WorldWideScience

Sample records for program delivery methods

  1. Dietary Changes by Expanded Food and Nutrition Education Program (EFNEP) Graduates Are Independent of Program Delivery Method.

    Science.gov (United States)

    Luccia, Barbara H. D.; Kunkel, Mary E.; Cason, Katherine L.

    2003-01-01

    Expanded Food and Nutrition Education Program graduates (n=1,141) who received either individual (21.3%), group (76.2%), or combined (2.5%) instruction were assessed. Independent of method, participants significantly improved the number of servings consumed from grains, vegetables, dairy, and meat and meat alternatives; total calories consumed;…

  2. Delivery methods for LVSD systems

    Science.gov (United States)

    Kasner, James H.; Brower, Bernard V.

    2011-06-01

    In this paper we present formats and delivery methods of Large Volume Streaming Data (LVSD) systems. LVSD systems collect TBs of data per mission with aggregate camera sizes in the 100 Mpixel to several Gpixel range at temporal rates of 2 - 60 Hz. We present options and recommendations for the different stages of LVSD data collection and delivery, to include the raw (multi-camera) data, delivery of processed (stabilized mosaic) data, and delivery of user-defined region of interest windows. Many LVSD systems use JPEG 2000 for the compression of raw and processed data. We explore the use of the JPEG 2000 Interactive Protocol (JPIP) for interactive client/server delivery to thick-clients (desktops and laptops) and MPEG-2 and H.264 to handheld thin-clients (tablets, cell phones). We also explore the use of 3D JPEG 2000 compression, defined in ISO 15444-2, for storage and delivery as well. The delivery of raw, processed, and region of interest data requires different metadata delivery techniques and metadata content. Beyond the format and delivery of data and metadata we discuss the requirements for a client/server protocol that provides data discovery and retrieval. Finally, we look into the future as LVSD systems perform automated processing to produce "information" from the original data. This information may include tracks of moving targets, changes of the background, snap shots of targets, fusion of multiple sensors, and information about "events" that have happened.

  3. Participant satisfaction with a school telehealth education program using interactive compressed video delivery methods in rural Arkansas.

    Science.gov (United States)

    Bynum, Ann B; Cranford, Charles O; Irwin, Cathy A; Denny, George S

    2002-08-01

    Socioeconomic and demographic factors can affect the impact of telehealth education programs that use interactive compressed video technology. This study assessed program satisfaction among participants in the University of Arkansas for Medical Sciences' School Telehealth Education Program delivered by interactive compressed video. Variables in the one-group posttest study were age, gender, ethnicity, education, community size, and program topics for years 1997-1999. The convenience sample included 3,319 participants in junior high and high schools. The School Telehealth Education Program provided information about health risks, disease prevention, health promotion, personal growth, and health sciences. Adolescents reported medium to high levels of satisfaction regarding program interest and quality. Significantly higher satisfaction was expressed for programs on muscular dystrophy, anatomy of the heart, and tobacco addiction (p Education Program, delivered by interactive compressed video, promoted program satisfaction among rural and minority populations and among junior high and high school students. Effective program methods included an emphasis on participants' learning needs, increasing access in rural areas among ethnic groups, speaker communication, and clarity of the program presentation.

  4. The Effectiveness of Distance Education, Using Blended Method of Delivery for Limited-Resource Audiences in the Nutrition Education Program

    Science.gov (United States)

    Campbell, Casey; Koszewski, Wanda M.; Behrends, Donnia

    2013-01-01

    The study reported here sought to determine if the use of distance education lessons for teaching limited resource participants in a nutrition education program (NEP) is as effective as face-to-face methodology. One hundred and six participants were in the experimental group. Data was gathered at entry and examined behavior change, nutrient intake…

  5. Vaccine Delivery Methods into the Future

    Directory of Open Access Journals (Sweden)

    Vasso Apostolopoulos

    2016-03-01

    Full Text Available Several modes of vaccine delivery have been developed in the last 25 years, which induce strong immune responses in pre-clinical models and in human clinical trials. Some modes of delivery include, adjuvants (aluminum hydroxide, Ribi formulation, QS21, liposomes, nanoparticles, virus like particles, immunostimulatory complexes (ISCOMs, dendrimers, viral vectors, DNA delivery via gene gun, electroporation or Biojector 2000, cell penetrating peptides, dendritic cell receptor targeting, toll-like receptors, chemokine receptors and bacterial toxins. There is an enormous amount of information and vaccine delivery methods available for guiding vaccine and immunotherapeutics development against diseases.

  6. Renewable energy delivery systems and methods

    Science.gov (United States)

    Walker, Howard Andrew

    2013-12-10

    A system, method and/or apparatus for the delivery of energy at a site, at least a portion of the energy being delivered by at least one or more of a plurality of renewable energy technologies, the system and method including calculating the load required by the site for the period; calculating the amount of renewable energy for the period, including obtaining a capacity and a percentage of the period for the renewable energy to be delivered; comparing the total load to the renewable energy available; and, implementing one or both of additional and alternative renewable energy sources for delivery of energy to the site.

  7. Home Delivery Medicament Program: access, inactivity and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Roque da Silva Araújo

    Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.

  8. FastStats: Births -- Method of Delivery

    Science.gov (United States)

    ... Whooping Cough or Pertussis Family Life Marriage and Divorce Health Care and Insurance Access to Health Care ... 1990–2013 [PDF - 423 KB] Primary Cesarean Delivery Rates, by State: Results From the Revised Birth Certificate, ...

  9. Examination of the Relationship of Community College Opticianry Student Outcomes with Instructional Delivery Methods and Student Age

    Science.gov (United States)

    Underwood, William B.; Hernandez-Gantes, Victor M.

    2017-01-01

    The purpose of this study was to determine whether student outcomes are a function of participation in different modes of delivery and student age in an Opticianry program at the community college level. The three instructional delivery methods were traditional face-to-face instruction, online delivery, and a hybrid format where students take…

  10. Infection Control Practices and Program Management in Labor and Delivery Units: A Cross-Sectional Study From Iran

    OpenAIRE

    Tabatabaei; Behmanesh Pour; Azadeh

    2016-01-01

    Background Although Iranian women increasingly attend hospitals for childbirth, no information is available on programs and practices related to infection control in labor and delivery units. Objectives This study aims to investigate infection control program management and midwives’ practices in labor and delivery units. Patients and Methods We analyzed data related to infection c...

  11. Microneedles: quick and easy delivery methods of vaccines.

    Science.gov (United States)

    Kwon, Ki Mun; Lim, Su-Min; Choi, Seulgi; Kim, Da-Hee; Jin, Hee-Eun; Jee, Grace; Hong, Kee-Jong; Kim, Joo Young

    2017-07-01

    Vaccination is the most efficient method for infectious disease prevention. Parenteral injections such as intramuscular, intradermal, and subcutaneous injections have several advantages in vaccine delivery, but there are many drawbacks. Thus, the development of a new vaccine delivery system has long been required. Recently, microneedles have been attracting attention as new vaccination tools. Microneedle is a highly effective transdermal vaccine delivery method due to its mechanism of action, painlessness, and ease of use. Here, we summarized the characteristics of microneedles and the possibilities as a new vaccine delivery route.

  12. Influencing factors in choosing delivery method: Iranian primiparous women's perspective.

    Science.gov (United States)

    Moosavi, Ahmad; Sheikhlou, Sepideh Gareh; Sheikhlou, Sara Gareh; Abdolahi, Kolsum; Yaminifar, Leila; Maktabi, Maryam

    2017-04-01

    Studies on the primiparous mothers' decision on delivery method are limited. The aim of his study was to determine the factors that influence the choice of delivery method by Iranian primiparous women. This cross-sectional study was conducted in April through September 2014. Participants were 460 primiparous women in 8 hospitals of 4 cities in Iran. Finally, 230 cesarean section and 230 vaginal delivery women were selected. Inclusion criteria were being primiparous, and having no contraindication for vaginal delivery. Study tool was a researcher-developed questionnaire that its validity and reliability were proved. Data were gathered by direct interview and analyzed by SPSS version 16. Average age of the participants was 23 years. Factors that correlated with the choice of Cesarean section were upper education, high socioeconomic level, tendency of husband, living with the husband's family, insistence of the physician, receiving maternal care in personal offices, fear of delivery pain, low knowledge of the mother, high age of marriage and pregnancy, history of abortion, and lack of family support. More than 60% of the participants had little knowledge about the delivery methods. Satisfaction with cesarean section was 70% and with the vaginal delivery was 77%. Half of the cesareans were performed on the insistence of the physician. Considering the factors identified in this study, can enforce the intention of mothers to have vaginal delivery by improving their knowledge and perception about this delivery method.

  13. Awareness and perceptions of Turkish women towards delivery methods

    Directory of Open Access Journals (Sweden)

    Şükrü Yıldız

    2014-06-01

    Full Text Available Objective: Our aim is to identify the causes of the women’s preferences of vaginal delivery vs. cesarean section and their attitudes for an elective cesarean section. Methods: 400 healthy woman who had applied for antenatal care were included in the study. A questionnaire which is consisted of 21 questions, focused on preference toward mode of delivery and the etiology of these preferences was conducted as a face to face interview. According to history of delivery methods, women have separated into three groups as; women have never given birth/nulliparous (group 1, women who had only vaginal deliveries (group 2, and women who had at least one cesarean deliveries/previous cesarean section (group 3. Results: Of the 400 women questioned, 348 (%87 opted for vaginal delivery, whereas only 52 (%13 opted for an elective caesarean delivery. Ratios of cesarean delivery preference is high in group 3 (%47.5 than group 1( %26 and 2 (%2.7 . Main reasons for vaginal delivery preference: feeling of less pain, fast and easy recovery and less bleeding and infection risc for mothers were the most common preference reasons among all 3 groups. The most common reasons for choosing caesarean delivery were: ‘more comfortable and easy’ in group 1 and ‘tubal ligation demand’ in group 3. ‘Less pain’ and ‘fear of tearing (episiotomy’ also other common reasons for choosing cesarean delivery among all 3 groups. Conclusion: In order to reduce the rate of implemented cesarean section, it is substantially important to encourage educated women and those who have experienced advanced maternal age for increasing the rate of vaginal delivery. J Clin Exp Invest 2014; 5 (2: 173-178

  14. Course Delivery Platform Changes and Instructional Delivery Methods: Student Attitudes and Perceptions

    Science.gov (United States)

    Garner, William E.; Pack, Tresvil G.; Szirony, Gary M.; Beeson, Eric T.

    2013-01-01

    The purposes of this study were to examine students' perceptions and attitudes toward changes in Distance Education (DE) course management systems and to evaluate their instructional delivery preferences. Students (N = 145) enrolled in an online master's degree program on either a full- or part-time basis completed an online survey instrument…

  15. Parenting Interventions Implementation Science: How Delivery Format Impacts the Parenting Wisely Program

    Science.gov (United States)

    Cotter, Katie L.; Bacallao, Martica; Smokowski, Paul R.; Robertson, Caroline I. B.

    2013-01-01

    Objectives: This study examines the implementation and effectiveness of Parenting Wisely, an Internet-based parenting skills intervention. The study assesses whether parents benefit from Parenting Wisely participation and whether the delivery format influences program effectiveness. Method: This study uses a quasi-experimental design.…

  16. Methods and metrics challenges of delivery-system research

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    Alexander Jeffrey A

    2012-03-01

    Full Text Available Abstract Background Many delivery-system interventions are fundamentally about change in social systems (both planned and unplanned. This systems perspective raises a number of methodological challenges for studying the effects of delivery-system change--particularly for answering questions related to whether the change will work under different conditions and how the change is integrated (or not into the operating context of the delivery system. Methods The purpose of this paper is to describe the methodological and measurement challenges posed by five key issues in delivery-system research: (1 modeling intervention context; (2 measuring readiness for change; (3 assessing intervention fidelity and sustainability; (4 assessing complex, multicomponent interventions; and (5 incorporating time in delivery-system models to discuss recommendations for addressing these issues. For each issue, we provide recommendations for how research may be designed and implemented to overcome these challenges. Results and conclusions We suggest that a more refined understanding of the mechanisms underlying delivery-system interventions (treatment theory and the ways in which outcomes for different classes of individuals change over time are fundamental starting points for capturing the heterogeneity in samples of individuals exposed to delivery-system interventions. To support the research recommendations outlined in this paper and to advance understanding of the "why" and "how" questions of delivery-system change and their effects, funding agencies should consider supporting studies with larger organizational sample sizes; longer duration; and nontraditional, mixed-methods designs. A version of this paper was prepared under contract with the Agency for Healthcare Research and Quality (AHRQ, US Department of Health and Human Services for presentation and discussion at a meeting on "The Challenge and Promise of Delivery System Research," held in Sterling, VA, on

  17. Nonlinear programming analysis and methods

    CERN Document Server

    Avriel, Mordecai

    2012-01-01

    This text provides an excellent bridge between principal theories and concepts and their practical implementation. Topics include convex programming, duality, generalized convexity, analysis of selected nonlinear programs, techniques for numerical solutions, and unconstrained optimization methods.

  18. Programming the finite element method

    CERN Document Server

    Smith, I M; Margetts, L

    2013-01-01

    Many students, engineers, scientists and researchers have benefited from the practical, programming-oriented style of the previous editions of Programming the Finite Element Method, learning how to develop computer programs to solve specific engineering problems using the finite element method. This new fifth edition offers timely revisions that include programs and subroutine libraries fully updated to Fortran 2003, which are freely available online, and provides updated material on advances in parallel computing, thermal stress analysis, plasticity return algorithms, convection boundary c

  19. Crystallization Methods for Preparation of Nanocrystals for Drug Delivery System.

    Science.gov (United States)

    Gao, Yuan; Wang, Jingkang; Wang, Yongli; Yin, Qiuxiang; Glennon, Brian; Zhong, Jian; Ouyang, Jinbo; Huang, Xin; Hao, Hongxun

    2015-01-01

    Low water solubility of drug products causes delivery problems such as low bioavailability. The reduced particle size and increased surface area of nanocrystals lead to the increasing of the dissolution rate. The formulation of drug nanocrystals is a robust approach and has been widely applied to drug delivery system (DDS) due to the significant development of nanoscience and nanotechnology. It can be used to improve drug efficacy, provide targeted delivery and minimize side-effects. Crystallization is the main and efficient unit operation to produce nanocrystals. Both traditional crystallization methods such as reactive crystallization, anti-solvent crystallization and new crystallization methods such as supercritical fluid crystallization, high-gravity controlled precipitation can be used to produce nanocrystals. The current mini-review outlines the main crystallization methods addressed in literature. The advantages and disadvantages of each method were summarized and compared.

  20. Methods for robustness programming

    NARCIS (Netherlands)

    Olieman, N.J.

    2008-01-01

    Robustness of an object is defined as the probability that an object will have properties as required. Robustness Programming (RP) is a mathematical approach for Robustness estimation and Robustness optimisation. An example in the context of designing a food product, is finding the best composition

  1. Resource consumption of a diffusion model for prevention programs: the PROSPER delivery system.

    Science.gov (United States)

    Crowley, Daniel M; Jones, Damon E; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L

    2012-03-01

    To prepare public systems to implement evidence-based prevention programs for adolescents, it is necessary to have accurate estimates of programs' resource consumption. When evidence-based programs are implemented through a specialized prevention delivery system, additional costs may be incurred during cultivation of the delivery infrastructure. Currently, there is limited research on the resource consumption of such delivery systems and programs. In this article, we describe the resource consumption of implementing the PROSPER (PROmoting School-Community-University Partnerships to Enhance Resilience) delivery system for a period of 5 years in one state, and how the financial and economic costs of its implementation affect local communities as well as the Cooperative Extension and University systems. We used a six-step framework for conducting cost analysis, using a Cost-Procedure-Process-Outcome Analysis model (Yates, Analyzing costs, procedures, processes, and outcomes in human services: An introduction, 1996; Yates, 2009). This method entails defining the delivery System; bounding cost parameters; identifying, quantifying, and valuing systemic resource Consumption, and conducting sensitivity analysis of the cost estimates. Our analyses estimated both the financial and economic costs of the PROSPER delivery system. Evaluation of PROSPER illustrated how costs vary over time depending on the primacy of certain activities (e.g., team development, facilitator training, program implementation). Additionally, this work describes how the PROSPER model cultivates a complex resource infrastructure and provides preliminary evidence of systemic efficiencies. This work highlights the need to study the costs of diffusion across time and broadens definitions of what is essential for successful implementation. In particular, cost analyses offer innovative methodologies for analyzing the resource needs of prevention systems. Copyright © 2012 Society for Adolescent Health and

  2. Current HPLC Methods for Assay of Nano Drug Delivery Systems.

    Science.gov (United States)

    Tekkeli, Serife Evrim Kepekci; Kiziltas, Mustafa Volkan

    2017-01-01

    In nano drug formulations the mechanism of release is a critical process to recognize controlled and targeted drug delivery systems. In order to gain high bioavailability and specificity from the drug to reach its therapeutic goal, the active substance must be loaded into the nanoparticles efficiently. Therefore, the amount in biological fluids or tissues and the remaining amount in nano carriers are very important parameters to understand the potential of the nano drug delivery systems. For this aim, suitable and validated quantitation methods are required to determine released drug concentrations from nano pharmaceutical formulations. HPLC (High Performance Liquid Chromatography) is one of the most common techniques used for determination of released drug content out of nano drug formulations, in different physical conditions, over different periods of time. Since there are many types of HPLC methods depending on detector and column types, it is a challenge for the researchers to choose a suitable method that is simple, fast and validated HPLC techniques for their nano drug delivery systems. This review's goal is to compare HPLC methods that are currently used in different nano drug delivery systems in order to provide detailed and useful information for researchers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  3. Does the Classroom Delivery Method Make a Difference?

    Science.gov (United States)

    Bunn, Esther; Fischer, Mary; Marsh, Treba

    2014-01-01

    This study seeks to determine if a difference exists in student performance and participation between an online and face-to-face Accounting Intermediate I class taught by the same professor. Even though students self-selected which course section to enroll, no significant difference was found to exist between the delivery method of the two courses…

  4. Impact of early admission in labor on method of delivery.

    Science.gov (United States)

    Rahnama, P; Ziaei, S; Faghihzadeh, S

    2006-03-01

    The effect of the timing of admission in labor unit on the method of delivery was evaluated in a cohort study. Four hundred and sixty six low-risk nulliparous women who were admitted in the labor unit in latent phase (group 1) were compared with 329 parturient women who were admitted in the active phase (group 2) to determine rate of and reasons for cesarean section, cervical dilation at the time of cesarean, and the rate of labor augmentation. The number of cesarean deliveries in group 1 was greater than that in the group 2 (301 vs 80, p<0.0001 ). The main reason for cesarean section in group 1 was dystocia, and in 2, fetal distress. The rate of cesarean section in the women who were augmented was greater in group 1 than in group 2 (54% vs 23%, p<0.0001). Later admission in labor increases the rate of spontaneous vaginal delivery in low risk nulliparous women.

  5. Comparison of skin optical clearing by different drug delivery method

    Energy Technology Data Exchange (ETDEWEB)

    Mao, Z; Ge, X [Department of Fundamental Theories, Shandong Sports University, Jinan, 250102 (China); Li, E, E-mail: mm73@163.com [Institute of Physical Education, Huazhong Normal University, Wuhan, 430079 (China)

    2011-01-01

    Previous studies have shown that optical clearing techniques have great potential for optical diagnosis and therapy. In order to further discuss the effect by different drug delivery method, diffusion chambers were used to simulate in vivo physiological environment; and the optical clearing agents were acted on the surface of porcine skin, the saline was contacted with the dermal side (epidermal application). Then they were compared with the traditional method-samples immersed in the optical clearing agents (mainly dermal immersion). The transmission intensity of skin was monitored by an integrating sphere system. The changes in thickness were measured before and after experiments. The results showed that the optical clearing effect and the changes in thickness are not coincident under the two different methods. It indicates that the optical clearing effect and mechanism may relate to the drug delivery method.

  6. Separable programming theory and methods

    CERN Document Server

    Stefanov, Stefan M

    2001-01-01

    In this book, the author considers separable programming and, in particular, one of its important cases - convex separable programming Some general results are presented, techniques of approximating the separable problem by linear programming and dynamic programming are considered Convex separable programs subject to inequality equality constraint(s) and bounds on variables are also studied and iterative algorithms of polynomial complexity are proposed As an application, these algorithms are used in the implementation of stochastic quasigradient methods to some separable stochastic programs Numerical approximation with respect to I1 and I4 norms, as a convex separable nonsmooth unconstrained minimization problem, is considered as well Audience Advanced undergraduate and graduate students, mathematical programming operations research specialists

  7. Frank Gilbreth and health care delivery method study driven learning.

    Science.gov (United States)

    Towill, Denis R

    2009-01-01

    The purpose of this article is to look at method study, as devised by the Gilbreths at the beginning of the twentieth century, which found early application in hospital quality assurance and surgical "best practice". It has since become a core activity in all modern methods, as applied to healthcare delivery improvement programmes. The article traces the origin of what is now currently and variously called "business process re-engineering", "business process improvement" and "lean healthcare" etc., by different management gurus back to the century-old pioneering work of Frank Gilbreth. The outcome is a consistent framework involving "width", "length" and "depth" dimensions within which healthcare delivery systems can be analysed, designed and successfully implemented to achieve better and more consistent performance. Healthcare method (saving time plus saving motion) study is best practised as co-joint action learning activity "owned" by all "players" involved in the re-engineering process. However, although process mapping is a key step forward, in itself it is no guarantee of effective re-engineering. It is not even the beginning of the end of the change challenge, although it should be the end of the beginning. What is needed is innovative exploitation of method study within a healthcare organisational learning culture accelerated via the Gilbreth Knowledge Flywheel. It is shown that effective healthcare delivery pipeline improvement is anchored into a team approach involving all "players" in the system especially physicians. A comprehensive process study, constructive dialogue, proper and highly professional re-engineering plus managed implementation are essential components. Experience suggests "learning" is thereby achieved via "natural groups" actively involved in healthcare processes. The article provides a proven method for exploiting Gilbreths' outputs and their many successors in enabling more productive evidence-based healthcare delivery as summarised

  8. Integrated project delivery methods for energy renovation of social housing

    OpenAIRE

    Tadeo Baldiri Salcedo Rahola

    2015-01-01

    Optimised project delivery methods forsocial housing energy renovationsEuropean Social Housing Organisations (SHOs) are currently facing challenging times. The ageing of their housing stock and the economic crisis, which has affected both their finances and the finances of their tenants, are testing their capacity to stick to their aim of providing decent and affordable housing. Housing renovation projects offer the possibility of upgrading the health and comfort levels of their old housing s...

  9. Rate-programming of nano-particulate delivery systems for smart bioactive scaffolds in tissue engineering.

    Science.gov (United States)

    Izadifar, Mohammad; Haddadi, Azita; Chen, Xiongbiao; Kelly, Michael E

    2015-01-09

    Development of smart bioactive scaffolds is of importance in tissue engineering, where cell proliferation, differentiation and migration within scaffolds can be regulated by the interactions between cells and scaffold through the use of growth factors (GFs) and extra cellular matrix peptides. One challenge in this area is to spatiotemporally control the dose, sequence and profile of release of GFs so as to regulate cellular fates during tissue regeneration. This challenge would be addressed by rate-programming of nano-particulate delivery systems, where the release of GFs via polymeric nanoparticles is controlled by means of the methods of, such as externally-controlled and physicochemically/architecturally-modulated so as to mimic the profile of physiological GFs. Identifying and understanding such factors as the desired release profiles, mechanisms of release, physicochemical characteristics of polymeric nanoparticles, and externally-triggering stimuli are essential for designing and optimizing such delivery systems. This review surveys the recent studies on the desired release profiles of GFs in various tissue engineering applications, elucidates the major release mechanisms and critical factors affecting release profiles, and overviews the role played by the mathematical models for optimizing nano-particulate delivery systems. Potentials of stimuli responsive nanoparticles for spatiotemporal control of GF release are also presented, along with the recent advances in strategies for spatiotemporal control of GF delivery within tissue engineered scaffolds. The recommendation for the future studies to overcome challenges for developing sophisticated particulate delivery systems in tissue engineering is discussed prior to the presentation of conclusions drawn from this paper.

  10. Transportation risk management : international practices for program development and project delivery.

    Science.gov (United States)

    2012-08-01

    Managing transportation networks, including agency : management, program development, and project : delivery, is extremely complex and fraught with : uncertainty. Administrators, planners, and engineers : coordinate a multitude of organizational and ...

  11. Integrated project delivery methods for energy renovation of social housing

    Directory of Open Access Journals (Sweden)

    Tadeo Baldiri Salcedo Rahola

    2015-11-01

    Full Text Available Optimised project delivery methods forsocial housing energy renovationsEuropean Social Housing Organisations (SHOs are currently facing challenging times. The ageing of their housing stock and the economic crisis, which has affected both their finances and the finances of their tenants, are testing their capacity to stick to their aim of providing decent and affordable housing. Housing renovation projects offer the possibility of upgrading the health and comfort levels of their old housing stock to current standards and improve energy efficiency, and this solution also addresses the fuel poverty problems suffered by some tenants. Unfortunately, the limited financial capacity of SHOs is hampering the scale of housing renovation projects and the energy savings achieved. At the same time, the renovation of the existing housing stock is seen as one of the most promising alternative routes to achieving the ambitious CO2 emissions reduction targets set by European authorities – namely, to reduce EU CO2 emissions to 20% below their 1990 levels by 2020. The synergy between European targets and the aims of SHOs has been addressed by the energy policies of the member states, which focus on the potential energy savings achievable by renovating social housing. In fact, the European initiatives have prioritised energy savings in social housing renovations to such an extent that these are referred to as ‘energy renovations’. Energy renovation is therefore a renovation project with higher energy savings target than a regular renovation project.In total, European SHOs own 21.5 million dwellings representing around 9.4% of the total housing stock. Each SHO owns a large number of dwellings, which means there are fewer people to convince of the need to make energy savings through building renovations, maximising the potentially high impact of decisions. Moreover, SHOs are responsible for maintaining and upgrading their properties in order to continue

  12. Integrated project delivery methods for energy renovation of social housing

    Directory of Open Access Journals (Sweden)

    Tadeo Baldiri Salcedo Rahola

    2015-11-01

    Full Text Available Optimised project delivery methods forsocial housing energy renovations European Social Housing Organisations (SHOs are currently facing challenging times. The ageing of their housing stock and the economic crisis, which has affected both their finances and the finances of their tenants, are testing their capacity to stick to their aim of providing decent and affordable housing. Housing renovation projects offer the possibility of upgrading the health and comfort levels of their old housing stock to current standards and improve energy efficiency, and this solution also addresses the fuel poverty problems suffered by some tenants. Unfortunately, the limited financial capacity of SHOs is hampering the scale of housing renovation projects and the energy savings achieved.  At the same time, the renovation of the existing housing stock is seen as one of the most promising alternative routes to achieving the ambitious CO2 emissions reduction targets set by European authorities – namely, to reduce EU CO2 emissions to 20% below their 1990 levels by 2020. The synergy between European targets and the aims of SHOs has been addressed by the energy policies of the member states, which focus on the potential energy savings achievable by renovating social housing. In fact, the European initiatives have prioritised energy savings in social housing renovations to such an extent that these are referred to as ‘energy renovations’. Energy renovation is therefore a renovation project with higher energy savings target than a regular renovation project. In total, European SHOs own 21.5 million dwellings representing around 9.4% of the total housing stock. Each SHO owns a large number of dwellings, which means there are fewer people to convince of the need to make energy savings through building renovations, maximising the potentially high impact of decisions. Moreover, SHOs are responsible for maintaining and upgrading their properties in order to continue

  13. Chronic, programmed polypeptide delivery from an implanted, multireservoir microchip device.

    Science.gov (United States)

    Prescott, James H; Lipka, Sara; Baldwin, Samuel; Sheppard, Norman F; Maloney, John M; Coppeta, Jonathan; Yomtov, Barry; Staples, Mark A; Santini, John T

    2006-04-01

    Implanted drug delivery systems are being increasingly used to realize the therapeutic potential of peptides and proteins. Here we describe the controlled pulsatile release of the polypeptide leuprolide from microchip implants over 6 months in dogs. Each microchip contains an array of discrete reservoirs from which dose delivery can be controlled by telemetry.

  14. Dynamic Line Rating Oncor Electric Delivery Smart Grid Program

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Justin; Smith, Cale; Young, Mike; Donohoo, Ken; Owen, Ross; Clark, Eddit; Espejo, Raul; Aivaliotis, Sandy; Stelmak, Ron; Mohr, Ron; Barba, Cristian; Gonzalez, Guillermo; Malkin, Stuart; Dimitrova, Vessela; Ragsdale, Gary; Mitchem, Sean; Jeirath, Nakul; Loomis, Joe; Trevino, Gerardo; Syracuse, Steve; Hurst, Neil; Mereness, Matt; Johnson, Chad; Bivens, Carrie

    2013-05-04

    Electric transmission lines are the lifeline of the electric utility industry, delivering its product from source to consumer. This critical infrastructure is often constrained such that there is inadequate capacity on existing transmission lines to efficiently deliver the power to meet demand in certain areas or to transport energy from high-generation areas to high-consumption regions. When this happens, the cost of the energy rises; more costly sources of power are used to meet the demand or the system operates less reliably. These economic impacts are known as congestion, and they can amount to substantial dollars for any time frame of reference: hour, day or year. There are several solutions to the transmission constraint problem, including: construction of new generation, construction of new transmission facilities, rebuilding and reconductoring of existing transmission assets, and Dynamic Line Rating (DLR). All of these options except DLR are capital intensive, have long lead times and often experience strong public and regulatory opposition. The Smart Grid Demonstration Program (SGDP) project co-funded by the Department of Energy (DOE) and Oncor Electric Delivery Company developed and deployed the most extensive and advanced DLR installation to demonstrate that DLR technology is capable of resolving many transmission capacity constraint problems with a system that is reliable, safe and very cost competitive. The SGDP DLR deployment is the first application of DLR technology to feed transmission line real-time dynamic ratings directly into the system operation’s State Estimator and load dispatch program, which optimizes the matching of generation with load demand on a security, reliability and economic basis. The integrated Dynamic Line Rating (iDLR)1 collects transmission line parameters at remote locations on the lines, calculates the real-time line rating based on the equivalent conductor temperature, ambient temperature and influence of wind and solar

  15. Materials and methods for delivery of biological drugs

    Science.gov (United States)

    Zelikin, Alexander N.; Ehrhardt, Carsten; Healy, Anne Marie

    2016-11-01

    Biological drugs generated via recombinant techniques are uniquely positioned due to their high potency and high selectivity of action. The major drawback of this class of therapeutics, however, is their poor stability upon oral administration and during subsequent circulation. As a result, biological drugs have very low bioavailability and short therapeutic half-lives. Fortunately, tools of chemistry and biotechnology have been developed into an elaborate arsenal, which can be applied to improve the pharmacokinetics of biological drugs. Depot-type release systems are available to achieve sustained release of drugs over time. Conjugation to synthetic or biological polymers affords long circulating formulations. Administration of biological drugs through non-parenteral routes shows excellent performance and the first products have reached the market. This Review presents the main accomplishments in this field and illustrates the materials and methods behind existing and upcoming successful formulations and delivery strategies for biological drugs.

  16. 47 CFR 63.02 - Exemptions for extensions of lines and for systems for the delivery of video programming.

    Science.gov (United States)

    2010-10-01

    ... systems for the delivery of video programming. 63.02 Section 63.02 Telecommunication FEDERAL... systems for the delivery of video programming. (a) Any common carrier is exempt from the requirements of... with respect to the establishment or operation of a system for the delivery of video programming. ...

  17. 77 FR 47383 - Annual Assessment of the Status of Competition in the Market for the Delivery of Video Programming

    Science.gov (United States)

    2012-08-08

    ... COMMISSION Annual Assessment of the Status of Competition in the Market for the Delivery of Video Programming... annually to Congress on the status of competition in markets for the delivery of video programming. This... delivery of video programming for the Commission's Fifteenth Report (15th Report). The 15th Report will...

  18. Preferred Educational Delivery Strategies among Limited Income Older Adults Enrolled in Community Nutrition Education Programs

    Science.gov (United States)

    Parker, Stephany; Powell, Laura; Hermann, Janice; Phelps, Joshua; Brown, Barbara

    2011-01-01

    The study reported here explored educational delivery preference of limited income older Oklahomans. Sixty participants 60 years or older enrolled in Community Nutrition Education Programs observed three educational delivery strategies and participated in a group discussion. Two researchers independently coded focus group transcripts and frequency…

  19. Energy-efficient Public Procurement: Best Practice in Program Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Payne, Christopher [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Weber, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Semple, Abby [Public Procurement Analysis, London (United Kingdom)

    2013-02-15

    This document illustrates the key issues and considerations involved in implementing energy-efficient public procurement. Our primary sources of information have been our partners in the Super Efficient Equipment and Appliance Deployment (SEAD) Initiative Procurement Working Group. Where applicable, we have highlighted specific ways in which working group participants have successfully overcome barriers to delivering effective programs. The following key points emerge from this analysis of programs for energy-efficient public procurement. Lessons for both developed and developing programs are highlighted throughout the guide. 1. Policy: Policy provides the initiative to begin a transition from first cost to life-cycle cost based purchasing methods and culture. Effective policy is well-communicated, establishes accountability from top to bottom of organizations and simplifies the processes necessary to comply. Flexibility and responsiveness are essential in policy development and implementation. Mandatory and voluntary policies may complement one another. 2. Procurement Criteria: Procurement staff must be confident that energy-efficient procurement criteria offer the best long-term value for their organization’s money and represent real environmental gains. Involving multiple stakeholders at the early stages of the criteria creation process can result in greater levels of cooperation from private industry. Criteria should make comparison of products easy for purchasers and require minimal additional calculations. Criteria will need to be regularly updated to reflect market developments. 3. Training: Resources for the creation of training programs are usually very limited, but well-targeted training is necessary in order for a program to be effective. Training must emphasize a process that is efficient for purchasers and simplifies compliance. Purchaser resources and policy must be well designed for training to be effective. Training program development is an

  20. An Analysis Of Delivery Methods And Outcome Of Child Birth Case Of South-Western Nigeria

    Directory of Open Access Journals (Sweden)

    Alatise Olufemi Ebenezer

    2015-08-01

    Full Text Available This research work studied the trend of the methods involved in child delivery where methods involved in child delivery are normal delivery elective caesarean section and emergency caesarean section. Data about delivery from University College Hospital Ibadan in Nigeria were used for all the analysis involved data based on these three methods and their outcomes was sourced from the record units of the hospital under consideration. The data used for the analysis spread through 2012 and 2013 where 1000 units of delivery records was randomly taken and the trend at which women request delivery through elective method was obtained. The comparison of the outcomes of the three methods was carried out in other to see their contributions to the risk at birth. The major risk at birth considered is Death both the perinatal and maternal mortality. The dependency of the outcomes of the methods with variables mothers age and methods of delivery was determined and also discover which of these variables having highest contribution to death during child delivery. The analyses were carried out using chi square multinomial logistic regression and simple percentages while Statistical package for social sciences was used for the analysis. Through analysis other women age groups has 99.9 less contribution to death than age group 17. Normal delivery has highest number of delivery likewise age-group 30 and above elective caesarean section is more likely to contribute to death than emergency caesarean section when compare to the normal delivery.

  1. Home Delivery Medicament Program: access, inactivity and cardiovascular risk.

    Science.gov (United States)

    Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê

    2016-10-10

    to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion

  2. Delivery of an Engineering Seminar to a High School International Exchange Program

    Science.gov (United States)

    Iwata, Setsuo; Matsuishi, Masakatsu; Yoshida, Keishiro; Kim, Youngjong

    Kanazawa Institute of Technology (KIT) supported a high school international exchange program between Komatsu Senior High School of Japan and Daejeon Science High School of South Korea through the delivery of a two-day pre-college engineering seminar in 2008. Students were asked to build stronger and more attractive bridges using as little balsa wood as possible. We delivered the course content through four pedagogical methods: the Plan-Do-Check-Action Cycle, hands-on exercises, cooperative learning, and presentations in English. Students also gained technical knowledge and an international way of thinking. This paper discusses the experience of supporting a high school international exchange program and the results of student feedback.

  3. Magnetofection: A Reproducible Method for Gene Delivery to Melanoma Cells

    Directory of Open Access Journals (Sweden)

    Lara Prosen

    2013-01-01

    Full Text Available Magnetofection is a nanoparticle-mediated approach for transfection of cells, tissues, and tumors. Specific interest is in using superparamagnetic iron oxide nanoparticles (SPIONs as delivery system of therapeutic genes. Magnetofection has already been described in some proof-of-principle studies; however, fine tuning of the synthesis of SPIONs is necessary for its broader application. Physicochemical properties of SPIONs, synthesized by the co-precipitation in an alkaline aqueous medium, were tested after varying different parameters of the synthesis procedure. The storage time of iron(II sulfate salt, the type of purified water, and the synthesis temperature did not affect physicochemical properties of SPIONs. Also, varying the parameters of the synthesis procedure did not influence magnetofection efficacy. However, for the pronounced gene expression encoded by plasmid DNA it was crucial to functionalize poly(acrylic acid-stabilized SPIONs (SPIONs-PAA with polyethyleneimine (PEI without the adjustment of its elementary alkaline pH water solution to the physiological pH. In conclusion, the co-precipitation of iron(II and iron(III sulfate salts with subsequent PAA stabilization, PEI functionalization, and plasmid DNA binding is a robust method resulting in a reproducible and efficient magnetofection. To achieve high gene expression is important, however, the pH of PEI water solution for SPIONs-PAA functionalization, which should be in the alkaline range.

  4. Public health sealant delivery programs: optimal delivery and the cost of practice acts.

    Science.gov (United States)

    Scherrer, Christina R; Griffin, Paul M; Swann, Julie L

    2007-01-01

    The greatest unmet health need for US children is dental care. School-based sealant programs target low-income, high-risk second graders and are effective in preventing caries for as long as the sealant material remains in place. However, it is not clear whether such programs make efficient use of available resources and staffing. The authors used discrete event simulation to determine the optimal combinations of staffing levels and sealant stations for school-based sealant programs. Using data provided by state programs and the literature, they modeled different-sized programs under different practice act constraints and determined times and associated costs. A detailed economic analysis was done for Wisconsin. For general, direct, or indirect supervision, it is optimal to have only 1 dentist or no dentists for no supervision. For general supervision, it is optimal to have the dentist and dental assistant to come on separate days to screen. The cost savings for adding an assistant and chair averaged over all of the program sizes and travel distances ranged from 4.50% (SE= 0.89) to 10.94% (SE= 0.56). Significant cost savings also result from reducing the required supervision level (8.72% [SE = 1.61] to 29.96% [SE= 1.67]). The cost of the practice act for the state of Wisconsin for 2003 was from USD 83,041 to USD 346,156, significantly more than its annual budget. States could save money by relaxing restrictions on the type of personnel who can deliver sealants in public health settings and by productivity gains through proper consideration of staffing. The savings could be used to improve access to sealant programs and further reduce disparities in oral health.

  5. Programmed co-delivery of paclitaxel and doxorubicin boosted by camouflaging with erythrocyte membrane

    Science.gov (United States)

    Fu, Qiang; Lv, Piping; Chen, Zhongke; Ni, Dezhi; Zhang, Lijun; Yue, Hua; Yue, Zhanguo; Wei, Wei; Ma, Guanghui

    2015-02-01

    Combination chemotherapy has been proven promising for cancer treatment, but unsatisfactory therapeutic data and increased side effects slow down the development in the clinic. In this study, we develop an effective approach to co-encapsulate a hydrophilic-hydrophobic chemotherapeutic drug pair (paclitaxel and doxorubicin) into magnetic O-carboxymethyl-chitosan nanoparticles. To endow them with the ability of programmed delivery, these carriers are further camouflaged with an Arg-Gly-Asp anchored erythrocyte membrane. Compared with the traditional polyethylene glycol coating method, this biomimetic decoration strategy is demonstrated to be superior in prolonging circulation time, improving tumor accumulation, facilitating tumor uptake, and tuning intracellular fate. These outstanding properties enable the as-designed nanodevice to exhibit greater tumor growth inhibition ability and much lower side effects than the combined use of commercial formulations.Combination chemotherapy has been proven promising for cancer treatment, but unsatisfactory therapeutic data and increased side effects slow down the development in the clinic. In this study, we develop an effective approach to co-encapsulate a hydrophilic-hydrophobic chemotherapeutic drug pair (paclitaxel and doxorubicin) into magnetic O-carboxymethyl-chitosan nanoparticles. To endow them with the ability of programmed delivery, these carriers are further camouflaged with an Arg-Gly-Asp anchored erythrocyte membrane. Compared with the traditional polyethylene glycol coating method, this biomimetic decoration strategy is demonstrated to be superior in prolonging circulation time, improving tumor accumulation, facilitating tumor uptake, and tuning intracellular fate. These outstanding properties enable the as-designed nanodevice to exhibit greater tumor growth inhibition ability and much lower side effects than the combined use of commercial formulations. Electronic supplementary information (ESI) available. See DOI

  6. METHOD OF CHOOSING THE TECHNOLOGY OF VEHICLE OPERATION ON DELIVERY ROUTES

    Directory of Open Access Journals (Sweden)

    Ye. Nagornyi

    2014-10-01

    Full Text Available A method for determining the technology of vehicles operation on delivery (team routes, which allows to determine the optimal sequence of cargo delivery to customers by vehicles of certain capacity in order to meet the requirements of cargo owners regarding the conditions of service is offered. Recommendations for creation of an automated system of forming the technology of vehicles operation on delivery routes are developed.

  7. Factors Associated with Teacher Delivery of a Classroom-Based Tier 2 Prevention Program.

    Science.gov (United States)

    Sutherland, Kevin S; Conroy, Maureen A; McLeod, Bryce D; Algina, James; Kunemund, Rachel L

    2018-02-01

    Teachers sometimes struggle to deliver evidence-based programs designed to prevent and ameliorate chronic problem behaviors of young children with integrity. Identifying factors associated with variations in the quantity and quality of delivery is thus an important goal for the field. This study investigated factors associated with teacher treatment integrity of BEST in CLASS, a tier-2 prevention program designed for young children at risk for developing emotional/behavioral disorders. Ninety-two early childhood teachers and 231 young children at-risk for emotional/behavioral disorders participated in the study. Latent growth curve analyses indicated that both adherence and competence of delivery increased across six observed time points. Results suggest that teacher education and initial levels of classroom quality may be important factors to consider when teachers deliver tier-2 (i.e., targeted to children who are not responsive to universal or tier-1 programming) prevention programs in early childhood settings. Teachers with higher levels of education delivered the program with more adherence and competence initially. Teachers with higher initial scores on the Emotional Support subscale of the Classroom Assessment Scoring System (CLASS) delivered the program with more competence initially and exhibited higher growth in both adherence and competence of delivery across time. Teachers with higher initial scores on the Classroom Organization subscale of the CLASS exhibited lower growth in adherence across time. Contrary to hypotheses, teacher self-efficacy did not predict adherence, and teachers who reported higher initial levels of Student Engagement self-efficacy exhibited lower growth in competence of delivery. Results are discussed in relation to teacher delivery of evidence-based programs in early childhood classrooms.

  8. A cost effectiveness study of integrated care in health services delivery: a diabetes program in Australia

    Directory of Open Access Journals (Sweden)

    Snow Jill

    2008-10-01

    Full Text Available Abstract Background Type 2 diabetes is rapidly growing as a proportion of the disease burden in Australia as elsewhere. This study addresses the cost effectiveness of an integrated approach to assisting general practitioners (GPs with diabetes management. This approach uses a centralized database of clinical data of an Australian Division of General Practice (a network of GPs to co-ordinate care according to national guidelines. Methods Long term outcomes for patients in the program were derived using clinical parameters after 5 years of program participation, and the United Kingdom Prospective Diabetes Study (UKPDS Outcomes Model, to project outcomes for 40 years from the time of diagnosis and from 5 years post-diagnosis. Cost information was obtained from a range of sources. While program costs are directly available, and costs of complications can be estimated from the UKPDS model, other costs are estimated by comparing costs in the Division with average costs across the state or the nation. The outcome and cost measures are used derive incremental cost-effectiveness ratios. Results The clinical data show that the program is effective in the short term, with improvement or no statistical difference in most clinical measures over 5 years. Average HbA1c levels increased by less than expected over the 5 year period. While the program is estimated to generate treatment cost savings, overall net costs are positive. However, the program led to projected improvements in expected life years and Quality Adjusted Life Expectancy (QALE, with incremental cost effectiveness ratios of $A8,106 per life-year saved and $A9,730 per year of QALE gained. Conclusions The combination of an established model of diabetes progression and generally available data has provided an opportunity to establish robust methods of testing the cost effectiveness of a program for which a formal control group was not available. Based on this methodology, integrated health care

  9. Relational coordination promotes quality of chronic care delivery in Dutch disease-management programs.

    Science.gov (United States)

    Cramm, Jane Murray; Nieboer, Anna Petra

    2012-01-01

    Previous studies have shown that relational coordination is positively associated with the delivery of hospital care, acute care, emergency care, trauma care, and nursing home care. The effect of relational coordination in primary care settings, such as disease-management programs, remains unknown. This study examined relational coordination between general practitioners and other professionals in disease-management programs and assessed the impact of relational coordination on the delivery of chronic illness care. Professionals (n = 188; response rate = 57%) in 19 disease-management programs located throughout the Netherlands completed surveys that assessed relational coordination and chronic care delivery. We used a cross-sectional study design. Our study demonstrated that the delivery of chronic illness care was positively related to relational coordination. We found positive relationships with community linkages (r = .210, p management support (r = .217, p management team members: practice nurses (M = 2.69 vs. 3.73; p management professionals with different disciplines is expected to improve chronic illness care delivery.

  10. How does delivery method influence factors that contribute to women's childbirth experiences?

    Science.gov (United States)

    Carquillat, Pierre; Boulvain, Michel; Guittier, Marie-Julia

    2016-12-01

    whether delivery method influences factors contributing to women's childbirth experience remains debated. we compared subjective childbirth experience according to different delivery methods. this study used a cross-sectional design. the setting comprised two university hospitals: one in Geneva, Switzerland and one in Clermont-Ferrand, France. a total of 291 primiparous women were recruited from July 2014 to January 2015 during their stay in the maternity wards. The mean age of the participants was 30.8 (SD=4.7) years, and most were Swiss or European (86%). the 'Questionnaire for Assessing Childbirth Experience' was sent between four and six weeks after delivery. Clinimetric and psychometric approaches were used to assess childbirth experience according to delivery method. the mean scores of the four questionnaire dimensions varied significantly by delivery method. 'First moments with the newborn' was more negatively experienced by women from the caesarean section group compared to those who delivered vaginally (pchildbirth experience. a comparison of best expected positive responses to each item (clinimetric approach) showed useful results for clinicians. This research indicated that delivery method influenced key factors (psychometric approach) of the childbirth experience. delivery method should not be considered alone and health professionals should focus on what is important for women to foster a more positive experience. In addition, women who have had an emergency caesarean section require special attention during post partum. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Neurolinguistics Programming: Method or Myth?

    Science.gov (United States)

    Gumm, W. B.; And Others

    1982-01-01

    The preferred modality by which 50 right-handed female college students encoded experience was assessed by recordings of conjugate eye movements, content analysis of the subject's verbal report, and the subject's self-report. Kappa analyses failed to reveal any agreement of the three assessment methods. (Author)

  12. Discount method for programming language evaluation

    DEFF Research Database (Denmark)

    Kurtev, Svetomir; Christensen, Tommy Aagaard; Thomsen, Bent

    2016-01-01

    This paper presents work in progress on developing a Discount Method for Programming Language Evaluation inspired by the Discount Usability Evaluation method (Benyon 2010) and the Instant Data Analysis method (Kjeldskov et al. 2004). The method is intended to bridge the gap between small scale...

  13. Family Coaching as a delivery modality for evidence-based prevention programs.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Rotheram-Fuller, Erin; Youssef, Maryann K

    2017-08-01

    Family Coaching is proposed as a new delivery format for evidence-based prevention programs (EBPPs). Three recent developments in health promotion support the potential efficacy of Family Coaching: (1) renewed interest in integrated prevention programs for multiple risk factors and behavior changes, (2) broad and long-term impacts of family-based interventions, and (3) popular acceptance of "coaching" as a nonstigmatizing, goal-focused intervention strategy. Family coaches are community members and paraprofessionals trained in common elements of EBPP. Family Coaching has specific goals, is short term, and has definable outcomes. Coaches frame the program's goals to be consistent with the family's values, normalize the family's experience, assess their strengths, and help the family set goals and develop skills and routines to problem solve challenging situations. Broad dissemination of EBPP will be facilitated with delivery formats that are flexible to meet families' priorities and providers' desires and capacities to tailor programs to local contexts.

  14. A Best Practice Modular Design of a Hybrid Course Delivery Structure for an Executive Education Program

    Science.gov (United States)

    Klotz, Dorothy E.; Wright, Thomas A.

    2017-01-01

    This article highlights a best practice approach that showcases the highly successful deployment of a hybrid course delivery structure for an Operations core course in an Executive MBA Program. A key design element of the approach was the modular design of both the course itself and the learning materials. While other hybrid deployments may stress…

  15. A Comprehensive Planning Model and Delivery System for Leadership Training Programs.

    Science.gov (United States)

    Janosik, Steven M.; Sina, Julie A.

    1988-01-01

    Presents an eight-step planning model that operationally defines a comprehensive delivery systems approach to campuswide leadership training. Lists four goals of the model: to increase efficiency of leadership training through shared resources, to decrease costs, to provide quality control, and to increase impact of programming effort by creating…

  16. Using program impact pathways to understand and improve program delivery, utilization, and potential for impact of Helen Keller International's homestead food production program in Cambodia.

    Science.gov (United States)

    Olney, Deanna K; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

    2013-06-01

    Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to understand why these programs, which have been successful in increasing intake of micronutrient-rich foods, have had such limited documented impact on nutrition outcomes. To conduct a process evaluation of Helen Keller International's (HKI's) homestead food production program in Cambodia to assess whether the program was operating as planned (in terms of design, delivery, and utilization) and to identify ways in which the program might need to be strengthened in order to increase its potential for impact. A program theory framework, which laid out the primary components along the hypothesized program impact pathways, was developed in collaboration with HKI and used to design the research. Semistructured interviews and focus group discussions with program beneficiaries (n = 36 and 12, respectively), nonbeneficiaries (n = 12), and program implementers (n = 17 and 2, respectively) and observations of key program delivery points, including health and nutrition training sessions (n = 6), village model farms (n = 6), and household gardens of beneficiaries (n = 36) and nonbeneficiaries (n = 12), were conducted to assess the delivery and utilization of the primary program components along the impact pathways. The majority of program components were being delivered and utilized as planned. However, challenges with some of the key components posited to improve outcomes such as anemia and growth were noted. Among these were a gap in the expected pathway from poultry production to increased intake of eggs and poultry meat, and some weaknesses in the delivery of the health and nutrition training sessions and related improvements in knowledge among the village health volunteers and beneficiaries. Although the program has been successful in delivering the majority of the program

  17. Convection-enhanced delivery of AAV2 in white matter--a novel method for gene delivery to cerebral cortex.

    Science.gov (United States)

    Barua, N U; Woolley, M; Bienemann, A S; Johnson, D; Wyatt, M J; Irving, C; Lewis, O; Castrique, E; Gill, S S

    2013-10-30

    Convection-enhanced delivery (CED) is currently under investigation for delivering therapeutic agents to subcortical targets in the brain. Direct delivery of therapies to the cerebral cortex, however, remains a significant challenge. We describe a novel method of targeting adeno-associated viral vector (AAV) mediated gene therapies to specific cerebral cortical regions by performing high volume, high flow rate infusions into underlying white matter in a large animal (porcine) model. Infusion volumes of up to 700 μl at flow rates as high as 10 μl/min were successfully performed in white matter without adverse neurological sequelae. Co-infusion of AAV2/5-GFP with 0.2% Gadolinium in artificial CSF confirmed transgene expression in the deep layers of cerebral cortex overlying the infused areas of white matter. AAV-mediated gene therapies have been previously targeted to the cerebral cortex by performing intrathalamic CED and exploiting axonal transport. The novel method described in this study facilitates delivery of gene therapies to specific regions of the cerebral cortex without targeting deep brain structures. AAV-mediated gene therapies can be targeted to specific cortical regions by performing CED into underlying white matter. This technique could be applied to the treatment of neurological disorders characterised by cerebral cortical degeneration. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. GRAFTING OF HUMAN BONE MARROW STROMAL CELLS INTO SPINAL CORD INJURY: A COMPARISON OF DELIVERY METHODS

    Science.gov (United States)

    Paul, Courtney; Samdani, Amer F.; Betz, Randal R.; Fischer, Itzhak; Neuhuber, Birgit

    2011-01-01

    Study Design Three groups of 6 rats received subtotal cervical spinal cord hemisections followed with marrow stromal cell (MSC) transplants by lumbar puncture (LP), intravenous delivery (IV) or direct injection into the injury (control). Animals survived for 4 or 21 days. Objective Cell therapy is a promising strategy for the treatment of spinal cord injury (SCI). The mode of cell delivery is crucial for the translation to the clinic. Injections directly into the parenchyma may further damage already compromised tissue; therefore, less invasive methods like LP or IV delivery are preferable. Summary of Background Data Human bone marrow stromal cells (MSC) are multipotent mesenchymal adult stem cells that have a potential for autologous transplantation, obviating the need for immune suppression. While previous studies have established that MSC can be delivered to the injured spinal cord by both LP and IV, the efficacy of cell delivery has not been directly compared with respect to efficacy of delivery and effects on the host. Methods Purified MSC from a human donor were transplanted into the CSF at the lumbar region (LP), into the femoral vein (IV), or directly into the injury (control). After sacrifice, spinal cord sections were analyzed for MSC graft size, tissue sparing, host immune response, and glial scar formation, using specific antibodies as well as Nissl-myelin staining. Results LP delivery of MSC to the injured spinal cord is superior to IV delivery. Cell engraftment and tissue sparing were significantly better after LP delivery and host immune response after LP delivery was reduced compared to IV delivery. Conclusions LP is an ideal minimally-invasive technique to deliver cellular transplants to the injured spinal cord. It is superior to IV delivery and, together with the potential for autologous transplantation, lends itself for clinical application. PMID:19182705

  19. Medical care delivery in the US space program

    Science.gov (United States)

    Stewart, Donald F.

    1991-01-01

    The stated goal of this meeting is to examine the use of telemedicine in disaster management, public health, and remote health care. NASA has a vested interest in providing health care to crews in remote environments. NASA has unique requirements for telemedicine support, in that our flight crews conduct their job in the most remote of all work environments. Compounding the degree of remoteness are other environmental concerns, including confinement, lack of atmosphere, spaceflight physiological deconditioning, and radiation exposure, to name a few. In-flight medical care is a key component in the overall support for missions, which also includes extensive medical screening during selection, preventive medical programs for astronauts, and in-flight medical monitoring and consultation. This latter element constitutes the telemedicine aspect of crew health care. The level of in-flight resources dedicated to medical care is determined by the perceived risk of a given mission, which in turn is related to mission duration, planned crew activities, and length of time required for return to definitive medical care facilities.

  20. Comet Assay: A Method to Evaluate Genotoxicity of Nano-Drug Delivery System

    OpenAIRE

    Morteza Eskandani; Somayeh Vandghanooni

    2011-01-01

    Introduction: Drug delivery systems could induce cellular toxicity as side effect of nanomaterials. The mechanism of toxicity usually involves DNA damage. The comet assay or single cell gel electrophoresis (SCGE) is a sensitive method for detecting strand damages in the DNA of a cell with applications in genotoxicity testing and molecular epidemiology as well as fundamental research in DNA damage and repair. Methods: In the current study, we reviewed recent drug delivery researches related to...

  1. Simple Calculation Programs for Biology Immunological Methods

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Simple Calculation Programs for Biology Immunological Methods. Computation of Ab/Ag Concentration from EISA data. Graphical Method; Raghava et al., 1992, J. Immuno. Methods 153: 263. Determination of affinity of Monoclonal Antibody. Using non-competitive ...

  2. Can the delivery method influence lower urinary tract symptoms triggered by the first pregnancy?

    Directory of Open Access Journals (Sweden)

    Simone Botelho

    2012-04-01

    Full Text Available INTRODUCTION AND OBJECTIVES: The increase of the intensity of urinary symptoms in late pregnancy and postpartum has been well documented by several authors, but their causes remain uncertain, partly because of its probable multifactor origin. There are also controversies whether the etiology of lower urinary tract symptoms during pregnancy is the same as postpartum and whether the method of delivery could influence the risk of onset of urinary symptoms. This study aimed to evaluate the urinary symptoms triggered during pregnancy and its evolution in the late puerperium, correlating them with the delivery method. MATERIALS AND METHODS: A longitudinal study was conducted, which included 75 primigravidae women, classified according to method of delivery as: (VD vaginal delivery with right mediolateral episiotomy (n = 28; (CS elective caesarean section (n = 26; and (EC emergency caesarean section (n = 21. Urinary symptoms were assessed in the last trimester of pregnancy and at 45 days (± 10 of puerperium with validated versions for Portuguese language of the following questionnaires: International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF and the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB. RESULTS: It was observed that frequency, urgency, nocturia and urge incontinence, triggered during pregnancy, decreased significantly in the postpartum period, regardless of the delivery method (p = 0.0001. However, symptoms related to urinary loss due to stress persisted after vaginal delivery (p = 0.0001. CONCLUSIONS: Urgency, frequency and nocturia triggered during pregnancy tend to disappear in the late postpartum period, regardless of the delivery method, but the symptoms related to urinary loss due to stress tend to persist in late postpartum period after vaginal delivery.

