will be extracted from electronic medical records and patient questionnaires, and qualitative evaluation from provider and patient interviews. Discussion We plan to disseminate study findings widely and directly inform implementation strategies by governments, professional bodies, and non-government organisations including the partner organisations.

  7. Fluxless aluminum brazing

    Science.gov (United States)

    Werner, W.J.

    1974-01-01

    This invention relates to a fluxless brazing alloy for use in forming brazed composites made from members of aluminum and its alloys. The brazing alloy consists of 35-55% Al, 10--20% Si, 25-60% Ge; 65-88% Al, 2-20% Si, 2--18% In; 65--80% Al, 15-- 25% Si, 5- 15% Y. (0fficial Gazette)

  8. Aluminum Corrosion and Turbidity

    International Nuclear Information System (INIS)

    Longtin, F.B.

    2003-01-01

    Aluminum corrosion and turbidity formation in reactors correlate with fuel sheath temperature. To further substantiate this correlation, discharged fuel elements from R-3, P-2 and K-2 cycles were examined for extent of corrosion and evidence of breaking off of the oxide film. This report discusses this study

  9. Aluminum concentration in hydrangeas

    International Nuclear Information System (INIS)

    Yanagawa, M.; Haruyama, Y.; Saito, M.

    2008-01-01

    We have been trying to measure concentration of aluminum in Ajisai, Hydrangea macrophylla for these days. But due to bad luck, we have encountered detector trouble for two years in a low. Thus, we have few data to analyze and obtained quite limited results. (author)

  10. BWR emergency procedure guidelines

    International Nuclear Information System (INIS)

    Post, J.S.; Karner, E.F.; Stratman, R.A.

    1984-01-01

    This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

  11. ALUMINUM AND CHROMIUM LEACHING WORKSHOP WHITEPAPER

    International Nuclear Information System (INIS)

    McCabe, D; Jeff Pike, J; Bill Wilmarth, B

    2007-01-01

    A workshop was held on January 23-24, 2007 to discuss the status of processes to leach constituents from High Level Waste (HLW) sludges at the Hanford and Savannah River Sites. The objective of the workshop was to examine the needs and requirements for the HLW flowsheet for each site, discuss the status of knowledge of the leaching processes, communicate the research plans, and identify opportunities for synergy to address knowledge gaps. The purpose of leaching of non-radioactive constituents from the sludge waste is to reduce the burden of material that must be vitrified in the HLW melter systems, resulting in reduced HLW glass waste volume, reduced disposal costs, shorter process schedules, and higher facility throughput rates. The leaching process is estimated to reduce the operating life cycle of SRS by seven years and decrease the number of HLW canisters to be disposed in the Repository by 1000 [Gillam et al., 2006]. Comparably at Hanford, the aluminum and chromium leaching processes are estimated to reduce the operating life cycle of the Waste Treatment Plant by 20 years and decrease the number of canisters to the Repository by 15,000-30,000 [Gilbert, 2007]. These leaching processes will save the Department of Energy (DOE) billions of dollars in clean up and disposal costs. The primary constituents targeted for removal by leaching are aluminum and chromium. It is desirable to have some aluminum in glass to improve its durability; however, too much aluminum can increase the sludge viscosity, glass viscosity, and reduce overall process throughput. Chromium leaching is necessary to prevent formation of crystalline compounds in the glass, but is only needed at Hanford because of differences in the sludge waste chemistry at the two sites. Improving glass formulations to increase tolerance of aluminum and chromium is another approach to decrease HLW glass volume. It is likely that an optimum condition can be found by both performing leaching and improving

  12. Achieving Carbon Neutrality in the Global Aluminum Industry

    Science.gov (United States)

    Das, Subodh

    2012-02-01

    In the 21st century, sustainability is widely regarded as the new corporate culture, and leading manufacturing companies (Toyota, GE, and Alcoa) and service companies (Google and Federal Express) are striving towards carbon neutrality. The current carbon footprint of the global aluminum industry is estimated at 500 million metric tonnes carbon dioxide equivalent (CO2eq), representing about 1.7% of global emissions from all sources. For the global aluminum industry, carbon neutrality is defined as a state where the total "in-use" CO2eq saved from all products in current use, including incremental process efficiency improvements, recycling, and urban mining activities, equals the CO2eq expended to produce the global output of aluminum. This paper outlines an integrated and quantifiable plan for achieving "carbon neutrality" in the global aluminum industry by advocating five actionable steps: (1) increase use of "green" electrical energy grid by 8%, (2) reduce process energy needs by 16%, (3) deploy 35% of products in "in-use" energy saving applications, (4) divert 6.1 million metric tonnes/year from landfills, and (5) mine 4.5 million metric tonnes/year from aluminum-rich "urban mines." Since it takes 20 times more energy to make aluminum from bauxite ore than to recycle it from scrap, the global aluminum industry could set a reasonable, self-imposed energy/carbon neutrality goal to incrementally increase the supply of recycled aluminum by at least 1.05 metric tonnes for every tonne of incremental production via primary aluminum smelter capacity. Furthermore, the aluminum industry can and should take a global leadership position by actively developing internationally accepted and approved carbon footprint credit protocols.

  13. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Painuly, J.P.; Turkson, J.; Meyer, H.J.; Markandya, A.

    1999-09-01

    This document is a summary version of the methodological guidelines for climate change mitigation assessment developed as part of the Global Environment Facility (GEF) project Economics of Greenhouse Gas Limitations; Methodological Guidelines. The objectives of this project have been to develop a methodology, an implementing framework and a reporting system which countries can use in the construction of national climate change mitigation policies and in meeting their future reporting obligations under the FCCC. The methodological framework developed in the Methodological Guidelines covers key economic concepts, scenario building, modelling tools and common assumptions. It was used by several country studies included in the project. (au) 13 refs.

  14. Borated aluminum alloy manufacturing technology

    International Nuclear Information System (INIS)

    Shimojo, Jun; Taniuchi, Hiroaki; Kajihara, Katsura; Aruga, Yasuhiro

    2003-01-01

    Borated aluminum alloy is used as the basket material of cask because of its light weight, thermal conductivity and superior neutron absorbing abilities. Kobe Steel has developed a unique manufacturing process for borated aluminum alloy using a vacuum induction melting method. In this process, aluminum alloy is melted and agitated at higher temperatures than common aluminum alloy fabrication methods. It is then cast into a mold in a vacuum atmosphere. The result is a high quality aluminum alloy which has a uniform boron distribution and no impurities. (author)

  15. Interconnection Guidelines

    Science.gov (United States)

    The Interconnection Guidelines provide general guidance on the steps involved with connecting biogas recovery systems to the utility electrical power grid. Interconnection best practices including time and cost estimates are discussed.

  16. Effluent Guidelines

    Science.gov (United States)

    Effluent guidelines are national standards for wastewater discharges to surface waters and municipal sewage treatment plants. We issue the regulations for industrial categories based on the performance of treatment and control technologies.

  17. OSART guidelines

    International Nuclear Information System (INIS)

    1988-02-01

    The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the operational safety of nuclear power plants. These OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness

  18. A cluster randomized trial to improve adherence to evidence-based guidelines on diabetes and reduce clinical inertia in primary care physicians in Belgium: study protocol [NTR 1369].

    NARCIS (Netherlands)

    Borgermans, L.D.A.; Goderis, G.; Broeke, C.V.; Mathieu, C.; Aertgeerts, B.; Verbeke, G.; Carbonez, A.; Ivanova, A.; Grol, R.P.T.M.; Heyrman, J.

    2008-01-01

    ABSTRACT: BACKGROUND: Most quality improvement programs in diabetes care incorporate aspects of clinician education, performance feedback, patient education, care management, and diabetes care teams to support primary care physicians. Few studies have applied all of these dimensions to address

  19. Analysis of Aluminum Resource Supply Structure and Guarantee Degree in China Based on Sustainable Perspective

    Directory of Open Access Journals (Sweden)

    Shaoli Liu

    2016-12-01

    Full Text Available Aluminum is a strategic mineral resource, and China’s aluminum production and consumption is fairly large. However, its supply guarantee is uncertain because of a high dependency on external raw materials. This uncertainty may expand, so finding a way to reduce the uncertainty of aluminum resource supply is especially important. This paper applies the SFA method to analyze the aluminum flows in mainland China from 1996 to 2014, and establishes a supply structure model to measure its supply guarantee degree. The results claim that: (1 China’s aluminum production can satisfy demand and even create a surplus; (2 Domestic self-productive primary and secondary aluminum increased at an annual rate of 12% and 24%; (3 The proportion of self-productive secondary aluminum in the supply structure increased from 7.7% in 1996 to 12.8% in 2014, while that of primary aluminum decreased from 79.6% to 42.8%; (4 The total supply guarantee degree decreased from 87.3% to 55.6% in this period. These results provide a feasible way to solve this plight: the proportion of secondary aluminum in the supply structure should be enhanced, and an efficient aluminum resource recycling system needs to be established as soon as possible to ensure its sustainable supply.

  20. Dutch physiotherapy guidelines for low back pain

    NARCIS (Netherlands)

    Bekkering, Geertruida E; Hendriks, H.J.M.; Koes, Bart W; Oostendorp, R. A B; Ostelo, R. W J G; Thomassen, J. M C; van Tulder, M. W.

    2003-01-01

    Many guidelines for the management of low back pain in primary care have been published during recent years, but guidelines for physiotherapy do not yet exist. Therefore, physiotherapy guidelines have been developed, reflecting the consequences of the current state of knowledge of effective and

  1. Phases in lanthanum-nickel-aluminum alloys

    International Nuclear Information System (INIS)

    Mosley, W.C.

    1992-01-01

    Lanthanum-nickel-aluminum (LANA) alloys will be used to pump, store and separate hydrogen isotopes in the Replacement Tritium Facility (RTF). The aluminum content (y) of the primary LaNi 5 -phase is controlled to produce the desired pressure-temperature behavior for adsorption and desorption of hydrogen. However, secondary phases cause decreased capacity and some may cause undesirable retention of tritium. Twenty-three alloys purchased from Ergenics, Inc. for development of RTF processes have been characterized by scanning electron microscopy (SEM) and by electron microprobe analysis (EMPA) to determine the distributions and compositions of constituent phases. This memorandum reports the results of these characterization studies. Knowledge of the structural characteristics of these alloys is a useful first step in selecting materials for specific process development tests and in interpreting results of those tests. Once this information is coupled with data on hydrogen plateau pressures, retention and capacity, secondary phase limits for RTF alloys can be specified

  2. Aluminum recycling—An integrated, industrywide approach

    Science.gov (United States)

    Das, Subodh K.; Green, John A. S.; Kaufman, J. Gilbert; Emadi, Daryoush; Mahfoud, M.

    2010-02-01

    The aluminum industry is a leading proponent of global sustainability and strongly advocates the use of recycled metal. As the North American primary aluminum industry continues to move offshore to other geographic areas such as Iceland and the Middle East, where energy is more readily available at lower cost, the importance of the secondary (i.e., recycled metal) market in the U.S. will continue to increase. The purpose of this paper is to take an integrated, industry-wide look at the recovery of material from demolished buildings, shredded automobiles, and aging aircraft, as well as from traditional cans and other rigid containers. Attempts will be made to assess how the different alloys used in these separate markets can be recycled in the most energy-efficient manner.

  3. Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

    NARCIS (Netherlands)

    Avendonk, M.J.P van; Mensink, P.A.J.S.; Drenthen, A.J.; Binsbergen, J.J. van

    2012-01-01

    The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines.

  4. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    Full Text Available Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.  http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionPAGE CONTENTSGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because

  5. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    -only material should be submitted and sent for peer review simultaneously with the primary manuscript. 2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because they help authors describe the study in enough detail for it to be evaluated by editors, reviewers, readers, and other researchers evaluating the medical literature. Authors of review manuscripts are encouraged to describe the methods used for locating, selecting, extracting, and synthesizing data; this is mandatory for systematic reviews. Good sources for reporting guidelines are the EQUATOR Network and the NLM's Research Reporting Guidelines and Initiatives. 3. Manuscript SectionsThe following are general requirements for reporting within sections of all study designs and manuscript formats. a. Title Page General information about an article and its authors is presented on a manuscript title page and usually includes the article title, author information, any disclaimers, sources of support, word count, and sometimes the number of tables and figures. Article title. The title provides a distilled description of the complete article and should include information that, along with the Abstract, will make electronic retrieval of the article sensitive and specific. Reporting guidelines recommend and some journals require that information about the study design be a part of the title (particularly important for randomized trials and systematic reviews and meta-analyses. Some journals require a short title, usually no more than 40 characters (including letters and spaces on the title page or as a separate entry in an electronic submission system. Electronic submission systems may restrict the number of characters in the title

  6. 21 CFR 73.1645 - Aluminum powder.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Aluminum powder. 73.1645 Section 73.1645 Food and... ADDITIVES EXEMPT FROM CERTIFICATION Drugs § 73.1645 Aluminum powder. (a) Identity. (1) The color additive aluminum powder shall be composed of finely divided particles of aluminum prepared from virgin aluminum. It...

  7. Aluminum fin-stock alloys

    International Nuclear Information System (INIS)

    Gul, R.M.; Mutasher, F.

    2007-01-01

    Aluminum alloys have long been used in the production of heat exchanger fins. The comparative properties of the different alloys used for this purpose has not been an issue in the past, because of the significant thickness of the finstock material. However, in order to make fins lighter in weight, there is a growing demand for thinner finstock materials, which has emphasized the need for improved mechanical properties, thermal conductivity and corrosion resistance. The objective of this project is to determine the effect of iron, silicon and manganese percentage increment on the required mechanical properties for this application by analyzing four different aluminum alloys. The four selected aluminum alloys are 1100, 8011, 8079 and 8150, which are wrought non-heat treatable alloys with different amount of the above elements. Aluminum alloy 1100 serve as a control specimen, as it is commercially pure aluminum. The study also reports the effect of different annealing cycles on the mechanical properties of the selected alloys. Metallographic examination was also preformed to study the effect of annealing on the precipitate phases and the distribution of these phases for each alloy. The microstructure analysis of the aluminum alloys studied indicates that the precipitated phase in the case of aluminum alloys 1100 and 8079 is beta-FeAI3, while in 8011 it is a-alfa AIFeSi, and the aluminum alloy 8150 contains AI6(Mn,Fe) phase. The comparison of aluminum alloys 8011 and 8079 with aluminum alloy 1100 show that the addition of iron and silicon improves the percent elongation and reduces strength. The manganese addition increases the stability of mechanical properties along the annealing range as shown by the comparison of aluminum alloy 8150 with aluminum alloy 1100. Alloy 8150 show superior properties over the other alloys due to the reaction of iron and manganese, resulting in a preferable response to thermal treatment and improved mechanical properties. (author)

  8. Atenção primária à saúde: diretrizes, desafios e recomendações. Revisão de bibliografia internacional Primary health care: guidelines, challenges and recommendations. A review of international literature

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo Silva Souza

    2011-01-01

    Full Text Available Apresentamos uma revisão de bibliografia internacional que teve por objetivo identificar e analisar a diversidade de temas associados à Atenção Primária à Saúde, especialmente o cotidiano de trabalho de seus profissionais, suas diretrizes e seus desafios políticos e clínicos. Analisamos os resumos de 105 artigos publicados entre 1999 e 2009. Selecionamos, para análise, 34 artigos identificados de acordo com critérios específicos. Criamos categorias temáticas e comparamos os dados com certa literatura brasileira sobre o tema. Os artigos centram-se no profissional de medicina e enfatizam a noção de medicina baseada em evidências. Abordam principalmente a implementação de diretrizes na Atenção Primária e as relações entre profissionais e usuários. Admitem a complexidade da Atenção Primária e a importância de aproximação à realidade dos pacientes. Entretanto, não abordam a intersetorialidade, não questionam radicalmente o especialismo curativista e não mencionam a promoção de cidadania, autonomia e cogestão junto aos usuários. Falam da necessidade de abordar problemas "humanos" nos níveis de implementação de diretrizes, encontro clínico etc., mas se mostram distanciados das ciências humanas.We present a review of international literature, aiming at identifying and analyzing the diversity of themes associated to Primary Health Care. We focused on the characteristics of the work of health care personnel, its guidelines and its political and clinical challenges. We analyzed the abstracts of 105 articles published between 1999 and 2009. Then, we integrally read and analyzed 34 articles, creating thematic categories. We compared data to Brazilian literature on the subject. The articles focus on physician's work and emphasize the notion of evidence-based medicine. They mainly approach the implementation of guidelines to primary health care and the professional-patient relations. They acknowledge the complexity of

  9. Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care--the Management of OsteoArthritis In Consultations (MOSAICS) study protocol.

    Science.gov (United States)

    Dziedzic, Krysia S; Healey, Emma L; Porcheret, Mark; Ong, Bie Nio; Main, Chris J; Jordan, Kelvin P; Lewis, Martyn; Edwards, John J; Jinks, Clare; Morden, Andrew; McHugh, Gretl A; Ryan, Sarah; Finney, Andrew; Jowett, Sue; Oppong, Raymond; Afolabi, Ebenezer; Pushpa-Rajah, Angela; Handy, June; Clarkson, Kris; Mason, Elizabeth; Whitehurst, Tracy; Hughes, Rhian W; Croft, Peter R; Hay, Elaine M

    2014-08-27

    There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving 'quality markers' of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain. A mixed methods study with a nested cluster randomised controlled trial. This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive 'whole-system' evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations

  10. The impact of a primary care e-communication intervention on the participation of chronic disease patients who had not reached guideline suggested treatment goals.

    Science.gov (United States)

    Lussier, Marie-Thérèse; Richard, Claude; Glaser, Emma; Roberge, Denis

    2016-04-01

    To evaluate the efficacy of two web-based educational approaches on doctor-patient communication. The study focused on chronic disease (CD) patients in a lengthy relationship with their family physician (FP) who had not reached guideline suggested treatment goals (off-target) for their CDs. 322 hypertensive, diabetic, or dyslipidemic patients of 18 FPs were randomised into three groups: Usual Care (UC), e-Learning (e-L) and e-Learning+Workshop (e-L+W). Interventions were based on Cegala's PACE system: Prepare, Ask questions, Check understanding, Express concerns. Communication was evaluated using the Roter Interaction Analysis System (RIAS), MEDICODE and questionnaires. Encounter length was similar across groups. RIAS showed that e-L+W group engaged in more socio-emotional talk and PACE-like utterances. MEDICODE showed that interventions increased frequency, initiative and dialogue for selected CD medication themes. Quality of communication was perceived as satisfactory at baseline and did not change. Following interventions, CD patients were more activated even in well-established doctor-patient relationships. PACE web-based interventions are accessible and effective at increasing CD patients' participation. They increase legitimacy to express the patient experience. FPs should present this type of training to CD patients as an integral part of their routine practice and consider referring patients to complete it. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Adherence to treatment guidelines for primary sarcomas affects patient survival: a side study of the European CONnective TIssue CAncer NETwork (CONTICANET).

    Science.gov (United States)

    Rossi, C R; Vecchiato, A; Mastrangelo, G; Montesco, M C; Russano, F; Mocellin, S; Pasquali, S; Scarzello, G; Basso, U; Frasson, A; Pilati, P; Nitti, D; Lurkin, A; Ray-Coquard, I

    2013-06-01

    The impact of adherence to clinical practice guidelines (CPGs) for loco-regional treatment (i.e. surgery and radiotherapy) and chemotherapy on local disease control and survival in sarcoma patients was investigated in a European study conducted in an Italian region (Veneto). The completeness of the adherence to the Italian CPGs for sarcomas treatment was assessed by comparing the patient's charts and the CPGs. Propensity score-adjusted multivariate survival analysis was used to assess the impact of CPGs adherence on patient clinical outcomes. A total of 151 patients were included. Adherence to CPGs for loco-regional therapy and chemotherapy was observed in 106 out of 147 (70.2%) and 129 out of 139 (85.4%) patients, respectively. Non-adherence to CPGs for loco-regional treatment was independently associated with AJCC stage III disease [odds ratio (OR) 1.77, P = 0.011] and tumor-positive excision margin (OR 3.55, P = 0.003). Patients not treated according to the CPGs were at a higher risk of local recurrence [hazard ratio (HR) 5.4, P < 0.001] and had a shorter sarcoma-specific survival (HR 4.05, P < 0.001), independently of tumor stage. Incomplete adherence to CPGs for loco-regional treatment of sarcomas was associated with worse prognosis in patients with non-metastatic tumors.

  12. Production of aluminum metal by electrolysis of aluminum sulfide

    Science.gov (United States)

    Minh, Nguyen Q.; Loutfy, Raouf O.; Yao, Neng-Ping

    1984-01-01

    Production of metallic aluminum by the electrolysis of Al.sub.2 S.sub.3 at 700.degree.-800.degree. C. in a chloride melt composed of one or more alkali metal chlorides, and one or more alkaline earth metal chlorides and/or aluminum chloride to provide improved operating characteristics of the process.

  13. Helium trapping in aluminum and sintered aluminum powders

    International Nuclear Information System (INIS)

    Das, S.K.; Kaminsky, M.; Rossing, T.

    1975-01-01

    The surface erosion of annealed aluminum and of sintered aluminum powder (SAP) due to blistering from implantation of 100-keV 4 He + ions at room temperature has been investigated. A substantial reduction in the blistering erosion rate in SAP was observed from that in pure annealed aluminum. In order to determine whether the observed reduction in blistering is due to enhanced helium trapping or due to helium released, the implanted helium profiles in annealed aluminum and in SAP have been studied by Rutherford backscattering. The results show that more helium is trapped in SAP than in aluminum for identical irradiation conditions. The observed reduction in erosion from helium blistering in SAP is more likely due to the dispersion of trapped helium at the large Al-Al 2 O 3 interfaces and at the large grain boundaries in SAP than to helium release

  14. Selective Adsorption of Sodium Aluminum Fluoride Salts from Molten Aluminum

    Energy Technology Data Exchange (ETDEWEB)

    Leonard S. Aubrey; Christine A. Boyle; Eddie M. Williams; David H. DeYoung; Dawid D. Smith; Feng Chi

    2007-08-16

    Aluminum is produced in electrolytic reduction cells where alumina feedstock is dissolved in molten cryolite (sodium aluminum fluoride) along with aluminum and calcium fluorides. The dissolved alumina is then reduced by electrolysis and the molten aluminum separates to the bottom of the cell. The reduction cell is periodically tapped to remove the molten aluminum. During the tapping process, some of the molten electrolyte (commonly referred as “bath” in the aluminum industry) is carried over with the molten aluminum and into the transfer crucible. The carryover of molten bath into the holding furnace can create significant operational problems in aluminum cast houses. Bath carryover can result in several problems. The most troublesome problem is sodium and calcium pickup in magnesium-bearing alloys. Magnesium alloying additions can result in Mg-Na and Mg-Ca exchange reactions with the molten bath, which results in the undesirable pickup of elemental sodium and calcium. This final report presents the findings of a project to evaluate removal of molten bath using a new and novel micro-porous filter media. The theory of selective adsorption or removal is based on interfacial surface energy differences of molten aluminum and bath on the micro-porous filter structure. This report describes the theory of the selective adsorption-filtration process, the development of suitable micro-porous filter media, and the operational results obtained with a micro-porous bed filtration system. The micro-porous filter media was found to very effectively remove molten sodium aluminum fluoride bath by the selective adsorption-filtration mechanism.

  15. Methodological guidelines

    International Nuclear Information System (INIS)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-01-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs

  16. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-04-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs.

  17. AIDS guidelines.

    Science.gov (United States)

    Berger, R

    1986-04-30

    The Sun article, "Employers finding that AIDS in the workplace is a managerial nightmare" (April 3), did not accurately portray the status of AIDS in the workplace. The AIDS virus, HTLV III, is transmitted by body fluids, primarily semen and blood, and there is no known risk of transmitting the virus by casual contact in the workplace. The Center for Disease Control (CDC) released guidelines for child care workers last August. Guidelines on preventing transmission of AIDS in the workplace were issued by CDC in November 1985. These guidelines specifically discussed health care, personal service, and food service workers. The recommendations were against routine screening. Furthermore, employment should not be restricted on the basis of a positive HTLV III antibody test. A person with HTLV III infection should be exempt from the workplace only if there are circumstances interfering with job performance. In Maryland, the Governor's Task Force on AIDS has gone on record as endorsing CDC guidelines related to employment. Furthermore, the task force condemns discrimination based on the disease AIDS, AIDS Related Complex (ARC), or HTLV III infection. Increasingly AIDS patients are being considered legally disabled and therefore are protected by federal and state laws prohibiting discrimination on the basis of a handicap. Marylanders who are subjected to mandatory HTLV III screening in the workplace, or if discriminated against on the basis of HTLV III inefction, should contact the Maryland Commission on Human Relations, the Maryland Department of Health and Mental Hygiene, or the Health Education Resource Organization (HERO). All 3 of these resources guarantee confidentiality. It is only by employees reporting incidents that a nightmare in the workplace can be avoided in Maryland. full text

  18. GRADE guidelines

    DEFF Research Database (Denmark)

    Guyatt, Gordon H; Thorlund, Kristian; Oxman, Andrew D

    2013-01-01

    Presenting continuous outcomes in Summary of Findings tables presents particular challenges to interpretation. When each study uses the same outcome measure, and the units of that measure are intuitively interpretable (e.g., duration of hospitalization, duration of symptoms), presenting differences...... and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  19. ASCOT guidelines

    International Nuclear Information System (INIS)

    1994-05-01

    These guidelines describe an approach used in conducting an Assessment of Safety Culture in Organizations Team (ASCOT) review. They are intended to assist the team members in conducting their reviews and at the same time provide guidance to hosts preparing to receive an ASCOT review. They may also be used by any organization wishing to conduct their own self-assessment of safety culture, independent of an ASCOT review

  20. Aluminum anode for aluminum-air battery - Part I: Influence of aluminum purity

    Science.gov (United States)

    Cho, Young-Joo; Park, In-Jun; Lee, Hyeok-Jae; Kim, Jung-Gu

    2015-03-01

    2N5 commercial grade aluminum (99.5% purity) leads to the lower aluminum-air battery performances than 4N high pure grade aluminum (99.99% purity) due to impurities itself and formed impurity complex layer which contained Fe, Si, Cu and others. The impurity complex layer of 2N5 grade Al declines the battery voltage on standby status. It also depletes discharge current and battery efficiency at 1.0 V which is general operating voltage of aluminum-air battery. However, the impurity complex layer of 2N5 grade Al is dissolved with decreasing discharge voltage to 0.8 V. This phenomenon leads to improvement of discharge current density and battery efficiency by reducing self-corrosion reaction. This study demonstrates the possibility of use of 2N5 grade Al which is cheaper than 4N grade Al as the anode for aluminum-air battery.

  1. Invisible Display in Aluminum

    DEFF Research Database (Denmark)

    Prichystal, Jan Phuklin; Hansen, Hans Nørgaard; Bladt, Henrik Henriksen

    2005-01-01

    Bang & Olufsen a/s has been working with ideas for invisible integration of displays in metal surfaces. Invisible integration of information displays traditionally has been possible by placing displays behind transparent or semitransparent materials such as plastic or glass. The wish for an integ......Bang & Olufsen a/s has been working with ideas for invisible integration of displays in metal surfaces. Invisible integration of information displays traditionally has been possible by placing displays behind transparent or semitransparent materials such as plastic or glass. The wish...... for an integrated display in a metal surface is often ruled by design and functionality of a product. The integration of displays in metal surfaces requires metal removal in order to clear the area of the display to some extent. The idea behind an invisible display in Aluminum concerns the processing of a metal...

  2. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    to food and eating and the emergence of proposals for integrated guidelines. It explores the conflicts and controversies that have arisen in the wake of the various proposals and identifies a number of different types of conflicts. These relate to conflicts of interests between the various actors involved...... and political resistance against initiatives that are perceived as being in conflict with the values of a market economy and free trade. Furthermore, there are controversies that can be broadly characterised as relating to the politics of knowledge and have to do with the differentiation of expertise...

  3. [Microbiological corrosion of aluminum alloys].

    Science.gov (United States)

    Smirnov, V F; Belov, D V; Sokolova, T N; Kuzina, O V; Kartashov, V R

    2008-01-01

    Biological corrosion of ADO quality aluminum and aluminum-based construction materials (alloys V65, D16, and D16T) was studied. Thirteen microscopic fungus species and six bacterial species proved to be able to attack aluminum and its alloys. It was found that biocorrosion of metals by microscopic fungi and bacteria was mediated by certain exometabolites. Experiments on biocorrosion of the materials by the microscopic fungus Alternaria alternata, the most active biodegrader, demonstrated that the micromycete attack started with the appearance of exudate with pH 8-9 on end faces of the samples.

  4. Aluminum hydroxide issue closure package

    International Nuclear Information System (INIS)

    Bergman, T.B.