  3. The effect of a structured neonatal resuscitation program on delivery room practices.

    LENUS (Irish Health Repository)

    Ryan, C A

    2012-02-03

    PURPOSE: This study evaluated the introduction of the Neonatal Resuscitation Program (NRP) of the American Academy of Pediatrics and the American Heart Association into the delivery room of an Irish maternity hospital. DESIGN: Prospective, controlled observational study of 51 deliveries before and 51 deliveries following the training of delivery room personnel in the NRP. SAMPLE: Participants were 33 nurse-midwives and 11 pediatric resident physicians. MAIN OUTCOME VARIABLE: Evaluation of postdelivery, newborn resuscitation practices. RESULTS: The introduction of the NRP was associated with significant improvements in delivery room preparation, in the evaluation and management of the newborn infant, and in thermal protection at birth. Although there was a trend to use more free-flow oxygen following the introduction of the NRP, this was not statistically significant. Bag and mask ventilation was also used more frequently following NRP training. However, there were no significant differences in the use of endotracheal intubation, chest compressions, and medications. Fifteen of the 51 infants became hypothermic prior to the introduction of the NRP; none of the infants developed hypothermia in the post-NRP part of the study.

  4. Measurement of integrated healthcare delivery: a systematic review of methods and future research directions

    Directory of Open Access Journals (Sweden)

    Martin Strandberg-Larsen

    2009-02-01

    Full Text Available Background: Integrated healthcare delivery is a policy goal of healthcare systems. There is no consensus on how to measure the concept, which makes it difficult to monitor progress. Purpose: To identify the different types of methods used to measure integrated healthcare delivery with emphasis on structural, cultural and process aspects. Methods: Medline/Pubmed, EMBASE, Web of Science, Cochrane Library, WHOLIS, and conventional internet search engines were systematically searched for methods to measure integrated healthcare delivery (published – April 2008. Results: Twenty-four published scientific papers and documents met the inclusion criteria. In the 24 references we identified 24 different measurement methods; however, 5 methods shared theoretical framework. The methods can be categorized according to type of data source: a questionnaire survey data, b automated register data, or c mixed data sources. The variety of concepts measured reflects the significant conceptual diversity within the field, and most methods lack information regarding validity and reliability. Conclusion: Several methods have been developed to measure integrated healthcare delivery; 24 methods are available and some are highly developed. The objective governs the method best used. Criteria for sound measures are suggested and further developments should be based on an explicit conceptual framework and focus on simplifying and validating existing methods.

  5. Simple Calculation Programs for Biology Other Methods

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Simple Calculation Programs for Biology Other Methods. Hemolytic potency of drugs. Raghava et al., (1994) Biotechniques 17: 1148. FPMAP: methods for classification and identification of microorganisms 16SrRNA. graphical display of restriction and fragment map of ...

  6. Delivery to the method of visible pilopronic materials

    Directory of Open Access Journals (Sweden)

    Zashchepkina N.M.

    2017-04-01

    Full Text Available The research considers the actual problem of determining the permeability of materials used for the production of personal protective equipment. Having analyzed the methods and instruments for determining the dust permeability and dust capacity of materials, the task is to develop an improved method for determining the dust permeability of materials with high accuracy, based on the use of television measuring instruments. This method is a collection of optical and electronic means by which information about the structure, state and properties of the object contained in its radiation is converted into an electrical signal. On the basis of television measuring instruments, a stand was designed, which made it possible, with a lesser error, to measure the dimensions of the cells of materials used for the production of personal protective equipment. A structural diagram is given and the principle of the stand for determining the dust-tightness of materials is described. New devices have been developed: for fixing materials, which makes it possible to reduce the measurement error and the device for movement of the sample under study. Experimental studies of materials using standard techniques and an improved method have been carried out. The error in measuring the permeability by the improved method has been reduced by 10 %.

  7. A Comparison of Vaginal Pressures and Abdominal Muscle Thickness According to Childbirth Delivery Method during the Valsalva Maneuver

    OpenAIRE

    Kim, Haroo; Kak, Hwang-Bo; Kim, Boin

    2014-01-01

    [Purpose] The purpose of this study was to compare the effect of childbirth delivery method on vaginal pressure and abdominal thickness during the Valsalva maneuver (VAL). [Subjects] Thirty healthy female volunteers (26–39 years of age) were selected for this research. Their delivery histories were: nulliparous 10, vaginal delivery 10, and Cesarean delivery 10. None of the participants had a history of incontinence. [Methods] In the crook-lying position, a perineometer probe was inserted into...

  8. Physical Activity Program Delivery by Professionals versus Volunteers: the TEAM Randomized Trial

    Science.gov (United States)

    Castro, Cynthia M.; Pruitt, Leslie A.; Buman, Matthew P.; King, Abby C.

    2010-01-01

    Background Older adults have low rates of physical activity participation but respond positively to telephone-mediated support programs. Programs are often limited by reliance on professional staff. This study tested telephone-based physical activity advice delivered by professional staff versus trained volunteer peer mentors. Design A 12-month, randomized, controlled clinical trial was executed from 2003–2008. Setting/participants: Twelve volunteer peer mentors and 181 initially inactive adults ages 50 years and older were recruited from the San Francisco Bay Area. Intervention Participants were randomized to: (1) telephone-based physical activity advice delivered by professional staff, (2) telephone-based physical activity advice delivered by trained volunteer peers, or (3) an attention-control arm of staff-delivered telephone support for nutrition. Main Outcome Measures: Moderate-intensity or more vigorous physical activity (MVPA) was assessed at baseline, 6, and 12 months with the CHAMPS Questionnaire, with accelerometry validation (Actigraph) in a randomly selected subsample. Treatment fidelity was examined through analysis of quantity and quality of intervention delivery. Results At 6 and 12 months, both physical activity arms significantly increased MVPA relative to the control arm. Both physical activity arms were comparable in quantity of intervention delivery, but peers demonstrated more versatility and comprehensiveness in quality of intervention content. Conclusions This study demonstrates that trained peer volunteers can effectively promote physical activity increases through telephone-based advice. The results support a program delivery model with good dissemination potential for a variety of community settings. PMID:21553972

  9. Tools and Methods for Hardening Communication Security of Energy Delivery Systems

    Energy Technology Data Exchange (ETDEWEB)

    Gadgil, Shrirang [Applied Communication Sciences, Basking Ridge, NJ (United States); Lin, Yow-Jian [Applied Communication Sciences, Basking Ridge, NJ (United States); Ghosh, Abhrajit [Applied Communication Sciences, Basking Ridge, NJ (United States); Samtani, Sunil [Applied Communication Sciences, Basking Ridge, NJ (United States); Kang, Jaewon [Applied Communication Sciences, Basking Ridge, NJ (United States); Siegell, Bruce [Applied Communication Sciences, Basking Ridge, NJ (United States); Kaul, Vikram [Applied Communication Sciences, Basking Ridge, NJ (United States); Unger, John [Applied Communication Sciences, Basking Ridge, NJ (United States); De Bruet, Andre [DTE Energy, Detroit, MI (United States); Martinez, Catherine [DTE Energy, Detroit, MI (United States); Vermeulen, Gerald [DTE Energy, Detroit, MI (United States); Rasche, Galen [Electric Power Research Inst. (EPRI), Palo Alto, CA (United States); Sternfeld, Scott [Electric Power Research Inst. (EPRI), Palo Alto, CA (United States); Berthier, Robin [Univ. of Illinois, Urbana-Champaign, IL (United States); Bobba, Rakesh [Univ. of Illinois, Urbana-Champaign, IL (United States); Campbell, Roy [Univ. of Illinois, Urbana-Champaign, IL (United States); Sanders, Williams [Univ. of Illinois, Urbana-Champaign, IL (United States)

    2014-09-28

    This document summarizes the research and development work the TT Government Solutions (TTGS), d.b.a. Applied Communication Sciences (ACS), team performed for the Department of Energy Cybersecurity for Energy Delivery Systems (CEDS) program. It addresses the challenges in protecting critical grid control and data communication, including the identification of vulnerabilities and deficiencies of communication protocols commonly used in energy delivery systems (e.g., ICCP, DNP3, C37.118, C12.22), as well as the development of effective means to detect and prevent the exploitation of such vulnerabilities and deficiencies.

  10. DISTANCE DELIVERY OF NUTRITION EDUCATION AS A METHOD FOR PROVIDING CONTINUING EDUCATION

    Directory of Open Access Journals (Sweden)

    Nurhan UNUSAN

    2007-01-01

    Full Text Available Distance learning applications in nutrition education have evolved together with communication technology. Distance delivery is transforming the culture of professional health education by expanding access to learners, introducing novel teaching and learning methods, as well as shifting the paradigm of how instructors and students interact. The aim of the paper is to prepare a participant centred, active learning model. The model proposed in this article is based on the literature review. This model resembles active delivery models that have been highly successful in increasing learning and problem solving abilities in other courses. The model focuses on constructs that distance delivery courses should address during design and assessment. For a model to be succeeded the required prerequisites should involve the establishment of a centre for educational technology, to take a model in forming the infrastructure for web based distance delivery, to update the technology required, and to train supporting staff to help in the design of web material/documentation.

  11. Student Performance in a Quantitative Methods Course under Online and Face-to-Face Delivery

    Science.gov (United States)

    Verhoeven, Penny; Wakeling, Victor

    2011-01-01

    In a study conducted at a large public university, the authors assessed, for an upper-division quantitative methods business core course, the impact of delivery method (online versus face-toface) on the success rate (percentage of enrolled students earning a grade of A, B, or C in the course). The success rate of the 161 online students was 55.3%,…

  12. Determining the Effectiveness of Various Delivery Methods in an Information Technology/Information Systems Curriculum

    Science.gov (United States)

    Davis, Gary Alan; Kovacs, Paul J.; Scarpino, John; Turchek, John C.

    2010-01-01

    The emergence of increasingly sophisticated communication technologies and the media-rich extensions of the World Wide Web have prompted universities to use alternatives to the traditional classroom teaching and learning methods. This demand for alternative delivery methods has led to the development of a wide range of eLearning techniques.…

  13. Imaging method for monitoring delivery of high dose rate brachytherapy

    Science.gov (United States)

    Weisenberger, Andrew G; Majewski, Stanislaw

    2012-10-23

    A method for in-situ monitoring both the balloon/cavity and the radioactive source in brachytherapy treatment utilizing using at least one pair of miniature gamma cameras to acquire separate images of: 1) the radioactive source as it is moved in the tumor volume during brachytherapy; and 2) a relatively low intensity radiation source produced by either an injected radiopharmaceutical rendering cancerous tissue visible or from a radioactive solution filling a balloon surgically implanted into the cavity formed by the surgical resection of a tumor.

  14. Sport psychology education: a preliminary survey on chartered physiotherapists' preferred methods of training delivery.

    Science.gov (United States)

    Arvinen-Barrow, Monna; Hemmings, Brian; Becker, Caryl A; Booth, Lynn

    2008-11-01

    To gain an insight to the existing suggestions and recommendations on chartered physiotherapists' preferred methods of delivery for further training in sport psychology. 22 delegates (14 women, 8 men) from the 2006 Association of Chartered Physiotherapists in Sports Medicine/International Federation of Sports Physiotherapy annual conference (response rate 53.7%). A questionnaire survey for best method of sport psychology delivery was developed. The most suitable methods for sport-psychology-training delivery were workshops, seminars, mentoring, and coaching. Intense training days and weekends were considered most appropriate. The vast majority were willing to travel over 50 miles to receive training, and they indicated that the most suitable organizations to arrange training would be professional bodies and associations. The findings provide suggestions into how further training in sport psychology for chartered physiotherapists could be delivered. To gain more detailed information on these issues, however, further research with a larger sample size is recommended.

  15. The delivery of distance education--is it time for doctoral programs in gerontology?

    Science.gov (United States)

    Heinz, Melinda; Martin, Peter; Doll, Gayle; Pearson-Scott, Jean

    2015-01-01

    The delivery of higher education in gerontology is changing; students are now able to receive an education solely online. Perhaps it is time to consider offering this option at the doctoral level. A needs assessment was conducted to assess whether a doctoral program in gerontology should be created in the Great Plains Interactive Distance Education Alliance (GPIDEA) program. An online survey was sent to 247 students enrolled in the GPIDEA program and to students who had taken a GPIDEA course in gerontology but were not currently enrolled in the program. One hundred and twenty-three students began the survey, although only 120 students completed the survey. Findings indicated students are interested in a doctoral program in gerontology. Approximately 65% of students were interested in obtaining a PhD from a distance education program. However, an applied program focusing on community outreach and leadership was of most interest to students. Students were less interested in research-based programs or in research residency. Therefore, the development of distance education doctoral degree programs in gerontology may need to be created differently than "traditional" formats.

  16. A method to reconstruct and apply 3D primary fluence for treatment delivery verification.

    Science.gov (United States)

    Liu, Shi; Mazur, Thomas R; Li, Harold; Curcuru, Austen; Green, Olga L; Sun, Baozhou; Mutic, Sasa; Yang, Deshan

    2017-01-01

    In this study, a method is reported to perform IMRT and VMAT treatment delivery verification using 3D volumetric primary beam fluences reconstructed directly from planned beam parameters and treatment delivery records. The goals of this paper are to demonstrate that 1) 3D beam fluences can be reconstructed efficiently, 2) quality assurance (QA) based on the reconstructed 3D fluences is capable of detecting additional treatment delivery errors, particularly for VMAT plans, beyond those identifiable by other existing treatment delivery verification methods, and 3) QA results based on 3D fluence calculation (3DFC) are correlated with QA results based on physical phantom measurements and radiation dose recalculations. Using beam parameters extracted from DICOM plan files and treatment delivery log files, 3D volumetric primary fluences are reconstructed by forward-projecting the beam apertures, defined by the MLC leaf positions and modulated by beam MU values, at all gantry angles using first-order ray tracing. Treatment delivery verifications are performed by comparing 3D fluences reconstructed using beam parameters in delivery log files against those reconstructed from treatment plans. Passing rates are then determined using both voxel intensity differences and a 3D gamma analysis. QA sensitivity to various sources of errors is defined as the observed differences in passing rates. Correlations between passing rates obtained from QA derived from both 3D fluence calculations and physical measurements are investigated prospectively using 20 clinical treatment plans with artificially introduced machine delivery errors. Studies with artificially introduced errors show that common treatment delivery problems including gantry angle errors, MU errors, jaw position errors, collimator rotation errors, and MLC leaf position errors were detectable at less than normal machine tolerances. The reported 3DFC QA method has greater sensitivity than measurement-based QA methods

  17. Choice and changes of contraceptive methods after primiparous delivery in Shanghai.

    Science.gov (United States)

    Xue, L; Yuan, W; Lou, C H; Wu, J Q; Fang, K J; Gao, E S

    1999-03-01

    This study assessed the contraceptive method of choice and tendency of method switching of women after their first birth in Shanghai, China. The assessment was based on 15 months follow-up after the first delivery. Included in the study were 3701 primiparous women aged 18-43 years, with 1833 women living in an urban area and 1868 living in a rural area. Results showed that 15 months after delivery 95.46% had already used a contraceptive method. The leading first choice among urban women was the condom (50.72%), followed by the IUD (29.09%), while the leading first choice among rural women was the IUD (56.65%), followed by the condom (30.60%). Among women who had never used a contraceptive method, 33.77% of urban women and 18.52% of rural women switched method 15 months after delivery. The major reason for the contraceptive method switching was method failure attributed to improper use. Furthermore, the choice of contraceptive method after first birth varied significantly by women's characteristics. Urban, well-educated women, breast-feeding women and older women preferred the condom and the rhythm method over oral contraceptives. Family planning workers should increase women's awareness of the benefits and disadvantages of different contraceptive methods, dispel myths, and improve women's informed choice.

  18. The Effect of Educational Intervention on Selection of Delivery Method Based on Health Belief Model.

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Baghianimoghadam

    2014-07-01

    Discussion- In this study educational intervention based on health belief model increased the awareness of pregnant women, However ,it has not been effective on their performance. Because many factors other than knowledge are involved in the choice of delivery method, It is proposed to enhance the efficiency of this model simultaneously different patterns that can be used effectively on other factors.

  19. Influence of Course Delivery Method and Proctoring on Performance in Introductory Economics

    OpenAIRE

    Wachenheim, Cheryl J.

    2011-01-01

    This work was published in the Review of Agricultural Economics. See Wachenheim, C.J. 2009. Final Exam Scores in Introductory Economics Courses: Effect of Course Delivery Method and Proctoring. Review of Agricultural Economics 31(3), pp. 640-652.

  20. Selected Instructional Delivery Methods and Teaching Techniques for Teaching School Law Courses.

    Science.gov (United States)

    Gordon, Howard R. D.

    This paper reviews the literature on the relevance of learner characteristics and learning styles when planning law school courses, focusing on the instructional delivery methods and teaching techniques applicable to law school courses. It examines the four major learning modalities: kinesthetic, tactual, auditory, and visual; and the four major…

  1. Project Delivery Methods and Contracting Approaches Available for Implementation by the Texas Department of Transportation

    Science.gov (United States)

    2001-10-01

    Public agencies across the country are pursuing innovative project delivery methods such as design-build (D-B) and construction manager-at-risk (CM-at-risk) to improve cycle-time performance on projects, and numerous transportation departments are cu...

  2. Online vs Face-to-Face: Educator Opinions on Professional Development Delivery Methods

    Science.gov (United States)

    Thomas, Teresa Scruggs

    2010-01-01

    The purpose of this study was to assess teacher perceptions regarding the effectiveness of online courses as a delivery method for professional development. Participants were divided into two groups, educators who have participated in and now teach professional development courses online (instructors) and educators who have participated in the…

  3. Online Learning Communities and Teacher Professional Development: Methods for Improved Education Delivery

    Science.gov (United States)

    Lindberg, J. Ola, Ed.; Olofsson, Anders D., Ed.

    2009-01-01

    In today's society, the professional development of teachers is urgent due to the constant change in working conditions and the impact that information and communication technologies have in teaching practices. "Online Learning Communities and Teacher Professional Development: Methods for Improved Education Delivery" features innovative…

  4. An Assessment of Teachers' Preference for Lecture Delivery Methods in Medical Education

    Science.gov (United States)

    Seth, Vikas; Upadhyaya, Prerna; Ahmad, Mushtaq; Kumar, Virendra

    2010-01-01

    The aim of the study was to assess the medical teachers' preference for various lecture delivery methods like the lectures using chalkboard, utilizing transparencies with an overhead projector (OHP) or lectures using a PowerPoint presentation and their frequency of use of teaching aids. The faculty of the medical college was asked to fill in the…

  5. Training Delivery Methods as Source of Dynamic Capabilities: The Case of Sports' Organisations

    Science.gov (United States)

    Arraya, Marco António Mexia; Porfírio, Jose António

    2017-01-01

    Purpose: Training as an important source of dynamic capabilities (DC) is important to the performance of sports' organisations (SO) both to athletes and to non-athletic staff. There are a variety of training delivery methods (TDMs). The purpose of this study is to determine from a set of six TDMs which one is considered to be the most suitable to…

  6. Action Research to Improve Methods of Delivery and Feedback in an Access Grid Room Environment

    Science.gov (United States)

    McArthur, Lynne C.; Klass, Lara; Eberhard, Andrew; Stacey, Andrew

    2011-01-01

    This article describes a qualitative study which was undertaken to improve the delivery methods and feedback opportunity in honours mathematics lectures which are delivered through Access Grid Rooms. Access Grid Rooms are facilities that provide two-way video and audio interactivity across multiple sites, with the inclusion of smart boards. The…

  7. A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis.

    Science.gov (United States)

    Kennedy, Carol A; Warmington, Kelly; Flewelling, Carol; Shupak, Rachel; Papachristos, Angelo; Jones, Caroline; Linton, Denise; Beaton, Dorcas E; Lineker, Sydney; Hogg-Johnson, Sheilah

    2017-02-01

    Introduction We evaluated two modes of delivery of an inflammatory arthritis education program ("Prescription for Education" (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. Methods We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T1), immediately following RxEd (T2), and at six months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. Results A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T1), with follow-up completed by 95% ( n = 117) at T2 and 62% ( n = 76) at T3. No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (-0.1, 0.1); I 0.73 (-0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. Discussion Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups.

  8. A Comparison of Vaginal Pressures and Abdominal Muscle Thickness According to Childbirth Delivery Method during the Valsalva Maneuver.

    Science.gov (United States)

    Kim, Haroo; Kak, Hwang-Bo; Kim, Boin

    2014-03-01

    [Purpose] The purpose of this study was to compare the effect of childbirth delivery method on vaginal pressure and abdominal thickness during the Valsalva maneuver (VAL). [Subjects] Thirty healthy female volunteers (26-39 years of age) were selected for this research. Their delivery histories were: nulliparous 10, vaginal delivery 10, and Cesarean delivery 10. None of the participants had a history of incontinence. [Methods] In the crook-lying position, a perineometer probe was inserted into the vagina and the transducer was placed transversely on the right side of the body during the Valsalva maneuver. [Results] There were significant differences in the thickness of the transverses abdominis (TrA) between in all the groups rest and the Valsalva maneuver, and there were significant differences in the internus oblique (IO) in the nulliparous group. During the Valsalva maneuver, there were significant differences in the TrA between the nulliparous group and the vaginal delivery group, and there were significant differences in the IO between the nulliparous delivery group and the vaginal delivery group, and between the nulliparous group and the Cesarean section group. Delivery history changed vaginal pressure, and there were significant differences between the nulliparous group and the vaginal delivery group, and between the nulliparous group and the Cesarean delivery group. [Conclusion] Pregnancy and delivery method may affect pelvic floor and abdominal muscles during the Valsalva maneuver.

  9. Computational Experiment Study on Selection Mechanism of Project Delivery Method Based on Complex Factors

    Directory of Open Access Journals (Sweden)

    Xiang Ding

    2014-01-01

    Full Text Available Project delivery planning is a key stage used by the project owner (or project investor for organizing design, construction, and other operations in a construction project. The main task in this stage is to select an appropriate project delivery method. In order to analyze different factors affecting the PDM selection, this paper establishes a multiagent model mainly to show how project complexity, governance strength, and market environment affect the project owner’s decision on PDM. Experiment results show that project owner usually choose Design-Build method when the project is very complex within a certain range. Besides, this paper points out that Design-Build method will be the prior choice when the potential contractors develop quickly. This paper provides the owners with methods and suggestions in terms of showing how the factors affect PDM selection, and it may improve the project performance.

  10. An in vitro evaluation of the pressure generated during programmed intermittent epidural bolus injection at varying infusion delivery speeds.

    Science.gov (United States)

    Klumpner, Thomas T; Lange, Elizabeth M S; Ahmed, Heena S; Fitzgerald, Paul C; Wong, Cynthia A; Toledo, Paloma

    2016-11-01

    Programmed intermittent bolus injection of epidural anesthetic solution results in decreased anesthetic consumption and better patient satisfaction compared with continuous infusion, presumably by better spread of the anesthetic solution in the epidural space. It is not known whether the delivery speed of the bolus injection influences analgesia outcomes. The objective of this in vitro study was to determine the pressure generated by a programmed intermittent bolus pump at 4 infusion delivery speeds through open-ended, single-orifice and closed-end, multiorifice epidural catheters. In vitro observational study. Not applicable. Not applicable. A CADD-Solis Pain Management System v3.0 with Programmed Intermittent Bolus Model 2110 was connected via a 3-way adapter to an epidural catheter and a digital pressure transducer. Pressures generated by delivery speeds of 100, 175, 300, and 400 mL/h of saline solution were tested with 4 epidural catheters (2 single orifice and 2 multiorifice). These runs were replicated on 5 pumps. Analysis of variance was used to compare the mean peak pressures of each delivery speed within each catheter group (single orifice and multiorifice). Thirty runs at each delivery speed were performed with each type of catheter for a total of 240 experimental runs. Peak pressure increased with increasing delivery speeds in both catheter groups (Pintermittent infusion boluses, the delivery speed of saline solution through epidural catheters was directly related to the peak pressures. Future work should evaluate whether differences in the delivery speed of anesthetic solution into the epidural space correlate with differences in the duration and quality of analgesia during programmed intermittent epidural bolus delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Modifications to ART service delivery models by health facilities in Uganda in promotion of intervention sustainability: a mixed methods study.

    Science.gov (United States)

    Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

    2017-04-04

    In November 2015, WHO released new treatment guidelines recommending that all diagnosed as HIV positive be enrolled on antiretroviral therapy (ART). Sustaining and expanding ART scale-up programs in resource-limited settings will require adaptations and modifications to traditional ART delivery models to meet the rapid increase in demand. We identify modifications to ART service delivery models by health facilities in Uganda to sustain ART interventions over a 10-year period (2004-2014). A mixed methods approach involving two study phases was adopted. In the first phase, a survey of a nationally representative sample of health facilities (n = 195) in Uganda which were accredited to provide ART between 2004 and 2009 was conducted. The second phase involved semi-structured interviews (n = 18) with ART clinic managers of 6 of the 195 health facilities purposively selected from the first study phase. We adopted a thematic framework consisting of four categories of modifications (format, setting, personnel, and population). The majority of health facilities 185 (95%) reported making modifications to ART interventions between 2004 and 2014. Of the 195 health facilities, 157 (81%) rated the modifications made to ART as "major." Modifications to ART were reported under all the four themes. The quantitative and qualitative findings are integrated and presented under four themes. Format: Reducing the frequency of clinic appointments and pharmacy-only refill programs was identified as important strategies for decongesting ART clinics. Home-based care programs were introduced to reduce provider ART delivery costs. Personnel: Task shifting to non-physician cadre was reported in 181 (93%) of the health facilities. Visits to the ART clinic were rationalized in favor of the sub-population deemed to have more clinical need. Two health facilities focused on patients living nearer the health facilities to align with targets set by external donors. Over the study period

  12. TranScreen-N: Method for rapid screening of trans-ungual drug delivery enhancers.

    Science.gov (United States)

    Murthy, S Narasimha; Vaka, Siva Ram Kiran; Sammeta, Srinivasa Murthy; Nair, Anroop B

    2009-11-01

    Topical monotherapy of nail diseases such as onychomycosis and nail psoriasis has been less successful due to poor permeability of the human nail plate to topically administered drugs. Chemical enhancers are utilized to improve the drug delivery across the nail plate. Choosing the most effective chemical enhancers for the given drug and formulation is highly critical in determining the efficacy of topical therapy of nail diseases. Screening the large pool of enhancers using currently followed diffusion cell experiments would be tedious and expensive. The main objective of this study is to develop TranScreen-N, a high throughput method of screening trans-ungual drug permeation enhancers. It is a rapid microwell plate based method which involves two different treatment procedures; the simultaneous exposure treatment and the sequential exposure treatment. In the present study, several chemicals were evaluated by TranScreen-N and by diffusion studies in the Franz diffusion cell (FDC). Good agreement of in vitro drug delivery data with TranScreen-N data provided validity to the screening technique. In TranScreen-N technique, the enhancers can be grouped according to whether they need to be applied before or simultaneously with drugs (or by either procedures) to enhance the drug delivery across the nail plate. TranScreen-N technique can significantly reduce the cost and duration required to screen trans-ungual drug delivery enhancers. (c) 2009 Wiley-Liss, Inc. and the American Pharmacists Association

  13. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program

    Directory of Open Access Journals (Sweden)

    Fennell Mary L

    2009-09-01

    Full Text Available Abstract Background In this article, we describe the National Cancer Institute (NCI Community Cancer Centers Program (NCCCP pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. Discussion The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. Summary The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align to achieve these improvements, and at what cost.

  14. Programming by Numbers -- A Programming Method for Complete Novices

    NARCIS (Netherlands)

    Glaser, Hugh; Hartel, Pieter H.

    2000-01-01

    Students often have difficulty with the minutiae of program construction. We introduce the idea of `Programming by Numbers', which breaks some of the programming process down into smaller steps, giving such students a way into the process of Programming in the Small. Programming by Numbers does not

  15. SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

    Energy Technology Data Exchange (ETDEWEB)

    McNiven, A; Jaffray, D; Letourneau, D [Princess Margaret Cancer Centre and Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada)

    2015-06-15

    Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

  16. Inspection Methods in Programming: Cliches and Plans.

    Science.gov (United States)

    1987-12-01

    PROGRAM ELEMENT. PROJECT. TASK Artificial Inteligence Laboratory AREA & WORK UN IT NUMBERS J 545 Technology Square Cambridge, MA 02139 $L. CONTROLLING...U) MASSACHUSETTS INST OF TECH CAMBRIDGE ARTIFICIAL INTELLIGENCE LAB C RICH DEC 87 AI-M-±05 UNCLASSIFIED NW014-B5-K-0124 F/G 12/5 NL ’lllll l l l...S %P W. J % % %s MASSACHUSETTS INSTITUTE OF TECHNOLOGY N ARTIFICIAL INTELLIGENCE LABORATORY 00 A.I. Memo No. 1005 December 1987 N Inspection Methods

  17. Mental Illness Stigma Intervention in African Americans: Examining Two Delivery Methods.

    Science.gov (United States)

    Vinson, Ebony S; Abdullah, Tahirah; Brown, Tamara L

    2016-05-01

    Stigma surrounding mental illness and mental health treatment remains a significant problem, particularly among African Americans. This study sought to examine the effects of 2 intervention delivery methods in reducing reported stigma. African Americans (n = 158) were nonrandomly assigned to an in-person contact or video condition and administered a survey immediately before, after, and 2 weeks following the stigma intervention. The in vivo contact condition consisted of an African American man discussing his experiences with mental illness and psychotherapy. The session was recorded, and the recording was used for the video condition. There were no significant effects based on delivery method; however, there was a significant effect for time on stigma and help-seeking attitude measures. Further research is needed to determine the overall effectiveness of the intervention.

  18. Rural and urban women entrepreneurs: A comparison of service needs and delivery methods priorities

    Directory of Open Access Journals (Sweden)

    Davis, A.

    2011-01-01

    Full Text Available Women entrepreneurs face a wide variety of barriers and challenges throughout the life and growth of their entrepreneurial venture. This study expands the knowledge base on women entrepreneurs’ needs, specifically their needs in terms of service areas and service delivery method preferences. Twenty three “needed” service areas were identified by 95 Manitoba based women entrepreneurs. The first five included: finding new customers, growth benefits and tools, market expansion, general marketing, and networking skills. This study also examined the differences between urban and rural based entrepreneurs. Two service need areas “how to find mentors and role models” and “legal issues” exhibited statistically significant priority differences. Service delivery methods did not produce any statistically significant differences. Overall, this study concludes that regardless of location, women entrepreneurs’ training and support needs are not significantly that different. The effects of entrepreneurial stage and years in business on entrepreneurial support needs are also examined.

  19. Systems and methods for bi-directional energy delivery with galvanic isolation

    Science.gov (United States)

    Kajouke, Lateef A.

    2013-06-18

    Systems and methods are provided for bi-directional energy delivery. A charging system comprises a first bi-directional conversion module, a second bi-directional conversion module, and an isolation module coupled between the first bi-directional conversion module and the second bi-directional conversion module. The isolation module provides galvanic isolation between the first bi-directional conversion module and the second bi-directional conversion module.

  20. Method of targeted delivery of laser beam to isolated retinal rods by fiber optics.

    Science.gov (United States)

    Sim, Nigel; Bessarab, Dmitri; Jones, C Michael; Krivitsky, Leonid

    2011-11-01

    A method of controllable light delivery to retinal rod cells using an optical fiber is described. Photo-induced current of the living rod cells was measured with the suction electrode technique. The approach was tested with measurements relating the spatial distribution of the light intensity to photo-induced current. In addition, the ion current responses of rod cells to polarized light at two different orientation geometries of the cells were studied.

  1. Comet Assay: A Method to Evaluate Genotoxicity of Nano-Drug Delivery System

    Directory of Open Access Journals (Sweden)

    Morteza Eskandani

    2011-08-01

    Full Text Available Introduction: Drug delivery systems could induce cellular toxicity as side effect of nanomaterials. The mechanism of toxicity usually involves DNA damage. The comet assay or single cell gel electrophoresis (SCGE is a sensitive method for detecting strand damages in the DNA of a cell with applications in genotoxicity testing and molecular epidemiology as well as fundamental research in DNA damage and repair. Methods: In the current study, we reviewed recent drug delivery researches related to SCGE. Results: We found that one preference for choosing the assay is that comet images may result from apoptosis-mediated nuclear fragmentation. This method has been widely used over the last decade in several different areas. Overall cells, such as cultured cells are embedded in agarose on a microscope slide, lysed with detergent, and treated with high salt. Nucleoids are supercoiled DNA form. When the slide is faced to alkaline electrophoresis any breakages present in the DNA cause the supercoiling to relax locally and loops of DNA extend toward the anode as a ‘‘comet tail’’. Conclusion: This article provides a relatively comprehensive review upon potentiality of the comet assay for assessment of DNA damage and accordingly it can be used as an informative platform in genotoxicity studies of drug delivery systems.

  2. Comet Assay: A Method to Evaluate Genotoxicity of Nano-Drug Delivery System

    Science.gov (United States)

    Vandghanooni, Somayeh; Eskandani, Morteza

    2011-01-01

    Introduction Drug delivery systems could induce cellular toxicity as side effect of nanomaterials. The mechanism of toxicity usually involves DNA damage. The comet assay or single cell gel electrophoresis (SCGE) is a sensitive method for detecting strand damages in the DNA of a cell with applications in genotoxicity testing and molecular epidemiology as well as fundamental research in DNA damage and repair. Methods In the current study, we reviewed recent drug delivery researches related to SCGE. Results We found that one preference for choosing the assay is that comet images may result from apoptosis-mediated nuclear fragmentation. This method has been widely used over the last decade in several different areas. Overall cells, such as cultured cells are embedded in agarose on a microscope slide, lysed with detergent, and treated with high salt. Nucleoids are supercoiled DNA form. When the slide is faced to alkaline electrophoresis any breakages present in the DNA cause the supercoiling to relax locally and loops of DNA extend toward the anode as a ‘‘comet tail’’. Conclusion This article provides a relatively comprehensive review upon potentiality of the comet assay for assessment of DNA damage and accordingly it can be used as an informative platform in genotoxicity studies of drug delivery systems. PMID:23678412

  3. Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations.

    Science.gov (United States)

    Friedman, Audrey Jusko; Cosby, Roxanne; Boyko, Susan; Hatton-Bauer, Jane; Turnbull, Gale

    2011-03-01

    The objective of this study was to determine effective teaching strategies and methods of delivery for patient education (PE). A systematic review was conducted and reviews with or without meta-analyses, which examined teaching strategies and methods of delivery for PE, were included. Teaching strategies identified are traditional lectures, discussions, simulated games, computer technology, written material, audiovisual sources, verbal recall, demonstration, and role playing. Methods of delivery focused on how to deliver the teaching strategies. Teaching strategies that increased knowledge, decreased anxiety, and increased satisfaction included computer technology, audio and videotapes, written materials, and demonstrations. Various teaching strategies used in combination were similarly successful. Moreover, structured-, culturally appropriate- and patient-specific teachings were found to be better than ad hoc teaching or generalized teaching. Findings provide guidance for establishing provincial standards for the delivery of PE. Recommendations concerning the efficacy of the teaching strategies and delivery methods are provided.

  4. [Method of delivery and condition of newborn at 25-30 weeks of gestation].

    Science.gov (United States)

    Jankova, I; Dimitrov, A

    2010-01-01

    The aim of this study is to assess the impact of method of delivery--per vias naturales and by CS on condition of preterm newborn vias naturals and 32 through CS (22 emergency CS and 10 in the planned order). The condition of newborns is found immediately after birth by Apgar score at 1st and 5th minute and the values of pH, BE and blood gases in the blood sample from a.umbilicalis. Comparison of the average values of Apgar 1 st and 5th min, pH, BE, pO2 and pCO2 in preterm born per vias naturals and by CS showed statistically significant difference in three indicators pH, BE and pCO2 and highest frequency of acidosis in an emergency operative abdominal delivery. Juxtapositioning the groups vaginal birth and CS planning in order not found statistically significant differences in BE (p = 0.616), pH (p = 0.399) and pCO2 (p = 0.448). This led to the initial conclusion that the state of newborns in both groups is the same irrespective of birth. After interpretation of the ABS in each case it has been established substantial difference in frequency of uncompensated (0% vs. 19.4%) and compensated metabolic acidosis (50% vs. 36.8%) in premature born through CS in planning orderliness and per vias naturales. The method of delivery is a factor which influences the adjacent state of prematurity after birth. The highest incidence of hypoxia is associated with CS in terms of urgency. In comparison with vaginal birth, planned CS in order seems to be a favorable method of delivery for preterm fetus.

  5. Conservation program delivery in the southern U.S.: Preferences and interactions.

    Science.gov (United States)

    Galik, Christopher S; Grala, Robert K

    2017-08-01

    A lingering challenge in implementation of ecosystem-based planning is translating high-level conservation objectives to discrete management initiatives. Recent research underscores this, emphasizing the importance of the processes by which plans are developed and how programs to implement plans are delivered to stakeholders. This study contributes to the existing program design, research methodology, and conservation practice literature through an assessment of landowner and conservation practitioner relationships in the Gulf Coastal Plains and Ozarks (GCPO) region of the southern U.S. The study utilizes online and mail surveys to gather data on landowner interactions with conservation practitioner organizations and interactions between practitioner organizations themselves. Data from the surveys suggest different patterns of interaction as reported by landowners and those reported by practitioner organizations working in the region, with landowners generally interacting more with extension and industry organizations and conservation practitioners interacting more with state and federal agencies. Key informant data also allows for analysis of the conservation practitioner network in the GCPO region. Resulting analysis suggests a well-connected network among the state and federal organizations critical to development and delivery of conservation programs in the GCPO LCC region. Though such configurations may be beneficial for the diffusion of innovative practices across a network, they may nonetheless require continued efforts to coordinate activities at the regional scale, an important component of practice-driven, ecosystem-level management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

    Science.gov (United States)

    Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

    2016-01-01

    Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

  7. Development and delivery of a pharmacist training program to increase naloxone access in Kentucky.

    Science.gov (United States)

    Palmer, Emma; Hart, Steve; Freeman, Patricia R

    To describe the development and delivery of a comprehensive training program for Kentucky pharmacists to enable dispensation of naloxone per protocol. In May 2015, the Kentucky Board of Pharmacy (KBP) promulgated regulations outlining the requirements for pharmacists to initiate the dispensing of naloxone under a physician-approved protocol. The Advancing Pharmacy Practice in Kentucky Coalition, a partnership between Kentucky's Colleges of Pharmacy, KBP, and state and local pharmacists associations, developed and offered educational programming to fulfill this regulation. Pharmacists who completed the 90-minute program could apply to KBP for registration as a naloxone-certified pharmacist. The program consists of a 90-minute session covering naloxone access, opioid overdoses, the pharmacology and use of naloxone, protocol development, patient identification, and resources. Sessions were offered live and via webinar. Sessions have also been incorporated into the pharmacy curriculum at the 2 colleges of pharmacy in Kentucky. Between June 28, 2015, and June 1, 2016, a total of 1254 pharmacists and 348 student pharmacists completed training. Of those, 646 (52%) have applied to KBP and received naloxone-certified status. The program was well received, with 87% of learners ranking the usefulness of the information presented as excellent. Learners cited screening tips, protocol information, patient screening information, and education resources as information they will implement in their practice. The swift deployment of training to a wide variety of pharmacy professionals has resulted in a substantial number of naloxone-certified pharmacists across Kentucky. Through a coordinated training initiative involving all major pharmacy stakeholders, we reached many individuals rapidly, documenting the value of this approach for future training endeavors. This educational initiative may enhance pharmacy practice across Kentucky and the nation by expanding and educating on the

  8. Comet assay: a method to evaluate genotoxicity of nano-drug delivery system.

    Science.gov (United States)

    Vandghanooni, Somayeh; Eskandani, Morteza

    2011-01-01

    Drug delivery systems could induce cellular toxicity as side effect of nanomaterials. The mechanism of toxicity usually involves DNA damage. The comet assay or single cell gel electrophoresis (SCGE) is a sensitive method for detecting strand damages in the DNA of a cell with applications in genotoxicity testing and molecular epidemiology as well as fundamental research in DNA damage and repair. In the current study, we reviewed recent drug delivery researches related to SCGE. We found that one preference for choosing the assay is that comet images may result from apoptosis-mediated nuclear fragmentation. This method has been widely used over the last decade in several different areas. Overall cells, such as cultured cells are embedded in agarose on a microscope slide, lysed with detergent, and treated with high salt. Nucleoids are supercoiled DNA form. When the slide is faced to alkaline electrophoresis any breakages present in the DNA cause the supercoiling to relax locally and loops of DNA extend toward the anode as a ''comet tail''. This article provides a relatively comprehensive review upon potentiality of the comet assay for assessment of DNA damage and accordingly it can be used as an informative platform in genotoxicity studies of drug delivery systems.

  9. Roles of Social Movement Organizations for Securing Workers' Safety in Korea: A Case Study of Abolition of the 30-Minute Delivery Guarantee Program in Pizza Delivery Service.

    Science.gov (United States)

    Park, Ji-Eun; Kim, Myoung-Hee

    2016-07-01

    Many restaurants in Korea maintain quick-delivery service programs to satisfy customers. This service allows delivery workers limited time to deliver, which frequently put them in danger. Most of the workers are young, work part-time, and are rarely organized into trade unions. In this article, through a case study of the social movement to abolish the 30-minute delivery guarantee program of pizza companies in Korea, we argue that social movements involving social movement organizations (SMOs) and individual citizens could serve as a means to rectify this problem. We show how the SMOs developed and expanded the movement using a framing perspective and how the general public became involved through social media. Data was collected via online searching. Interview scripts from key players of SMOs and unofficial documents they provided were also reviewed. Three SMOs primarily led the movement, successfully forming a frame that emphasized social responsibility. SMOs also utilized social media to link their standing frame with unmobilized citizens and to expand the movement. We identified contributing factors and limitations of the movement and drew lessons that could be applied to other sectors where workers are in vulnerable positions. © The Author(s) 2016.

  10. Dynamics of Indel Profiles Induced by Various CRISPR/Cas9 Delivery Methods

    DEFF Research Database (Denmark)

    Kosicki, Michael; Rajan, Sandeep S; Lorenzetti, Flaminia C

    2017-01-01

    The introduction of CRISPR/Cas9 gene editing in mammalian cells is a scientific breakthrough, which has greatly affected basic research and gene therapy. The simplicity and general access to CRISPR/Cas9 reagents has in an unprecedented manner "democratized" gene targeting in biomedical research...... approach. In this study we review the most commonly used indel detection methods and using a robust, sensitive, and cost efficient Indel Detection by Amplicon Analysis method, we have investigated the impact of the most commonly used CRISPR/Cas9 delivery formats, including lentivirus transduction, plasmid...

  11. Preclinical evaluation of gene delivery methods for the treatment of loco-regional disease in breast cancer.

    LENUS (Irish Health Repository)

    Rajendran, Simon

    2011-04-01

    Preclinical results with various gene therapy strategies indicate significant potential for new cancer treatments. However, many therapeutics fail at clinical trial, often due to differences in tissue physiology between animal models and humans, and tumor phenotype variation. Clinical data relevant to treatment strategies may be generated prior to clinical trial through experimentation using intact patient tissue ex vivo. We developed a novel tumor slice model culture system that is universally applicable to gene delivery methods, using a realtime luminescence detection method to assess gene delivery. Methods investigated include viruses (adenovirus [Ad] and adeno-associated virus), lipofection, ultrasound (US), electroporation and naked DNA. Viability and tumor populations within the slices were well maintained for seven days, and gene delivery was qualitatively and quantitatively examinable for all vectors. Ad was the most efficient gene delivery vector with transduction efficiency >50%. US proved the optimal non-viral gene delivery method in human tumor slices. The nature of the ex vivo culture system permitted examination of specific elements. Parameters shown to diminish Ad gene delivery included blood, regions of low viability and secondary disease. US gene delivery was significantly reduced by blood and skin, while tissue hyperthermia improved gene delivery. US achieved improved efficacy for secondary disease. The ex vivo model was also suitable for examination of tissue-specific effects on vector expression, with Ad expression mediated by the CXCR4 promoter shown to provide a tumor selective advantage over the ubiquitously active cytomegalovirus promoter. In conclusion, this is the first study incorporating patient tissue models in comparing gene delivery from various vectors, providing knowledge on cell-type specificity and examining the crucial biological factors determining successful gene delivery. The results highlight the importance of in

  12. Preclinical evaluation of gene delivery methods for the treatment of loco-regional disease in breast cancer.

    LENUS (Irish Health Repository)

    Rajendran, Simon

    2012-01-31

    Preclinical results with various gene therapy strategies indicate significant potential for new cancer treatments. However, many therapeutics fail at clinical trial, often due to differences in tissue physiology between animal models and humans, and tumor phenotype variation. Clinical data relevant to treatment strategies may be generated prior to clinical trial through experimentation using intact patient tissue ex vivo. We developed a novel tumor slice model culture system that is universally applicable to gene delivery methods, using a realtime luminescence detection method to assess gene delivery. Methods investigated include viruses (adenovirus [Ad] and adeno-associated virus), lipofection, ultrasound (US), electroporation and naked DNA. Viability and tumor populations within the slices were well maintained for seven days, and gene delivery was qualitatively and quantitatively examinable for all vectors. Ad was the most efficient gene delivery vector with transduction efficiency >50%. US proved the optimal non-viral gene delivery method in human tumor slices. The nature of the ex vivo culture system permitted examination of specific elements. Parameters shown to diminish Ad gene delivery included blood, regions of low viability and secondary disease. US gene delivery was significantly reduced by blood and skin, while tissue hyperthermia improved gene delivery. US achieved improved efficacy for secondary disease. The ex vivo model was also suitable for examination of tissue-specific effects on vector expression, with Ad expression mediated by the CXCR4 promoter shown to provide a tumor selective advantage over the ubiquitously active cytomegalovirus promoter. In conclusion, this is the first study incorporating patient tissue models in comparing gene delivery from various vectors, providing knowledge on cell-type specificity and examining the crucial biological factors determining successful gene delivery. The results highlight the importance of in

  13. Space program management methods and tools

    CERN Document Server

    Spagnulo, Marcello; Balduccini, Mauro; Nasini, Federico

    2013-01-01

    Beginning with the basic elements that differentiate space programs from other management challenges, Space Program Management explains through theory and example of real programs from around the world, the philosophical and technical tools needed to successfully manage large, technically complex space programs both in the government and commercial environment. Chapters address both systems and configuration management, the management of risk, estimation, measurement and control of both funding and the program schedule, and the structure of the aerospace industry worldwide.

  14. Synthesis of the project leadership staffing needs for successful development of alternative delivery programs.

    Science.gov (United States)

    2017-08-01

    This research provides a synthesis of practices in organizational structuring and professional staffing of the innovative delivery units in several state DOTs across the nation that are actively utilizing alternative project delivery. Several major c...

  15. Transtheoretical Model-based Nursing Intervention on Lifestyle Change: A Review Focused on Intervention Delivery Methods.

    Science.gov (United States)

    Lee, Joo Yun; Park, Hyeoun-Ae; Min, Yul Ha

    2015-06-01

    The transtheoretical model (TTM) was used to provide tailored nursing for lifestyle management such as diet, physical activity, and smoking cessation. The present study aims to assess the provision of intervention delivery methods, intervention elements, and stage-matched interventions, in order to identify ways in which information technology is used in the TTM-based research. The relevant literature was selected by two researchers using inclusion criteria after searching for "TTM (transtheoretical or stage of change)" and "nursing" from the databases PubMed and CINAHL. The selected studies were categorized in terms of study characteristics, intervention delivery method, intervention element, and use and level of stage-matched intervention. A total of 35 studies were selected including eight studies that used information communication technology (ICT). Nine different intervention delivery methods were used, of which "face-to-face" was the most common at 24 times. Of the 35 studies, 26 provided stage-matched interventions. Seven different intervention elements were used, of which "counseling" was the most common at 27 times. Of all the intervention elements, tailored feedback used ICT the most at seven instances out of nine, and there was a significant difference in the rate of ICT usage among intervention elements. ICT is not yet actively used in the TTM-based nursing interventions. Stage-matched interventions and TTM concepts were shown to be in partial use also in the TTM-based interventions. Therefore, it is necessary to develop a variety of ways to use ICT in tailored nursing interventions and to use TTM frameworks and concepts. Copyright © 2015. Published by Elsevier B.V.

  16. Pectosomes and Chitosomes as Delivery Systems for Metronidazole: The One-Pot Preparation Method

    Directory of Open Access Journals (Sweden)

    Nataša Škalko-Basnet

    2013-09-01

    Full Text Available Mucoadhesive liposomes offer a potential for improved residence time of liposomal systems targeting contact with mucosal tissues, such as in buccal, oral, colon, and vaginal drug delivery. Most of the currently available methods rely on the coating of preformed liposomes by various mucoadhesive polymers. The aim of this study was to develop novel mucoadhesive system by the one-pot preparation method. The pectin- and chitosan-containing liposomes, namely pectosomes and chitosomes, were prepared by the modified solvent injection method. In order to optimize this novel delivery system, we used pectins and chitosans of both high and low degree of esterification/deacetylation (DE/DD, respectively. Sonication was applied to reduce the original vesicle size. All vesicles were characterized for their size, zeta potential, metronidazole entrapment, and stability. Both pectosomes and chitosomes were found to entrap more metronidazole than conventional plain liposomes. Preliminary data indicate that the polymer is present on the liposomal surface, embedded within inner liposomal bilayers, and entrapped inside the aqueous compartment. The next step in the evaluation of this system is the testing of its mucoadhesiveness.

  17. Impact of financial incentives on alcohol intervention delivery in primary care: a mixed-methods study.

    Science.gov (United States)

    O'Donnell, Amy; Haighton, Catherine; Chappel, David; Shevills, Colin; Kaner, Eileen

    2016-11-25

    Local and national financial incentives were introduced in England between 2008 and 2015 to encourage screening and brief alcohol intervention delivery in primary care. We used routine Read Code data and interviews with General Practitioners (GPs) to assess their impact. A sequential explanatory mixed-methods study was conducted in 16 general practices representing 106,700 patients and 99 GPs across two areas in Northern England. Data were extracted on screening and brief alcohol intervention delivery for 2010-11 and rates were calculated by practice incentive status. Semi-structured interviews with 14 GPs explored which factors influence intervention delivery and recording in routine consultations. Screening and brief alcohol intervention rates were higher in financially incentivised compared to non-incentivised practices. However absolute rates were low across all practices. Rates of short screening test administration ranged from 0.05% (95% CI: 0.03-0.08) in non-incentivised practices to 3.92% (95% CI: 3.70-4.14) in nationally incentivised practices. For the full AUDIT, rates were also highest in nationally incentivised practices (3.68%, 95% CI: 3.47-3.90) and lowest in non-incentivised practices (0.17%, 95% CI: 0.13-0.22). Delivery of alcohol interventions was highest in practices signed up to the national incentive scheme (9.23%, 95% CI: 8.91-9.57) and lowest in non-incentivised practices (4.73%, 95% CI: 4.50-4.96). GP Interviews highlighted a range of influences on alcohol intervention delivery and subsequent recording including: the hierarchy of different financial incentive schemes; mixed belief in the efficacy of alcohol interventions; the difficulty of codifying complex conditions; and GPs' beliefs about patient-centred practice. Financial incentives have had some success in encouraging screening and brief alcohol interventions in England, but levels of recorded activity remain low. To improve performance, future policies must prioritise alcohol

  18. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    Directory of Open Access Journals (Sweden)

    Schlein Karen

    2013-01-01

    Full Text Available Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social franchising, there is no published documentation of how quality levels might be set in the context of franchised private providers, nor what quality assurance measures can or should exist within social franchises. The aim of this study was to better understand the quality assurance systems currently utilized in social franchises, and to determine if there are shared standards for practice or quality outcomes that exist across programs. Methods The study included three data sources and levels of investigation: 1 Self-reported program data; 2 Scoping telephone interviews; and 3 In-depth field interviews and clinic visits. Results Social Franchises conceive of quality assurance not as an independent activity, but rather as a goal that is incorporated into all areas of franchise operations, including recruitment, training, monitoring of provider performance, monitoring of client experience and the provision of feedback. Conclusions These findings are the first evidence to support the 2002 conceptual model of social franchising which proposed that the assurance of quality was one of the three core goals of all social franchises. However, while quality is important to franchise programs, quality assurance systems overall are not reflective of the evidence to-date on quality measurement or quality improvement best practices. Future research in this area is needed to better understand the details of quality assurance systems as applied in social franchise programs, the process by which quality assurance

  19. IMRT dose delivery effects in radiotherapy treatment planning using Monte Carlo methods

    Science.gov (United States)

    Tyagi, Neelam

    Inter- and intra-leaf transmission and head scatter can play significant roles in Intensity Modulated Radiation Therapy (IMRT)-based treatment deliveries. In order to accurately calculate the dose in the IMRT planning process, it is therefore important that the detailed geometry of the multi-leaf collimator (MLC), in addition to other components in the accelerator treatment head be accurately modeled. In this thesis Monte Carlo (MC) methods have been used to model the treatment head of a Varian linear accelerator. A comprehensive model of the Varian 120-leaf MLC has been developed within the DPM MC code and has been verified against measurements in homogeneous and heterogeneous phantom geometries under different IMRT delivery circumstances. Accuracy of the MLC model in simulating details in the leaf geometry has been established over a range of arbitrarily shaped fields and IMRT fields. A sensitivity analysis of the effect of the electron-on-target parameters and the structure of the flattening filter on the accuracy of calculated dose distributions has been conducted. Adjustment of the electron-on-target parameters resulting in optimal agreement with measurements was an iterative process, with the final parameters representing a tradeoff between small (3x3 cm2) and large (40x40 cm2) field sizes. A novel method based on adaptive kernel density estimation, in the phase space simulation process is also presented as an alternative to particle recycling. Using this model dosimetric differences between MLC-based static (SMLC) and dynamic (DMLC) deliveries have been investigated. Differences between SMLC and DMLC, possibly related to fluence and/or spectral changes, appear to vary systematically with the density of the medium. The effect of fluence modulation due to leaf sequencing shows differences, up to 10% between plans developed with 1% and 10% fluence intervals for both SMLC and DMLC-delivered sequences. Dose differences between planned and delivered leaf sequences

  20. An efficient parallel stochastic simulation method for analysis of nonviral gene delivery systems

    KAUST Repository

    Kuwahara, Hiroyuki

    2011-01-01

    Gene therapy has a great potential to become an effective treatment for a wide variety of diseases. One of the main challenges to make gene therapy practical in clinical settings is the development of efficient and safe mechanisms to deliver foreign DNA molecules into the nucleus of target cells. Several computational and experimental studies have shown that the design process of synthetic gene transfer vectors can be greatly enhanced by computational modeling and simulation. This paper proposes a novel, effective parallelization of the stochastic simulation algorithm (SSA) for pharmacokinetic models that characterize the rate-limiting, multi-step processes of intracellular gene delivery. While efficient parallelizations of the SSA are still an open problem in a general setting, the proposed parallel simulation method is able to substantially accelerate the next reaction selection scheme and the reaction update scheme in the SSA by exploiting and decomposing the structures of stochastic gene delivery models. This, thus, makes computationally intensive analysis such as parameter optimizations and gene dosage control for specific cell types, gene vectors, and transgene expression stability substantially more practical than that could otherwise be with the standard SSA. Here, we translated the nonviral gene delivery model based on mass-action kinetics by Varga et al. [Molecular Therapy, 4(5), 2001] into a more realistic model that captures intracellular fluctuations based on stochastic chemical kinetics, and as a case study we applied our parallel simulation to this stochastic model. Our results show that our simulation method is able to increase the efficiency of statistical analysis by at least 50% in various settings. © 2011 ACM.

  1. Design of Drug Delivery Methods for the Brain and Central Nervous System

    Science.gov (United States)

    Lueshen, Eric

    -enhanced drug delivery (CED) is a technique used to bypass the BBB via direct intracranial injection using a catheter driven by a positive pressure gradient from an infusion pump. Although CED boasts the advantage of achieving larger drug distribution volumes compared to diffusion driven methods, difficulty in predicting drug spread and preventing backflow along the catheter shaft commonly occur. In this dissertation, a method for predicting drug distributions in the brain using diffusion tensor imaging (DTI) data is employed to show how small variations in catheter placement can lead to drastically different volumes of drug distribution in vivo. The impact that microfluid flow has on deformable brain phantom gel is studied in order to elucidate the causes of backflow, and the results are used to develop backflow-free catheters with safe volumetric flow rates up to 10 ?l/min. Through implementation of our backflow-free catheter designs, physicians will be able to target specific regions of the brain with improved accuracy, increased drug concentration, and larger drug distribution geometries. Intrathecal (IT) drug delivery involves direct drug infusion into the spinal canal and has become standard practice for treating many CNS diseases. Although IT drug delivery boasts the advantage of reduced systemic toxicity compared to oral and intravenous techniques, current IT delivery protocols lack a means of sufficient drug targeting at specific locations of interest within the CNS. In this dissertation, the method of intrathecal magnetic drug targeting (IT-MDT) is developed to overcome the limited targeting capabilities of standard IT drug delivery protocols. The basic idea behind IT-MDT is to guide intrathecally-injected, drug-functionalized magnetic nanoparticles (MNPs) using an external magnetic field to diseased regions within the spinal canal. Cerebrospinal fluid (CSF) transport phenomena are studied, and in vitro human spine surrogates are built. Experiments are run on the in

  2. Self-Efficacy of Choosing Delivery Method and Labor Among Pregnant Women in Pars-Abad City

    Directory of Open Access Journals (Sweden)

    Safieh Kanani

    2014-09-01

    Full Text Available Introduction: Self-efficacy is a person’s belief on his or her own ability to successfully perform a task. It is one’s own ability to cope with stressful situations and implement necessary actions, especially in labor. The aim of this study was to investigate the effect of self-efficacy on choosing delivery method and labor among women. Materials and Methods: This was a cross-sectional and descriptive study. The non-probability sample consisted of 200 primiparous and multipara women in the third trimester of pregnancy recruited from five urban health care centers in Pars-Abad city, Ardebil province, Iran, in 2014. The standard and self-administered questionnaires were used for data collection including demographic variables and self-efficacy of choosing natural vaginal delivery and labor via self-report method. Data analysis was performed using SPSS-21 software by chi-square, Fisher exact test and independent T-test. Results: The mean age of all participants was 25.19 (±4.48. A significant difference was found between spouse education levels, having supplemental insurance and employment status with choosing the delivery method (P < 0.05. Self-efficacy to choose natural vaginal delivery and self-efficacy of labor were associated with parity and choosing the delivery method (P<0.001 the average two types of self-efficacy were higher in multipara women and those who selected natural delivery method. Conclusion: Self-efficacy to choose natural vaginal delivery and labor determies choosing the delivery method and is related to parity. Therefore, it is suggested to focus on self-efficacy in educational interventions to reduce fear of childbirth, especially in primiparous women.

  3. Methods for determining agent concentration profiles in agarose gel during convection-enhanced delivery.

    Science.gov (United States)

    Sindhwani, Nikhil; Ivanchenko, Oleksandr; Lueshen, Eric; Prem, Komal; Linninger, Andreas A

    2011-03-01

    Convection-enhanced delivery (CED) is a promising technique to deliver large molecular weight drugs to the human brain for treatment of Parkinson's, Alzheimer's, or brain tumors. Researchers have used agarose gels to study mechanisms of agent transport in soft tissues like brain due to its similar mechanical and transport properties. However, inexpensive quantitative techniques to precisely measure achieved agent distribution in agarose gel phantoms during CED are missing. Such precise measurements of concentration distribution are needed to optimize drug delivery. An optical experimental method to accurately quantify agent concentration in agarose is presented. A novel geometry correction algorithm is used to determine real concentrations from observable light intensities captured by a digital camera. We demonstrate the technique in dye infusion experiments that provide cylindrical and spherical distributions when infusing with porous membrane and conventional single-port catheters, respectively. This optical method incorporates important parameters, such as optimum camera exposure, captured camera intensity calibration, and use of collimated light source for maximum precision. We compare experimental results with numerical solutions to the convection diffusion equation. The solutions of convection-diffusion equations in the cylindrical and spherical domains were found to match the experimental data obtained by geometry correction algorithm.

  4. Resolution methods in proving the program correctness

    Directory of Open Access Journals (Sweden)

    Markoski Branko

    2007-01-01

    Full Text Available Program testing determines whether its behavior matches the specification, and also how it behaves in different exploitation conditions. Proving of program correctness is reduced to finding a proof for assertion that given sequence of formulas represents derivation within a formal theory of special predicted calculus. A well-known variant of this conception is described: correctness based on programming logic rules. It is shown that programming logic rules may be used in automatic resolution procedure. Illustrative examples are given, realized in prolog-like LP-language (with no restrictions to Horn's clauses and without the final failure. Basic information on LP-language are also given. It has been shown how a Pascal-program is being executed in LP-system proffer.

  5. Use of electronic group method in assessing food safety training needs and delivery methods among international college students in the U.S.

    Science.gov (United States)

    Garden-Robinson, Julie; Eighmy, Myron A; Lyonga, Agnes Ngale

    2010-12-01

    The purpose of this study was to determine the types of unfamiliar foods international students in the U.S. encounter and to assess food safety information that international students would like to receive for mitigating risks associated with handling and preparing unfamiliar foods. The study identified preferred instructional delivery methods and media for receiving food safety training or information. An electronic group method was used for this study. The electronic group method was chosen to maximize group efficiency by allowing participants to share ideas simultaneously and anonymously with minimal use of time and resources.Types of different (unfamiliar) foods were grouped into major categories. Fast and ready-to-eat foods, and processed and frozen foods constituted a major change for some international students, who were accustomed to homemade and fresh foods in their countries. Participants were interested in receiving information about how to safely handle and prepare unfamiliar foods in their new environment. Preferred methods for receiving food safety information included written materials, online publications, presentations, and materials provided during student orientation. Food packages, websites, and television programs were other preferred methods of receiving food safety information. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. National findings regarding health IT use and participation in health care delivery reform programs among office-based physicians.

    Science.gov (United States)

    Heisey-Grove, Dawn; Patel, Vaishali

    2017-01-01

    Our objective was to characterize physicians' participation in delivery and payment reform programs over time and describe how participants in these programs were using health information technology (IT) to coordinate care, engage patients, manage patient populations, and improve quality. A nationally representative cohort of physicians was surveyed in 2012 (unweighted N = 2567) and 2013 (unweighted N = 2399). Regression analyses used those survey responses to identify associations between health IT use and participation in and attrition from patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and pay-for-performance programs (P4Ps). In 2013, 45% of physicians participated in PCMHs, ACOs, or P4Ps. While participation in each program increased (P Health IT use was associated with greater program participation (RR = 1.07-1.16). PCMH, ACO, and P4P participants were more likely than nonparticipants to perform quality improvement and patient engagement activities electronically (RR = 1.09-1.14); only ACO participants were more likely to share information electronically (RR = 1.07-1.09). Participation in delivery and payment reform programs increased between 2012 and 2013. Participating physicians were more likely to use health IT. There was significant attrition from and switching between PCMHs, ACOs, and P4Ps. This work provides the basis for understanding physician participation in and attrition from delivery and payment reform programs, as well as how health IT was used to support those programs. Understanding health IT use by program participants may help to identify factors enabling a smooth transition to alternative payment models. Published by Oxford University Press on behalf of the American Medical Informatics Association 2016. This work is written by US Government employees and is in the public domain in the United States.

  7. Bespoke program design for school-aged therapy disability service delivery.

    Science.gov (United States)

    Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi

    2012-01-01

    This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.

  8. Cell number and transfection volume dependent peptide nucleic acid antisense activity by cationic delivery methods

    DEFF Research Database (Denmark)

    Llovera Nadal, Laia; Berthold, Peter; Nielsen, Peter E

    2012-01-01

    have now quantitatively compared the cellular activity (in the pLuc705 HeLa cell splice correction system) of PNA antisense oligomers using lipoplex delivery of cholesterol- and bisphosphonate-PNA conjugates, polyplex delivery via a PNA-polyethyleneimine conjugate and CPP delivery via a PNA...

  9. Trends in Canadian faculties of education: An overview of graduate programs, curricular offerings, exit requirements, and modes of delivery.

    Directory of Open Access Journals (Sweden)

    Carla Abreu Ellis

    2008-07-01

    Full Text Available Introduction This research investigated universities registered with the Association of Universities and Colleges of Canada (AUCC whose primary instructional language was English. A content analysis was performed on university web pages related to the following content: (a frequency of graduate programs being offered, (b types of degrees being offered, (c frequency and variation of program of study offerings, (d variation of exit requirements, and (e modalities of course delivery. This research provides an overview and analysis of graduate level programs, more precisely Masters and Doctorate degrees, offered through faculties of education in Canada. An understanding of the findings of this research may benefit Canadian university administrative bodies in providing a source in which they may compare findings with their current offerings and programming. Prospective students of graduate programs in education may also benefit from the information provided in this study when choosing a program of study by ameliorating their knowledge of current programs, curriculum offerings, and modes of course delivery being offered by faculties of education in Canada.

  10. Interior-Point Methods for Linear Programming: A Review

    Science.gov (United States)

    Singh, J. N.; Singh, D.

    2002-01-01

    The paper reviews some recent advances in interior-point methods for linear programming and indicates directions in which future progress can be made. Most of the interior-point methods belong to any of three categories: affine-scaling methods, potential reduction methods and central path methods. These methods are discussed together with…

  11. Microparticles Produced by the Hydrogel Template Method for Sustained Drug Delivery

    Science.gov (United States)

    Lu, Ying; Sturek, Michael; Park, Kinam

    2014-01-01

    Polymeric microparticles have been used widely for sustained drug delivery. Current methods of microparticle production can be improved by making homogeneous particles in size and shape, increasing the drug loading, and controlling the initial burst release. In the current study, the hydrogel template method was used to produce homogeneous poly(lactide-co-glycolide) (PLGA) microparticles and to examine formulation and process-related parameters. Poly(vinyl alcohol) (PVA) was used to make hydrogel templates. The parameters examined include PVA molecular weight, type of PLGA (as characterized by lactide content, inherent viscosity), polymer concentration, drug concentration and composition of solvent system. Three model compounds studied were risperidone, methylprednisolone acetate and paclitaxel. The ability of the hydrogel template method to produce microparticles with good conformity to template was dependent on molecular weight of PVA and viscosity of the PLGA solution. Drug loading and encapsulation efficiency were found to be influenced by PLGA lactide content, polymer concentration and composition of the solvent system. The drug loading and encapsulation efficiency were 28.7% and 82% for risperidone, 31.5% and 90% for methylprednisolone acetate, and 32.2 % and 92 % for paclitaxel, respectively. For all three drugs, release was sustained for weeks, and the in vitro release profile of risperidone was comparable to that of microparticles prepared using the conventional emulsion method. The hydrogel template method provides a new approach of manipulating microparticles. PMID:24333903

  12. Development of strategies to reduce cesarean delivery rates in iran 2012-2014: A mixed methods study

    Directory of Open Access Journals (Sweden)

    Razieh Lotfi

    2014-01-01

    Full Text Available Background: With the change in population policy from birth control toward encouraging birth and population growth in Iran, repeated cesarean deliveries as a main reason of cesarean section are associated with more potential adverse consequences. The aim of this research was to explore effective strategies to reduce cesarean delivery rates in Iran. Methods: A mixed methodological study was designed and implemented. First, using a qualitative approach, concepts and influencing factors of increased cesarean delivery were explored. Based on the findings of this phase of the study, a questionnaire including the proposed strategies to reduce cesarean delivery was developed. Then in a quantitative phase, the questionnaire was assessed by key informants from across the country and evaluated to obtain more effective strategies to reduce cesarean delivery. Ten participants in the qualitative study included policy makers from the Ministry of Health, obstetricians, midwives and anthropologists. In the next step, 141 participants from private and public hospitals, insurance experts, Academic Associations of Midwifery, and policy makers in Maternity Health Affairs of Ministry of Health were invited to assess and provide feedback on the strategies that work to reduce cesarean deliveries. Results: Qualitative data analysis showed four concept related to increased cesarean delivery rates including; "standardization", "education", "amending regulations", and "performance supervision". Effective strategies extracted from qualitative data were rated by participants then, using ACCEPT derived from A as attainability, C as costing, C as complication, E as effectiveness, P as popularity, and T as timing table 19 strategies were detected as priorities. Conclusions: Although developing effective strategies to reduce cesarean delivery rates is complex process because of the multi-factorial nature of increased cesarean deliveries, in this study we have achieved

  13. Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study.

    Science.gov (United States)

    Brooks, Mohamad I; Thabrany, Hasbullah; Fox, Matthew P; Wirtz, Veronika J; Feeley, Frank G; Sabin, Lora L

    2017-02-02

    The growing momentum for quality and affordable health care for all has given rise to the recent global universal health coverage (UHC) movement. As part of Indonesia's strategy to achieve the goal of UHC, large investments have been made to increase health access for the poor, resulting in the implementation of various health insurance schemes targeted towards the poor and near-poor, including the Jamkesmas program. In the backdrop of Indonesia's aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. The objective of this study was to evaluate the association of health facility and skilled birth deliveries among poor women with and without Jamkesmas and explore perceived barriers to health insurance membership and maternal health service utilization. We used a mixed-methods design. Utilizing data from the 2012 Indonesian Demographic and Health Survey (n = 45,607), secondary analysis using propensity score matching was performed on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). In-depth interviews (n = 51) were conducted in the provinces of Jakarta and Banten among poor women, midwives, and government representatives. Thematic framework analysis was performed on qualitative data to explore perceived barriers. In 2012, 63.0% of women did not have health insurance; 19.1% had Jamkesmas. Poor women with Jamkesmas were 19% (OR = 1.19 [1.03-1.37]) more likely to have HFD and 17% (OR = 1.17 [1.01-1.35]) more likely to have SBD compared to poor women without insurance. Qualitative interviews highlighted key issues, including: lack of proper documentation for health insurance registration; the preference of pregnant women to deliver in their parents' village; the use of traditional birth attendants; distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. Poor women with

  14. 20 CFR 652.208 - How are core services and intensive services related to the methods of service delivery described...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are core services and intensive services... applicable three methods of service delivery described in § 652.207(b)(2). These methods are: (a) Self-service; (b) Facilitated self-help service; and (c) Staff-assisted service. ...

  15. Alternative formulations, delivery methods, and administration options for psychotropic medications in elderly patients with behavioral and psychological symptoms of dementia.

    Science.gov (United States)

    Muramatsu, Russ S; Litzinger, Mark H J; Fisher, Ed; Takeshita, Junji

    2010-04-01

    The purpose of this paper was to review alternative formulations, delivery methods, and administration options for psychotropic medications in elderly patients with behavioral and psychological symptoms of dementia (BPSD). A MEDLINE search was conducted initially in December 2008 and was updated in September 2009, including the search terms pharmacologic treatment and dementia, behavioral and psychological symptoms of dementia, alternative psychotropic medication formulations, alternative dosing methods of medication, drug delivery options, antidepressants and dementia, anxiolytics and dementia, antipsychotics and dementia, mood stabilizers and dementia, cognitive enhancers and dementia, medications and enteral feeding tubes, and hiding medication. Studies were limited to English-language articles dated from 1950 to 2009. Additional relevant articles were obtained by reviewing the references in the initial articles. Drug Facts and Comparisons 4.0 Online, Lexi-Comp Online, and Lexi-Drugs Online were used to obtain additional information. Targeted patients were elderly individuals with BPSD who were considered difficult to treat because they were unable to swallow, were refusing medications, or were not able to eat or drink per physician order. In addition to the standard capsule or tablet given orally, a variety of formulations and delivery methods for psychotropic medications are available. Options include short- and long-acting intramuscular, intravenous, liquid, orally disintegrating, transdermal patch, sublingual, and rectal forms. Additionally, all formulations can be further altered in substance, delivery, or both. For example, tablets may be crushed and capsules opened; this changes their formulation and allows the option of mixing with food or liquids to be taken by mouth or through a tube. Caution must be used, however; in certain cases, alteration of the original form or the intended delivery method is contraindicated. In addition, many alternative

  16. A Partnership Training Program: Studying Targeted Drug Delivery Using Nanoparticles in Breast Cancer Diagnosis and Therapy

    Science.gov (United States)

    2014-10-01

    adhesion of drug delivery carriers throughout the circulatory system and the in vivo circulation time of the nanomedicine can be controlled by modulating...Environ Sci Process Impacts 2013;15:23–38. Magde D, Elson E, Webb WW. Thermodynamic fluctuations in a reacting system — measurement by fluorescence...nanotechnology in medicine, the use of various nanomaterials as pharmaceutical delivery systems for drugs, DNA, and imaging agents has gained increasing

  17. Determination of in vitro usnic acid delivery into porcine skin using a HPLC method.

    Science.gov (United States)

    Serafini, Mairim Russo; Detoni, Cassia Britto; Guterres, Sílvia Stanisçuaski; da Silva, Gabriel Francisco; de Souza Araújo, Adriano Antunes

    2015-01-01

    Usnic acid, a lichen metabolite, has been proposed as a potential topical treatment for microbial skin lesions, burn wounds as well as a sunscreen. An isocratic HPLC method was validated according to FDA's Guidance for Industry: Bioanalytical Method Validation to determine skin penetration and permeation of usnic acid. The penetration and permeation of usnic acid was evaluated using Franz cells and porcine skin. The method was valid according to selectivity, linearity, precision, accuracy and stability. Usnic acid was quantified in the skin surface (6.13 µg cm(2)), stratum corneum (34.4 µg cm(2)), viable epidermis (5.6 µg cm(2)), dermis (28.2 µg cm(2)) and receptor compartment (3.2 µg cm(2)). These results help us to understand the penetration profile of usnic acid and plan topical therapeutic approaches as well as new topical delivery systems to modulate this penetration profile. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Modeling foam delivery mechanisms in deep vadose-zone remediation using method of characteristics.

    Science.gov (United States)

    Roostapour, A; Kam, S I

    2012-12-01

    This study investigates foam delivery mechanisms in vadose-zone remediation by using Method of Characteristics (MoC), a mathematical tool long been used for the analysis of miscible and immiscible flooding in porous media in petroleum industry. MoC converts the governing material-balance partial differential equations into a series of ordinary differential equations, and the resulting solutions are in a form of wave propagation (more specifically, for chemical species and phase saturations) through the system as a function of time and space. Deep vadose-zone remediation has special features compared to other conventional remediation applications. They include, not limited to, a high level of heterogeneity, a very dry initial condition with low water saturation (S(w)), pollutants such as metals and radionuclides fully dissolved in groundwater, and a serious concern about downward migration during the remediation treatments. For the vadose-zone remediation processes to be successful, the injected aqueous phase should carry chemicals to react with pollutants and precipitate them for immobilization and stabilization purposes. As a result, foams are believed to be an effective means, and understanding foam flow mechanism in situ is a key to the optimal design of field applications. Results show that foam delivery mechanism is indeed very complicated, making the optimum injection condition field-specific. The five major parameters selected (i.e., initial saturation of the medium, injection foam quality, surfactant adsorption, foam strength, and foam stability) are shown to be all important, interacting with each other. Results also imply that although dry foam injection is generally recommended, too dry injection condition is found to hurt this process due to slow foam propagation. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Granular contact dynamics using mathematical programming methods

    DEFF Research Database (Denmark)

    Krabbenhoft, K.; Lyamin, A. V.; Huang, J.

    2012-01-01

    A class of variational formulations for discrete element analysis of granular media is presented. These formulations lead naturally to convex mathematical programs that can be solved using standard and readily available tools. In contrast to traditional discrete element analysis, the present...... is developed and it is concluded that the associated sliding rule, in the context of granular contact dynamics, may be viewed as an artifact of the time discretization and that the use of an associated flow rule at the particle scale level generally is physically acceptable. (C) 2012 Elsevier Ltd. All rights...

  20. Improvement of program-goal method in defence planning system

    Directory of Open Access Journals (Sweden)

    Р.М. Федоренко

    2005-01-01

    Full Text Available  The article proposes the conception of defence planning system development with program-goal method application that based on analysis of advanced experience of developed countries. Article specified the place of program-goal method in resolving defence planning tasks of national security.

  1. Reduction of dimensionality in dynamic programming-based solution methods for nonlinear integer programming

    Directory of Open Access Journals (Sweden)

    Balasubramanian Ram

    1988-01-01

    Full Text Available This paper suggests a method of formulating any nonlinear integer programming problem, with any number of constraints, as an equivalent single constraint problem, thus reducing the dimensionality of the associated dynamic programming problem.

  2. An in vivo dose verification method for SBRT-VMAT delivery using the EPID.

    Science.gov (United States)

    McCowan, P M; Van Uytven, E; Van Beek, T; Asuni, G; McCurdy, B M C

    2015-12-01

    Radiation treatments have become increasingly more complex with the development of volumetric modulated arc therapy (VMAT) and the use of stereotactic body radiation therapy (SBRT). SBRT involves the delivery of substantially larger doses over fewer fractions than conventional therapy. SBRT-VMAT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. Electronic portal imaging devices (EPIDs) are available on most commercial linear accelerators (Linacs) and their documented use for dosimetry makes them valuable tools for patient dose verification. In this work, the authors customize and validate a physics-based model which utilizes on-treatment EPID images to reconstruct the 3D dose delivered to the patient during SBRT-VMAT delivery. The SBRT Linac head, including jaws, multileaf collimators, and flattening filter, were modeled using Monte Carlo methods and verified with measured data. The simulation provides energy spectrum data that are used by their "forward" model to then accurately predict fluence generated by a SBRT beam at a plane above the patient. This fluence is then transported through the patient and then the dose to the phosphor layer in the EPID is calculated. Their "inverse" model back-projects the EPID measured focal fluence to a plane upstream of the patient and recombines it with the extra-focal fluence predicted by the forward model. This estimate of total delivered fluence is then forward projected onto the patient's density matrix and a collapsed cone convolution algorithm calculates the dose delivered to the patient. The model was tested by reconstructing the dose for two prostate, three lung, and two spine SBRT-VMAT treatment fractions delivered to an anthropomorphic phantom. It was further validated against actual patient data for a lung and spine SBRT-VMAT plan. The results were verified with the

  3. A novel four-dimensional radiotherapy method for lung cancer: imaging, treatment planning and delivery

    Energy Technology Data Exchange (ETDEWEB)

    Alasti, H [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Cho, Y B [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Vandermeer, A D [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Abbas, A [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Norrlinger, B [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Shubbar, S [Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Bezjak, A [Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada)

    2006-06-21

    We present treatment planning methods based on four-dimensional computed tomography (4D-CT) to incorporate tumour motion using (1) a static field and (2) a dynamic field. Static 4D fields are determined to include the target in all breathing phases, whereas dynamic 4D fields are determined to follow the shape of the tumour assessed from 4D-CT images with a dynamic weighting factor. The weighting factor selection depends on the reliability of patient breathing and limitations of the delivery system. The static 4D method is compared with our standard protocol for gross tumour volume (GTV) coverage, mean lung dose and V20. It was found that the GTV delineated on helical CT without incorporating breathing motion does not adequately represent the target compared to the GTV delineated from 4D-CT. Dosimetric analysis indicates that the static 4D-CT based technique results in a reduction of the mean lung dose compared with the standard protocol. Measurements on a moving phantom and simulations indicated that 4D radiotherapy (4D-RT) synchronized with respiration-induced motion further reduces mean lung dose and V20, and may allow safe application of dose escalation and CRT/IMRT. The motions of the chest cavity, tumour and thoracic structures of 24 lung cancer patients are also analysed.

  4. Inhalation method for delivery of nanoparticles to the Drosophila respiratory system for toxicity testing

    Energy Technology Data Exchange (ETDEWEB)

    Posgai, Ryan; Ahamed, Maqusood [Department of Biology, University of Dayton, Dayton, OH, 45469-2320 (United States); Hussain, Saber M. [Applied Biotechnology Branch, Human Effectiveness Directorate Air Force Research Laboratory/RHBP, Wright-Patterson Air Force Base, OH, 45433 (United States); Rowe, John J. [Department of Biology, University of Dayton, Dayton, OH, 45469-2320 (United States); Nielsen, Mark G., E-mail: Mark.Nielsen@notes.udayton.edu [Department of Biology, University of Dayton, Dayton, OH, 45469-2320 (United States)

    2009-12-20

    The growth of the nanotechnology industry and subsequent proliferation of nanoparticle types present the need to rapidly assess nanoparticle toxicity. We present a novel, simple and cost-effective nebulizer-based method to deliver nanoparticles to the Drosophila melanogaster respiratory system, for the purpose of toxicity testing. FluoSpheres (registered) , silver, and CdSe/ZnS nanoparticles of different sizes were effectively aerosolized, showing the system is capable of functioning with a wide range of nanoparticle types and sizes. Red fluorescent CdSe/ZnS nanoparticles were successfully delivered to the fly respiratory system, as visualized by fluorescent microscopy. Silver coated and uncoated nanoparticles were delivered in a toxicity test, and induced Hsp70 expression in flies, confirming the utility of this model in toxicity testing. This is the first method developed capable of such delivery, provides the advantage of the Drosophila health model, and can serve as a link between tissue culture and more expensive mammalian models in a tiered toxicity testing strategy.

  5. Programmed delivery of verapamil hydrochloride from tablet in a capsule device

    Directory of Open Access Journals (Sweden)

    Mukesh Lal Sah

    2012-06-01

    Full Text Available The aim of the present work was to develop a programmed drug delivery system which would be able to release the drug after 6 h of lag time by use of hydrophilic polymers. The capsule body was made impermeable by use of formaldehyde vapor treatment, while the cap was untreated. The capsule was filled with two layered tablets (tablet-in-capsule, followed by a sodium bicarbonate:citric acid mixture (SBCM and lactose as bulking agent. Sodium alginate, chitosan, HPMC K15 and chitosan:sodium alginate complex (CSAC were used as the rate modulating layer. Through combined use of HPMC K15 and adjusting the ratio of CSAC, the desired lag time of 6 h was obtained. The effect of the bulking agents on the lag time were also studied and it was found that the lag time was decreased with higher amounts of lactose, and delayed dissolution and decreased lag time was observed at higher amount of effervescent mixture.O objetivo do presente trabalho foi desenvolver sistema de liberação programada de cloridrato de verapamil capaz de liberação imediata do fármaco após 6 h de intervalo de tempo usando polímeros hidrofílicos. O corpo da cápsula foi impermeabilizado por tratamento de vapor de formaldeído, enquanto a tampa não foi submetida ao tratamento. Dois comprimidos foram inseridos na cápsula (comprimidos em cápsula seguido de mistura de bicarbonato de sódio: ácido cítrico e lactose, utilizados como excipientes. O alginato de sódio, a quitosana, o HPMC K15 e o complexo quitosana:alginato de sódio foram utilizados para modular a razão de liberação do fármaco. A combinação entre o HPMC K15 e o ajuste da proporção do complexo quitosana:alginato de sódio permitiu a liberação do fármaco após 6 h. O efeito dos excipientes na liberação do fármaco foi também avaliado. Verificou-se que o tempo de latência foi reduzido na presença de maior quantidade de lactose, enquanto o menor tempo foi observado empregando maior concentração da

  6. A Review of Analytical Methods for the Identification and Characterization of Nano Delivery Systems in Food

    NARCIS (Netherlands)

    Luykx, D.M.A.M.; Peters, R.J.B.; Ruth, van S.M.; Bouwmeester, H.

    2008-01-01

    Detection and characterization of nano delivery systems is an essential part of understanding the benefits as well as the potential toxicity of these systems in food. This review gives a detailed description of food nano delivery systems based on lipids, proteins, and/or polysaccharides and

  7. MRI-Guided Focused Ultrasound as a New Method of Drug Delivery

    Directory of Open Access Journals (Sweden)

    M. Thanou

    2013-01-01

    Full Text Available Ultrasound-mediated drug delivery under the guidance of an imaging modality can improve drug disposition and achieve site-specific drug delivery. The term focal drug delivery has been introduced to describe the focal targeting of drugs in tissues with the help of imaging and focused ultrasound. Focal drug delivery aims to improve the therapeutic profile of drugs by improving their specificity and their permeation in defined areas. Focused-ultrasound- (FUS- mediated drug delivery has been applied with various molecules to improve their local distribution in tissues. FUS is applied with the aid of microbubbles to enhance the permeability of bioactive molecules across BBB and improve drug distribution in the brain. Recently, FUS has been utilised in combination with MRI-labelled liposomes that respond to temperature increase. This strategy aims to “activate” nanoparticles to release their cargo locally when triggered by hyperthermia induced by FUS. MRI-guided FUS drug delivery provides the opportunity to improve drug bioavailability locally and therefore improve the therapeutic profiles of drugs. This drug delivery strategy can be directly translated to clinic as MRg FUS is a promising clinically therapeutic approach. However, more basic research is required to understand the physiological mechanism of FUS-enhanced drug delivery.

  8. Blended Synchronous Delivery Mode in Graduate Programs: A Literature Review and Its Implementation in the Master Teacher Program

    Science.gov (United States)

    Lakhal, Sawsen; Bateman, Dianne; Bédard, Janie

    2017-01-01

    The aim of this study is to present a narrative literature review of advantages, challenges, and conditions for the success of blended synchronous course delivery mode. For this purpose, we searched the database EditLib and analyzed 16 existing papers from 2001 to 2016. The conditions for success were operationalized in the Master Teacher Program…

  9. Acute and Impaired Wound Healing: Pathophysiology and Current Methods for Drug Delivery, Part 2: Role of Growth Factors in Normal and Pathological Wound Healing: Therapeutic Potential and Methods of Delivery

    Science.gov (United States)

    Demidova-Rice, Tatiana N.; Hamblin, Michael R.; Herman, Ira M.

    2012-01-01

    This is the second of 2 articles that discuss the biology and pathophysiology of wound healing, reviewing the role that growth factors play in this process and describing the current methods for growth factor delivery into the wound bed. PMID:22820962

  10. A General Method for Intracellular Protein Delivery through 'E-tag' Protein Engineering and Arginine Functionalized Gold Nanoparticles.

    Science.gov (United States)

    Mout, Rubul; Rotello, Vincent M

    2017-12-20

    In this protocol, we describe a method for direct cytosolic protein delivery that avoids endosomal entrapment of the delivered proteins. We achieved this by tagging the desired protein with an oligo glutamic acid tag (E-tag), and subsequently using carrier gold nanoparticles to deliver these E-tagged proteins. When E-tagged proteins and nanoparticles were mixed, they formed nanoassemblies, which got fused to cell membrane upon incubation and directly released the E-tagged protein into cell cytosol. We used this method to deliver a wide variety of proteins with different sizes, charges, and functions in various cell lines (Mout et al., 2017). To use this protocol, the first step is to generate the required materials (gold nanoparticles, recombinant E-tagged proteins). Laboratory-synthesis of gold nanoparticles has been previously described (Yang et al., 2011). Desired E-tagged proteins can be cloned from the corresponding genes, and expressed and purified using standard laboratory procedures. We will use E-tagged green fluorescent protein (GFP) as a reference protein here. Users can simply insert an E-tag into their protein of interest, at either terminus. To achieve maximum delivery efficiency, we suggest users testing different length of E-tags. For example, we inserted E = 0 to 20 (E0 means no E-tag insertion, and E20 means 20 glutamic acids insertion in a row) to most of the proteins we tested, and screened for optimal E-tagged length for highest delivery efficiency. E10-tagged proteins gave us the highest delivery efficiency for most of the proteins (except for Cas9, where E20 tag showed highest delivery efficiency). Once these materials are ready, it takes about ~10 min to make the E-tagged protein and nanoparticle nanoassemblies, which are immediately used for delivery. Complete delivery (~100% for GFP-E10) is achieved in less than 3 h.

  11. Statewide program to promote institutional delivery in Gujarat, India: who participates and the degree of financial subsidy provided by the Chiranjeevi Yojana program.

    Science.gov (United States)

    Sidney, Kristi; Iyer, Veena; Vora, Kranti; Mavalankar, Dileep; De Costa, Ayesha

    2016-01-27

    The Chiranjeevi Yojana (CY) is a large public-private partnership program in Gujarat, India, under which the state pays private sector obstetricians to provide childbirth services to poor and tribal women. The CY was initiated statewide in 2007 because of the limited ability of the public health sector to provide emergency obstetric care and high out-of-pocket expenditures in the private sector (where most qualified obstetricians work), creating financial access barriers for poor women. Despite a million beneficiaries, there have been few reports studying CY, particularly the proportion of vulnerable women being covered, the expenditures they incur in connection with childbirth, and the level of subsidy provided to beneficiaries by the program. Cross-sectional facility based the survey of participants in three districts of Gujarat in 2012-2013. Women were interviewed to elicit sociodemographic characteristics, out-of-pocket expenditures, and CY program details. Descriptive statistics, chi square, and a multivariable logistic regression were performed. Of the 901 women surveyed in 129 facilities, 150 (16 %) were CY beneficiaries; 336 and 415 delivered in government and private facilities, respectively. Only 36 (24 %) of the 150 CY beneficiaries received a completely cashless delivery. Median out-of-pocket for vaginal/cesarean delivery among CY beneficiaries was $7/$71. The median degree of subsidy for women in CY who delivered vaginally/cesarean was 85/71 % compared to out-of-pocket expenditure of $44/$208 for vaginal/cesarean delivery paid by non-program beneficiaries in the private health sector. CY beneficiaries experienced a substantially subsidized childbirth compared to women who delivered in non-accredited private facilities. However, despite the government's efforts at increasing access to delivery services for poor women in the private sector, uptake was low and very few women experienced a cashless delivery. While the long-term focus remains on

  12. Comparative evaluation of viral, nonviral and physical methods of gene delivery to normal and transformed lung epithelial cells.

    Science.gov (United States)

    Gilbert, Jennifer L; Purcell, James; Strappe, Padraig; McCabe, Matthew; O'Brien, Timothy; O'Dea, Shirley

    2008-09-01

    Few studies have directly compared the efficiencies of gene delivery methods that target normal lung cells versus lung tumor cells. We report the first study directly comparing the efficiency and toxicity of viral [adeno-associated virus (AAV2, 5, 6) and lentivirus], nonviral (Effectene, SuperFect and Lipofectamine 2000) and physical [particle-mediated gene transfer (PMGT)] methods of gene delivery in normal mouse lung cells and in mouse adenocarcinoma cells. Lentivirus pseudotyped with the vesicular stomatitis virus glycoprotein was the most efficient gene transfer method for normal mouse airway epithelial cells [25.95 (+/-3.57) %] whereas AAV6 was most efficient for MLE-12 adenocarcinoma cells [68.2 (+/-3.2) %]. PMGT was more efficient in normal mouse airway epithelial cells than AAV5, Lipofectamine 2000 and SuperFect. AAV5 displayed the lowest transfection efficiency at less than 10% in both cell types. PMGT was the only method that resulted in significant toxicity. In summary, for all of the gene delivery methods examined here, lung tumor cells were transfected more easily than normal lung cells. Lipofectamine 2000 is potentially highly selective for lung tumor cells whereas AAV6 and lentivirus vesicular stomatitis virus glycoprotein may be useful for gene delivery strategies that require targeting of both normal and tumor cells.

  13. The Usefulness of Appreciative Inquiry As a Method to Identify Mass Sports Program Success

    Directory of Open Access Journals (Sweden)

    Bernadine VAN GRAMBERG

    2010-06-01

    Full Text Available The importance of the relationship between good health and physical activity is well known. Despite the growth of public mass sports programs in many countries, few evaluate them to ensure they meet their targets. Measuring organizational effectiveness and program success in public sports organizations is difficult and cannot be done directly as it involves a number of complex dimensions involving both internal (organizational and external (customer factors. Recognizing this, the paper advances the Appreciative Inquiry approach as a culturally sensitive method to focus on the positives of human experience rather than finding faults or gaps and as a means of identifying the success factors of service delivery. The paper outlines the research strategy to investigate success in Malaysian mass sport programs.

  14. A novel method for sub-arc VMAT dose delivery verification based on portal dosimetry with an EPID.

    Science.gov (United States)

    Cools, Ruud A M; Dirkx, Maarten L P; Heijmen, Ben J M

    2017-11-01

    The EPID-based sub-arc verification of VMAT dose delivery requires synchronization of the acquired electronic portal images (EPIs) with the VMAT delivery, that is, establishment of the start- and stop-MU of the acquired images. To realize this, published synchronization methods propose the use of logging features of the linac or dedicated hardware solutions. In this study, we developed a novel, software-based synchronization method that only uses information inherently available in the acquired images. The EPIs are continuously acquired during pretreatment VMAT delivery and converted into Portal Dose Images (PDIs). Sub-arcs of approximately 10 MU are then defined by combining groups of sequentially acquired PDIs. The start- and stop-MUs of measured sub-arcs are established in a synchronization procedure, using only dosimetric information in measured and predicted PDIs. Sub-arc verification of a VMAT dose delivery is based on comparison of measured sub-arc PDIs with synchronized, predicted sub-arc PDIs, using γ-analyses. To assess the accuracy of this new method, measured and predicted PDIs were compared for 20 clinically applied VMAT prostate cancer plans. The sensitivity of the method for detection of delivery errors was investigated using VMAT deliveries with intentionally inserted, small perturbations (25 error scenarios; leaf gap deviations ≤ 1.5 mm, leaf motion stops during ≤ 15 MU, linac output error ≤ 2%). For the 20 plans, the average failed pixel rates (FPR) for full-arc and sub-arc dose QA were 0.36% ± 0.26% (1 SD) and 0.64% ± 0.88%, based on 2%/2 mm and 3%/3 mm γ-analyses, respectively. Small systematic perturbations of up to 1% output error and 1 mm leaf offset were detected using full-arc QA. Sub-arc QA was able to detect positioning errors in three leaves only during approximately 20 MU and small dose delivery errors during approximately 40 MU. In an ROC analysis, the area under the curve (AUC) for the combined full-arc/sub-arc approach was

  15. TICS: A System For The Authoring and Delivery Of Interactive Instructional Programs.

    Science.gov (United States)

    Kaplow, Roy; And Others

    The Teacher-Interactive Computer System (TICS) is an on-line and interactive programing system for authoring interactive programs, particularly instructional programs. The system provides a fairly natural language, in which the author's statements for creating items in a program, for examining the structure and flow, for simulating its use by…

  16. A convenient method to prepare emulsified polyacrylate nanoparticles from powders [corrected] for drug delivery applications.

    Science.gov (United States)

    Garay-Jimenez, Julio C; Turos, Edward

    2011-08-01

    We describe a method to obtain purified, polyacrylate nanoparticles in a homogeneous powdered form that can be readily reconstituted in aqueous media for in vivo applications. Polyacrylate-based nanoparticles can be easily prepared by emulsion polymerization using a 7:3 mixture of butyl acrylate and styrene in water containing sodium dodecyl sulfate as a surfactant and potassium persulfate as a water-soluble radical initiator. The resulting emulsions contain nanoparticles measuring 40-50 nm in diameter with uniform morphology, and can be purified by centrifugation and dialysis to remove larger coagulants as well as residual surfactant and monomers associated with toxicity. These purified emulsions can be lyophilized in the presence of maltose (a non-toxic cryoprotectant) to provide a homogeneous dried powder, which can be reconstituted as an emulsion by addition of an aqueous diluent. Dynamic light scattering and microbiological experiments were carried out on the reconstituted nanoparticles. This procedure allows for ready preparation of nanoparticle emulsions for drug delivery applications. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. The effectiveness of the PRISMA integrated service delivery network: preliminary report on methods and baseline data

    Directory of Open Access Journals (Sweden)

    Réjean Hébert

    2008-02-01

    Full Text Available Purpose: The PRISMA study analyzes an innovative coordination-type integrated service delivery (ISD system developed to improve continuity and increase the effectiveness and efficiency of services, especially for older and disabled populations. The objective of the PRISMA study is to evaluate the effectiveness of this system to improve health, empowerment and satisfaction of frail older people, modify their health and social services utilization, without increasing the burden of informal caregivers. The objective of this paper is to present the methodology and give baseline data on the study participants. Methods: A quasi-experimental study with pre-test, multiple post-tests, and a comparison group was used to evaluate the impact of PRISMA ISD. Elders at risk of functional decline (501 experimental, 419 control participated in the study. Results: At entry, the two groups were comparable for most variables. Over the first year, when the implementation rate was low (32%, participants from the control group used fewer services than those from the experimental group. After the first year, no significant statistical difference was observed for functional decline and changes in the other outcome variables. Conclusion: This first year must be considered a baseline year, showing the situation without significant implementation of PRISMA ISD systems. Results for the following years will have to be examined with consideration of these baseline results.

  18. Our practice is our passion: development and delivery of a 21st-century doctor of public health program.

    Science.gov (United States)

    DeBate, Rita D; Petersen, Donna J; Wathington, Deanna; Wolfe-Quintero, Kate

    2015-03-01

    Twenty-first century advances have significantly altered the functions of public health professionals, resulting in a need for advanced level training in community health leadership and practice-oriented research without interruption of professional careers. We present an example of an innovative Doctor of Public Health (DrPH) program developed at the University of South Florida College of Public Health. This program incorporates 21st century public health competencies within a competency-based curricular model, delivered in a hybrid format (fall or spring online delivery and a 1-week face-to-face summer institute) in collaboration between academic and practice-based public health professionals at local and national levels. This revised competency-based program is an example of how to meet the needs of the 21st century public health practitioners while maintaining their connections to the practice world.

  19. Effects of Phytophthora cinnamomi isolate, inoculum delivery method, flood, and drought on vigor, disease severity and mortality of blueberry plants

    Science.gov (United States)

    Four studies evaluated the effect of Phytophthora cinnamomi isolates, inoculum delivery methods, and flood and drought conditions on vigor, disease severity scores, and survival of blueberry plants grown in pots in the greenhouse. Phytophthora cinnamomi isolates were obtained from blueberry plants ...

  20. Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan.

    Science.gov (United States)

    Hajizadeh, Shayesteh; Tehrani, Fahimeh Ramezani; Simbar, Masoumeh; Farzadfar, Farshad

    2016-01-01

    The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density. In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline. After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001). The results of this study showed that an increase in the density of midwives

  1. Method to render second order beam optics programs symplectic

    Energy Technology Data Exchange (ETDEWEB)

    Douglas, D.; Servranckx, R.V.

    1984-10-01

    We present evidence that second order matrix-based beam optics programs violate the symplectic condition. A simple method to avoid this difficulty, based on a generating function approach to evaluating transfer maps, is described. A simple example illustrating the non-symplectricity of second order matrix methods, and the effectiveness of our solution to the problem, is provided. We conclude that it is in fact possible to bring second order matrix optics methods to a canonical form. The procedure for doing so has been implemented in the program DIMAT, and could be implemented in programs such as TRANSPORT and TURTLE, making them useful in multiturn applications. 15 refs.

  2. Microencapsulation as a novel delivery method for the potential antidiabetic drug, Probucol

    Directory of Open Access Journals (Sweden)

    Mooranian A

    2014-09-01

    Full Text Available Armin Mooranian,1 Rebecca Negrulj,1 Nigel Chen-Tan,2 Hesham S Al-Sallami,3 Zhongxiang Fang,4 TK Mukkur,5 Momir Mikov,6,7 Svetlana Golocorbin-Kon,6,7 Marc Fakhoury,8 Gerald F Watts,9 Vance Matthews,10 Frank Arfuso,5 Hani Al-Salami1 1Biotechnology and Drug Development Research Laboratory School of Pharmacy, Curtin Health Innovation Research Institute, Biosciences Research Precinct, Curtin University, Perth, Western Australia, Australia; 2Faculty of Science and Engineering, Curtin University, Perth, Western Australia, Australia; 3School of Pharmacy, University of Otago, Dunedin, New Zealand; 4School of Public Health, Curtin University, Perth, Western Australia, Australia; 5Curtin Health Innovation Research Institute, Biosciences Research Precinct, School of Biomedical Science, Curtin University, Perth, Western Australia, Australia; 6Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Serbia; 7Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Serbia; 8Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; 9School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia; 10Laboratory for Metabolic Dysfunction, UWA Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia Introduction: In previous studies, we successfully designed complex multicompartmental microcapsules as a platform for the oral targeted delivery of lipophilic drugs in type 2 diabetes (T2D. Probucol (PB is an antihyperlipidemic and antioxidant drug with the potential to show benefits in T2D. We aimed to create a novel microencapsulated formulation of PB and to examine the shape, size, and chemical, thermal, and rheological properties of these microcapsules in vitro. Method: Microencapsulation was carried out using the Büchi-based microencapsulating system developed in our laboratory. Using the polymer, sodium

  3. Unipolar versus bipolar radiofrequency treatment of rhytides and laxity using a mobile painless delivery method.

    Science.gov (United States)

    Alexiades-Armenakas, Macrene; Dover, Jeffrey S; Arndt, Kenneth A

    2008-09-01

    Previous studies have shown that radiofrequency (RF) energy is a safe and effective treatment for rhytide-reduction. This randomized, blinded, split-face study assesses the safety and efficacy of the unipolar versus bipolar handpieces on an RF device with a mobile delivery method for the treatment of rhytides and laxity using quantitative grading. In this randomized, blinded, split-face design study, 10 subjects (aged 18-75 years) with a clinically observable excess of rhytides and laxity (minimum grade 2 out of 4) on the face received four treatments at 1-week intervals with random assignment of unipolar RF to one side and bipolar RF to the contralateral side. Each side received approximately four passes per treatment delivered in a mobile continuous manner. Results were evaluated by two blinded investigators of photographs employing a comprehensive 4-point grading scale at baseline, and 1- and 3-month follow-up visits after the final treatment. All subjects completed and responded to treatment. The blinded evaluations demonstrated the following mean percent improvements in grading scores of rhytides and laxity: for the unipolar side 6.0+/-4.6% and 4.6+/-4.8% versus the bipolar side 4.4+/-2.5 and 7.3+/-3.5%. The degree of improvement approached but did not achieve statistical significance for either handpiece, but demonstrated a trend toward improvement (P = 0.5599 unipolar vs. 0.1108 bipolar). The treatment was painless (rated 0 out of 10 by all subjects) and side effects included minimal erythema which resolved within 1-3 hours. No crusting, dyspigmentation or scarring was observed. This randomized, split-face study with blinded evaluations employing a quantitative grading scale demonstrated that minimal pass, mobile energy delivery serial treatments with either the unipolar or bipolar handpieces of a novel RF device appears to safe and painless. Each handpiece demonstrated minimal clinical efficacy which was not statistically significant, but with a trend

  4. Systems and methods for interpolation-based dynamic programming

    KAUST Repository

    Rockwood, Alyn

    2013-01-03

    Embodiments of systems and methods for interpolation-based dynamic programming. In one embodiment, the method includes receiving an object function and a set of constraints associated with the objective function. The method may also include identifying a solution on the objective function corresponding to intersections of the constraints. Additionally, the method may include generating an interpolated surface that is in constant contact with the solution. The method may also include generating a vector field in response to the interpolated surface.

  5. An overview of solution methods for multi-objective mixed integer linear programming programs

    DEFF Research Database (Denmark)

    Andersen, Kim Allan; Stidsen, Thomas Riis

    Multiple objective mixed integer linear programming (MOMIP) problems are notoriously hard to solve to optimality, i.e. finding the complete set of non-dominated solutions. We will give an overview of existing methods. Among those are interactive methods, the two phases method and enumeration...... methods. In particular we will discuss the existing branch and bound approaches for solving multiple objective integer programming problems. Despite the fact that branch and bound methods has been applied successfully to integer programming problems with one criterion only a few attempts has been made...

  6. Primal-Dual Method of Solving Convex Quadratic Programming Problems

    Directory of Open Access Journals (Sweden)

    V. Moraru

    2000-10-01

    Full Text Available This paper presents a primal-dual method for solving quadratic programming problems. The method is based on finding an exact solution of a finite sequence of unconstrained quadratic prigraamming problems and on finding an aproximative solution of constrained minimization problem with simple constraints. The subproblem with simple constraints is solved by the interior-reflective Newton's method [6].

  7. Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek

    2017-07-01

    The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level.

  8. Does involvement of local NGOs enhance public service delivery? Cautionary evidence from a malaria-prevention program in India.

    Science.gov (United States)

    Das, Ashis; Friedman, Jed; Kandpal, Eeshani

    2018-01-01

    Partnerships between government and non-state actors that aim to enhance the quality or efficiency of service delivery are increasingly common in today's development policy landscape. We investigate the impacts of such an approach using data from an experimental supportive intervention to India's malaria control program that leveraged local non-state capacity in order to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by 3 NGOs, contracted out by the Indian government, in 2 endemic districts in the state of Odisha. We find that program impact significantly varied by location. Examining 3 potential sources of this variation (differential population characteristics, differential health worker characteristics, and differential implementer characteristics), we provide evidence that both population and NGO characteristics significantly affected the success of the program. Specifically, the results suggest that the quality and effort of the local implementer played a key role in the differential effectiveness. We discuss these findings as they relate to the external validity of development policy evaluations and, specifically, for the ability of health and other service delivery systems to benefit from limited non-state capacity in underresourced areas. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Conceptual evaluation of population health surveillance programs: method and example.

    Science.gov (United States)

    El Allaki, Farouk; Bigras-Poulin, Michel; Ravel, André

    2013-03-01

    Veterinary and public health surveillance programs can be evaluated to assess and improve the planning, implementation and effectiveness of these programs. Guidelines, protocols and methods have been developed for such evaluation. In general, they focus on a limited set of attributes (e.g., sensitivity and simplicity), that are assessed quantitatively whenever possible, otherwise qualitatively. Despite efforts at standardization, replication by different evaluators is difficult, making evaluation outcomes open to interpretation. This ultimately limits the usefulness of surveillance evaluations. At the same time, the growing demand to prove freedom from disease or pathogen, and the Sanitary and Phytosanitary Agreement and the International Health Regulations require stronger surveillance programs. We developed a method for evaluating veterinary and public health surveillance programs that is detailed, structured, transparent and based on surveillance concepts that are part of all types of surveillance programs. The proposed conceptual evaluation method comprises four steps: (1) text analysis, (2) extraction of the surveillance conceptual model, (3) comparison of the extracted surveillance conceptual model to a theoretical standard, and (4) validation interview with a surveillance program designer. This conceptual evaluation method was applied in 2005 to C-EnterNet, a new Canadian zoonotic disease surveillance program that encompasses laboratory based surveillance of enteric diseases in humans and active surveillance of the pathogens in food, water, and livestock. The theoretical standard used for evaluating C-EnterNet was a relevant existing structure called the "Population Health Surveillance Theory". Five out of 152 surveillance concepts were absent in the design of C-EnterNet. However, all of the surveillance concept relationships found in C-EnterNet were valid. The proposed method can be used to improve the design and documentation of surveillance programs. It

  10. How do the characteristics of breast cancer diagnostic assessment programmes influence service delivery: A mixed methods study.

    Science.gov (United States)

    Gagliardi, A R; Honein-AbouHaidar, G; Stuart-McEwan, T; Smylie, J; Arnaout, A; Seely, J; Wright, F C; Dobrow, M J; Brouwers, M C; Bukhanov, K; McCready, D R

    2017-06-21

    Diagnostic assessment programmes (DAPs) coordinate multidisciplinary teamwork (MDT), and improve wait times and patient satisfaction. No research has established optimal DAP design. This study explored how DAP characteristics influence service delivery. A mixed methods case study of four breast cancer DAPs was conducted including qualitative interviews with health-care providers and retrospective chart review. Data were integrated using multiple approaches. Twenty-three providers were interviewed; 411 medical records were reviewed. The number of visits and wait times from referral to diagnosis and consultation were lowest at a one-stop model. DAP characteristics (rural-remote region, human resources, referral volume, organisation of services, adherence to service delivery targets and one-stop model) may influence service delivery (number of visits, wait times). MDT, influenced by other DAP characteristics (co-location of staff, patient navigators, team functioning), may also influence service delivery. While the one-stop model may be ideal, all sites experienced similar and unique challenges. Further research is needed to understand how to optimise the organisation and delivery of DAP services. Measures reflecting individual, team and patient-reported outcomes should be used to assess the effectiveness and impact of DAPs in addition to more traditional measures such as wait times. © 2017 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  11. Application of the simplex method of linear programming model to ...

    African Journals Online (AJOL)

    This work discussed how the simplex method of linear programming could be used to maximize the profit of any business firm using Saclux Paint Company as a case study. It equally elucidated the effect variation in the optimal result obtained from linear programming model, will have on any given firm. It was demonstrated ...

  12. Data Collection Methods for Evaluating Museum Programs and Exhibitions

    Science.gov (United States)

    Nelson, Amy Crack; Cohn, Sarah

    2015-01-01

    Museums often evaluate various aspects of their audiences' experiences, be it what they learn from a program or how they react to an exhibition. Each museum program or exhibition has its own set of goals, which can drive what an evaluator studies and how an evaluation evolves. When designing an evaluation, data collection methods are purposefully…

  13. A review of analytical methods for the identification and characterization of nano delivery systems in food.

    Science.gov (United States)

    Luykx, Dion M A M; Peters, Ruud J B; van Ruth, Saskia M; Bouwmeester, Hans

    2008-09-24

    Detection and characterization of nano delivery systems is an essential part of understanding the benefits as well as the potential toxicity of these systems in food. This review gives a detailed description of food nano delivery systems based on lipids, proteins, and/or polysaccharides and investigates the current analytical techniques that can be used for the identification and characterization of these delivery systems in food products. The analytical approaches have been subdivided into three groups; separation techniques, imaging techniques, and characterization techniques. The principles of the techniques together with their advantages and drawbacks, and reported applications concerning nano delivery systems, or otherwise related compounds are discussed. The review shows that for a sufficient characterization, the nano delivery systems need to be separated from the food matrix, for which high-performance liquid chromatography or field flow fractionation are the most promising techniques. Subsequently, online photon correlation spectroscopy and mass spectrometry seem to be a convenient combination of techniques to characterize a wide variety of nano delivery systems.

  14. From Entry to Practice to Advanced Nurse Practitioner - The Progression of Competencies and How They Assist in Delivery of eHealth Programs for Healthy Ageing.

    Science.gov (United States)

    Rodger, Daragh; Hussey, Pamela

    2017-01-01

    Most of the health issues encountered in persons of older age are the result of one or more chronic diseases. The evidence base reports that chronic diseases can be prevented or delayed by engaging in healthy behaviors. Education provides a cost effective intervention on both economic grounds in addition to delivery of optimal patient outcomes. Information and Communication Technology (ICT) increasingly is viewed as a critical utility in eHealth delivery, providing scope for expanding online education facilities for older persons. Developing nursing competencies in the delivery of eHealth solutions to deliver user education programs therefore makes sense. This chapter discusses nursing competencies on the development of targeted eHealth programs for healthy ageing. The role of Advanced Nurse Practitioner in Ireland and its associated competency set identifies how a strong action learning model can be designed to deliver eHealth educational programs for effective delivery of healthy ageing in place.

  15. Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis.

    Directory of Open Access Journals (Sweden)

    Michael Burnim

    2017-10-01

    Full Text Available The mainstay of current schistosomiasis control programs is mass preventive chemotherapy of school-aged children with praziquantel. This treatment is delivered through school-based, community-based, or combined school- and community-based systems. Attaining very high coverage rates for children is essential in mass schistosomiasis treatment programs, as is ensuring that there are no persistently untreated subpopulations, a potential challenge for school-based programs in areas with low school enrollment. This review sought to compare the different treatment delivery methods based both on their coverage of school-aged children overall and on their coverage specifically of non-enrolled children. In addition, qualitative community or programmatic factors associated with high or low coverage rates were identified, with suggestions for overall coverage improvement.This review was registered prospectively with PROSPERO (CRD 42015017656. Five hundred forty-nine publication of potential relevance were identified through database searches, reference lists, and personal communications. Eligible studies included those published before October 2015, written in English or French, containing quantitative or qualitative data about coverage rates for MDA of school-aged children with praziquantel. Among the 22 selected studies, combined community- and school-based programs achieved the highest median coverage rates (89%, followed by community-based programs (72%. School-based programs had both the lowest median coverage of children overall (49% and the lowest coverage of the non-enrolled subpopulation of children. Qualitatively, major factors affecting program success included fear of side effects, inadequate education about schistosomiasis, lack of incentives for drug distributors, and inequitable distribution to minority groups.This review provides an evidence-based framework for the development of future schistosomiasis control programs. Based on our results

  16. Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis.

    Science.gov (United States)

    Burnim, Michael; Ivy, Julianne A; King, Charles H

    2017-10-01

    The mainstay of current schistosomiasis control programs is mass preventive chemotherapy of school-aged children with praziquantel. This treatment is delivered through school-based, community-based, or combined school- and community-based systems. Attaining very high coverage rates for children is essential in mass schistosomiasis treatment programs, as is ensuring that there are no persistently untreated subpopulations, a potential challenge for school-based programs in areas with low school enrollment. This review sought to compare the different treatment delivery methods based both on their coverage of school-aged children overall and on their coverage specifically of non-enrolled children. In addition, qualitative community or programmatic factors associated with high or low coverage rates were identified, with suggestions for overall coverage improvement. This review was registered prospectively with PROSPERO (CRD 42015017656). Five hundred forty-nine publication of potential relevance were identified through database searches, reference lists, and personal communications. Eligible studies included those published before October 2015, written in English or French, containing quantitative or qualitative data about coverage rates for MDA of school-aged children with praziquantel. Among the 22 selected studies, combined community- and school-based programs achieved the highest median coverage rates (89%), followed by community-based programs (72%). School-based programs had both the lowest median coverage of children overall (49%) and the lowest coverage of the non-enrolled subpopulation of children. Qualitatively, major factors affecting program success included fear of side effects, inadequate education about schistosomiasis, lack of incentives for drug distributors, and inequitable distribution to minority groups. This review provides an evidence-based framework for the development of future schistosomiasis control programs. Based on our results, a combined

  17. R&D program benefits estimation: DOE Office of Electricity Delivery and Energy Reliability

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2006-12-04

    The overall mission of the U.S. Department of Energy’s Office of Electricity Delivery and Energy Reliability (OE) is to lead national efforts to modernize the electric grid, enhance the security and reliability of the energy infrastructure, and facilitate recovery from disruptions to the energy supply. In support of this mission, OE conducts a portfolio of research and development (R&D) activities to advance technologies to enhance electric power delivery. Multiple benefits are anticipated to result from the deployment of these technologies, including higher quality and more reliable power, energy savings, and lower cost electricity. In addition, OE engages State and local government decision-makers and the private sector to address issues related to the reliability and security of the grid, including responding to national emergencies that affect energy delivery. The OE R&D activities are comprised of four R&D lines: High Temperature Superconductivity (HTS), Visualization and Controls (V&C), Energy Storage and Power Electronics (ES&PE), and Distributed Systems Integration (DSI).