    1998-01-01

    Aluminum hydroxide coatings on fuel elements stored in aluminum canisters in K West Basin were measured in July and August 1998. Good quality data was produced that enabled statistical analysis to determine a bounding value for aluminum hydroxide at a 99% confidence level. The updated bounding value is 10.6 kg per Multi-Canister Overpack (MCO), compared to the previously estimated bounding value of 8 kg/MCO. Thermal analysis using the updated bounding value, shows that the MCO generates oxygen concentrate that are below the lower flammability limits during the 40-year interim storage period and are, therefore, acceptable

  5. Packaging material and aluminum. Hoso zairyo to aluminum

    Energy Technology Data Exchange (ETDEWEB)

    Itaya, T [Mitsubishi Aluminum Co. Ltd., Tokyo (Japan)

    1992-02-01

    The present paper introduces aluminum foil packaging materials among the relation between packing materials and aluminum. The characteristics of aluminum foil in the packaging area are in its barrier performance, non-toxicity, tastelessness and odorlessness. Its excellent functions and processibility suit best as functional materials for food, medicine and industrial material packaging. While an aluminum foil may be used as a single packing material as in foils used in homes, many of it as a packaging material are used in combination with adhesives, papers or plastic films, or coated or printed. It is used as composite materials laminated or coated with other materials according to their use for the purpose of complementing the aluminum foil as the base material. Representative method to laminate aluminum foils include the wet lamination, dry lamination, thermally dissolved lamination and extruded lamination. The most important quality requirement in lamination is the adhesion strength, which requires a close attention in selecting the kinds of adhesive, laminating conditions, and aging conditions. 8 figs., 6 tabs.

  6. Updated Life-Cycle Assessment of Aluminum Production and Semi-fabrication for the GREET Model

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Qiang [Argonne National Lab. (ANL), Argonne, IL (United States); Kelly, Jarod C. [Argonne National Lab. (ANL), Argonne, IL (United States); Burnham, Andrew [Argonne National Lab. (ANL), Argonne, IL (United States); Elgowainy, Amgad [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-09-01

    This report serves as an update for the life-cycle analysis (LCA) of aluminum production based on the most recent data representing the state-of-the-art of the industry in North America. The 2013 Aluminum Association (AA) LCA report on the environmental footprint of semifinished aluminum products in North America provides the basis for the update (The Aluminum Association, 2013). The scope of this study covers primary aluminum production, secondary aluminum production, as well as aluminum semi-fabrication processes including hot rolling, cold rolling, extrusion and shape casting. This report focuses on energy consumptions, material inputs and criteria air pollutant emissions for each process from the cradle-to-gate of aluminum, which starts from bauxite extraction, and ends with manufacturing of semi-fabricated aluminum products. The life-cycle inventory (LCI) tables compiled are to be incorporated into the vehicle cycle model of Argonne National Laboratory’s Greenhouse Gases, Regulated Emissions, and Energy Use in Transportation (GREET) Model for the release of its 2015 version.

  7. Heated Aluminum Tanks Resist Corrosion

    Science.gov (United States)

    Johnson, L. E.

    1983-01-01

    Simple expedient of heating foam-insulated aluminum alloy tanks prevents corrosion by salt-laden moisture. Relatively-small temperature difference between such tank and surrounding air will ensure life of tank is extended by many years.

  8. Evaluation of a meal replacement-based weight management program in primary care settings according to the actual European Clinical Practice Guidelines for the Management of Obesity in Adults.

    Science.gov (United States)

    Kruschitz, Renate; Wallner-Liebmann, Sandra Johanna; Lothaller, Harald; Luger, Maria; Schindler, Karin; Hoppichler, Friedrich; Ludvik, Bernhard

    2014-10-01

    The purpose of this study was the evaluation of a weight loss program in primary care settings with respect to the European Clinical Practice Guidelines for the Management of Obesity in Adults with regard to the long-term success of changes in body weight and composition. Overweight and obese patients (n = 1167) who underwent a standardized meal replacement-based weight loss program (myLINE(®), AENGUS, Austria) in primary care settings were included in this evaluation. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis (AKERN BIA101(®), BIACORPUS RX4000(®), SoftwareBodycomp Version 8.4 Professional). Data of patients who participated at least 12 months in the program were analyzed retrospectively and compared with their baseline data. After 12 months, a weight loss of 8.6 ± 7.5 kg (mean ± standard deviation) or 8.2 ± 7.8 % from baseline was seen (p < 0.001). In all, 71.9 % of all patients achieved a minimal weight loss of 5 %, and 18.8 % lost 15 % of their initial weight. In comparison with the baseline (35.7 ± 11.5 kg), body fat decreased to 29.6 ± 10.7 kg, which is 83.7 ± 18.9 % from baseline (100 %; p < 0.001). Body cell mass showed an absolute reduction of - 1.4 ± 2.2 kg (p < 0.001), although a relative increase of 1.5 ± 2.5 % (p < 0.001). There were no significant differences between male and female subjects regarding changes in weight, body fat, and body cell mass. The evaluated program complies with the European Clinical Practice Guidelines for Management of Obesity in Adults (2008), which recommend a weight reduction of 5-15 % from initial weight within 6 months. Furthermore, the data showed a significant reduction of body fat and a relative increase of body cell mass.

  9. Validity of the Aluminum Equivalent Approximation in Space Radiation Shielding

    Science.gov (United States)

    Badavi, Francis F.; Adams, Daniel O.; Wilson, John W.

    2009-01-01

    The origin of the aluminum equivalent shield approximation in space radiation analysis can be traced back to its roots in the early years of the NASA space programs (Mercury, Gemini and Apollo) wherein the primary radiobiological concern was the intense sources of ionizing radiation causing short term effects which was thought to jeopardize the safety of the crew and hence the mission. Herein, it is shown that the aluminum equivalent shield approximation, although reasonably well suited for that time period and to the application for which it was developed, is of questionable usefulness to the radiobiological concerns of routine space operations of the 21 st century which will include long stays onboard the International Space Station (ISS) and perhaps the moon. This is especially true for a risk based protection system, as appears imminent for deep space exploration where the long-term effects of Galactic Cosmic Ray (GCR) exposure is of primary concern. The present analysis demonstrates that sufficiently large errors in the interior particle environment of a spacecraft result from the use of the aluminum equivalent approximation, and such approximations should be avoided in future astronaut risk estimates. In this study, the aluminum equivalent approximation is evaluated as a means for estimating the particle environment within a spacecraft structure induced by the GCR radiation field. For comparison, the two extremes of the GCR environment, the 1977 solar minimum and the 2001 solar maximum, are considered. These environments are coupled to the Langley Research Center (LaRC) deterministic ionized particle transport code High charge (Z) and Energy TRaNsport (HZETRN), which propagates the GCR spectra for elements with charges (Z) in the range I aluminum equivalent approximation for a good polymeric shield material such as genetic polyethylene (PE). The shield thickness is represented by a 25 g/cm spherical shell. Although one could imagine the progression to greater

  10. Metallic aluminum in combustion; Metalliskt aluminium i foerbraenningen

    Energy Technology Data Exchange (ETDEWEB)

    Backman, Rainer; Berg, Magnus; Bostroem, Dan; Hirota, Catherine; Oehman, Marcus; Oehrstroem, Anna

    2007-06-15

    Although aluminum is easily oxidized and melts at temperatures lower than those common in combustion, it can pass through the combustion chamber almost unscathed. If one performs calculations of thermodynamic equilibriums, conditions under which this could happen are extreme in comparison to those generally found in a furnace. Metallic aluminum may yet be found in rather large concentrations in fly ashes. There are also indications that metallic aluminum is present in deposits inside the furnaces. The objectives for the present investigation are better understanding of the behavior of the metallic aluminum in the fuel when it passes through an incinerator and to suggest counter/measures that deal with the problems associated with it. The target group is primary incineration plants using fuel that contains aluminum foil, for example municipal waste, industrial refuse or plastic reject from cardboard recycling. Combustion experiments were performed in a bench scale reactor using plastic reject obtained from the Fiskeby Board mill. First the gas velocity at which a fraction of the reject hovers was determined for the different fuel fractions, yielding a measure for their propensity to be carried over by the combustion gases. Second fractions rich in aluminum foils were combusted with time, temperature and gas composition as parameters. The partially combusted samples were analyzed using SEM/EDS. The degree of oxidation was determined using TGA/DTA. Reference material from full scale incinerators was obtained by collecting fly ash samples from five plants and analyzing them using XRD and SEM/EDS. The results show that thin aluminum foils may easily be carried over from the furnace. Furthermore, it was very difficult to fully oxidize the metallic flakes. The oxide layer on the surface prevents further diffusion of oxygen to the molten core of the flake. The contribution of these flakes to the build of deposits in a furnace is confirmed by earlier investigations in pilot

  11. Chrome - Free Aluminum Coating System

    Science.gov (United States)

    Bailey, John H.; Gugel, Jeffrey D.

    2010-01-01

    This slide presentation concerns the program to qualify a chrome free coating for aluminum. The program was required due to findings by OSHA and EPA, that hexavalent chromium, used to mitigate corrosion in aerospace aluminum alloys, poses hazards for personnel. This qualification consisted of over 4,000 tests. The tests revealed that a move away from Cr+6, required a system rather than individual components and that the maximum corrosion protection required pretreatment, primer and topcoat.

  12. "Ripples" in an Aluminum Pool?

    Science.gov (United States)

    Rohr, James; Wang, Si-Yin; Nesterenko, Vitali F.

    2018-05-01

    Our motivation for this article is for students to realize that opportunities for discovery are all around them. Discoveries that can still puzzle present day researchers. Here we explore an observation by a middle school student concerning the production of what appears to be water-like "ripples" produced in aluminum foil when placed between two colliding spheres. We both applaud and explore the student's reasoning that the ripples were formed in a melted aluminum pool.

  13. Exergy analysis of aluminum recovery from municipal solid waste incineration

    DEFF Research Database (Denmark)

    Vyzinkarova, Dana; Allegrini, Elisa; Laner, D.

    Two main challenges, associated with the recovery of aluminum from state-of-the-art municipal solid waste (MSW) incineration plants, are yield as well as quality losses of metallic aluminum due to particle surface oxidation and presence of impurities. Yet, in the framework of life cycle assessment...... (LCA) a direct measure for expressing the quality of primary and secondary resources is missing. In view of a possible solution, exergy has been proposed as a concept to evaluate the quality of resources. In this paper, LCA and exergy analyses for two waste treatment approaches are conducted...... in parallel to each other, with a goal to evaluate the added value of exergy for LCA studies in the resource recovery context. The functional unit is the treatment of 1 ton MSW. Two alternative approaches for recovering aluminum from MSW directed to a waste-to-energy plant are considered. A) MSW is treated...

  14. The aluminum smelting process and innovative alternative technologies.

    Science.gov (United States)

    Kvande, Halvor; Drabløs, Per Arne

    2014-05-01

    The industrial aluminum production process is addressed. The purpose is to give a short but comprehensive description of the electrolysis cell technology, the raw materials used, and the health and safety relevance of the process. This article is based on a study of the extensive chemical and medical literature on primary aluminum production. At present, there are two main technological challenges for the process--to reduce energy consumption and to mitigate greenhouse gas emissions. A future step may be carbon dioxide gas capture and sequestration related to the electric power generation from fossil sources. Workers' health and safety have now become an integrated part of the aluminum business. Work-related injuries and illnesses are preventable, and the ultimate goal to eliminate accidents with lost-time injuries may hopefully be approached in the future.

  15. The Aluminum Smelting Process and Innovative Alternative Technologies

    Science.gov (United States)

    Drabløs, Per Arne

    2014-01-01

    Objective: The industrial aluminum production process is addressed. The purpose is to give a short but comprehensive description of the electrolysis cell technology, the raw materials used, and the health and safety relevance of the process. Methods: This article is based on a study of the extensive chemical and medical literature on primary aluminum production. Results: At present, there are two main technological challenges for the process—to reduce energy consumption and to mitigate greenhouse gas emissions. A future step may be carbon dioxide gas capture and sequestration related to the electric power generation from fossil sources. Conclusions: Workers' health and safety have now become an integrated part of the aluminum business. Work-related injuries and illnesses are preventable, and the ultimate goal to eliminate accidents with lost-time injuries may hopefully be approached in the future. PMID:24806723

  16. A Virtual Aluminum Reduction Cell

    Science.gov (United States)

    Zhang, Hongliang; Zhou, Chenn Q.; Wu, Bing; Li, Jie

    2013-11-01

    The most important component in the aluminum industry is the aluminum reduction cell; it has received considerable interests and resources to conduct research to improve its productivity and energy efficiency. The current study focused on the integration of numerical simulation data and virtual reality technology to create a scientifically and practically realistic virtual aluminum reduction cell by presenting complex cell structures and physical-chemical phenomena. The multiphysical field simulation models were first built and solved in ANSYS software (ANSYS Inc., Canonsburg, PA, USA). Then, the methodology of combining the simulation results with virtual reality was introduced, and a virtual aluminum reduction cell was created. The demonstration showed that a computer-based world could be created in which people who are not analysis experts can see the detailed cell structure in a context that they can understand easily. With the application of the virtual aluminum reduction cell, even people who are familiar with aluminum reduction cell operations can gain insights that make it possible to understand the root causes of observed problems and plan design changes in much less time.

  17. Predoctoral Curriculum Guidelines for Biomaterials.

    Science.gov (United States)

    Journal of Dental Education, 1986

    1986-01-01

    The American Association of Dental Schools' predoctoral guidelines for biomaterials curricula includes notes on interrelationships between this and other fields, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives for each content area, and information on sequencing, faculty and…

  18. Soft tissue sarcoma - Compliance with guidelines

    NARCIS (Netherlands)

    Nijhuis, PHA; Schaapveld, M; Otter, R; Hoekstra, HJ

    2001-01-01

    BACKGROUND. Because soft tissue sarcomas (STS) are rare, guidelines for the diagnosis and treatment of patients with STS were developed. Because the diagnostic management is essential for definitive treatment, adherence to these guidelines is important. METHODS. Primary STS registered by the

  19. Gas evolution behavior of aluminum in mortar

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, Shuji; Matsumoto, Junko; Banba, Tsunetaka [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1996-10-01

    As a part of study of leaching behavior for solidified dry low level radioactive waste, gas evolution behavior of aluminum in mortar was investigated, and a plan of our research was proposed. The effect of pH on corrosion rate of aluminum, corrosion product, time dependency of corrosion rate of aluminum in mortar, change of corrosion mechanism, the effects of Na, Ca and Cl ions on corrosion rate of aluminum in mortar and corrosion behavior of aluminum when aluminum was used as sacrificed anode in reinforced concrete were previously clarified. Study of the effects of environmental factors such as pH, kind of ions and temperature on gas evolution behavior of aluminum and the effect of aluminum/carbon steel surface ratio no gas evolution behavior of aluminum were planed. (author). 75 refs.

  20. Gas evolution behavior of aluminum in mortar

    International Nuclear Information System (INIS)

    Hashizume, Shuji; Matsumoto, Junko; Banba, Tsunetaka

    1996-10-01

    As a part of study of leaching behavior for solidified dry low level radioactive waste, gas evolution behavior of aluminum in mortar was investigated, and a plan of our research was proposed. The effect of pH on corrosion rate of aluminum, corrosion product, time dependency of corrosion rate of aluminum in mortar, change of corrosion mechanism, the effects of Na, Ca and Cl ions on corrosion rate of aluminum in mortar and corrosion behavior of aluminum when aluminum was used as sacrificed anode in reinforced concrete were previously clarified. Study of the effects of environmental factors such as pH, kind of ions and temperature on gas evolution behavior of aluminum and the effect of aluminum/carbon steel surface ratio no gas evolution behavior of aluminum were planed. (author). 75 refs

  1. ASSET guidelines

    International Nuclear Information System (INIS)

    1990-11-01

    The IAEA Assessment of Safety Significant Events Team (ASSET) Service provides advice and assistance to Member States to enhance the overall level of plant safety while dealing with the policy of prevention of incidents at nuclear power plants. The ASSET programme, initiated in 1986, is not restricted to any particular group of Member States, whether developing or industrialized, but is available to all countries with nuclear power plants in operation or approaching commercial operation. The IAEA Safety Series publications form common basis for the ASSET reviews, including the Nuclear Safety Standards (NUSS) and the Basic Safety Principles (Recommendations of Safety Series No. 75-INSAG-3). The ASSET Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of their review of incident investigations. Additional guidance and reference material is provided by the IAEA to complement the expertise of the ASSET members. ASSET reviews accept different approaches that contribute to ensuring an effective prevention of incidents at plants. Suggestions are offered to enhance plant safety performance. Commendable good practices are identified and generic lessons are communicated to other plants, where relevant, for long term improvement

  2. Curriculum Guidelines for Clinical Dental Hygiene.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    The American Association of Dental Schools curriculum guidelines for clinical dental hygiene include definitions, notes on the interrelationship of courses, an overview of course objectives, and suggested primary educational goals, prerequisites, core content, specific objectives, sequencing, faculty, and facilities. (MSE)

  3. British Columbia water quality guidelines (criteria): 1998 edition

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.; Pommen, L.W.; Swain, L.G.

    1998-08-01

    British Columbia has developed water quality guidelines in order that water quality data can be assessed and site-specific water quality objectives can be prepared. The guidelines provide benchmarks for the assessment of water quality and setting water quality objectives. Guidelines are provided to protect the following six major water uses: drinking water, aquatic life, wildlife, recreation/aesthetics, agriculture, and industrial. Water quality encompasses the physical, chemical and biological quality of the water, sediment and biota. Among other quality criteria the guide provides maximum approved concentrations for nitrogen, aluminum, copper, cyanide, lead, mercury, and molybdenum. 30 tabs.

  4. DEGAM-Leitlinien als App für Mobiltelefone – Einsatz, Anregungen und Nutzen für den Lernprozess von Studierenden im Fach Allgemeinmedizin [Smartphone Application of Primary Care Guidelines used in Education of Medical Students

    Directory of Open Access Journals (Sweden)

    Waldmann, Uta-Maria

    2013-02-01

    Full Text Available [english] Background and Objective: The guidelines of the German College of General Practitioners and Family Physicians (DEGAM on frequent and important reasons for encounter in Primary Care play a central role in the teaching of Family Medicine. They were edited by the authors into an app for mobile phones, making them available at all times to General Practitioners and medical students. This study examines the issue: how useful do students consider this application within their learning process in Family Medicine? Method: The short versions of the 15 DEGAM guidelines were processed as a web app (for all smartphone software systems including offline utilisation, and offered to students in the Family Medicine course, during clinical attachments in General Practice, on elective compulsory courses or for their final year rotation in General Practice. The evaluation was made with a structured survey using the feedback function of the Moodle learning management system [] with Likert scales and free-text comments. Results: Feedback for evaluation came from 14 (25% of the student testers from the Family Medicine course (9, the clinical attachment in General Practice (1, the final year rotation in General Practice (1 and elective compulsory courses (4. Students rated the app as an additional benefit to the printed/pdf-form. They use it frequently and successfully during waiting periods and before, during, or after lectures. In addition to general interest and a desire to become acquainted with the guidelines and to learn, the app is consulted with regard to general (theoretical questions, rather than in connection with contact with patients. Interest in and knowledge of the guidelines is stimulated by the app, and on the whole the application can be said to be well suited to the needs of this user group. Discussion: The students evaluated the guidelines app positively: as a modern way of familiarising them with the guidelines and expanding their

  5. Weld Repair of Thin Aluminum Sheet

    Science.gov (United States)

    Beuyukian, C. S.; Mitchell, M. J.

    1986-01-01

    Weld repairing of thin aluminum sheets now possible, using niobium shield and copper heat sinks. Refractory niobium shield protects aluminum adjacent to hole, while copper heat sinks help conduct heat away from repair site. Technique limits tungsten/inert-gas (TIG) welding bombardment zone to melt area, leaving surrounding areas around weld unaffected. Used successfully to repair aluminum cold plates on Space Shuttle, Commercial applications, especially in sealing fractures, dents, and holes in thin aluminum face sheets or clad brazing sheet in cold plates, heat exchangers, coolers, and Solar panels. While particularly suited to thin aluminum sheet, this process also used in thicker aluminum material to prevent surface damage near weld area.

  6. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second p age and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the Content 1.1.1 Subheading of the Content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www.teachingenglish.org

  7. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the content 1.1.1 Subheading of the content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Back Matter| 79 80 | STUDIES IN ENGLISH LANGUAGE AND EDUCATION, Volume 1, Number 1, March 2014 Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v

  8. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the Content  1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  9. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  10. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  11. Mexican Asthma Guidelines: GUIMA 2017

    Directory of Open Access Journals (Sweden)

    Désirée Larenas-Linnemann

    2017-04-01

    Full Text Available Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included. After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico.

  12. Guidelines for Description

    NARCIS (Netherlands)

    Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

    2013-01-01

    The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

  13. Recrystallization in Commercially Pure Aluminum

    DEFF Research Database (Denmark)

    Bay, Bent; Hansen, Niels

    1984-01-01

    Recrystallization behavior in commercial aluminum with a purity of 99.4 pct was studied by techniques such as high voltage electron microscopy, 100 kV transmission electron microscopy, and light microscopy. Sample parameters were the initial grain size (290 and 24 microns) and the degree of defor......Recrystallization behavior in commercial aluminum with a purity of 99.4 pct was studied by techniques such as high voltage electron microscopy, 100 kV transmission electron microscopy, and light microscopy. Sample parameters were the initial grain size (290 and 24 microns) and the degree...... are discussed and compared with results from an earlier study1 covering the recrystallization behavior of commercial aluminum of the same purity deformed at higher degrees of deformation (50 to 90 pct reduction in thickness by cold-rolling)....

  14. Aluminum nitride nanophotonic circuits operating at ultraviolet wavelengths

    Energy Technology Data Exchange (ETDEWEB)

    Stegmaier, M.; Ebert, J.; Pernice, W. H. P., E-mail: wolfram.pernice@kit.edu [Institute of Nanotechnology, Karlsruhe Institute of Technology, 76133 Karlsruhe (Germany); Meckbach, J. M.; Ilin, K.; Siegel, M. [Institute of Micro- und Nanoelectronic Systems, Karlsruhe Institute of Technology, 76187 Karlsruhe (Germany)

    2014-03-03

    Aluminum nitride (AlN) has recently emerged as a promising material for integrated photonics due to a large bandgap and attractive optical properties. Exploiting the wideband transparency, we demonstrate waveguiding in AlN-on-Insulator circuits from near-infrared to ultraviolet wavelengths using nanophotonic components with dimensions down to 40 nm. By measuring the propagation loss over a wide spectral range, we conclude that both scattering and absorption of AlN-intrinsic defects contribute to strong attenuation at short wavelengths, thus providing guidelines for future improvements in thin-film deposition and circuit fabrication.

  15. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  16. Aluminum-air battery crystallizer

    Science.gov (United States)

    Maimoni, A.

    1987-01-01

    A prototype crystallizer system for the aluminum-air battery operated reliably through simulated startup and shutdown cycles and met its design objectives. The crystallizer system allows for crystallization and removal of the aluminium hydroxide reaction product; it is required to allow steady-state and long-term operation of the aluminum-air battery. The system has to minimize volume and maintain low turbulence and shear to minimize secondary nucleation and energy consumption while enhancing agglomeration. A lamella crystallizer satisfies system constraints.

  17. Aluminum-carbon composite electrode

    Science.gov (United States)

    Farahmandi, C. Joseph; Dispennette, John M.

    1998-07-07

    A high performance double layer capacitor having an electric double layer formed in the interface between activated carbon and an electrolyte is disclosed. The high performance double layer capacitor includes a pair of aluminum impregnated carbon composite electrodes having an evenly distributed and continuous path of aluminum impregnated within an activated carbon fiber preform saturated with a high performance electrolytic solution. The high performance double layer capacitor is capable of delivering at least 5 Wh/kg of useful energy at power ratings of at least 600 W/kg.

  18. Aluminum nitride insulating films for MOSFET devices

    Science.gov (United States)

    Lewicki, G. W.; Maserjian, J.

    1972-01-01

    Application of aluminum nitrides as electrical insulator for electric capacitors is discussed. Electrical properties of aluminum nitrides are analyzed and specific use with field effect transistors is defined. Operational limits of field effect transistors are developed.

  19. The effect of zinc on the aluminum anode of the aluminum-air battery

    Science.gov (United States)

    Tang, Yougen; Lu, Lingbin; Roesky, Herbert W.; Wang, Laiwen; Huang, Baiyun

    Aluminum is an ideal material for batteries, due to its excellent electrochemical performance. Herein, the effect of zinc on the aluminum anode of the aluminum-air battery, as an additive for aluminum alloy and electrolytes, has been studied. The results show that zinc can decrease the anodic polarization, restrain the hydrogen evolution and increase the anodic utilization rate.

  20. 75 FR 70689 - Kaiser Aluminum Fabricated Products, LLC; Kaiser Aluminum-Greenwood Forge Division; Currently...

    Science.gov (United States)

    2010-11-18

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

  1. Osteoarthritis guidelines: Barriers to implementation and solutions.

    Science.gov (United States)

    Ferreira de Meneses, Sarah; Rannou, Francois; Hunter, David J

    2016-06-01

    Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. 75 FR 80527 - Aluminum Extrusions From China

    Science.gov (United States)

    2010-12-22

    ...)] Aluminum Extrusions From China AGENCY: United States International Trade Commission. ACTION: Scheduling of... of subsidized and less-than-fair-value imports from China of aluminum extrusions, primarily provided... contained in Aluminum Extrusions From the People's Republic of China: Notice of Preliminary Determination of...

  3. 21 CFR 73.2645 - Aluminum powder.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Aluminum powder. 73.2645 Section 73.2645 Food and... ADDITIVES EXEMPT FROM CERTIFICATION Cosmetics § 73.2645 Aluminum powder. (a) Identity and specifications. The color additive aluminum powder shall conform in identity and specifications to the requirements of...

  4. 21 CFR 582.1125 - Aluminum sulfate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Aluminum sulfate. 582.1125 Section 582.1125 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1125 Aluminum sulfate. (a) Product. Aluminum sulfate. (b) Conditions of use. This substance...

  5. 21 CFR 182.1125 - Aluminum sulfate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Aluminum sulfate. 182.1125 Section 182.1125 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR... Substances § 182.1125 Aluminum sulfate. (a) Product. Aluminum sulfate. (b) Conditions of use. This substance...

  6. Aluminum break-point contacts

    NARCIS (Netherlands)

    Heinemann, Martina; Groot, R.A. de

    1997-01-01

    Ab initio molecular dynamics is used to study the contribution of a single Al atom to an aluminum breakpoint contact during the final stages of breaking and the initial stages of the formation of such a contact. A hysteresis effect is found in excellent agreement with experiment and the form of the

  7. Decarbonization process for carbothermically produced aluminum

    Science.gov (United States)

    Bruno, Marshall J.; Carkin, Gerald E.; DeYoung, David H.; Dunlap, Sr., Ronald M.

    2015-06-30

    A method of recovering aluminum is provided. An alloy melt having Al.sub.4C.sub.3 and aluminum is provided. This mixture is cooled and then a sufficient amount of a finely dispersed gas is added to the alloy melt at a temperature of about 700.degree. C. to about 900.degree. C. The aluminum recovered is a decarbonized carbothermically produced aluminum where the step of adding a sufficient amount of the finely dispersed gas effects separation of the aluminum from the Al.sub.4C.sub.3 precipitates by flotation, resulting in two phases with the Al.sub.4C.sub.3 precipitates being the upper layer and the decarbonized aluminum being the lower layer. The aluminum is then recovered from the Al.sub.4C.sub.3 precipitates through decanting.

  8. Aluminum and Phthalates in Calcium Gluconate: Contribution From Glass and Plastic Packaging.

    Science.gov (United States)

    Yokel, Robert A; Unrine, Jason M

    2017-01-01

    Aluminum contamination of parenteral nutrition solutions has been documented for 3 decades. It can result in elevated blood, bone, and whole body aluminum levels associated with neurotoxicity, reduced bone mass and mineral content, and perhaps hepatotoxicity. The primary aluminum source among parenteral nutrition components is glass-packaged calcium gluconate, in which aluminum concentration in the past 3 decades has averaged approximately 4000 μg/L, compared with nutrition solutions; 2 packaged in glass (from France and the United States) and 1 in plastic (from Germany); in a recently released plastic-packaged solution (from the United States); and in the 2 glass containers. Phthalate concentration was determined in selected samples of each product and leachate of the plastic containers. The initial aluminum concentration was approximately 5000 μg/L in the 2 glass-packaged products and approximately 20 μg/L in the plastic-packaged product, and increased approximately 30%, 50%, and 100% in 2 years, respectively. The aluminum concentration in a recently released Calcium Gluconate Injection USP was approximately 320 μg/L. Phthalates were not detected in any calcium gluconate solutions or leachates. Plastic packaging greatly reduces the contribution of aluminum to parenteral nutrition solutions from calcium gluconate compared with the glass-packaged product.

  9. Aluminum stress and its role in the phospholipid signaling pathway in plants and possible biotechnological applications.

    Science.gov (United States)

    Poot-Poot, Wilberth; Hernandez-Sotomayor, Soledad M Teresa

    2011-10-01

    An early response of plants to environmental signals or abiotic stress suggests that the phospholipid signaling pathway plays a pivotal role in these mechanisms. The phospholipid signaling cascade is one of the main systems of cellular transduction and is related to other signal transduction mechanisms. These other mechanisms include the generation of second messengers and their interactions with various proteins, such as ion channels. This phospholipid signaling cascade is activated by changes in the environment, such as phosphate starvation, water, metals, saline stres, and plant-pathogen interactions. One important factor that impacts agricultural crops is metal-induced stress. Because aluminum has been considered to be a major toxic factor for agriculture conducted in acidic soils, many researchers have focused on understanding the mechanisms of aluminum toxicity in plants. We have contributed the last fifteen years in this field by studying the effects of aluminum on phospholipid signaling in coffee, one of the Mexico's primary crops. We have focused our research on aluminum toxicity mechanisms in Coffea arabica suspension cells as a model for developing future contributions to the biotechnological transformation of coffee crops such that they can be made resistant to aluminum toxicity. We conclude that aluminum is able to not only generate a signal cascade in plants but also modulate other signal cascades generated by other types of stress in plants. The aim of this review is to discuss possible involvement of the phospholipid signaling pathway in the aluminum toxicity response of plant cells. Copyright © 2011 Wiley Periodicals, Inc.