  18. Delivery of a urology online course using Moodle versus didactic lectures methods.

    Science.gov (United States)

    Reis, Leonardo Oliveira; Ikari, Osamu; Taha-Neto, Khaled A; Gugliotta, Antonio; Denardi, Fernandes

    2015-02-01

    To subjectively and objectively compare an accessible interactive electronic library using Moodle with lectures for urology teaching of medical students. Forty consecutive fourth-year medical students and one urology teacher were exposed to two teaching methods (4 weeks each) in the form of problem-based learning: - lectures and - student-centered group discussion based on Moodle (modular object-oriented dynamic learning environment) full time online delivered (24/7) with video surgeries, electronic urology cases and additional basic principles of the disease process. All 40 students completed the study. While 30% were moderately dissatisfied with their current knowledge base, online learning course delivery using Moodle was considered superior to the lectures by 86% of the students. The study found the following observations: (1) the increment in learning grades ranged from 7.0 to 9.7 for students in the online Moodle course compared to 4.0-9.6 to didactic lectures; (2) the self-reported student involvement in the online course was characterized as large by over 60%; (3) the teacher-student interaction was described as very frequent (50%) and moderately frequent (50%); and (4) more inquiries and requisitions by students as well as peer assisting were observed from the students using the Moodle platform. The Moodle platform is feasible and effective, enthusing medical students to learn, improving immersion in the urology clinical rotation and encouraging the spontaneous peer assisted learning. Future studies should expand objective evaluations of knowledge acquisition and retention. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Refinement of the Diatom Episome Maintenance Sequence and Improvement of Conjugation-based DNA Delivery Methods

    Directory of Open Access Journals (Sweden)

    Rachel E Diner

    2016-08-01

    Full Text Available Conjugation of episomal plasmids from bacteria to diatoms advances diatom genetic manipulation by simplifying transgene delivery and providing a stable and consistent gene expression platform. To reach its full potential, this nascent technology requires new optimized expression vectors and a deeper understanding of episome maintenance. Here we present the development of an additional diatom vector (pPtPBR1, based on the parent plasmid pBR322, to add a plasmid maintained at medium copy number in E. coli to the diatom genetic toolkit. Using this new vector, we evaluated the contribution of individual yeast DNA elements comprising the 1.4-kb tripartite CEN6-ARSH4-HIS3 sequence that enables episome maintenance in P. tricornutum. While various combinations of these individual elements enable efficient conjugation and high ex-conjugant yield in P. tricornutum, individual elements alone do not. Conjugation of episomes containing CEN6-ARSH4 and a small sequence from the low GC content 3’ end of HIS3 produced the highest number of diatom ex-conjugant colonies, resulting in a smaller and more efficient vector design. Our findings suggest that the CEN6 and ARSH4 sequences function differently in yeast and diatoms, and that low GC content regions of greater than ~500 bp are a potential indicator of a functional diatom episome maintenance sequence. Additionally, we have developed improvements to the conjugation protocol including a higher-throughput option utilizing 12-well plates, and plating methods that improve ex-conjugant yield and reduce time and materials required for the conjugation protocol. The data presented offer additional information regarding the mechanism by which the yeast-derived sequence enables diatom episome maintenance, and demonstrate options for flexible vector design.

  20. A Novel Delivery Method of Cyclovirobuxine D for Brain-Targeting: Chitosan Coated Nanoparticles Loading Cyclovirobuxine D by Intranasal Administration.

    Science.gov (United States)

    Wei, Hanmei; Lai, Sisi; Wei, Jiabao; Yang, Lei; Jiang, Ning; Wang, Qing; Yu, Yang

    2018-08-01

    The blood-brain barrier (BBB) restricts the delivery of most drugs to the brain. In our previous study, the feasibility of cyclovirobuxine D delivery to the brain by a non-invasive nasal route was evaluated. In this study, a suitable drug delivery system by way of intranasal administration was developed, which could improve brain targeting. First, a formulation of cyclovirobuxine D (CVB-D) based on chitosan nanoparticles (CS-CVB-D-NPs) was prepared by the modified ionotropic gelation method through single-factor screening experiment. The CS-CVB-D-NPs with a entrapment efficiency (EE) of (62.82±2.59)% were found to be of a narrow polydispersity index (PI) (0.19±0.01) and (235.37± 12.71) nm in size, with a zeta potential of (33.9 ± 1.7) mV. The NPs possessed a sustained release characterization with in vitro release of 88.03 ± 2.30% at 24 h. In vivo, the higher AUC0-t(brain) of CS-CVB-D-NPs by intranasal administration revealed the development of a novel brain-targeting delivery method of CVB-D.

  1. Application of Fused Deposition Modelling (FDM) Method of 3D Printing in Drug Delivery.

    Science.gov (United States)

    Long, Jingjunjiao; Gholizadeh, Hamideh; Lu, Jun; Bunt, Craig; Seyfoddin, Ali

    2017-01-01

    Three-dimensional (3D) printing is an emerging manufacturing technology for biomedical and pharmaceutical applications. Fused deposition modelling (FDM) is a low cost extrusion-based 3D printing technique that can deposit materials layer-by-layer to create solid geometries. This review article aims to provide an overview of FDM based 3D printing application in developing new drug delivery systems. The principle methodology, suitable polymers and important parameters in FDM technology and its applications in fabrication of personalised tablets and drug delivery devices are discussed in this review. FDM based 3D printing is a novel and versatile manufacturing technique for creating customised drug delivery devices that contain accurate dose of medicine( s) and provide controlled drug released profiles. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Active enhancement methods for intra- and transdermal drug delivery: a review

    Directory of Open Access Journals (Sweden)

    Barbara Zorec

    2013-05-01

    Full Text Available Transdermal route has some advantages over other drug administration routes. These include avoidance of first pass effect (hepatic metabolism, better pharmacokinetic profile, reduction of side effects and good patient compliance. The greatest obstacle for the drugs to be delivered through the skin is overcoming the impermeable outermost layer of the skin – the stratum corneum. Quite a few enhancement techniques can be used to overcome the stratum corneum barrier and facilitate transdermal drug delivery. These include various passive (penetration enhancers, liposomes and active approaches (electroporation, iontophoresis, microneedles, which are of prime interest for transdermal drug delivery research area.

  3. Pyrochemical and Dry Processing Methods Program. A selected bibliography

    Energy Technology Data Exchange (ETDEWEB)

    McDuffie, H.F.; Smith, D.H.; Owen, P.T.

    1979-03-01

    This selected bibliography with abstracts was compiled to provide information support to the Pyrochemical and Dry Processing Methods (PDPM) Program sponsored by DOE and administered by the Argonne National Laboratory. Objectives of the PDPM Program are to evaluate nonaqueous methods of reprocessing spent fuel as a route to the development of proliferation-resistant and diversion-resistant methods for widespread use in the nuclear industry. Emphasis was placed on the literature indexed in the ERDA--DOE Energy Data Base (EDB). The bibliography includes indexes to authors, subject descriptors, EDB subject categories, and titles.

  4. Numerical methods of mathematical optimization with Algol and Fortran programs

    CERN Document Server

    Künzi, Hans P; Zehnder, C A; Rheinboldt, Werner

    1971-01-01

    Numerical Methods of Mathematical Optimization: With ALGOL and FORTRAN Programs reviews the theory and the practical application of the numerical methods of mathematical optimization. An ALGOL and a FORTRAN program was developed for each one of the algorithms described in the theoretical section. This should result in easy access to the application of the different optimization methods.Comprised of four chapters, this volume begins with a discussion on the theory of linear and nonlinear optimization, with the main stress on an easily understood, mathematically precise presentation. In addition

  5. Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study

    Science.gov (United States)

    Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

    2016-01-01

    Background American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. Objective We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet’s potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. Methods This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths’ perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using

  6. Using Blended Learning as an Innovative Delivery Model for an In-House Language Program

    Science.gov (United States)

    Gadbois, Manon; Quildon, Denise

    2013-01-01

    This paper reports on the development and implementation in 2012 of McGill University's French at Work program for McGill employees, using a blended learning model. The program is an example of how a reduction in face-to-face teaching presents one solution to employees' scheduling constraints and how this model might offer suggestions for the…

  7. Should Your College Start a Center for the Delivery of Contract Training Programs? ERIC Digest.

    Science.gov (United States)

    Deegan, William L.

    Community colleges have been at the forefront in providing contract training programs for clients such as businesses, health care organizations, and government agencies. Many state governments are beginning to provide resources for these programs as an incentive to attract or retain business and industry. One of the consequences of the demand for…

  8. An efficient linear programming method for Optimal Transportation

    OpenAIRE

    Oberman, Adam M.; Ruan, Yuanlong

    2015-01-01

    An efficient method for computing solutions to the Optimal Transportation (OT) problem with a wide class of cost functions is presented. The standard linear programming (LP) discretization of the continuous problem becomes intractible for moderate grid sizes. A grid refinement method results in a linear cost algorithm. Weak convergence of solutions is stablished. Barycentric projection of transference plans is used to improve the accuracy of solutions. The method is applied to more general pr...

  9. Potential Cost-Effectiveness of an Influenza Vaccination Program Offering Microneedle Patch for Vaccine Delivery in Children.

    Science.gov (United States)

    Wong, Carlos; Jiang, Minghuan; You, Joyce H S

    2016-01-01

    The influenza vaccine coverage rate of children is low in Hong Kong. Microneedle patches (MNPs) is a technology under development for painless delivery of vaccines. This study aimed to examine the potential clinical outcomes and direct medical costs of an influenza program offering MNP vaccine to children who have declined intramuscular (IM) vaccine in Hong Kong. A decision model was designed to compare potential outcomes between IM vaccine program and a program offering MNP vaccine to those declined IM vaccine (IM/MNP program) in a hypothetical cohort of children over one-year time horizon. The model outcomes included direct medical cost, influenza infection rate, mortality rate, and quality-adjusted life-years (QALYs) loss. Model inputs were retrieved from published literature. Sensitivity analyses were performed to examine the robustness of model results. In base-case analysis, IM/MNP program was more costly per child (USD19.13 versus USD13.69; USD1 = HKD7.8) with lower influenza infection rate (98.9 versus 124.8 per 1,000 children), hospitalization rate (0.83 versus 1.05 per 1,000 children) and influenza-related mortality rate (0.00042 versus 0.00052 per 1,000 children) when compared to IM program. The incremental cost per QALY saved (ICER) of IM/MNP program versus IM program was 27,200 USD/QALY. Using gross domestic product (GDP) per capita of Hong Kong (USD40,594) as threshold of willingness-to-pay (WTP) per QALY, one-way sensitivity analysis found ICER of IM/MNP to exceed WTP when duration of illness in outpatient setting was 1.39-time of IM vaccine cost. In 10,000 Monte Carlo simulations, IM/MNP program was the preferred option in 57.28% and 91.68% of the time, using 1x and 3x GDP per capita as WTP threshold, respectively. Acceptance of IM/MNP program as the preferred program was subject to the WTP threshold, duration of illness in outpatient settings, and cost of MNP vaccine.

  10. Potential Cost-Effectiveness of an Influenza Vaccination Program Offering Microneedle Patch for Vaccine Delivery in Children.

    Directory of Open Access Journals (Sweden)

    Carlos Wong

    Full Text Available The influenza vaccine coverage rate of children is low in Hong Kong. Microneedle patches (MNPs is a technology under development for painless delivery of vaccines. This study aimed to examine the potential clinical outcomes and direct medical costs of an influenza program offering MNP vaccine to children who have declined intramuscular (IM vaccine in Hong Kong.A decision model was designed to compare potential outcomes between IM vaccine program and a program offering MNP vaccine to those declined IM vaccine (IM/MNP program in a hypothetical cohort of children over one-year time horizon. The model outcomes included direct medical cost, influenza infection rate, mortality rate, and quality-adjusted life-years (QALYs loss. Model inputs were retrieved from published literature. Sensitivity analyses were performed to examine the robustness of model results.In base-case analysis, IM/MNP program was more costly per child (USD19.13 versus USD13.69; USD1 = HKD7.8 with lower influenza infection rate (98.9 versus 124.8 per 1,000 children, hospitalization rate (0.83 versus 1.05 per 1,000 children and influenza-related mortality rate (0.00042 versus 0.00052 per 1,000 children when compared to IM program. The incremental cost per QALY saved (ICER of IM/MNP program versus IM program was 27,200 USD/QALY. Using gross domestic product (GDP per capita of Hong Kong (USD40,594 as threshold of willingness-to-pay (WTP per QALY, one-way sensitivity analysis found ICER of IM/MNP to exceed WTP when duration of illness in outpatient setting was 1.39-time of IM vaccine cost. In 10,000 Monte Carlo simulations, IM/MNP program was the preferred option in 57.28% and 91.68% of the time, using 1x and 3x GDP per capita as WTP threshold, respectively.Acceptance of IM/MNP program as the preferred program was subject to the WTP threshold, duration of illness in outpatient settings, and cost of MNP vaccine.

  11. Telemedicine delivery of patient education in remote Ontario communities: feasibility of an Advanced Clinician Practitioner in Arthritis Care (ACPAC-led inflammatory arthritis education program

    Directory of Open Access Journals (Sweden)

    Warmington K

    2017-02-01

    Full Text Available Kelly Warmington,1 Carol Flewelling,2 Carol A Kennedy,3,4 Rachel Shupak,5 Angelo Papachristos,5 Caroline Jones,5 Denise Linton,3 Dorcas E Beaton,3,4,6–8 Sydney Lineker9 1Learning Institute, The Hospital for Sick Children, 2Telemedicine Program, 3Musculoskeletal Health & Outcomes Research, St. Michael’s Hospital, 4Institute for Work & Health, 5Martin Family Centre for Arthritis Care & Research, St. Michael’s Hospital, 6Graduate Department of Health Policy, Management and Evaluation, 7Graduate Department of Rehabilitation Science, 8Department of Occupational Science and Occupational Therapy, University of Toronto, 9The Arthritis Society (Ontario Division, Toronto, ON, Canada Objective: Telemedicine-based approaches to health care service delivery improve access to care. It was recognized that adults with inflammatory arthritis (IA living in remote areas had limited access to patient education and could benefit from the 1-day Prescription for Education (RxEd program. The program was delivered by extended role practitioners with advanced training in arthritis care. Normally offered at one urban center, RxEd was adapted for videoconference delivery through two educator development workshops that addressed telemedicine and adult education best practices. This study explores the feasibility of and participant satisfaction with telemedicine delivery of the RxEd program in remote communities.Materials and methods: Participants included adults with IA attending the RxEd program at one of six rural sites. They completed post-course program evaluations and follow-up interviews. Educators provided post-course feedback to identify program improvements that were later implemented.Results: In total, 123 people (36 in-person and 87 remote, across 6 sites participated, attending one of three RxEd sessions. Remote participants were satisfied with the quality of the videoconference (% agree/strongly agree: could hear the presenter (92.9% and discussion

  12. Laser beam uniformity and stability using homogenizer-based fiber optic launch method: square core fiber delivery

    Science.gov (United States)

    Lizotte, Todd E.

    2011-03-01

    Over the years, technological achievements within the laser medical diagnostic, treatment, and therapy markets have led to ever increasing requirements for greater control of critical laser beam parameters. Increased laser power/energy stabilization, temporal and spatial beam shaping and flexible laser beam delivery systems with ergonomic focusing or imaging lens systems are sought by leading medical laser system producers. With medical procedures that utilize laser energy, there is a constant emphasis on reducing adverse effects that come about by the laser itself or its optical system, but even when these variables are well controlled the medical professional will still need to deal with the multivariate nature of the human body. Focusing on the variables that can be controlled, such as accurate placement of the laser beam where it will expose a surface being treated as well as laser beam shape and uniformity is critical to minimizing adverse conditions. This paper covers the use of fiber optic beam delivery as a means of defining the beam shape (intensity/power distribution uniformity) at the target plane as well as the use of fiber delivery as a means to allow more flexible articulation of the laser beam over the surface being treated. The paper will present a new concept of using a square core fiber beam delivery design utilizing a unique micro lens array (MLA) launch method that improves the overall stability of the system, by minimizing the impact of the laser instability. The resulting performance of the prototype is presented to demonstrate its stability in comparison to simple lens launch techniques, with an emphasis on homogenization and articulated fiber delivery.

  13. A Process Evaluation of the Friendships and Dating Program for Adults with Developmental Disabilities: Measuring the Fidelity of Program Delivery

    Science.gov (United States)

    Ward, Karen M.; Windsor, Richard; Atkinson, Julie P.

    2012-01-01

    Adults with intellectual and developmental disabilities are frequently abused in dating and partnered relationships. The Friendships and Dating Program (FDP) was developed to prevent violence in dating and partnered relationships and to teach social skills needed to develop healthy, meaningful relationships among this population. A pilot study…

  14. Evaluating a physician leadership development program - a mixed methods approach.

    Science.gov (United States)

    Throgmorton, Cheryl; Mitchell, Trey; Morley, Tom; Snyder, Marijo

    2016-05-16

    Purpose - With the extent of change in healthcare today, organizations need strong physician leaders. To compensate for the lack of physician leadership education, many organizations are sending physicians to external leadership programs or developing in-house leadership programs targeted specifically to physicians. The purpose of this paper is to outline the evaluation strategy and outcomes of the inaugural year of a Physician Leadership Academy (PLA) developed and implemented at a Michigan-based regional healthcare system. Design/methodology/approach - The authors applied the theoretical framework of Kirkpatrick's four levels of evaluation and used surveys, observations, activity tracking, and interviews to evaluate the program outcomes. The authors applied grounded theory techniques to the interview data. Findings - The program met targeted outcomes across all four levels of evaluation. Interview themes focused on the significance of increasing self-awareness, building relationships, applying new skills, and building confidence. Research limitations/implications - While only one example, this study illustrates the importance of developing the evaluation strategy as part of the program design. Qualitative research methods, often lacking from learning evaluation design, uncover rich themes of impact. The study supports how a PLA program can enhance physician learning, engagement, and relationship building throughout and after the program. Physician leaders' partnership with organization development and learning professionals yield results with impact to individuals, groups, and the organization. Originality/value - Few studies provide an in-depth review of evaluation methods and outcomes of physician leadership development programs. Healthcare organizations seeking to develop similar in-house programs may benefit applying the evaluation strategy outlined in this study.

  15. Solution Method of Multi-Product Two-Stage Logistics Problem with Constraints of Delivery Course

    Science.gov (United States)

    Ataka, Shinichiro; Gen, Mitsuo

    The logistics network design is one of the important phase of Supply Chain Management (SCM) and it is the problem that should be optimized for long-term promotion of efficiency of the whole supply chain. Usually a plant produces different type of products. Even if it is a factory of the same company, delivery is different by a kind of a produced product. The restrictions which this model has are deeply concerned with TP in the real world. In this paper, we consider the logistics network design problems with multi-products and constraints for delivery course. To solve the problem, we used a hybrid priority-based Genetic Algorithm (h-priGA), and we tried the comparison experiment with priority-based Genetic Algorithm (priGA)and h-priGA, we show it about the effectiveness of h-priGA.

  16. The effect of pelvic floor muscle exercises program on sexual self-efficacy in primiparous women after delivery.

    Science.gov (United States)

    Golmakani, Nahid; Zare, Zahra; Khadem, Nayereh; Shareh, Hossein; Shakeri, Mohammad Taghi

    2015-01-01

    Selection and acceptance of appropriate sexual behavior and sexual function are made difficult by low sexual self-efficacy in the postpartum period. The general purpose of this research is to define the effects of an 8-week pelvic floor muscle exercise program on sexual self-efficacy in primiparous women after childbirth. This clinical trial was performed on 79 primiparous women who referred to health care centers, Mashhad, Iran in 2013, 8 weeks after delivery, to receive health care services. They were selected by easy sampling. The samples were randomly assigned to either intervention or control group. The intervention group was trained in Kegel exercises for 8 weeks. Both groups were evaluated at 4 and 8 weeks. Data collection tools included: Demographic information, sexual self-efficacy, and Brink scale. Data were analyzed using repeated measures, Friedman test, t-test, and Mann-Whitney test. The results showed significant increase in pelvic floor muscle strength in the intervention group at 4 and 8 weeks after exercises (P exercises (P = 0.001). The findings showed that 8-week pelvic muscle exercises increase the sexual self-efficacy in women after delivery.

  17. Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health-promoting programs.

    Science.gov (United States)

    Barnett, Leda; Kendall, Elizabeth

    2011-04-01

    This study investigated the application of an educational health promotion program, the Stanford Chronic Disease Self-Management Program (CDSM), within three Queensland Aboriginal (Murri) communities (rural, regional and urban). A participant-observation approach was used and qualitative data was collected through interviews and focus groups. A total of 39 people participated, al of whom had been exposed to the program in different ways (i.e. leaders, health professionals, Elders who sponsored the program) during its recent deployment in their communities. Across all three regions, Aboriginal engagement in the program was found to be influenced by core factors that are well known and reflect our general understanding about Aboriginal history (e.g. the impact of negative medica interactions, the lack of cultural competence, the use of culturally insensitive methods of service delivery, the collectivity of Murri life and the holistic concept of health). However, a more important finding was that irrespective of these broad factors, the acceptability of the program in each community depended on the extent to which it had embraced and espoused several localised processes. The impact and nature of these processes differed across each region. Four local processes reflected the unique characteristics and profile of each community.They included the need to be responsive to local systems and structures, to incorporate local cultural traditions and knowledge bases, to use locally accepted forms of cultural communication, and to facilitate oca community participation and leadership in the program. Importantly, these factors determined the experience of the program within each community, ultimately influencing its acceptability, effectiveness and sustainability.

  18. Contraceptive method-mix and family planning program in Vietnam.

    Science.gov (United States)

    Hardjanti, K

    1995-01-01

    delivery system to provide a wide range of methods, and developing specific service delivery systems for specific methods are optional strategies to expand method choice in Vietnam.

  19. Methods of psychoeducational program evaluation in mental health settings.

    Science.gov (United States)

    Walsh, J

    1992-04-01

    Psychoeducational programs for families of the mentally ill became widespread during the 1980s as a means of providing a forum for the relevant education and mutual support of participants. While these programs are thought to be extremely useful as interventions, very little emphasis has been placed on evaluation as a means of demonstrating their effectiveness in achieving goals. There is a possibility, then, that psychoeducation will continue to flourish with little direct evidence of positive outcomes for its family participants. This article consists of a literature review of existing methods of psychoeducational program evaluation, both quantitative and qualitative, all of which may be applicable in certain circumstances. The process by which an evaluation instrument was developed for a program with families of the mentally ill is then presented in some detail.

  20. Method and computer program product for maintenance and modernization backlogging

    Science.gov (United States)

    Mattimore, Bernard G; Reynolds, Paul E; Farrell, Jill M

    2013-02-19

    According to one embodiment, a computer program product for determining future facility conditions includes a computer readable medium having computer readable program code stored therein. The computer readable program code includes computer readable program code for calculating a time period specific maintenance cost, for calculating a time period specific modernization factor, and for calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. In another embodiment, a computer-implemented method for calculating future facility conditions includes calculating a time period specific maintenance cost, calculating a time period specific modernization factor, and calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. Other embodiments are also presented.

  1. A Dynamic Programming Based Improvement Heuristic for a Repetitive Routing Problem of Grasp-and-Delivery Robots

    Science.gov (United States)

    Shurbevski, Aleksandar; Karuno, Yoshiyuki; Nagamochi, Hiroshi

    We consider a repetitive routing problem of a single grasp-and-delivery robot used on a printed circuit board (PCB) assembly line. The robot arranges n identical pins from their current configuration to the next required one by transferring at most one pin at a time. The pins support a PCB from underneath to prevent it from overbending, while an automated manipulator embeds electronic parts in the PCB from above. Given an initial configuration of pins and a sequence of m required configurations, the problem asks to find a transfer route of the robot that minimizes the route length over all m transitions. A polynomial time approximation algorithm with factor two has been proposed by the authors to the problem. In this paper, we design a dynamic programming (DP) procedure to improve its empirical performance, and also conduct numerical experiments to show how well the proposed DP procedure performs.

  2. Relaxation and decomposition methods for mixed integer nonlinear programming

    CERN Document Server

    Nowak, Ivo; Bank, RE

    2005-01-01

    This book presents a comprehensive description of efficient methods for solving nonconvex mixed integer nonlinear programs, including several numerical and theoretical results, which are presented here for the first time. It contains many illustrations and an up-to-date bibliography. Because on the emphasis on practical methods, as well as the introduction into the basic theory, the book is accessible to a wide audience. It can be used both as a research and as a graduate text.

  3. A method and fortran program for quantitative sampling in paleontology

    Science.gov (United States)

    Tipper, J.C.

    1976-01-01

    The Unit Sampling Method is a binomial sampling method applicable to the study of fauna preserved in rocks too well cemented to be disaggregated. Preliminary estimates of the probability of detecting each group in a single sampling unit can be converted to estimates of the group's volumetric abundance by means of correction curves obtained by a computer simulation technique. This paper describes the technique and gives the FORTRAN program. ?? 1976.

  4. Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain.

    LENUS (Irish Health Repository)

    Toomey, Elaine

    2017-08-04

    Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent\\/triangulation design.

  5. The application of the dynamic programming method in investment optimization

    Directory of Open Access Journals (Sweden)

    Petković Nina

    2016-01-01

    Full Text Available This paper deals with the problem of investment in Measuring Transformers Factory in Zajecar and the application of the dynamic programming method as one of the methods used in business process optimization. Dynamic programming is a special case of nonlinear programming that is widely applicable to nonlinear systems in economics. Measuring Transformers Factory in Zajecar was founded in 1969. It manufactures electrical equipment, primarily low and medium voltage current measuring transformers, voltage transformers, bushings, etc. The company offers a wide range of products and for this paper's needs the company's management selected three products for each of which optimal investment costing was made. The purpose was to see which product would be the most profitable and thus proceed with the manufacturing and selling of that particular product or products.

  6. Investigation of the Relationship between Green Design and Project Delivery Methods

    Energy Technology Data Exchange (ETDEWEB)

    Bilec, Melissa M.; Ries, Robert J.

    2008-04-24

    The selection of the project delivery method (PDM) for any project is critical--it establishes communication, coordination, and contractual issues between the owner, contractor, and designer. With an increase in the number of green design projects, understanding the relationship between the PDM and green design is paramount to project and contract management. It is reasonable to assume that a positive relationship between green design and design-build (DB) exists since both theoretically are intended to foster an integrated, holistic, and collaborative project. This research examines the relationship between the design-bid-build (DBB), construction management (CM), and DB PDMs and green design with the goal of establishing best practices and identifying potential synergies between them. The research collected information by conducting primarily telephone interviews with approximately twenty-five individuals, including owners, contractors, and designers involved in completed green design projects, mainly in the public sector. The interviews developed a general understanding of the current state of knowledge and experience and not a rigorous quantitative analysis. Upon completion of the interviews, the tabulated results were summarized and green project characteristics and project-PDM interactions emerged. Existing published research was evaluated to reveal aspects of PDMs independent of green design. Best practices were ascertained by combining information from the interviews and published research. Best practices are as follows: (1) Project implementation features--The decision to use DB as PDM on green design or other projects should be based on the specific project features; e.g., well-defined scope and adequate owner staffing. DB will not produce successful results on all projects. (2) Collaboration--Project team collaboration early in the design and construction process is an important aspect of green projects, and collaboration was considered somewhat more

  7. Study program for constant current capacitor charging method

    Energy Technology Data Exchange (ETDEWEB)

    Pugh, C.

    1978-10-04

    The objective of the study program was to determine the best method of charging 20,000 to 132,000 microfarads of capacitance to 22 kVdc in 14 to 15 sec. Component costs, sizes, weights, line current graphs, copies of calculations and manufacturer's data are included.

  8. Reconstructing Program Theories : Methods Available and Problems to be Solved

    NARCIS (Netherlands)

    Leeuw, Frans de

    2003-01-01

    This paper discusses methods for reconstructing theories underlying programs and policies. It describes three approaches. One is empirical–analytical in nature and focuses on interviews, documents and argumentational analysis. The second has strategic assessment, group dynamics, and dialogue as its

  9. Dynamic Frames Based Verification Method for Concurrent Java Programs

    NARCIS (Netherlands)

    Mostowski, Wojciech

    2016-01-01

    In this paper we discuss a verification method for concurrent Java programs based on the concept of dynamic frames. We build on our earlier work that proposes a new, symbolic permission system for concurrent reasoning and we provide the following new contributions. First, we describe our approach

  10. Adaptation-II of the surrogate methods for linear programming ...

    African Journals Online (AJOL)

    Adaptation-II of the surrogate methods for linear programming problems. SO Oko. Abstract. No Abstract. Global Journal of Mathematical Sciences Vol. 5(1) 2006: 63-71. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/gjmas.v5i1.21381.

  11. Path Following in the Exact Penalty Method of Convex Programming.

    Science.gov (United States)

    Zhou, Hua; Lange, Kenneth

    2015-07-01

    Classical penalty methods solve a sequence of unconstrained problems that put greater and greater stress on meeting the constraints. In the limit as the penalty constant tends to ∞, one recovers the constrained solution. In the exact penalty method, squared penalties are replaced by absolute value penalties, and the solution is recovered for a finite value of the penalty constant. In practice, the kinks in the penalty and the unknown magnitude of the penalty constant prevent wide application of the exact penalty method in nonlinear programming. In this article, we examine a strategy of path following consistent with the exact penalty method. Instead of performing optimization at a single penalty constant, we trace the solution as a continuous function of the penalty constant. Thus, path following starts at the unconstrained solution and follows the solution path as the penalty constant increases. In the process, the solution path hits, slides along, and exits from the various constraints. For quadratic programming, the solution path is piecewise linear and takes large jumps from constraint to constraint. For a general convex program, the solution path is piecewise smooth, and path following operates by numerically solving an ordinary differential equation segment by segment. Our diverse applications to a) projection onto a convex set, b) nonnegative least squares, c) quadratically constrained quadratic programming, d) geometric programming, and e) semidefinite programming illustrate the mechanics and potential of path following. The final detour to image denoising demonstrates the relevance of path following to regularized estimation in inverse problems. In regularized estimation, one follows the solution path as the penalty constant decreases from a large value.

  12. Path Following in the Exact Penalty Method of Convex Programming

    Science.gov (United States)

    Zhou, Hua; Lange, Kenneth

    2015-01-01

    Classical penalty methods solve a sequence of unconstrained problems that put greater and greater stress on meeting the constraints. In the limit as the penalty constant tends to ∞, one recovers the constrained solution. In the exact penalty method, squared penalties are replaced by absolute value penalties, and the solution is recovered for a finite value of the penalty constant. In practice, the kinks in the penalty and the unknown magnitude of the penalty constant prevent wide application of the exact penalty method in nonlinear programming. In this article, we examine a strategy of path following consistent with the exact penalty method. Instead of performing optimization at a single penalty constant, we trace the solution as a continuous function of the penalty constant. Thus, path following starts at the unconstrained solution and follows the solution path as the penalty constant increases. In the process, the solution path hits, slides along, and exits from the various constraints. For quadratic programming, the solution path is piecewise linear and takes large jumps from constraint to constraint. For a general convex program, the solution path is piecewise smooth, and path following operates by numerically solving an ordinary differential equation segment by segment. Our diverse applications to a) projection onto a convex set, b) nonnegative least squares, c) quadratically constrained quadratic programming, d) geometric programming, and e) semidefinite programming illustrate the mechanics and potential of path following. The final detour to image denoising demonstrates the relevance of path following to regularized estimation in inverse problems. In regularized estimation, one follows the solution path as the penalty constant decreases from a large value. PMID:26366044

  13. Competency Based Curriculum. Revised Delivery Systems for Culinary Arts Program. Project Report.

    Science.gov (United States)

    Spokane Community Coll., WA.

    Developed through a grant that enabled faculty members to work together to define goals and set objectives, this curriculum guide contains course objectives for the culinary arts program at Spokane Community College in Washington. Objectives are provided for the following courses: culinary techniques and skill development (two levels),…

  14. 77 FR 27273 - Surface Transportation Project Delivery Pilot Program; Caltrans Audit Report

    Science.gov (United States)

    2012-05-09

    ...) and Environmental Justice information. Caltrans has also developed new CIA guidance. 2. Improved level... in the Pilot Program. Continued errors in the quarterly reports. As has been the case in every audit, the quarterly reports prepared by Caltrans listing environmental approvals and decisions made under...

  15. 77 FR 10599 - Surface Transportation Project Delivery Pilot Program; Caltrans Audit Report

    Science.gov (United States)

    2012-02-22

    ... working team that holds monthly calls to share Community Impact Assessment (CIA) and Environmental Justice... from participation in the Pilot Program. Continued errors in the quarterly reports. As has been the case in every audit, the quarterly reports prepared by Caltrans listing environmental approvals and...

  16. GIS Application to Define Biomass Collection Points as Sources for Linear Programming of Delivery Networks

    NARCIS (Netherlands)

    Velazquez-Marti, B.; Annevelink, E.

    2009-01-01

    Much bio-energy can be obtained from wood pruning operations in forests and fruit orchards. Several spatial studies have been carried out for biomass surveys, and many linear programming models have been developed to model the logistics of bio-energy chains. These models can assist in determining

  17. Course Design and Delivery Specifications as a Tool for Ensuring Quality in an Online Training Program

    Science.gov (United States)

    Docq, Françoise

    2015-01-01

    This case discusses the design, implementation, and regulation of a hybrid training program (60 credits over two years) organised by three business schools in Europe, and stretching over a five-year period. Following an incremental design process, the design team faced multiple challenges, from finding the added value of hybridization to choosing…

  18. Enhancing the Delivery of Supplemental Nutrition Assistance Program Education through Geographic Information Systems

    Science.gov (United States)

    Stone, Matthew

    2011-01-01

    The Network for a Healthy California (Network) employs a Geographic Information System (GIS) to identify the target audience and plan program activities because GIS is a powerful tool for assisting in data integration and planning. This paper describes common uses of GIS by Network contractors as well as demonstrating the possibilities of GIS as a…

  19. Special Deliveries: Certified Nurse-Midwifery Programs Lacking in New England

    Science.gov (United States)

    Franzosa, Alyssa

    2012-01-01

    With Boston serving as a hub of both educational and medical excellence, it's no wonder that New England has a high reputation to uphold in both of these areas. However, Boston and the rest of the region lack a specific degree program that is putting New England below the radars of potential midwives. Certified nurse-midwifery is a popular field…

  20. THE EDUCATIONAL-METHODICAL “GIS-BAIKAL” PROGRAM

    Directory of Open Access Journals (Sweden)

    A. N. Beshentsev

    2017-01-01

    Full Text Available The article outlines the main types of territorial activities that need qualified personnel in the field of creating and using subject and interdisciplinary geoinformation systems. Methodical problems of modern geoinformation education in the Baikal region are determined and emphasis is placed on the need for training students and schoolchildren of senior classes on regional geographic material. As a means of optimizing geoinformation education and public education, the “GISBaikal” teaching and methodological program has been proposed and tested. Technological and methodological elements of this program have been considered. The advantages of electronic teaching aids are substantiated, the features of visual materials are considered, the authors’ methodical development is proposed, combining multimedia presentations and printed materials. The goals and objectives of the educational GIS, consisting of information, technological and analytical subsystems, are defined, the structure and content of subsystems is described. The territorial levels for the solution of spatial problems are established, the corresponding scales and elements of the content of topographic bases are determined. The results of approbation of the program in conducting summer environmental practices with students and schoolchildren in the senior classes at the Istomino IEOC on the shores of Lake Baikal are presented. The mechanism of training, the time organization, procedures and operations of carrying out field and cameral work during the program implementation is described. In conclusion, the assessment of the educational potential of the proposed educational and methodological program is given, the conclusions about its effectiveness are substantiated, the fields of application are proposed.

  1. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    Science.gov (United States)

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

  2. Indigenous health program evaluation design and methods in Australia: a systematic review of the evidence.

    Science.gov (United States)

    Lokuge, Kamalini; Thurber, Katherine; Calabria, Bianca; Davis, Meg; McMahon, Kathryn; Sartor, Lauren; Lovett, Raymond; Guthrie, Jill; Banks, Emily

    2017-10-01

    Indigenous Australians experience a disproportionately higher burden of disease compared to non-Indigenous Australians. High-quality evaluation of Indigenous health programs is required to inform health and health services improvement. We aimed to quantify methodological and other characteristics of Australian Indigenous health program evaluations published in the peer-reviewed literature. Systematic review of peer-reviewed literature (November 2009-2014) on Indigenous health program evaluation. We identified 118 papers describing evaluations of 109 interventions; 72.0% were university/research institution-led. 82.2% of evaluations included a quantitative component; 49.2% utilised quantitative data only and 33.1% used both quantitative and qualitative data. The most common design was a before/after comparison (30.5%, n=36/118). 7.6% of studies (n=9/118) used an experimental design: six individual-level and three cluster-randomised controlled trials. 56.8% (67/118) reported on service delivery/process outcomes (versus health or health risk factor outcomes) only. Given the number of Indigenous health programs that are implemented, few evaluations overall are published in the peer-reviewed literature and, of these, few use optimal methodologies such as mixed methods and experimental design. Implications for public health: Multiple strategies are required to increase high-quality, accessible evaluation in Indigenous health, including supporting stronger research-policy-practice partnerships and capacity building for evaluation by health services and government. © 2017 The Authors.

  3. Implementation of the parametric variation method in an EMTP program

    DEFF Research Database (Denmark)

    Holdyk, Andrzej; Holbøll, Joachim

    2013-01-01

    The paper presents an algorithm for- and shows the implementation of a method to perform parametric variation studies using electromagnetic transients programs applied to an offshore wind farm. Those kind of studies are used to investigate the sensitivity of a given phenomena to variation...... of parameters in an electric system. The proposed method allows varying any parameter of a circuit, including the simulation settings and exploits the specific structure of the ATP-EMTP software. In the implementation of the method, Matlab software is used to control the execution of the ATP solver. Two...

  4. A comparison of online versus workbook delivery of a self-help positive parenting program.

    Science.gov (United States)

    Sanders, Matthew R; Dittman, Cassandra K; Farruggia, Susan P; Keown, Louise J

    2014-06-01

    A noninferiority randomized trial design compared the efficacy of two self-help variants of the Triple P-Positive Parenting Program: an online version and a self-help workbook. We randomly assigned families of 193 children displaying early onset disruptive behavior difficulties to the online (N = 97) or workbook (N = 96) interventions. Parents completed questionnaire measures of child behavior, parenting, child maltreatment risk, personal adjustment and relationship quality at pre- and post-intervention and again at 6-month follow up. The short-term intervention effects of the Triple P Online program were not inferior to the workbook on the primary outcomes of disruptive child behavior and dysfunctional parenting as reported by both mothers and fathers. Both interventions were associated with significant and clinically meaningful declines from pre- to post-intervention in levels of disruptive child behavior, dysfunctional parenting styles, risk of child maltreatment, and inter-parental conflict on both mother and father report measures. Intervention effects were largely maintained at 6-month follow up, thus supporting the use of self-help parenting programs within a comprehensive population-based system of parenting support to reduce child maltreatment and behavioral problems in children.

  5. Gender differences in driving under the influence (DUI) program client characteristics: implications for treatment delivery.

    Science.gov (United States)

    Reilly, Kelly; Woodruff, Susan I; Hohman, Melinda; Barker, Melanie

    2018-02-05

    The purpose of this descriptive study was to examine gender differences in the characteristics of clients in a large Driving Under the Influence program in Southern California. We analyzed secondary de-identified data from a large Driving Under the Influence program for the years 2009-2014 (n = 19,619). Sociodemographic characteristics, measures of physical and mental comorbidity, and alcohol use severity measures were compared for male and female clients. Women averaged 32.85 years of age (SD = 10.70), while men were slightly older at 34.2 years (SD = 11.19). Females comprised an increasingly greater percentage of the client population over the time period studied (27.6% to 30.7%). In a multivariable model, compared to male clients, females were more likely to be White non-Hispanic, not currently married, and younger. Women were more likely than men to report anxiety, depression, and a history of domestic violence. Blood alcohol content at arrest and measures of hazardous drinking did not differ significantly by gender. Results suggested that gender-specific DUI programs may be useful.

  6. Comparative Study of Various Delivery Methods for the Supply of Alpha-Ketoglutarate to the Neural Cells for Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Tanushree Vishnoi

    2013-01-01

    Full Text Available Delivery of growth factors or bioactive molecules plays an important role in tissue engineering, as the duration to which these are supplied can modulate the cell fate. Thus, the delivery method plays an important role, and the same is presented in this work wherein the exogenous supply of alpha-ketoglutarate (α-KG gave better results for fast proliferating cells as compared to delivery by microspheres or microspheres incorporated scaffolds which can be used while culturing slow growing cells. All these studies were performed in two dimensional (2D and three dimensional (3D setups in which chitosan-gelatin-polypyrrole has been used as 3-D scaffolds. Chitosan and gelatin microspheres alone as well as incorporated in the cryogels were characterized. MTT assay done using neuro-2a cell line showed approximately 42% and 70% increment in cellular proliferation when gelatin and chitosan microspheres were added in a 3-D setup, respectively, as compared to the control. Biochemical analysis of ammonia showed 6-fold reductions in ammonia level in a 3-D setup compared to the control. We also studied the synthesis of a neurotransmitter-like glutamate and found that its concentration increased up to 0.25 mg/ml when the microspheres were added exogenously in a 3-D system.

  7. Hyperbranched Self-Immolative Polymers (hSIPs) for Programmed Payload Delivery and Ultrasensitive Detection.

    Science.gov (United States)

    Liu, Guhuan; Zhang, Guofeng; Hu, Jinming; Wang, Xiaorui; Zhu, Mingqiang; Liu, Shiyong

    2015-09-16

    Upon stimuli-triggered single cleavage of capping moieties at the focal point and chain terminal, self-immolative dendrimers (SIDs) and linear self-immolative polymers (l-SIPs) undergo spontaneous domino-like radial fragmentation and cascade head-to-tail depolymerization, respectively. The nature of response selectivity and signal amplification has rendered them a unique type of stimuli-responsive materials. Moreover, novel design principles are required for further advancement in the field of self-immolative polymers (SIPs). Herein, we report the facile fabrication of water-dispersible SIPs with a new chain topology, hyperbranched self-immolative polymers (hSIPs), by utilizing one-pot AB2 polycondensation methodology and sequential postfunctionalization. The modular engineering of three categories of branching scaffolds, three types of stimuli-cleavable capping moieties at the focal point, and seven different types of peripheral functional groups and polymeric building blocks affords both structurally and functionally diverse hSIPs with chemically tunable amplified-release features. On the basis of the hSIP platform, we explored myriad functions including visible light-triggered intracellular release of peripheral conjugated drugs in a targeted and spatiotemporally controlled fashion, intracellular delivery and cytoplasmic reductive milieu-triggered plasmid DNA release via on/off multivalency switching, mitochondria-targeted fluorescent sensing of H2O2 with a detection limit down to ∼20 nM, and colorimetric H2O2 assay via triggered dispersion of gold nanoparticle aggregates. To further demonstrate the potency and generality of the hSIP platform, we further configure it into biosensor design for the ultrasensitive detection of pathologically relevant antigens (e.g., human carcinoembryonic antigen) by integrating with enzyme-mediated cycle amplification with positive feedback and enzyme-linked immunosorbent assay (ELISA).

  8. How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study.

    Science.gov (United States)

    Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

    2017-02-23

    Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. 4 DAPs at 2 teaching and 2 community hospitals in Canada. 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural-remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes

  9. Dissipative Particle Dynamics Method on PH-Responsive Polymeric Drug Delivery System

    Science.gov (United States)

    Guo, Yingying

    2013-03-01

    The self-assembled morphologies formed by polymer in selective solvent could be potentially used as drug-delivery vehicles and has attracted great attention recently. In our work, the drug release mechanism of polymeric delivery vehicle (polymeric microsphere) is investigated with Dissipative particle dynamics simulation. Poly (Lactic Acid)-b-polyethylene glycol (PLA-b-PEG) diblock copolymer is the carrier while IBU is selected as the model drug. A core-shell spherical micelle with drug encapsulated in the core is obtained in our simulation. By changing the medium from neutral to acid, the drugs release via a diffuse mechanism. Both the formation mechanism of the encapsulant and the release mechanism for the drugs are studied in our work. For the formation process, it can be ascribed as the coalesce of the small clusters and the disperse of the drugs; while for the drug release behavior, the process can be divided for three stages: (1) swell of the polymeric carrier, (2) drug diffuse in the carrier and some acid molecules disperse into the carrier, (3) drug release towards the acid medium. Our results might provide a mesoscopic methodology for the evaluation and prediction for polymeric self-assemblies as a carrier for pharmaceutical interest.

  10. Microencapsulation as a novel delivery method for the potential antidiabetic drug, Probucol.

    Science.gov (United States)

    Mooranian, Armin; Negrulj, Rebecca; Chen-Tan, Nigel; Al-Sallami, Hesham S; Fang, Zhongxiang; Mukkur, T K; Mikov, Momir; Golocorbin-Kon, Svetlana; Fakhoury, Marc; Watts, Gerald F; Matthews, Vance; Arfuso, Frank; Al-Salami, Hani

    2014-01-01

    In previous studies, we successfully designed complex multicompartmental microcapsules as a platform for the oral targeted delivery of lipophilic drugs in type 2 diabetes (T2D). Probucol (PB) is an antihyperlipidemic and antioxidant drug with the potential to show benefits in T2D. We aimed to create a novel microencapsulated formulation of PB and to examine the shape, size, and chemical, thermal, and rheological properties of these microcapsules in vitro. Microencapsulation was carried out using the Büchi-based microencapsulating system developed in our laboratory. Using the polymer, sodium alginate (SA), empty (control, SA) and loaded (test, PB-SA) microcapsules were prepared at a constant ratio (1:30). Complete characterizations of microcapsules, in terms of morphology, thermal profiles, dispersity, and spectral studies, were carried out in triplicate. PB-SA microcapsules displayed uniform and homogeneous characteristics with an average diameter of 1 mm. The microcapsules exhibited pseudoplastic-thixotropic characteristics and showed no chemical interactions between the ingredients. These data were further supported by differential scanning calorimetric analysis and Fourier transform infrared spectral studies, suggesting microcapsule stability. The new PB-SA microcapsules have good structural properties and may be suitable for the oral delivery of PB in T2D. Further studies are required to examine the clinical efficacy and safety of PB in T2D.

  11. Method: low-cost delivery of the cotton leaf crumple virus-induced gene silencing system

    Directory of Open Access Journals (Sweden)

    Tuttle John

    2012-08-01

    Full Text Available Abstract Background We previously developed a virus-induced gene silencing (VIGS vector for cotton from the bipartite geminivirusCotton leaf crumple virus (CLCrV. The original CLCrV VIGS vector was designed for biolistic delivery by a gene gun. This prerequisite limited the use of the system to labs with access to biolistic equipment. Here we describe the adaptation of this system for delivery by Agrobacterium (Agrobacterium tumefaciens. We also describe the construction of two low-cost particle inflow guns. Results The biolistic CLCrV vector was transferred into two Agrobacterium binary plasmids. Agroinoculation of the binary plasmids into cotton resulted in silencing and GFP expression comparable to the biolistic vector. Two homemade low-cost gene guns were used to successfully inoculate cotton (G. hirsutum and N. benthamiana with either the CLCrV VIGS vector or the Tomato golden mosaic virus (TGMV VIGS vector respectively. Conclusions These innovations extend the versatility of CLCrV-based VIGS for analyzing gene function in cotton. The two low-cost gene guns make VIGS experiments affordable for both research and teaching labs by providing a working alternative to expensive commercial gene guns.

  12. 77 FR 48733 - Transitional Program for Covered Business Method Patents-Definitions of Covered Business Method...

    Science.gov (United States)

    2012-08-14

    ... August 14, 2012 Part IV Department of Commerce Patent and Trademark Office 37 CFR Part 42 Transitional Program for Covered Business Method Patents--Definitions of Covered Business Method Patent and... / Rules and Regulations#0;#0; ] DEPARTMENT OF COMMERCE Patent and Trademark Office 37 CFR Part 42 RIN 0651...

  13. Integrated Data Collection Analysis (IDCA) Program - SSST Testing Methods

    Energy Technology Data Exchange (ETDEWEB)

    Sandstrom, Mary M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brown, Geoffrey W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Preston, Daniel N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pollard, Colin J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Warner, Kirstin F. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Remmers, Daniel L. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Sorensen, Daniel N. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Whinnery, LeRoy L. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Phillips, Jason J. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Shelley, Timothy J. [Bureau of Alcohol, Tobacco and Firearms (ATF), Huntsville, AL (United States); Reyes, Jose A. [Applied Research Associates, Tyndall AFB, FL (United States); Hsu, Peter C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Reynolds, John G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2013-03-25

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the methods used for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis during the IDCA program. These methods changed throughout the Proficiency Test and the reasons for these changes are documented in this report. The most significant modifications in standard testing methods are: 1) including one specified sandpaper in impact testing among all the participants, 2) diversifying liquid test methods for selected participants, and 3) including sealed sample holders for thermal testing by at least one participant. This effort, funded by the Department of Homeland Security (DHS), is putting the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study will suggest new guidelines and methods and possibly establish the SSST testing accuracies needed to develop safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods wherever possible. The testing performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent.

  14. Comparison of maternal and neonatal outcomes from full-dilatation cesarean deliveries using the Fetal Pillow or hand-push method.

    Science.gov (United States)

    Safa, Huda; Beckmann, Michael

    2016-12-01

    To compare maternal and neonatal outcomes of full-dilatation cesarean deliveries using the Fetal Pillow or hand- push method. A retrospective cohort study included data from all women who underwent full-dilatation cesarean deliveries at term that involved the use of the Fetal Pillow or the hand-push method at Mater Mothers' Hospital, Brisbane, Australia between May 1, 2013 and March 31, 2015. Maternal (estimated blood loss, need for blood transfusion, uterine angle extension, and duration of stay in hospital following delivery) and neonatal outcomes (5-minute Apgar score below 7, cord arterial pH, admission to neonatal intensive care unit, and need for endotracheal intubation) were compared between the two treatment methods. Of 361 cesarean deliveries performed at full dilation during the study period, clinicians documented the use of a Fetal Pillow in 91 deliveries and use of the hand-push method in 69. Lower mean intra-operative blood loss (P=0.026), a shorter duration of postpartum hospital admission (P=0.002), and higher mean cord arterial pH (P=0.003) were observed in the Fetal Pillow group. The Fetal Pillow appears to be a safe and effective aid for the delivery of the fetal head during cesarean deliveries at full dilatation. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Adherence to a Prophylactic Swallowing Therapy Program During (Chemo) Radiotherapy: Impact of Service-Delivery Model and Patient Factors.

    Science.gov (United States)

    Wall, Laurelie R; Ward, Elizabeth C; Cartmill, Bena; Hill, Anne J; Porceddu, Sandro V

    2017-04-01

    Intensive, prophylactic swallowing therapy programs have been developed to improve dysphagia outcomes for patients with head/neck cancer (HNC) receiving (chemo)radiotherapy ([C]RT). Across studies, variable therapy adherence rates have been reported. Preliminary research suggests that service-delivery mode and demographic factors may influence adherence. This study examined patient adherence to a prophylactic swallowing therapy protocol across three service-delivery models: (1) clinician-directed face-to-face therapy, (2) technology-assisted therapy using the telepractice application, SwallowIT and (3) independent patient-directed therapy. The secondary aim explored the impact of patient factors on adherence. Patients with oropharyngeal HNC receiving definitive (C)RT were randomised to receive the Pharyngocise exercise protocol via clinician-directed (n = 26), patient-directed (n = 27) or SwallowIT-assisted (n = 26) models. Adherence was calculated as the percentage of prescribed exercise completed. Multiple patient factors were recorded at baseline. Adherence across the 6 weeks in all groups was low (27%), and declined from week 4 of (C)RT. The clinician-directed model yielded significantly (p = 0.014) better adherence than patient-directed therapy in weeks 1-3. There was also a trend for higher adherence in the SwallowIT group compared to patient-directed in weeks 1-3 (p = 0.064). Multivariable linear modelling identified active smoking at baseline (p Telepractice may provide an alternate model to support adherence where service constraints limit intensive clinician-directed therapy.

  16. Microfabricated needles for transdermal delivery of macromolecules and nanoparticles: fabrication methods and transport studies.

    Science.gov (United States)

    McAllister, Devin V; Wang, Ping M; Davis, Shawn P; Park, Jung-Hwan; Canatella, Paul J; Allen, Mark G; Prausnitz, Mark R

    2003-11-25

    Arrays of micrometer-scale needles could be used to deliver drugs, proteins, and particles across skin in a minimally invasive manner. We therefore developed microfabrication techniques for silicon, metal, and biodegradable polymer microneedle arrays having solid and hollow bores with tapered and beveled tips and feature sizes from 1 to 1,000 microm. When solid microneedles were used, skin permeability was increased in vitro by orders of magnitude for macromolecules and particles up to 50 nm in radius. Intracellular delivery of molecules into viable cells was also achieved with high efficiency. Hollow microneedles permitted flow of microliter quantities into skin in vivo, including microinjection of insulin to reduce blood glucose levels in diabetic rats.

  17. Investigation of a piezoelectric droplet delivery method for fuel injection and physical property evaluation

    Science.gov (United States)

    Zhao, Wei; Menon, Shyam

    2017-11-01

    A piezoelectric droplet generator is investigated to deliver liquid hydrocarbon fuels to a micro-combustor application. Besides fuel delivery, the setup is intended to measure fuel physical properties such as viscosity and surface tension. These properties are highly relevant to spray generation in internal combustion engines. Accordingly, a drop-on-demand piezoelectric dispenser is used to generate fuel droplet trains, which are studied using imaging and Phase Doppler Particle Anemometry (PDPA). The diagnostics provide information regarding droplet size and velocity and their evolution over time. The measurements are correlated with results from one-dimensional (1D) models that incorporate sub-models for piezo-electric actuation and droplet vaporization. By validating the 1D models for fuels with known physical properties, a technique is developed that has the capability to meter low-vapor pressure liquid fuels to the microcombustor and use information from the droplet train to calculate physical properties of novel fuels.

  18. Literature review of HPV vaccine delivery strategies: considerations for school- and non-school based immunization program.

    Science.gov (United States)

    Paul, Proma; Fabio, Anthony

    2014-01-09

    School-based vaccination is becoming a more widely considered method of delivering HPV immunizations to an adolescent population; however, many countries do not have experience with delivering adolescent vaccines or school-based programs. This literature review will summarize the experiences from countries implementing non-health facility-based and health facility-based vaccination programs and assess HPV vaccine coverage. In October 2012, a systematic search in PubMed for studies related to the evaluation of national/regional, pilot, or demonstration HPV immunization programs that worked within existing health system yielded nine articles, representing seventeen countries. School-based programs achieved high HPV vaccination coverage rates in 9 to 13-year-old girls across the different studies and geographic locations, suggesting non-health facility-based programs are possible for HPV vaccine introduction. Grade-based, compared to age-based, eligibility criteria may be easier to implement in school settings. More studies are needed to explore the methods to standardize estimates for HPV vaccine coverage so that programs can be appropriately evaluated. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. A Method for Evaluating Physical Activity Programs in Schools.

    Science.gov (United States)

    Kelly, Cheryl; Carpenter, Dick; Tucker, Elizabeth; Luna, Carmen; Donovan, John; Behrens, Timothy K

    2017-09-14

    Providing opportunities for students to be physically active during the school day leads to increased academic performance, better focus, and fewer behavioral problems. As schools begin to incorporate more physical activity programming into the school day, evaluators need methods to measure how much physical activity students are being offered through this programming. Because classroom-based physical activity is often offered in 3-minute to 5-minute bouts at various times of the day, depending on the teachers' time to incorporate it, it is a challenge to evaluate this activity. This article describes a method to estimate the number of physical activity minutes provided before, during, and after school. The web-based tool can be used to gather data cost-effectively from a large number of schools. Strategies to increase teacher response rates and assess intensity of activity should be explored.

  20. Next Generation Nuclear Plant Methods Technical Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Richard R. Schultz; Abderrafi M. Ougouag; David W. Nigg; Hans D. Gougar; Richard W. Johnson; William K. Terry; Chang H. Oh; Donald W. McEligot; Gary W. Johnsen; Glenn E. McCreery; Woo Y. Yoon; James W. Sterbentz; J. Steve Herring; Temitope A. Taiwo; Thomas Y. C. Wei; William D. Pointer; Won S. Yang; Michael T. Farmer; Hussein S. Khalil; Madeline A. Feltus

    2010-12-01

    One of the great challenges of designing and licensing the Very High Temperature Reactor (VHTR) is to confirm that the intended VHTR analysis tools can be used confidently to make decisions and to assure all that the reactor systems are safe and meet the performance objectives of the Generation IV Program. The research and development (R&D) projects defined in the Next Generation Nuclear Plant (NGNP) Design Methods Development and Validation Program will ensure that the tools used to perform the required calculations and analyses can be trusted. The Methods R&D tasks are designed to ensure that the calculational envelope of the tools used to analyze the VHTR reactor systems encompasses, or is larger than, the operational and transient envelope of the VHTR itself. The Methods R&D focuses on the development of tools to assess the neutronic and thermal fluid behavior of the plant. The fuel behavior and fission product transport models are discussed in the Advanced Gas Reactor (AGR) program plan. Various stress analysis and mechanical design tools will also need to be developed and validated and will ultimately also be included in the Methods R&D Program Plan. The calculational envelope of the neutronics and thermal-fluids software tools intended to be used on the NGNP is defined by the scenarios and phenomena that these tools can calculate with confidence. The software tools can only be used confidently when the results they produce have been shown to be in reasonable agreement with first-principle results, thought-problems, and data that describe the “highly ranked” phenomena inherent in all operational conditions and important accident scenarios for the VHTR.

  1. Next Generation Nuclear Plant Methods Technical Program Plan -- PLN-2498

    Energy Technology Data Exchange (ETDEWEB)

    Richard R. Schultz; Abderrafi M. Ougouag; David W. Nigg; Hans D. Gougar; Richard W. Johnson; William K. Terry; Chang H. Oh; Donald W. McEligot; Gary W. Johnsen; Glenn E. McCreery; Woo Y. Yoon; James W. Sterbentz; J. Steve Herring; Temitope A. Taiwo; Thomas Y. C. Wei; William D. Pointer; Won S. Yang; Michael T. Farmer; Hussein S. Khalil; Madeline A. Feltus

    2010-09-01

    One of the great challenges of designing and licensing the Very High Temperature Reactor (VHTR) is to confirm that the intended VHTR analysis tools can be used confidently to make decisions and to assure all that the reactor systems are safe and meet the performance objectives of the Generation IV Program. The research and development (R&D) projects defined in the Next Generation Nuclear Plant (NGNP) Design Methods Development and Validation Program will ensure that the tools used to perform the required calculations and analyses can be trusted. The Methods R&D tasks are designed to ensure that the calculational envelope of the tools used to analyze the VHTR reactor systems encompasses, or is larger than, the operational and transient envelope of the VHTR itself. The Methods R&D focuses on the development of tools to assess the neutronic and thermal fluid behavior of the plant. The fuel behavior and fission product transport models are discussed in the Advanced Gas Reactor (AGR) program plan. Various stress analysis and mechanical design tools will also need to be developed and validated and will ultimately also be included in the Methods R&D Program Plan. The calculational envelope of the neutronics and thermal-fluids software tools intended to be used on the NGNP is defined by the scenarios and phenomena that these tools can calculate with confidence. The software tools can only be used confidently when the results they produce have been shown to be in reasonable agreement with first-principle results, thought-problems, and data that describe the “highly ranked” phenomena inherent in all operational conditions and important accident scenarios for the VHTR.

  2. Quasi-Newton Methods for Solving Nonlinear Programming Problems

    Directory of Open Access Journals (Sweden)

    V.Moraru

    1996-03-01

    Full Text Available In the present paper the problem of constrained equality optimization is reduced to sequential solving a series of problems of quadratic programming. The Hessian of the Lagrangian is approximated by a sequence of symmetric positive definite matrices. The matrix approximation is updated at every iteration by a Gram- Schmidt modified algorithm. We establish that methods is locally convergent and the sequence {xk}converges to the solution a two-step superlinear rate.

  3. COMPARISON BETWEEN SYNCHRONOUS AND ASYNCHRONOUS INSTRUCTIONAL DELIVERY METHOD OF TRAINING PROGRAMME ON IN-SERVICE PHYSICAL EDUCATORS’ KNOWLEDGE

    Directory of Open Access Journals (Sweden)

    Kyriaki EMMANOUILIDOU,

    2012-08-01

    Full Text Available The purpose of the study was to compare the influences of a training programme’s instructional delivery method (synchronous and asynchronous on Greek in-service physical educators’ cognitive understanding on student assessment. Forty nine participants were randomly divided into synchronous, asynchronous, and control group. The experimental groups participated in the same training programme with different online instructional method. The control group received no intervention. A 17-item questionnaire was completed before and after programme implementation by the entire sample. A two-way analysis of variance with repeated measures on the last factor was used for data analysis. The methods x measures interaction effect were significant. Both experimental groups, unlike the control, presented a similar significant increase in their understanding. Conclusively, synchronous and asynchronous instructional approaches of a training programme enhance equally Greek physical educators’ cognitive understanding.

  4. Human resources for health strategies adopted by providers in resource-limited settings to sustain long-term delivery of ART: a mixed-methods study from Uganda.

    Science.gov (United States)

    Zakumumpa, Henry; Taiwo, Modupe Oladunni; Muganzi, Alex; Ssengooba, Freddie

    2016-10-19

    Human resources for health (HRH) constraints are a major barrier to the sustainability of antiretroviral therapy (ART) scale-up programs in Sub-Saharan Africa. Many prior approaches to HRH constraints have taken a top-down trend of generalized global strategies and policy guidelines. The objective of the study was to examine the human resources for health strategies adopted by front-line providers in Uganda to sustain ART delivery beyond the initial ART scale-up phase between 2004 and 2009. A two-phase mixed-methods approach was adopted. In the first phase, a survey of a nationally representative sample of health facilities (n = 195) across Uganda was conducted. The second phase involved in-depth interviews (n = 36) with ART clinic managers and staff of 6 of the 195 health facilities purposively selected from the first study phase. Quantitative data was analysed based on descriptive statistics, and qualitative data was analysed by coding and thematic analysis. The identified strategies were categorized into five themes: (1) providing monetary and non-monetary incentives to health workers on busy ART clinic days; (2) workload reduction through spacing ART clinic appointments; (3) adopting training workshops in ART management as a motivation strategy for health workers; (4) adopting non-physician-centred staffing models; and (5) devising ART program leadership styles that enhanced health worker commitment. Facility-level strategies for responding to HRH constraints are feasible and can contribute to efforts to increase country ownership of HIV programs in resource-limited settings. Consideration of the human resources for health strategies identified in the study by ART program planners and managers could enhance the long-term sustainment of ART programs by providers in resource-limited settings.

  5. A validated stability-indicating HPLC method for determination of brimonidine tartrate in BRI/PHEMA drug delivery systems.

    Science.gov (United States)

    Sun, Jianguo; Zhang, Xiuwen; Huang, Taomin

    2017-07-11

    A simple, rapid and accurate stability-indicating reverse phase high performance liquid chromatography (RP-HPLC) was developed and validated for the determination of brimonidine tartrate in brimonidine tartrate/poly(2-hydroxyethyl methacrylate) (BRI/PHEMA) drug delivery contact lenses and pharmaceutical formulations. Optimum chromatographic conditions for separating brimonidine tartrate from other impurities in the leaching liquor of BRI/PHEMA drug delivery contact lenses or pharmaceutical formulations have been achieved by using a Diamonsil C18 column (150 mm × 4.6 mm, 5 μm) as a stationary phase and a mixture solution of phosphate buffer (10 mM, pH3.5) containing 0.5% triethlamine and methanol (85:15, v/v) as a mobile phase at a flow rate of 1 mL/min. The theoretical plates for the brimonidine tartrate measurement were calculated to be 8360 when detection was performed at 246 nm using a diode array detector. The proposed method was validated in accordance with ICH guidelines with respect to linearity, accuracy, precision, robustness, specificity, limit of detection and quantitation. Regression analysis showed a good correlation (R2 > 0.999) for brimonidine tartrate in the concentration range of 0.01-50 μg/mL. The peak purity factor is ≥980 for the analyte after all types of stress tests, indicating an excellent separation of brimonidine tartrate peak from other impurities. The measurement course could be completed within 10 min, which was very quick, effective and convenient. Overall, the proposed stability-indicating method was suitable for routine quality control and drug analysis of brimonidine tartrate in BRI/PHEMA drug delivery contact lenses and other pharmaceutical formulations.

  6. A Partnership Training Program: Studying Targeted Drug Delivery Using Nanoparticles in Breast Cancer Diagnosis and Therapy

    Science.gov (United States)

    2012-10-01

    mentors and invited speakers (months 1-48). c. Johns Hopkins University ICMIC Seminar Series organized by Dr. Bhujwalla (months 1-48). d. To attend... plasma membrane, whereas the cells that had lost membrane integrity due to necrosis showed red PI staining throughout the nuclei. To further...to examine the antimetastasis effects arising from here.Methods Preparation of f-NPs Gadolinium metallofullerene (Gd@C82) was synthesized by an arc

  7. A Partnership Training Program: Studying Targeted Drug Delivery Using Nanoparticles In Breast Cancer Diagnosis and Therapy

    Science.gov (United States)

    2015-12-01

    Paravision methods. Last summer, Dr. Liang Shan mentored two graduate students (Ms. Christina Becco and Ms. Morgan Morrow) from the College of Dentistry ...nanoconstructs for imaging and therapy of aggressive pediatric brain tumors Rohan Fernandas (Children’s Nat Med Centr, PI) Paul Wang (mentor) (10/01/13...Chinese Academy of Medical Sciences Shimelis Hailu Chemistry Shuang Shi Dentistry Zhenjiang Zhang Chemistry/Radiology Predoctoral M.D./Ph.D

  8. Smartphones for Smarter Delivery of Mental Health Programs: A Systematic Review

    OpenAIRE

    Donker, Tara; Petrie, Katherine; Proudfoot, Judy; Clarke, Janine; Birch, Mary-Rose; Christensen, Helen

    2013-01-01

    Background The rapid growth in the use of mobile phone applications (apps) provides the opportunity to increase access to evidence-based mental health care. Objective Our goal was to systematically review the research evidence supporting the efficacy of mental health apps for mobile devices (such as smartphones and tablets) for all ages. Methods A comprehensive literature search (2008-2013) in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, PsycTESTS, Compendex,...

  9. Diplomatic advantages and threats in global health program selection, design, delivery and implementation: development and application of the Kevany Riposte.

    Science.gov (United States)

    Kevany, Sebastian

    2015-05-27

    Global health programs, as supported by organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief (PEPFAR), stand to make significant contributions to international medical outcomes. Traditional systems of monitoring and evaluation, however, fail to capture downstream, indirect, or collateral advantages (and threats) of intervention selection, design, and implementation from broader donor perspectives, including those of the diplomatic and foreign policy communities, which these programs also generate. This paper describes the development a new métier under which assessment systems designed to consider the diplomatic value of global health initiatives are described and applied based on previously-identified "Top Ten" criteria. The "Kevany Riposte" and the "K-Score" were conceptualized based on a retrospective and collective assessment of the author's participation in the design, implementation and delivery of a range of global health interventions related to the HIV/AIDS epidemic. Responses and associated scores reframe intervention worth or value in terms of global health diplomacy criteria such as "adaptability", "interdependence", "training," and "neutrality". Response options ranged from "highly advantageous" to "significant potential threat". Global health initiatives under review were found to generate significant advantages from the diplomatic perspective. These included (1) intervention visibility and associations with donor altruism and prestige, (2) development of international non-health collaborations and partnerships, (3) adaptability and responsiveness of service delivery to local needs, and (4) advancement of broader strategic goals of the international community. Corresponding threats included (1) an absence of formal training of project staff on broader political and international relations roles and responsibilities, (2) challenges to recipient cultural and religious practices

  10. Erythrocyte membrane-coated NIR-triggered biomimetic nanovectors with programmed delivery for photodynamic therapy of cancer

    Science.gov (United States)

    Ding, Hui; Lv, Yanlin; Ni, Dezhi; Wang, Jie; Tian, Zhiyuan; Wei, Wei; Ma, Guanghui

    2015-05-01

    A new type of photodynamic therapy (PDT) agents using upconversion nanoparticles (UCNPs) with incorporated photosensitizers as the inner core and an erythrocyte membrane (RM) decorated with dual targeting moieties as the cloak is developed. Owing to the endogenous nature of RM, the RM-coating endows the PDT agents with perfect biocompatibility and stealth ability to escape from the entrapment by the reticulo-endothelial system (RES). More importantly, owing to the unique nature of erythrocyte as an oxygen carrier in the blood, the RM outer layer of the agents unequivocally facilitates the permeation of ground-state molecular oxygen (3O2) and the singlet oxygen (1O2) as compared to the previously developed PDT agents with other types of coating. Another salient feature of the as-prepared PDT platform is the decoration of RM with dual targeting moieties for selective recognition of cancer cells and mitochondrial targeting, respectively. The synergistic effect of RM coating and dual-targeting of such feature-packed agents are investigated in tumor-bearing mice and the improved PDT therapeutic efficacy is confirmed, which is the first paradigm where RM-coated NIR-triggered nanovectors with programmed delivery ability is applied in PDT of tumor in vivo.A new type of photodynamic therapy (PDT) agents using upconversion nanoparticles (UCNPs) with incorporated photosensitizers as the inner core and an erythrocyte membrane (RM) decorated with dual targeting moieties as the cloak is developed. Owing to the endogenous nature of RM, the RM-coating endows the PDT agents with perfect biocompatibility and stealth ability to escape from the entrapment by the reticulo-endothelial system (RES). More importantly, owing to the unique nature of erythrocyte as an oxygen carrier in the blood, the RM outer layer of the agents unequivocally facilitates the permeation of ground-state molecular oxygen (3O2) and the singlet oxygen (1O2) as compared to the previously developed PDT agents with

  11. Effects of infectious virus dose and bloodmeal delivery method on susceptibility of Aedes aegypti and Aedes albopictus to chikungunya virus.

    Science.gov (United States)

    Pesko, Kendra; Westbrook, Catherine J; Mores, Christopher N; Lounibos, L Philip; Reiskind, Michael H

    2009-03-01

    Chikungunya virus (CHIKV) is an arbovirus (genus Alphavirus, family Togaviridae) that has recently caused disease outbreaks in the Indian Ocean basin and southern Europe. These outbreaks could be associated with a possible shift in primary vector from Aedes aegypti to Ae. albopictus. To evaluate vector competence differences in possible CHIKV vectors, we evaluated the dose-dependant susceptibility of Florida strains of Ae. albopictus and Ae. aegypti for infection with a La Réunion island strain of CHIKV. Pledget and water-jacketed membrane feeding systems were also evaluated. We show that both Aedes spp. were susceptible to the highest CHIKV doses, whereas only Ae. albopictus developed disseminated infections after exposure to the two lowest doses. Infection rates for both mosquito species were significantly affected by the bloodmeal delivery method used. This information is important in assessing risk of an outbreak of imported CHIKV in the United States, in determining differences in vectorial capacity of these two vector species, and in evaluating arbovirus delivery methods in the laboratory.

  12. Fabrication Methods and Performance of Low-Permeability Microfluidic Components for a Miniaturized Wearable Drug Delivery System.

    Science.gov (United States)

    Mescher, Mark J; Swan, Erin E Leary; Fiering, Jason; Holmboe, Maria E; Sewell, William F; Kujawa, Sharon G; McKenna, Michael J; Borenstein, Jeffrey T

    2009-06-01

    In this paper, we describe low-permeability components of a microfluidic drug delivery system fabricated with versatile micromilling and lamination techniques. The fabrication process uses laminate sheets which are machined using XY milling tables commonly used in the printed-circuit industry. This adaptable platform for polymer microfluidics readily accommodates integration with silicon-based sensors, printed-circuit, and surface-mount technologies. We have used these methods to build components used in a wearable liquid-drug delivery system for in vivo studies. The design, fabrication, and performance of membrane-based fluidic capacitors and manual screw valves provide detailed examples of the capability and limitations of the fabrication method. We demonstrate fluidic capacitances ranging from 0.015 to 0.15 μL/kPa, screw valves with on/off flow ratios greater than 38 000, and a 45× reduction in the aqueous fluid loss rate to the ambient due to permeation through a silicone diaphragm layer.

  13. Fabrication Methods and Performance of Low-Permeability Microfluidic Components for a Miniaturized Wearable Drug Delivery System

    Science.gov (United States)

    Mescher, Mark J.; Swan, Erin E. Leary; Fiering, Jason; Holmboe, Maria E.; Sewell, William F.; Kujawa, Sharon G.; McKenna, Michael J.; Borenstein, Jeffrey T.

    2010-01-01

    In this paper, we describe low-permeability components of a microfluidic drug delivery system fabricated with versatile micromilling and lamination techniques. The fabrication process uses laminate sheets which are machined using XY milling tables commonly used in the printed-circuit industry. This adaptable platform for polymer microfluidics readily accommodates integration with silicon-based sensors, printed-circuit, and surface-mount technologies. We have used these methods to build components used in a wearable liquid-drug delivery system for in vivo studies. The design, fabrication, and performance of membrane-based fluidic capacitors and manual screw valves provide detailed examples of the capability and limitations of the fabrication method. We demonstrate fluidic capacitances ranging from 0.015 to 0.15 μL/kPa, screw valves with on/off flow ratios greater than 38 000, and a 45× reduction in the aqueous fluid loss rate to the ambient due to permeation through a silicone diaphragm layer. PMID:20852729

  14. Current Progress in Gene Delivery Technology Based on Chemical Methods and Nano-carriers

    OpenAIRE

    Jin, Lian; Zeng, Xin; Liu, Ming; Deng, Yan; He, Nongyue

    2014-01-01

    Gene transfer methods are promising in the field of gene therapy. Current methods for gene transfer include three major groups: viral, physical and chemical methods. This review mainly summarizes development of several types of chemical methods for gene transfer in vitro and in vivo by means of nano-carriers like; calcium phosphates, lipids, and cationic polymers including chitosan, polyethylenimine, polyamidoamine dendrimers, and poly(lactide-co-glycolide). This review also briefly introduce...

  15. Which is best method for instillation of topical therapy to the upper urinary tract? An in vivo porcine study to evaluate three delivery methods

    Directory of Open Access Journals (Sweden)

    Zhenbang Liu

    Full Text Available ABSTRACT Purpose: To compare the staining intensity of the upper urinary tract (UUT urothelium among three UUT delivery methods in an in vivo porcine model. Materials and methods: A fluorescent dye solution (indigo carmine was delivered to the UUT via three different methods: antegrade perfusion, vesico-ureteral reflux via in-dwelling ureteric stent and retrograde perfusion via a 5F open-ended ureteral catheter. Twelve renal units were tested with 4 in each method. After a 2-hour delivery time, the renal-ureter units were harvested en bloc. Time from harvesting to analysis was also standardised to be 2 hours in each arm. Three urothelium samples of the same weight and size were taken from each of the 6 pre-defined points (upper pole, mid pole, lower pole, renal pelvis, mid ureter and distal ureter and the amount of fluorescence was measured with a spectrometer. Results: The mean fluorescence detected at all 6 predefined points of the UUT urothelium was the highest for the retrograde method. This was statistically significant with p-value less than <0.05 at all 6 points. Conclusions: Retrograde infusion of UUT by an open ended ureteral catheter resulted in highest mean fluorescence detected at all 6 pre-defined points of the UUT urothelium compared to antegrade infusion and vesico-ureteral reflux via indwelling ureteric stents indicating retrograde method ideal for topical therapy throughout the UUT urothelium. More clinical studies are needed to demonstrate if retrograde method could lead to better clinical outcomes compared to the other two methods.

  16. Lanreotide depot deep subcutaneous injection: a new method of delivery and its associated benefits

    Directory of Open Access Journals (Sweden)

    Carmichael JD

    2012-01-01

    Full Text Available John D CarmichaelDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: Acromegaly is a rare disease characterized by excessive growth hormone secretion, usually from a pituitary tumor. Treatment options include surgery, medical therapy, and in some cases, radiation therapy. Current medical therapy consists of treatment with somatostatin analog medications or a growth hormone receptor antagonist. There are two somatostatin analogs currently in use, octreotide and lanreotide. Both are supplied in long-acting formulations and are of comparable biochemical efficacy. Lanreotide is supplied in a prefilled syringe and is injected into deep subcutaneous tissue. Studies have been conducted to assess the efficacy of self- or partner administration, and have demonstrated that injection of lanreotide can be accomplished reliably and safely outside a physician's office. For patients who have achieved biochemical control with lanreotide, the FDA has recently approved an extended dosing interval. Selected patients may be able to receive the medication less frequently with injections of 120 mg administered every 6 or 8 weeks. This review focuses on the use of lanreotide in the treatment of acromegaly, the safety and efficacy of the drug, and the benefits afforded to patients because of unique aspects of the delivery of lanreotide.Keywords: acromegaly, treatment, lanreotide, somatostatin analog, pituitary tumor

  17. Program-target methods of management small business

    Directory of Open Access Journals (Sweden)

    Gurova Ekaterina

    2017-01-01

    Full Text Available Experience of small businesses in Russia are just beginning their path to development. difficulties arise with the involvement of small businesses in the implementation of government development programmes. Small business in modern conditions to secure a visible prospect of development without the implementation of state support programmes. Ways and methods of regulation of development of the market economy are diverse. The total mass of the huge role is played by the program-target methods of regulation. The article describes the basic principles on the use of program-target approach to the development of a specific sector of the economy, as small businesses, designed to play an important role in getting the national economy out of crisis. The material in this publication is built from the need to maintain the connection between the theory of government regulation, practice of formation of development programs at the regional level and the needs of small businesses. Essential for the formation of entrepreneurship development programmes is to preserve the flexibility of small businesses in making management decisions related to the selection and change of activities.

  18. A mixed-methods evaluation of an Integrated Medication Management program and implications for implementation.

    Science.gov (United States)

    Fischer, Shira H; Armstrong, Courtney K; Duffy, Erin L; Hussey, Peter S

    Improving medication adherence is a common and challenging issue. Taking medications as prescribed becomes particularly difficult for individuals with multiple chronic conditions. Poor adherence can lead to exacerbated health issues and prolonged disease severity. Medication Therapy Management is increasingly being used to help clinics improve medication adherence and reduce adverse events, but factors that enable implementation of such programs are not well identified. To describe the factors associated with implementation of an innovative pharmacy program and to measure the impact of the intervention. This mixed-methods cohort study in a federal qualified health center with its own pharmacy examined the implementation and the impact of a broad program including MTM. The intervention included appointments with pharmacists, communication between pharmacists and physicians, and, for some, monthly pre-packaged medications. Semi-structured interviews with patients and staff were recorded, transcribed, and analyzed for themes relating to implementation, satisfaction, and challenges. Quantitative methods using data collected by the pharmacists at each visit were used to compare the first visit to those at later visits and provided measures of impact on diabetes control, statin use, and medication-related problems (MRPs). Qualitative interviews identified enabling factors that contributed to successful implementation of this program, including: program factors such as data access, communication with patients, and dedicated staff; organizational factors such as culture of integration, leadership support, and staffing; and lastly, environmental factors such as the availability of 340B funding. Quantitative analyses were limited by poor retention and lack of a similarly-documented comparison group. Health outcomes were not found to be significantly better, though there was a significant decrease in some kinds of MRPs. This program was well received by patients and staff and

  19. Smartphones for smarter delivery of mental health programs: a systematic review.

    Science.gov (United States)

    Donker, Tara; Petrie, Katherine; Proudfoot, Judy; Clarke, Janine; Birch, Mary-Rose; Christensen, Helen

    2013-11-15

    The rapid growth in the use of mobile phone applications (apps) provides the opportunity to increase access to evidence-based mental health care. Our goal was to systematically review the research evidence supporting the efficacy of mental health apps for mobile devices (such as smartphones and tablets) for all ages. A comprehensive literature search (2008-2013) in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, PsycTESTS, Compendex, and Inspec was conducted. We included trials that examined the effects of mental health apps (for depression, anxiety, substance use, sleep disturbances, suicidal behavior, self-harm, psychotic disorders, eating disorders, stress, and gambling) delivered on mobile devices with a pre- to posttest design or compared with a control group. The control group could consist of wait list, treatment-as-usual, or another recognized treatment. In total, 5464 abstracts were identified. Of those, 8 papers describing 5 apps targeting depression, anxiety, and substance abuse met the inclusion criteria. Four apps provided support from a mental health professional. Results showed significant reductions in depression, stress, and substance use. Within-group and between-group intention-to-treat effect sizes ranged from 0.29-2.28 and 0.01-0.48 at posttest and follow-up, respectively. Mental health apps have the potential to be effective and may significantly improve treatment accessibility. However, the majority of apps that are currently available lack scientific evidence about their efficacy. The public needs to be educated on how to identify the few evidence-based mental health apps available in the public domain to date. Further rigorous research is required to develop and test evidence-based programs. Given the small number of studies and participants included in this review, the high risk of bias, and unknown efficacy of long-term follow-up, current findings should be interpreted with caution, pending replication. Two

  20. Navigating the high seas of Federal Programs to ensure usable science delivery

    Science.gov (United States)

    Bachelet, D. M.; Gough, M.; Baker, B.; Sheehan, T.; Mutch, T.; Brown, M.

    2016-12-01

    Oregon State University, University of Idaho, and the University of Washington. With much experience with local and regional managers and federal programs we will show examples of exciting successes and report on some challenges in coordinating exchanges and extracting valuable feedback to improve the usability of web applications.

  1. Enzymatic Polymerization of Cyclic Monomers in Ionic Liquids as a Prospective Synthesis Method for Polyesters Used in Drug Delivery Systems

    Directory of Open Access Journals (Sweden)

    Urszula Piotrowska

    2014-12-01

    Full Text Available Biodegradable or bioresorbable polymers are commonly used in various pharmaceutical fields (e.g., as drug delivery systems, therapeutic systems or macromolecular drug conjugates. Polyesters are an important class of polymers widely utilized in pharmacy due to their biodegradability and biocompatibility features. In recent years, there has been increased interest in enzyme-catalyzed ring-opening polymerization (e-ROP of cyclic esters as an alternative method of preparation of biodegradable or bioresorbable polymers. Ionic liquids (ILs have been presented as green solvents in enzymatic ring-opening polymerization. The activity, stability, selectivity of enzymes in ILs and the ability to catalyze polyester synthesis under these conditions are discussed. Overall, the review demonstrates that e-ROP of lactones or lactides could be an effective method for the synthesis of useful biomedical polymers.

  2. Sample Injector Fabrication and Delivery Method Development for Serial Crystallography using Synchrotrons and X-ray Free Electron Lasers

    Science.gov (United States)

    Nelson, Garrett Charles

    Sample delivery is an essential component in biological imaging using serial diffraction from X-ray Free Electron Lasers (XFEL) and synchrotrons. Recent developments have made possible the near-atomic resolution structure determination of several important proteins, including one G protein-coupled receptor (GPCR) drug target, whose structure could not easily have been determined otherwise (Appendix A). In this thesis I describe new sample delivery developments that are paramount to advancing this field beyond what has been accomplished to date. Soft Lithography was used to implement sample conservation in the Gas Dynamic Virtual Nozzle (GDVN). A PDMS/glass composite microfluidic injector was created and given the capability of millisecond fluidic switching of a GDVN liquid jet within the divergent section of a 2D Laval-like GDVN nozzle, providing a means of collecting sample between the pulses of current XFELs. An oil/water droplet immersion jet was prototyped that suspends small sample droplets within an oil jet such that the sample droplet frequency may match the XFEL pulse repetition rate. A similar device was designed to use gas bubbles for synchronized "on/off" jet behavior and for active micromixing. 3D printing based on 2-Photon Polymerization (2PP) was used to directly fabricate reproducible GDVN injectors at high resolution, introducing the possibility of systematic nozzle research and highly complex GDVN injectors. Viscous sample delivery using the "LCP injector" was improved with a method for dealing with poorly extruding sample mediums when using full beam transmission from the Linac Coherent Light Source (LCLS), and a new viscous crystal-carrying medium was characterized for use in both vacuum and atmospheric environments: high molecular weight Polyethylene Glycol.

  3. Mathematical programming methods for large-scale topology optimization problems

    DEFF Research Database (Denmark)

    Rojas Labanda, Susana

    This thesis investigates new optimization methods for structural topology optimization problems. The aim of topology optimization is finding the optimal design of a structure. The physical problem is modelled as a nonlinear optimization problem. This powerful tool was initially developed for mech......This thesis investigates new optimization methods for structural topology optimization problems. The aim of topology optimization is finding the optimal design of a structure. The physical problem is modelled as a nonlinear optimization problem. This powerful tool was initially developed...... for the classical minimum compliance problem. Two of the state-of-the-art optimization algorithms are investigated and implemented for this structural topology optimization problem. A Sequential Quadratic Programming (TopSQP) and an interior point method (TopIP) are developed exploiting the specific mathematical...

  4. Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System.

    Science.gov (United States)

    Liu, Vincent X; Rosas, Efren; Hwang, Judith; Cain, Eric; Foss-Durant, Anne; Clopp, Molly; Huang, Mengfei; Lee, Derrick C; Mustille, Alex; Kipnis, Patricia; Parodi, Stephen

    2017-07-19

    Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery). Implementation began in February and March 2014 and concluded by the end of 2014 at 20 medical centers within the Kaiser Permanente Northern California integrated health care delivery system. A multifaceted ERAS program designed with a particular focus on perioperative pain management, mobility, nutrition, and patient engagement. The primary outcome was hospital length of stay. Secondary outcomes included hospital mortality, home discharge, 30-day readmission rates, and complication rates. The study included a total of 3768 patients undergoing elective colorectal resection (mean [SD] age, 62.7 [14.1] years; 1812 [48.1%] male) and 5002 patients undergoing emergency hip fracture repair (mean [SD] age, 79.5 [11.8] years; 1586 [31.7%] male). Comparator surgical patients included 5556 patients undergoing elective gastrointestinal surgery and 1523 patients undergoing emergency orthopedic surgery. Most process metrics had significantly greater changes in the ERAS target populations after implementation compared with comparator surgical populations, including those for ambulation, nutrition, and opioid use. Hospital length of stay and postoperative complication rates were also significantly lower among ERAS target populations after implementation. The rate ratios for postoperative complications were 0.68 (95% CI, 0.46-0.99; P = .04) for patients

  5. Four criteria to evaluate providers' service-delivery response to new contraceptive introduction.

    Science.gov (United States)

    León, Federico R; Arévalo, Marcos; Lundgren, Rebecka; Jennings, Victoria; Huapaya, Ana; Panfichi, Rosario

    2007-08-01

    This article presents an evaluation framework developed to assess the first-level effects of introducing the Standard Days Method (SDM) in Peru Ministry of Health clinics. Four questions are asked: 1) To what extent do providers routinely achieve SDM service delivery standards? 2) Is the time invested in SDM delivery consistent with program norms? 3) How does SDM delivery compare with delivery of established methods? and 4) How does SDM introduction affect delivery of established methods? A study at 62 clinics demonstrated the framework's usefulness. The Standard Days Method introduction had positive overall effects on the quality of care but provider training needed adjustments.

  6. Percutaneous Vaccination as an Effective Method of Delivery of MVA and MVA-Vectored Vaccines.

    Directory of Open Access Journals (Sweden)

    Clement A Meseda

    Full Text Available The robustness of immune responses to an antigen could be dictated by the route of vaccine inoculation. Traditional smallpox vaccines, essentially vaccinia virus strains, that were used in the eradication of smallpox were administered by percutaneous inoculation (skin scarification. The modified vaccinia virus Ankara is licensed as a smallpox vaccine in Europe and Canada and currently undergoing clinical development in the United States. MVA is also being investigated as a vector for the delivery of heterologous genes for prophylactic or therapeutic immunization. Since MVA is replication-deficient, MVA and MVA-vectored vaccines are often inoculated through the intramuscular, intradermal or subcutaneous routes. Vaccine inoculation via the intramuscular, intradermal or subcutaneous routes requires the use of injection needles, and an estimated 10 to 20% of the population of the United States has needle phobia. Following an observation in our laboratory that a replication-deficient recombinant vaccinia virus derived from the New York City Board of Health strain elicited protective immune responses in a mouse model upon inoculation by tail scarification, we investigated whether MVA and MVA recombinants can elicit protective responses following percutaneous administration in mouse models. Our data suggest that MVA administered by percutaneous inoculation, elicited vaccinia-specific antibody responses, and protected mice from lethal vaccinia virus challenge, at levels comparable to or better than subcutaneous or intramuscular inoculation. High titers of specific neutralizing antibodies were elicited in mice inoculated with a recombinant MVA expressing the herpes simplex type 2 glycoprotein D after scarification. Similarly, a recombinant MVA expressing the hemagglutinin of attenuated influenza virus rgA/Viet Nam/1203/2004 (H5N1 elicited protective immune responses when administered at low doses by scarification. Taken together, our data suggest that

  7. Local transplantation is an effective method for cell delivery in the osteogenesis imperfecta murine model.

    Science.gov (United States)

    Pauley, Penelope; Matthews, Brya G; Wang, Liping; Dyment, Nathaniel A; Matic, Igor; Rowe, David W; Kalajzic, Ivo

    2014-09-01

    Osteogenesis imperfecta is a serious genetic disorder that results from improper type I collagen production. We aimed to evaluate whether bone marrow stromal cells (BMSC) delivered locally into femurs were able to engraft, differentiate into osteoblasts, and contribute to formation of normal bone matrix in the osteogenesis imperfect murine (oim) model. Donor BMSCs from bone-specific reporter mice (Col2.3GFP) were expanded in vitro and transplanted into the femoral intramedullary cavity of oim mice. Engraftment was evaluated after four weeks. We detected differentiation of donor BMSCs into Col2.3GFP+ osteoblasts and osteocytes in cortical and trabecular bone of transplanted oim femurs. New bone formation was detected by deposition of dynamic label in the proximity to the Col2.3GFP+ osteoblasts, and new bone showed more organized collagen structure and expression of type I α2 collagen. Col2.3GFP cells were not found in the contralateral femur indicating that transplanted osteogenic cells did not disseminate by circulation. No osteogenic engraftment was observed following intravenous transplantation of BMSCs. BMSC cultures derived from transplanted femurs showed numerous Col2.3GFP+ colonies, indicating the presence of donor progenitor cells. Secondary transplantation of cells recovered from recipient femurs and expanded in vitro also showed Col2.3GFP+ osteoblasts and osteocytes confirming the persistence of donor stem/progenitor cells. We show that BMSCs delivered locally in oim femurs are able to engraft, differentiate into osteoblasts and osteocytes and maintain their progenitor potential in vivo. This suggests that local delivery is a promising approach for introduction of autologous MSC in which mutations have been corrected.

  8. Fibrin nanoconstructs: a novel processing method and their use as controlled delivery agents

    Science.gov (United States)

    Praveen, G.; Sreerekha, P. R.; Menon, Deepthy; Nair, Shantikumar V.; Prasad Chennazhi, Krishna

    2012-03-01

    Fibrin nanoconstructs (FNCs) were prepared through a modified water-in-oil emulsification-diffusion route without the use of any surfactants, resulting in a high yield synthesis of fibrin nanotubes (FNTs) and fibrin nanoparticles (FNPs). The fibrin nanoconstructs formed an aligned structure with self-assembled nanotubes with closed heads that eventually formed spherical nanoparticles of size ˜250 nm. The nanotubes were typically ˜700 nm long and 150-300 nm in diameter, with a wall thickness of ˜50 nm and pore diameter of about 150-250 nm. These constructs showed high stability against aggregation indicated by a zeta potential of -44 mV and an excellent temperature stability upto 200 °C. Furthermore, they were found to be enzymatically degradable, thereby precluding any long term toxicity effects. These unique fibrin nanostructures were analyzed for their ability to deliver tacrolimus, an immunosuppressive drug that is used widely to prevent the initial phase of tissue rejection during allogenic transplantation surgeries. Upon conjugation with tacrolimus, a drug encapsulation efficiency of 66% was achieved, with the in vitro release studies in PBS depicting a sustained and complete drug release over a period of one week at the physiological pH of 7.4. At a more acidic pH, the drug release was very slow, suggesting their potential for oral-intestinal drug administration as well. The in vivo drug absorption rates analyzed in Sprague Dawley rats further confirmed the sustained release pattern of tacrolimus for both oral and parenteral delivery routes. The novel fibrin nanoconstructs developed using a green chemistry approach thus proved to be excellent biodegradable nanocarriers for oral as well as parenteral administrations, with remarkable potential also for delivering specific growth factors in tissue engineering scaffolds.

  9. Using the Internet as a Supplemental Delivery Method on University Concepts of Fitness Classes

    Science.gov (United States)

    Mooneyhan, Andy

    2012-01-01

    The purpose of this study was to compare the traditional teaching method of Concepts of Fitness (CF) with a teaching method using the Internet as an instructional supplement. Participants in the study were 52 students (27 male, 25 female) from a four-year institution of higher learning. Participants were enrolled in a required, general education…

  10. Difference in prevalence of common mental disorder as measured using four questionnaire delivery methods among young people in rural Zimbabwe.

    Science.gov (United States)

    Langhaug, Lisa F; Cheung, Yin Bun; Pascoe, Sophie; Hayes, Richard; Cowan, Frances M

    2009-11-01

    Previous studies have suggested that interviewer-administered questionnaires can under-estimate the prevalence of depression and suicidal ideation when compared with self-administered ones. We report here on differences in prevalence of reporting mental health between four questionnaire delivery modes (QDM). Mental health was assessed using the Shona Symptom Questionnaire (SSQ), a locally validated 14-item indigenous measure for common mental affective disorders. A representative sample of 1495 rural Zimbabwean adolescents (median age 18) was randomly allocated to one of four questionnaire delivery modes: self-administered questionnaire (SAQ), SAQ with audio (AASI), interviewer-administered questionnaire (IAQ), and audio computer-assisted survey instrument (ACASI). Prevalence of common affective disorders varied between QDM (52.3%, 48.6%, 41.5%, and 63.6% for SAQ, AASI, IAQ, and ACASI respectively (P<0.001)). Fewer participants failed to complete SSQ using IAQ and ACASI than other methods (1.6% vs. 12.3%; P<0.001). Qualitative data suggested that respondents found it difficult answering questions honestly in front of an interviewer. Direction of accuracy cannot be ascertained due to lack of objective or clinical assessments of affective disorders. Estimates of prevalence of psychosomatic symptoms and suicidal ideation varied according to mode of interview. As each mode's direction of accuracy remains unresolved evaluations of interventions continue to be hampered.

  11. Development of a qualitative exploratory case study research method to explore sustained delivery of cognitive services.

    Science.gov (United States)

    Kaae, Susanne; Søndergaard, Birthe; Haugbølle, Lotte Stig; Traulsen, Janine Morgall

    2010-02-01

    To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the

  12. Self-assembling peptide amphiphiles and related methods for growth factor delivery

    Energy Technology Data Exchange (ETDEWEB)

    Stupp, Samuel I; Donners, Jack J.J.M.; Silva, Gabriel A; Behanna, Heather A; Anthony, Shawn G

    2013-11-12

    Amphiphilic peptide compounds comprising one or more epitope sequences for binding interaction with one or more corresponding growth factors, micellar assemblies of such compounds and related methods of use.

  13. Single-Injection HPLC Method for Rapid Analysis of a Combination Drug Delivery System

    National Research Council Canada - National Science Library

    Tucker, Robert M; Parcher, Benjamin W; Jones, Ella F; Desai, Tejal A

    2012-01-01

    .... We present a single-step method for quantifying three model therapeutics released from a model hydrogel scaffold using high-performance liquid chromatography (HPLC). Poly(ethylene glycol) dimethacrylate (PEGDMA...

  14. Self-assembling peptide amphiphiles and related methods for growth factor delivery

    Science.gov (United States)

    Stupp, Samuel I [Chicago, IL; Donners, Jack J. J. M.; Silva, Gabriel A [Chicago, IL; Behanna, Heather A [Chicago, IL; Anthony, Shawn G [New Stanton, PA

    2012-03-20

    Amphiphilic peptide compounds comprising one or more epitope sequences for binding interaction with one or more corresponding growth factors, micellar assemblies of such compounds and related methods of use.

  15. Syringe-feeding as a novel delivery method for accurate individual dosing of probiotics in rats

    DEFF Research Database (Denmark)

    Tillmann, Sandra; Wegener, Gregers

    2017-01-01

    Probiotic administration to rodents is typically achieved using oral gavage or water bottles, but both approaches may compromise animal welfare, bacterial viability, dosing accuracy, or ease of administration. Oral gavage dosing may induce stress, especially when given daily over several weeks...... leftovers or clogging of the bottle further threaten the reliability of this method. To date, no method has been described that can provide non-stressful precise dosing of probiotics or prebiotics in individual rats. In accordance with the 3R principles (replace, reduce, refine), we propose syringe......-feeding as a refinement method for simple yet accurate administration of probiotics. Animals hereby voluntarily consume the solution directly from a syringe held into their home cage, thereby enabling controlled dosing of individual animals. This method requires a short training phase of approximately 3 days, but is very...

  16. Morphological analysis: a method for selecting ICT applications in South African government service delivery

    CSIR Research Space (South Africa)

    Plauché, M

    2010-01-01

    Full Text Available Successful ICT projects depend on complex, interrelated sociological and technical factors for which there are no standard theoretical framework for prediction or analysis. Morphological analysis is a problem-solving method for defining, linking...

  17. The effect of pelvic floor muscle exercises program on sexual self-efficacy in primiparous women after delivery

    OpenAIRE

    Golmakani, Nahid; Zare, Zahra; Khadem, Nayereh; Shareh, Hossein; Shakeri, Mohammad Taghi

    2015-01-01

    Background: Selection and acceptance of appropriate sexual behavior and sexual function are made difficult by low sexual self-efficacy in the postpartum period. The general purpose of this research is to define the effects of an 8-week pelvic floor muscle exercise program on sexual self-efficacy in primiparous women after childbirth. Materials and Methods: This clinical trial was performed on 79 primiparous women who referred to health care centers, Mashhad, Iran in 2013, 8 weeks after delive...

  18. Bayesian methods for hackers probabilistic programming and Bayesian inference

    CERN Document Server

    Davidson-Pilon, Cameron

    2016-01-01

    Bayesian methods of inference are deeply natural and extremely powerful. However, most discussions of Bayesian inference rely on intensely complex mathematical analyses and artificial examples, making it inaccessible to anyone without a strong mathematical background. Now, though, Cameron Davidson-Pilon introduces Bayesian inference from a computational perspective, bridging theory to practice–freeing you to get results using computing power. Bayesian Methods for Hackers illuminates Bayesian inference through probabilistic programming with the powerful PyMC language and the closely related Python tools NumPy, SciPy, and Matplotlib. Using this approach, you can reach effective solutions in small increments, without extensive mathematical intervention. Davidson-Pilon begins by introducing the concepts underlying Bayesian inference, comparing it with other techniques and guiding you through building and training your first Bayesian model. Next, he introduces PyMC through a series of detailed examples a...

  19. The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People

    Directory of Open Access Journals (Sweden)

    Alice Knight

    2017-02-01

    Full Text Available Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence measures into the routine data collection processes of a service for high-risk young people, and identify the number and nature of risk factors experienced by participants. Methods: The youth service is a rural based NGO comprised of multiple program components: (i engagement activities; (ii case management; (iii diversionary activities; (iv personal development; and (v learning and skills. A best-evidence assessment tool was developed by staff and researchers and embedded into the service’s existing intake procedure. Assessment items were organised into demographic characteristics and four domains of risk: education and employment; health and wellbeing; substance use; and crime. Descriptive data are presented and summary risk variables were created for each domain of risk. A count of these summary variables represented the number of co-occurring risks experienced by each participant. The feasibility of this process was determined by the proportion of participants who completed the intake assessment and provided research consent. Results: This study shows 85% of participants completed the assessment tool demonstrating that data on participant risk factors can feasibly be collected by embedding a best-evidence assessment tool into the routine data collection processes of a service. The most prevalent risk factors were school absence, unemployment, suicide ideation, mental distress, substance use, low levels of physical activity, low health service utilisation

  20. The NCI Patient Navigation Research Program Methods, Protocol and Measures

    Science.gov (United States)

    Freund, Karen M; Battaglia, Tracy A; Calhoun, Elizabeth; Dudley, Donald J.; Fiscella, Kevin; Paskett, Electra; Raich, Peter C.; Roetzheim, Richard G.

    2009-01-01

    Background Patient, provider, and systems barriers contribute to delays in cancer care, lower quality of care, and poorer outcomes in vulnerable populations, including low income, underinsured, and racial/ethnic minority populations. Patient navigation is emerging as an intervention to address this problem, but navigation requires a clear definition and a rigorous testing of its effectiveness. Pilot programs have provided some evidence of benefit, but have been limited by evaluation of single-site interventions and varying definitions of navigation. To overcome these limitations, a nine-site National Cancer Institute Patient Navigation Research Program (PNRP) was initiated. Methods The PNRP is charged with designing, implementing and evaluating a generalizable patient navigation program targeting vulnerable populations. Through a formal committee structure, the PNRP has developed a definition of patient navigation and metrics to assess the process and outcomes of patient navigation in diverse settings, compared with concurrent continuous control groups. Results The PNRP defines patient navigation as support and guidance offered to vulnerable persons with abnormal cancer screening or a cancer diagnosis, with the goal of overcoming barriers to timely, quality care. Primary outcomes of the PNRP are (1) time to diagnostic resolution, (2) time to initiation of cancer treatment, (3) patient satisfaction with care, and (4) cost effectiveness, for breast, cervical, colon/rectum, and/or prostate cancer. Conclusions The metrics to assess the processes and outcomes of patient navigation have been developed for the NCI-sponsored Patient Navigator Research Program. If the metrics are found to be valid and reliable, they may prove useful to other investigators. PMID:18951521

  1. Connecting the dots and merging meaning: using mixed methods to study primary care delivery transformation.

    Science.gov (United States)

    Scammon, Debra L; Tomoaia-Cotisel, Andrada; Day, Rachel L; Day, Julie; Kim, Jaewhan; Waitzman, Norman J; Farrell, Timothy W; Magill, Michael K

    2013-12-01

    To demonstrate the value of mixed methods in the study of practice transformation and illustrate procedures for connecting methods and for merging findings to enhance the meaning derived. An integrated network of university-owned, primary care practices at the University of Utah (Community Clinics or CCs). CC has adopted Care by Design, its version of the Patient Centered Medical Home. Convergent case study mixed methods design. Analysis of archival documents, internal operational reports, in-clinic observations, chart audits, surveys, semistructured interviews, focus groups, Centers for Medicare and Medicaid Services database, and the Utah All Payer Claims Database. Each data source enriched our understanding of the change process and understanding of reasons that certain changes were more difficult than others both in general and for particular clinics. Mixed methods enabled generation and testing of hypotheses about change and led to a comprehensive understanding of practice change. Mixed methods are useful in studying practice transformation. Challenges exist but can be overcome with careful planning and persistence. © Health Research and Educational Trust.

  2. The HACMS program: using formal methods to eliminate exploitable bugs

    Science.gov (United States)

    Launchbury, John; Richards, Raymond

    2017-01-01

    For decades, formal methods have offered the promise of verified software that does not have exploitable bugs. Until recently, however, it has not been possible to verify software of sufficient complexity to be useful. Recently, that situation has changed. SeL4 is an open-source operating system microkernel efficient enough to be used in a wide range of practical applications. Its designers proved it to be fully functionally correct, ensuring the absence of buffer overflows, null pointer exceptions, use-after-free errors, etc., and guaranteeing integrity and confidentiality. The CompCert Verifying C Compiler maps source C programs to provably equivalent assembly language, ensuring the absence of exploitable bugs in the compiler. A number of factors have enabled this revolution, including faster processors, increased automation, more extensive infrastructure, specialized logics and the decision to co-develop code and correctness proofs rather than verify existing artefacts. In this paper, we explore the promise and limitations of current formal-methods techniques. We discuss these issues in the context of DARPA’s HACMS program, which had as its goal the creation of high-assurance software for vehicles, including quadcopters, helicopters and automobiles. This article is part of the themed issue ‘Verified trustworthy software systems’. PMID:28871050

  3. Quality of delivery of the Standard Days Method as compared with contraceptive pills in Rwanda.

    Science.gov (United States)

    León, Federico R; Blair, Caroline; Huapaya, Ana; Lundgren, Rebecka; Mukabatsinda, Marie; Muramutsa, Félix; Jennings, Victoria

    2006-10-01

    Replicating a Peruvian study, this research introduced the Standard Days Method (SDM) into Rwanda Ministry of Health clinics and evaluated client counselling on the new method against that given for contraceptive pills. Providers received technical reinforcement concerning established methods in addition to SDM training. To evaluate their quality of care, simulated clients implemented a service test in visits to 20 clinics. As in Peru, providers exchanged significantly more relevant information with clients who chose SDM than with those who chose pills. Also, a minority of providers posed barriers to SDM access by refusing to give SDM tools to the client until she brought her partner for consultation. The findings of this study confirm that SDM counselling is generally satisfactory, although SDM training needs adjustment, and that the rigour of providers' pill counselling remains below capacity.

  4. Preparation and pharmaceutical evaluation of nano-fiber matrix supported drug delivery system using the solvent-based electrospinning method.

    Science.gov (United States)

    Hamori, Mami; Yoshimatsu, Shiori; Hukuchi, Yuki; Shimizu, Yuki; Fukushima, Keizo; Sugioka, Nobuyuki; Nishimura, Asako; Shibata, Nobuhito

    2014-04-10

    In this study, utilizing the solvent-based electrospinning (ES) method, which is mainly employed in the textile industry, we prepared nanofiber-based capsules including drugs for controlled-release delivery systems using methacrylic acid copolymer (EUDRAGIT(®) S100, MAC) as a polymer, and evaluated their in vitro drug dissolution profiles and in vivo pharmacokinetics in rats. As the model drugs, uranine (UN) was used as a water-soluble drug and nifedipine (NP) as a water-insoluble drug. The mean diameters of drug free nano-fiber and nano-fiber including NP or UN were 751.5 ± 67.2, 703.3 ± 71.2 and 2477.8 ± 206.1 nm, respectively. X-ray diffraction for the nano-fibrotic sheet showed that UN and/or NP were packed in nano-fiber in an amorphous form. The in vitro release of UN or NP from the nano-fiber packed capsules (NFPC) and milled-powder of nano-fiber packed capsules (MPPC) showed controlled release of UN or NP as compared to capsules of a physical mixture of MAC and each drug. An in vivo pharmacokinetic study in rats after intraduodenal administration of NFPC or MPPC including UN and/or NP clearly demonstrated that application of nano-fibrotic technique as a drug delivery system offers drastic changes in pharmacokinetic profiles for both water-soluble and water-insoluble drugs. The ES method is a useful technique to prepare a nano-fiber like solid dispersion for polar or nonpolar drugs, and has wide potential pharmaceutical applications. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Design of eudragit RL nanoparticles by nanoemulsion method as carriers for ophthalmic drug delivery of ketotifen fumarate

    Directory of Open Access Journals (Sweden)

    Saieede Soltani

    2016-05-01

    Full Text Available Objective(s: Ketotifen fumarate (KF is a selective and noncompetitive histamine antagonist (H1-receptor that is used topically in the treatment of allergic conditions of rhinitis and conjunctivitis. The aim of this study was to formulate and improve an ophthalmic delivery system of KF.Ocular nanoparticles were prepared with the objective of reducing the frequency of administration and obtaining controlled release to improve the anti-inflammatory drug delivery. Materials and Methods:In the present study, ocular KF loaded Eudragit RL 100 nanoparticles were prepared using O/W solvent diffusion method. The nanoparticles were evaluated for particle size, entrapment efficiency, surface morphology, X-ray diffraction (XRD, Fourier transform spectroscopy (FTIR, and differential scanning calorimetry (DSC. In vitro release and permeation studies were also carried out on nanoparticles. Results: An average size range of 182 to 314.30 nm in diameter was obtained and encapsulation efficiency up to 95.0% was observed for all the formulations. Drug release for all formulations after 24 hr was between 65.51% and 88.82% indicating effective controlled release property of KF. The mechanism of drug release for best formulation was found to be fickian diffusion mechanism. KF nanoparticles containing high polymer concentration (1:15 presented a faster drug release and a higher drug penetration; on the contrary, nanoparticles containing low polymer concentration (1:7.5 were able to give a more sustained release of the drug and thus a slower KF permeation through the cornea. Conclusion: The study revealed that KF NPs were capable of releasing the drug for a prolonged period of time and increasing the ocular bioavailability.

  6. Acceptability of vaginal film, soft-gel capsule, and tablet as potential microbicide delivery methods among African women.

    Science.gov (United States)

    Nel, Annalene M; Mitchnick, Lynne B; Risha, Peter; Muungo, Lungwani Tyson Makoye; Norick, Pamela M

    2011-08-01

    Vaginal microbicides are in development for the prevention of HIV transmission to women via sexual intercourse. Acceptability of the microbicide delivery method in the targeted population is important to product adherence and, therefore, product effectiveness. It is anticipated that multiple delivery methods will be required to satisfy personal preferences among future microbicide users. A total of 526 sexually active women aged 18-30 years participated in a consumer product preference study in Burkina Faso, Tanzania, and Zambia. Screened women who had given consent were instructed to use each of the three products (placebo formulations of a vaginal tablet, film, and soft-gel capsule) once daily for 7 consecutive days for a total of 21 days. Women were interviewed about their impressions of the product at the completion of each 7-day trial period. Over 80% of women reported they liked using each dosage form, and over 85% said they would definitely use it. The film and soft-gel capsule were chosen significantly more often than the tablet as the preferred dosage form (39% and 37% vs. 25%, respectively) mainly because of faster dissolving time and easier insertion. Women in Burkina Faso and Tanzania preferred the soft-gel capsule (42%-46%), whereas Zambian women preferred the film (51%). Age, socioeconomic status, and marital status did not significantly affect product preference. All three dosage forms were acceptable to the women surveyed. Preferred dosage forms varied by country. These data suggest that the availability of microbicides in multiple dosage forms may increase acceptability, adherence, and, therefore, effectiveness.

  7. Method for delivery of small molecules and proteins across the cell wall of algae using molecular transporters

    Science.gov (United States)

    Geihe, Erika; Trantow, Brian; Wender, Paul; Hyman, Joel M.; Parvin, Bahram

    2017-11-14

    The introduction of tools to study, control or expand the inner-workings of algae has been slow to develop. Provided are embodiments of a molecular method based on guanidinium-rich molecular transporters (GR-MoTrs) for bringing molecular cargos into algal cells. The methods of the disclosure have been shown to work in wild-type algae that have an intact cell wall. Developed using Chlamydomonas reinhardtii, this method is also successful with less studied algae, including Neochloris oleoabundans and Scenedesmus dimorphus, thus providing a new and versatile tool for algal research and modification. The method of delivering a cargo compound to an algal cell comprises contacting an algal cell with a guanidinium-rich delivery vehicle comprising a guanidinium-rich molecular transporter (GR-MoTr) linked to a cargo compound desired to be delivered to the algal cell, whereby the guanidinium-rich molecular transporter can traverse the algal cell wall, thereby delivering the cargo compound to the algal cell.

  8. Preferred Methods of Learning for Nursing Students in an On-Line Degree Program.

    Science.gov (United States)

    Hampton, Debra; Pearce, Patricia F; Moser, Debra K

    Investigators have demonstrated that on-line courses result in effective learning outcomes, but limited information has been published related to preferred teaching strategies. Delivery of on-line courses requires various teaching methods to facilitate interaction between students, content, and technology. The purposes of this study were to understand student teaching/learning preferences in on-line courses to include (a) differences in preferred teaching/learning methods for on-line nursing students across generations and (b) which teaching strategies students found to be most engaging and effective. Participants were recruited from 2 accredited, private school nursing programs (N=944) that admit students from across the United States and deliver courses on-line. Participants provided implied consent, and 217 (23%) students completed the on-line survey. Thirty-two percent of the students were from the Baby Boomer generation (1946-1964), 48% from Generation X (1965-1980), and 20% from the Millennial Generation (born after 1980). The preferred teaching/learning methods for students were videos or narrated PowerPoint presentations, followed by synchronous Adobe Connect educations sessions, assigned journal article reading, and e-mail dialog with the instructor. The top 2 methods identified by participants as the most energizing/engaging and most effective for learning were videos or narrated PowerPoint presentations and case studies. The teaching/learning method least preferred by participants and that was the least energizing/engaging was group collaborative projects with other students; the method that was the least effective for learning was wikis. Baby Boomers and Generation X participants had a significantly greater preference for discussion board (Plearning (Plearning methods for on-line students. Faculty need to incorporate various teaching methodologies within on-line courses to include both synchronous and asynchronous activities and interactive and passive

  9. Self-management toolkit and delivery strategy for end-of-life pain: the mixed-methods feasibility study.

    Science.gov (United States)

    Bennett, Michael I; Mulvey, Matthew R; Campling, Natasha; Latter, Sue; Richardson, Alison; Bekker, Hilary; Blenkinsopp, Alison; Carder, Paul; Closs, Jose; Farrin, Amanda; Flemming, Kate; Gallagher, Jean; Meads, David; Morley, Stephen; O'Dwyer, John; Wright-Hughes, Alexandra; Hartley, Suzanne

    2017-12-01

    Pain affects most people approaching the end of life and can be severe for some. Opioid analgesia is effective, but evidence is needed about how best to support patients in managing these medicines. To develop a self-management support toolkit (SMST) and delivery strategy and to test the feasibility of evaluating this intervention in a future definitive trial. Phase I - evidence synthesis and qualitative interviews with patients and carers. Phase II - qualitative semistructured focus groups and interviews with patients, carers and specialist palliative care health professionals. Phase III - multicentre mixed-methods single-arm pre-post observational feasibility study. Phase I - six patients and carers. Phase II - 15 patients, four carers and 19 professionals. Phase III - 19 patients recruited to intervention that experienced pain, living at home and were treated with strong opioid analgesia. Process evaluation interviews with 13 patients, seven carers and 11 study nurses. Self-Management of Analgesia and Related Treatments at the end of life (SMART) intervention comprising a SMST and a four-step educational delivery approach by clinical nurse specialists in palliative care over 6 weeks. Recruitment rate, treatment fidelity, treatment acceptability, patient-reported outcomes (such as scores on the Brief Pain Inventory, Self-Efficacy for Managing Chronic Disease Scale, Edmonton Symptom Assessment Scale, EuroQol-5 Dimensions, Satisfaction with Information about Medicines Scale, and feasibility of collecting data on health-care resource use for economic evaluation). Phase I - key themes on supported self-management were identified from evidence synthesis and qualitative interviews. Phase II - the SMST was developed and refined. The delivery approach was nested within a nurse-patient consultation. Phase III - intervention was delivered to 17 (89%) patients, follow-up data at 6 weeks were available on 15 patients. Overall, the intervention was viewed as acceptable and

  10. Utilization of clean and safe delivery service package of health services extension program and associated factors in rural kebeles of Kafa Zone, Southwest Ethiopia.