  10. Emergency Response Guideline Development

    International Nuclear Information System (INIS)

    Gary D Storrick

    2007-01-01

    Task 5 of the collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled 'Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor' focuses on operator control and protection system interaction, with particular emphasis on developing emergency response guidelines (ERGs). As in the earlier tasks, we will use the IRIS plant as a specific example of an integrated primary system reactor (IPSR) design. The present state of the IRIS plant design--specifically, the lack of a detailed secondary system design--precludes establishing detailed emergency procedures at this time. However, we can create a structure for their eventual development. This report summarizes our progress to date. Section 1.2 describes the scope of this effort. Section 2 compares IPSR ERG development to the recent AP1000 effort, and identifies three key plant differences that affect the ERGs and control room designs. The next three sections investigate these differences in more detail. Section 3 reviews the IRIS Safety-by-Design philosophy and its impact on the ERGs. Section 4 looks at differences between the IRIS and traditional loop PWR I and C Systems, and considers their implications for both control room design and ERG development. Section 5 examines the implications of having one operating staff control multiple reactor units. Section 6 provides sample IRIS emergency operating procedures (EOPs). Section 7 summarizes our conclusions

  11. An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

    Directory of Open Access Journals (Sweden)

    Lemieux-Charles Louise

    2009-07-01

    Full Text Available Abstract Background Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption. Methods The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension and institutional care (chronic ulcer, chronic heart failure topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies. Discussion Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective

  12. Aluminum precipitation from Hanford DSSF

    International Nuclear Information System (INIS)

    Borgen, D.; Frazier, P.; Staton, G.

    1994-01-01

    A series of pilot scale tests using simulated Double Shell Slurry Feed (DSSF) showed that well-settled aluminum precipitate can be produced in Hanford double shell tank (DST) high level waste by slow neutralization with carbon dioxide. This pretreatment could provide an early grout feed and free tank space, as well as facilitate downstream processes such as ion exchange by providing a less caustic feed. A total of eight test runs were completed using a 10-ft tall 3-in i.d. glass column. The 10-ft height corresponds to about one third of the vertical height of a DST, hence providing a reasonable basis for extrapolating the observed precipitate settling and compaction to the actual waste tank environment. Four runs (three with a simplified simulant and one with a chemically complete simulant) produced well settled precipitates averaging 1.5 to 2 feet high. Aluminum gel rather than settled precipitate resulted from one test where neutralization was too rapid

  13. Electrically Conductive Anodized Aluminum Surfaces

    Science.gov (United States)

    Nguyen, Trung Hung

    2006-01-01

    Anodized aluminum components can be treated to make them sufficiently electrically conductive to suppress discharges of static electricity. The treatment was conceived as a means of preventing static electric discharges on exterior satin-anodized aluminum (SAA) surfaces of spacecraft without adversely affecting the thermal-control/optical properties of the SAA and without need to apply electrically conductive paints, which eventually peel off in the harsh environment of outer space. The treatment can also be used to impart electrical conductivity to anodized housings of computers, medical electronic instruments, telephoneexchange equipment, and other terrestrial electronic equipment vulnerable to electrostatic discharge. The electrical resistivity of a typical anodized aluminum surface layer lies between 10(exp 11) and 10(exp 13) Omega-cm. To suppress electrostatic discharge, it is necessary to reduce the electrical resistivity significantly - preferably to anodized surface becomes covered and the pores in the surface filled with a transparent, electrically conductive metal oxide nanocomposite. Filling the pores with the nanocomposite reduces the transverse electrical resistivity and, in the original intended outer-space application, the exterior covering portion of the nanocomposite would afford the requisite electrical contact with the outer-space plasma. The electrical resistivity of the nanocomposite can be tailored to a value between 10(exp 7) and 10(exp 12) Omega-cm. Unlike electrically conductive paint, the nanocomposite becomes an integral part of the anodized aluminum substrate, without need for adhesive bonding material and without risk of subsequent peeling. The electrodeposition process is compatible with commercial anodizing production lines. At present, the electronics industry uses expensive, exotic, electrostaticdischarge- suppressing finishes: examples include silver impregnated anodized, black electroless nickel, black chrome, and black copper. In

  14. System dynamics analysis of strategies to reduce energy use in aluminum-intensive sectors

    Energy Technology Data Exchange (ETDEWEB)

    Hanes, Rebecca J.; Nicholson, Scott; 25-29 June 2017, Carpenter, Alberta

    2017-07-13

    Aluminum is one of the most widely used materials in industry, with applications in buildings, vehicles, aircraft, and consumer products. Its ubiquity is also on the rise: aluminum is beginning to supplant steel in lightweight vehicles and aircraft, and is used in many green or LEED-certified buildings. Although aluminum tends to be highly recycled, particularly by manufacturers of aluminum products, the sector as a whole is still far from a closed system. As a result, the increase in aluminum consumption also means an increase in primary aluminum production-an energy-intensive process-and an increase in consumption of the raw material bauxite, which in the U.S. is almost entirely imported. Our objectives for this study are to identify and analyze aluminum sector technologies and practices that reduce the energy required to manufacture aluminum products and reduce U.S. dependence on imported aluminum and bauxite. To accomplish these objectives, we will develop a system dynamics (SD) model of aluminum production, use and recycling in key application areas, including aerospace, ground vehicles and consumer products. The model will cover the entire aluminum supply chain as it exists in the U.S., from bauxite importing and refining, to the manufacture of products, to the product use phase and end-of-life processing steps. Aluminum flows throughout the model will be determined by the annual domestic demand for each application area as well as demand projections that extend to 2030. Energy consumption will be tracked based on the flows of aluminum through each step of the supply chain. Using the SD model, we will evaluate several technologies and practices that have the potential to reduce energy consumption and reliance on imported bauxite. These include implementation of advanced primary aluminum production technologies, increased recycling within and between application areas, increased material efficiency and increased product lifetimes. Each of these strategies

  15. Bioinspired, Graphene/Al2O3 Doubly Reinforced Aluminum Composites with High Strength and Toughness.

    Science.gov (United States)

    Zhang, Yunya; Li, Xiaodong

    2017-11-08

    Nacre, commonly referred to as nature's armor, has served as a blueprint for engineering stronger and tougher bioinspired materials. Nature organizes a brick-and-mortar-like architecture in nacre, with hard bricks of aragonite sandwiched with soft biopolymer layers. However, cloning nacre's entire reinforcing mechanisms in engineered materials remains a challenge. In this study, we employed hybrid graphene/Al 2 O 3 platelets with surface nanointerlocks as hard bricks for primary load bearer and mechanical interlocking, along with aluminum laminates as soft mortar for load distribution and energy dissipation, to replicate nacre's architecture and reinforcing effects in aluminum composites. Compared with aluminum, the bioinspired, graphene/Al 2 O 3 doubly reinforced aluminum composite demonstrated an exceptional, joint improvement in hardness (210%), strength (223%), stiffness (78%), and toughness (30%), which are even superior over nacre. This design strategy and model material system should guide the synthesis of bioinspired materials to achieve exceptionally high strength and toughness.

  16. Effect of Tritium on Cracking Threshold in 7075 Aluminum

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Morgan, M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-02-28

    The effect of long-term exposure to tritium gas on the cracking threshold (KTH) of 7075 Aluminum Alloy was investigated. The alloy is the material of construction for a cell used to contain tritium in an accelerator at Jefferson Laboratory designed for inelastic scattering experiments on nucleons. The primary safety concerns for the Jefferson Laboratory tritium cell is a tritium leak due to mechanical failure of windows from hydrogen isotope embrittlement, radiation damage, or loss of target integrity from accidental excessive beam heating due to failure of the raster or grossly mis-steered beam. Experiments were conducted to investigate the potential for embrittlement of the 7075 Aluminum alloy from tritium gas.

  17. Physical Activity Guidelines

    Science.gov (United States)

    ... use this site. health.gov Physical Activity Guidelines Physical Activity Physical activity is key to improving the health of the Nation. Based on the latest science, the Physical Activity Guidelines for Americans is an essential resource for ...

  18. Infrared radiation properties of anodized aluminum

    Energy Technology Data Exchange (ETDEWEB)

    Kohara, S. [Science Univ. of Tokyo, Noda, Chiba (Japan). Dept. of Materials Science and Technology; Niimi, Y. [Science Univ. of Tokyo, Noda, Chiba (Japan). Dept. of Materials Science and Technology

    1996-12-31

    The infrared radiation heating is an efficient and energy saving heating method. Ceramics have been used as an infrared radiant material, because the emissivity of metals is lower than that of ceramics. However, anodized aluminum could be used as the infrared radiant material since an aluminum oxide film is formed on the surface. In the present study, the infrared radiation properties of anodized aluminum have been investigated by determining the spectral emissivity curve. The spectral emissivity curve of anodized aluminum changed with the anodizing time. The spectral emissivity curve shifted to the higher level after anodizing for 10 min, but little changed afterwards. The infrared radiant material with high level spectral emissivity curve can be achieved by making an oxide film thicker than about 15 {mu}m on the surface of aluminum. Thus, anodized aluminum is applicable for the infrared radiation heating. (orig.)

  19. Visitor's Computer Guidelines | CTIO

    Science.gov (United States)

    Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Guidelines Library Facilities Outreach NOAO-S EPO Program team Art of Darkness Image Gallery EPO/CADIAS ‹› You are here CTIO Home » Astronomers » Visitor's Computer Guidelines Visitor's Computer

  20. New electrolytes for aluminum production: Ionic liquids

    Science.gov (United States)

    Zhang, Mingming; Kamavarum, Venkat; Reddy, Ramana G.

    2003-11-01

    In this article, the reduction, refining/recycling, and electroplating of aluminum from room-temperature molten salts are reviewed. In addition, the characteristics of several non-conventional organic solvents, electrolytes, and molten salts are evaluated, and the applicability of these melts for production of aluminum is discussed with special attention to ionic liquids. Also reviewed are electrochemical processes and conditions for electrodeposition of aluminum using ionic liquids at near room temperatures.

  1. PREPARATION OF ACTINIDE-ALUMINUM ALLOYS

    Science.gov (United States)

    Moore, R.H.

    1962-09-01

    BS>A process is given for preparing alloys of aluminum with plutonium, uranium, and/or thorium by chlorinating actinide oxide dissolved in molten alkali metal chloride with hydrochloric acid, chlorine, and/or phosgene, adding aluminum metal, and passing air and/or water vapor through the mass. Actinide metal is formed and alloyed with the aluminum. After cooling to solidification, the alloy is separated from the salt. (AEC)

  2. An all aluminum alloy UHV components

    International Nuclear Information System (INIS)

    Sugisaki, Kenzaburo

    1985-01-01

    An all aluminum components was developed for use with UHV system. Aluminum alloy whose advantage are little discharge gas, easy to bake out, light weight, little damage against radieactivity radiation is used. Therefore, as it is all aluminum alloy, baking is possible. Baking temperature is 150 deg C in case of not only ion pump, gate valve, angle valve but also aluminum components. Ion pump have to an ultrahigh vacuum of order 10 -9 torr can be obtained without baking, 10 -10 torr order can be obtained after 24 hour of baking. (author)

  3. Gut: An underestimated target organ for Aluminum.

    Science.gov (United States)

    Vignal, C; Desreumaux, P; Body-Malapel, M

    2016-06-01

    Since World War II, several factors such as an impressive industrial growth, an enhanced environmental bioavailability and intensified food consumption have contributed to a significant amplification of human exposure to aluminum. Aluminum is particularly present in food, beverages, some drugs and airbone dust. In our food, aluminum is superimposed via additives and cooking utensils. Therefore, the tolerable intake of aluminum is exceeded for a significant part of the world population, especially in children who are more vulnerable to toxic effects of pollutants than adults. Faced with this oral aluminum influx, intestinal tract is an essential barrier, especially as 38% of ingested aluminum accumulates at the intestinal mucosa. Although still poorly documented to date, the impact of oral exposure to aluminum in conditions relevant to real human exposure appears to be deleterious for gut homeostasis. Aluminum ingestion affects the regulation of the permeability, the microflora and the immune function of intestine. Nowadays, several arguments are consistent with an involvement of aluminum as an environmental risk factor for inflammatory bowel diseases. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Investigating aluminum alloy reinforced by graphene nanoflakes

    Energy Technology Data Exchange (ETDEWEB)

    Yan, S.J., E-mail: shaojiuyan@126.com [Beijing Institute of Aeronautical Materials, Beijing 100095 (China); Dai, S.L.; Zhang, X.Y.; Yang, C.; Hong, Q.H.; Chen, J.Z. [Beijing Institute of Aeronautical Materials, Beijing 100095 (China); Lin, Z.M. [Aviation Industry Corporation of China, Beijing 100022 (China)

    2014-08-26

    As one of the most important engineering materials, aluminum alloys have been widely applied in many fields. However, the requirement of enhancing their mechanical properties without sacrificing the ductility is always a challenge in the development of aluminum alloys. Thanks to the excellent physical and mechanical properties, graphene nanoflakes (GNFs) have been applied as promising reinforcing elements in various engineering materials, including polymers and ceramics. However, the investigation of GNFs as reinforcement phase in metals or alloys, especially in aluminum alloys, is still very limited. In this study, the aluminum alloy reinforced by GNFs was successfully prepared via powder metallurgy approach. The GNFs were mixed with aluminum alloy powders through ball milling and followed by hot isostatic pressing. The green body was then hot extruded to obtain the final GNFs reinforced aluminum alloy nanocomposite. The scanning electron microscopy and transmission electron microscope analysis show that GNFs were well dispersed in the aluminum alloy matrix and no chemical reactions were observed at the interfaces between the GNFs and aluminum alloy matrix. The mechanical properties' testing results show that with increasing filling content of GNFs, both tensile and yield strengths were remarkably increased without losing the ductility performance. These results not only provided a pathway to achieve the goal of preparing high strength aluminum alloys with excellent ductilitybut they also shed light on the development of other metal alloys reinforced by GNFs.

  5. 40 CFR 180.1091 - Aluminum isopropoxide and aluminum secondary butoxide; exemption from the requirement of a...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Aluminum isopropoxide and aluminum... PESTICIDE CHEMICAL RESIDUES IN FOOD Exemptions From Tolerances § 180.1091 Aluminum isopropoxide and aluminum secondary butoxide; exemption from the requirement of a tolerance. Aluminum isopropoxide (CAS Reg. No. 555...

  6. The new hypertension guidelines.

    Science.gov (United States)

    Stern, Ralph H

    2013-10-01

    The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

  7. Guideline of guidelines: asymptomatic microscopic haematuria.

    Science.gov (United States)

    Linder, Brian J; Bass, Edward J; Mostafid, Hugh; Boorjian, Stephen A

    2018-02-01

    The aim of the present study was to review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). We reviewed the haematuria guidelines from: the American Urological Association; the consensus statement by the Canadian Urological Association, Canadian Urologic Oncology Group and Bladder Cancer Canada; the American College of Physicians; the Joint Consensus Statement of the Renal Association and British Association of Urological Surgeons; and the National Institute for Health and Care Excellence. All guidelines reviewed recommend evaluation for AMH in the absence of potential benign aetiologies, with the evaluation including cystoscopy and upper urinary tract imaging. Existing guidelines vary in their definition of AMH (role of urine dipstick vs urine microscopy), the age threshold for recommending evaluation, and the optimal imaging method (computed tomography vs ultrasonography). Of the reviewed guidelines, none recommended the use of urine cytology or urine markers during the initial AMH evaluation. Patients should have ongoing follow-up after a negative initial AMH evaluation. Significant variation exists among current guidelines for AMH with respect to who should be evaluated and in what manner. Given the patient and health system implications of balancing appropriately focused and effective diagnostic evaluation, AMH represents a valuable future research opportunity. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  8. Hydrogen effects in aluminum alloys

    International Nuclear Information System (INIS)

    Louthan, M.R. Jr.; Caskey, G.R. Jr.; Dexter, A.H.

    1976-01-01

    The permeability of six commercial aluminum alloys to deuterium and tritium was determined by several techniques. Surface films inhibited permeation under most conditions; however, contact with lithium deuteride during the tests minimized the surface effects. Under these conditions phi/sub D 2 / = 1.9 x 10 -2 exp (--22,400/RT) cc (NTP)atm/sup -- 1 / 2 / s -1 cm -1 . The six alloys were also tested before, during, and after exposure to high pressure hydrogen, and no hydrogen-induced effects on the tensile properties were observed

  9. First-principles investigation of aluminum intercalation and diffusion in TiO2 materials: Anatase versus rutile

    Science.gov (United States)

    Tang, Weiqiang; Xuan, Jin; Wang, Huizhi; Zhao, Shuangliang; Liu, Honglai

    2018-04-01

    Aluminum-ion batteries, emerging as a promising post-lithium battery solution, have been a subject of increasing research interest. Yet, most existing aluminum-ion research has focused on electrode materials development and synthesis. There has been a lack of fundamental understanding of the electrode processes and thus theoretical guidelines for electrode materials selection and design. In this study, by using density functional theory, we for the first time report a first-principles investigation on the thermodynamic and kinetic properties of aluminum intercalation into two common TiO2 polymorphs, i.e., anatase and rutile. After examining the aluminum intercalation sites, intercalation voltages, storage capacities and aluminum diffusion paths in both cases, we demonstrate that the stable aluminum intercalation site locates at the center of the O6 octahedral for TiO2 rutile and off center for TiO2 anatase. The maximum achievable Al/Ti ratios for rutile and anatase are 0.34375 and 0.36111, respectively. Although rutile is found to have an aluminum storage capacity slightly higher than anatase, the theoretical specific energy of rutile can reach 20.90 Wh kg-1, nearly twice as high as anatase (9.84 Wh kg-1). Moreover, the diffusion coefficient of aluminum ions in rutile is 10-9 cm2 s-1, significantly higher than that in anatase (10-20 cm2 s-1). In this regard, TiO2 rutile appears to be a better candidate than anatase as an electrode material for aluminum-ion batteries.

  10. Radiological risk comparison guidelines

    International Nuclear Information System (INIS)

    Hallinan, E.J.; Muhlestein, L.D.; Brown, L.F.; Yoder, R.E.

    1992-01-01

    An important aspect of DOE safety analyses is estimating potential accident risk. The estimates are used to: determine if additional controls are needed, identify Safety Class Items, and demonstrate adequate risk reduction. Thus, guidelines are needed to measure comparative risks. The Westinghouse M ampersand O Nuclear Facility Safety Committee and the Safety Envelope Working Group have developed radiological risk guidelines for comparing the risks from individual accident analyses. These guidelines were prepared under contract with the US Department of Energy. These guidelines are based on historical DOE guidelines and current requirements, and satisfy DOE and technical community proposals. for goals that demonstrate acceptable risk. The guidelines consist of a frequency versus consequence curve for credible accidents. Offsite and onsite guidelines are presented. The offsite risk acceptance guidelines are presented in Figure 1. The guidelines are nearly isorisk for anticipated events where impacts are chronic, and provide additional reduction for unlikely events where impacts may be acute and risk uncertainties may be significant. The guidelines are applied to individual release accident scenarios where a discrete frequency and consequence has been estimated. The guideline curves are not to be used for total risk assessments. Common cause events are taken into consideration only for an individual facility. Frequencies outside the guideline range are considered to be local site option (analyst judgement) as far as assessments of risk acceptance are concerned. If the curve is exceeded, then options include either a more detailed analysis or imposing additional preventive or mitigative features. Another presentation discusses implementation in detail. Additional work is needed to provide risk comparison guidelines for releases from multiple facilities and for toxic releases

  11. Investigation of thermal conductivity and oxidation behaviour of reaction bonded aluminum nitride (RBAN) ceramics

    International Nuclear Information System (INIS)

    Salahi, E; Moztarzadeh, F.; Margoosian, V.; Heinrich, J. G.

    2003-01-01

    AlN samples have been produced by reaction bonding process using AlN and aluminum powders as starting materials. Different aluminum nitride and aluminum powders ratios were mixed in ethanol media, dried, isostatically and nitrided in (N 2 )atmosphere. Results showed that conversion of to AlN depends strongly on the amount of aluminum starting powder and decreased with increasing after a maximum at 25 Al wt %. Changing the particle size and morphology of the aluminum starting powder leads to change in the conversion ratio and microstructure of RBAN ceramics. Typical scanning electron micrographs of RBAN sample indicating primary and secondary aluminum nitride morphology and pore structure. The oxidation behavior of RABN samples showed the weight gain depends on the average particle size, morphology and amount of Al in starting mixture and pore structure. Samples have been manufactured with equi-axed morphology of Al starting powder have thermal conductivity higher than the samples have been manufactured with flake-like morphology. These differences were directly related to the different microstructure of RBAN samples

  12. Aluminum corrosion product release kinetics

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Matt, E-mail: Matthew.Edwards@cnl.ca; Semmler, Jaleh; Guzonas, Dave; Chen, Hui Qun; Toor, Arshad; Hoendermis, Seanna

    2015-07-15

    Highlights: • Release of Al corrosion product was measured in simulated post-LOCA sump solutions. • Increased boron was found to enhance Al release kinetics at similar pH. • Models of Al release as functions of time, temperature, and pH were developed. - Abstract: The kinetics of aluminum corrosion product release was examined in solutions representative of post-LOCA sump water for both pressurized water and pressurized heavy-water reactors. Coupons of AA 6061 T6 were exposed to solutions in the pH 7–11 range at 40, 60, 90 and 130 °C. Solution samples were analyzed by inductively coupled plasma atomic emission spectroscopy, and coupon samples were analyzed by secondary ion mass spectrometry. The results show a distinct “boron effect” on the release kinetics, expected to be caused by an increase in the solubility of the aluminum corrosion products. New models were developed to describe both sets of data as functions of temperature, time, and pH (where applicable)

  13. Controlling harmful algae blooms using aluminum-modified clay.

    Science.gov (United States)

    Liu, Yang; Cao, Xihua; Yu, Zhiming; Song, Xiuxian; Qiu, Lixia

    2016-02-15

    The performances of aluminum chloride modified clay (AC-MC), aluminum sulfate modified clay (AS-MC) and polyaluminum chloride modified clay (PAC-MC) in the removal of Aureococcus anophagefferens were compared, and the potential mechanisms were analyzed according to the dispersion medium, suspension pH and clay surface charges. The results showed that AC-MC and AS-MC had better efficiencies in removing A.anophagefferens than PAC-MC. The removal mechanisms of the three modified clays varied. At optimal coagulation conditions, the hydrolysates of AC and AS were mainly monomers, and they transformed into Al(OH)3(am) upon their addition to algae culture, with the primary mechanism being sweep flocculation. The PAC mainly hydrolyzed to the polyaluminum compounds, which remained stable when added to the algae culture, and the flocculation mainly occurred through polyaluminum compounds. The suspension pH significantly influenced the aluminum hydrolysate and affected the flocculation between the modified clay and algae cells. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Aluminum alloy and associated anode and battery

    International Nuclear Information System (INIS)

    Tarcy, G.P.

    1990-01-01

    This patent describes an aluminum alloy. It comprises: eutectic amounts of at least two alloying elements selected from the group consisting of bismuth, cadmium, scandium, gallium, indium, lead, mercury, thallium, tin, and zinc with the balance being aluminum and the alloying elements being about 0.01 to 3.0 percent by weight of the alloy

  15. 21 CFR 172.310 - Aluminum nicotinate.

    Science.gov (United States)

    2010-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES PERMITTED FOR DIRECT ADDITION TO FOOD FOR HUMAN CONSUMPTION Special Dietary and Nutritional Additives § 172.310 Aluminum nicotinate. Aluminum nicotinate may be safely...

  16. Scientific Background for Processing of Aluminum Waste

    Science.gov (United States)

    Kononchuk, Olga; Alekseev, Alexey; Zubkova, Olga; Udovitsky, Vladimir

    2017-11-01

    Changing the source of raw materials for producing aluminum and the emergence of a huge number of secondary alumina waste (foundry slag, sludge, spent catalysts, mineral parts of coal and others that are formed in various industrial enterprises) require the creation of scientific and theoretical foundations for their processing. In this paper, the aluminum alloys (GOST 4784-97) are used as an aluminum raw material component, containing the aluminum component produced as chips in the machine-building enterprises. The aluminum waste is a whole range of metallic aluminum alloys including elements: magnesium, copper, silica, zinc and iron. Analysis of the aluminum waste A1- Zn-Cu-Si-Fe shows that depending on the content of the metal the dissolution process of an aluminum alloy should be treated as the result of the chemical interaction of the metal with an alkaline solution. It is necessary to consider the behavior of the main components of alloys in an alkaline solution as applied to the system Na2O - Al2O3 - SiO2 - CO2 - H2O.

  17. Aluminum low temperature smelting cell metal collection

    Science.gov (United States)

    Beck, Theodore R.; Brown, Craig W.

    2002-07-16

    A method of producing aluminum in an electrolytic cell containing alumina dissolved in an electrolyte. The method comprises the steps of providing a molten salt electrolyte in an electrolytic cell having an anodic liner for containing the electrolyte, the liner having an anodic bottom and walls including at least one end wall extending upwardly from the anodic bottom, the anodic liner being substantially inert with respect to the molten electrolyte. A plurality of non-consumable anodes is provided and disposed vertically in the electrolyte. A plurality of cathodes is disposed vertically in the electrolyte in alternating relationship with the anodes. The anodes are electrically connected to the anodic liner. An electric current is passed through the anodic liner to the anodes, through the electrolyte to the cathodes, and aluminum is deposited on said cathodes. Oxygen bubbles are generated at the anodes and the anodic liner, the bubbles stirring the electrolyte. Molten aluminum is collected from the cathodes into a tubular member positioned underneath the cathodes. The tubular member is in liquid communication with each cathode to collect the molten aluminum therefrom while excluding electrolyte. Molten aluminum is delivered through the tubular member to a molten aluminum reservoir located substantially opposite the anodes and cathodes. The molten aluminum is collected from the cathodes and delivered to the reservoir while avoiding contact of the molten aluminum with the anodic bottom.

  18. Laboratory Powder Metallurgy Makes Tough Aluminum Sheet

    Science.gov (United States)

    Royster, D. M.; Thomas, J. R.; Singleton, O. R.

    1993-01-01

    Aluminum alloy sheet exhibits high tensile and Kahn tear strengths. Rapid solidification of aluminum alloys in powder form and subsequent consolidation and fabrication processes used to tailor parts made of these alloys to satisfy such specific aerospace design requirements as high strength and toughness.

  19. Aluminum extrusion with a deformable die

    NARCIS (Netherlands)

    Assaad, W.

    2010-01-01

    Aluminum extrusion process is one of metal forming processes. In aluminum extrusion, a work-piece (billet) is pressed through a die with an opening that closely resembles a desired shape of a profile. By this process, long profiles with an enormous variety of cross-sections can be produced to

  20. Reduction of Oxidative Melt Loss of Aluminum and Its Alloys

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Subodh K. Das; Shridas Ningileri

    2006-03-17

    identified as the primary factor that accelerates dross formation specifically in the transition from two phases to three phase growth. Limiting magnesium oxidation on the surface of molten aluminum therefore becomes the key to minimizing melt loss, and technology was developed to prevent magnesium oxidation on the aluminum surface. This resulted in a lot of the work being focused on the control of Mg oxidation. Two potential molten metal covering agents that could inhibit dross formation during melting and holding consisting of boric acid and boron nitride were identified. The latter was discounted by industry as it resulted in Boron pick up by the melt beyond that allowed by specifications during plant trials. The understanding of the kinetics of dross formation by the industry partners helped them understand how temperature, alloy chemistry and furnace atmosphere (burner controls--e.g. excess air) effected dross formation. This enables them to introduce in their plant process changes that reduced unnecessary holding at high temperatures, control burner configurations, reduce door openings to avoid ingress of air and optimize charge mixes to ensure rapid melting and avoid excess oxidation.

  1. Trends in the global aluminum fabrication industry

    Science.gov (United States)

    Das, Subodh; Yin, Weimin

    2007-02-01

    The aluminum fabrication industry has become more vital to the global economy as international aluminum consumption has grown steadily in the past decades. Using innovation, value, and sustainability, the aluminum industry is strengthening its position not only in traditional packaging and construction applications but also in the automotive and aerospace markets to become more competitive and to face challenges from other industries and higher industrial standards. The aluminum fabrication industry has experienced a significant geographical shift caused by rapid growth in emerging markets in countries such as Brazil, Russia, India, and China. Market growth and distribution will vary with different patterns of geography and social development; the aluminum industry must be part of the transformation and keep pace with market developments to benefit.

  2. Aluminum-based metal-air batteries

    Science.gov (United States)

    Friesen, Cody A.; Martinez, Jose Antonio Bautista

    2016-01-12

    Provided in one embodiment is an electrochemical cell, comprising: (i) a plurality of electrodes, comprising a fuel electrode that comprises aluminum and an air electrode that absorbs gaseous oxygen, the electrodes being operable in a discharge mode wherein the aluminum is oxidized at the fuel electrode and oxygen is reduced at the air electrode, and (ii) an ionically conductive medium, comprising an organic solvent; wherein during non-use of the cell, the organic solvent promotes formation of a protective interface between the aluminum of the fuel electrode and the ionically conductive medium, and wherein at an onset of the discharge mode, at least some of the protective interface is removed from the aluminum to thereafter permit oxidation of the aluminum during the discharge mode.