    Science.gov (United States)

    Bayou, Negalign Berhanu; Gacho, Yohannes Haile Michael

    2013-07-01

    In Ethiopia, 94% of births take place at home unattended by trained persons. The government introduced an innovative strategy, Health Services Extension Program in 2003. Clean and safe delivery service is a component of maternal and child healthcare package of the program. However, little is known about the status of uptake of the service. This study thus aimed to assess utilization of clean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia. A community based cross sectional survey was conducted in rural kebeles of Kefa Zone from January 21(st) to February 25(th), 2009 using a sample of 229 mothers. Kafa Zone is located 465 kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structured questionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. Pextension workers should consider antenatal care visits as opportunities for this purpose.

  11. Design of Eudragit RL 100 nanoparticles by nanoprecipitation method for ocular drug delivery.

    Science.gov (United States)

    Das, Swarnali; Suresh, Preeti K; Desmukh, Rohitas

    2010-04-01

    The objective of the current study was to prepare positively charged amphotericin-B-loaded nanoparticles providing a controlled release formulation. The particles were prepared by solvent displacement or nanoprecipitation method. The non-biodegradable positively charged polymer Eudragit RL 100 was used to prepare the different formulations with varying ratios of drug and polymer. The formulations were evaluated in terms of particle size, zeta potential, and differential scanning calorimetry measurements. Drug entrapment and release properties were examined also. The antimicrobial activity against Fusarium solani was determined. In vivo eye irritation study was carried out by a modified Draize test. All the formulations remained within a size range of 130 to 300 nm in fresh preparation as well as after 2 months. The zeta potential was positive (+22 to +42 mV) for all the formulations and was suitable for ophthalmic application. A prolonged drug release was shown by all the formulations. The formulation possesses a good antifungal activity against Fusarium solani when tested by disk diffusion method, and no eye irritation on in vivo testing was found. The objective of the current study was to prepare positively charged amphotericin-B-loaded nanoparticles providing a controlled release formulation. The described formulation displayed good antifungal activity against Fusarium solani when tested by disk diffusion method, and no eye irritation on in vivo testing was found. Copyright 2010 Elsevier Inc. All rights reserved.

  12. Data and methods to facilitate delivery system reform: harnessing collective intelligence to learn from positive deviance.

    Science.gov (United States)

    Luft, Harold S

    2010-10-01

    Researchers often focus on the data and methods to assess policy changes, but data and methods can also be policy tools. To improve, health care systems need mechanisms and incentives for continually gathering, assessing, and acting on data. This requires (1) more comprehensive data, (2) converting data into information, and (3) incentives to apply that information. Restructured economic incentives can encourage clinicians to increase value (higher quality and/or lower cost) for their patients. While necessary, incentives are not sufficient-information is also needed. Incentives can lead clinicians to demand better information. Much of the necessary data is already used in patient care and billing; some additional variables will come directly from patients. The notion builds on two concepts: collective intelligence and positive deviance. The former characterizes knowledge gained from observing the behavior of many independent actors adapting to changing situations. Positive deviants are those who achieve far better results than expected. By rewarding positive deviants, rather than trying to identify and "correct" those who are problematic, providers will voluntarily identify themselves and their methods for achieving superior outcomes. © Health Research and Educational Trust.

  13. Highly efficient method for gene delivery into mouse dorsal root ganglia neurons.

    Science.gov (United States)

    Yu, Lingli; Reynaud, Florie; Falk, Julien; Spencer, Ambre; Ding, Yin-Di; Baumlé, Véronique; Lu, Ruisheng; Castellani, Valérie; Yuan, Chonggang; Rudkin, Brian B

    2015-01-01

    The development of gene transfection technologies has greatly advanced our understanding of life sciences. While use of viral vectors has clear efficacy, it requires specific expertise and biological containment conditions. Electroporation has become an effective and commonly used method for introducing DNA into neurons and in intact brain tissue. The present study describes the use of the Neon® electroporation system to transfect genes into dorsal root ganglia neurons isolated from embryonic mouse Day 13.5-16. This cell type has been particularly recalcitrant and refractory to physical or chemical methods for introduction of DNA. By optimizing the culture condition and parameters including voltage and duration for this specific electroporation system, high efficiency (60-80%) and low toxicity (>60% survival) were achieved with robust differentiation in response to Nerve growth factor (NGF). Moreover, 3-50 times fewer cells are needed (6 × 10(4)) compared with other traditional electroporation methods. This approach underlines the efficacy of this type of electroporation, particularly when only limited amount of cells can be obtained, and is expected to greatly facilitate the study of gene function in dorsal root ganglia neuron cultures.

  14. Highly efficient method for gene delivery in mouse dorsal root ganglia neurons

    Directory of Open Access Journals (Sweden)

    Lingli eYu

    2015-02-01

    Full Text Available The development of gene transfection technologies has greatly advanced our understanding of life sciences. While use of viral vectors has clear efficacy, it requires specific expertise and biological containment conditions. Electroporation has become an effective and commonly used method for introducing DNA into neurons and in intact brain tissue. The present study describes the use of the Neon® electroporation system to transfect genes into dorsal root ganglia neurons isolated from embryonic mouse Day 13.5 to 16. This cell type has been particularly recalcitrant and refractory to physical or chemical methods for introduction of DNA. By optimizing the culture condition and parameters including voltage and duration for this specific electroporation system, high efficiency (60 – 80% and low toxicity (> 60% survival were achieved with robust differentiation in response to Nerve growth factor (NGF. Moreover, 3-50 times fewer cells are needed (6x104 compared with other traditional electroporation methods. This approach underlines the efficacy of this type of electroporation, particularly when only limited amount of cells can be obtained, and is expected to greatly facilitate the study of gene function in dorsal root ganglia neuron cultures.

  15. Home Visitation Programs for At-risk Young Families: A Systematic Literature Review

    National Research Council Canada - National Science Library

    J.E. Drummond; A.E. Weir; G.M. Kysela

    2002-01-01

    ... home visitation for at-risk young families as the major delivery method. Objectives: To describe the program components, practices, outcomes, and reliability of the evaluation approaches. Methods...

  16. A versatile, quantitative analytical method for pharmaceutical relevant lipids in drug delivery systems.

    Science.gov (United States)

    Jeschek, Dominik; Lhota, Gabriele; Wallner, Jakob; Vorauer-Uhl, Karola

    2016-02-05

    Over the past few years, liposomal formulations as drug carrier systems have markedly advanced in pharmaceutical research and development. Therefore, analytical methods to characterize liposome-based formulations are required. One particular issue in liposome analysis is the imbalance of lipid ratios within the vesicle formulations and the detectability of degradation products such as lysophospholipids and fatty acids caused by hydrolysis, especially in low molar ranges. Here, a highly sensitive and selective reversed-phase high-performance liquid chromatography (rp-HPLC) method is described by the combination of an organic solvent/trifluoroacetic acid (TFA) triggered gradient and the application of an evaporative light scattering detector (ELSD). Gain setting adjustments of the ELSD were applied to obtain an optimal detection profile of the analyzed substances. This optimization provides simultaneous separation and quantification of 16 components, including different phosphatidylcholines, phosphatidylglycerols and their degradation products, as well as cholesterol. Parameters such as limit of detection (LOD) and limit of quantification (LOQ) were determined for each of the components and had ranges from 0.25-1.00mg/mL (LOD) and 0.50-2.50μg/mL (LOQ), respectively. The intra-day precision for all analytes is less than 3% (RSD) and inter-day precision is about 8%. The applicability of the method was verified by analyzing two different liposome formulations consisting of DSPC:DPPC:DSPG:Chol (35:35:20:10) and DSPC:DPPC:DSPG (38:38:24). For degradation studies, both formulations were stored at 4°C and at ambient temperature. Additionally, forced degradation experiments were performed to determine hydrolysis mass balances. A total recovery of 96-102% for phospholipid compounds was found. Analytical data revealed that the sensitivity, selectivity, accuracy, and resolution are appropriate for the detection and quantification of phospholipids and their hydrolysis products

  17. An Evaluation of the AFIT Teleteach Expanded Delivery System (TEDS) Method of Instruction (Phase 1).

    Science.gov (United States)

    1980-06-01

    reverse sid ait necesary and identify by block nuawborj Teleteach Attitudes InstrucTional Method Learning Effectiveness A? IT 20. ABSTRACT (Continue...an reverse side If naeesary mnd Identity by block number) Thesis Chairmani Micheal B. McCormick, Lt Col. USA’F DD I711473 EDITION OF 1 -OV&SIS3OUSOLETE...dur--ng the first session o-f each Ccss. This test covered a -.w4de rarge,7 c: >nra logistcal ton ics and -.,as devised to determ.Lne -,he begzlnnlng

  18. Smart Magnetically Responsive Hydrogel Nanoparticles Prepared by a Novel Aerosol-Assisted Method for Biomedical and Drug Delivery Applications

    Directory of Open Access Journals (Sweden)

    Ibrahim M. El-Sherbiny

    2011-01-01

    Full Text Available We have developed a novel spray gelation-based method to synthesize a new series of magnetically responsive hydrogel nanoparticles for biomedical and drug delivery applications. The method is based on the production of hydrogel nanoparticles from sprayed polymeric microdroplets obtained by an air-jet nebulization process that is immediately followed by gelation in a crosslinking fluid. Oligoguluronate (G-blocks was prepared through the partial acid hydrolysis of sodium alginate. PEG-grafted chitosan was also synthesized and characterized (FTIR, EA, and DSC. Then, magnetically responsive hydrogel nanoparticles based on alginate and alginate/G-blocks were synthesized via aerosolization followed by either ionotropic gelation or both ionotropic and polyelectrolyte complexation using CaCl2 or PEG-g-chitosan/CaCl2 as crosslinking agents, respectively. Particle size and dynamic swelling were determined using dynamic light scattering (DLS and microscopy. Surface morphology of the nanoparticles was examined using SEM. The distribution of magnetic cores within the hydrogels nanoparticles was also examined using TEM. In addition, the iron and calcium contents of the particles were estimated using EDS. Spherical magnetic hydrogel nanoparticles with average particle size of 811 ± 162 to 941 ± 2 nm were obtained. This study showed that the developed method is promising for the manufacture of hydrogel nanoparticles, and it represents a relatively simple and potential low-cost system.

  19. Content analysis of age verification, purchase and delivery methods of internet e-cigarette vendors, 2013 and 2014.

    Science.gov (United States)

    Williams, Rebecca S; Derrick, Jason; Liebman, Aliza Kate; LaFleur, Kevin; Ribisl, Kurt M

    2017-05-08

    Identify the population of internet e-cigarette vendors (IEVs) and conduct content analyses of their age verification, purchase and delivery methods in 2013 and 2014. We used multiple sources to identify IEV websites, primarily complex search algorithms scanning more than 180 million websites. In 2013, we manually screened 32 446 websites, identifying 980 IEVs, selecting the 281 most popular for content analysis. This methodology yielded 31 239 websites for screening in 2014, identifying 3096 IEVs, with 283 selected for content analysis. The proportion of vendors that sold online-only, with no retail store, dropped significantly from 2013 (74.7%) to 2014 (64.3%) (pverification or relying exclusively on strategies that cannot effectively verify age. Effective age verification strategies such as online age verification services (7.1% in 2013 and 8.5% in 2014), driving licences (1.8% in 2013 and 7.4% in 2014, pverification at delivery (6.4% in 2013 and 8.1% in 2104) were rarely advertised on IEV websites. Nearly all vendors advertised accepting credit cards, and about ¾ shipping via United States Postal Service, similar to the internet cigarette industry prior to federal bans. The number of IEVs grew sharply from 2013 to 2014, with poor age verification practices. New and expanded regulations for online e-cigarette sales are needed, including strict age and identity verification requirements. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Moderating effects of parental well-being on parenting efficacy outcomes by intervention delivery model of the early risers conduct problems prevention program.

    Science.gov (United States)

    Piehler, Timothy F; Lee, Susanne S; Bloomquist, Michael L; August, Gerald J

    2014-10-01

    Parent-focused preventive interventions for youth conduct problems are efficacious when offered in different models of delivery (e.g., individual in-home, group center-based). However, we know little about the characteristics of parents associated with a positive response to a particular model of delivery. We randomly assigned the parents of an ethnically diverse sample of kindergarten through second grade students (n = 246) displaying elevated levels of aggression to parent-focused program delivery models emphasizing receiving services in a community center largely with groups (Center; n = 121) or receiving services via an individualized in-home strategy (Outreach; n = 125). In both delivery models, parents received parent skills training and goal setting/case management/referrals over an average of 16 months. Structural equation modeling revealed a significant interaction between parental well-being at baseline and intervention delivery model in predicting parenting efficacy at year 2, while controlling for baseline levels of parenting efficacy. Within the Outreach model, parents with lower levels of well-being as reported at baseline appeared to show greater improvements in parenting efficacy than parents with higher levels of well-being. Within the Center model, parental well-being did not predict parenting efficacy outcomes. The strong response of low well-being parents within the Outreach model suggests that this may be the preferred model for these parents. These findings provide support for further investigation into tailoring delivery model of parent-focused preventive interventions using parental well-being in order to improve parenting outcomes.

  1. A novel method for monolithic fabrication of polymer microneedles on a platform for transdermal drug delivery.

    Science.gov (United States)

    Chaudhuri, Buddhadev P; Ceyssens, F; Van Hoof, C; Puers, R

    2013-01-01

    This paper reports on the creation of a novel method for monolithic fabrication of out-of-plane polymer (SU-8) microneedles incorporating sharpness of needle-tips, hollowness of needle lumen as well as a platform on which the microneedles stand orthogonally with the hollow of the needle lumen continuous through the platform. In essence, both the microneedle as well as the platform on which it stands, are made of the same polymer material, rendering the process monolithic. The microneedle tips produced were quite sharp with tip diameters ranging between 5 to 10 µm, needle heights greater than 1 mm and resulting aspect ratio of 40. Further, mechanical tests performed on the fabricated microneedles demonstrate a critical compressive failure load of about 173 mN on average per microneedle, which translates into a safety factor greater than one for skin penetration.

  2. Control method for peak power delivery with limited DC-bus voltage

    Science.gov (United States)

    Edwards, John; Xu, Longya; Bhargava, Brij B.

    2006-09-05

    A method for driving a neutral point-clamped multi-level voltage source inverter supplying a synchronous motor is provided. A DC current is received at a neutral point-clamped multi-level voltage source inverter. The inverter has first, second, and third output nodes. The inverter also has a plurality of switches. A desired speed of a synchronous motor connected to the inverter by the first second and third nodes is received by the inverter. The synchronous motor has a rotor and the speed of the motor is defined by the rotational rate of the rotor. A position of the rotor is sensed, current flowing to the motor out of at least two of the first, second, and third output nodes is sensed, and predetermined switches are automatically activated by the inverter responsive to the sensed rotor position, the sensed current, and the desired speed.

  3. UTERINE COMPRESSION SUTURES: A METHOD OF SURGICAL HAEMOSTASIS DURING CAESAREAN DELIVERY (HYSTEROSCOPIC ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Maria Petrovna Evseeva

    2017-01-01

    Full Text Available Background: to assess the efficiency of uterine compression sutures in treatment of severe postpartum hemorrhage. Materials and methods: 55 patients who had been performed cesarean section from 2013 to 2015 were examined. The basic group included 25 patients with uterine compression sutures that had been performed to stop severe postpartum hemorrhage, the control group – 30 patients without severe postpartum hemorrhage. The main outcome measures were the ability to stop hemorrhage, complications of postpartum period and the assessment of the uterine cavity by hysteroscopy. Results: uterine compression sutures stopped postpartum hemorrhage in 19 of 25 cases (76%. None of the women developed postpartum period complications related to the procedure. Ten women underwent hysteroscopy after uterine compression sutures. Two women (20% had ligature in the uterine cavity. Conclusion: Our results suggest that uterine compression sutures is an effective and safe treatment for postpartum haemorrhage.

  4. pH-sensitive micelles for targeted drug delivery prepared using a novel membrane contactor method.

    Science.gov (United States)

    Laouini, Abdallah; Koutroumanis, Konstantinos P; Charcosset, Catherine; Georgiadou, Stella; Fessi, Hatem; Holdich, Richard G; Vladisavljević, Goran T

    2013-09-25

    A novel membrane contactor method was used to produce size-controlled poly(ethylene glycol)-b-polycaprolactone (PEG-PCL) copolymer micelles composed of diblock copolymers with different average molecular weights, Mn (9200 or 10,400 Da) and hydrophilic fractions, f (0.67 or 0.59). By injecting 570 L m(-2) h(-1) of the organic phase (a 1 mg mL(-1) solution of PEG-PCL in tetrahydrofuran) through a microengineered nickel membrane with a hexagonal pore array and 200 μm pore spacing into deionized water agitated at 700 rpm, the micelle size linearly increased from 92 nm for a 5-μm pore size to 165 nm for a 40-μm pore size. The micelle size was finely tuned by the agitation rate, transmembrane flux and aqueous to organic phase ratio. An encapsulation efficiency of 89% and a drug loading of ~75% (w/w) were achieved when a hydrophobic drug (vitamin E) was entrapped within the micelles, as determined by ultracentrifugation method. The drug-loaded micelles had a mean size of 146 ± 7 nm, a polydispersity index of 0.09 ± 0.01, and a ζ potential of -19.5 ± 0.2 mV. When drug-loaded micelles where stored for 50 h, a pH sensitive drug release was achieved and a maximum amount of vitamin E (23%) was released at the pH of 1.9. When a pH-sensitive hydrazone bond was incorporated between PEG and PCL blocks, no significant change in micelle size was observed at the same micellization conditions.

  5. Drug delivery formulations of ordered and nonordered mesoporous silica: comparison of three drug loading methods.

    Science.gov (United States)

    Limnell, Tarja; Santos, Hélder A; Mäkilä, Ermei; Heikkilä, Teemu; Salonen, Jarno; Murzin, Dmitry Yu; Kumar, Narendra; Laaksonen, Timo; Peltonen, Leena; Hirvonen, Jouni

    2011-08-01

    A poorly soluble model drug, indomethacin (IMC), was loaded into two types of silica particles using three different loading methods. The loading efficiency and the extent/rate of drug release were evaluated. Widely used equipment in pharmaceutical laboratories, rotavapor and fluid bed, were used in the loading. The porous materials used were ordered mesoporous silica MCM-41 and nonordered silica gel Syloid 244 FP EU. The materials differ both in their pore properties and particle sizes. Tablets were successfully compressed from the IMC-loaded particles. Mechanical stability of the porous structures was studied with XRPD and nitrogen sorption after tableting and drug release was evaluated at pH 5.5 before and after tableting. The release of the poorly soluble IMC was faster from the Syloid than from the MCM-41, presumably due to the larger pore size and smaller particle size. Loading of IMC into the MCM-41 microparticles improved the drug dissolution, and blending the microparticles with pharmaceutical excipients improved the IMC release even further. The fast release was also maintained after tableting. Loading of IMC into the Syloid particles alone was sufficient to produce similar IMC release profiles, as in the case of MCM-41 with the excipients. Copyright © 2011 Wiley-Liss, Inc.

  6. A modified single-cell electroporation method for molecule delivery into a motile protist, Euglena gracilis.

    Science.gov (United States)

    Ohmachi, Masashi; Fujiwara, Yoshie; Muramatsu, Shuki; Yamada, Koji; Iwata, Osamu; Suzuki, Kengo; Wang, Dan Ohtan

    2016-11-01

    Single-cell transfection is a powerful technique for delivering chemicals, drugs, or probes into arbitrary, specific single cells. This technique is especially important when the analysis of molecular function and cellular behavior in individual microscopic organisms such as protists requires the precise identification of the target cell, as fluorescence labeling of bulk populations makes tracking of individual motile protists virtually impossible. Herein, we have modified current single-cell electroporation techniques for delivering fluorescent markers into single Euglena gracilis, a motile photosynthetic microalga. Single-cell electroporation introduced molecules into individual living E. gracilis cells after a negative pressure was applied through a syringe connected to the micropipette to the target cell. The new method achieves high transfection efficiency and viability after electroporation. With the new technique, we successfully introduced a variety of molecules such as GFP, Alexa Fluor 488, and exciton-controlled hybridization-sensitive fluorescent oligonucleotide (ECHO) RNA probes into individual motile E. gracilis cells. We demonstrate imaging of endogenous mRNA in living E. gracilis without interfering with their physiological functions, such as swimming or division, over an extended period of time. Thus the modified single-cell electroporation technique is suitable for delivering versatile functional molecules into individual motile protists. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Same-day initiation of the transdermal hormonal delivery system (contraceptive patch) versus traditional initiation methods.

    Science.gov (United States)

    Murthy, Amitasrigowri S; Creinin, Mitchell D; Harwood, Bryna; Schreiber, Courtney A

    2005-11-01

    Published comparisons of oral contraceptive pill (OCP) initiation methods demonstrate that OCP initiation at the office visit ("Quick Start") resulted in higher continuation rates into the second cycle. This trial was performed to investigate whether Quick Start with the contraceptive patch would provide similar results. Sixty women were randomized to initiate use of the contraceptive patch using Quick Start (Group 1, n=30) or on the first day of their next menses (Group 2, n=30). Telephone contact at 6 weeks occurred to ensure that the second cycle had been initiated. A single follow-up visit was scheduled after completion of the third patch cycle. Continuation rates for Groups 1 and 2 were 97% and 93% (p=1.0), respectively, into the second cycle, and 93% and 90%, respectively, into the third cycle (p=1.0). Only approximately half of the subjects planned to continue using the patch after the study. Quick Start for the contraceptive patch did not improve continuation rates into the second or third cycle.

  8. Doxycycline delivery from PLGA microspheres prepared by a modified solvent removal method.

    Science.gov (United States)

    Patel, Roshni S; Cho, Daniel Y; Tian, Cheng; Chang, Amy; Estrellas, Kenneth M; Lavin, Danya; Furtado, Stacia; Mathiowitz, Edith

    2012-01-01

    We report on the development of a modified solvent removal method for the encapsulation of hydrophilic drugs within poly(lactic-co-glycolic acid) (PLGA). Using a water/oil/oil double emulsion, hydrophilic doxycycline was encapsulated within PLGA spheres with particle diameters ranging from approximately 600 nm to 19 µm. Encapsulation efficiencies of up to 74% were achieved for theoretical loadings from 1% to 10% (w/w), with biphasic release over 85 days with nearly complete release at the end of this time course. About 1% salt was added to the formulations to examine its effects on doxycycline release; salt modulated release only by increasing the magnitude of initial release without altering kinetics. Fourier transform infrared spectroscopy indicated no characteristic differences between doxycycline-loaded and control spheres. Differential scanning calorimetry and X-ray diffraction suggest that there may be a molecular dispersion of the doxycycline within the spheres and the doxycycline may be in an amorphous state, which could explain the slow, prolonged release of the drug.

  9. A comparison between the two methods of magnesium sulfate administration for duration of 12 versus 24 h after delivery in patients with severe preeclampsia.

    Science.gov (United States)

    Kashanian, Maryam; Koohpayehzadeh, Jalil; Sheikhansari, Narges; Bararpour, Foroozan; Sahraian, Ghazal; Asadolla, Sara

    2016-01-01

    To compare between the two methods of magnesium sulfate administration for duration of 12 versus 24 h after delivery in patients with severe preeclampsia. The study was performed as a randomized clinical trial on 182 cases of severe preeclampsia. In one group, Mg sulfate (MgSO4) was prescribed for 12 h after delivery and, in the other group, it was prescribed for 24 h after delivery. Both groups were compared for occurrence of convulsion and other adverse effects. The women of the two groups did not have significant difference according to age, BMI, parity and gravidity, gestational age at the time of delivery. Also, systolic blood pressure, diastolic blood pressure, antihypertensive use, previous diabetes and renal disorders, gestational diabetes, and proteinuria were similar in both groups before treatment. One woman had convulsion in the 12-h group and MgSO4 was continued for 24 h in this case. Blood pressure, urine volume, and laboratory indexes did not show significant differences between the two groups before and after treatment. Also, adverse effects were similar in both groups. Pain of the injection site was less in the 12-h group (p = 0.048). Administration of MgSO4 for a duration of 12 h after delivery should be considered somehow as effective as 24 h prescription for preventing convulsion after delivery.

  10. Noninvasive targeting delivery and in vivo magnetic resonance tracking method for live apoptotic cells in cerebral ischemia with functional Fe2O3 magnetic nanoparticles.

    Science.gov (United States)

    Saito, Atsushi; Mekawy, Moataz M; Sumiyoshi, Akira; Riera, Jorge J; Shimizu, Hiroaki; Kawashima, Ryuta; Tominaga, Teiji

    2016-03-11

    Apoptotic neuronal death is known as programmed cell death. Inhibition of this progression might contribute to a new treatment strategy. However, methods for in vivo detection of live apoptotic cells are in need to be developed and established. The purpose of this study is to develop a new method for in vivo brain imaging for live apoptotic lesions using magnetic resonance imaging (MRI). We focused on the specific accumulation of our recently developed functional magnetic nanoparticles (FMNPs) into apoptotic cells using a rat cerebral ischemia model. Sulphorhodamine B, fluorescent dye was linked to valylalanylaspartic acid fluoromethyl ketone as a pan-caspase inhibitor to form SR-FLIVO. SR-FLIVO was bound with FMNPs to develop SR-FLIVO-FMNP probe. Ischemic rat brains were scanned by 7T MRI before and after intravenous injection of SR-FLIVO-FMNP and the distribution was evaluated by subtraction images of T2* colored mapping. SR-FLIVO, intracellular FMNPs, and T2* reduction area were histologically analyzed. The distribution of SR-FLIVO-FMNP was evaluated by subtracting the T2* signal images and was significantly correlated with the histological findings by TUNEL staining. Our experimental results revealed several findings where our newly developed probe SR-FLIVO-FMNP was intravenously administered into ischemic rats and FLIVO expression was tracked and found in apoptotic cells in rat brains after cerebral ischemia. A remarkable T2* reduction within the ischemic lesion was recorded using MRI based SR-FLIVO-FMNP probe as a contrasting agent due to the specific probe accumulation in apoptotic cells whereas, no observation of T2* reduction within the non-ischemic lesion due to no probe accumulation in non-apoptotic cells. Histological analysis based on the correlation between FLIVO and TUNEL staining showed that almost all FLIVO-positive cells were positive for TUNEL staining. These findings suggest the possibility for establishment of in vivo targeting delivery

  11. Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study.

    Science.gov (United States)

    Nygaard, Ingrid E; Clark, Erin; Clark, Lauren; Egger, Marlene J; Hitchcock, Robert; Hsu, Yvonne; Norton, Peggy; Sanchez-Birkhead, Ana; Shaw, Janet; Sheng, Xiaoming; Varner, Michael

    2017-01-10

    Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, 'Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery', uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes. Using quantitative methods, we will evaluate whether pelvic floor support and symptoms 1 year after the first vaginal delivery are affected by biologically plausible factors that may impact muscle, nerve and connective tissue healing during recovery (first 8 weeks postpartum) and strengthening (remainder of the first postpartum year). Using qualitative methods, we will examine cultural aspects of perceptions, explanations of changes in pelvic floor support, and actions taken by Mexican-American and Euro-American primipara, emphasising early changes after childbirth. We will summarise project results in a resource toolkit that will enhance opportunities for dialogue between women, their families and providers, and across lay and medical discourses. We anticipate enrolling up to 1530 nulliparous women into the prospective cohort study during the third trimester, following those who deliver vaginally 1 year postpartum. Participants will be drawn from this cohort to meet the project's aims. The University of Utah and Intermountain Healthcare Institutional Review Boards approved this study. Data are stored in a

  12. Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery.

    Science.gov (United States)

    Soeteman, Marijn; Peters, Vera; Busari, Jamiu O

    2015-01-01

    In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic's waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1) accessibility to caregivers and 2) quality of service and available amenities. We conducted a multi-method survey using 1) a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2) specially designed questionnaires to investigate patients' perceptions of our wait time and how to improve our services. The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55%) felt that 10-20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%). Finally, a large number of patients (97%) were satisfied with the quality of service and with the accessibility to caregivers (94%). The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of service in patients.

  13. Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery

    Directory of Open Access Journals (Sweden)

    Soeteman M

    2015-03-01

    Full Text Available Marijn Soeteman,1 Vera Peters,2 Jamiu O Busari1,3 1Department of Pediatrics, Atrium Medical Center, Heerlen, 2Faculty of Health, Medicine and Life Sciences, 3Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands Objective: In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic’s waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1 accessibility to caregivers and 2 quality of service and available amenities. Design: We conducted a multi-method survey using 1 a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2 specially designed questionnaires to investigate patients’ perceptions of our wait time and how to improve our services. Results: The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55% felt that 10–20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%. Finally, a large number of patients (97% were satisfied with the quality of service and with the accessibility to caregivers (94%. Conclusion: The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of

  14. Effectiveness of the different methods of inhalation drugs delivery in children with bronchial asthma

    Directory of Open Access Journals (Sweden)

    S.M. Nedelska

    2017-03-01

    Full Text Available Aim of the work — to evaluate the effectiveness of inhalation technique when using different types of inhalers (dry powder inhalers — Turbuhaler, Diskus, metered-dose inhalers, breath-actuated inhalers — Easyhaler. Materials and methods. 45 patients aged 6–17 years underwent the evaluation of inhalation technique accuracy with the use of In-Check-Dial — apparatus, which imitates the airway resistance that should be overcome during inspiration through different inhaler types, and measure inspiration velocity. Incidence of mistakes was studied in different age groups. Results. 80 % of children aged 6–7 years made mistakes while using Turbuhaler, 73.3 % — metered-dose inhaler, 60 % — Easyhaler. There were no mistakes in patients making inhalation by means of Diskhaler. 100 % of children aged 12–14 years incorrectly used metered-dose inhaler. Easyhaler was incorrectly used in 66.6 % of cases, Diskhaler — in 26.6 %. Among elder group, incidence of mistakes when making inhalations through Turbuhaler was lower — 40 % in 12–14-year-old group and 25 % — in 15–17-year-old (р < 0.05. Children of 15–17 years old are able to use Turbuhaler and Diskus (mistakes in 33.3 and 46.6 %, respectively. At the same time, none of the patients have done the correct inhalation by means of metered-dose inhaler, 93.3 % of the patients have mistakes when using Easyhaler. Conclusions. The incidence of mistakes depends on the age and inhaler type and reaches 26–100 %. Minimal quantity of mistakes is seen for Diskus (in all age groups, maxi­mal — for metered-dose inhaler. For the purpose of optimal inhaler choice in a child with bronchial asthma, it is advisable to measure the inspiratory flow with the help of In-Check-Dial before therapy administration.

  15. Operational challenges in delivery of a charity care program for diabetic retinopathy screening in an urban setting.

    Science.gov (United States)

    Chedid, Erica H; Golden, Quin R; Jager, Rama D

    2013-01-01

    The University of Chicago Medicine (UCM) partners with Chicago Family Health Center (Chicago Family) in the Diabetic Retinopathy Screening Program (DRP), a charity care program to screen uninsured and underinsured patients with diabetes for diabetic retinopathy, which is a leading cause of preventable vision loss in the US. The DRP faced operational challenges throughout its pilot year: a high number of ungradable retinal images, slow turnaround time for reading retinal images and sending results, incomplete referrals, and a high rate of no-shows for diagnostic appointments. Chicago Family recalled patients with ungradable images for repeat imaging, and regular training was provided to staff taking the images. Weekly e-mails were sent to the physician champion reminding him to read images, and image software was installed on his laptop. Patients received reminder cards and preappointment and postappointment phone call reminders, and appointment information was shared with referring physicians. The UCM clinic was double-booked, so patients were seen within four weeks of referral. Discussions were held with UCM/Chicago Family teams to stress the influence of timely referrals on no-show rate; reminders were sent to referring physicians for referrals. Complete referrals were received within five days; the overall number of ungradable images decreased; image report turnaround time continued to be a challenge because of difficulties related to physician availability and technology; show rates began to increase. The methods of this intervention will translate well to other programs that provide care for similar patient populations in urban areas.

  16. Chitosan based micro- and nanoparticles for colon-targeted delivery of vancomycin prepared by alternative processing methods.

    Science.gov (United States)

    Cerchiara, T; Abruzzo, A; di Cagno, M; Bigucci, F; Bauer-Brandl, A; Parolin, C; Vitali, B; Gallucci, M C; Luppi, B

    2015-05-01

    The aim of this work was to prepare chitosan (CH) based particulate formulations for colon delivery of vancomycin (VM). Chitosan microparticles (MPs) and nanoparticles (NPs) loaded with VM were prepared using different CH/tripolyphosphate (TPP) molar ratios and different technological processes. In particular, nanoparticles were prepared by ionic gelation and freeze-drying to recover these particles, or, alternatively, by spray-drying method. Microparticles were prepared using a different spray-dryer. Micro- and nanoparticles were characterized in terms of size distributions by photon correlation spectroscopy (PCS), while encapsulation and drug loading efficiencies were studied using a dialysis method. Fourier Transform Infrared Spectroscopy (FT-IR) was employed to determine the surface composition of the micro- and nanoparticles respectively, and the morphologies of the developed systems were studied by scanning electron microscopy (SEM). Water uptake as well as drug release profiles were also measured. Antibacterial activity against Staphylococcus aureus, a Gram-positive model strain, was evaluated. FT-IR results suggested an electrostatic interaction between VM and CH/TPP particles. Moreover, the particles were found to hold a positive zeta-potential, indicating the presence of CH on the particle surfaces. Particle size and encapsulation efficiency were mainly influenced by the different manufacturing processes employed. Nanoparticles obtained by spray-drying showed the best results in terms of water uptake and drug release rate. Moreover, they showed a good bactericidal activity against S. aureus. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Overview of Methods Able to Overcome Impediments to tumor Drug Delivery with Special Attention to Tumor Interstitial Fluid.

    Directory of Open Access Journals (Sweden)

    Gianfranco eBaronzio

    2015-07-01

    Full Text Available Every drug used to treat cancer (chemotherapeutics, immunologic, monoclonal antibodies, nanoparticles, radionuclides must reach the targeted cells through the tumor environment at adequate concentrations, in order to exert their cell-killing effects. For any of these agents to reach the goal cells they must overcome a number of impediments created by the tumor microenvironment, beginning with tumor interstitial fluid pressure (TIFP and a multifactorial increase in composition of the extracellular matrix (ECM. A primary modifier of tumor microenvironment is hypoxia, which increases the production of growth factors such as vascular endothelial growth factor (VEGF and platelet-derived growth factor (PDGF. These growth factors released by both tumor cells and bone marrow recruited myeloid cells (MDS, form abnormal vasculature characterized by vessels that are tortuous and more permeable. Increased leakiness combined with increased inflammatory byproducts accumulates fluid within the tumor mass [tumor interstitial fluid (TIF], ultimately creating an increased pressure (TIFP. Fibroblasts are also up-regulated by the tumor microenvironment, and deposit fibers that further augment the density of the extracellular matrix (ECM, thus, further worsening the TIFP. Increased TIFP with the ECM are the major obstacles to adequate drug delivery. By decreasing TIFP and decreasing ECM density, we can expect an associated rise in drug concentration within the tumor itself. In this overview we will describe all the methods (drugs, nutraceuticals, physical methods of treatment able to lower TIFP and to modify ECM that can be used for increasing drug concentration within the tumor tissue.

  18. 20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

    Science.gov (United States)

    2010-04-01

    ... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER... describes the roles of such partners in the One-Stop delivery system and applies to the Welfare-to-Work...

  19. Understanding home delivery in a context of user fee reduction: a cross-sectional mixed methods study in rural Burkina Faso.

    Science.gov (United States)

    De Allegri, Manuela; Tiendrebéogo, Justin; Müller, Olaf; Yé, Maurice; Jahn, Albrecht; Ridde, Valéry

    2015-12-11

    Several African countries have recently reduced/removed user fees for maternal care, producing considerable increases in the utilization of delivery services. Still, across settings, a conspicuous number of women continue to deliver at home. This study explores reasons for home delivery in rural Burkina Faso, where a successful user fee reduction policy is in place since 2007. The study took place in the Nouna Health District and adopted a triangulation mixed methods design, combining quantitative and qualitative data collection and analysis methods. The quantitative component relied on use of data from the 2011 round of a panel household survey conducted on 1130 households. We collected data on utilization of delivery services from all women who had experienced a delivery in the previous twelve months and investigated factors associated with home delivery using multivariate logistic regression. The qualitative component relied on a series of open-ended interviews with 55 purposely selected households and 13 village leaders. We analyzed data using a mixture of inductive and deductive coding. Of the 420 women who reported a delivery, 47 (11 %) had delivered at home. Random effect multivariate logistic regression revealed a clear, albeit not significant trend for women from a lower socio-economic status and living outside an area to deliver at home. Distance to the health facility was found to be positively significantly associated with home delivery. Qualitative findings indicated that women and their households valued facility-based delivery above home delivery, suggesting that cultural factors do not shape the decision where to deliver. Qualitative findings confirmed that geographical access, defined in relation to the condition of the roads and the high transaction costs associated with travel, and the cost-sharing fees still applied at point of use represent two major barriers to access facility-based delivery. Findings suggest that the current policy in

  20. ALPprolog --- A New Logic Programming Method for Dynamic Domains

    OpenAIRE

    Drescher, Conrad; Thielscher, Michael

    2011-01-01

    Logic programming is a powerful paradigm for programming autonomous agents in dynamic domains, as witnessed by languages such as Golog and Flux. In this work we present ALPprolog, an expressive, yet efficient, logic programming language for the online control of agents that have to reason about incomplete information and sensing actions.

  1. Applying dynamic simulation modeling methods in health care delivery research-the SIMULATE checklist: report of the ISPOR simulation modeling emerging good practices task force.

    Science.gov (United States)

    Marshall, Deborah A; Burgos-Liz, Lina; IJzerman, Maarten J; Osgood, Nathaniel D; Padula, William V; Higashi, Mitchell K; Wong, Peter K; Pasupathy, Kalyan S; Crown, William

    2015-01-01

    Health care delivery systems are inherently complex, consisting of multiple tiers of interdependent subsystems and processes that are adaptive to changes in the environment and behave in a nonlinear fashion. Traditional health technology assessment and modeling methods often neglect the wider health system impacts that can be critical for achieving desired health system goals and are often of limited usefulness when applied to complex health systems. Researchers and health care decision makers can either underestimate or fail to consider the interactions among the people, processes, technology, and facility designs. Health care delivery system interventions need to incorporate the dynamics and complexities of the health care system context in which the intervention is delivered. This report provides an overview of common dynamic simulation modeling methods and examples of health care system interventions in which such methods could be useful. Three dynamic simulation modeling methods are presented to evaluate system interventions for health care delivery: system dynamics, discrete event simulation, and agent-based modeling. In contrast to conventional evaluations, a dynamic systems approach incorporates the complexity of the system and anticipates the upstream and downstream consequences of changes in complex health care delivery systems. This report assists researchers and decision makers in deciding whether these simulation methods are appropriate to address specific health system problems through an eight-point checklist referred to as the SIMULATE (System, Interactions, Multilevel, Understanding, Loops, Agents, Time, Emergence) tool. It is a primer for researchers and decision makers working in health care delivery and implementation sciences who face complex challenges in delivering effective and efficient care that can be addressed with system interventions. On reviewing this report, the readers should be able to identify whether these simulation modeling

  2. Factors influencing the selection of delivery with no one present in Northern Nigeria: implications for policy and programs

    Directory of Open Access Journals (Sweden)

    Fapohunda B

    2014-01-01

    Full Text Available Bolaji Fapohunda,1 Nosakhare Orobaton1,21International Division, John Snow Inc, Rosslyn, VA, USA; 2Targeted States High Impact Project (TSHIP, Bauchi, NigeriaAbstract: This paper examines the effects of demographic, socioeconomic, and women's autonomy factors on the utilization of delivery assistance in Sokoto State, Nigeria. Data were obtained from the Nigeria 2008 Demographic and Health Survey (DHS. Bivariate analysis and logistic regression procedures were conducted. The study revealed that delivery with no one present and with unskilled attendance accounted for roughly 95% of all births in Sokoto State. Mothers with existing high risk factors, including higher parity, were more likely to select unsafe/unskilled delivery practices than younger, lower-parity mothers. Evidenced by the high prevalence of delivery with traditional birth attendants, this study demonstrates that expectant mothers are willing to obtain care from a provider, and their odds of using accessible, affordable, skilled delivery is high, should such an option be presented. This conclusion is supported by the high correlation between a mother's socioeconomic status and the likelihood of using skilled attendance. To improve the access to, and increase the affordability of, skilled health attendants, we recommended two solutions: 1 the use of cash subsidies to augment women's incomes in order to reduce finance-related barriers in the use of formal health services, thus increasing demand; and 2 a structural improvement that will increase women's economic security by improving their access to higher education, income, and urban ideation.Keywords: Sokoto State, delivery attendance, maternal mortality rate, maternal health, reproductive health, demographic and health surveys, poverty

  3. Fundamental study on the magnetic field control method using multiple HTS coils for Magnetic Drug Delivery System

    Science.gov (United States)

    Hirano, R.; Kim, S. B.; Nakagawa, T.; Tomisaka, Y.; Ueda, H.

    2017-07-01

    The magnetic drug delivery system (MDDS) is a key technology to reduce the side effects in the medical applications, and the magnetic force control is very important issue in MDDS. In this application, the strength of magnetic field and gradient required to MDDS devices are 54 mT and 5.5 T/m, respectively. We proposed the new magnetic force control system that consists of the multiple racetrack HTS magnets. We can control the magnetic field gradient along the longitudinal direction by the arrangement of the multiple racetrack HTS magnets and operating current of each magnet. When the racetrack HTS magnets were used, the critical current was reduced by the self-magnetic field. Therefore, the shape design of HTS magnet to reduce the magnet field into the surface of HTS tapes was required. Therefore, the electromagnetic analysis based on finite element method (FEM) was carried out to design and optimize the shape of multiple racetrack HTS magnet. We were able to suppress the reduction of critical current by placing the magnetic substance at upper and lower side of the HTS magnets. It was confirmed that obtained maximum values of magnetic field strength and field gradient were 33 mT and 0.18 T/m, respectively.

  4. Evaluation of a New Entomopathogenic Strain of Beauveria bassiana and a New Field Delivery Method against Solenopsis invicta.

    Directory of Open Access Journals (Sweden)

    Jun Li

    Full Text Available Solenopsis invicta Buren is one of the most important pests in China, and control measures are mainly based on the use of synthetic pesticides, which may be inadequate and unsustainable. Hence, there is a growing interest in developing biological control alternatives for managing S. invicta, such as the use of entomopathogenic fungi. To facilitate the commercialization of entomopathogenic fungi against S. invicta, 10 Beauveria bassiana isolates originating from different hosts were tested for virulence in laboratory bioassays, and the most pathogenic strain, ZGNKY-5, was tested in field studies using an improved pathogen delivery system. The cumulative mortality rate reached 93.40% at 1×108 mL-1 conidia after 504 h. The germination and invasion of the spores were observed under a scanning electron microscope, and several conidia adhered to the cuticle of S. invicta after 2 h. Furthermore, the germ tubes of the conidia oriented toward the cuticle after 48 h, and the mycelium colonized the entire body after 96 h. Based on the efficacy observed in the laboratory trials, further experiments were performed with ZGNKY-5 strain to evaluate its utility in an injection control technology against S. invicta in the field. We found that three dosage treatments of ZGNKY-5 strain (500 mL, 750 mL, and 1,000 mL per nest had significant control effects. Our results show that this strain of Beauveria bassiana and our control method were effective against S. invicta in both laboratory and field settings.

  5. PREDICTION OF MEAT PRODUCT QUALITY BY THE MATHEMATICAL PROGRAMMING METHODS

    Directory of Open Access Journals (Sweden)

    A. B. Lisitsyn

    2016-01-01

    Full Text Available Abstract Use of the prediction technologies is one of the directions of the research work carried out both in Russia and abroad. Meat processing is accompanied by the complex physico-chemical, biochemical and mechanical processes. To predict the behavior of meat raw material during the technological processing, a complex of physico-technological and structural-mechanical indicators, which objectively reflects its quality, is used. Among these indicators are pH value, water binding and fat holding capacities, water activity, adhesiveness, viscosity, plasticity and so on. The paper demonstrates the influence of animal proteins (beef and pork on the physico-chemical and functional properties before and after thermal treatment of minced meat made from meat raw material with different content of the connective and fat tissues. On the basis of the experimental data, the model (stochastic dependence parameters linking the quantitative resultant and factor variables were obtained using the regression analysis, and the degree of the correlation with the experimental data was assessed. The maximum allowable levels of meat raw material replacement with animal proteins (beef and pork were established by the methods of mathematical programming. Use of the information technologies will significantly reduce the costs of the experimental search and substantiation of the optimal level of replacement of meat raw material with animal proteins (beef, pork, and will also allow establishing a relationship of product quality indicators with quantity and quality of minced meat ingredients.

  6. Applying dynamic simulation modeling methods in health care delivery research - the SIMULATE checklist: Report of the ISPOR simulation modeling emerging good practices task force

    NARCIS (Netherlands)

    Marshall, Deborah A.; Burgos-Liz, Lina; IJzerman, Maarten Joost; Osgood, Nathaniel D.; Padula, William V.; Higashi, Mitchell K.; Wong, Peter K.; Pasupathy, Kalyan S.; Crown, William

    2015-01-01

    Health care delivery systems are inherently complex, consisting of multiple tiers of interdependent subsystems and processes that are adaptive to changes in the environment and behave in a nonlinear fashion. Traditional health technology assessment and modeling methods often neglect the wider health

  7. Optimization of gene delivery methods in Xenopus laevis kidney (A6) and Chinese hamster ovary (CHO) cell lines for heterologous expression of Xenopus inner ear genes.

    Science.gov (United States)

    Ramirez-Gordillo, Daniel; Trujillo-Provencio, Casilda; Knight, V Bleu; Serrano, Elba E

    2011-10-01

    The Xenopus inner ear provides a useful model for studies of hearing and balance because it shares features with the mammalian inner ear, and because amphibians are capable of regenerating damaged mechanosensory hair cells. The structure and function of many proteins necessary for inner ear function have yet to be elucidated and require methods for analysis. To this end, we seek to characterize Xenopus inner ear genes outside of the animal model through heterologous expression in cell lines. As part of this effort, we aimed to optimize physical (electroporation), chemical (lipid-mediated; Lipofectamine™ 2000, Metafectene® Pro), and biological (viral-mediated; BacMam virus Cellular Lights™ Tubulin-RFP) gene delivery methods in amphibian (Xenopus; A6) cells and mammalian (Chinese hamster ovary (CHO)) cells. We successfully introduced the commercially available pEGFP-N3, pmCherry-N1, pEYFP-Tubulin, and Cellular Lights™ Tubulin-RFP fluorescent constructs to cells and evaluated their transfection or transduction efficiencies using the three gene delivery methods. In addition, we analyzed the transfection efficiency of a novel construct synthesized in our laboratory by cloning the Xenopus inner ear calcium-activated potassium channel β1 subunit, then subcloning the subunit into the pmCherry-N1 vector. Every gene delivery method was significantly more effective in CHO cells. Although results for the A6 cell line were not statistically significant, both cell lines illustrate a trend towards more efficient gene delivery using viral-mediated methods; however the cost of viral transduction is also much higher. Our findings demonstrate the need to improve gene delivery methods for amphibian cells and underscore the necessity for a greater understanding of amphibian cell biology.

  8. Statistics Student Performance and Anxiety: Comparisons in Course Delivery and Student Characteristics

    Science.gov (United States)

    Hedges, Sarai

    2017-01-01

    The statistics education community continues to explore the differences in performance outcomes and in student attitudes between online and face-to-face delivery methods of statistics courses. In this quasi-experimental study student persistence, exam, quiz, and homework scores were compared between delivery methods, class status, and programs of…

  9. Integrating Software-Architecture-Centric Methods into Extreme Programming (XP)

    National Research Council Canada - National Science Library

    Nord, Robert L; Tomayko, James E; Wojcik, Rob

    2004-01-01

    ...). These methods include the Architecture Tradeoff Analysis Method (Registered Tradename), the SEI Quality Attribute Workshop, the SE Attribute-Driven Design method, the SE Cost Benefit Analysis Method, and SEI Active Reviews for Intermediate Design...

  10. An iterative method for tri-level quadratic fractional programming problems using fuzzy goal programming approach

    Science.gov (United States)

    Kassa, Semu Mitiku; Tsegay, Teklay Hailay

    2017-08-01

    Tri-level optimization problems are optimization problems with three nested hierarchical structures, where in most cases conflicting objectives are set at each level of hierarchy. Such problems are common in management, engineering designs and in decision making situations in general, and are known to be strongly NP-hard. Existing solution methods lack universality in solving these types of problems. In this paper, we investigate a tri-level programming problem with quadratic fractional objective functions at each of the three levels. A solution algorithm has been proposed by applying fuzzy goal programming approach and by reformulating the fractional constraints to equivalent but non-fractional non-linear constraints. Based on the transformed formulation, an iterative procedure is developed that can yield a satisfactory solution to the tri-level problem. The numerical results on various illustrative examples demonstrated that the proposed algorithm is very much promising and it can also be used to solve larger-sized as well as n-level problems of similar structure.

  11. Distribution of a viscous binder during high shear granulation--sensitivity to the method of delivery and its impact on product properties.

    Science.gov (United States)

    Tan, Bernice Mei Jin; Loh, Zhi Hui; Soh, Josephine Lay Peng; Liew, Celine Valeria; Heng, Paul Wan Sia

    2014-01-02

    Binder distribution in the powder mass during high shear granulation is especially critical with the use of viscous liquid binders and with short processing times. A viscous liquid binder was delivered into the powder mass at two flow rates using three methods: pouring, pumping and spraying from a pressure pot. Binder content analyses at the scale of individual granules were conducted to investigate the impact of different delivery conditions on the homogeneity of binder distribution. There was clear evidence of non-uniformity of binder content among individual granules across all delivery conditions, particularly for the fast rates of delivery. Poorer reproducibility values of tablet thickness and disintegration time were observed when binder was poured but this may be overcome by pumping or spraying from the pressure pot. Greater homogeneity of binder distribution occurred with the slow rates of delivery and led to the earlier onset of granule growth and a consequent increase in granule size. Larger granule size and lower proportion of fines were in turn associated with increased granule bulk density and improvement of granule flow. In conclusion, delivery of a viscous binder at a slow rate either by pumping or via a pressure pot was most desirable during granulation. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. The expanded program on immunization service delivery in the Dschang health district, west region of Cameroon: a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Walter Ebile Akoh

    2016-08-01

    Full Text Available Abstract Background Vaccination is the most effective intervention strategy, and the provision of vaccination at fixed posts and outreach posts is a backbone of a sustainable vaccination system in developing countries. Access to immunization services is still limited in Cameroon. Several health districts in the west region have recorded new epidemic outbreaks, including the occurrence of a wild polio virus epidemic outbreak in 2013. The aim of this study was to assess immunization service delivery in one of the largest health districts in the west region of Cameroon; the Dschang Health district. Methods It was a cross sectional study conducted in 2013, in 42 health facilities covering 18 health areas in the Dschang Health District. Data were collected with questionnaires administered to health personnel face to face and an observation grid was used to assess resources and tools. Data were entered and analyzed in Epi Info. Results A total of 42 health facilities were assessed and 77 health personnel were interviewed. Overall, 29 (69.0 % health facilities organized one vaccination session monthly, 2 (4.8 % organized an outreach within the last 3 months prior to the study, 15 (35.7 % did not have a vaccination micro plan, 24 (32.9 % health personnel had not been supervised for at least the last 6 months prior to the study, 7 (16.7 % health facilities did not have a functional refrigerator, 1 (2.4 % did not have a vaccine carrier, 23 (54.8 % did not have a means of transport (vehicle or motorcycle and 12 (28.6 % did not have an EPI guideline. The knowledge of health personnel on vaccine and cold chain management, and on diseases of the EPI under epidemiological surveillance was found to be limited. Conclusion The frequency and strategic provision of immunization services in the Dschang Health district is inadequate. Resource availability for an adequate provision of immunization services is insufficient. The knowledge of health personnel

  13. IFNA approved Chinese Anaesthesia Nurse Education Program: A Delphi method.

    Science.gov (United States)

    Hu, Jiale; Fallacaro, Michael D; Jiang, Lili; Wu, Junyan; Jiang, Hong; Shi, Zhen; Ruan, Hong

    2017-09-01

    Numerous nurses work in operating rooms and recovery rooms or participate in the performance of anaesthesia in China. However, the scope of practice and the education for Chinese Anaesthesia Nurses is not standardized, varying from one geographic location to another. Furthermore, most nurses are not trained sufficiently to provide anaesthesia care. This study aimed to develop the first Anaesthesia Nurse Education Program in Mainland China based on the Educational Standards of the International Federation of Nurse Anaesthetists. The Delphi technique was applied to develop the scope of practice, competencies for Chinese Anaesthesia Nurses and education program. In 2014 the Anaesthesia Nurse Education Program established by the hospital applied for recognition by the International Federation of Nurse Anaesthetists. The Program's curriculum was evaluated against the IFNA Standards and recognition was awarded in 2015. The four-category, 50-item practice scope, and the three-domain, 45-item competency list were identified for Chinese Anaesthesia Nurses. The education program, which was established based on the International Federation of Nurse Anaesthetists educational standards and Chinese context, included nine curriculum modules. In March 2015, 13 candidates received and passed the 21-month education program. The Anaesthesia Nurse Education Program became the first program approved by the International Federation of Nurse Anaesthetists in China. Policy makers and hospital leaders can be confident that anaesthesia nurses graduating from this Chinese program will be prepared to demonstrate high level patient care as reflected in the recognition by IFNA of their adoption of international nurse anaesthesia education standards. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Nurse mentor perceptions in the delivery of a home-based cardiac rehabilitation program to support patients living in rural areas: An interpretive study.

    Science.gov (United States)

    Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

    2017-05-01

    Home-based cardiac rehabilitation (CR) programs improve health outcomes for people diagnosed with heart disease. Mentoring of patients by nurses trained in CR has been proposed as an innovative model of cardiac care. Little is known however, about the experience of mentors facilitating such programs and adapting to this new role. The aim of this qualitative study was to explore nurse mentor perceptions of their role in the delivery of a home-based CR program for rural patients unable to attend a hospital or outpatient CR program. Seven nurses mentored patients by telephone providing patients with education, psychosocial support and lifestyle advice during their recovery. An open-ended survey was administered to mentors by email and findings revealed mentors perceived their role to be integral to the success of the program. Nurses were satisfied with the development of their new role as patient mentors. They believed their collaborative skills, knowledge and experience in coronary care, timely support and guidance of patients during their recovery and use of innovative audiovisual resources improved the health outcomes of patients not able to attend traditional programs. Cardiac nurses in this study perceived that they were able to successfully transition from their normal work practices in hospital to mentoring patients in their homes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Methods and Patterns for User-Friendly Quantum Programming.

    Science.gov (United States)

    Singh, Alexandros; Giannakis, Konstantinos; Kastampolidou, Kalliopi; Papalitsas, Christos

    2017-01-01

    The power and efficiency of particular quantum algorithms over classical ones has been proved. The rise of quantum computing and algorithms has highlighted the need for appropriate programming means and tools. Here, we present a brief overview of some techniques and a proposed methodology in writing quantum programs and designing languages. Our approach offers "user-friendly" features to ease the development of such programs. We also give indicative snippets in an untyped fragment of the Qumin language, describing well-known quantum algorithms.

  16. Numerical calculation of elastohydrodynamic lubrication methods and programs

    CERN Document Server

    Huang, Ping

    2015-01-01

    The book not only offers scientists and engineers a clear inter-disciplinary introduction and orientation to all major EHL problems and their solutions but, most importantly, it also provides numerical programs on specific application in engineering. A one-stop reference providing equations and their solutions to all major elastohydrodynamic lubrication (EHL) problems, plus numerical programs on specific applications in engineering offers engineers and scientists a clear inter-disciplinary introduction and a concise program for practical engineering applications to most important EHL problems

  17. Dissemination of Chronic Disease Self-Management Education (CDSME Programs in the United States: Intervention Delivery by Rurality

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2017-06-01

    Full Text Available Background: Alongside the dramatic increase of older adults in the United States (U.S., it is projected that the aging population residing in rural areas will continue to grow. As the prevalence of chronic diseases and multiple chronic conditions among adults continues to rise, there is additional need for evidence-based interventions to assist the aging population to improve lifestyle behaviors, and self-manage their chronic conditions. The purpose of this descriptive study was to identify the geospatial dissemination of Chronic Disease Self-Management Education (CDSME Programs across the U.S. in terms of participants enrolled, workshops delivered, and counties reached. These dissemination characteristics were compared across rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas, and non-metro areas not adjacent to metro areas. Methods: This descriptive study analyzed data from a national repository including efforts from 83 grantees spanning 47 states from December 2009 to December 2016. Counts were tabulated and averages were calculated. Results: CDSME Program workshops were delivered in 56.4% of all U.S. counties one or more times during the study period. Of the counties where a workshop was conducted, 50.5% were delivered in non-metro areas. Of the 300,640 participants enrolled in CDSME Programs, 12% attended workshops in non-metro adjacent areas, and 7% attended workshops in non-metro non-adjacent areas. The majority of workshops were delivered in healthcare organizations, senior centers/Area Agencies on Aging, and residential facilities. On average, participants residing in non-metro areas had better workshop attendance and retention rates compared to participants in metro areas. Conclusions: Findings highlight the established role of traditional organizations/entities within the aging services network, to reach remote areas and serve diverse participants (e.g., senior centers. To facilitate growth in rural

  18. A qualitative study on barriers to utilisation of institutional delivery services in Moroto and Napak districts, Uganda: implications for programming.

    Science.gov (United States)

    Wilunda, Calistus; Quaglio, Gianluca; Putoto, Giovanni; Lochoro, Peter; Dall'Oglio, Giovanni; Manenti, Fabio; Atzori, Andrea; Lochiam, Rose Miligan; Takahashi, Risa; Mukundwa, Aline; Oyerinde, Koyejo

    2014-08-04

    Skilled attendance at delivery is critical in prevention of maternal deaths. However, many women in low- and middle-income countries still deliver without skilled assistance. This study was carried out to identify perceived barriers to utilisation of institutional delivery in two districts in Karamoja, Uganda. Data were collected through participatory rural appraisal (PRA) with 887 participants (459 women and 428 men) in 20 villages in Moroto and Napak districts. Data were analysed using deductive content analysis. Notes taken during PRA session were edited, triangulated and coded according to recurring issues. Additionally, participants used matrix ranking to express their perceived relative significance of the barriers identified. The main barriers to utilisation of maternal health services were perceived to be: insecurity, poverty, socio-cultural factors, long distances to health facilities, lack of food at home and at health facilities, lack of supplies, drugs and basic infrastructure at health facilities, poor quality of care at health facilities, lack of participation in planning for health services and the ready availability of traditional birth attendants (TBAs). Factors related to economic and physical inaccessibility and lack of infrastructure, drugs and supplies at health facilities were highly ranked barriers to utilisation of institutional delivery. A comprehensive approach to increasing the utilisation of maternal health care services in Karamoja is needed. This should tackle both demand and supply side barriers using a multi-sectorial approach since the main barriers are outside the scope of the health sector. TBAs are still active in Karamoja and their role and influence on maternal health in this region cannot be ignored. A model for collaboration between skilled health workers and TBAs in order to increase institutional deliveries is needed.

  19. Clinician-led, peer-led, and internet-delivered dissonance-based eating disorder prevention programs: Acute effectiveness of these delivery modalities.

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Shaw, Heather; Gau, Jeff M

    2017-09-01

    Because independent trials have provided evidence for the efficacy and effectiveness of the dissonance-based Body Project eating disorder prevention program, the present trial tested whether clinicians produce the largest intervention effects, or whether delivery can be task-shifted to less expensive undergraduate peer educators or to Internet delivery without effect size attenuation, focusing on acute effects. In this study, 680 young women (Mage = 22.2 years, SD = 7.1) recruited at colleges in 2 states were randomized to clinician-led Body Project groups, peer-led Body Project groups, the Internet-based eBody Project, or an educational video control condition. Participants in all 3 variants of the Body Project intervention showed significantly greater reductions in eating disorder risk factors and symptoms than did educational video controls. Participants in clinician-led and peer-led Body Project groups showed significantly greater reductions in risk factors than did eBody Project participants, but effects for the 2 types of groups were similar. Eating disorder onset over 7-month follow-up was significantly lower for peer-led Body Project group participants versus eBody Project participants (2.2% vs. 8.4%) but did not differ significantly between other conditions. The evidence that all 3 dissonance-based prevention programs outperformed an educational video condition, that both group-based interventions outperformed the Internet-based intervention in risk factor reductions, and that the peer-led groups showed lower eating disorder onset over follow-up than did the Internet-based intervention is novel. These acute-effects data suggest that both group-based interventions produce superior eating disorder prevention effects than does the Internet-based intervention and that delivery can be task-shifted to peer leaders. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Defining pediatric inpatient cardiology care delivery models: A survey of pediatric cardiology programs in the USA and Canada.

    Science.gov (United States)

    Mott, Antonio R; Neish, Steven R; Challman, Melissa; Feltes, Timothy F

    2017-05-01

    The treatment of children with cardiac disease is one of the most prevalent and costly pediatric inpatient conditions. The design of inpatient medical services for children admitted to and discharged from noncritical cardiology care units, however, is undefined. North American Pediatric Cardiology Programs were surveyed to define noncritical cardiac care unit models in current practice. An online survey that explored institutional and functional domains for noncritical cardiac care unit was crafted. All questions were multi-choice with comment boxes for further explanation. The survey was distributed by email four times over a 5-month period. Most programs (n = 45, 60%) exist in free-standing children's hospitals. Most programs cohort cardiac patients on noncritical cardiac care units that are restricted to cardiac patients in 39 (54%) programs or restricted to cardiac and other subspecialty patients in 23 (32%) programs. The most common frontline providers are categorical pediatric residents (n = 58, 81%) and nurse practitioners (n = 48, 67%). However, nurse practitioners are autonomous providers in only 21 (29%) programs. Only 33% of programs use a postoperative fast-track protocol. When transitioning care to referring physicians, most programs (n = 53, 72%) use facsimile to deliver pertinent patient information. Twenty-two programs (31%) use email to transition care, and eighteen (25%) programs use verbal communication. Most programs exist in free-standing children's hospitals in which the noncritical cardiac care units are in some form restricted to cardiac patients. While nurse practitioners are used on most noncritical cardiac care units, they rarely function as autonomous providers. The majority of programs in this survey do not incorporate any postoperative fast-track protocols in their practice. Given the current era of focused handoffs within hospital systems, relatively few programs utilize verbal handoffs to the referring pediatric

  1. Application of graftech method for pro-gramming of discrete technological process

    Directory of Open Access Journals (Sweden)

    Pigiel, M.

    2007-01-01

    Full Text Available This article contains description of a new programming method of PLC controllers, presently a fundamental tool in discrete process auto-mation. A PLC user, applying standard languages for programming of sequence processes, is forced to rely on intuitive methods as well as his own experience. For this reason, the authors attempted to work out a method, which would allow for simple execution of the program-ming process with no limits regarding number of steps and input and output signals. The result of these studies is a method named Graftech by its authors. The method consists in determination of a functional program in LD language, basing on process algorithm written with SFC network. The rules concerning determination of the functional program are also described. Application of Graftech method is illustrated with an example of automatic ejector of casting molds.

  2. Graphical programming interface: A development environment for MRI methods.

    Science.gov (United States)

    Zwart, Nicholas R; Pipe, James G

    2015-11-01

    To introduce a multiplatform, Python language-based, development environment called graphical programming interface for prototyping MRI techniques. The interface allows developers to interact with their scientific algorithm prototypes visually in an event-driven environment making tasks such as parameterization, algorithm testing, data manipulation, and visualization an integrated part of the work-flow. Algorithm developers extend the built-in functionality through simple code interfaces designed to facilitate rapid implementation. This article shows several examples of algorithms developed in graphical programming interface including the non-Cartesian MR reconstruction algorithms for PROPELLER and spiral as well as spin simulation and trajectory visualization of a FLORET example. The graphical programming interface framework is shown to be a versatile prototyping environment for developing numeric algorithms used in the latest MR techniques. © 2014 Wiley Periodicals, Inc.

  3. Overview of Evaluation Methods for R&D Programs. A Directory of Evaluation Methods Relevant to Technology Development Programs

    Energy Technology Data Exchange (ETDEWEB)

    Ruegg, Rosalie [TIA Consulting, Inc., Emeral Isle, NC (United States); Jordan, Gretchen B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2007-03-01

    This document provides guidance for evaluators who conduct impact assessments to determine the “realized” economic benefits and costs, energy, environmental benefits, and other impacts of the Office of Energy Efficiency and Renewable Energy’s (EERE) R&D programs. The focus of this Guide is on realized outcomes or impacts of R&D programs actually experienced by American citizens, industry, and others.

  4. An introduction to meshfree methods and their programming

    CERN Document Server

    Liu, GR

    2005-01-01

    Friendly and straightforward presentation and beginner orientated Provides the fundamentals of numerical analysis that are particularly important to meshfree methods. Wide coverage of meshfree methods: EFG, RPIM, MLPG, LRPIM, MWS and collocation methods Detailed comparison case studies for many existing meshfree methods Well-tested computer source codes are attached with useful descriptions and readily test examples Soft copy of these source codes are available also at http://www.nus.edu.sg/ACES.

  5. Obstetric anal sphincter injury, risk factors and method of delivery - an 8-year analysis across two tertiary referral centers.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2013-10-01

    Obstetric anal sphincter injury (OASIS) represents a major cause of maternal morbidity and is a risk factor for the development of fecal incontinence. We set out to analyze the incidence of OASIS and its association with mode of delivery in two large obstetric hospitals across an 8-year study period.

  6. Simple Calculation Programs for Biology Methods in Molecular ...

    Indian Academy of Sciences (India)

    GMAP: A program for mapping potential restriction sites. RE sites in ambiguous and non-ambiguous DNA sequence; Minimum number of silent mutations required for introducing a RE sites; Set theory for searching RE sites; Raghava and Sahni (1994) Biotechniques 16:1116 ...

  7. Content and Method in a Thanatology Training Program for Paraprofessionals.

    Science.gov (United States)

    Harris, Audrey P.

    1980-01-01

    A training program of paraprofessionals was developed in a university teaching hospital. Trainees were exposed to seminars and a supervised practicum. The objectives of the experience included sensitization of persons in the natural helping network to psychosocial needs of seriously ill persons and their families. (Author)

  8. Surfactant therapy of pulmonary conditions excluding those with primary surfactant deficiency and bronchoscopy as delivery method: an overview of Russian patents and publications.

    Science.gov (United States)

    Jargin, Sergei V

    2013-08-01

    Preparations of pulmonary surfactant are used for the treatment of respiratory distress syndrome in a newborn. Their applicability as a method of routine for lung diseases beyond the neonatal period is questionable. Some publications from the former Soviet Union (SU) have reported on successful surfactant therapy of ARDS in children and adults as well as for inhalation injuries, pneumonia, and tuberculosis. Bronchoscopy was used and recommended as a method of surfactant delivery for ARDS, some types of pneumonia and tuberculosis. Manufacturing processes of surfactant preparations from bovine lung and amniotic fluid, described by Russian patents, and bronchoscopy as a delivery mode are discussed here. A concluding point is that some reports from the former SU about administration of exogenous surfactant in pulmonary conditions, excluding those with primary surfactant deficiency, are only partly confirmed by the international literature.

  9. Improving programming skills of Mechanical Engineering students by teaching in C# multi-objective optimizations methods

    National Research Council Canada - National Science Library

    Adrian Florea; Ileana Ioana Cofaru

    2017-01-01

    .... This paper represents a software development guide for designers of suspension systems with less programming skills that will enable them to implement their own optimization methods that improve...

  10. An introduction to nonlinear programming. IV - Numerical methods for constrained minimization

    Science.gov (United States)

    Sorenson, H. W.; Koble, H. M.

    1976-01-01

    An overview is presented of the numerical solution of constrained minimization problems. Attention is given to both primal and indirect (linear programs and unconstrained minimizations) methods of solution.

  11. Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study.

    Science.gov (United States)

    Markham, Christine M; Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

    2016-11-21

    American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet's potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths' perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Sites

  12. Cyclic delivery scheduling to customers with different priorities

    Directory of Open Access Journals (Sweden)

    Katarzyna Zofia Gdowska

    2013-12-01

    Full Text Available Background: In this paper a cyclic delivery scheduling problem for customers with different priorities is presented. Shops, which are provided with deliveries, are occasionally located in places which are crucial for the proper flow of traffic. In such places coordination of deliveries is crucial; therefore it allows to completely eliminate the phenomenon of the simultaneous arrivals of suppliers. Methods: In this paper the cyclic delivery scheduling problem for customers with different priorities was presented. To this theoretical problem a mix integer programming model was developed. Specific approach to the cyclic delivery scheduling problem is inspired by timetabling problem for urban public transport. Results: Mixed integer programming model was employed for solving four cases of cyclic delivery scheduling problem for customers with different priorities. When the value of the synchronization priority assigned to a single customer raised then the total number of synchronizations in the whole network decreased. In order to compare solutions a synchronization rate was utilized. A simple factor was utilized - the proportion of number of synchronizations of deliveries to a given customer to the total number of synchronizations obtained for the whole network. When the value of synchronization priority raised then the value of synchronization rate of this customer improved significantly. Conclusions: The mixed integer programming model for the cyclic delivery scheduling problem for customers with different priorities presented in this paper can be utilized for generating schedules of serving customers located in places where only one delivery can be received and unloaded at one go and where there is no space for other suppliers to wait in a queue. Such a schedule can be very useful for organizing deliveries to small shops united in a franchising network, since they operate in a way that is very similar to the network presented in this paper

  13. Kidneys cytomembranes stability in pregnant women with type 1 diabetes and pregnancy outcomes dependingon the method of insulin delivery

    Directory of Open Access Journals (Sweden)

    Zul'fiya Raisovna Alimetova

    2012-12-01

    Full Text Available Objective. To evaluate of kidney cytomembranes stability during pregnancy and its outcomes in patients with diabetes mellitus type on type 1 with different stages of diabetic nephropathy (DN according to the route of insulin administration.Materials and Methods. We study 100 pregnant women with type 1 diabetes with the introduction of insulin in the mode of multiple subcutaneous injections (MSII and with portable dispenser with a continuous subcutaneous insulin infusion (CSII. DN stage determined by the level of albumin in the daily urine. Cytomembranes stability assessment conducted on daily excretion of ethanolamine and phospholipids with urine in each trimester. Pregnancy outcomes were analyzed in 52 patients with type 1 diabetes. In the group of pregnant women with delivery at term 38-40 weeks we also analyzed the status of newborns.Results. Indicators of cytomembranes stability of kidneys in pregnant women on CSII consistent with those in healthy pregnant women (p>0.05 the whole pregnancy, regardless of the level of daily urinary albumin excretion. There were no differences in cytomembrana stability of kidneys between the group of patients on MSII with normal albumin excretion (NAU and the control group regardless to the gestational age (p>0.05. With the introduction of insulin in the mode of MSII on the stage of microalbuminuria (MAU in the 3rd trimester we found the increase of ethanolamine excretion as compared to control groupy (U=8,00, p=0.012 and the group on CSII with a similar stage of nephropathy (U=2.00, p=0.033. In patients with proteinuria (PU in the group on the MSII in the third trimester phospholipids excretion is increased with a daily urine (U=27,5, p=0.03 and U=22,00, p=0.07 for patients MSII and CSII, respectively. The use of an insulin pump allowed to prolong gestational period, even in severe proteinuric stage of nephropathy. Manifestations of diabetic fetopathy as macrosomia, hypoglycemia in the fetus at birth time

  14. An intergenerational program for persons with dementia using Montessori methods.

    Science.gov (United States)

    Camp, C J; Judge, K S; Bye, C A; Fox, K M; Bowden, J; Bell, M; Valencic, K; Mattern, J M

    1997-10-01

    An intergenerational program bringing together older adults with dementia and preschool children in one-on-one interactions is described. Montessori activities, which have strong ties to physical and occupational therapy, as well as to theories of developmental and cognitive psychology, are used as the context for these interactions. Our experience indicates that older adults with dementia can still serve as effective mentors and teachers to children in an appropriately structured setting.

  15. Integrating Program Assessment and a Career Focus into a Research Methods Course

    Science.gov (United States)

    Senter, Mary Scheuer

    2017-01-01

    Sociology research methods students in 2013 and 2016 implemented a series of "real world" data gathering activities that enhanced their learning while assisting the department with ongoing program assessment and program review. In addition to the explicit collection of program assessment data on both students' development of sociological…

  16. MoDOT pavement preservation research program volume IV, pavement evaluation tools-data collection methods.

    Science.gov (United States)

    2015-10-01

    The overarching goal of the MoDOT Pavement Preservation Research Program, Task 3: Pavement Evaluation Tools Data : Collection Methods was to identify and evaluate methods to rapidly obtain network-level and project-level information relevant to :...

  17. National Weatherization Assistance Program Impact Evaluation - Client Satisfaction Survey: WAP Service Delivery from the Client's Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Carolyn [Carolyn Miller Consulting, Princeton, NJ (United States); Carroll, David [APPRISE, Inc., Princeton, NJ (United States); Berger, Jacqueline [APPRISE, Inc., Princeton, NJ (United States); Driscoll, Colleen [APPRISE, Inc., Princeton, NJ (United States); Tonn, Bruce Edward [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-10-01

    This report presents the results of a survey of recipients to measure satisfaction with services provided by local weatherization agencies being supported by funding from Department of Energy's Weatherization Assistance Program.

  18. The NASA/industry Design Analysis Methods for Vibrations (DAMVIBS) program: A government overview

    Science.gov (United States)

    Kvaternik, Raymond G.

    1993-01-01

    NASA-Langley, under the Design Analysis Methods for Vibrations (DAMVIBS) Program, set out in 1984 to establish the technology base needed by the rotorcraft industry for developing an advanced finite-element-based dynamics design analysis capability for vibrations. Considerable work has been done by the industry participants in the program since that time. Because the DAMVIBS Program is being phased out, a government/industry assessment of the program has been made to identify those accomplishments and contributions which may be ascribed to the program. The purpose of this paper is to provide an overview of the program and its accomplishments and contributions from the perspective of the government sponsoring organization.

  19. From the Cover: Microfabricated needles for transdermal delivery of macromolecules and nanoparticles: Fabrication methods and transport studies

    Science.gov (United States)

    McAllister, Devin V.; Wang, Ping M.; Davis, Shawn P.; Park, Jung-Hwan; Canatella, Paul J.; Allen, Mark G.; Prausnitz, Mark R.

    2003-11-01

    Arrays of micrometer-scale needles could be used to deliver drugs, proteins, and particles across skin in a minimally invasive manner. We therefore developed microfabrication techniques for silicon, metal, and biodegradable polymer microneedle arrays having solid and hollow bores with tapered and beveled tips and feature sizes from 1 to 1,000 μm. When solid microneedles were used, skin permeability was increased in vitro by orders of magnitude for macromolecules and particles up to 50 nm in radius. Intracellular delivery of molecules into viable cells was also achieved with high efficiency. Hollow microneedles permitted flow of microliter quantities into skin in vivo, including microinjection of insulin to reduce blood glucose levels in diabetic rats. transdermal drug delivery | skin | microelectromechanical systems | solid microneedle | hollow needle injection

  20. Older Adults and Emerging Digital Service Delivery: A Mixed Methods Study on Information and Communications Technology Use, Skills, and Attitudes.

    Science.gov (United States)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability.

  1. Space age health care delivery

    Science.gov (United States)

    Jones, W. L.

    1977-01-01

    Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.

  2. A comparative study on optimization methods for the constrained nonlinear programming problems

    Directory of Open Access Journals (Sweden)

    Yeniay Ozgur

    2005-01-01

    Full Text Available Constrained nonlinear programming problems often arise in many engineering applications. The most well-known optimization methods for solving these problems are sequential quadratic programming methods and generalized reduced gradient methods. This study compares the performance of these methods with the genetic algorithms which gained popularity in recent years due to advantages in speed and robustness. We present a comparative study that is performed on fifteen test problems selected from the literature.

  3. The Historical Method of Inquiry in a Teacher Training Program: Theory and Metatheory.

    Science.gov (United States)

    Kimmons, Ron

    A historical method of inquiry can be applied to an experimental teacher training program, specifically, the Ford Training and Preparation Program (FTPP). The historical method requires gathering a lot of loose ideas and events that have been part of the project and hanging them together in an integrated way. To achieve this, two organizing…

  4. Fundamental solution of the problem of linear programming and method of its determination

    Science.gov (United States)

    Petrunin, S. V.

    1978-01-01

    The idea of a fundamental solution to a problem in linear programming is introduced. A method of determining the fundamental solution and of applying this method to the solution of a problem in linear programming is proposed. Numerical examples are cited.

  5. Impact of alternative reimbursement strategies in the new cooperative medical scheme on caesarean delivery rates: a mixed-method study in rural China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-07-01

    Full Text Available Abstract Background The rate of caesarean delivery (CD in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS, aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Methods Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs and in-depth key informant interviews (KIIs were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. Results The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for

  6. Assessing the impact of a new delivery method of insulin on glycemic control using a novel trial design

    Directory of Open Access Journals (Sweden)

    Thomas Strack

    2009-01-01

    Full Text Available Thomas Strack1, Luc Martinez2, Stefano Del Prato3, Larry Blonde4, Burkhard Göke5, Vincent Woo6, Ann Millward7, Ramon Gomis8, Bill Canovatchel1, David Lawrence1, Nick Freemantle9 on behalf of the EXPERIENCE Trial Team1Pfizer Inc., New York, NY, USA; 2Société Française de Médecine Générale, Issy les Moulineaux, France; 3University of Pisa, Pisa, Italy; 4Ochsner Medical Center, New Orleans, LO, USA; 5University of Munich, Munich, Germany; 6Health Sciences Centre, Winnipeg, Canada; 7Peninsula Medical School, Plymouth, UK; 8University of Barcelona, Barcelona, Spain; 9University of Birmingham, Birmingham, UKObjective: The purpose of the trial was to examine the impact of inhaled human insulin (INH on patient or physician willingness to adopt insulin after oral diabetes agent failure.Research design and methods: The EXPERIENCE trial was a one-year randomized controlled trial conducted at primary, secondary and tertiary care facilities in Europe and North America. The primary study endpoint was difference in glycated hemoglobin (A1c between randomized groups at 26 weeks, and results from that phase have been reported previously. The present report concerns results from the second 26-week extension phase. We also consider the applicability of the design. The trial recruited 727 patients with type 2 diabetes mellitus who, prior to randomization, were using two or more oral diabetes agents and whose A1c was ≥8.0%. Patients were randomized to two treatment settings: Group 1 (usual care with the option of INH or Group 2 (usual care only. Usual care included adjusting oral therapy (optimizing current regimen or adding/deleting agents and/or initiating subcutaneous (SC insulin.Results: At baseline, insulin was initiated by more (odds ratio [OR] 6.0;95% confidence interval [CI] 4.2 to 8.8; P < 0.0001 patients in Group 1 (86.2%; 76.7% INH plus 9.5% SC than in Group 2 (50.7%; SC insulin only. The largest reduction from baseline in A1c was in Group 1 (

  7. Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs.

    Directory of Open Access Journals (Sweden)

    Arianna Rubin Means

    2016-10-01

    Full Text Available While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration.We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list.In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group.Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and efficient integrated NTD

  8. AFRL/NASA Shaped Sonic Boom Experiment Flight Test Program. Delivery Order 0021: Origins and Overview of the Shaped Sonic Boom Demonstration Program

    National Research Council Canada - National Science Library

    Pawlowski, Joseph W; Graham, David H; Boccadoro, Charles H; Coen, Peter G; Maglieri, Domenic J

    2005-01-01

    The goal of the DARPA Shaped Sonic Boom Demonstration (SSBD) Program was to demonstrate for the first time in flight that sonic booms can be substantially reduced by incorporating specialized aircraft shaping techniques...

  9. Teaching methods and surgical training in North American graduate periodontics programs: exploring the landscape.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-06-01

    This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (Pperiodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.

  10. From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

    Science.gov (United States)

    Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

    2015-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

  11. 76 FR 25345 - Annual Assessment of the Status of Competition in the Market for the Delivery of Video Programming

    Science.gov (United States)

    2011-05-04

    ...- side economies of scale, where large MVPDs can spread fixed costs over more subscribers or negotiate... than one programming stream as a result of the digital transition increase the competitiveness of... supply-side economies of scale that enable commonly owned broadcast television stations to spread fixed...

  12. Impact of alternative reimbursement strategies in the new cooperative medical scheme on caesarean delivery rates: a mixed-method study in rural China.

    Science.gov (United States)

    Huang, Kun; Tao, Fangbiao; Bogg, Lennart; Tang, Shenglan

    2012-07-24

    The rate of caesarean delivery (CD) in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS), aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs) and in-depth key informant interviews (KIIs) were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for CD and vaginal deliveries did not have a

  13. Temperature Programmed Reduction/Oxidation (TPR/TPO) Methods

    Science.gov (United States)

    Gervasini, Antonella

    The redox properties of the metal oxides impart them peculiar catalytic activity which is exploited in reactions of oxidation and reduction of high applicative importance. It is possible to measure the extent of oxidation/reduction of given metal oxide by thermal methods which are become very popular: TPR and TPO analyses. By successive experiments of reduction and oxidation (TPR-TPO cycles) it is possible to control the reversible redox ability of a given oxide in view of its use as catalyst. The two methods are here presented with explanation on some possibility of exploitation of kinetic study to derive quantitative information on the reduction/oxidation of the oxide. Examples of selected metal oxides with well-established redox properties which have been used in catalytic processes are shown.

  14. Acquisition Program Problem Detection Using Text Mining Methods

    Science.gov (United States)

    2012-03-01

    this method into their practices (Berry & Kogan, 2010). Latent Semantic Analysis (LSA), Probabilistic Latent Semantic Analysis (PLSA), Latent...also known as Latent Semantic Indexing, uses a series of three matrices (document eigenvector, eigenvalue, and term eigenvector) to approximate the...Estimate at Complete • EVM: Earned Value Management • HTML: Hyper Text Markup Language • LDA: Latent Dirichlet Allocation • LSA: Latent Semantic Analysis

  15. ADVANCING THE STUDY OF VIOLENCE AGAINST WOMEN USING MIXED METHODS: INTEGRATING QUALITATIVE METHODS INTO A QUANTITATIVE RESEARCH PROGRAM

    Science.gov (United States)

    Testa, Maria; Livingston, Jennifer A.; VanZile-Tamsen, Carol

    2011-01-01

    A mixed methods approach, combining quantitative with qualitative data methods and analysis, offers a promising means of advancing the study of violence. Integrating semi-structured interviews and qualitative analysis into a quantitative program of research on women’s sexual victimization has resulted in valuable scientific insight and generation of novel hypotheses for testing. This mixed methods approach is described and recommendations for integrating qualitative data into quantitative research are provided. PMID:21307032

  16. Advancing the study of violence against women using mixed methods: integrating qualitative methods into a quantitative research program.

    Science.gov (United States)

    Testa, Maria; Livingston, Jennifer A; VanZile-Tamsen, Carol

    2011-02-01

    A mixed methods approach, combining quantitative with qualitative data methods and analysis, offers a promising means of advancing the study of violence. Integrating semi-structured interviews and qualitative analysis into a quantitative program of research on women's sexual victimization has resulted in valuable scientific insight and generation of novel hypotheses for testing. This mixed methods approach is described and recommendations for integrating qualitative data into quantitative research are provided.

  17. ADVANCING THE STUDY OF VIOLENCE AGAINST WOMEN USING MIXED METHODS: INTEGRATING QUALITATIVE METHODS INTO A QUANTITATIVE RESEARCH PROGRAM

    OpenAIRE

    Testa, Maria; Livingston, Jennifer A.; VanZile-Tamsen, Carol

    2011-01-01

    A mixed methods approach, combining quantitative with qualitative data methods and analysis, offers a promising means of advancing the study of violence. Integrating semi-structured interviews and qualitative analysis into a quantitative program of research on women’s sexual victimization has resulted in valuable scientific insight and generation of novel hypotheses for testing. This mixed methods approach is described and recommendations for integrating qualitative data into quantitative res...

  18. Comparison of Statistical Methods for Detector Testing Programs

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, John Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Abhold, Mark [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-10-14

    A typical goal for any detector testing program is to ascertain not only the performance of the detector systems under test, but also the confidence that systems accepted using that testing program’s acceptance criteria will exceed a minimum acceptable performance (which is usually expressed as the minimum acceptable success probability, p). A similar problem often arises in statistics, where we would like to ascertain the fraction, p, of a population of items that possess a property that may take one of two possible values. Typically, the problem is approached by drawing a fixed sample of size n, with the number of items out of n that possess the desired property, x, being termed successes. The sample mean gives an estimate of the population mean p ≈ x/n, although usually it is desirable to accompany such an estimate with a statement concerning the range within which p may fall and the confidence associated with that range. Procedures for establishing such ranges and confidence limits are described in detail by Clopper, Brown, and Agresti for two-sided symmetric confidence intervals.

  19. A Method for Automatic Runtime Verification of Automata-Based Programs

    OpenAIRE

    Oleg, Stepanov; Anatoly, Shalyto

    2008-01-01

    Currently Model Checking is the only practically used method for verification of automata-based programs. However, current implementations of this method only allow verification of simple automata systems. We suggest using a different approach, runtime verification, for verification of automata systems. We discuss advantages and disadvantages of this approach, propose a method for automatic verification of automata-based programs which uses this approach and conduct experimental performance s...

  20. A Novel Method for Super-selective Coil Embolization Using an Extremely Soft Bare Coil through a Liquid Embolic Delivery Microcatheter

    Science.gov (United States)

    HORIE, Nobutaka; HAYASHI, Kentaro; MORIKAWA, Minoru; IZUMO, Tsuyoshi; NAGATA, Izumi

    Endovascular coil embolization for intracranial aneurysms, arteriovenous malformations (AVMs), dural arteriovenous fistulas (AVFs), and hypervascular tumors are recognized as an effective adjunctive or curative treatment. In this setting, it is sometimes difficult to navigate a coil delivery microcatheter to the target point of a tiny, tortuous vessel. We herein present a case series of a novel method that enabled super-selective coil embolization using an extremely soft bare, electrodetachable coil (ED extrasoft® coil) through a liquid embolic delivery microcatheter (Marathon®). The Marathon® catheter was successfully placed at the target point of the tiny, tortuous vessel, and coil embolization was achieved in all 16 patients with 9 AVMs, 2 distal aneurysms, 2 AVFs, and 3 meningiomas. The primary ED extrasoft® coil and delivery wire have a very small radius, and the coil is rapidly detachable with an alarm notice from the generator even under Marathon® with one marker. We believe that this technique can provide safe and efficient embolization for selected patients. PMID:24670315

  1. The state-led large scale public private partnership 'Chiranjeevi Program' to increase access to institutional delivery among poor women in Gujarat, India: How has it done? What can we learn?

    Science.gov (United States)

    De Costa, Ayesha; Vora, Kranti S; Ryan, Kayleigh; Sankara Raman, Parvathy; Santacatterina, Michele; Mavalankar, Dileep

    2014-01-01

    Many low-middle income countries have focused on improving access to and quality of obstetric care, as part of promoting a facility based intra-partum care strategy to reduce maternal mortality. The state of Gujarat in India, implements a facility based intra-partum care program through its large for-profit private obstetric sector, under a state-led public-private-partnership, the Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians to perform deliveries for poor/tribal women. We examine CY performance, its contribution to overall trends in institutional deliveries in Gujarat over the last decade and its effect on private and public sector deliveries there. District level institutional delivery data (public, private, CY), national surveys, poverty estimates, census data were used. Institutional delivery trends in Gujarat 2000-2010 are presented; including contributions of different sectors and CY. Piece-wise regression was used to study the influence of the CY program on public and private sector institutional delivery. Institutional delivery rose from 40.7% (2001) to 89.3% (2010), driven by sharp increases in private sector deliveries. Public sector and CY contributed 25-29% and 13-16% respectively of all deliveries each year. In 2007, 860 of 2000 private obstetricians participated in CY. Since 2007, >600,000 CY deliveries occurred i.e. one-third of births in the target population. Caesareans under CY were 6%, higher than the 2% reported among poor women by the DLHS survey just before CY. CY did not influence the already rising proportion of private sector deliveries in Gujarat. This paper reports a state-led, fully state-funded, large-scale public-private partnership to improve poor women's access to institutional delivery - there have been >600,000 beneficiaries. While caesarean proportions are higher under CY than before, it is uncertain if all beneficiaries who require sections receive these. Other issues to explore include

  2. Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain.

    Science.gov (United States)

    Toomey, Elaine; Matthews, James; Hurley, Deirdre A

    2017-08-04

    Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design. Feasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy. 60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman's correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation. Quantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists' individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists' knowledge (Spearman's association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity. The intervention was delivered with high fidelity. This study contributes

  3. Integrating design science theory and methods to improve the development and evaluation of health communication programs.

    Science.gov (United States)

    Neuhauser, Linda; Kreps, Gary L

    2014-12-01

    Traditional communication theory and research methods provide valuable guidance about designing and evaluating health communication programs. However, efforts to use health communication programs to educate, motivate, and support people to adopt healthy behaviors often fail to meet the desired goals. One reason for this failure is that health promotion issues are complex, changeable, and highly related to the specific needs and contexts of the intended audiences. It is a daunting challenge to effectively influence health behaviors, particularly culturally learned and reinforced behaviors concerning lifestyle factors related to diet, exercise, and substance (such as alcohol and tobacco) use. Too often, program development and evaluation are not adequately linked to provide rapid feedback to health communication program developers so that important revisions can be made to design the most relevant and personally motivating health communication programs for specific audiences. Design science theory and methods commonly used in engineering, computer science, and other fields can address such program and evaluation weaknesses. Design science researchers study human-created programs using tightly connected build-and-evaluate loops in which they use intensive participatory methods to understand problems and develop solutions concurrently and throughout the duration of the program. Such thinking and strategies are especially relevant to address complex health communication issues. In this article, the authors explore the history, scientific foundation, methods, and applications of design science and its potential to enhance health communication programs and their evaluation.

  4. Design, delivery, and validation of a trainer curriculum for the national laparoscopic colorectal training program in England.

    Science.gov (United States)

    Mackenzie, Hugh; Cuming, Tamzin; Miskovic, Danilo; Wyles, Susannah M; Langsford, Laura; Anderson, John; Thomas-Gibson, Siwan; Valori, Roland; Hanna, George B; Coleman, Mark G; Francis, Nader

    2015-01-01

    To validate the delivery and efficacy of the national laparoscopic colorectal surgery "training the trainer" (Lapco TT) curriculum. The National Training Programme in Laparoscopic Colorectal Surgery designed the Lapco TT curriculum to improve, standardize, and benchmark the quality of training. Evidence for such courses rarely extends beyond subjective feedback. The Lapco TT curriculum tailors key teaching skills for laparoscopic colorectal surgery: training structure, skills deconstruction, trainer intervention, and performance enhancing feedback. Ten Lapco TT courses were delivered to 65 national Lapco trainers since 2010. The course was validated at Kirkpatrick's 4 levels of evaluation: (i) pre- and post-course interviews reflecting initial reaction; (ii) training quality assessment on simulated scenarios using the Structured Training Trainer Assessment Report (STTAR) tool; (iii) follow-up interviews at 4 to 6 months; and (iv) delegate performance ratings, by their trainees, using the mini-STTAR and the delegates' trainees learning curves before and after the course. There were significant improvements in training in the post-course simulated scenario, especially in the "set" (P situations. Findings mirrored in performance ratings by their trainees: overall (4.37 vs 4.46, P = 0.040), agreed learning points (3.65 vs 4.00, P = 0.042), encouraged self-reflection (3.67 vs 3.94, P = 0.046), and encouraged team awareness (3.53 vs 4.05, P = 0.045). The learning curve of delegates' trainees improved after the course. The Lapco TT curriculum improved training performance in the short- and long-term, provided a structured training framework, and enhanced the learning curve of delegates' trainees.

  5. An introduction to fuzzy linear programming problems theory, methods and applications

    CERN Document Server

    Kaur, Jagdeep

    2016-01-01

    The book presents a snapshot of the state of the art in the field of fully fuzzy linear programming. The main focus is on showing current methods for finding the fuzzy optimal solution of fully fuzzy linear programming problems in which all the parameters and decision variables are represented by non-negative fuzzy numbers. It presents new methods developed by the authors, as well as existing methods developed by others, and their application to real-world problems, including fuzzy transportation problems. Moreover, it compares the outcomes of the different methods and discusses their advantages/disadvantages. As the first work to collect at one place the most important methods for solving fuzzy linear programming problems, the book represents a useful reference guide for students and researchers, providing them with the necessary theoretical and practical knowledge to deal with linear programming problems under uncertainty.

  6. A method for verification of treatment delivery in HDR prostate brachytherapy using a flat panel detector for both imaging and source tracking

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Ryan L., E-mail: ryan.smith@wbrc.org.au; Millar, Jeremy L.; Franich, Rick D. [Alfred Health Radiation Oncology, The Alfred Hospital, Melbourne, VIC 3004, Australia and School of Science, RMIT University, Melbourne, VIC 3000 (Australia); Haworth, Annette [School of Science, RMIT University, Melbourne, VIC 3000, Australia and Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne, VIC 3002 (Australia); Panettieri, Vanessa [Alfred Health Radiation Oncology, The Alfred Hospital, Melbourne, VIC 3004 (Australia)

    2016-05-15

    Purpose: Verification of high dose rate (HDR) brachytherapy treatment delivery is an important step, but is generally difficult to achieve. A technique is required to monitor the treatment as it is delivered, allowing comparison with the treatment plan and error detection. In this work, we demonstrate a method for monitoring the treatment as it is delivered and directly comparing the delivered treatment with the treatment plan in the clinical workspace. This treatment verification system is based on a flat panel detector (FPD) used for both pre-treatment imaging and source tracking. Methods: A phantom study was conducted to establish the resolution and precision of the system. A pretreatment radiograph of a phantom containing brachytherapy catheters is acquired and registration between the measurement and treatment planning system (TPS) is performed using implanted fiducial markers. The measured catheter paths immediately prior to treatment were then compared with the plan. During treatment delivery, the position of the {sup 192}Ir source is determined at each dwell position by measuring the exit radiation with the FPD and directly compared to the planned source dwell positions. Results: The registration between the two corresponding sets of fiducial markers in the TPS and radiograph yielded a registration error (residual) of 1.0 mm. The measured catheter paths agreed with the planned catheter paths on average to within 0.5 mm. The source positions measured with the FPD matched the planned source positions for all dwells on average within 0.6 mm (s.d. 0.3, min. 0.1, max. 1.4 mm). Conclusions: We have demonstrated a method for directly comparing the treatment plan with the delivered treatment that can be easily implemented in the clinical workspace. Pretreatment imaging was performed, enabling visualization of the implant before treatment delivery and identification of possible catheter displacement. Treatment delivery verification was performed by measuring the

  7. CRISPR/Cas9 system as an innovative genetic engineering tool: Enhancements in sequence specificity and delivery methods.

    Science.gov (United States)

    Jo, Young-Il; Suresh, Bharathi; Kim, Hyongbum; Ramakrishna, Suresh

    2015-12-01

    While human gene therapy has gained significant attention for its therapeutic promise, CRISPR/Cas9 technology has made a breakthrough as an efficient genome editing tool by emulating prokaryotic immune defense mechanisms. Although many studies have found that CRISPR/Cas9 technology is more efficient, specific and manipulable than previous generations of gene editing tools, it can be further improved by elevating its overall efficiency in a higher frequency of genome modifications and reducing its off-target effects. Here, we review the development of CRISPR/Cas9 technology, focusing on enhancement of its sequence specificity, reduction of off-target effects and delivery systems. Moreover, we describe recent successful applications of CRISPR/Cas9 technology in laboratory and clinical studies. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Selecting a dynamic simulation modeling method for health care delivery research-part 2: report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force.

    Science.gov (United States)

    Marshall, Deborah A; Burgos-Liz, Lina; IJzerman, Maarten J; Crown, William; Padula, William V; Wong, Peter K; Pasupathy, Kalyan S; Higashi, Mitchell K; Osgood, Nathaniel D

    2015-03-01

    In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling can be used more effectively than other modeling methods. The hierarchical relationship between the health care delivery system, providers, patients, and other stakeholders exhibits a level of complexity that ought to be captured using dynamic simulation modeling methods. As a tool to help researchers decide whether dynamic simulation modeling is an appropriate method for modeling the effects of an intervention on a health care system, we presented the System, Interactions, Multilevel, Understanding, Loops, Agents, Time, Emergence (SIMULATE) checklist consisting of eight elements. This report builds on the previous work, systematically comparing each of the three most commonly used dynamic simulation modeling methods-system dynamics, discrete-event simulation, and agent-based modeling. We review criteria for selecting the most suitable method depending on 1) the purpose-type of problem and research questions being investigated, 2) the object-scope of the model, and 3) the method to model the object to achieve the purpose. Finally, we provide guidance for emerging good practices for dynamic simulation modeling in the health sector, covering all aspects, from the engagement of decision makers in the model design through model maintenance and upkeep. We conclude by providing some recommendations about the application of these methods to add value to informed decision making, with an emphasis on stakeholder engagement, starting with the problem definition. Finally, we identify areas in which further methodological development will likely occur given the growing "volume, velocity and variety" and availability of "big data" to provide empirical evidence and techniques

  9. A Comparison of Traditional Worksheet and Linear Programming Methods for Teaching Manure Application Planning.

    Science.gov (United States)

    Schmitt, M. A.; And Others

    1994-01-01

    Compares traditional manure application planning techniques calculated to meet agronomic nutrient needs on a field-by-field basis with plans developed using computer-assisted linear programming optimization methods. Linear programming provided the most economical and environmentally sound manure application strategy. (Contains 15 references.) (MDH)

  10. Comparison of linear, mixed integer and non-linear programming methods in energy system dispatch modelling

    DEFF Research Database (Denmark)

    Ommen, Torben Schmidt; Markussen, Wiebke Brix; Elmegaard, Brian

    2014-01-01

    differences and differences between the solution found by each optimisation method. One of the investigated approaches utilises LP (linear programming) for optimisation, one uses LP with binary operation constraints, while the third approach uses NLP (non-linear programming). The LP model is used...

  11. A method for verification of treatment delivery in HDR prostate brachytherapy using a flat panel detector for both imaging and source tracking.

    Science.gov (United States)

    Smith, Ryan L; Haworth, Annette; Panettieri, Vanessa; Millar, Jeremy L; Franich, Rick D

    2016-05-01

    Verification of high dose rate (HDR) brachytherapy treatment delivery is an important step, but is generally difficult to achieve. A technique is required to monitor the treatment as it is delivered, allowing comparison with the treatment plan and error detection. In this work, we demonstrate a method for monitoring the treatment as it is delivered and directly comparing the delivered treatment with the treatment plan in the clinical workspace. This treatment verification system is based on a flat panel detector (FPD) used for both pre-treatment imaging and source tracking. A phantom study was conducted to establish the resolution and precision of the system. A pretreatment radiograph of a phantom containing brachytherapy catheters is acquired and registration between the measurement and treatment planning system (TPS) is performed using implanted fiducial markers. The measured catheter paths immediately prior to treatment were then compared with the plan. During treatment delivery, the position of the (192)Ir source is determined at each dwell position by measuring the exit radiation with the FPD and directly compared to the planned source dwell positions. The registration between the two corresponding sets of fiducial markers in the TPS and radiograph yielded a registration error (residual) of 1.0 mm. The measured catheter paths agreed with the planned catheter paths on average to within 0.5 mm. The source positions measured with the FPD matched the planned source positions for all dwells on average within 0.6 mm (s.d. 0.3, min. 0.1, max. 1.4 mm). We have demonstrated a method for directly comparing the treatment plan with the delivered treatment that can be easily implemented in the clinical workspace. Pretreatment imaging was performed, enabling visualization of the implant before treatment delivery and identification of possible catheter displacement. Treatment delivery verification was performed by measuring the source position as each dwell was delivered

  12. Using Quality Improvement Methods and Time-Driven Activity-Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic.

    Science.gov (United States)

    Tan, Ryan Y C; Met-Domestici, Marie; Zhou, Ke; Guzman, Alexis B; Lim, Soon Thye; Soo, Khee Chee; Feeley, Thomas W; Ngeow, Joanne

    2016-03-01

    To meet increasing demand for cancer genetic testing and improve value-based cancer care delivery, National Cancer Centre Singapore restructured the Cancer Genetics Service in 2014. Care delivery processes were redesigned. We sought to improve access by increasing the clinic capacity of the Cancer Genetics Service by 100% within 1 year without increasing direct personnel costs. Process mapping and plan-do-study-act (PDSA) cycles were used in a quality improvement project for the Cancer Genetics Service clinic. The impact of interventions was evaluated by tracking the weekly number of patient consultations and access times for appointments between April 2014 and May 2015. The cost impact of implemented process changes was calculated using the time-driven activity-based costing method. Our study completed two PDSA cycles. An important outcome was achieved after the first cycle: The inclusion of a genetic counselor increased clinic capacity by 350%. The number of patients seen per week increased from two in April 2014 (range, zero to four patients) to seven in November 2014 (range, four to 10 patients). Our second PDSA cycle showed that manual preappointment reminder calls reduced the variation in the nonattendance rate and contributed to a further increase in patients seen per week to 10 in May 2015 (range, seven to 13 patients). There was a concomitant decrease in costs of the patient care cycle by 18% after both PDSA cycles. This study shows how quality improvement methods can be combined with time-driven activity-based costing to increase value. In this paper, we demonstrate how we improved access while reducing costs of care delivery. Copyright © 2016 by American Society of Clinical Oncology.

  13. Methods and challenges for the health impact assessment of vaccination programs in Latin America

    OpenAIRE

    Sartori, Ana Marli Christovam; Nascimento, Andr?ia de F?tima; Yuba, T?nia Yuka; de So?rez, Patr?cia Coelho; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for pu...

  14. Delivery of integrated diabetes care using logistics and information technology--the Joint Asia Diabetes Evaluation (JADE) program.

    Science.gov (United States)

    Chan, Juliana C N; Ozaki, Risa; Luk, Andrea; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C; Wong, Patrick; Wong, Rebecca; Chung, Harriet; Chiu, Cherry; Wolthers, Troels; Tong, Peter C Y; Ko, Gary T C; So, Wing-Yee; Lyubomirsky, Greg

    2014-12-01

    Diabetes is a global epidemic, and many affected individuals are undiagnosed, untreated, or uncontrolled. The silent and multi-system nature of diabetes and its complications, with complex care protocols, are often associated with omission of periodic assessments, clinical inertia, poor treatment compliance, and care fragmentation. These barriers at the system, patient, and care-provider levels have resulted in poor control of risk factors and under-usage of potentially life-saving medications such as statins and renin-angiotensin system inhibitors. However, in the clinical trial setting, use of nurses and protocol with frequent contact and regular monitoring have resulted in marked differences in event rates compared to epidemiological data collected in the real-world setting. The phenotypic heterogeneity and cognitive-psychological-behavioral needs of people with diabetes call for regular risk stratification to personalize care. Quality improvement initiatives targeted at patient education, task delegation, case management, and self-care promotion had the largest effect size in improving cardio-metabolic risk factors. The Joint Asia Diabetes Evaluation (JADE) program is an innovative care prototype that advocates a change in clinic setting and workflow, coordinated by a doctor-nurse team and augmented by a web-based portal, which incorporates care protocols and a validated risk engine to provide decision support and regular feedback. By using logistics and information technology, supported by a network of health-care professionals to provide integrated, holistic, and evidence-based care, the JADE Program aims to establish a high-quality regional diabetes database to reflect the status of diabetes care in real-world practice, confirm efficacy data, and identify unmet needs. Through collaborative efforts, we shall evaluate the feasibility, acceptability, and cost-effectiveness of this "high tech, soft touch" model to make diabetes and chronic disease care more

  15. The Value of Developing a Mixed-Methods Program of Research.

    Science.gov (United States)

    Simonovich, Shannon

    2017-07-01

    This article contributes to the discussion of the value of utilizing mixed methodological approaches to conduct nursing research. To this end, the author of this article proposes creating a mixed-methods program of research over time, where both quantitative and qualitative data are collected and analyzed simultaneously, rather than focusing efforts on designing singular mixed-methods studies. A mixed-methods program of research would allow for the best of both worlds: precision through focus on one method at a time, and the benefits of creating a robust understanding of a phenomenon over the trajectory of one's career through examination from various methodological approaches.

  16. After Delivery

    Science.gov (United States)

    ... for Association Events Messaging Tools Recruiting Advocates Local Market Planning Training Webinars News & Events Advocacy News Call ... A Listen En Español After Delivery After your baby arrives, your body begins to recover from the ...

  17. Forceps Delivery

    Science.gov (United States)

    ... 2015. Related Signs of labor Forceps delivery About Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  18. Participation of HIV prevention programs among men who have sex with men in two cities of China—a mixed method study

    Directory of Open Access Journals (Sweden)

    Ma Wei

    2012-10-01

    Full Text Available Abstract Background Although various HIV prevention programs targeting men who have sex with men (MSM are operating in China, whether and how these programs are being utilized is unclear. This study explores participation of HIV prevention programs and influencing factors among MSM in two cities in China. Methods This is a mixed-method study conducted in Beijing and Chongqing. A qualitative study consisting of in-depth interviews with 54 MSM, 11 key informants, and 8 focus group discussions, a cross-sectional survey using respondent-driven sampling among 998 MSM were conducted in 2009 and 2010 respectively to elicit information on MSM’s perception and utilization of HIV prevention programs. Qualitative findings were integrated with quantitative multivariate factors to explain the quantitative findings. Results Fifty-six percent of MSM in Chongqing and 75.1% in Beijing ever participated in at least one type of HIV prevention program (P=0.001. Factors related to participation in HIV prevention programs included age, ethnicity, income, HIV risk perception, living with boyfriend, living in urban area, size of MSM social network, having talked about HIV status with partners, and knowing someone who is HIV positive. Reasons why MSM did not participate in HIV prevention programs included logistical concerns like limited time for participation and distance to services; program content and delivery issues such as perceived low quality services and distrust of providers; and, cultural issues like HIV-related stigma and low risk perception. Conclusions The study shows that there is much room for improvement in reaching MSM in China. HIV prevention programs targeting MSM in China may need to be more comprehensive and incorporate the cultural, logistic and HIV-related needs of the population in order to effectively reach and affect this population’s risk for HIV.

  19. Novel synthesizing method of pH-dependent doxorubicin-loaded anti-CD22-labelled drug delivery nanosystem

    Directory of Open Access Journals (Sweden)

    Sun M

    2015-09-01

    Full Text Available Mengjiao Sun,1,* Jun Wang,1,* Qin Lu,1 Guohua Xia,2 Yu Zhang,3 Lina Song,3 Yongjun Fang11Department of Hematology/Oncology, Nanjing Children’s Hospital, Nanjing Medical University, 2Department of Hematology, Zhongda Hospital, Medical School, Southeast University, 3State Key Laboratory of Bioelectronics, Southeast University, Nanjing, People’s Republic of China*These authors have contributed equally to this workAbstract: The objective of this study was to investigate the anticancer efficacy of dimercaptosuccinic acid-modified iron oxide magnetic nanoparticles coloaded with anti-CD22 antibodies and doxorubicin (anti-CD22-MNPs-DOX on non-Hodgkin’s lymphoma cells. The physical properties of anti-CD22-MNPs-DOX were studied and its antitumor effect on Raji cells in vitro was evaluated using the Cell Counting Kit-8 assay. Furthermore, cell apoptosis and intracellular accumulation of doxorubicin were determined by flow cytometry. The results revealed that anti-CD22-MNPs-DOX inhibited the proliferation of Raji cells, significantly increased the uptake of doxorubicin, and induced apoptosis. Therefore, it was concluded that a coloaded antibody and chemo­therapeutic drug with magnetic nanoparticles might be an efficient targeted treatment strategy for non-Hodgkin’s lymphoma.Keywords: doxorubicin, anti-CD22 antibody, drug delivery system, target selection, non-Hodgkin lymphoma

  20. Utilizing geophysical methods for asessment and characterization of canal seepage in El Paso's lower valley irrigation delivery systems

    Science.gov (United States)

    Cegon, Amanda Brooke

    El Paso County Water Improvement District No. 1 (EPCWID No.1) delivers the Rio Grande water for agricultural production and urban uses through numerous networked irrigation canals. Of the nearly 86 billion gallons of water released annually for irrigation uses in Texas, billions are lost due to evaporation and seepage in unlined canals with 56 million gallons of the billions are lost in Franklin Canal annually due to improper lining and sediment variation of the canals. To characterize seepage patterns and identify areas of high seepage, Electrical Resistivity, Ground Truthing via soil sample analysis were used along three, half-mile long sectioned canals during irrigation and non-irrigation seasons. The data lines acquired were processed in EARTHIMAGER 2D to create 2D vertical resistivity inversion profiles to locate potential areas of high seepage/high resistivity. The research results will help El Paso County Water Improvement District No. 1 to develop management strategies to conserve water and improve the delivery efficiency systems which leads to economic growth in the Rio Grande Basin.

  1. Instructional Methods for Neuroscience in Nurse Anesthesia Graduate Programs: A Survey of Educational Programs

    Science.gov (United States)

    1999-10-01

    36 Table 13. Alzheimer s/Dementia . . . . . . . . . . . . . .37 Table 14. Autonomic Hyperreflexia...practice of his father in general medicine. He wrote a little known medical monograph on "Observations on the Nature and Cure of Gout" in 1805...2.0 13.53 Instructional Methods 41 Alzheimer s and Dementia was instructed be textbooks (33%)(SD)=28, lectures (42%)(SD)=31, computers (1%)(SD)=3

  2. The use of emerging informatics techniques to evaluate the delivery of NMAETC programs to address HIV and AIDS disparities.

    Science.gov (United States)

    Hsu, Chiehwen Ed; Watson, Keisha; Boekeloo, Bradley; Shang, Ning; Metzger, Christiana; Downer, Goulda

    2010-12-01

    Information technologies are employed to evaluate health program and better target recruitment of health care workforce for underserved communities, where needs for providers are greatest. With increased resources in reducing human immunodeficiency virus (HIV)/AIDS disparities and provider training, it may be important to know whether training is delivered in geographic areas where HIV/AIDS demonstrates high prevalence. The present study employs an informatics approach to identifying effectiveness of AIDS educational intervention in minority populations adversely affected by the disease. We seek to assess the National Minority AIDS Education and Training Center (NMAETC) on whether training activities are delivered appropriately in areas with high AIDS prevalence. A geographic information systems application was developed to relate NMAETC provider training activities to its spatial relationship of AIDS prevalence of 4 major US racial/ethnic groups (fiscal years 2005-2006). Trainees' locations were geocoded by zip code. We overlaid AIDS prevalence of major demographic communities by state with the US Census region and division boundaries to visually inspect the patterns of distribution and potential spatial association. NMAETC training better targeted providers in 3 US Census regions and census divisions. The regions with higher provider training level generally corresponded to geographic areas with high AIDS prevalence for some minority populations. Additional efforts could be extended to recruit providers in the areas where the incidences were high for some communities. Most NMAETC provider training activities occurred in the states with a high AIDS prevalence. Additional efforts could be extended to recruit the providers in those regions where HIV/AIDS are more prevalent for some minority populations.

  3. Membrane and Nuclear Permeabilization by Polymeric pDNA Vehicles: Efficient Method for Gene Delivery or Mechanism of Cytotoxicity?

    Science.gov (United States)

    Grandinetti, Giovanna; Smith, Adam E.; Reineke, Theresa M.

    2012-01-01

    The aim of this study is to compare the cytotoxicity mechanisms of linear PEI to two analogous polymers synthesized by our group: a hydroxyl-containing poly(L-tartaramidoamine) (T4) and a version containing an alkyl chain spacer poly(adipamidopentaethylenetetramine) (A4) by studying the cellular responses to polymer transfection. We have also synthesized analogues of T4 with different molecular weights (degrees of polymerization of 6, 12, and 43) to examine the role of molecular weight on the cytotoxicity mechanisms. Several mechanisms of polymer-induced cytotoxicity are investigated, including plasma membrane permeabilization, the formation of potentially harmful polymer degradation products during transfection including reactive oxygen species, and nuclear membrane permeabilization. We hypothesized that since cationic polymers are capable of disrupting the plasma membrane, they may also be capable of disrupting the nuclear envelope, which could be a potential mechanism of how the pDNA is delivered into the nucleus (other than nuclear envelope breakdown during mitosis). Using flow cytometry and confocal microscopy, we show that the polycations with the highest amount of protein expression and toxicity, PEI and T443, are capable of inducing nuclear membrane permeability. This finding is important for the field of nucleic acid delivery in that not only could direct nucleus permeabilization be a mechanism for pDNA nuclear import but also a potential mechanism of cytotoxicity and cell death. We also show that the production of reactive oxygen species is not a main mechanism of cytotoxicity, and that the presence or absence of hydroxyl groups as well as polymer length plays a role in polyplex size and charge in addition to protein expression efficiency and toxicity. PMID:22175236

  4. Developing a Web-Based Weight Management Program for Childhood Cancer Survivors: Rationale and Methods.

    Science.gov (United States)

    Zhang, Fang Fang; Meagher, Susan; Scheurer, Michael; Folta, Sara; Finnan, Emily; Criss, Kerry; Economos, Christina; Dreyer, ZoAnn; Kelly, Michael

    2016-11-18

    Due to advances in the field of oncology, survival rates for children with cancer have improved significantly. However, these childhood cancer survivors are at a higher risk for obesity and cardiovascular diseases and for developing these conditions at an earlier age. In this paper, we describe the rationale, conceptual framework, development process, novel components, and delivery plan of a behavioral intervention program for preventing unhealthy weight gain in survivors of childhood acute lymphoblastic leukemia (ALL). A Web-based program, the Healthy Eating and Active Living (HEAL) program, was designed by a multidisciplinary team of researchers who first identified behaviors that are appropriate targets for weight management in childhood ALL survivors and subsequently developed the intervention components, following core behavioral change strategies grounded in social cognitive and self-determination theories. The Web-based HEAL curriculum has 12 weekly self-guided sessions to increase parents' awareness of the potential impact of cancer treatment on weight and lifestyle habits and the importance of weight management in survivors' long-term health. It empowers parents with knowledge and skills on parenting, nutrition, and physical activity to help them facilitate healthy eating and active living soon after the child completes intensive cancer treatment. Based on social cognitive theory, the program is designed to increase behavioral skills (goal-setting, self-monitoring, and problem-solving) and self-efficacy and to provide positive reinforcement to sustain behavioral change. Lifestyle interventions are a priority for preventing the early onset of obesity and cardiovascular risk factors in childhood cancer survivors. Intervention programs need to meet survivors' targeted behavioral needs, address specific barriers, and capture a sensitive window for behavioral change. In addition, they should be convenient, cost-effective and scalable. Future studies are needed

  5. Improving programming skills of Mechanical Engineering students by teaching in C# multi-objective optimizations methods

    Directory of Open Access Journals (Sweden)

    Florea Adrian

    2017-01-01

    Full Text Available Designing an optimized suspension system that meet the main functions of comfort, safety and handling on poor quality roads is a goal for researchers. This paper represents a software development guide for designers of suspension systems with less programming skills that will enable them to implement their own optimization methods that improve traditional methods by using their domain knowledge.