  3. Friction Pull Plug Welding in Aluminum Alloys

    Science.gov (United States)

    Brooke, Shane A.; Bradford, Vann

    2012-01-01

    NASA's Marshall Space Flight Center (MSFC) has recently invested much time and effort into the process development of Friction Pull Plug Welding (FPPW). FPPW, is a welding process similar to Friction Push Plug Welding in that, there is a small rotating part (plug) being spun and simultaneously pulled (forged) into a larger part. These two processes differ, in that push plug welding requires an internal reaction support, while pull plug welding reacts to the load externally. FPPW was originally conceived as a post proof repair technique for the Space Shuttle fs External Tank. FPPW was easily selected as the primary weld process used to close out the termination hole on the Constellation Program's ARES I Upper Stage circumferential Self-Reacting Friction Stir Welds (SR-FSW). The versatility of FPPW allows it to also be used as a repair technique for both SR-FSW and Conventional Friction Stir Welds. To date, all MSFC led development has been concentrated on aluminum alloys (2195, 2219, and 2014). Much work has been done to fully understand and characterize the process's limitations. A heavy emphasis has been spent on plug design, to match the various weldland thicknesses and alloy combinations. This presentation will summarize these development efforts including weld parameter development, process control, parameter sensitivity studies, plug repair techniques, material properties including tensile, fracture and failure analysis.

  4. Recrystallization resistance in aluminum alloys containing zirconium

    International Nuclear Information System (INIS)

    Ranganathan, K.

    1991-01-01

    Zirconium forms a fine dispersion of the metastable β' (Al 3 Zr) phase that controls recrystallization by retarding the motion of high-angle boundaries. The primary material chosen for this research was aluminum alloy 7150 containing zinc, magnesium, and copper as the major solute elements and zirconium as the dispersoid-forming element. The size, distribution, and the volume fraction of β' was controlled by varying the alloy composition and preheat practices. Preheated ingots were subjected to a specific sequence of hot-rolling operations to evaluate the resistance to recrystallization of the different microstructures. Optical and transmission electron microscopy (TEM) techniques were used to investigate the influence of dispersoid morphology resulting from the thermal treatments and deformation processing on the recrystallization behavior of the alloy. Studies were conducted to determine the influence of the individual solute elements present in 7150 on the precipitation of β' and consequently on the recrystallization behavior of the material. These studies were done on compositional variants of commercial 7150

  5. Aluminum phosphate shows more adjuvanticity than Aluminum hydroxide in recombinant hepatitis –B vaccine formulation

    Directory of Open Access Journals (Sweden)

    2008-08-01

    Full Text Available Background: Although a number of investigation have been carried out to find alternative adjuvants to aluminum salts in vaccine formulations, they are still extensively used due to their good track record of safety, low cost and proper adjuvanticity with a variety of antigens. Adsorption of antigens onto aluminum compounds depends heavily on electrostatic forces between adjuvant and antigen. Commercial recombinant protein hepatitis B vaccines containing aluminum hydroxide as adjuvant is facing low induction of immunity in some sections of the vaccinated population. To follow the current global efforts in finding more potent hepatitis B vaccine formulation, adjuvanticity of aluminum phosphate has been compared to aluminum hydroxide. Materials and methods: The adjuvant properties of aluminum hydroxide and aluminum phosphate in a vaccine formulation containing a locally manufactured hepatitis B (HBs surface antigen was evaluated in Balb/C mice. The formulations were administered intra peritoneally (i.p. and the titers of antibody which was induced after 28 days were determined using ELISA technique. The geometric mean of antibody titer (GMT, seroconversion and seroprotection rates, ED50 and relative potency of different formulations were determined. Results: All the adjuvanicity markers obtained in aluminum phosphate formulation were significantly higher than aluminum hydroxide. The geometric mean of antibody titer of aluminum phosphate was approximately three folds more than aluminum hydroxide. Conclusion: Aluminum phosphate showed more adjuvanticity than aluminum hydroxide in hepatitis B vaccine. Therefore the use of aluminum phosphate as adjuvant in this vaccine may lead to higher immunity with longer duration of effects in vaccinated groups.

  6. Aluminum recovery as a product with high added value using aluminum hazardous waste

    International Nuclear Information System (INIS)

    David, E.; Kopac, J.

    2013-01-01

    Highlights: • Granular and compact aluminum dross were physically and chemically characterized. • A relationship between density, porosity and metal content from dross was established. • Chemical reactions involving aluminum in landfill and negative consequences are shown. • A processing method for aluminum recovering from aluminum dross was developed. • Aluminum was recovered as an value product with high grade purity such as alumina. -- Abstract: The samples of hazardous aluminum solid waste such as dross were physically and chemically characterized. A relationship between density, porosity and metal content of dross was established. The paper also examines the chemical reactions involving aluminum dross in landfill and the negative consequences. To avoid environmental problems and to recovery the aluminum, a processing method was developed and aluminum was recovered as an added value product such as alumina. This method refers to a process at low temperature, in more stages: acid leaching, purification, precipitation and calcination. At the end of this process aluminum was extracted, first as Al 3+ soluble ions and final as alumina product. The composition of the aluminum dross and alumina powder obtained were measured by applying the leaching tests, using atomic absorption spectrometry (AAS) and chemical analysis. The mineralogical composition of aluminum dross samples and alumina product were determined by X-ray diffraction (XRD) and the morphological characterization was performed by scanning electron microscopy (SEM). The method presented in this work allows the use of hazardous aluminum solid waste as raw material to recover an important fraction from soluble aluminum content as an added value product, alumina, with high grade purity (99.28%)

  7. Reporting guidelines and journal quality in otolaryngology.

    Science.gov (United States)

    Henderson, A H; Upile, T; Pilavakis, Y; Patel, N N

    2016-10-01

    Journals increasingly use reporting guidelines to standardise research papers, partly to improve quality. Although defining journal quality is difficult, various calculated metrics are used. This study investigates guideline adoption by otolaryngology journals and whether a relationship exists between this and journal quality. Retrospective MEDLINE database review for English language, Index Medicus, journals of interest to otolaryngologists (October 2013). The resulting journals were examined for the number of guidelines endorsed and then tabulated against surrogate measures of journal quality (Impact factor, Eigenfactor, SCImago, Source-Normalised rank). The primary outcome measure was the number of recognised reporting guidelines endorsed per journal. This was then correlated against journal quality scores. For comparison, a further small sample correlation was performed with 6 randomly selected and 6 high-profile clinical non-otolaryngology journals. 37 otolaryngology journals were identified. Number of guidelines used and quality scores were not normally distributed. Mean guideline usage was 1.0 for otolaryngology journals, 1.5 for randomly selected, and 5.5 for the high-profile journals. Only 18/37 (49%) otolaryngology journals endorsed any guidelines, compared with 11/12 non-otolaryngology journals. Within otolaryngology, Eigenfactor positively correlated with guideline use (r = 0.4, n = 44, p otolaryngology journals is low. Although it might be expected that use of reporting guidelines improved quality, this is not reflected in the derived quality scores in otolaryngology. This may reflect low levels of use/enforcement, that quality indicators are inherently flawed, or that generalised guidelines are not always appropriate or valued by editors. © 2015 John Wiley & Sons Ltd.

  8. A naturalização da identidade social precarizada na indústria do alumínio primário paraense The acknowledgment of the precarious social identity in the primary aluminum industry in the state of Pará, Brazil

    Directory of Open Access Journals (Sweden)

    Attila Magno e Silva Barbosa

    2010-04-01

    Full Text Available O objetivo deste trabalho é analisar em que medida o processo de terceirização em uma indústria de alumínio primário no município de Barcarena, no estado do Pará, produz diferenciações nas identidades sociais dos trabalhadores diretos e dos terceirizados. Como se sabe, os terceirizados possuem estatuto diferenciado no espaço de trabalho, o que os exclui da rede de benefícios oferecida pelas empresas. Nesse sentido, a sociedade passa a conviver não apenas com a fragilidade presente na relação salarial, mas também com o desmoronamento dos princípios reguladores da sociabilidade entre os trabalhadores. A hipótese levantada é a de que os estatutos mais precários que fundamentam a condição dos terceirizados se estendem por toda a constituição da vida social destes e lhes confere uma identidade social distinta. Foram realizadas 15 entrevistas com cada grupo de trabalhadores e duas entrevistas com dirigentes sindicais, também analisamos o acordo coletivo dos trabalhadores diretos com a empresa e os relatórios anuais desta desde o ano de 2003.This study intends to examine to what extent the outsourcing process in an industry of primary aluminum, in the city of Barcarena, Pará, results in differentiation in the social identities of direct and outsourced workers. Outsourced workers have a different status in the workplace, which excludes them from the benefits offered by the companies. As a result, society has to deal not only with the fragility of the wage relationship, but also with the collapse of the principles that regulate sociability among workers. The hypothesis is that the precarious statutes responsible for the conditions of outsourced workers are extended throughout their social lives, which gives them a distinct social identity. Fifteen interviews were conducted with each group of workers; two union leaders were also interviewed. Furthermore, the article examines the collective agreement between the direct workers

  9. Public informations guidelines

    International Nuclear Information System (INIS)

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities

  10. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

  11. IMAGE Programming Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Stehfest, E; De Waal, L.

    2010-09-15

    This document describes the requirements and guidelines for the software of the IMAGE system. The motivation for this report was a substantial restructuring of the source code for IMAGE version 2.5. The requirements and guidelines relate to design considerations as well as to aspects of maintainability and portability. The design considerations determine guidelines about subjects, such as program structure, model hierarchy, the use of data modules, and the error message system. Maintainability and portability aspects determine the guidelines on, for example, the Fortran 90 standard, naming conventions, code lay-out, and internal documentation.

  12. Guidelines for radiological interventions

    International Nuclear Information System (INIS)

    Kauffmann, G.W.

    1998-01-01

    The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

  13. DART model for thermal conductivity of U3Si2 Aluminum dispersion fuel

    International Nuclear Information System (INIS)

    Rest, J.; Snelgrove, J.L.; Hofman, G.L.

    2004-01-01

    This paper describes the primary physical models that form the basis of the DART model for calculating irradiation-induced changes in the thermal conductivity of aluminum dispersion fuel. DART calculations of fuel swelling, pore closure, and thermal conductivity are compared with measured values. (author)

  14. Process for anodizing aluminum foil

    International Nuclear Information System (INIS)

    Ball, J.A.; Scott, J.W.

    1984-01-01

    In an integrated process for the anodization of aluminum foil for electrolytic capacitors including the formation of a hydrous oxide layer on the foil prior to anodization and stabilization of the foil in alkaline borax baths during anodization, the foil is electrochemically anodized in an aqueous solution of boric acid and 2 to 50 ppm phosphate having a pH of 4.0 to 6.0. The anodization is interrupted for stabilization by passing the foil through a bath containing the borax solution having a pH of 8.5 to 9.5 and a temperature above 80 0 C. and then reanodizing the foil. The process is useful in anodizing foil to a voltage of up to 760 V

  15. Oxidation dynamics of aluminum nanorods

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ying [Argonne Leadership Computing Facility, Argonne National Laboratory, Argonne, Illinois 60439 (United States); Kalia, Rajiv K.; Nakano, Aiichiro; Vashishta, Priya [Collaboratory for Advanced Computing and Simulations, Department of Physics and Astronomy, Department of Chemical Engineering and Materials Science, Department of Computer Science, University of Southern California, Los Angeles, California 90089-0242 (United States)

    2015-02-23

    Aluminum nanorods (Al-NRs) are promising fuels for pyrotechnics due to the high contact areas with oxidizers, but their oxidation mechanisms are largely unknown. Here, reactive molecular dynamics simulations are performed to study thermally initiated burning of oxide-coated Al-NRs with different diameters (D = 26, 36, and 46 nm) in oxygen environment. We found that thinner Al-NRs burn faster due to the larger surface-to-volume ratio. The reaction initiates with the dissolution of the alumina shell into the molten Al core to generate heat. This is followed by the incorporation of environmental oxygen atoms into the resulting Al-rich shell, thereby accelerating the heat release. These results reveal an unexpectedly active role of the alumina shell as a “nanoreactor” for oxidation.

  16. Curriculum Guidelines for Predoctoral Oral Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1987

    1987-01-01

    The American Association of Dental Schools' guidelines for oral radiology curricula give an overview of the field and its interrelationships with other fields and outline the primary educational objectives, prerequisites, core content, specific behavioral objectives, sequencing, faculty, facilities, and occupational hazards to be considered in…

  17. Curriculum Guidelines for Pathology and Oral Pathology.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines for dental school pathology courses describe the interrelationships of general, systemic, and oral pathology; primary educational goals; prerequisites; a core curriculum outline and behavioral objectives for each type of pathology. Notes on sequencing, faculty, facilities, and occupational hazards are included. (MSE)

  18. Bioassay guideline 2: guidelines for tritium bioassay

    International Nuclear Information System (INIS)

    1983-01-01

    This guideline is one of a series under preparation by the Federal-Provincial Working Group on Bioassay and In Vivo Monitoring Criteria. In this report tritium compounds have been grouped into four categories for the purpose of calculating Annual Limits on Intake and Investigation Levels: tritium gas, tritiated water, tritium-labelled compounds and nucleic acid precursors

  19. Glaucoma-service provision in Scotland: introduction and need for Scottish Intercollegiate Guidelines Network guidelines.

    Science.gov (United States)

    Syrogiannis, Andreas; Rotchford, Alan P; Agarwal, Pankaj Kumar; Kumarasamy, Manjula; Montgomery, Donald; Burr, Jennifer; Sanders, Roshini

    2015-01-01

    To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care. A glaucoma-survey questionnaire was sent to all consultant glaucomatologists in Scotland. The design of SIGN guidelines was based on the results of the questionnaire using SIGN methodology. Over 90% of Scottish glaucoma care is triaged and delivered within hospital services. Despite GOS referral, information is variable. There are no consistent discharge practices to the community. These results led to defined research questions that were answered, thus formulating the content of the SIGN guidelines. The guideline covers the assessment of patients in primary care, referral criteria to hospital, discharge criteria from hospital to community, and monitoring of patients at risk of glaucoma. With increasing age and limitations to hospital resources, refining glaucoma pathways between primary and secondary care has become a necessity. Scotland has unique eye care arrangements with both the GOS and Eye Care Integration project. It is hoped that implementation of SIGN guidelines will identify glaucoma at the earliest opportunity and reduce the rate of false-positive referrals to hospital.

  20. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

    2015-01-01

    diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

  1. Whitebark pine planting guidelines

    Science.gov (United States)

    Ward McCaughey; Glenda L. Scott; Kay L. Izlar

    2009-01-01

    This article incorporates new information into previous whitebark pine guidelines for planting prescriptions. Earlier 2006 guidelines were developed based on review of general literature, research studies, field observations, and standard US Forest Service survival surveys of high-elevation whitebark pine plantations. A recent study of biotic and abiotic factors...

  2. Guidelines for Learning Stations.

    Science.gov (United States)

    Fehrle, Carl C.; Schulz, Jolene

    Guidelines for designing and planning learning stations for pupils at the elementary grade level include suggestions on how to develop a station that will be successful in meeting the learners' needs. Instructions for the use of tapes at a station and matching pupils with stations are given, as are guidelines on classroom arrangement and record…

  3. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

    The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

  4. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)

    2012-04-01

    The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  5. Maintenance Trades Guidelines

    Science.gov (United States)

    Weidner, Theodore J.

    2008-01-01

    In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…

  6. Decontamination and reuse of ORGDP aluminum scrap

    International Nuclear Information System (INIS)

    Compere, A.L.; Griffith, W.L.; Hayden, H.W.; Wilson, D.F.

    1996-12-01

    The Gaseous Diffusion Plants, or GDPs, have significant amounts of a number of metals, including nickel, aluminum, copper, and steel. Aluminum was used extensively throughout the GDPs because of its excellent strength to weight ratios and good resistance to corrosion by UF 6 . This report is concerned with the recycle of aluminum stator and rotor blades from axial compressors. Most of the stator and rotor blades were made from 214-X aluminum casting alloy. Used compressor blades were contaminated with uranium both as a result of surface contamination and as an accumulation held in surface-connected voids inside of the blades. A variety of GDP studies were performed to evaluate the amounts of uranium retained in the blades; the volume, area, and location of voids in the blades; and connections between surface defects and voids. Based on experimental data on deposition, uranium content of the blades is 0.3%, or roughly 200 times the value expected from blade surface area. However, this value does correlate with estimated internal surface area and with lengthy deposition times. Based on a literature search, it appears that gaseous decontamination or melt refining using fluxes specific for uranium removal have the potential for removing internal contamination from aluminum blades. A melt refining process was used to recycle blades during the 1950s and 1960s. The process removed roughly one-third of the uranium from the blades. Blade cast from recycled aluminum appeared to perform as well as blades from virgin material. New melt refining and gaseous decontamination processes have been shown to provide substantially better decontamination of pure aluminum. If these techniques can be successfully adapted to treat aluminum 214-X alloy, internal and, possibly, external reuse of aluminum alloys may be possible

  7. Understanding Transferable Supply Chain Lessons and Practices to a “High-Tech” Industry Using Guidelines from a Primary Sector Industry: A Case Study in the Food Industry Supply Chain

    Science.gov (United States)

    Coronado Mondragon, Adrian E.; Coronado, Etienne S.

    2015-01-01

    Flexibility and innovation at creating shapes, adapting processes, and modifying materials characterize composites materials, a “high-tech” industry. However, the absence of standard manufacturing processes and the selection of materials with defined properties hinder the configuration of the composites materials supply chain. An interesting alternative for a “high-tech” industry such as composite materials would be to review supply chain lessons and practices in “low-tech” industries such as food. The main motivation of this study is to identify lessons and practices that comprise innovations in the supply chain of a firm in a perceived “low-tech” industry that can be used to provide guidelines in the design of the supply chain of a “high-tech” industry, in this case composite materials. This work uses the case study/site visit with analogy methodology to collect data from a Spanish leading producer of fresh fruit juice which is sold in major European markets and makes use of a cold chain. The study highlights supply base management and visibility/traceability as two elements of the supply chain in a “low-tech” industry that can provide guidelines that can be used in the configuration of the supply chain of the composite materials industry. PMID:25821848

  8. Understanding transferable supply chain lessons and practices to a "high-tech" industry using guidelines from a primary sector industry: a case study in the food industry supply chain.

    Science.gov (United States)

    Coronado Mondragon, Adrian E; Coronado Mondragon, Christian E; Coronado, Etienne S

    2015-01-01

    Flexibility and innovation at creating shapes, adapting processes, and modifying materials characterize composites materials, a "high-tech" industry. However, the absence of standard manufacturing processes and the selection of materials with defined properties hinder the configuration of the composites materials supply chain. An interesting alternative for a "high-tech" industry such as composite materials would be to review supply chain lessons and practices in "low-tech" industries such as food. The main motivation of this study is to identify lessons and practices that comprise innovations in the supply chain of a firm in a perceived "low-tech" industry that can be used to provide guidelines in the design of the supply chain of a "high-tech" industry, in this case composite materials. This work uses the case study/site visit with analogy methodology to collect data from a Spanish leading producer of fresh fruit juice which is sold in major European markets and makes use of a cold chain. The study highlights supply base management and visibility/traceability as two elements of the supply chain in a "low-tech" industry that can provide guidelines that can be used in the configuration of the supply chain of the composite materials industry.

  9. Fatigue analysis of aluminum drill pipes

    Directory of Open Access Journals (Sweden)

    João Carlos Ribeiro Plácido

    2005-12-01

    Full Text Available An experimental program was performed to investigate the fundamental fatigue mechanisms of aluminum drill pipes. Initially, the fatigue properties were determined through small-scale tests performed in an optic-mechanical fatigue apparatus. Additionally, full-scale fatigue tests were carried out with three aluminum drill pipe specimens under combined loading of cyclic bending and constant axial tension. Finally, a finite element model was developed to simulate the stress field along the aluminum drill pipe during the fatigue tests and to estimate the stress concentration factors inside the tool joints. By this way, it was possible to estimate the stress values in regions not monitored during the fatigue tests.

  10. Global Imaging referral guidelines

    International Nuclear Information System (INIS)

    Kawooya, M.; Perez, M.; Lau, L.; Reeed, M.

    2010-01-01

    The medical imaging specialists called for global referral guidelines which would be made available to referring doctors. These referral guidelines should be:- Applicable in different health care settings, including resource-poor settings; Inclusive in terms of the range of clinical conditions; User-friendly and accessible (format/media); Acceptable to stakeholders, in particular to the referrers as the main target audience. To conceive evidence-based medicine as an integration of best research evidence with clinical expertise and patient values. The Direct recipients of the Referral Guidelines would be:- Referrers: general practitioners / family doctors; paediatricians; emergency department doctors; other specialists and health workers. Providers (medical imaging practitioners): radiologists; nuclear medicine physicians; radiographers; other appropriately qualified practitioners providing diagnostic imaging services. For the Referral Guidelines to be effective there need to be: Credibility evidence-based Practicality end user involvement Context local resources, disease profiles Endorsement, opinion leaders Implementation- policy, education, CPOE - Monitoring of the use clinical audit, report feedback. The aim of the Referral Guidelines Project was to: Produce global referral guidelines that are evidence-based, cost effective and appropriate for the local setting, and include consideration of available equipment and expertise (RGWG; SIGs); Include supporting information about radiation doses, potential risks, protection of children and pregnant women (introductory chapter); Facilitate the implementation of the guidelines through guidance and tools (e.g. implementation guides, checklists, capacity building tools, guides on stakeholders engagement, audit support criteria); Conduct pilot testing in different clinical settings from each of the six WHO regions; Promote the inclusion of the referral guidelines in the curricula of medical schools; Develop and implement

  11. Guidelines - let's take a break and then move forward together!

    DEFF Research Database (Denmark)

    Bro, Flemming; Waldorff, Frans Boch

    2004-01-01

    With our limited resources, the national colleges of general practice in the Nordic countries should select only a few important topics and only get involved in guideline preparations if they have a primary care perspective. We need not develop our own guidelines from scratch, but should take...

  12. Guidelines - let's take a break and then move forward together!

    DEFF Research Database (Denmark)

    Bro, Flemming; Waldorff, Frans Boch

    2004-01-01

    With our limited resources, the national colleges of general practice in the Nordic countries should select only a few important topics and only get involved in guideline preparations if they have a primary care perspective. We need not develop our own guidelines from scratch, but should take exi...

  13. Nanshan Aluminum Reached Strategic Cooperation with CSR Corporation Limited

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    As a key supplier of aluminum profiles and aluminum plate,sheet and trip products for CSR Corporation Limited,Nanshan Aluminum will join hands with CSR Corporation Limited to reach strategic cooperation.On January 5,Nanshan Aluminum signed strategic cooperation agreement with CSR Sifang Locomotive&Rolling; Stock Co.,Ltd,both

  14. 49 CFR 178.505 - Standards for aluminum drums.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Standards for aluminum drums. 178.505 Section 178... PACKAGINGS Non-bulk Performance-Oriented Packaging Standards § 178.505 Standards for aluminum drums. (a) The following are the identification codes for aluminum drums: (1) 1B1 for a non-removable head aluminum drum...

  15. Formulation and method for preparing gels comprising hydrous aluminum oxide

    Science.gov (United States)

    Collins, Jack L.

    2014-06-17

    Formulations useful for preparing hydrous aluminum oxide gels contain a metal salt including aluminum, an organic base, and a complexing agent. Methods for preparing gels containing hydrous aluminum oxide include heating a formulation to a temperature sufficient to induce gel formation, where the formulation contains a metal salt including aluminum, an organic base, and a complexing agent.

  16. 46 CFR 154.195 - Aluminum cargo tank: Steel enclosure.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Aluminum cargo tank: Steel enclosure. 154.195 Section... Equipment Hull Structure § 154.195 Aluminum cargo tank: Steel enclosure. (a) An aluminum cargo tank and its... the aluminum cargo tank must meet the steel structural standards of the American Bureau of Shipping...

  17. A simple aluminum gasket for use with both stainless steel and aluminum flanges

    Energy Technology Data Exchange (ETDEWEB)

    Langley, R.A.

    1991-01-01

    A technique has been developed for making aluminum wire seal gaskets of various sizes and shapes for use with both stainless steel and aluminum alloy flanges. The gasket material used is 0.9999 pure aluminum, drawn to a diameter of 3 mm. This material can be easily welded and formed into various shapes. A single gasket has been successfully used up to five times without baking. The largest gasket tested to date is 3.5 m long and was used in the shape of a parallelogram. Previous use of aluminum wire gaskets, including results for bakeout at temperatures from 20 to 660{degree}C, is reviewed. A search of the literature indicates that this is the first reported use of aluminum wire gaskets for aluminum alloy flanges. The technique is described in detail, and the results are summarized. 11 refs., 4 figs.

  18. Compliance with standard treatment guidelines in the management ...

    African Journals Online (AJOL)

    Peter Rapula Siko

    Introduction: Hypertension is a leading lifestyle disease and major cause of morbidity ... Drug Policy (NDP) in 1996.3,4 This was intended to promote ... through the use of different guidelines for primary health care ..... Elderly Program (SHEP).

  19. Coordination Structure of Aluminum in Magnesium Aluminum Hydroxide Studied by 27Al NMR

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The coordination structure of aluminum in magnesium aluminum hydroxide was studiedby 27Al NMR. The result showed that tetrahedral aluminum (AlⅣ) existed in magnesiumaluminum hydroxide, and the contents of AlⅣ increased with the increase of the ratio of Al/Mg andwith the peptizing temperature. AlⅣ originated from the so-called Al13 polymer with the structureof one Al tetrahedron surrounded by twelve Al octahedrons.

  20. Aluminum exclusion and aluminum tolerance in woody plants.

    Science.gov (United States)

    Brunner, Ivano; Sperisen, Christoph

    2013-01-01

    The aluminum (Al) cation Al(3) (+) is highly rhizotoxic and is a major stress factor to plants on acid soils, which cover large areas of tropical and boreal regions. Many woody plant species are native to acid soils and are well adapted to high Al(3) (+) conditions. In tropical regions, both woody Al accumulator and non-Al accumulator plants occur, whereas in boreal regions woody plants are non-Al accumulators. The mechanisms of these adaptations can be divided into those that facilitate the exclusion of Al(3) (+) from root cells (exclusion mechanisms) and those that enable plants to tolerate Al(3) (+) once it has entered the root and shoot symplast (internal tolerance mechanisms). The biochemical and molecular basis of these mechanisms have been intensively studied in several crop plants and the model plant Arabidopsis. In this review, we examine the current understanding of Al(3) (+) exclusion and tolerance mechanisms from woody plants. In addition, we discuss the ecology of woody non-Al accumulator and Al accumulator plants, and present examples of Al(3) (+) adaptations in woody plant populations. This paper complements previous reviews focusing on crop plants and provides insights into evolutionary processes operating in plant communities that are widespread on acid soils.

  1. The Oxidation Products of Aluminum Hydride and Boron Aluminum Hydride Clusters

    Science.gov (United States)

    2016-01-04

    AFRL-AFOSR-VA-TR-2016-0075 The Oxidation Products of Aluminum Hydride and Boron Aluminum Hydride Clusters KIT BOWEN JOHNS HOPKINS UNIV BALTIMORE MD...2. REPORT TYPE Final Performance 3. DATES COVERED (From - To) 30-09-2014 to 29-09-2015 4. TITLE AND SUBTITLE The Oxidation Products of Aluminum ...Hydride and Boron Aluminum Hydride Clusters 5a.  CONTRACT NUMBER 5b.  GRANT NUMBER FA9550-14-1-0324 5c.  PROGRAM ELEMENT NUMBER 61102F 6. AUTHOR(S) KIT

  2. 40 CFR 63.5753 - How do I calculate the combined organic HAP content of aluminum wipedown solvents and aluminum...

    Science.gov (United States)

    2010-07-01

    ... HAP content of aluminum wipedown solvents and aluminum recreational boat surface coatings? 63.5753... Standards for Hazardous Air Pollutants for Boat Manufacturing Standards for Aluminum Recreational Boat Surface Coating Operations § 63.5753 How do I calculate the combined organic HAP content of aluminum...

  3. Electron-beam welding of aluminum alloys

    Energy Technology Data Exchange (ETDEWEB)

    Brillant, Marcel; de Bony, Yves

    1980-08-15

    The objective of this article is to describe the status of the application of electron-beam welding to aluminum alloys. These alloys are widely employed in the aeronautics, space and nuclear industries.

  4. Electrometallurgical treatment of aluminum-based fuels

    International Nuclear Information System (INIS)

    Willit, J. L.

    1998-01-01

    We have successfully demonstrated aluminum electrorefining from a U-Al-Si alloy that simulates spent aluminum-based reactor fuel. The aluminum product contains less than 200 ppm uranium. All the results obtained have been in agreement with predictions based on equilibrium thermodynamics. We have also demonstrated the need for adequate stirring to achieve a low-uranium product. Most of the other process steps have been demonstrated in other programs. These include uranium electrorefining, transuranic fission product scrubbing, fission product oxidation, and product consolidation by melting. Future work will focus on the extraction of active metal and rare earth fission products by a molten flux salt and scale-up of the aluminum electrorefining

  5. Masking of aluminum surface against anodizing

    Science.gov (United States)

    Crawford, G. B.; Thompson, R. E.

    1969-01-01

    Masking material and a thickening agent preserve limited unanodized areas when aluminum surfaces are anodized with chromic acid. For protection of large areas it combines well with a certain self-adhesive plastic tape.

  6. Aluminum titanate crucible for molten uranium

    International Nuclear Information System (INIS)

    Asbury, J.J.

    1975-01-01

    An improved crucible for molten uranium is described. The crucible or crucible liner is formed of aluminum titanate which essentially eliminates contamination of uranium and uranium alloys during molten states thereof. (U.S.)

  7. Interpretation of aluminum-alloy weld radiography

    Science.gov (United States)

    Duren, P. C.; Risch, E. R.

    1971-01-01

    Report proposes radiographic terminology standardization which allows scientific interpretation of radiographic films to replace dependence on individual judgement and experience. Report includes over 50 photographic pages where radiographs of aluminum welds with defects are compared with prepared weld sections photomacrographs.

  8. Recycling of aluminum to produce green energy

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, Susana Silva; Lopez Benites, Wendy; Alvarez Gallegos, Alberto A. [Centro de Investigacion en Ingenieria y Ciencias Aplicadas, Av. Universidad 1001, Col. Chamilpa, Cuernavaca, Morelos C.P. 62210 (Mexico); Sebastian, P.J. [Centro de Investigacion en Energia-UNAM, 62580 Temixco, Morelos (Mexico)

    2005-07-15

    High-purity hydrogen gas was generated from the chemical reaction of aluminum with sodium hydroxide. Several molar relations of sodium hydroxide/aluminum were investigated in this study. The experimental results showed that hydrogen yields are acceptable and its purity was good enough to be used in a proton exchange membrane (PEM) fuel cell to produce electricity. An estimation of the amount of energy produced from the reaction of 100 aluminum cans with caustic soda showed that the hydrogen production is feasible to be scaled up to reach up to 5kWh in a few hours. This study is environmentally friendly and also shows that green energy can be produced from aluminum waste at a low cost.

  9. Aluminum alloy excellent in neutron absorbing performance

    International Nuclear Information System (INIS)

    Iida, Tetsuya; Tamamura, Tadao; Morimoto, Hiroyuki; Ouchi, Ken-ichiro.

    1987-01-01

    Purpose: To obtain structural materials made of aluminum alloys having favorable neutron absorbing performance and excellent in the performance as structural materials such as processability and strength. Constitution: Powder of Gd 2 O 3 as a gadolinium compound or metal gadolinium is uniformly mixed with the powder of aluminum or aluminum alloy. The amount of the gadolinium compound added is set to 0.1 - 30 % by weight. No sufficient neutron absorbing performance can be obtained if it is less than 0.1 % by weight, whereas the processability and mechanical property of the alloy are degraded if it exceeds 30 % by weight. Further, the grain size is set to less about 50 μm. Further, since the neutron absorbing performance varies greatly if the aluminum powder size exceeds 100 μm, the diameter is set to less than about 100 μm. These mixtures are molded in a hot press. This enables to obtain aimed structural materials. (Takahashi, M.)

  10. Seacoast stress corrosion cracking of aluminum alloys

    Science.gov (United States)

    Humphries, T. S.; Nelson, E. E.

    1981-01-01

    The stress corrosion cracking resistance of high strength, wrought aluminum alloys in a seacoast atmosphere was investigated and the results were compared with those obtained in laboratory tests. Round tensile specimens taken from the short transverse grain direction of aluminum plate and stressed up to 100 percent of their yield strengths were exposed to the seacoast and to alternate immersion in salt water and synthetic seawater. Maximum exposure periods of one year at the seacoast, 0.3 or 0.7 of a month for alternate immersion in salt water, and three months for synthetic seawater were indicated for aluminum alloys to avoid false indications of stress corrosion cracking failure resulting from pitting. Correlation of the results was very good among the three test media using the selected exposure periods. It is concluded that either of the laboratory test media is suitable for evaluating the stress corrosion cracking performance of aluminum alloys in seacoast atmosphere.

  11. Inhibition of aluminum corrosion using Opuntia extract

    International Nuclear Information System (INIS)

    El-Etre, A.Y.

    2003-01-01

    The inhibitive action of the mucilage extracted from the modified stems of prickly pears, toward acid corrosion of aluminum, is tested using weight loss, thermometry, hydrogen evolution and polarization techniques. It was found that the extract acts as a good corrosion inhibitor for aluminum corrosion in 2.0 M HCl solution. The inhibition action of the extract was discussed in view of Langmuir adsorption isotherm. It was found that the adsorption of the extract on aluminum surface is a spontaneous process. The inhibition efficiency (IE) increases as the extract concentration is increased. The effect of temperature on the IE was studied. It was found that the presence of extract increases the activation energy of the corrosion reaction. Moreover, the thermodynamic parameters of the adsorption process were calculated. It was found also that the Opuntia extract provides a good protection to aluminum against pitting corrosion in chloride ion containing solutions

  12. Corrosion of aluminum components and remedial measures

    International Nuclear Information System (INIS)

    Sheikh, S.T.; Khalique, A.; Malik, F.A.

    2006-01-01

    Aluminum has versatile physical properties, mechanical strength, corrosion resistance, and is used in special applications like aerospace, automobiles and other strategic industries. The outdoor exposed structural components of aluminum have very good corrosion resistance due to the thick oxide layer (0.2 -0.4 micro). This study involves the corrosion of aluminum based components, though aluminum is protected by an oxide layer but due to extreme weather and environmental conditions the oxide layer was damaged. The corroded product was removed, pits or cavities formed due to the material removal were filled with epoxy resins and acrylic-based compounds containing fibreglass as reinforcement. Optimum results were obtained with epoxy resins incorporated with 5% glass fibers. The inner surface of the components was provided further protection with a cellulose nitrate compound. (author)

  13. Beryllium-aluminum alloys for investment castings

    International Nuclear Information System (INIS)

    Nachtrab, W.T.; Levoy, N.

    1997-01-01

    Beryllium-aluminum alloys containing greater than 60 wt % beryllium are very favorable materials for applications requiring light weight and high stiffness. However, when produced by traditional powder metallurgical methods, these alloys are expensive and have limited applications. To reduce the cost of making beryllium-aluminum components, Nuclear Metals Inc. (NMI) and Lockheed Martin Electronics and Missiles have recently developed a family of patented beryllium-aluminum alloys that can be investment cast. Designated Beralcast, the alloys can achieve substantial weight savings because of their high specific strength and stiffness. In some cases, weight has been reduced by up to 50% over aluminum investment casting. Beralcast is now being used to make thin wall precision investment castings for several advanced aerospace applications, such as the RAH-66 Comanche helicopter and F-22 jet fighter. This article discusses alloy compositions, properties, casting method, and the effects of cobalt additions on strength

  14. Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF).

    Science.gov (United States)

    Kirchhof, Paulus; Ammentorp, Bettina; Darius, Harald; De Caterina, Raffaele; Le Heuzey, Jean-Yves; Schilling, Richard John; Schmitt, Josef; Zamorano, Jose Luis

    2014-01-01

    We sought to describe the management of patients with atrial fibrillation (AF) in Europe after the release of the 2010 AF Guidelines of the European Society of Cardiology. The PREFER in AF registry enrolled consecutive patients with AF from January 2012 to January 2013 in 461 centres in seven European countries. Seven thousand two hundred and forty-three evaluable patients were enrolled, aged 71.5 ± 11 years, 60.1% male, CHA2DS2VASc score 3.4 ± 1.8 (mean ± standard deviation). Thirty per cent patients had paroxysmal, 24.0% had persistent, 7.2% had long-standing persistent, and 38.8% had permanent AF. Oral anticoagulation was used in the majority of patients: 4799 patients (66.3%) received a vitamin K antagonist (VKA) as mono-therapy, 720 patients a combination of VKA and antiplatelet agents (9.9%), 442 patients (6.1%) a new oral anticoagulant drugs (NOAC). Antiplatelet agents alone were given to 808 patients (11.2%), no antithrombotic therapy to 474 patients (6.5%). Of 7034 evaluable patients, 5530 (78.6%) patients were adequately rate controlled (mean heart rate 60-100 bpm). Half of the patients (50.7%) received rhythm control therapy by electrical cardioversion (18.1%), pharmacological cardioversion (19.5%), antiarrhythmic drugs (amiodarone 24.1%, flecainide or propafenone 13.5%, sotalol 5.5%, dronedarone 4.0%), and catheter ablation (5.0%). The management of AF patients in 2012 has adapted to recent evidence and guideline recommendations. Oral anticoagulant therapy with VKA (majority) or NOACs is given to over 80% of eligible patients, including those at risk for bleeding. Rate is often adequately controlled, and rhythm control therapy is widely used.

  15. Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF)

    Science.gov (United States)

    Kirchhof, Paulus; Ammentorp, Bettina; Darius, Harald; De Caterina, Raffaele; Le Heuzey, Jean-Yves; Schilling, Richard John; Schmitt, Josef; Zamorano, Jose Luis

    2014-01-01

    Aims We sought to describe the management of patients with atrial fibrillation (AF) in Europe after the release of the 2010 AF Guidelines of the European Society of Cardiology. Methods and results The PREFER in AF registry enrolled consecutive patients with AF from January 2012 to January 2013 in 461 centres in seven European countries. Seven thousand two hundred and forty-three evaluable patients were enrolled, aged 71.5 ± 11 years, 60.1% male, CHA2DS2VASc score 3.4 ± 1.8 (mean ± standard deviation). Thirty per cent patients had paroxysmal, 24.0% had persistent, 7.2% had long-standing persistent, and 38.8% had permanent AF. Oral anticoagulation was used in the majority of patients: 4799 patients (66.3%) received a vitamin K antagonist (VKA) as mono-therapy, 720 patients a combination of VKA and antiplatelet agents (9.9%), 442 patients (6.1%) a new oral anticoagulant drugs (NOAC). Antiplatelet agents alone were given to 808 patients (11.2%), no antithrombotic therapy to 474 patients (6.5%). Of 7034 evaluable patients, 5530 (78.6%) patients were adequately rate controlled (mean heart rate 60–100 bpm). Half of the patients (50.7%) received rhythm control therapy by electrical cardioversion (18.1%), pharmacological cardioversion (19.5%), antiarrhythmic drugs (amiodarone 24.1%, flecainide or propafenone 13.5%, sotalol 5.5%, dronedarone 4.0%), and catheter ablation (5.0%). Conclusion The management of AF patients in 2012 has adapted to recent evidence and guideline recommendations. Oral anticoagulant therapy with VKA (majority) or NOACs is given to over 80% of eligible patients, including those at risk for bleeding. Rate is often adequately controlled, and rhythm control therapy is widely used. PMID:24084680

  16. Fast LIBS Identification of Aluminum Alloys

    Directory of Open Access Journals (Sweden)

    Tawfik W.

    2007-04-01

    Full Text Available Laser-induced breakdown spectroscopy (LIBS has been applied to analysis aluminum alloy targets. The plasma is generated by focusing a 300 mJ pulsed Nd: YAG laser on the target in air at atmospheric pressure. Such plasma emission spectrum was collected using a one-meter length wide band fused-silica optical fiber connected to a portable Echelle spectrometer with intensified CCD camera. Spectroscopic analysis of plasma evolution of laser produced plasmas has been characterized in terms of their spectra, electron density and electron temperature assuming the LTE and optically thin plasma conditions. The LIBS spectrum was optimized for high S/N ratio especially for trace elements. The electron temperature and density were determined using the emission intensity and stark broadening, respectively, of selected aluminum spectral lines. The values of these parameters were found to change with the aluminum alloy matrix, i.e. they could be used as a fingerprint character to distinguish between different aluminum alloy matrices using only one major element (aluminum without needing to analysis the rest of elements in the matrix. Moreover, It was found that the values of T e and N e decrease with increasing the trace elements concentrations in the aluminum alloy samples. The obtained results indicate that it is possible to improve the exploitation of LIBS in the remote on-line industrial monitoring application, by following up only the values of T e and N e for aluminum in aluminum alloys as a marker for the correct alloying using an optical fiber probe.

  17. Fast LIBS Identification of Aluminum Alloys

    Directory of Open Access Journals (Sweden)

    Tawfik W.

    2007-04-01

    Full Text Available Laser-induced breakdown spectroscopy (LIBS has been applied to analysis aluminum alloy targets. The plasma is generated by focusing a 300 mJ pulsed Nd: YAG laser on the target in air at atmospheric pressure. Such plasma emission spectrum was collected using a one-meter length wide band fused-silica optical fiber connected to a portable Echelle spectrometer with intensified CCD camera. Spectroscopic analysis of plasma evolution of laser produced plasmas has been characterized in terms of their spectra, electron density and electron temperature assuming the LTE and optically thin plasma conditions. The LIBS spectrum was optimized for high S/N ratio especially for trace elements. The electron temperature and density were determined using the emission intensity and stark broadening, respectively, of selected aluminum spectral lines. The values of these parameters were found to change with the aluminum alloy matrix, i.e. they could be used as a fingerprint character to distinguish between different aluminum alloy matrices using only one major element (aluminum without needing to analysis the rest of elements in the matrix. Moreover, It was found that the values of T(e and N(e decrease with increasing the trace elements concentrations in the aluminum alloy samples. The obtained results indicate that it is possible to improve the exploitation of LIBS in the remote on-line industrial monitoring application, by following up only the values of T(e and N(e for the aluminum in aluminum alloys using an optical fiber probe.

  18. Anodizing of aluminum with improved corrosion properties

    International Nuclear Information System (INIS)

    John, P.; Khan, I.U.

    2010-01-01

    Anodizing of aluminum was studied in sulphuric/oxalic/boric acid electroiyte system. The corrosion resistance of the anodic oxide coating of aluminum was determined by potentiodynamic polarization test and scanning electron microscope (SEM) was used to investigate the surface morphology before and after corrosion test. It was found that the oxide coating obtained by this method showed better corrosion resistance with no significant difference in surface morphology. (author)

  19. The effects of ultrasonic solidification on aluminum

    OpenAIRE

    Đorđević Slavko 1

    2003-01-01

    The effect of ultrasound on characteristics of solidified aluminum was shown. An ultrasonic head and ultrasonic system for modification was designed and applied to the crystallizing aluminum melt. The ultrasonic generator allows power of 50-500 W, amplitude of oscillations 10-100 um.m and the operating frequency of 25 kHz. Ultrasonic modification was done by ultrasound introduced from above into the melt. Microstructure photographs show decreasing of the grain size more than five times.

  20. The effects of ultrasonic solidification on aluminum

    Directory of Open Access Journals (Sweden)

    Đorđević Slavko 1

    2003-01-01

    Full Text Available The effect of ultrasound on characteristics of solidified aluminum was shown. An ultrasonic head and ultrasonic system for modification was designed and applied to the crystallizing aluminum melt. The ultrasonic generator allows power of 50-500 W, amplitude of oscillations 10-100 um.m and the operating frequency of 25 kHz. Ultrasonic modification was done by ultrasound introduced from above into the melt. Microstructure photographs show decreasing of the grain size more than five times.

  1. Scientific Background for Processing of Aluminum Waste

    Directory of Open Access Journals (Sweden)

    Kononchuk Olga

    2017-01-01

    of the aluminum waste A1- Zn-Cu-Si-Fe shows that depending on the content of the metal the dissolution process of an aluminum alloy should be treated as the result of the chemical interaction of the metal with an alkaline solution. It is necessary to consider the behavior of the main components of alloys in an alkaline solution as applied to the system Na2O - Al2O3 - SiO2 - CO2 - H2O.

  2. Advanced powder metallurgy aluminum alloys and composites

    Science.gov (United States)

    Lisagor, W. B.; Stein, B. A.

    1982-01-01

    The differences between powder and ingot metallurgy processing of aluminum alloys are outlined. The potential payoff in the use of advanced powder metallurgy (PM) aluminum alloys in future transport aircraft is indicated. The national program to bring this technology to commercial fruition and the NASA Langley Research Center role in this program are briefly outlined. Some initial results of research in 2000-series PM alloys and composites that highlight the property improvements possible are given.

  3. Effect of extrusion stem speed on extrusion process for a hollow aluminum profile

    International Nuclear Information System (INIS)

    Zhang, Cunsheng; Zhao, Guoqun; Chen, Zhiren; Chen, Hao; Kou, Fujun

    2012-01-01

    Highlights: ► Extrusion stem speed has significant effects on extrusion process. ► An optimum value of stem speed exists for uniform metal flow distribution. ► A higher stem speed leads to a higher required extrusion force. ► A high stem speed leads to an improved welding quality of aluminum profile. - Abstract: Extrusion stem speed is one of important process parameters during aluminum profile extrusion, which directly influences the profile quality and choice of extrusion equipments. In this paper, the extrusion process of a thin-walled hollow aluminum profile was simulated by means of the HyperXtrude commercial software. Through a serial of numerical simulation, the effects of stem speed on extrusion process, such as metal flow behavior at die exit, temperature distribution, extrusion force, and welding pressure, have been investigated. The numerical results showed that there existed an optimum value of stem speed for flow velocity distribution. With the increasing stem speed, the temperature of the extrudate and required extrusion force increased, and the welding quality of extrudate would be improved. Through comprehensive comparison and analysis, the appropriate stem speed could be determined for practical extrusion production. Thus, the research results could give effective guideline for determining initial billet and die temperature and choosing the proper extrusion press in aluminum profile industry.

  4. Commentary on recent therapeutic guidelines for osteoarthritis.

    Science.gov (United States)

    Cutolo, Maurizio; Berenbaum, Francis; Hochberg, Marc; Punzi, Leonardo; Reginster, Jean-Yves

    2015-06-01

    Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. A symposium of European and US OA experts was held within the framework of the Annual European Congress of Rheumatology to discuss and compare guidelines and recommendations for the treatment of knee OA and to reach a consensus for management, particularly for areas in which there is no clear consensus: non-pharmacological therapy; efficacy and safety of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); intra-articular (i.a.) hyaluronates (HA); and the role of chondroitin sulfate (CS) and/or glucosamine sulfate (GS). All guidelines reviewed agree that knee OA is a progressive disease of the joint whose management requires non-pharmacological and pharmacological approaches. Discrepancies between guidelines are few and mostly reflect heterogeneity of expert panels involved, geographical differences in the availability of pharmacotherapies, and heterogeneity of the studies included. Panels chosen for guideline development should include experts with real clinical experience in drug use and patient management. Implementation of agreed guidelines can be thwarted by drug availability and reimbursement plans, resulting in optimal OA treatment being jeopardized, HA and symptomatic slow-acting drugs for osteoarthritis (SySADOAs) being clear examples of drugs whose availability and prescription can greatly vary geographically. In addition, primary care providers, often responsible for OA management (at least in early disease), may not adhere to clinical care guidelines, particularly for non-pharmacological OA treatment. Harmonization of the recommendations for knee OA treatment is challenging but feasible, as shown by the step-by-step therapeutic algorithm developed by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). More easily disseminated and

  5. Physicians' preferences for asthma guidelines implementation.

    Science.gov (United States)

    Kang, Min-Koo; Kim, Byung-Keun; Kim, Tae-Wan; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Kim, Sun-Sin; Min, Kyung-Up; Kim, You-Young; Cho, Sang-Heon

    2010-10-01

    Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.

  6. Research of plating aluminum and aluminum foil on internal surface of carbon fiber composite material centrifuge rotor drum

    International Nuclear Information System (INIS)

    Lu Xiuqi; Dong Jinping; Dai Xingjian

    2014-01-01

    In order to improve the corrosion resistance, thermal conductivity and sealability of the internal surface of carbon fiber/epoxy composite material centrifuge rotor drum, magnetron sputtering aluminum and pasting an aluminum foil on the inner wall of the drum are adopted to realize the aim. By means of XRD, SEM/EDS and OM, the surface topography of aluminum coated (thickness of 5 μm and 12 μm) and aluminum foil (12 μm) are observed and analyzed; the cohesion of between aluminum coated (or aluminum foil) and substrate material (CFRP) is measured by scratching experiment, direct drawing experiment, and shear test. Besides, the ultra-high-speed rotation experiment of CFRP ring is carried out to analyze stress and strain of coated aluminum (or aluminum foil) which is adhered on the ring. The results showed aluminum foil pasted on inner surface do better performance than magnetron sputtering aluminum on CFRP centrifuge rotor drum. (authors)

  7. Studies of aluminum in rat brain

    Energy Technology Data Exchange (ETDEWEB)

    Lipman, J.J.; Brill, A.B.; Som, P.; Jones, K.W.; Colowick, S.; Cholewa, M.

    1985-01-01

    The effects of high aluminum concentrations in rat brains were studied using /sup 14/C autoradiography to measure the uptake of /sup 14/C 2-deoxy-D-glucose (/sup 14/C-2DG) and microbeam proton-induced x-ray emission (microPIXE) with a 20-..mu..m resolution to measure concentrations of magnesium, aluminum, potassium, and calcium. The aluminum was introduced intracisternally in the form of aluminum tartrate (Al-T) while control animals were given sodium tartrate (Na-T). The /sup 14/C was administered intravenously. The animals receiving Al-T developed seizure disorders and had pathological changes that included cerebral cortical atrophy. The results showed that there was a decreased uptake of /sup 14/C-2DG in cortical regions in which increased aluminum levels were measured, i.e., there is a correlation between the aluminum in the rat brain and decreased brain glucose metabolism. A minimum detection limit of about 16 ppM (mass fraction) or 3 x 10/sup 9/ Al atoms was obtained for Al under the conditions employed. 14 refs., 4 figs., 1 tab.

  8. Aluminum neurotoxicity in the rat brain

    Energy Technology Data Exchange (ETDEWEB)

    Yumoto, S [Tokyo Univ. (Japan). Faculty of Medicine; Ohashi, H; Nagai, H; Kakimi, S; Ogawa, Y; Iwata, Y; Ishii, K

    1993-12-31

    To investigate the etiology of Alzheimer`s disease, we administered aluminum to healthy rats and examined the aluminum uptake in the brain and isolated brain cell nuclei by particle-induced X-ray emission (PIXE) analysis. Ten days after the last injection, Al was detected in the rat brain and in isolated brain cell nuclei by PIXE analysis. Al was also demonstrated in the brain after 15 months of oral aluminum administration. Moreover, Al was detected in the brain and isolated brain cell nuclei from the patients with Alzheimer`s disease. Silver impregnation studies revealed that spines attached to the dendritic processes of cortical nerve cells decreased remarkably after aluminum administration. Electron microscopy revealed characteristic inclusion bodies in the hippocampal nerve cells 75 days after the injection. These morphological changes in the rat brain after the aluminum administration were similar to those reportedly observed in the brain of Alzheimer`s disease patients. Our results indicate that Alzheimer`s disease is caused by irreversible accumulation of aluminum in the brain, as well as in the nuclei of brain cells. (author).

  9. Aluminum neurotoxicity in the rat brain

    International Nuclear Information System (INIS)

    Yumoto, S.; Ohashi, H.; Nagai, H.; Kakimi, S.; Ogawa, Y.; Iwata, Y.; Ishii, K.

    1992-01-01

    To investigate the etiology of Alzheimer's disease, we administered aluminum to healthy rats and examined the aluminum uptake in the brain and isolated brain cell nuclei by particle-induced X-ray emission (PIXE) analysis. Ten days after the last injection, Al was detected in the rat brain and in isolated brain cell nuclei by PIXE analysis. Al was also demonstrated in the brain after 15 months of oral aluminum administration. Moreover, Al was detected in the brain and isolated brain cell nuclei from the patients with Alzheimer's disease. Silver impregnation studies revealed that spines attached to the dendritic processes of cortical nerve cells decreased remarkably after aluminum administration. Electron microscopy revealed characteristic inclusion bodies in the hippocampal nerve cells 75 days after the injection. These morphological changes in the rat brain after the aluminum administration were similar to those reportedly observed in the brain of Alzheimer's disease patients. Our results indicate that Alzheimer's disease is caused by irreversible accumulation of aluminum in the brain, as well as in the nuclei of brain cells. (author)

  10. Studies of aluminum in rat brain

    International Nuclear Information System (INIS)

    Lipman, J.J.; Brill, A.B.; Som, P.; Jones, K.W.; Colowick, S.; Cholewa, M.

    1985-01-01

    The effects of high aluminum concentrations in rat brains were studied using 14 C autoradiography to measure the uptake of 14 C 2-deoxy-D-glucose ( 14 C-2DG) and microbeam proton-induced x-ray emission (microPIXE) with a 20-μm resolution to measure concentrations of magnesium, aluminum, potassium, and calcium. The aluminum was introduced intracisternally in the form of aluminum tartrate (Al-T) while control animals were given sodium tartrate (Na-T). The 14 C was administered intravenously. The animals receiving Al-T developed seizure disorders and had pathological changes that included cerebral cortical atrophy. The results showed that there was a decreased uptake of 14 C-2DG in cortical regions in which increased aluminum levels were measured, i.e., there is a correlation between the aluminum in the rat brain and decreased brain glucose metabolism. A minimum detection limit of about 16 ppM (mass fraction) or 3 x 10 9 Al atoms was obtained for Al under the conditions employed. 14 refs., 4 figs., 1 tab

  11. Hydrogen storage in sodium aluminum hydride.

    Energy Technology Data Exchange (ETDEWEB)

    Ozolins, Vidvuds; Herberg, J.L. (Lawrence Livermore National Laboratories, Livermore, CA); McCarty, Kevin F.; Maxwell, Robert S. (Lawrence Livermore National Laboratories, Livermore, CA); Stumpf, Roland Rudolph; Majzoub, Eric H.

    2005-11-01

    Sodium aluminum hydride, NaAlH{sub 4}, has been studied for use as a hydrogen storage material. The effect of Ti, as a few mol. % dopant in the system to increase kinetics of hydrogen sorption, is studied with respect to changes in lattice structure of the crystal. No Ti substitution is found in the crystal lattice. Electronic structure calculations indicate that the NaAlH{sub 4} and Na{sub 3}AlH{sub 6} structures are complex-ionic hydrides with Na{sup +} cations and AlH{sub 4}{sup -} and AlH{sub 6}{sup 3-} anions, respectively. Compound formation studies indicate the primary Ti-compound formed when doping the material at 33 at. % is TiAl{sub 3} , and likely Ti-Al compounds at lower doping rates. A general study of sorption kinetics of NaAlH{sub 4}, when doped with a variety of Ti-halide compounds, indicates a uniform response with the kinetics similar for all dopants. NMR multiple quantum studies of solution-doped samples indicate solvent interaction with the doped alanate. Raman spectroscopy was used to study the lattice dynamics of NaAlH{sub 4}, and illustrated the molecular ionic nature of the lattice as a separation of vibrational modes between the AlH{sub 4}{sup -} anion-modes and lattice-modes. In-situ Raman measurements indicate a stable AlH{sub 4}{sup -} anion that is stable at the melting temperature of NaAlH{sub 4}, indicating that Ti-dopants must affect the Al-H bond strength.

  12. DoD Implementation of the National Practitioner Data Bank Guidelines

    National Research Council Canada - National Science Library

    1998-01-01

    ... of their previous damaging or incompetent performance. The primary evaluation objective was to determine the Military Departments' overall effectiveness in implementing the NPDB program guidelines...

  13. Spray rolling aluminum alloy strip

    Energy Technology Data Exchange (ETDEWEB)

    McHugh, Kevin M.; Delplanque, J.-P.; Johnson, S.B.; Lavernia, E.J.; Zhou, Y.; Lin, Y

    2004-10-10

    Spray rolling combines spray forming with twin-roll casting to process metal flat products. It consists of atomizing molten metal with a high velocity inert gas, cooling the resultant droplets in flight and directing the spray between mill rolls. In-flight convection heat transfer from atomized droplets teams with conductive cooling at the rolls to rapidly remove the alloy's latent heat. Hot deformation of the semi-solid material in the rolls results in fully consolidated, rapidly solidified product. While similar in some ways to twin-roll casting, spray rolling has the advantage of being able to process alloys with broad freezing ranges at high production rates. This paper describes the process and summarizes microstructure and tensile properties of spray-rolled 2124 and 7050 aluminum alloy strips. A Lagrangian/Eulerian poly-dispersed spray flight and deposition model is described that provides some insight into the development of the spray rolling process. This spray model follows droplets during flight toward the rolls, through impact and spreading, and includes oxide film formation and breakup when relevant.

  14. Aluminum bioavailability from tea infusion.

    Science.gov (United States)

    Yokel, Robert A; Florence, Rebecca L

    2008-12-01

    The objective was to estimate oral Al bioavailability from tea infusion in the rat, using the tracer (26)Al. (26)Al citrate was injected into tea leaves. An infusion was prepared from the dried leaves and given intra-gastrically to rats which received concurrent intravenous (27)Al infusion. Oral Al bioavailability (F) was calculated from the area under the (26)Al, compared to (27)Al, serum concentration x time curves. Bioavailability from tea averaged 0.37%; not significantly different from water (F=0.3%), or basic sodium aluminum phosphate (SALP) in cheese (F=0.1-0.3%), but greater than acidic SALP in a biscuit (F=0.1%). Time to maximum serum (26)Al concentration was 1.25, 1.5, 8 and 4.8h, respectively. These results of oral Al bioavailability x daily consumption by the human suggest tea can provide a significant amount of the Al that reaches systemic circulation. This can allow distribution to its target organs of toxicity, the central nervous, skeletal and hematopoietic systems. Further testing of the hypothesis that Al contributes to Alzheimer's disease may be more warranted with studies focusing on total average daily food intake, including tea and other foods containing appreciable Al, than drinking water.

  15. Understanding of radiation effect on sink in aluminum base structure materials

    International Nuclear Information System (INIS)

    Choi, Sang Il; Kim, Ji Hyun

    2014-01-01

    In case of aluminum, a slightly different approach is needed for the evaluation of radiation damage. Unlikely other structure materials such as zirconium alloy and iron based alloy, aluminum generate not only matrix defect but also much transmutation. Quantitative analysis of radiation damage of aluminum have been done in two research method. First research method is calculation of radiation damage quantity in the matrix. In this research, quantity of transmutation and matrix damage are evaluated by KMC simulation from ENDF database of IAEA. Most recently, radiation damage such as defect and transmutation are calculated in the MNSR reactor environment. The second research method is evaluation of sink morphology change by irradiation, which research method focus on accumulating behavior of radiation defects. Matrix defect and transmutation are clustering or dissolved by thermal diffusion and energy statue. These clustering defect such as dislocation loop, void and bubble directly affect mechanical properties. In this research area, it is hard to using deterministic method because it should describe envious and various reaction module in detail. However, in case of probabilistic method, it could be explained without detail reaction module. Most recently, there was KMC modeling about vacancy and helium cluster. From this cluster modeling, transmutation is quantitatively analyzed. After that cluster effect on swelling are explained. Unfortunately, silicon, which is another transmutation of aluminum, effect are neglected. Also primary cluster, which is generated by cascade, effect are neglected. For the fundamental understanding of radiation effect on aluminum alloy, it is needed that more various parameter such as alloy element and primary cluster effect should be researched. However, until now there was not general modeling which include alloy element and primary cluster effect on aluminum. However, there was not specified KMC platform for the quantitative analysis of

  16. EMI Messaging Guidelines

    CERN Document Server

    Cons, L.

    2011-01-01

    Guidelines for potential users of messaging within EMI. The goal is to provide enough practical information so that EMI product teams can start investigating whether using messaging in their products can be beneficial or not.

  17. London 2012 packaging guidelines

    OpenAIRE

    2013-01-01

    These guidelines are intended to provide supplemental advice to suppliers and licensees regarding the provisions of the LOCOG Sustainable Sourcing Code that relate to packaging design and materials selection.

  18. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    As part of learning at the Nordic Workshop of Evidence-based Medicine, we have read with interest the practice guidelines for central venous access, published in your Journal in 2012.1 We appraised the quality of this guideline using the checklist developed by The Evidence-Based Medicine Working ...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....... Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...

  19. Adopting preoperative fasting guidelines.

    Science.gov (United States)

    Anderson, Megan; Comrie, Rhonda

    2009-07-01

    In 1999, the American Society of Anesthesiologists adopted preoperative fasting guidelines to enhance the quality and efficiency of patient care. Guidelines suggest that healthy, non-pregnant patients should fast six hours from solids and two hours from liquids. Although these guidelines are in place, studies suggest that providers are still using the blanket statement "NPO after midnight" without regard to patient characteristics, the procedure, or the time of the procedure. Using theory to help change provider's beliefs may help make change more successful. Rogers' Theory of Diffusion of Innovations can assist in changing long-time practice by laying the groundwork for an analysis of the benefits and disadvantages of proposed changes, such as changes to fasting orders, while helping initiate local protocols instead of additional national guidelines.

  20. OSART guidelines. 1992 edition

    International Nuclear Information System (INIS)

    1992-01-01

    The IAEA Operational Safety Review Team (OSART) Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as a guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness. Additional guidance and reference material has been prepared by the IAEA to complement the expertise of the OSART members

  1. Electrical safety guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

  2. Closed cooling water chemistry guidelines revision

    International Nuclear Information System (INIS)

    McElrath, Joel; Breckenridge, Richard

    2014-01-01

    This second revision of the Closed Cooling Water Chemistry Guideline addresses the use of chemicals and monitoring methods to mitigate corrosion, fouling, and microbiological growth in the closed cooling-water (CCW) systems of nuclear and fossil-fueled power plants. This revision has been endorsed by the utility chemistry community and represents another step in developing a more proactive chemistry program to limit or control closed cooling system degradation with increased consideration of corporate resources and plant-specific design and operating concerns. These guidelines were developed using laboratory data, operating experience, and input from organizations and utilities within and outside of the United States of America. It is the intent of the Revision Committee that these guidelines are applicable to all nuclear and fossil-fueled generating stations around the world. A committee of industry experts—including utility specialists, Institute of Nuclear Power Operations representatives, water-treatment service-company representatives, consultants, a primary contractor, and EPRI staff—collaborated in reviewing available data on closed cooling-water system corrosion and microbiological issues. Recognizing that each plant owner has a unique set of design, operating, and corporate concerns, the Guidelines Committee developed a methodology for plant-specific optimization. The guideline provides the technical basis for a reasonable but conservative set of chemical treatment and monitoring programs. The use of operating ranges for the various treatment chemicals discussed in this guideline will allow a power plant to limit corrosion, fouling, and microbiological growth in CCW systems to acceptable levels. The guideline now includes closed cooling chemistry regimes proven successful in use in the international community. The guideline provides chemistry constraints for the use of phosphates control, as well as pure water with pH control. (author)

  3. [Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

    Science.gov (United States)

    Planjar-Prvan, Miljenka; Granić, Davorka

    2005-01-01

    The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

  4. Ecologo guidelines spark disagreement

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    Defining what renewable means has been a challenge, but the authors of a new set of guidelines for the Ecologo certification of renewable low-impact electrcity expect after some delay to have the new rules on the street by March 2000.. There was contention in developing the guideline, according to Terra Choice Environmental Services, the company that created and applied criteria for Ecologo certification under the federal government's Environmetal Choice Program. Interim guidleines were developed and have been in place for renewable power since 1996, and have since been used to certify wood-waste biomass, landfill gas, small hydro and wind power plants, in addition to three green power marketing programs. The first draft of the revised guidelines was issued in March. It was one of the harder guidelines to have been worked on because Canadian power producers did not readily agree on what should qualify as renewable, particularly around the whole area of hydro. While small run-of-river hydro plants will continue to fit within the Ecologo guidelines, larger projects will not. Wind power producers are relatively happy with the latest version of TerraChoice's draft guidelines, released at the end of November. A significant revision of the original rules is a limit on the amount of older generation green power marketers who want to promote the green power Ecologo electricity can sell. At least 50% of their capacity must originate from plants installed after January 1, 1991

  5. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

    Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

  6. Anodized aluminum on LDEF: A current status of measurements on chromic acid anodized aluminum

    International Nuclear Information System (INIS)

    Golden, J.L.

    1992-01-01

    Chromic acid anodize was used as the exterior coating for aluminum surfaces on LDEF to provide passive thermal control. Chromic acid anodized aluminum was also used as test specimens in thermal control coatings experiments. The following is a compilation and analysis of the data obtained thus far

  7. Anodized aluminum on LDEF: A current status of measurements on chromic acid anodized aluminum

    Science.gov (United States)

    Golden, Johnny L.

    1992-01-01

    Chromic acid anodize was used as the exterior coating for aluminum surfaces on LDEF to provide passive thermal control. Chromic acid anodized aluminum was also used as test specimens in thermal control coatings experiments. The following is a compilation and analysis of the data obtained thus far.

  8. Casting Characteristics of High Cerium Content Aluminum Alloys

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, D; Rios, O R; Sims, Z C; McCall, S K; Ott, R T

    2017-09-05

    This paper compares the castability of the near eutectic aluminum-cerium alloy system to the aluminum-silicon and aluminum-copper systems. The alloys are compared based on die filling capability, feeding characteristics and tendency to hot tear in both sand cast and permanent mold applications. The castability ranking of the binary Al–Ce systems is as good as the aluminum-silicon system with some deterioration as additional alloying elements are added. In alloy systems that use cerium in combination with common aluminum alloying elements such as silicon, magnesium and/or copper, the casting characteristics are generally better than the aluminum-copper system. In general, production systems for melting, de-gassing and other processing of aluminum-silicon or aluminum-copper alloys can be used without modification for conventional casting of aluminum-cerium alloys.

  9. Progress in Aluminum Electrolysis Control and Future Direction for Smart Aluminum Electrolysis Plant

    Science.gov (United States)

    Zhang, Hongliang; Li, Tianshuang; Li, Jie; Yang, Shuai; Zou, Zhong

    2017-02-01

    The industrial aluminum reduction cell is an electrochemistry reactor that operates under high temperatures and highly corrosive conditions. However, these conditions have restricted the measurement of key control parameters, making the control of aluminum reduction cells a difficult problem in the industry. Because aluminum electrolysis control systems have a significant economic influence, substantial research has been conducted on control algorithms, control systems and information systems for aluminum reduction cells. This article first summarizes the development of control systems and then focuses on the progress made since 2000, including alumina concentration control, temperature control and electrolyte molecular ratio control, fault diagnosis, cell condition prediction and control system expansion. Based on these studies, the concept of a smart aluminum electrolysis plant is proposed. The frame construction, key problems and current progress are introduced. Finally, several future directions are discussed.

  10. Design, fabrication, and evaluation of charge-coupled devices with aluminum-anodized-aluminum gates

    Science.gov (United States)

    Gassaway, J. D.; Causey, W. H., Jr.

    1977-01-01

    A 4-phase, 49 1/2 bit CCD shift register was designed and fabricated using two levels of aluminum metallization with anodic Al2O3 insulation separating the layers. Test circuitry was also designed and constructed. A numerical analysis of an MOS-RC transmission line was made and results are given to characterize performance for various conductivities. The electrical design of the CCD included a low-noise dual-gate input and a balanced floating diffusion output circuit. Metallization was accomplished both by low voltage DC sputtering and thermal evaporation. The audization was according to published procedures using a buffered tartaric acid bath. Approximately 20 wafers were processed with 50 complete chips per wafer. All devices failed by shorting between the metal levels at some point. Experimental procedures eliminated temperature effects from sintering and drying, anodic oxide thickness, edge effects, photoresist stripping procedures, and metallization techniques as the primary causes of failure. It was believed from a study of SEM images that protuberances (hillocks) grow up from the first level metal through the oxide either causing a direct short or producing a weak, highly stressed insulation point which fails at low voltage. The cause of these hillocks is unknown; however, they have been observed to grow during temperature excursions to 470 C.

  11. Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Carter, R.J.

    1997-07-01

    This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

  12. Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

    International Nuclear Information System (INIS)

    Carter, R.J.

    1997-07-01

    This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

  13. Deposition behavior of residual aluminum in drinking water distribution system: Effect of aluminum speciation.

    Science.gov (United States)

    Zhang, Yue; Shi, Baoyou; Zhao, Yuanyuan; Yan, Mingquan; Lytle, Darren A; Wang, Dongsheng

    2016-04-01

    Finished drinking water usually contains some residual aluminum. The deposition of residual aluminum in distribution systems and potential release back to the drinking water could significantly influence the water quality at consumer taps. A preliminary analysis of aluminum content in cast iron pipe corrosion scales and loose deposits demonstrated that aluminum deposition on distribution pipe surfaces could be excessive for water treated by aluminum coagulants including polyaluminum chloride (PACl). In this work, the deposition features of different aluminum species in PACl were investigated by simulated coil-pipe test, batch reactor test and quartz crystal microbalance with dissipation monitoring. The deposition amount of non-polymeric aluminum species was the least, and its deposition layer was soft and hydrated, which indicated the possible formation of amorphous Al(OH)3. Al13 had the highest deposition tendency, and the deposition layer was rigid and much less hydrated, which indicated that the deposited aluminum might possess regular structure and self-aggregation of Al13 could be the main deposition mechanism. While for Al30, its deposition was relatively slower and deposited aluminum amount was relatively less compared with Al13. However, the total deposited mass of Al30 was much higher than that of Al13, which was attributed to the deposition of particulate aluminum matters with much higher hydration state. Compared with stationary condition, stirring could significantly enhance the deposition process, while the effect of pH on deposition was relatively weak in the near neutral range of 6.7 to 8.7. Copyright © 2015. Published by Elsevier B.V.

  14. A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice

    DEFF Research Database (Denmark)

    Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming

    2016-01-01

    BACKGROUND: Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from p...

  15. Electrochemically replicated smooth aluminum foils for anodic alumina nanochannel arrays

    International Nuclear Information System (INIS)

    Biring, Sajal; Tsai, K-T; Sur, Ujjal Kumar; Wang, Y-L

    2008-01-01

    A fast electrochemical replication technique has been developed to fabricate large-scale ultra-smooth aluminum foils by exploiting readily available large-scale smooth silicon wafers as the masters. Since the adhesion of aluminum on silicon depends on the time of surface pretreatment in water, it is possible to either detach the replicated aluminum from the silicon master without damaging the replicated aluminum and master or integrate the aluminum film to the silicon substrate. Replicated ultra-smooth aluminum foils are used for the growth of both self-organized and lithographically guided long-range ordered arrays of anodic alumina nanochannels without any polishing pretreatment

  16. Delineation of the primary tumour Clinical Target Volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG Oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines.

    Science.gov (United States)

    Grégoire, Vincent; Evans, Mererid; Le, Quynh-Thu; Bourhis, Jean; Budach, Volker; Chen, Amy; Eisbruch, Abraham; Feng, Mei; Giralt, Jordi; Gupta, Tejpal; Hamoir, Marc; Helito, Juliana K; Hu, Chaosu; Hunter, Keith; Johansen, Jorgen; Kaanders, Johannes; Laskar, Sarbani Ghosh; Lee, Anne; Maingon, Philippe; Mäkitie, Antti; Micciche', Francesco; Nicolai, Piero; O'Sullivan, Brian; Poitevin, Adela; Porceddu, Sandro; Składowski, Krzysztof; Tribius, Silke; Waldron, John; Wee, Joseph; Yao, Min; Yom, Sue S; Zimmermann, Frank; Grau, Cai

    2018-01-01

    Few studies have reported large inter-observer variations in target volume selection and delineation in patients treated with radiotherapy for head and neck squamous cell carcinoma. Consensus guidelines have been published for the neck nodes (see Grégoire et al., 2003, 2014), but such recommendations are lacking for primary tumour delineation. For the latter, two main schools of thoughts are prevailing, one based on geometric expansion of the Gross Tumour Volume (GTV) as promoted by DAHANCA, and the other one based on anatomical expansion of the GTV using compartmentalization of head and neck anatomy. For each anatomic location within the larynx, hypopharynx, oropharynx and oral cavity, and for each T-stage, the DAHANCA proposal has been comprehensively reviewed and edited to include anatomic knowledge into the geometric Clinical Target Volume (CTV) delineation concept. A first proposal was put forward by the leading authors of this publication (VG and CG) and discussed with opinion leaders in head and neck radiation oncology from Europe, Asia, Australia/New Zealand, North America and South America to reach a worldwide consensus. This consensus proposes two CTVs for the primary tumour, the so called CTV-P1 and CVT-P2, corresponding to a high and lower tumour burden, and which should be associated with a high and a lower dose prescription, respectively. Implementation of these guidelines in the daily practice of radiation oncology should contribute to reduce treatment variations from clinicians to clinicians, facilitate the conduct of multi-institutional clinical trials, and contribute to improved care of patients with head and neck carcinoma. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Design patterns for modelling guidelines

    NARCIS (Netherlands)

    Serban, Radu; Ten Teije, Annette; Marcos, Mar; Polo-Conde, Cristina; Rosenbrand, Kitty C J G M; Wittenberg, Jolanda; van Croonenborg, Joyce

    2005-01-01

    It is by now widely accepted that medical guidelines can help to significantly improve the quality of medical care. Unfortunately, constructing the required medical guidelines is a very labour intensive and costly process. The cost of guideline construction would decrease if guidelines could be

  18. Development of cancer treatment guidelines

    African Journals Online (AJOL)

    Krystyna Kiel

    2011-05-26

    May 26, 2011 ... KEYWORDS. Cancer;. Therapy;. Guidelines. Contents. 1. Why develop guidelines? ... Widely available guideline resources in cancer care. ... The use of guidelines in medicine has a long history. Many .... She has a negative family history. ... The patient has 1 cm grade 3 infiltrating ductal carcinoma.

  19. Japanese Guideline for Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Ichiro Katayama

    2011-01-01

    The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2009 (ADGL2009” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle.

  20. Are BTS guidelines followed?

    Science.gov (United States)

    2002-03-01

    In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax. The study's aim was to determine the level of adherence to these guidelines at a London teaching hospital. A retrospective case note audit of 59 episodes was performed. In patients undergoing intervention, the initial procedure was simple aspiration in 32 (73 per cent) and chest tube insertion in 12 (27 per cent) cases, contrasting with the BTS recommendation that aspiration should be attempted first in all such patients. Simple aspiration was successful on 34 per cent of occasions. Successful aspiration was associated with a significantly shorter hospital stay (median 3, range 1-11 days) than either failed aspiration (7, 3-66 days) or chest tube insertion without aspiration (9, 3-16 days). Other areas where practice differed from the BTS guidelines were clamping of chest tubes and use of a pursestring suture for wound closure. A follow up questionnaire suggested a lack of familiarity with the guidelines. These findings indicate that current management of spontaneous pneumothorax deviates from the BTS guidelines in potentially important respects.

  1. Precision forging technology for aluminum alloy

    Science.gov (United States)

    Deng, Lei; Wang, Xinyun; Jin, Junsong; Xia, Juchen

    2018-03-01

    Aluminum alloy is a preferred metal material for lightweight part manufacturing in aerospace, automobile, and weapon industries due to its good physical properties, such as low density, high specific strength, and good corrosion resistance. However, during forging processes, underfilling, folding, broken streamline, crack, coarse grain, and other macro- or microdefects are easily generated because of the deformation characteristics of aluminum alloys, including narrow forgeable temperature region, fast heat dissipation to dies, strong adhesion, high strain rate sensitivity, and large flow resistance. Thus, it is seriously restricted for the forged part to obtain precision shape and enhanced property. In this paper, progresses in precision forging technologies of aluminum alloy parts were reviewed. Several advanced precision forging technologies have been developed, including closed die forging, isothermal die forging, local loading forging, metal flow forging with relief cavity, auxiliary force or vibration loading, casting-forging hybrid forming, and stamping-forging hybrid forming. High-precision aluminum alloy parts can be realized by controlling the forging processes and parameters or combining precision forging technologies with other forming technologies. The development of these technologies is beneficial to promote the application of aluminum alloys in manufacturing of lightweight parts.

  2. Determination of aluminum by four analytical methods

    International Nuclear Information System (INIS)

    Hanson, T.J.; Smetana, K.M.

    1975-11-01

    Four procedures have been developed for determining the aluminum concentration in basic matrices. Atomic Absorption Spectroscopy (AAS) was the routine method of analysis. Citrate was required to complex the aluminum and eliminate matrix effects. AAS was the least accurate of the four methods studied and was adversely affected by high aluminum concentrations. The Fluoride Electrode Method was the most accurate and precise of the four methods. A Gran's Plot determination was used to determine the end point and average standard recovery was 100% +- 2%. The Thermometric Titration Method was the fastest method for determining aluminum and could also determine hydroxide concentration at the same time. Standard recoveries were 100% +- 5%. The pH Electrode Method also measures aluminum and hydroxide content simultaneously, but is less accurate and more time consuming that the thermal titration. Samples were analyzed using all four methods and results were compared to determine the strengths and weaknesses of each. On the basis of these comparisons, conclusions were drawn concerning the application of each method to our laboratory needs

  3. Characterization of acoustic cavitation in water and molten aluminum alloy.

    Science.gov (United States)

    Komarov, Sergey; Oda, Kazuhiro; Ishiwata, Yasuo; Dezhkunov, Nikolay

    2013-03-01

    High-intensive ultrasonic vibrations have been recognized as an attractive tool for refining the grain structure of metals in casting technology. However, the practical application of ultrasonics in this area remains rather limited. One of the reasons is a lack of data needed to optimize the ultrasonic treatment conditions, particularly those concerning characteristics of cavitation zone in molten aluminum. The main aim of the present study was to investigate the intensity and spectral characteristics of cavitation noise generated during radiation of ultrasonic waves into water and molten aluminum alloys, and to establish a measure for evaluating the cavitation intensity. The measurements were performed by using a high temperature cavitometer capable of measuring the level of cavitation noise within five frequency bands from 0.01 to 10MHz. The effect of cavitation treatment was verified by applying high-intense ultrasonic vibrations to a DC caster to refine the primary silicon grains of a model Al-17Si alloy. It was found that the level of high frequency noise components is the most adequate parameter for evaluating the cavitation intensity. Based on this finding, it was concluded that implosions of cavitation bubbles play a decisive role in refinement of the alloy structure. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. EAACI Food Allergy and Anaphylaxis Guidelines

    DEFF Research Database (Denmark)

    Muraro, A; Werfel, T; Hoffmann-Sommergruber, K

    2014-01-01

    on previous EAACI position papers on adverse reaction to foods and three recent systematic reviews on the epidemiology, diagnosis, and management of food allergy, and provide evidence-based recommendations for the diagnosis and management of food allergy. While the primary audience is allergists......, this document is relevant for all other healthcare professionals, including primary care physicians, and pediatric and adult specialists, dieticians, pharmacists and paramedics. Our current understanding of the manifestations of food allergy, the role of diagnostic tests, and the effective management...... of patients of all ages with food allergy is presented. The acute management of non-life-threatening reactions is covered in these guidelines, but for guidance on the emergency management of anaphylaxis, readers are referred to the related EAACI Anaphylaxis Guidelines....

  5. Lithium-aluminum-magnesium electrode composition

    Science.gov (United States)

    Melendres, Carlos A.; Siegel, Stanley

    1978-01-01

    A negative electrode composition is presented for use in a secondary, high-temperature electrochemical cell. The cell also includes a molten salt electrolyte of alkali metal halides or alkaline earth metal halides and a positive electrode including a chalcogen or a metal chalcogenide as the active electrode material. The negative electrode composition includes up to 50 atom percent lithium as the active electrode constituent and a magnesium-aluminum alloy as a structural matrix. Various binary and ternary intermetallic phases of lithium, magnesium, and aluminum are formed but the electrode composition in both its charged and discharged state remains substantially free of the alpha lithium-aluminum phase and exhibits good structural integrity.

  6. Lithium-aluminum-iron electrode composition

    Science.gov (United States)

    Kaun, Thomas D.

    1979-01-01

    A negative electrode composition is presented for use in a secondary electrochemical cell. The cell also includes an electrolyte with lithium ions such as a molten salt of alkali metal halides or alkaline earth metal halides that can be used in high-temperature cells. The cell's positive electrode contains a a chalcogen or a metal chalcogenide as the active electrode material. The negative electrode composition includes up to 50 atom percent lithium as the active electrode constituent in an alloy of aluminum-iron. Various binary and ternary intermetallic phases of lithium, aluminum and iron are formed. The lithium within the intermetallic phase of Al.sub.5 Fe.sub.2 exhibits increased activity over that of lithium within a lithium-aluminum alloy to provide an increased cell potential of up to about 0.25 volt.

  7. Diffusionless bonding of aluminum to Zircaloy-2

    International Nuclear Information System (INIS)

    Watson, R.D.

    1965-04-01

    Aluminum can be bonded to zirconium without difficulty even when a thin layer of oxide is present on the surface of the zirconium . No detectable diffusion takes place during the bonding process. The bond layer can be stretched as much. as 8% without affecting the bond. The bond can be heated for 1000 hours at 260 o C (500 o F), and can be water quenched from 260 o C (500 o F) without any noticeable change in the bond strength. An extrusion technique has been devised for making transition sections of aluminum bonded to zirconium which can then be used to join these metals by conventional welding. Welding can be done close to the bond zone without seriously affecting the integrity of the bond. This method of bonding aluminum to Zircaloy-2 is covered by Canadian patent 702,438 January 26, 1965. (author)

  8. NASA-427: A New Aluminum Alloy

    Science.gov (United States)

    Nabors, Sammy A.

    2015-01-01

    NASA's Marshall Space Flight Center researchers have developed a new, stronger aluminum alloy, ideal for cast aluminum products that have powder or paint-baked thermal coatings. With advanced mechanical properties, the NASA-427 alloy shows greater tensile strength and increased ductility, providing substantial improvement in impact toughness. In addition, this alloy improves the thermal coating process by decreasing the time required for heat treatment. With improvements in both strength and processing time, use of the alloy provides reduced materials and production costs, lower product weight, and better product performance. The superior properties of NASA-427 can benefit many industries, including automotive, where it is particularly well-suited for use in aluminum wheels.

  9. Aluminum phosphate ceramics for waste storage

    Science.gov (United States)

    Wagh, Arun; Maloney, Martin D

    2014-06-03

    The present disclosure describes solid waste forms and methods of processing waste. In one particular implementation, the invention provides a method of processing waste that may be particularly suitable for processing hazardous waste. In this method, a waste component is combined with an aluminum oxide and an acidic phosphate component in a slurry. A molar ratio of aluminum to phosphorus in the slurry is greater than one. Water in the slurry may be evaporated while mixing the slurry at a temperature of about 140-200.degree. C. The mixed slurry may be allowed to cure into a solid waste form. This solid waste form includes an anhydrous aluminum phosphate with at least a residual portion of the waste component bound therein.

  10. Study of aluminum-doped silicon clusters

    International Nuclear Information System (INIS)

    Zhan Shichang; Li Baoxing; Yang Jiansong

    2007-01-01

    Using full-muffin-tin-orbital molecular-dynamics (FP-LMTO-MD) method, we have investigated the effect of aluminum heteroatoms on the geometric structures and bond characteristics of Si n (n=5-10) clusters in detail. It is found that the geometric framework of the ground state structures for Si n (n=5-10) clusters change to some extent upon the substitution of Al atoms in some Si atoms. The effect of aluminum doping on the silicon clusters depends on the geometric structures of Si n (n=5-10) clusters. In particular, the calculations suggest that the aluminum doping would improve the bond strength of some Si-Si bonds in the mixed Si n - m Al m clusters

  11. Study on Explosive Forming of Aluminum Alloy

    Directory of Open Access Journals (Sweden)

    H Iyama

    2016-09-01

    Full Text Available Now, the aluminum alloy is often used as auto parts, for example, body, engine. For example, there are the body, a cylinder block, a piston, a connecting rod, interior, exterior parts, etc. These are practical used the characteristic of a light and strong aluminum alloy efficiently. However, although an aluminum alloy is lighter than steel, the elongation is smaller than that. Therefore, in press forming, some problems often occur. We have proposed use of explosive forming, in order to solve this problem. In the explosive forming, since a blank is formed at high speed, a strain rate effect becomes large and it can be made the elongation is larger. Then, in order to clarify this feature, we carried out experimental research and numerical analysis. In this paper, these contents will be discussed.

  12. OSART guidelines. 1994 edition

    International Nuclear Information System (INIS)

    1994-05-01

    These guidelines have been prepared to provide a basic structure and common reference both across the various areas covered by an OSART mission and across all the missions in the programme. As such, they are addressed, principally, to the team members of OSART missions but they will also provide guidance to a host nuclear plant preparing to receive a mission. The guidelines are intended to help each expert to formulate his review in the light of this own experience. They are not all inclusive and should not limit the expert's investigations, but are better considered as illustrating the adequate requirements for his review

  13. Data Qualification guidelines

    International Nuclear Information System (INIS)

    Edwards, T.B.; Shine, E.P.

    1992-01-01

    Data Qualification (DQ) is a formal, technical process whose objective is to affirm that experimental data are suitable for their intended use. Although it is not possible to develop a fixed recipe for the DQ process to cover all test situations, these general guidelines have been developed for the Nuclear Engineering Section to establish a framework for qualifying data from steady-state processing. These guidelines outline the role of the DQ team providing insight into the planning and conducting of the DQ process

  14. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  15. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  16. Air-Impregnated Nanoporous Anodic Aluminum Oxide Layers for Enhancing the Corrosion Resistance of Aluminum.

    Science.gov (United States)

    Jeong, Chanyoung; Lee, Junghoon; Sheppard, Keith; Choi, Chang-Hwan

    2015-10-13

    Nanoporous anodic aluminum oxide layers were fabricated on aluminum substrates with systematically varied pore diameters (20-80 nm) and oxide thicknesses (150-500 nm) by controlling the anodizing voltage and time and subsequent pore-widening process conditions. The porous nanostructures were then coated with a thin (only a couple of nanometers thick) Teflon film to make the surface hydrophobic and trap air in the pores. The corrosion resistance of the aluminum substrate was evaluated by a potentiodynamic polarization measurement in 3.5 wt % NaCl solution (saltwater). Results showed that the hydrophobic nanoporous anodic aluminum oxide layer significantly enhanced the corrosion resistance of the aluminum substrate compared to a hydrophilic oxide layer of the same nanostructures, to bare (nonanodized) aluminum with only a natural oxide layer on top, and to the latter coated with a thin Teflon film. The hydrophobic nanoporous anodic aluminum oxide layer with the largest pore diameter and the thickest oxide layer (i.e., the maximized air fraction) resulted in the best corrosion resistance with a corrosion inhibition efficiency of up to 99% for up to 7 days. The results demonstrate that the air impregnating the hydrophobic nanopores can effectively inhibit the penetration of corrosive media into the pores, leading to a significant improvement in corrosion resistance.

  17. Oxidation of nano-sized aluminum powders

    International Nuclear Information System (INIS)

    Vorozhtsov, A.B.; Lerner, M.; Rodkevich, N.; Nie, H.; Abraham, A.; Schoenitz, M.; Dreizin, E.L.

    2016-01-01

    Highlights: • Weight gain measured in TG oxidation experiments was split between particles of different sizes. • Reaction kinetics obtained by isoconversion explicitly accounting for the effect of size distribution. • Activation energy is obtained as a function of oxide thickness for growth of amorphous alumina. • Oxidation mechanism for nanopowders remains the same as for coarser aluminum powders. - Abstract: Oxidation of aluminum nanopowders obtained by electro-exploded wires is studied. Particle size distributions are obtained from transmission electron microscopy (TEM) images. Thermo-gravimetric (TG) experiments are complemented by TEM and XRD studies of partially oxidized particles. Qualitatively, oxidation follows the mechanism developed for coarser aluminum powder and resulting in formation of hollow oxide shells. Sintering of particles is also observed. The TG results are processed to account explicitly for the particle size distribution and spherical shapes, so that oxidation of particles of different sizes is characterized. The apparent activation energy is obtained as a function of the reaction progress using model-free isoconversion processing of experimental data. A complete phenomenological oxidation model is then proposed assuming a spherically symmetric geometry. The oxidation kinetics of aluminum powder is shown to be unaffected by particle sizes reduced down to tens of nm. The apparent activation energy describing growth of amorphous alumina is increasing at the very early stages of oxidation. The higher activation energy is likely associated with an increasing homogeneity in the growing amorphous oxide layer, initially containing multiple defects and imperfections. The trends describing changes in both activation energy and pre-exponent of the growing amorphous oxide are useful for predicting ignition delays of aluminum particles. The kinetic trends describing activation energies and pre-exponents in a broader range of the oxide

  18. Thermally sprayed coatings: Aluminum on lead

    International Nuclear Information System (INIS)

    Usmani, S.; Czajkowski, C.J.; Zatorski, R.

    1999-01-01

    An experimental program to determine the feasibility of thermally spraying aluminum on a lead substrate was initiated in support of the accelerator production of tritium (APT) Project for the US Department of Energy. The program consisted of two distinct parts: (1) the characterization of the thermally sprayed coatings, including microhardness testing, effects of heating, and microstructure and porosity determinations, and (2) effects of mercury doping and heat treatments on the thermally sprayed composite. The project determined that aluminum could successfully be thermally sprayed onto the lead. The coatings had a dense microstructure, with a Vicker's Pyramid Hardness (VPH) of about 60, and a maximum porosity (found in strips on the samples) of 12%

  19. Weld Development for Aluminum Fission Chamber

    Energy Technology Data Exchange (ETDEWEB)

    Cross, Carl Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Martinez, Jesse Norris [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-05-16

    The Sigma welding team was approached to help fabricate a small fission chamber (roughly ½ inch dia. x ½ inch tall cylinder). These chambers are used as radiation sensors that contain small traces of radionuclides (Cf 252, U 235, and U 238) that serve to ionize gas atoms in addition to external radiation. When a voltage is applied within the chamber, the resulting ion flow can be calibrated and monitored. Aluminum has the advantage of not forming radioactive compounds when exposed to high external radiation (except from minor Na alloy content). Since aluminum has not been used before in this application, this presented an unexplored challenge.

  20. Laser microprobe mass analysis (LAMMA) of aluminum and lead in fine roots and their ectomycorrhizal mantles of Norway spruce (Picea abies (L.) Karst.).

    Science.gov (United States)

    Eeckhaoudt, S; Vandeputte, D; Van Praag, H; Van Grieken, R; Jacob, W

    1992-03-01

    Fine roots and ectomycorrhizal root tips were sampled in a Norway spruce (Picea abies (L.) Karst.) stand in the eastern part of the Belgian Ardennes. The cellular and partly subcellular localizations of aluminum and lead were identified by the micro-analytical laser microprobe mass analysis (LAMMA) technique. In fine roots with secondary structure, localization of aluminum was limited to the peripheral cell layers. Lead was found in the outer layers, and also in the primary phloem. Aluminum penetrated the mycorrhizal mantle, but lead was seldom detected in ectomycorrhizae.

  1. Anodization process produces opaque, reflective coatings on aluminum

    Science.gov (United States)

    1965-01-01

    Opaque, reflective coatings are produced on aluminum articles by an anodizing process wherein the anodizing bath contains an aqueous dispersion of finely divided insoluble inorganic compounds. These particles appear as uniformly distributed occlusions in the anodic deposit on the aluminum.

  2. Evaluation of aluminum migration into foodstuffs from aluminium cookware

    Directory of Open Access Journals (Sweden)

    M Radi

    2014-05-01

    Full Text Available Nowadays, the existence of aluminum in human diet as a food contaminant has attracted the concerns of many researchers. It seems that the cooking pans are common sources of aluminum exposure through foodstuffs in Iran. The aim of this study was to evaluate the migration of aluminum from cooking containers into foodstuffs. For this purpose, solutions with different concentrations of citric acid, sodium chloride, fat, protein and sugar were prepared and migration of aluminum into these solutions was measured using atomic absorption spectrometry. Results showed that salt and citric acid concentrations could enhance aluminum migration; whereas, acid concentration was more effective than salt due to its corrosive effect. The intensity of heat processing and the duration of heat treatment had direct relation with aluminum migration. The aluminum content of cooked foods in aluminum cooking pans was also significantly more than control samples.

  3. Low Mass, Aluminum NOFBX Combustion Chamber Development, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Our team proposes to define a diffusion bonding process for aluminum as an enabling step to ultimately develop an innovative, lightweight, long life, aluminum...

  4. Exploration the extrudability of aluminum matrix composite (LM6/TIC ...

    African Journals Online (AJOL)

    Aluminum matrix composites (LM6/TiC) is a mix of excellent properties of aluminum ... ABAQUS/CAE software has been successfully employed for Modeling and ... Experimental results show that, many mechanical properties are improved and ...

  5. Effect of the aluminum flow pattern on the bonding of aluminum to oxidized Zircaloy-2

    International Nuclear Information System (INIS)

    Watson, R.D.; Lambert, J.P.

    1965-04-01

    The bonds produced when hot aluminum is allowed to flow smoothly from an extrusion die to the oxidized surface of a heated tube of Zircaloy-2 are consistently inferior to those produced with back-extruded flow. The difference is believed to be due to the reduction in, or elimination of, the oxide layer on the aluminum that comes in contact with the surface of the Zircaloy-2. This method of bonding aluminum to Zircaloy-2 is covered by Canadian patent 702,438 January 1965. (author)

  6. Estimates of the cost and energy consumption of aluminum-air electric vehicles

    Science.gov (United States)

    Cooper, J. F.

    1980-11-01

    Economic costs and primary energy consumption are estimated for general purpose electric vehicles using aluminum-air propulsion batteries within the time frame of the 1990's (earliest possible date of introduction). For an aluminum-air fuel economy of 36 tonne/km/kg-Al (optimized low-gallium alloys), a total refueling cost of 5.6 cents/km (1979$) was estimated for a 1.27 tonne vehicle. This is equivalent to $2 to 3/gal for automobiles of the same weight with fuel economies of 13.5 to 19.3 tonne-km/liter. The total primary energy consumption was estimated to be 1.3 to 1.7 kWh/km (coal) for the electric vehicle, which corresponds roughly to the energy cost of the automobiles using liquid fuels synthesized from coal. The energy consumption is 30 to 70 percent greater than the reference automobile using petroleum-derived gasoline.

  7. Instructional Guidelines. Welding.

    Science.gov (United States)

    Fordyce, H. L.; Doshier, Dale

    Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

  8. pre-art guidelines

    African Journals Online (AJOL)

    Enrique

    2004-11-01

    Nov 1, 2004 ... As these guidelines address pre-ART issues, only conditions that occur at ... All HIV-infected adults who are immunosuppressed, i.e. ... therefore recommended that HIV-infected health care ... vaccine in severely immunosuppressed persons, i.e. those ... with residual insecticides, the use of larvicides, and.

  9. Curricular Guidelines for Endodontics.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

  10. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Wattjes, Mike P; Rovira, Àlex; Miller, David

    2015-01-01

    . This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...

  11. Guidelines for Authors

    Indian Academy of Sciences (India)

    IAS Admin

    Please follow the instructions given below while preparing the manuscript. Articles which do not conform to the guidelines will not be considered. Authors are encouraged to submit their article in ASCII/MS Word/Latex version in a CD or by email to resonanc@ias.ernet.in. Title: Authors are requested to provide a) first title ...

  12. Formalization of Medical Guidelines

    Czech Academy of Sciences Publication Activity Database

    Peleška, Jan; Anger, Z.; Buchtela, David; Šebesta, K.; Tomečková, Marie; Veselý, Arnošt; Zvára, K.; Zvárová, Jana

    2005-01-01

    Roč. 1, - (2005), s. 133-141 ISSN 1801-5603 R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : GLIF model * formalization of guidelines * prevention of cardiovascular diseases Subject RIV: IN - Informatics, Computer Science

  13. Record Keeping Guidelines

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

    These guidelines are designed to educate psychologists and provide a framework for making decisions regarding professional record keeping. State and federal laws, as well as the American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct," generally require maintenance of appropriate records of psychological…

  14. GRADE Equity Guidelines 3

    DEFF Research Database (Denmark)

    Welch, Vivian A; Akl, Elie A; Pottie, Kevin

    2017-01-01

    OBJECTIVE: The aim of this paper is to describe a conceptual framework for how to consider health equity in the GRADE (Grading Recommendations Assessment and Development Evidence) guideline development process. STUDY DESIGN AND SETTING: Consensus-based guidance developed by the GRADE working grou...

  15. Field Campaign Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Voyles, J. W. [DOE ARM Climate Research Facility, Washington, DC (United States); Chapman, L. A. [DOE ARM Climate Research Facility, Washington, DC (United States)

    2015-12-01

    This document establishes a common set of guidelines for the Atmospheric Radiation Measurement (ARM) Climate Research Facility for planning, executing, and closing out field campaigns. The steps that guide individual field campaigns are described in the Field Campaign Tracking System and are specifically tailored to meet the scope of each field campaign.

  16. Space Guidelines for Libraries.

    Science.gov (United States)

    Wisconsin Coordinating Committee for Higher Education, Madison.

    The following guidelines are recommended: stack space--for each 10 volumes, one square foot of space; reading room--25 square feet per station x 20% of the total undergraduate population; carrel space--25% of the graduate enrollment x 45 square feet; office and auxilliary space--135 square feet x full time equivalent staff. (NI)

  17. Guidelines on testicular cancer

    NARCIS (Netherlands)

    Albers, Peter; Albrecht, Walter; Algaba, Ferran; Bokemeyer, Carsten; Cohn-Cedermark, Gabriella; Horwich, Alan; Klepp, Olbjoern; Laguna, M. Pilar; Pizzocaro, Giorgio

    2005-01-01

    To up-date the 2001 version of the EAU testicular cancer guidelines. A non-structured literature review until January 2005 using the MEDLINE database has been performed. Literature has been classified according to evidence-based medicine levels. Testicular cancer is a highly curable disease.

  18. Guidelines for Urban Labs

    DEFF Research Database (Denmark)

    Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

    2017-01-01

    urban lab initiatives from five different European cities: Antwerp (B), Graz and Leoben (A), Maastricht (NL) and Malmö (S). We do not pretend that these guidelines touch upon all possible challenges an urban lab may be confronted with, but we have incorporated all those we encountered in our...

  19. Transition of hydrated oxide layer for aluminum electrolytic capacitors

    International Nuclear Information System (INIS)

    Chi, Choong-Soo; Jeong, Yongsoo; Ahn, Hong-Joo; Lee, Jong-Ho; Kim, Jung-Gu; Lee, Jun-Hee; Jang, Kyung-Wook; Oh, Han-Jun

    2007-01-01

    A hydrous oxide film for the application as dielectric film is synthesized by immersion of pure aluminum in hot water. From a Rutherford backscattering analysis, the ratio of aluminum to oxygen atoms was found to be 3:2 in the anodized aluminum oxide film, and 2:1 in the hydrous oxide layer. Anodization of the hydrous oxide layer was more effective for the transition of amorphous anodic oxides to the crystalline aluminum oxides

  20. Defect reduction in seeded aluminum nitride crystal growth

    Science.gov (United States)

    Bondokov, Robert T.; Schowalter, Leo J.; Morgan, Kenneth; Slack, Glen A; Rao, Shailaja P.; Gibb, Shawn Robert

    2017-09-26

    Bulk single crystal of aluminum nitride (AlN) having an areal planar defect density.ltoreq.100 cm.sup.-2. Methods for growing single crystal aluminum nitride include melting an aluminum foil to uniformly wet a foundation with a layer of aluminum, the foundation forming a portion of an AlN seed holder, for an AlN seed to be used for the AlN growth. The holder may consist essentially of a substantially impervious backing plate.

  1. Microstructural Characterization of Aluminum-Lithium Alloys 1460 and 2195

    Science.gov (United States)

    Wang, Z. M.; Shenoy, R. N.

    1998-01-01

    Transmission electron microscopy (TEM) and differential scanning calorimetry (DSC) techniques were employed to characterize the precipitate distributions in lithium-containing aluminum alloys 1460 and 2195 in the T8 condition. TEM examinations revealed delta prime and T1 as the primary strengthening precipitates in alloys 1460 and 2195 respectively. TEM results showed a close similarity of the Russian alloy 1460 to the U.S. alloy 2090, which has a similar composition and heat treatment schedule. DSC analyses also indicate a comparable delta prime volume fraction. TEM study of a fractured tensile sample of alloy 1460 showed that delta prime precipitates are sheared by dislocations during plastic deformation and that intense stress fields arise at grain boundaries due to planar slip. Differences in fracture toughness of alloys 1460 and 2195 are rationalized on the basis of a literature review and observations from the present study.

  2. The CARE guidelines: consensus-based clinical case report guideline development.

    Science.gov (United States)

    Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

    2014-01-01

    A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Inspector qualification guidelines

    International Nuclear Information System (INIS)

    Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

    1994-07-01

    The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

  4. Inspector qualification guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

    1994-07-15

    The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.

  5. Use of low-cost aluminum in electric energy production

    Science.gov (United States)

    Zhuk, Andrey Z.; Sheindlin, Alexander E.; Kleymenov, Boris V.; Shkolnikov, Eugene I.; Lopatin, Marat Yu.

    Suppression of the parasitic corrosion while maintaining the electrochemical activity of the anode metal is one of the serious problems that affects the energy efficiency of aluminum-air batteries. The need to use high-purity aluminum or special aluminum-based alloys results in a significant increase in the cost of the anode, and thus an increase in the total cost of energy generated by the aluminum-air battery, which narrows the range of possible applications for this type of power source. This study considers the process of parasitic corrosion as a method for hydrogen production. Hydrogen produced in an aluminum-air battery by this way may be further employed in a hydrogen-air fuel cell (Hy-air FC) or in a heat engine, or it may be burnt to generate heat. Therefore, anode materials may be provided by commercially pure aluminum, commercially produced aluminum alloys, and secondary aluminum. These materials are much cheaper and more readily available than special anode alloys of aluminum and high-purity aluminum. The aim of present study is to obtain experimental data for comparison of energy and cost parameters of some commercially produced aluminum alloys, of high-purity aluminum, and of a special Al-ln anode alloy in the context of using these materials as anodes for an Al-air battery and for combined production of electrical power and hydrogen.

  6. 21 CFR 582.2122 - Aluminum calcium silicate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Aluminum calcium silicate. 582.2122 Section 582.2122 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....2122 Aluminum calcium silicate. (a) Product. Aluminum calcium silicate. (b) Tolerance. 2 percent. (c...

  7. 21 CFR 182.2122 - Aluminum calcium silicate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Aluminum calcium silicate. 182.2122 Section 182.2122 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....2122 Aluminum calcium silicate. (a) Product. Aluminum calcium silicate. (b) Tolerance. 2 percent. (c...

  8. Activated aluminum hydride hydrogen storage compositions and uses thereof

    Science.gov (United States)

    Sandrock, Gary; Reilly, James; Graetz, Jason; Wegrzyn, James E.

    2010-11-23

    In one aspect, the invention relates to activated aluminum hydride hydrogen storage compositions containing aluminum hydride in the presence of, or absence of, hydrogen desorption stimulants. The invention particularly relates to such compositions having one or more hydrogen desorption stimulants selected from metal hydrides and metal aluminum hydrides. In another aspect, the invention relates to methods for generating hydrogen from such hydrogen storage compositions.

  9. Passivation of aluminum with alkyl phosphonic acids for biochip applications

    Science.gov (United States)

    Attavar, Sachin; Diwekar, Mohit; Linford, Matthew R.; Davis, Mark A.; Blair, Steve

    2010-09-01

    Self-assembly of decylphosphonic acid (DPA) and octadecylphosphonic acid (ODPA) was studied on aluminum films using XPS, ToF-SIMS and surface wettability. Modified aluminum films were tested for passivation against silanization and subsequent oligonucleotide attachment. Passivation ratios of at least 450:1 compared to unprotected aluminum were obtained, as quantified by attachment of radio-labeled oligos.

  10. 21 CFR 73.1010 - Alumina (dried aluminum hydroxide).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Alumina (dried aluminum hydroxide). 73.1010... GENERAL LISTING OF COLOR ADDITIVES EXEMPT FROM CERTIFICATION Drugs § 73.1010 Alumina (dried aluminum hydroxide). (a) Identity. (1) The color additive alumina (dried aluminum hydroxide) is a white, odorless...

  11. 21 CFR 582.1781 - Sodium aluminum phosphate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sodium aluminum phosphate. 582.1781 Section 582.1781 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Additives § 582.1781 Sodium aluminum phosphate. (a) Product. Sodium aluminum phosphate. (b) Conditions of...

  12. 21 CFR 73.1015 - Chromium-cobalt-aluminum oxide.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Chromium-cobalt-aluminum oxide. 73.1015 Section 73... LISTING OF COLOR ADDITIVES EXEMPT FROM CERTIFICATION Drugs § 73.1015 Chromium-cobalt-aluminum oxide. (a) Identity. The color additive chromium-cobalt-aluminum oxide is a blue-green pigment obtained by calcining a...

  13. 21 CFR 182.1781 - Sodium aluminum phosphate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Sodium aluminum phosphate. 182.1781 Section 182.1781 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Food Substances § 182.1781 Sodium aluminum phosphate. (a) Product. Sodium aluminum phosphate. (b...

  14. Leptospirosis humana en la atención primaria de salud: pautas para su prevención y control Human leptospirosis in health primary care: guidelines for its prevention and control

    Directory of Open Access Journals (Sweden)

    Denis Berdasquera Corcho

    2007-09-01

    Full Text Available Durante las dos últimas décadas se ha observado a nivel mundial un alza en el número de casos de leptospirosis humana, frecuentemente asociada a desastres naturales. En Cuba, esta enfermedad tiene un comportamiento endemo epidémico, y estacional. Las características tropicales del país, el clima, la orografía, la red fluvial natural y la artificial, las extensas áreas agrícolas, y los regímenes lluviosos en determinadas épocas del año, han propiciado un aumento en el número de casos de esta enfermedad. En el presente artículo se hace una revisión documental del tema y se propone una guía para el control y prevención de esta zoonosis en la atención primaria de salud, y así brindarle al Médico de Familia elementos importantes para su trabajo diario en la comunidad.For two last decades it was observed a rise in cases of human leptospirosis frequently associated to natural disasters. In Cuba, this condition has a endemic, epidemic, and seasonal behaviour. Tropical features of our country, climate, orography, natural and artificial fluvial network, extensive agricultural areas, and rainy regimes en determined times of year, have propitiate a increase in case-number of this disease. In present paper a documentary review of this topic was made and we propose a guide for control and prevention of this zoonosis in health primary care, and thus provide to Family Physician with significant components for his daily practice in community.

  15. Bearing capacity check of aluminum profiles

    Directory of Open Access Journals (Sweden)

    Cristian Grigoraşenco

    2013-06-01

    Full Text Available Because of suspended ceiling options to be customizable they are the choice for implementation in spaces like offices buildings, schools, hospitals and commercial premises. Recent problems with suspended gypsum ceilings falling in some commercial premises led to verification by tensile test and flexural bearing capacity of 5 types of aluminum elements used to suspend the ceilings.

  16. Absorptive coating for aluminum solar panels

    Science.gov (United States)

    Desmet, D.; Jason, A.; Parr, A.

    1979-01-01

    Method for coating forming coating of copper oxide from copper component of sheet aluminum/copper alloy provides strong durable solar heat collector panels. Copper oxide coating has solar absorption characteristics similar to black chrome and is much simpler and less costly to produce.

  17. Aluminum Solubility in Complex Electrolytes - 13011

    Energy Technology Data Exchange (ETDEWEB)

    Agnew, S.F. [Columbia Energy and Environmental Services, Inc., 1806 Terminal Dr., Richland, WA 99354 (United States); Johnston, C.T. [Dept. of Crop, Soil, and Environmental Sciences, Purdue University, West Lafayette, IN 47907 (United States)

    2013-07-01

    Predicting aluminum solubility for Hanford and Savannah River waste liquids is very important for their disposition. It is a key mission goal at each Site to leach as much aluminum as practical from sludges in order to minimize the amount of vitrified high level waste. And it is correspondingly important to assure that any soluble aluminum does not precipitate during subsequent decontamination of the liquid leachates with ion exchange. This report shows a very simple and yet thermodynamic model for aluminum solubility that is consistent with a wide range of Al liquors, from simple mixtures of hydroxide and aluminate to over 300 Hanford concentrates and to a set of 19 Bayer liquors for temperatures from 20-100 deg. C. This dimer-dS{sub mix} (DDS) model incorporates an ideal entropy of mixing along with previous reports for the Al dimer, water activities, gibbsite, and bayerite thermodynamics. We expect this model will have broad application for nuclear wastes as well as the Bayer gibbsite process industry. (authors)

  18. Chemical Reduction Synthesis of Iron Aluminum Powders

    Science.gov (United States)

    Zurita-Méndez, N. N.; la Torre, G. Carbajal-De; Ballesteros-Almanza, L.; Villagómez-Galindo, M.; Sánchez-Castillo, A.; Espinosa-Medina, M. A.

    In this study, a chemical reduction synthesis method of iron aluminum (FeAl) nano-dimensional intermetallic powders is described. The process has two stages: a salt reduction and solvent evaporation by a heat treatment at 1100°C. The precursors of the synthesis are ferric chloride, aluminum foil chips, a mix of Toluene/THF in a 75/25 volume relationship, and concentrated hydrochloric acid as initiator of the reaction. The reaction time was 20 days, the product obtained was dried at 60 °C for 2 h and calcined at 400, 800, and 1100 °C for 4 h each. To characterize and confirm the obtained synthesis products, X-Ray Diffraction (XRD), and Scanning Electron Microscopy (SEM) techniques were used. The results of morphology and chemical characterization of nano-dimensional powders obtained showed a formation of agglomerated particles of a size range of approximately 150 nm to 1.0 μm. Composition of powders was identified as corundum (Al2O3), iron aluminide (FeAl3), and iron-aluminum oxides (Fe0. 53Al0. 47)2O3 phases. The oxide phases formation were associated with the reaction of atmospheric concentration-free oxygen during synthesis and sintering steps, reducing the concentration of the iron aluminum phase.

  19. Corrosion of Graphite Aluminum Metal Matrix Composites

    Science.gov (United States)

    1991-02-01

    cathodic protection of G/AI MMCs resulted in overprotection 13. Overprotection resulted from a local increase in pH near cathodic sites during...34Cathodic Overprotection of SiC/6061-T6 and G/6061- T6 Aluminum Alloy Metal Matrix Composites," Scripta Metallurgica, 22 (1988) 413-418. 14. R

  20. Electrometallurgical treatment of aluminum-matrix fuels

    International Nuclear Information System (INIS)

    Willit, J.L.; Gay, E.C.; Miller, W.E.; McPheeters, C.C.; Laidler, J.J.

    1996-01-01

    The electrometallurgical treatment process described in this paper builds on our experience in treating spent fuel from the Experimental Breeder Reactor (EBR-II). The work is also to some degree, a spin-off from applying electrometallurgical treatment to spent fuel from the Hanford single pass reactors (SPRs) and fuel and flush salt from the Molten Salt Reactor Experiment (MSRE) in treating EBR-II fuel, we recover the actinides from a uranium-zirconium fuel by electrorefining the uranium out of the chopped fuel. With SPR fuel, uranium is electrorefined out of the aluminum cladding. Both of these processes are conducted in a LiCl-KCl molten-salt electrolyte. In the case of the MSRE, which used a fluoride salt-based fuel, uranium in this salt is recovered through a series of electrochemical reductions. Recovering high-purity uranium from an aluminum-matrix fuel is more challenging than treating SPR or EBR-II fuel because the aluminum- matrix fuel is typically -90% (volume basis) aluminum

  1. Strong, corrosion-resistant aluminum tubing

    Science.gov (United States)

    Reed, M. W.; Adams, F. F.

    1980-01-01

    When aluminum tubing having good corrosion resistance and postweld strength is needed, type 5083 alloy should be considered. Chemical composition is carefully controlled and can be drawn into thin-wall tubing with excellent mechanical properties. Uses of tubing are in aircraft, boats, docks, and process equipment.

  2. Explosion hazards of aluminum finishing operations

    NARCIS (Netherlands)

    Taveau, J.R.; Hochgreb, Simone; Lemkowitz, S.M.; Roekaerts, D.J.E.M.

    2018-01-01

    Metal dust deflagrations have become increasingly common in recent years. They are also more devastating than deflagrations involving organic materials, owing to metals' higher heat of combustion, rate of pressure rise, explosion pressure and flame temperature. Aluminum finishing operations offer

  3. Explosion hazards of aluminum finishing operations

    NARCIS (Netherlands)

    Taveau, J.; Hochgreb, S.; Lemkowitz, S.M.; Roekaerts, D.J.E.M.

    2018-01-01

    Metal dust deflagrations have become increasingly common in recent years. They are also more devastating than deflagrations involving organic materials, owing to metals' higher heat of combustion, rate of pressure rise, explosion pressure and flame temperature. Aluminum finishing operations offer a

  4. The use of aluminum dome tank roofs

    International Nuclear Information System (INIS)

    Morovich, G.L.

    1992-01-01

    Since the late 1970's the aluminum dome tank roof has gained wide usage for both new and retrofit applications. The increased application for the structure results from a need for maintenance reduction, environmental considerations, concern for product quality and economics. The American Petroleum Institute (API) has approved Standard API 650, Appendix G - Structurally Supported Aluminum Dome Roofs for publication. The aluminum dome was originally used as weather cover for retrofiting external floating roof tanks. The roof was considered for the reduction of maintenance related to draining water from the external floating roofs and problems resulting from freezing of drain lines and snow accumulation. This paper reports that environmental concerns have expanded the value of aluminum dome roofs. Rainwater bypassing the seals of an external floating roof became classified as a hazardous material requiring special and expensive disposal procedures. The marketing terminal facilities typically do not have the capacity for proper treatment of contaminated bottom water. With new fuel additives being water soluble, water contamination not only created a hazardous waste disposal problem, but resulted in reduced product quality

  5. Molybdate Coatings for Protecting Aluminum Against Corrosion

    Science.gov (United States)

    Calle, Luz Marina; MacDowell, Louis G.

    2005-01-01

    Conversion coatings that comprise mixtures of molybdates and several additives have been subjected to a variety of tests to evaluate their effectiveness in protecting aluminum and alloys of aluminum against corrosion. Molybdate conversion coatings are under consideration as replacements for chromate conversion coatings, which have been used for more than 70 years. The chromate coatings are highly effective in protecting aluminum and its alloys against corrosion but are also toxic and carcinogenic. Hexavalent molybdenum and, hence, molybdates containing hexavalent molybdenum, have received attention recently as replacements for chromates because molybdates mimic chromates in a variety of applications but exhibit significantly lower toxicity. The tests were performed on six proprietary formulations of molybdate conversion coatings, denoted formulations A through F, on panels of aluminum alloy 2024-T3. A bare alloy panel was also included in the tests. The tests included electrochemical impedance spectroscopy (EIS), measurements of corrosion potentials, scanning electron microscopy (SEM) with energy-dispersive spectroscopy (EDS), and x-ray photoelectron spectroscopy (XPS).

  6. Radiation corrosion in aluminum alloy bellows

    International Nuclear Information System (INIS)

    Konno, Osamu

    1987-01-01

    Testing was carried out in which materials for vacuum devices (Al, Ti, Cu, SUS) are exposed to electron beams (50 MeV, average current 80 μA) to determine the changes in the quantity, partial pressure and composition of the gases released from the materials. The test appratus used are made of Al alloys alone. During the test, vacuum leak is found in the Al alloy bellows used in the drive device. The leak is found to result from corrosion caused by water. The surface structure is analyzed by SEM, EPMA, ESCA and IMA. It is confirmed that the Al alloy used as material for the bellows if highly resistant to corrosion. It is concluded that it is necessary to use high purity cooling water to prevent the cooling water from causing corrosion. It has been reported that high purity aluminum is very high in resistance to corrosion. Based on these measurements and considerations, it is suggested that when aluminum is to be used as material for vacuum devices in an accelerator, it is required to provide protection film on its surface to prevent corrosion or to use cooling water pipes cladded with pure aluminum and an aluminum alloy. In addition, the temperature of the cooling water should be set after adequately considering the environmental conditions in the room. (Nogami, K.)

  7. Stress Corrosion Cracking of Certain Aluminum Alloys

    Science.gov (United States)

    Hasse, K. R.; Dorward, R. C.

    1983-01-01

    SC resistance of new high-strength alloys tested. Research report describes progress in continuing investigation of stress corrosion (SC) cracking of some aluminum alloys. Objective of program is comparing SC behavior of newer high-strength alloys with established SC-resistant alloy.

  8. Reinforcement of Aluminum Castings with Dissimilar Metals

    Energy Technology Data Exchange (ETDEWEB)

    Han, Q

    2004-01-07

    The project ''Reinforcement of Aluminum Casting with Dissimilar Metal'' was a Cooperative Research and Development Agreements (CRADAs) between Oak Ridge National Laboratory (ORNL) and Cummins Inc. This project, technologies have been developed to reinforce aluminum castings with steel insert. Defect-free bond between the steel insert and the aluminum casting has been consistently obtained. The push-out experiment indicated that the bond strength is higher than that of the Al-Fin method. Two patents have been granted to the project team that is comprised of Cummins Inc. and ORNL. This report contains four sections: the coating of the steel pins, the cast-in method, microstructure characterization, and the bond strength. The section of the coating of the steel pins contains coating material selection, electro-plating technique for plating Cu and Ni on steel, and diffusion bonding of the coatings to the steel. The section of cast-in method deals with factors that affecting the quality of the metallurgical bond between the coated steel and the aluminum castings. The results of microstructure characteristics of the bonding are presented in the microstructure characterization section. A push-out experiment and the results obtained using this method is described in the section of bond strength/mechanical property.

  9. Effects of Hypervelocity Impacts on Silicone Elastomer Seals and Mating Aluminum Surfaces

    Science.gov (United States)

    deGroh, Henry C., III; Steinetz, Bruce M.

    2009-01-01

    While in space silicone based elastomer seals planned for use on NASA's Crew Exploration Vehicle (CEV) are exposed to threats from micrometeoroids and orbital debris (MMOD). An understanding of these threats is required to assess risks to the crew, the CEV orbiter, and missions. An Earth based campaign of hypervelocity impacts on small scale seal rings has been done to help estimate MMOD threats to the primary docking seal being developed for the Low Impact Docking System (LIDS). LIDS is being developed to enable the CEV to dock to the ISS (International Space Station) or to Altair (NASA's next lunar lander). The silicone seal on LIDS seals against aluminum alloy flanges on ISS or Altair. Since the integrity of a seal depends on both sealing surfaces, aluminum targets were also impacted. The variables considered in this study included projectile mass, density, speed, incidence angle, seal materials, and target surface treatments and coatings. Most of the impacts used a velocity near 8 km/s and spherical aluminum projectiles (density = 2.7 g/cubic cm), however, a few tests were done near 5.6 km/s. Tests were also performed using projectile densities of 7.7, 2.79, 2.5 or 1.14 g/cubic cm. Projectile incidence angles examined included 0 deg, 45 deg, and 60 deg from normal to the plane of the target. Elastomer compounds impacted include Parker's S0383-70 and Esterline's ELA-SA-401 in the as received condition, or after an atomic oxygen treatment. Bare, anodized and nickel coated aluminum targets were tested simulating the candidate mating seal surface materials. After impact, seals and aluminum plates were leak tested: damaged seals were tested against an undamaged aluminum plate; and undamaged seals were placed at various locations over craters in aluminum plates. It has been shown that silicone elastomer seals can withstand an impressive level of damage before leaking beyond allowable limits. In general on the tests performed to date, the diameter of the crater in

  10. Preparation of aluminum nitride-silicon carbide nanocomposite powder by the nitridation of aluminum silicon carbide

    NARCIS (Netherlands)

    Itatani, K.; Tsukamoto, R.; Delsing, A.C.A.; Hintzen, H.T.J.M.; Okada, I.

    2002-01-01

    Aluminum nitride (AlN)-silicon carbide (SiC) nanocomposite powders were prepared by the nitridation of aluminum-silicon carbide (Al4SiC4) with the specific surface area of 15.5 m2·g-1. The powders nitrided at and above 1400°C for 3 h contained the 2H-phases which consisted of AlN-rich and SiC-rich

  11. Computerization of guidelines: towards a "guideline markup language".

    Science.gov (United States)

    Dart, T; Xu, Y; Chatellier, G; Degoulet, P

    2001-01-01

    Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

  12. Appraisal tools for clinical practice guidelines: a systematic review.

    Directory of Open Access Journals (Sweden)

    Ulrich Siering

    Full Text Available Clinical practice guidelines can improve healthcare processes and patient outcomes, but are often of low quality. Guideline appraisal tools aim to help potential guideline users in assessing guideline quality. We conducted a systematic review of publications describing guideline appraisal tools in order to identify and compare existing tools.Among others we searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from 1995 to May 2011 for relevant primary and secondary publications. We also handsearched the reference lists of relevant publications. On the basis of the available literature we firstly generated 34 items to be used in the comparison of appraisal tools and grouped them into thirteen quality dimensions. We then extracted formal characteristics as well as questions and statements of the appraisal tools and assigned them to the items.We identified 40 different appraisal tools. They covered between three and thirteen of the thirteen possible quality dimensions and between three and 29 of the possible 34 items. The main focus of the appraisal tools were the quality dimensions "evaluation of evidence" (mentioned in 35 tools; 88%, "presentation of guideline content" (34 tools; 85%, "transferability" (33 tools; 83%, "independence" (32 tools; 80%, "scope" (30 tools; 75%, and "information retrieval" (29 tools; 73%. The quality dimensions "consideration of different perspectives" and "dissemination, implementation and evaluation of the guideline" were covered by only twenty (50% and eighteen tools (45% respectively.Most guideline appraisal tools assess whether the literature search and the evaluation, synthesis and presentation of the evidence in guidelines follow the principles of evidence-based medicine. Although conflicts of interest and norms and values of guideline developers, as well as patient involvement, affect the trustworthiness of guidelines, they are currently insufficiently considered. Greater focus should be

  13. Mexican Guidelines on the Diagnosis and Treatment of Urticaria

    Directory of Open Access Journals (Sweden)

    Désirée Larenas-Linnemann

    2014-11-01

    Full Text Available Background: Urticaria is a disease that a fth of the population shall suffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups –both specialists and primary health care workers–, necessary in Mexico. Material and method: Internationally recognized tools for guideline- development were used. An interdisciplinary group of clinical experts (some of them knowledgeable in methodology of guideline develop- ment determined the objectives and scope of the Evidence Based Clinical Practice Guideline with SCOPE. It was decided to adapt and transculturize international guidelines on the diagnosis and treatment of urticaria. With AGREE-II three high-quality guidelines (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007 were selected to function as basic guidelines (BG. A set of Clinical Questions was formulated that lead to recommendations/suggestions, based on these BG, taking into account the cultural and economic background of Mexico, according to GRADE recommendation development. Results: By a formal process of discussion and voting during several working-sessions, experts and rst level healthcare physicians deter- mined the wording of the nal guideline, taking particularly care of developing a document, adjusted to the reality, values and preferences of the Mexican patients. The use of oral second generation, non-sedating antihistamines as rst line treatment is emphasized. Conclusion: This document is an Evidence Based Clinical Practice Guideline for the diagnosis and treatment of acute and chronic urticaria, based on three, high quality, international guidelines. It was developed by a multidisciplinary group. Tables and algorithms make the guideline user-friendly for both, rst line health care physicians and specialists

  14. Investigation of Methods for Selectively Reinforcing Aluminum and Aluminum-Lithium Materials

    Science.gov (United States)

    Bird, R. Keith; Alexa, Joel A.; Messick, Peter L.; Domack, Marcia S.; Wagner, John A.

    2013-01-01

    Several studies have indicated that selective reinforcement offers the potential to significantly improve the performance of metallic structures for aerospace applications. Applying high-strength, high-stiffness fibers to the high-stress regions of aluminum-based structures can increase the structural load-carrying capability and inhibit fatigue crack initiation and growth. This paper discusses an investigation into potential methods for applying reinforcing fibers onto the surface of aluminum and aluminum-lithium plate. Commercially-available alumina-fiber reinforced aluminum alloy tapes were used as the reinforcing material. Vacuum hot pressing was used to bond the reinforcing tape to aluminum alloy 2219 and aluminum-lithium alloy 2195 base plates. Static and cyclic three-point bend testing and metallurgical analysis were used to evaluate the enhancement of mechanical performance and the integrity of the bond between the tape and the base plate. The tests demonstrated an increase in specific bending stiffness. In addition, no issues with debonding of the reinforcing tape from the base plate during bend testing were observed. The increase in specific stiffness indicates that selectively-reinforced structures could be designed with the same performance capabilities as a conventional unreinforced structure but with lower mass.

  15. Amenorrhea - primary

    Science.gov (United States)

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  16. Use of Standard Guidelines for Department of Medicine Summary Letters.

    Science.gov (United States)

    Fitz, Matthew; La Rochelle, Jeffrey; Lang, Valerie; DeWaay, Deborah; Adams, William; Nasraty, Farah

    2018-04-12

    Phenomenon: Fourth-year medical students obtain Department of Medicine (DOM) letters ("Chair" letters) to support their residency applications. Writing and interpreting DOM letters are challenging. There is heterogeneity in the letters that makes it difficult to both write and read these letters. The purpose of this study is to determine the value of new guidelines developed by a task force of clerkship directors and program directors in internal medicine and assess the implementation of these guidelines. The Clerkship Directors in Internal Medicine performed a cross-sectional survey of internal medicine clerkship directors at U.S. and Canadian medical schools in 2014. In addition, the primary author's institution reviewed 1,347 DOM letters between 2012 and 2014 to assess the implementation of these guidelines. The survey response rate was 78%. DOM letter writers reported the guidelines were better, easier to implement, and more compatible with the purpose of DOM letters than previously. Most letter readers reported that letters using the guidelines were more credible. Writers of DOM letters in lower academic ranks rated the letters with guidelines higher in several domains than those in higher academic ranks. Readers of DOM letters in higher academic ranks rated the letters with guidelines higher in several domains than those in lower academic ranks. In the DOM letters examined, the odds of meeting each guideline increased with each additional year. However, for 3 guidelines there was an initial decline in adherence from 2012 to 2013 before increasing again in 2014-the recommended length, clerkship description, and detailed narrative guidelines. Letters solely written by a chair were less likely to incorporate the guidelines. Insights: Clerkship directors often write the DOM letters and identify with the purpose of the guidelines. As writers, lower ranking academic faculty value the guidelines more than higher ranking academic faculty. As readers of DOM letters

  17. Estimation of aluminum and argon activation sources in the HANARO coolant

    International Nuclear Information System (INIS)

    Jun, Byung Jin; Lee, Byung Chul; Kim, Myong Seop

    2010-01-01

    The activation products of aluminum and argon are key radionuclides for operational and environmental radiological safety during the normal operation of open-tank-in-pool type research reactors using aluminum-clad fuels. Their activities measured in the primary coolant and pool surface water of HANARO have been consistent. We estimated their sources from the measured activities and then compared these values with their production rates obtained by a core calculation. For each aluminum activation product, an equivalent aluminum thickness (EAT) in which its production rate is identical to its release rate into the coolant is determined. For the argon activation calculation, the saturated argon concentration in the water at the temperature of the pool surface is assumed. The EATs are 5680, 266 and 1.2 nm, respectively, for Na-24, Mg-27 and Al-28, which are much larger than the flight lengths of the respective recoil nuclides. These values coincide with the water solubility levels and with the half-lives. The EAT for Na-24 is similar to the average oxide layer thickness (OLT) of fuel cladding as well; hence, the majority of them in the oxide layer may be released to the coolant. However, while the average OLT clearly increases with the fuel burn-up during an operation cycle, its effect on the pool-top radiation is not distinguishable. The source of Ar-41 is in good agreement with the calculated reaction rate of Ar-40 dissolved in the coolant

  18. Guidelines for Better Heart Health

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

  19. 2012 Guidelines for Water Reuse

    Science.gov (United States)

    This manual is a revision of the "2004 Water Reuse Guidelines." This document is a summary of reuse guidelines, with supporting information, for the benefit of utilities of utilities and regulatory agencies, particularly EPA.

  20. Paralympic emblem guidelines: London 2012

    OpenAIRE

    2015-01-01

    The purpose of these guidelines is to preserve and enhance the value of the Emblem for the benefit of all authorised users. These guidelines apply to LOCOG and IPC creative, marketing and communications personnel, agencies and consultants only.

  1. Method of melting and decontaminating radioactive contaminated aluminum material

    International Nuclear Information System (INIS)

    Uda, Tatsuhiko; Miura, Noboru; Kawasaki, Katsuo; Iba, Hajime.

    1986-01-01

    Purpose: To improve the decontaminating efficiency upon melting decontamination of radioactive-contaminated aluminum materials. Method: This invention concerns an improvement for the method of melting decontamination by adding slug agent composed of organic compound to contaminated aluminum material and extracting the radioactive materials into the slug thereby decontaminating the aluminum material. Specifically metals effective for reducing the active amount of aluminum are added such that the content is greater than a predetermined value in the heat melting process. The metal comprises Mg, Cu or a mixture thereof and the content is more than 4 % including those previously contained in the aluminum material. (Ikeda, J.)

  2. FLOWSHEET FOR ALUMINUM REMOVAL FROM SLUDGE BATCH 6

    International Nuclear Information System (INIS)

    Pike, J.; Gillam, J.

    2008-01-01

    Samples of Tank 12 sludge slurry show a substantially larger fraction of aluminum than originally identified in sludge batch planning. The Liquid Waste Organization (LWO) plans to formulate Sludge Batch 6 (SB6) with about one half of the sludge slurry in Tank 12 and one half of the sludge slurry in Tank 4. LWO identified aluminum dissolution as a method to mitigate the effect of having about 50% more solids in High Level Waste (HLW) sludge than previously planned. Previous aluminum dissolution performed in a HLW tank in 1982 was performed at approximately 85 C for 5 days and dissolved nearly 80% of the aluminum in the sludge slurry. In 2008, LWO successfully dissolved 64% of the aluminum at approximately 60 C in 46 days with minimal tank modifications and using only slurry pumps as a heat source. This report establishes the technical basis and flowsheet for performing an aluminum removal process in Tank 51 for SB6 that incorporates the lessons learned from previous aluminum dissolution evolutions. For SB6, aluminum dissolution process temperature will be held at a minimum of 65 C for at least 24 days, but as long as practical or until as much as 80% of the aluminum is dissolved. As planned, an aluminum removal process can reduce the aluminum in SB6 from about 84,500 kg to as little as 17,900 kg with a corresponding reduction of total insoluble solids in the batch from 246,000 kg to 131,000 kg. The extent of the reduction may be limited by the time available to maintain Tank 51 at dissolution temperature. The range of dissolution in four weeks based on the known variability in dissolution kinetics can range from 44 to more than 80%. At 44% of the aluminum dissolved, the mass reduction is approximately 1/2 of the mass noted above, i.e., 33,300 kg of aluminum instead of 66,600 kg. Planning to reach 80% of the aluminum dissolved should allow a maximum of 81 days for dissolution and reduce the allowance if test data shows faster kinetics. 47,800 kg of the dissolved

  3. Guidelines for emergency laparoscopy

    Directory of Open Access Journals (Sweden)

    Sauerland Stefan

    2006-10-01

    Full Text Available Abstract Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (European Association for Endoscopic Surgery provides scientifically founded recommendations about the role of laparoscopy in the different situations. Generally, laparoscopy is well suited for the therapy of the majority of diseases that cause acute abdominal pain.

  4. Severe accident management guidelines

    International Nuclear Information System (INIS)

    Uhle, Jennifer

    2014-01-01

    The events at Fukushima Daiichi have highlighted the importance of Severe Accident Management Guidelines (SAMGs). As the world has learned from the catastrophe and countries are considering changes to their nuclear regulatory programs, the content of SAMGs and their regulatory control are being evaluated. This presentation highlights several factors that are being addressed in the United States as rulemaking is underway pertaining to SAMGs. The question of how to be prepared for the unexpected is discussed with specific insights gleaned from Fukushima. (author)

  5. Guidelines on oncologic imaging

    International Nuclear Information System (INIS)

    1989-01-01

    The present issue of European Journal of Radiology is devoted to guidelines on oncologic imaging. 9 experts on imaging in suspected or evident oncologic disease have compiled a broad survey on strategies as well as techniques on oncologic imaging. The group gives advice for detecting tumours at specific tumour sites and use modern literature to emphasize their recommendations. All recommendations are short, comprehensive and authoritative. (orig./MG)

  6. Guidelines for Urban Labs

    DEFF Research Database (Denmark)

    Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

    2017-01-01

    These guidelines are intended for team members and managers of urban labs and, more generally, for civil servants and facilitators in cities working with experimental processes to tackle complex challenges. They aim to support the everyday practice of collaboratively experimenting and learning ho...... the result is inspiring and instructive for all those who want to wrap their minds around experimental co-creative approaches to urban governance and city development....

  7. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  8. Cancer screening guidelines.

    Science.gov (United States)

    Zoorob, R; Anderson, R; Cefalu, C; Sidani, M

    2001-03-15

    Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.

  9. Clinical practice guideline: Allergic rhinitis.

    Science.gov (United States)

    Seidman, Michael D; Gurgel, Richard K; Lin, Sandra Y; Schwartz, Seth R; Baroody, Fuad M; Bonner, James R; Dawson, Douglas E; Dykewicz, Mark S; Hackell, Jesse M; Han, Joseph K; Ishman, Stacey L; Krouse, Helene J; Malekzadeh, Sonya; Mims, James Whit W; Omole, Folashade S; Reddy, William D; Wallace, Dana V; Walsh, Sandra A; Warren, Barbara E; Wilson, Meghan N; Nnacheta, Lorraine C

    2015-02-01

    Allergic rhinitis (AR) is one of the most common diseases affecting adults. It is the most common chronic disease in children in the United States today and the fifth most common chronic disease in the United States overall. AR is estimated to affect nearly 1 in every 6 Americans and generates $2 to $5 billion in direct health expenditures annually. It can impair quality of life and, through loss of work and school attendance, is responsible for as much as $2 to $4 billion in lost productivity annually. Not surprisingly, myriad diagnostic tests and treatments are used in managing this disorder, yet there is considerable variation in their use. This clinical practice guideline was undertaken to optimize the care of patients with AR by addressing quality improvement opportunities through an evaluation of the available evidence and an assessment of the harm-benefit balance of various diagnostic and management options. The primary purpose of this guideline is to address quality improvement opportunities for all clinicians, in any setting, who are likely to manage patients with AR as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The guideline is intended to be applicable for both pediatric and adult patients with AR. Children under the age of 2 years were excluded from the clinical practice guideline because rhinitis in this population may be different than in older patients and is not informed by the same evidence base. The guideline is intended to focus on a limited number of quality improvement opportunities deemed most important by the working group and is not intended to be a comprehensive reference for diagnosing and managing AR. The recommendations outlined in the guideline are not intended to represent the standard of care for patient management, nor are the recommendations intended to limit treatment or care provided to individual patients. The development group made a strong

  10. Carbon contaminant in the ion processing of aluminum oxide film

    International Nuclear Information System (INIS)

    Chaug, Y.; Roy, N.

    1989-01-01

    Ion processing can induce contamination on the bombarded surface. However, this process is essential for the microelectronics device fabrication. Auger electron spectroscopy has been used to study the simultaneous deposition of carbon impurity during ion bombardment of magnetron rf-sputtering deposited aluminum oxide film. Ion bombardment on aluminum oxide results in a preferential removal of surface oxygen and a formation of a metastable state of aluminum suboxide. Cosputtered implanted carbon contaminant appears to have formed a new state of stoichiometry on the surface of the ion bombarded aluminum oxide and existed as an aluminum carbide. This phase has formed due to the interaction of the implanted carbon and the aluminum suboxide. The Ar + ion sputter etching rate is reduced for the carbon contaminated oxide. The electrical resistance of the aluminum oxide between two gold strips has been measured. It is found that the electrical resistance is also reduced due to the formation of the new stoichiometry on the surface

  11. Aluminum Target Dissolution in Support of the Pu-238 Program

    Energy Technology Data Exchange (ETDEWEB)

    McFarlane, Joanna [ORNL; Benker, Dennis [ORNL; DePaoli, David W [ORNL; Felker, Leslie Kevin [ORNL; Mattus, Catherine H [ORNL

    2014-09-01

    Selection of an aluminum alloy for target cladding affects post-irradiation target dissolution and separations. Recent tests with aluminum alloy 6061 yielded greater than expected precipitation in the caustic dissolution step, forming up to 10 wt.% solids of aluminum hydroxides and aluminosilicates. We present a study to maximize dissolution of aluminum metal alloy, along with silicon, magnesium, and copper impurities, through control of temperature, the rate of reagent addition, and incubation time. Aluminum phase transformations have been identified as a function of time and temperature, using X-ray diffraction. Solutions have been analyzed using wet chemical methods and X-ray fluorescence. These data have been compared with published calculations of aluminum phase diagrams. Temperature logging during the transients has been investigated as a means to generate kinetic and mass transport data on the dissolution process. Approaches are given to enhance the dissolution of aluminum and aluminosilicate phases in caustic solution.

  12. Soil and groundwater remediation guidelines for methanol

    International Nuclear Information System (INIS)

    2010-12-01

    Methanol is used by oil and gas operators to inhibit hydrate formation in the recovery of heavy oils, in natural gas production and transport, as well as in various other production applications. Emissions from methanol primary occur from miscellaneous solvent usage, methanol production, end-product manufacturing, and storage and handling losses. This document provided soil and groundwater remediation guidelines for methanol releases into the environment. The guidelines were consistent with the Alberta Environment tier 1 soil and groundwater framework. The chemical and physical properties of methanol were reviewed. The environmental fate and behavior of methanol releases was discussed, and the behaviour and effects of methanol in terrestrial and aquatic biota were evaluated. The toxicity of methanol and its effects in humans and mammalian species were reviewed. Soil quality and ground water quality guidelines were presented. Surface water and soil guideline calculation methods were provided, and ecological exposure and ground water pathways were discussed. Management limits for methanol concentrations were also provided. 162 refs., 18 tabs., 4 figs.

  13. Clinical practice guidelines within the Southern African development community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases

    Science.gov (United States)

    2012-01-01

    Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders

  14. Primary Prevention With Statins

    DEFF Research Database (Denmark)

    Mortensen, Martin B; Afzal, Shoaib; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: Guidelines recommend initiating primary prevention for atherosclerotic cardiovascular disease (ASCVD) with statins based on absolute ASCVD risk assessment. Recently, alternative trial-based and hybrid approaches were suggested for statin treatment eligibility. OBJECTIVES: This study...... the population studied, 42% were eligible for statin therapy according to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) risk assessment and cholesterol treatment guidelines approach, versus 56% with the trial-based approach and 21% with the hybrid approach. Among these statin......-eligible subjects, the ASCVD event rate per 1,000 person-years was 9.8, 6.8, and 11.2, respectively. The ACC/AHA-recommended absolute risk score was well calibrated around the 7.5% 10-year ASCVD risk treatment threshold and discriminated better than the trial-based or hybrid approaches. Compared with the ACC...

  15. Vapor corrosion of aluminum cladding alloys and aluminum-uranium fuel materials in storage environments

    International Nuclear Information System (INIS)

    Lam, P.; Sindelar, R.L.; Peacock, H.B. Jr.

    1997-04-01

    An experimental investigation of the effects of vapor environments on the corrosion of aluminum spent nuclear fuel (A1 SNF) has been performed. Aluminum cladding alloys and aluminum-uranium fuel alloys have been exposed to environments of air/water vapor/ionizing radiation and characterized for applications to degradation mode analysis for interim dry and repository storage systems. Models have been developed to allow predictions of the corrosion response under conditions of unlimited corrodant species. Threshold levels of water vapor under which corrosion does not occur have been identified through tests under conditions of limited corrodant species. Coupons of aluminum 1100, 5052, and 6061, the US equivalent of cladding alloys used to manufacture foreign research reactor fuels, and several aluminum-uranium alloys (aluminum-10, 18, and 33 wt% uranium) were exposed to various controlled vapor environments in air within the following ranges of conditions: Temperature -- 80 to 200 C; Relative Humidity -- 0 to 100% using atmospheric condensate water and using added nitric acid to simulate radiolysis effects; and Gamma Radiation -- none and 1.8 x 10 6 R/hr. The results of this work are part of the body of information needed for understanding the degradation of the A1 SNF waste form in a direct disposal system in the federal repository. It will provide the basis for data input to the ongoing performance assessment and criticality safety analyses. Additional testing of uranium-aluminum fuel materials at uranium contents typical of high enriched and low enriched fuels is being initiated to provide the data needed for the development of empirical models

  16. First-principles surface interaction studies of aluminum-copper and aluminum-copper-magnesium secondary phases in aluminum alloys

    Science.gov (United States)

    da Silva, Thiago H.; Nelson, Eric B.; Williamson, Izaak; Efaw, Corey M.; Sapper, Erik; Hurley, Michael F.; Li, Lan

    2018-05-01

    First-principles density functional theory-based calculations were performed to study θ-phase Al2Cu, S-phase Al2CuMg surface stability, as well as their interactions with water molecules and chloride (Cl-) ions. These secondary phases are commonly found in aluminum-based alloys and are initiation points for localized corrosion. Density functional theory (DFT)-based simulations provide insight into the origins of localized (pitting) corrosion processes of aluminum-based alloys. For both phases studied, Cl- ions cause atomic distortions on the surface layers. The nature of the distortions could be a factor to weaken the interlayer bonds in the Al2Cu and Al2CuMg secondary phases, facilitating the corrosion process. Electronic structure calculations revealed not only electron charge transfer from Cl- ions to alloy surface but also electron sharing, suggesting ionic and covalent bonding features, respectively. The S-phase Al2CuMg structure has a more active surface than the θ-phase Al2Cu. We also found a higher tendency of formation of new species, such as Al3+, Al(OH)2+, HCl, AlCl2+, Al(OH)Cl+, and Cl2 on the S-phase Al2CuMg surface. Surface chemical reactions and resultant species present contribute to establishment of local surface chemistry that influences the corrosion behavior of aluminum alloys.

  17. Review on Factors Influencing Physician Guideline Adherence in Cardiology.

    Science.gov (United States)

    Hoorn, C J G M; Crijns, H J G M; Dierick-van Daele, A T M; Dekker, L R C

    2018-04-09

    Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared to secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

  18. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  19. Etching Behavior of Aluminum Alloy Extrusions

    Science.gov (United States)

    Zhu, Hanliang

    2014-11-01

    The etching treatment is an important process step in influencing the surface quality of anodized aluminum alloy extrusions. The aim of etching is to produce a homogeneously matte surface. However, in the etching process, further surface imperfections can be generated on the extrusion surface due to uneven materials loss from different microstructural components. These surface imperfections formed prior to anodizing can significantly influence the surface quality of the final anodized extrusion products. In this article, various factors that influence the materials loss during alkaline etching of aluminum alloy extrusions are investigated. The influencing variables considered include etching process parameters, Fe-rich particles, Mg-Si precipitates, and extrusion profiles. This study provides a basis for improving the surface quality in industrial extrusion products by optimizing various process parameters.

  20. Generation and structural characterization of aluminum cyanoacetylide

    Energy Technology Data Exchange (ETDEWEB)

    Cabezas, Carlos; Peña, Isabel; Alonso, José L., E-mail: alargo@qf.uva.es, E-mail: jlalonso@qf.uva.es [Grupo de Espectroscopia Molecular (GEM), Edificio Quifima, Laboratorios de Espectroscopia y Bioespectroscopia, Unidad Asociada CSIC, Parque Científico Uva, Universidad de Valladolid, Paseo de Belén 5, 47011 Valladolid (Spain); Barrientos, Carmen; Largo, Antonio, E-mail: alargo@qf.uva.es, E-mail: jlalonso@qf.uva.es [Departamento de Química Física y Química Inorgánica, Facultad de Ciencias, Universidad de Valladolid, Campus Miguel Delibes, Paseo de Belén 7, 47011 Valladolid (Spain); Guillemin, Jean-Claude [Institut des Sciences Chimiques de Rennes, École Nationale Supérieure de Chimie de Rennes, CNRS, UMR 6226, 11 Allée de Beaulieu, CS 50837, 35708 Rennes Cedex 7 (France); Cernicharo, José [Group of Molecular Astrophysics, ICMM C/Sor Juana Ines de la Cruz N3 Cantoblanco, 28049 Madrid (Spain)

    2014-09-14

    Combined spectroscopy measurements and theoretical calculations bring to light a first investigation of a metallic cyanoacetylide, AlC{sub 3}N, using laser ablation molecular beam Fourier transform microwave spectroscopy. This molecule was synthesized in a supersonic expansion by the reaction of aluminum vapour with C{sub 3}N, produced from solid aluminum rods and BrCCCN in a newly constructed ablation-heating nozzle device. A set of accurate rotational and {sup 27}Al and {sup 14}N nuclear quadrupole coupling constants have been determined from the analysis of the rotational spectrum and compared with those predicted in a high-level ab initio study, conducting to the assignment of the observed species to linear AlCCCN. We have searched for this species towards the carbon-rich evolved star IRC + 10216 but only an upper limit to its abundance has been obtained.