  6. A Smooth Newton Method for Nonlinear Programming Problems with Inequality Constraints

    Directory of Open Access Journals (Sweden)

    Vasile Moraru

    2012-02-01

    Full Text Available The paper presents a reformulation of the Karush-Kuhn-Tucker (KKT system associated nonlinear programming problem into an equivalent system of smooth equations. Classical Newton method is applied to solve the system of equations. The superlinear convergence of the primal sequence, generated by proposed method, is proved. The preliminary numerical results with a problems test set are presented.

  7. Fuzzy physical programming for Space Manoeuvre Vehicles trajectory optimization based on hp-adaptive pseudospectral method

    Science.gov (United States)

    Chai, Runqi; Savvaris, Al; Tsourdos, Antonios

    2016-06-01

    In this paper, a fuzzy physical programming (FPP) method has been introduced for solving multi-objective Space Manoeuvre Vehicles (SMV) skip trajectory optimization problem based on hp-adaptive pseudospectral methods. The dynamic model of SMV is elaborated and then, by employing hp-adaptive pseudospectral methods, the problem has been transformed to nonlinear programming (NLP) problem. According to the mission requirements, the solutions were calculated for each single-objective scenario. To get a compromised solution for each target, the fuzzy physical programming (FPP) model is proposed. The preference function is established with considering the fuzzy factor of the system such that a proper compromised trajectory can be acquired. In addition, the NSGA-II is tested to obtain the Pareto-optimal solution set and verify the Pareto optimality of the FPP solution. Simulation results indicate that the proposed method is effective and feasible in terms of dealing with the multi-objective skip trajectory optimization for the SMV.

  8. ICD programming

    OpenAIRE

    Biffi, Mauro

    2014-01-01

    Background: Appropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome. Methods: Review of the literature on ICD therapy to generate ICD programmings that can be applied to the broad population of ICD and CRT-D carriers. Results: Arrhythmia detection should occur with a detection time ranging 9″–12″ in the VF zone, and 15″–60″ in the VT zone. Discriminator should be applied at least up to 200 bpm. ATP therap...

  9. The NASA digital VGH program. Exploration of methods and final results. Volume 1: Development of methods

    Science.gov (United States)

    Crabill, Norman L.

    1989-01-01

    Two hundred hours of Lockheed L 1011 digital flight data recorder data taken in 1973 were used to develop methods and procedures for obtaining statistical data useful for updating airliner airworthiness design criteria. Five thousand hours of additional data taken in 1978 to 1982 are reported in volumes 2, 3, 4 and 5.

  10. Temporospatial quantification of fluorescein-labeled sinonasal irrigation delivery.

    Science.gov (United States)

    Bleier, Benjamin S; Debnath, Indranil; Harvey, Richard J; Schlosser, Rodney J

    2011-01-01

    Treatment of sinonasal disease is predicated on the delivery and retention of the agent at the desired location. Despite multiple distribution studies, there remains a need for a method capable quantifying not only the site and amount of agent deposition but the rate of clearance as well. Five patients underwent endoscopic image capture of 3 subsites over 15 minutes following fluorescein-dyed irrigation using a squeeze bottle, nasal saline spray, or nasal gel spray. Area and intensity staining were quantified using a graphics editing program. Total intensity scores were compared using a Student t test. The squeeze bottle was the only method demonstrating delivery to the oropharynx (37 ± 22 mm(2) ). The nasal gel resulted in the greatest coverage of the middle turbinate region (10 ± 15 mm(2) ) while the nasal saline spray (75 ± 31 mm(2) ) resulted in the greatest inferior turbinate coverage. No significant differences in clearance rates were found between delivery methods at any subsite. This method is capable of quantifying both the area and intensity of fluorescein deposition using a variety of delivery methods. While small variations in subsite coverage were noted, all methods resulted in significant internal valve deposition. Despite differences in delivery volume and viscosity, all methods resulted in similar rates of fluorescein clearance. Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

  11. A molecular method for the delivery of small molecules and proteins across the cell wall of algae using molecular transporters

    OpenAIRE

    Hyman, Joel M.; Geihe, Erika I.; Trantow, Brian M.; Parvin, Bahram; Wender, Paul A.

    2012-01-01

    Interest in algae has significantly accelerated with the increasing recognition of their potentially unique role in medical, materials, energy, bioremediation, and synthetic biological research. However, the introduction of tools to study, control, or expand the inner-workings of algae has lagged behind. Here we describe a general molecular method based on guanidinium-rich molecular transporters (GR-MoTrs) for bringing small and large cargos into algal cells. Significantly, this method is sho...

  12. Potential function methods for approximately solving linear programming problems theory and practice

    CERN Document Server

    Bienstock, Daniel

    2002-01-01

    Potential Function Methods For Approximately Solving Linear Programming Problems breaks new ground in linear programming theory. The book draws on the research developments in three broad areas: linear and integer programming, numerical analysis, and the computational architectures which enable speedy, high-level algorithm design. During the last ten years, a new body of research within the field of optimization research has emerged, which seeks to develop good approximation algorithms for classes of linear programming problems. This work both has roots in fundamental areas of mathematical programming and is also framed in the context of the modern theory of algorithms. The result of this work, in which Daniel Bienstock has been very much involved, has been a family of algorithms with solid theoretical foundations and with growing experimental success. This book will examine these algorithms, starting with some of the very earliest examples, and through the latest theoretical and computational developments.

  13. Methods of teaching and evaluating electrocardiogram interpretation skills among cardiology fellowship programs in the United States.

    Science.gov (United States)

    Auseon, Alex J; Schaal, Stephen F; Kolibash, Albert J; Nagel, Rollin; Lucey, Catherine R; Lewis, Richard P

    2009-01-01

    This study examines the methods used by cardiology training programs within the United States to teach electrocardiogram (ECG) interpretation and prepare fellows for the American Board of Internal Medicine board examination. A link to an 18-question Web-based survey was electronically mailed to 198 fellowship directors in the United States. The response rate was 45%. Most participating programs were university hospitals or affiliates (77%) and of moderate size (at least 11 total fellows [72%]). Programs were coordinated by senior (68%) general (60%) cardiologists. Only 42% of the programs performed formal testing. The American Board of Internal Medicine answer sheet was used by most faculty (92%) when teaching ECG interpretation. Teaching of ECG interpretation varies among US fellowship programs. Coordination of curricula is performed by senior faculty, likely reflecting a trend toward subspecialization and dilution of ECG expertise among younger faculty. Future endeavors should focus on curriculum standardization with regular competency assessment.

  14. METHODS OF TEACHING STUDENTS FOR SOLVING PROBLEMS ON ARRAYS PROCESSING IN THE DELPHI VISUAL PROGRAMMING ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    Vitalii M. Bazurin

    2015-05-01

    Full Text Available Delphi visual programming environment provides ample opportunities for visual mapping arrays. There are a number of Delphi screen form components, which help you to visualize the array on the form. Processing arrays programs in Delphi environment have their differences from the same programs in Pascal. The article describes these differences. Also, the features of student learning methods for solving problems of array processing using Delphi visual components are highlighted. It has been exposed sequence and logic of the teaching material on arrays processing using TStringGrid and TMemo components.

  15. Method for Statically Checking an Object-oriented Computer Program Module

    Science.gov (United States)

    Bierhoff, Kevin M. (Inventor); Aldrich, Jonathan (Inventor)

    2012-01-01

    A method for statically checking an object-oriented computer program module includes the step of identifying objects within a computer program module, at least one of the objects having a plurality of references thereto, possibly from multiple clients. A discipline of permissions is imposed on the objects identified within the computer program module. The permissions enable tracking, from among a discrete set of changeable states, a subset of states each object might be in. A determination is made regarding whether the imposed permissions are violated by a potential reference to any of the identified objects. The results of the determination are output to a user.

  16. Patient- and delivery-level factors related to acceptance of HIV counseling and testing services among tuberculosis patients in South Africa: a qualitative study with community health workers and program managers.

    Science.gov (United States)

    Heunis, J Christo; Wouters, Edwin; Norton, Wynne E; Engelbrecht, Michelle C; Kigozi, N Gladys; Sharma, Anjali; Ragin, Camille

    2011-03-23

    South Africa has a high tuberculosis (TB)-human immunodeficiency virus (HIV) coinfection rate of 73%, yet only 46% of TB patients are tested for HIV. To date, relatively little work has focused on understanding why TB patients may not accept effective services or participate in programs that are readily available in healthcare delivery systems. The objective of the study was to explore barriers to and facilitators of participation in HIV counseling and testing (HCT) among TB patients in the Free State Province, from the perspective of community health workers and program managers who offer services to patients on a daily basis. These two provider groups are positioned to alter the delivery of HCT services in order to improve patient participation and, ultimately, health outcomes. Group discussions and semistructured interviews were conducted with 40 lay counselors, 57 directly observed therapy (DOT) supporters, and 13 TB and HIV/acquired immune deficiency syndrome (AIDS) program managers in the Free State Province between September 2007 and March 2008. Sessions were audio-recorded, transcribed, and thematically analyzed. The themes emerging from the focus group discussions and interviews included four main suggested barrier factors: (1) fears of HIV/AIDS, TB-HIV coinfection, death, and stigma; (2) perceived lack of confidentiality of HIV test results; (3) staff shortages and high workload; and (4) poor infrastructure to encourage, monitor, and deliver HCT. The four main facilitating factors emerging from the group and individual interviews were (1) encouragement and motivation by health workers, (2) alleviation of health worker shortages, (3) improved HCT training of professional and lay health workers, and (4) community outreach activities. Our findings provide insight into the relatively low acceptance rate of HCT services among TB patients from the perspective of two healthcare workforce groups that play an integral role in the delivery of effective health

  17. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders.

    Science.gov (United States)

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-08-11

    The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. The direct service delivery cost of Medicines360's LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product's non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation and provider training should be prioritized

  18. Biopharmaceutical Assessment and Irritation Potential of Microemulsions and Conventional Systems Containing Oil from Syagrus cearensis for Topical Delivery of Amphotericin B Using Alternative Methods.

    Science.gov (United States)

    Sousa, Giovana D; Kishishita, Juliana; Aquino, Kátia A S; Presgrave, Octávio A F; Leal, Leila B; Santana, Davi P

    2017-07-01

    The aim of this study was to compare the biopharmaceutical characteristics and irritation potentials of microemulsions (MEs) and conventional systems (CSs) containing oil from Syagrus cearensis for topical delivery of Amphotericin B (AmB). Pseudo-ternary phase diagrams were constructed using a water titration method to develop the MEs, and the CSs were prepared according to the classical technique of phase inversion. In the skin permeation and retention study, dermatomed pig skin without stratum corneum was used as an alternative disturbed skin model. The irritation potential was evaluated using three different methods, chorioallantoic membrane assays (HET-CAM and CAM-TBS), and bovine corneal opacity and permeability (BCOP) test. The optimized formulation (ME1) consisting of 0.1% (w/w) Amphotericin B, 9.1% (w/w) catolé oil, 81% (w/w) Smix (1:1, Tween 20 and Kolliphor EL) possessed droplet size of 31.02 ± 0.9 nm, zeta potential of -23.4 mV, and viscosity 0.63 ± 0.1 Pa.s. ME1 exhibited greater retention of AmB in to skin layers (84.79 ± 2.08 μg cm(-2)) than all the others formulations. In general, MEs showed higher drug release and retention than CSs and all of the formulations showed greater retentivity than permeability. Only MEs developed using Labrasol/Plurol Oleique (L/PO) as the surfactant and co-surfactant exhibited a moderate irritation potential; all other MEs and CSs were classified as non-irritants or slight irritants. The results indicate that formulations containing oil from S. cearensis are promising alternatives for the delivery of AmB targeting the treatment of cutaneous leishmaniasis.

  19. APPLYING ROBUST RANKING METHOD IN TWO PHASE FUZZY OPTIMIZATION LINEAR PROGRAMMING PROBLEMS (FOLPP

    Directory of Open Access Journals (Sweden)

    Monalisha Pattnaik

    2014-12-01

    Full Text Available Background: This paper explores the solutions to the fuzzy optimization linear program problems (FOLPP where some parameters are fuzzy numbers. In practice, there are many problems in which all decision parameters are fuzzy numbers, and such problems are usually solved by either probabilistic programming or multi-objective programming methods. Methods: In this paper, using the concept of comparison of fuzzy numbers, a very effective method is introduced for solving these problems. This paper extends linear programming based problem in fuzzy environment. With the problem assumptions, the optimal solution can still be theoretically solved using the two phase simplex based method in fuzzy environment. To handle the fuzzy decision variables can be initially generated and then solved and improved sequentially using the fuzzy decision approach by introducing robust ranking technique. Results and conclusions: The model is illustrated with an application and a post optimal analysis approach is obtained. The proposed procedure was programmed with MATLAB (R2009a version software for plotting the four dimensional slice diagram to the application. Finally, numerical example is presented to illustrate the effectiveness of the theoretical results, and to gain additional managerial insights. 

  20. A randomized comparative trial of combinational methods for preventing post-spinal hypotension at elective cesarean delivery

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2011-01-01

    Conclusions: Among the three studied methods, administration of ephedrine plus bandage of the lower extremities was the most effective one in reducing the incidence of post-spinal hypotension. The groups were not clinically different concerning the effect of treatment on newborn health.

  1. Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

    Science.gov (United States)

    Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

    2014-10-08

    The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care. The BETTER 2 program aims to expand the implementation of the intervention used in the original BETTER trial into communities across Canada (Alberta, Ontario, Newfoundland and Labrador, the Northwest Territories and Nova Scotia). This proactive approach provides at-risk patients with an intervention from the prevention practitioner, a health-care professional. Using the BETTER toolkit, the prevention practitioner determines which CDPS actions the patient is eligible to receive, and through shared decision-making and motivational interviewing, develops a unique and individualized 'prevention prescription' with the patient. This intervention is 1) personalized; 2) addressing multiple conditions; 3) integrated through linkages to local, regional, or national resources; and 4) longitudinal by assessing patients over time. The BETTER 2 program brings together primary care providers, policy/decision makers and researchers to work towards improving CDPS in primary care. The target patient population is adults aged 40-65. The reach, effectiveness, adoption, implementation, maintain (RE-AIM) framework will inform the evaluation of the program through qualitative and quantitative methods. A composite index will be used to quantitatively assess the effectiveness of the prevention practitioner intervention. The CDPS actions

  2. Light Water Reactor Sustainability Program: Evaluation of Localized Cable Test Methods for Nuclear Power Plant Cable Aging Management Programs

    Energy Technology Data Exchange (ETDEWEB)

    Glass, Samuel W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fifield, Leonard S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hartman, Trenton S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-05-30

    This Pacific Northwest National Laboratory (PNNL) milestone report describes progress to date on the investigation of nondestructive test (NDE) methods focusing particularly on local measurements that provide key indicators of cable aging and damage. The work includes a review of relevant literature as well as hands-on experimental verification of inspection capabilities. As NPPs consider applying for second, or subsequent, license renewal (SLR) to extend their operating period from 60 years to 80 years, it important to understand how the materials installed in plant systems and components will age during that time and develop aging management programs (AMPs) to assure continued safe operation under normal and design basis events (DBE). Normal component and system tests typically confirm the cables can perform their normal operational function. The focus of the cable test program is directed toward the more demanding challenge of assuring the cable function under accident or DBE. Most utilities already have a program associated with their first life extension from 40 to 60 years. Regrettably, there is neither a clear guideline nor a single NDE that can assure cable function and integrity for all cables. Thankfully, however, practical implementation of a broad range of tests allows utilities to develop a practical program that assures cable function to a high degree. The industry has adopted 50% elongation at break (EAB) relative to the un-aged cable condition as the acceptability standard. All tests are benchmarked against the cable EAB test. EAB is a destructive test so the test programs must apply an array of other NDE tests to assure or infer the overall set of cable’s system integrity. These cable NDE programs vary in rigor and methodology. As the industry gains experience with the efficacy of these programs, it is expected that implementation practice will converge to a more common approach. This report addresses the range of local NDE cable tests that are

  3. APRIORI: A FORTRAN IV Computer Program to Select the Most Powerful A Priori Comparison Method in an Analysis of Variance.

    Science.gov (United States)

    Conard, Elizabeth H.; Lutz, J. Gary

    1979-01-01

    A program is described which selects the most powerful among four methods for conducting a priori comparisons in an analysis of variance: orthogonal contrasts, Scheffe's method, Dunn's method, and Dunnett's test. The program supplies the critical t ratio and the per-comparison Type I error risk for each of the relevant methods. (Author/JKS)

  4. Methods and challenges for the health impact assessment of vaccination programs in Latin America

    Directory of Open Access Journals (Sweden)

    Ana Marli Christovam Sartori

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  5. Methods for evaluating and ranking transportation energy conservation programs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1981-04-30

    Methods for comparative evaluations of the Office of Transportation programs designed to help achieve significant reductions in the consumption of petroleum by different forms of transportation while maintaining public, commercial, and industrial mobility are described. Assessments of the programs in terms of petroleum savings, incremental costs to consumers of the technologies and activities, probability of technical and market success, and external impacts due to environmental, economic, and social factors are inputs to the evaluation methodologies presented. The methods described for evaluating the programs on a comparative basis are three ranking functions and a policy matrix listing important attributes of the programs and the technologies and activities with which they are concerned and include the traditional net present value measure which computes the present worth of petroleum savings less the present worth of costs. This is modified by dividing by the present value of DOE funding to obtain a net present value per program dollar, which is the second ranking function. The third ranking function is broader in that it takes external impacts into account and is known as the comprehensive ranking function. Procedures are described for making computations of the ranking functions and the attributes that require computation. Computations are made for the electric vehicle, Stirling engine, gas turbine, and MPG mileage guide program. (MCW)

  6. Cost Savings From the Provision of Specific Methods of Contraception in a Publicly Funded Program

    Science.gov (United States)

    Rostovtseva, Daria P.; Brindis, Claire D.; Biggs, M. Antonia; Hulett, Denis; Darney, Philip D.

    2009-01-01

    Objectives. We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955 000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. Methods. We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. Results. More than half of the 178 000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. Conclusions. All contraceptive methods were cost-effective—they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods. PMID:18703437

  7. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method.Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars.Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively.The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  8. Using Mixed Methods and Collaboration to Evaluate an Education and Public Outreach Program (Invited)

    Science.gov (United States)

    Shebby, S.; Shipp, S. S.

    2013-12-01

    Traditional indicators (such as the number of participants or Likert-type ratings of participant perceptions) are often used to provide stakeholders with basic information about program outputs and to justify funding decisions. However, use of qualitative methods can strengthen the reliability of these data and provide stakeholders with more meaningful information about program challenges, successes, and ultimate impacts (Stern, Stame, Mayne, Forss, David & Befani, 2012). In this session, presenters will discuss how they used a mixed methods evaluation to determine the impact of an education and public outreach (EPO) program. EPO efforts were intended to foster more effective, sustainable, and efficient utilization of science discoveries and learning experiences through three main goals 1) increase engagement and support by leveraging of resources, expertise, and best practices; 2) organize a portfolio of resources for accessibility, connectivity, and strategic growth; and 3) develop an infrastructure to support coordination. The evaluation team used a mixed methods design to conduct the evaluation. Presenters will first discuss five potential benefits of mixed methods designs: triangulation of findings, development, complementarity, initiation, and value diversity (Greene, Caracelli & Graham, 2005). They will next demonstrate how a 'mix' of methods, including artifact collection, surveys, interviews, focus groups, and vignettes, was included in the EPO project's evaluation design, providing specific examples of how alignment between the program theory and the evaluation plan was best achieved with a mixed methods approach. The presentation will also include an overview of different mixed methods approaches and information about important considerations when using a mixed methods design, such as selection of data collection methods and sources, and the timing and weighting of quantitative and qualitative methods (Creswell, 2003). Ultimately, this presentation will

  9. Novel methods for Solving Economic Dispatch of Security-Constrained Unit Commitment Based on Linear Programming

    Science.gov (United States)

    Guo, Sangang

    2017-09-01

    There are two stages in solving security-constrained unit commitment problems (SCUC) within Lagrangian framework: one is to obtain feasible units’ states (UC), the other is power economic dispatch (ED) for each unit. The accurate solution of ED is more important for enhancing the efficiency of the solution to SCUC for the fixed feasible units’ statues. Two novel methods named after Convex Combinatorial Coefficient Method and Power Increment Method respectively based on linear programming problem for solving ED are proposed by the piecewise linear approximation to the nonlinear convex fuel cost functions. Numerical testing results show that the methods are effective and efficient.

  10. Waste Tank Organic Safety Program: Analytical methods development. Progress report, FY 1994

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.A.; Clauss, S.A.; Grant, K.E. [and others

    1994-09-01

    The objectives of this task are to develop and document extraction and analysis methods for organics in waste tanks, and to extend these methods to the analysis of actual core samples to support the Waste Tank organic Safety Program. This report documents progress at Pacific Northwest Laboratory (a) during FY 1994 on methods development, the analysis of waste from Tank 241-C-103 (Tank C-103) and T-111, and the transfer of documented, developed analytical methods to personnel in the Analytical Chemistry Laboratory (ACL) and 222-S laboratory. This report is intended as an annual report, not a completed work.

  11. SU-F-BRE-10: Methods to Simulate and Measure the Attenuation for Modeling a Couch Top with Rails for FFF Treatment Delivery On the Varian Edge Linac

    Energy Technology Data Exchange (ETDEWEB)

    Gulam, M; Gardner, S; Zhao, B; Snyder, K; Song, K; Li, H; Gordon, J; Wen, N; Chetty, I [Henry Ford Health System, Detroit, MI (United States); Kearns, W [Varian Medical Systems, Clemmons, NC (United States)

    2014-06-15

    Purpose: To measure attenuation for modelling of the KVue Couchtop for 6X and 10X FFF SRS/SBRT treatment Methods: Treatment planning simulation studies were done using 6X FFF beams to estimate the dosimetric impact of KVue couchtops (including the Q-Fix IGRT [carbon fiber] and Calypso [nonconductive Kevlar material]) with a structure model obtained from a research workstation (Eclipse, advanced planning interface (API) v13). Prior to installation on the Varian Edge linac, the couchtop along with (Kevlar) rails were CT scanned with the rails at various positions. An additional scan with the couchtop 15cm above the CT table top was obtained with 20cm solid water to facilitate precised/indexed data acquisition. Measurements for attenuation were obtained for field sizes of 2, 4 and 10 cm{sup 2} at 42 gantry angles including 6 pairs of opposing fields and other angles for oblique delivery where the beams traversed the couchtop and or rails. The delivery was fully automated with xml scripts running in developer mode. The results were then used to determine an accurate structure model for AAA (Eclipse v11) planning of IMRT and RapidArc delivery. Results: The planning simulation relative dose attenuation for oblique entry was not significantly different than the Exact IGRT or BrainLab iBeam couch except that the rails added 6% additional attenuation. The relative attenuation measurements for PA, PA (rails: inner position), oblique, oblique (rails: outer position), oblique (rails: inner position) were: −2.0%, −2.5%, −15.6%, −2.5%, −5.0% for 6X FFF and −1.4%, −1.5%, −12.2%, − 2.5%, −5.0% for 10X FFF with slight decrease in attenuation versus field size. A Couch structure model (with HU values) was developed. Calculation compared to measurement showed good agreement except for oblique (rails: outer position) where differences approached a magnitude of 6%. Conclusion: A model of the couch structures has been developed accounting for attenuation for FFF

  12. An Ultra-High Performance Liquid Chromatographic-Tandem Mass Spectrometric Method for the Determination of Sinomenine in Human Plasma after Transdermal Delivery of the Zhengqing Fengtongning Injection

    Directory of Open Access Journals (Sweden)

    Tingbo Chen

    2015-04-01

    Full Text Available A sensitive, precise and selective ultra-high performance liquid chromatography method coupled with triple-quadrupole mass spectrometry was developed and validated for the determination of trace amounts of sinomenine (ng/mL in minute volumes of human plasma. Fifty microliter plasma samples were precipitated using methanol to extract sinomenine. Separation was carried out on a C18 column with a water and acetonitrile mobile phase gradient with formic acid as an additive. The mass spectrometry data were obtained in the positive ion mode, and the transition of multiple reactions was monitored at m/z 330.2→181.0 for sinomenine quantification. The working assay range for sinomenine was linear from 0.1173 to 15.02 ng/mL with the lower limit of quantification of 0.1173 ng/mL. The precision and accuracy of the method was less than 15% in intra-day and inter-day experiments with a matrix effect of less than 6.5%. After validation, the quantitative method was applied to analyze sinomenine levels in human plasma after transdermal delivery of the Zhengqing Fengtongning Injection. The results showed that some samples contained sinomenine within the concentration range 0.4131–4.407 ng/mL.

  13. Clinical and histological results in the treatment of atrophic and hypertrophic scars using a combined method of radiofrequency, ultrasound, and transepidermal drug delivery.

    Science.gov (United States)

    Trelles, Mario A; Martínez-Carpio, Pedro A

    2016-08-01

    Scars are problematic for thousands of patients. Scarring is a natural part of the healing process after an injury. However, the appearance of a scar and its treatment depend on multiple factors and on the experience of the therapist and the options available. Despite a plethora of rapidly evolving treatment options and technical advances, the management of atrophic and hypertrophic scars remains difficult. Innovative technologies provide an attractive alternative to conventional methods in the treatment of scars. The purpose of this trial was to determine the clinical and histological results of a method of treatment that combines radiofrequency, ultrasound, and transepidermal drug delivery. This was a prospective study conducted on 14 patients with scars of different sizes, types, and characteristics. All patients underwent six treatment sessions with the Legato device. Atrophic scars were treated with retinoic acid and hypertrophic scars with triamcinolone. Photographs and biopsies were taken before treatment and at 6 months after the last treatment session. The scars improved significantly (P histological images of scar tissue in six patients in whom attenuation in the range of 55-75% was achieved are shown. Biopsies show regenerative changes in the scar tissue, in both the epidermis and dermis. The method makes it possible to treat extensive, heterogeneous scars on different sites with good results that are similar and predictable. © 2016 The International Society of Dermatology.

  14. System and Method for Providing a Climate Data Analytic Services Application Programming Interface Distribution Package

    Science.gov (United States)

    Schnase, John L. (Inventor); Duffy, Daniel Q. (Inventor); Tamkin, Glenn S. (Inventor)

    2016-01-01

    A system, method and computer-readable storage devices for providing a climate data analytic services application programming interface distribution package. The example system can provide various components. The system provides a climate data analytic services application programming interface library that enables software applications running on a client device to invoke the capabilities of a climate data analytic service. The system provides a command-line interface that provides a means of interacting with a climate data analytic service by issuing commands directly to the system's server interface. The system provides sample programs that call on the capabilities of the application programming interface library and can be used as templates for the construction of new client applications. The system can also provide test utilities, build utilities, service integration utilities, and documentation.

  15. Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

    Science.gov (United States)

    Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

    2017-12-01

    Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly

  16. Developing medical educators – a mixed method evaluation of a teaching education program

    OpenAIRE

    Roos, Marco; Kadmon, Martina; Kirschfink, Michael; Koch, Eginhard; Jünger, Jana; Strittmatter-Haubold, Veronika; Steiner, Thorsten

    2014-01-01

    Background: It is well accepted that medical faculty teaching staff require an understanding of educational theory and pedagogical methods for effective medical teaching. The purpose of this study was to evaluate the effectiveness of a 5-day teaching education program.Methods: An open prospective interventional study using quantitative and qualitative instruments was performed, covering all four levels of the Kirkpatrick model: Evaluation of 1) ‘Reaction’ on a professional and emotional level...

  17. Linear programming models and methods of matrix games with payoffs of triangular fuzzy numbers

    CERN Document Server

    Li, Deng-Feng

    2016-01-01

    This book addresses two-person zero-sum finite games in which the payoffs in any situation are expressed with fuzzy numbers. The purpose of this book is to develop a suite of effective and efficient linear programming models and methods for solving matrix games with payoffs in fuzzy numbers. Divided into six chapters, it discusses the concepts of solutions of matrix games with payoffs of intervals, along with their linear programming models and methods. Furthermore, it is directly relevant to the research field of matrix games under uncertain economic management. The book offers a valuable resource for readers involved in theoretical research and practical applications from a range of different fields including game theory, operational research, management science, fuzzy mathematical programming, fuzzy mathematics, industrial engineering, business and social economics. .

  18. A Two-Phase Support Method for Solving Linear Programs: Numerical Experiments

    Directory of Open Access Journals (Sweden)

    Mohand Bentobache

    2012-01-01

    Full Text Available We develop a single artificial variable technique to initialize the primal support method for solving linear programs with bounded variables. We first recall the full artificial basis technique, then we will present the proposed algorithm. In order to study the performances of the suggested algorithm, an implementation under the MATLAB programming language has been developed. Finally, we carry out an experimental study about CPU time and iterations number on a large set of the NETLIB test problems. These test problems are practical linear programs modelling various real-life problems arising from several fields such as oil refinery, audit staff scheduling, airline scheduling, industrial production and allocation, image restoration, multisector economic planning, and data fitting. It has been shown that our approach is competitive with our implementation of the primal simplex method and the primal simplex algorithm implemented in the known open-source LP solver LP_SOLVE.

  19. Photoproduction of W Bosons at HERA Reweighting Method for implementing QCD Corrections in Monte Carlo Programs

    CERN Document Server

    Diener, K P O; Spira, Michael; Diener, Kai-Peer O.; Schwanenberger, Christian; Spira, Michael

    2003-01-01

    A procedure of implementing QCD corrections in Monte Carlo programs by a reweighting method is described for the photoproduction of W bosons at HERA. Tables for W boson production in LO and NLO are given in bins of the transverse momentum of the W boson and its rapidity.

  20. Exploring Top-Rated MBA Programs for Best Practices in Internationalizing Curricula: A Mixed Methods Study

    Science.gov (United States)

    Flores, Kelly A.

    2010-01-01

    To investigate if, and how, curriculum developers are incorporating opportunities to develop global competence into business curricula, the Exploratory Design: Taxonomy Development Model (Qualitative Emphasized) was conducted on top-rated MBA programs. This three-phase mixed methods approach revealed 11 global competencies (or taxonomies) and 84…

  1. 34 CFR 429.1 - What is the Bilingual Vocational Materials, Methods, and Techniques Program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What is the Bilingual Vocational Materials, Methods, and Techniques Program? 429.1 Section 429.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION BILINGUAL VOCATIONAL...

  2. Effects of Translation Methods in Imported Instructional Video Programs on Taiwan Fourth Graders' Memory.

    Science.gov (United States)

    Tyan, Nay-ching Nancy; Hu, Yi-chain

    The purpose of this study was to investigate the effects of various translation methods used in imported instructional video programs on Taiwan elementary school students' visual and verbal memory. Following pretesting, 128 fourth grade students from an urban public elementary school in northern Taiwan participated. The students in 4 experimental…

  3. VET Program Completion Rates: An Evaluation of the Current Method. Occasional Paper

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2016

    2016-01-01

    This work asks one simple question: "how reliable is the method used by the National Centre for Vocational Education Research (NCVER) to estimate projected rates of VET program completion?" In other words, how well do early projections align with actual completion rates some years later? Completion rates are simple to calculate with a…

  4. 77 FR 7080 - Changes To Implement Transitional Program for Covered Business Method Patents

    Science.gov (United States)

    2012-02-10

    ... Patent and Trademark Office 37 CFR Part 42 RIN 0651-AC73 Changes To Implement Transitional Program for Covered Business Method Patents AGENCY: United States Patent and Trademark Office, Commerce. ACTION: Notice of proposed rulemaking. SUMMARY: The United States Patent and Trademark Office (Office or USPTO...

  5. Evaluation Methods Used during the Assessment of an Academic Program at Micro-Level

    Science.gov (United States)

    Chinembiri, France

    2017-01-01

    This paper majors on the evaluation criteria and methods used for the assessment of health education programs in the United States. The choice of the topic is dictated by the fact that there is need to improve on the quality of the graduates that the different nursing and medical institutions in the United States produce. By looking at the…

  6. Methods and Models of the Hanford Internal Dosimetry Program, PNNL-MA-860

    Energy Technology Data Exchange (ETDEWEB)

    Carbaugh, Eugene H.; Bihl, Donald E.; Maclellan, Jay A.

    2003-01-03

    This manual describes the technical basis for the design of the routine radiobioassay monitoring program and assessments of internal dose. Its purpose is to provide a historical record of the methods, models, and assumptions used for internal dosimetry at Hanford, and serve as a technical reference for radiation protection and dosimetry staff.

  7. Three Methods for Language Acquisition: Total Physical Response; the Tomatis Program; Suggestopedia.

    Science.gov (United States)

    Bancroft, W. Jane

    Total Physical Response is a strategy for learning second languages developed by James J. Asher. The Tomatis program, developed in France by Alfred Tomatis, is a method for treating dyslexia and communication problems and is also used for teaching basic elements of foreign languages. Suggestology is a psychotherapeutic system based on yogic…

  8. Quantity with Quality? Teaching Quantitative and Qualitative Methods in an LIS Master's Program.

    Science.gov (United States)

    Liebscher, Peter

    1998-01-01

    Discusses the need for an integrated approach to teaching both qualitative and quantitative research methods in library and information science master's degree programs. Also suggests a scenario for applying it within the realm of a single semester course. (Author/LRW)

  9. A Method, Computer Program and System for Inferring Relations Between Cultural Specific Concepts in Two Cultures

    DEFF Research Database (Denmark)

    2013-01-01

    The present invention relates to a method, computer program and system for inferring relations between cultural specific concepts (CSC) in two cultures at least comprising the steps of - extracting and listing said cultural specific concepts (CSCs) and features of said CSCs from at least a first...

  10. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  11. Etiological factors of preterm delivery

    Directory of Open Access Journals (Sweden)

    Elvira Brkičević

    2013-09-01

    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. Preterm birth is a major course of neonatal morbidity and mortality, the incidence of premature delivery in developedcountries is 5 to 9%. Aims of this study were to determine the common etiological factors for preterm delivery, most common weeks of gestation for pretern delivery, and most commom way of delivery for preterm delivery.Methods: The study included 600 patients divided into two groups, experimental group (included 300 preterm delivered pregnant women, control group (included 300 term delivered women.Results: The incidence of preterm delivery in pregnant women younger than 18 years was 4.4%, and in pregnant women older than 35 years was 14%. 44.6 % of preterm delivered women at the experimentalgroup had lower education. In the experimental group burdened obstetrical history had 29%, 17.2% had a preterm delivery, 35.6% had a premature rupture of membranes, 15% had a preterm delivery before32 weeks of gestation, 12.4% between 32-33.6 weeks of gestation, while 72.6% of deliveries were between 34- 36.6 weeks of gestation. Multiple pregnancy as an etiological factor was present in 10.07% ofcases. Extragenital diseases were present in 10.4%. In the experimental group there were 29%, while in the control group there were 15% subjects with burdened obstetrical history.Conclusions: Preterm birth more often occurs in a pregnant women younger than 18 and older than 35 years, and in a pregnant women of lower educational degree. Preterm delivery in the most commoncases was fi nished in period from 34 to 36.6 weeks of gestation. The most common etiological factor of preterm delivery in the experimental group was preterm rupture of membranes and idiopathic pretermdelivery.

  12. Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system

    National Research Council Canada - National Science Library

    Shea, Christopher M; Reiter, Kristin L; Weaver, Mark A; McIntyre, Molly; Mose, Jason; Thornhill, Jonathan; Malone, Robb; Weiner, Bryan J

    2014-01-01

    Meaningful Use (MU) provides financial incentives for electronic health record (EHR) implementation. EHR implementation holds promise for improving healthcare delivery, but also requires substantial changes for providers and staff...

  13. The 2D Hyperlink/Geocaching hybrid as a New Method for Improving Communication and Educational Delivery in Environmental Science

    Science.gov (United States)

    Graham, J.; Byrne, J. M.

    2009-12-01

    Geocaching is a game of hiding and locating caches (treasures), usually with the aid of a GPS-enabled device, and then posting the locations online for others to discover. Its remarkable success as a cultural phenomenon - transcending the traditional boundaries of age, gender, race and culture, while seamlessly combining the elements of technology, mental challenge, travel, geography, orienteering and entertainment - has been well documented. One would expect, therefore, that something so accessible and so physically, mentally and technologically engaging could also have great potential as an educational tool; specifically for the teaching of environmental science in situ. The attempts to date, however, have been disappointing. It will be the purpose of this poster to demonstrate a new and effective approach to educational environmental science-based geocaching; one which treats discreet elements of the living landscape as caches (rather than obstacles), and which combines several commonly available technologies so as to create a rich, immersive experience for viewers of many ages and backgrounds. Specifically, our poster will demonstrate how traditional geocaching methods can be dramatically improved, for the purposes of education, by combining it with 2D hyperlinking technologies in such a way as to allow the viewer to access a variety of different online and/or offline media elements - documentaries, texts, websites, animations, and images, while immersed in the physical environment to which they relate. It will be shown that this site-specific approach to environmental education has considerable potential for improving the meaningful dialogue between environmental scientists and the general public.

  14. Si-modified BHA bioceramics as a drug delivery system: Effect of modification method on structure and Rifampicin release

    Directory of Open Access Journals (Sweden)

    Olena Sych

    2015-09-01

    Full Text Available The work is devoted to the investigation of two different methods for introduction of silicon into ceramics, based on biogenic hydroxyapatite (BHA, on the structure and properties. Thus, porous samples of Si-modified BHA-based ceramics containing 2 or 5 wt.% Si were prepared by using two different precursors, i.e. polymethylsiloxane polyhydrate and fine silica (Aerosil® 200 powder. After the modification with silicon a marked change in the structure of material was observed. The use of Aerosil® 200 permits preparation of a more uniform structure as compared to that obtained by using polymethylsiloxane polyhydrate. However, the latter promotes an increase in both the porosity of samples (from 43 to 62.3% and their solubility in saline (from 0.18 to 1.20 wt.%/day as compared to the results obtained after the modification with Aerosil® 200, where maximal porosity and solubility were 48.5% and 0.23 wt.%/day, respectively. At the same time, the modification of hydroxyapatite ceramics with silicon using silica makes it possible to prolong release of a drug (e.g. Rifampicin out of sample pores for the first 24 h as compared to the ceramics modified with polymethylsiloxane polyhydrate.

  15. Effect of delivery method and population size of Trichoderma harzianum on growth response of unrooted chrysanthemum cuttings.

    Science.gov (United States)

    MacKenzie, A J; Ownley, B H; Starman, T W; Windham, M T

    2000-08-01

    In a previous study, addition of Trichoderma harzianum Rifai isolate T-12 to a propagative medium resulted in improved performance of chrysanthemum cuttings. However, root and shoot growth of one cultivar, 'Dark Bronze Charm', were more responsive to a lower (5 g T-12/kg medium) than higher (25 g T-12/kg medium) rate of fungal propagules, suggesting potential phytotoxicity at higher concentrations. The objectives of this study were to investigate higher rates of T-12 medium amendment for phytotoxicity, and to examine an alternative method of delivering the fungus to the propagative medium in order to obtain a more uniform response from cuttings. Isolate T-12 was added to the propagative medium as either a powdered peat-bran amendment (0, 5, or 50 g T-12/kg medium) or as alginate prills (80 or 800 g T-12/kg medium). There were no differences among treatments on day seven, but by day 21, shoot fresh weight and heights were significantly greater for plants treated with prills at 800 g T-12/kg medium. Both prill treatments resulted in greater shoot height on day 14 and 21 than all other treatments, which were similar to controls. Amendment with T-12 powder at 50 g/kg increased root length, but 80 g/kg medium added as prills decreased root dry weight compared to the control. The highest rate of T-12 (800 g prills/kg medium) had no effect on root growth. This suggests that moderate, rather than high rates of T-12 are more effective in promoting rooting of unrooted chrysanthemum, and that there is a potential for phytotoxic effects on root growth with higher rates.

  16. Effect of Drug Loading Method and Drug Physicochemical Properties on the Material and Drug Release Properties of Poly (Ethylene Oxide Hydrogels for Transdermal Delivery

    Directory of Open Access Journals (Sweden)

    Rachel Shet Hui Wong

    2017-07-01

    Full Text Available Novel poly (ethylene oxide (PEO hydrogel films were synthesized via UV cross-linking with pentaerythritol tetra-acrylate (PETRA as cross-linking agent. The purpose of this work was to develop a novel hydrogel film suitable for passive transdermal drug delivery via skin application. Hydrogels were loaded with model drugs (lidocaine hydrochloride (LID, diclofenac sodium (DIC and ibuprofen (IBU via post-loading and in situ loading methods. The effect of loading method and drug physicochemical properties on the material and drug release properties of medicated film samples were characterized using scanning electron microscopy (SEM, swelling studies, differential scanning calorimetry (DSC, fourier transform infrared spectroscopy (FT-IR, tensile testing, rheometry, and drug release studies. In situ loaded films showed better drug entrapment within the hydrogel network and also better polymer crystallinity. High drug release was observed from all studied formulations. In situ loaded LID had a plasticizing effect on PEO hydrogel, and films showed excellent mechanical properties and prolonged drug release. The drug release mechanism for the majority of medicated PEO hydrogel formulations was determined as both drug diffusion and polymer chain relaxation, which is highly desirable for controlled release formulations.

  17. PROGRAMMING OF METHODS FOR THE NEEDS OF LOGISTICS DISTRIBUTION SOLVING PROBLEMS

    Directory of Open Access Journals (Sweden)

    Andrea Štangová

    2014-06-01

    Full Text Available Logistics has become one of the dominant factors which is affecting the successful management, competitiveness and mentality of the global economy. Distribution logistics materializes the connesciton of production and consumer marke. It uses different methodology and methods of multicriterial evaluation and allocation. This thesis adresses the problem of the costs of securing the distribution of product. It was therefore relevant to design a software product thet would be helpful in solvin the problems related to distribution logistics. Elodis – electronic distribution logistics program was designed on the basis of theoretical analysis of the issue of distribution logistics and on the analysis of the software products market. The program uses a multicriterial evaluation methods to deremine the appropriate type and mathematical and geometrical method to determine an appropriate allocation of the distribution center, warehouse and company.

  18. Methods and challenges for the health impact assessment of vaccination programs in Latin America.

    Science.gov (United States)

    Sartori, Ana Marli Christovam; Nascimento, Andréia de Fátima; Yuba, Tânia Yuka; Soárez, Patrícia Coelho de; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  19. [The German program for disease management guidelines. Background, methods, and development process].

    Science.gov (United States)

    Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika; Sänger, Sylvia; Heymans, Lothar; Thole, Henning; Trapp, Henrike; Lorenz, Wilfried; Selbmann, Hans-Konrad; Encke, Albrecht

    2006-10-15

    The Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 by the German Medical Association (umbrella organization of the German Chambers of Physicians) and joined by the Association of the Scientific Medical Societies (AWMF; umbrella organization of more than 150 professional societies) and by the National Association of Statutory Health Insurance Physicians (NASHIP) in 2003. The program provides a conceptual basis for disease management, focusing on high-priority health-care topics and aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. It is organized by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the German DM-CPG Program is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health-care provision and facilitating the coordination of care for the individual patient through time and across interfaces. Within the last year, DM-CPGs have been published for asthma, chronic obstructive pulmonary disease, type 2 diabetes, and coronary heart disease. In addition, experts from national patient self-help groups have been developing patient guidance based upon the recommendations for health-care providers. The article describes background, methods, and tools of the DM-CPG Program, and is the first of a publication series dealing with innovative recommendations and aspects of the program.

  20. Support Method of Model Description Error Detection on a Programming Environment for Multi Agent Simulation

    Science.gov (United States)

    Itakura, Kota; Hatakeyama, Go; Akiyoshi, Masanori; Komoda, Norihisa

    Recently, there are various proposals on tool for multi-agent simulation. However, in such simulation tools, analysts who do not have programming skill spend a lot of time to develop programs because notation of simulation models is not defined sufficiently and programming language is varied on tools. To solve this problem, a programming environment that defines the notation of simulation model has poposed. In this environment, analysts can design simulation with a graph representation and get the program code without writing programs. However, it is difficult to find errors that cause unintended behavior in simulation. Therefore, we propose a support method as a model debugger which helps users to find errors. The debugger generates candidates of errors, using a user's report of unintended behavior based on “typical report patterns”. Candidates of errors are extracted from “tree structure of error-inducing factors” that consists of source patterns of errors. In this paper, we executed experiments that compare time needed for examinees to find errors. Experimental results show the time to find errors by utilizing our model debugger is shortened.

  1. Selecting a Dynamic Simulation Modeling Method for Health Care Delivery Research—Part 2: Report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Marshall, Deborah A.; Burgos-Liz, Lina; IJzerman, Maarten Joost; Crown, William; Padula, William V.; Wong, Peter K.; Pasupathy, Kalyan S.; Higashi, Mitchell K.; Osgood, Nathaniel D.

    2015-01-01

    In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling

  2. A Multiobjective Programming Method for Ranking All Units Based on Compensatory DEA Model

    Directory of Open Access Journals (Sweden)

    Haifang Cheng

    2014-01-01

    Full Text Available In order to rank all decision making units (DMUs on the same basis, this paper proposes a multiobjective programming (MOP model based on a compensatory data envelopment analysis (DEA model to derive a common set of weights that can be used for the full ranking of all DMUs. We first revisit a compensatory DEA model for ranking all units, point out the existing problem for solving the model, and present an improved algorithm for which an approximate global optimal solution of the model can be obtained by solving a sequence of linear programming. Then, we applied the key idea of the compensatory DEA model to develop the MOP model in which the objectives are to simultaneously maximize all common weights under constraints that the sum of efficiency values of all DMUs is equal to unity and the sum of all common weights is also equal to unity. In order to solve the MOP model, we transform it into a single objective programming (SOP model using a fuzzy programming method and solve the SOP model using the proposed approximation algorithm. To illustrate the ranking method using the proposed method, two numerical examples are solved.

  3. A two-stage inexact joint-probabilistic programming method for air quality management under uncertainty.

    Science.gov (United States)

    Lv, Y; Huang, G H; Li, Y P; Yang, Z F; Sun, W

    2011-03-01

    A two-stage inexact joint-probabilistic programming (TIJP) method is developed for planning a regional air quality management system with multiple pollutants and multiple sources. The TIJP method incorporates the techniques of two-stage stochastic programming, joint-probabilistic constraint programming and interval mathematical programming, where uncertainties expressed as probability distributions and interval values can be addressed. Moreover, it can not only examine the risk of violating joint-probability constraints, but also account for economic penalties as corrective measures against any infeasibility. The developed TIJP method is applied to a case study of a regional air pollution control problem, where the air quality index (AQI) is introduced for evaluation of the integrated air quality management system associated with multiple pollutants. The joint-probability exists in the environmental constraints for AQI, such that individual probabilistic constraints for each pollutant can be efficiently incorporated within the TIJP model. The results indicate that useful solutions for air quality management practices have been generated; they can help decision makers to identify desired pollution abatement strategies with minimized system cost and maximized environmental efficiency. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Adopting an Evidence-Based Lifestyle Physical Activity Program: Dissemination Study Design and Methods.

    Science.gov (United States)

    Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P

    2012-06-01

    BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government

  5. cp-R, an interface the R programming language for clinical laboratory method comparisons.

    Science.gov (United States)

    Holmes, Daniel T

    2015-02-01

    Clinical scientists frequently need to compare two different bioanalytical methods as part of assay validation/monitoring. As a matter necessity, regression methods for quantitative comparison in clinical chemistry, hematology and other clinical laboratory disciplines must allow for error in both the x and y variables. Traditionally the methods popularized by 1) Deming and 2) Passing and Bablok have been recommended. While commercial tools exist, no simple open source tool is available. The purpose of this work was to develop and entirely open-source GUI-driven program for bioanalytical method comparisons capable of performing these regression methods and able to produce highly customized graphical output. The GUI is written in python and PyQt4 with R scripts performing regression and graphical functions. The program can be run from source code or as a pre-compiled binary executable. The software performs three forms of regression and offers weighting where applicable. Confidence bands of the regression are calculated using bootstrapping for Deming and Passing Bablok methods. Users can customize regression plots according to the tools available in R and can produced output in any of: jpg, png, tiff, bmp at any desired resolution or ps and pdf vector formats. Bland Altman plots and some regression diagnostic plots are also generated. Correctness of regression parameter estimates was confirmed against existing R packages. The program allows for rapid and highly customizable graphical output capable of conforming to the publication requirements of any clinical chemistry journal. Quick method comparisons can also be performed and cut and paste into spreadsheet or word processing applications. We present a simple and intuitive open source tool for quantitative method comparison in a clinical laboratory environment. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  6. Safer Roads: Comparisons Between Road Assessment Program and Composite Road Safety Index Method

    Directory of Open Access Journals (Sweden)

    Mohd Razelan Intan Suhana

    2017-01-01

    Full Text Available In most countries, crash statistics have becoming very crucial in evaluating road’s safety level. In Malaysia, these data are very important in deciding crash-prone areas known as black spot where specific road improvements plan will be proposed. However due to the unavailability of reliable crash data in many developing countries, appropriate road maintenance measures are facing great troubles. In light of that, several proactive methods in defining road’s safety level such as Road Assessment Program (RAP have emerged. This research aim to compare two proactive methods that have been tested in Malaysian roads ; road assessment program and road environment risk index which was developed based on composite index theory in defining road’s safety level. Composite road environment risk index was combining several crucial environment indicators, assigning weight and aggregating the individual index together to form a single value representing the road’s safety level. Based on the results, it can be concluded that both road assessment program and composite road environment risk index are contradicted in six different ways such as type of speed used, type of analysis used and their final outcomes. However, with an aim to promote safer roads, these two methods can be used concurrently as the outcomes in both methods seems to fulfil each other’s gap very well.

  7. Java Programs for Using Newmark's Method and Simplified Decoupled Analysis to Model Slope Performance During Earthquakes

    Science.gov (United States)

    Jibson, Randall W.; Jibson, Matthew W.

    2003-01-01

    Landslides typically cause a large proportion of earthquake damage, and the ability to predict slope performance during earthquakes is important for many types of seismic-hazard analysis and for the design of engineered slopes. Newmark's method for modeling a landslide as a rigid-plastic block sliding on an inclined plane provides a useful method for predicting approximate landslide displacements. Newmark's method estimates the displacement of a potential landslide block as it is subjected to earthquake shaking from a specific strong-motion record (earthquake acceleration-time history). A modification of Newmark's method, decoupled analysis, allows modeling landslides that are not assumed to be rigid blocks. This open-file report is available on CD-ROM and contains Java programs intended to facilitate performing both rigorous and simplified Newmark sliding-block analysis and a simplified model of decoupled analysis. For rigorous analysis, 2160 strong-motion records from 29 earthquakes are included along with a search interface for selecting records based on a wide variety of record properties. Utilities are available that allow users to add their own records to the program and use them for conducting Newmark analyses. Also included is a document containing detailed information about how to use Newmark's method to model dynamic slope performance. This program will run on any platform that supports the Java Runtime Environment (JRE) version 1.3, including Windows, Mac OSX, Linux, Solaris, etc. A minimum of 64 MB of available RAM is needed, and the fully installed program requires 400 MB of disk space.

  8. Methods used for Undergraduate Education at the University of Alaska Southeast Environmental Sciences Program

    Science.gov (United States)

    Heavner, M. J.; Hood, E. W.; Connor, C. L.

    2004-12-01

    The Environmental Science Program at the University of Alaska Southeast in Juneau, Alaska utilizes our unique outdoor field experience opportunities as part of both the classroom experience and our undergraduate research component. This presentation focuses on our successes in taking advantage of our surrounding environment in the maritime rainforest of the Alaska panhandle to enhance our undergraduate program. We will highlight some of our most successful undergraduate experiences, which include a snow pack monitoring site at our local ski area, glacier mass balance studies on the Mendenhall Glacier, glacial geology studies in Glacier Bay National Park, and the development of wireless networks to monitor bats. We will describe methods we have used to integrate the field opportunities into our program.

  9. Using Program Package NSPCG to Analyze the Trunk Reservation Service Protection Method

    DEFF Research Database (Denmark)

    Barker, Vincent A.; Nielsen, Bo Friis

    1994-01-01

    Unlike certain service protection methods for mixed traffic streams, such as the class-limitation method, the trunk reservation scheme cannot be based on a product form property of a stationary probability distribution vector. Rather, the analysis of the trunk reservation scheme requires solving......, by purely numerical methods, a set of balance equations, Ax = 0, often of very high order. Since the coefficient matrix is typically sparse, it is natural to apply iterative methods to this task. Many such methods have been incorporated in program package NSPCG, developed at the Center for Numerical...... Analysis at the University of Texas at Austin. In this paper we report our experience in applying the NSPCG package to a typical system arising from the trunk reservation scheme....

  10. Implementation of visual programming methods for numerical techniques used in electromagnetic field theory

    Directory of Open Access Journals (Sweden)

    Metin Varan

    2017-08-01

    Full Text Available Field theory is one of the two sub-field theories in electrical and electronics engineering that for creates difficulties for undergraduate students. In undergraduate period, field theory has been taught under the theory of electromagnetic fields by which describes using partial differential equations and integral methods. Analytical methods for solution of field problems on the basis of a mathematical model may result the understanding difficulties for undergraduate students due to their mathematical and physical infrastructure. The analytical methods which can be applied in simple model lose their applicability to more complex models. In this case, the numerical methods are used to solve more complex equations. In this study, by preparing some field theory‘s web-based graphical user interface numerical methods of applications it has been aimed to increase learning levels of field theory problems for undergraduate and graduate students while taking in mind their computer programming capabilities.

  11. Mehar Methods for Fuzzy Optimal Solution and Sensitivity Analysis of Fuzzy Linear Programming with Symmetric Trapezoidal Fuzzy Numbers

    Directory of Open Access Journals (Sweden)

    Sukhpreet Kaur Sidhu

    2014-01-01

    Full Text Available The drawbacks of the existing methods to obtain the fuzzy optimal solution of such linear programming problems, in which coefficients of the constraints are represented by real numbers and all the other parameters as well as variables are represented by symmetric trapezoidal fuzzy numbers, are pointed out, and to resolve these drawbacks, a new method (named as Mehar method is proposed for the same linear programming problems. Also, with the help of proposed Mehar method, a new method, much easy as compared to the existing methods, is proposed to deal with the sensitivity analysis of the same type of linear programming problems.

  12. A Controlled Evaluation of a High School Biomedical Pipeline Program: Design and Methods

    Science.gov (United States)

    Winkleby, Marilyn A.; Ned, Judith; Ahn, David; Koehler, Alana; Fagliano, Kathleen; Crump, Casey

    2013-07-01

    Given limited funding for school-based science education, non-school-based programs have been developed at colleges and universities to increase the number of students entering science- and health-related careers and address critical workforce needs. However, few evaluations of such programs have been conducted. We report the design and methods of a controlled trial to evaluate the Stanford Medical Youth Science Program's Summer Residential Program (SRP), a 25-year-old university-based biomedical pipeline program. This 5-year matched cohort study uses an annual survey to assess educational and career outcomes among four cohorts of students who participate in the SRP and a matched comparison group of applicants who were not chosen to participate in the SRP. Matching on sociodemographic and academic background allows control for potential confounding. This design enables the testing of whether the SRP has an independent effect on educational- and career-related outcomes above and beyond the effects of other factors such as gender, ethnicity, socioeconomic background, and pre-intervention academic preparation. The results will help determine which curriculum components contribute most to successful outcomes and which students benefit most. After 4 years of follow-up, the results demonstrate high response rates from SRP participants and the comparison group with completion rates near 90 %, similar response rates by gender and ethnicity, and little attrition with each additional year of follow-up. This design and methods can potentially be replicated to evaluate and improve other biomedical pipeline programs, which are increasingly important for equipping more students for science- and health-related careers.

  13. BOOK REVIEW: Advanced Topics in Computational Partial Differential Equations: Numerical Methods and Diffpack Programming

    Science.gov (United States)

    Katsaounis, T. D.

    2005-02-01

    The scope of this book is to present well known simple and advanced numerical methods for solving partial differential equations (PDEs) and how to implement these methods using the programming environment of the software package Diffpack. A basic background in PDEs and numerical methods is required by the potential reader. Further, a basic knowledge of the finite element method and its implementation in one and two space dimensions is required. The authors claim that no prior knowledge of the package Diffpack is required, which is true, but the reader should be at least familiar with an object oriented programming language like C++ in order to better comprehend the programming environment of Diffpack. Certainly, a prior knowledge or usage of Diffpack would be a great advantage to the reader. The book consists of 15 chapters, each one written by one or more authors. Each chapter is basically divided into two parts: the first part is about mathematical models described by PDEs and numerical methods to solve these models and the second part describes how to implement the numerical methods using the programming environment of Diffpack. Each chapter closes with a list of references on its subject. The first nine chapters cover well known numerical methods for solving the basic types of PDEs. Further, programming techniques on the serial as well as on the parallel implementation of numerical methods are also included in these chapters. The last five chapters are dedicated to applications, modelled by PDEs, in a variety of fields. The first chapter is an introduction to parallel processing. It covers fundamentals of parallel processing in a simple and concrete way and no prior knowledge of the subject is required. Examples of parallel implementation of basic linear algebra operations are presented using the Message Passing Interface (MPI) programming environment. Here, some knowledge of MPI routines is required by the reader. Examples solving in parallel simple PDEs using

  14. Physiotherapists supporting self-management through health coaching: a mixed methods program evaluation.

    Science.gov (United States)

    Dufour, Sinéad Patricia; Graham, Shane; Friesen, Josh; Rosenblat, Michael; Rous, Colin; Richardson, Julie

    2015-01-01

    To evaluate a program in support of chronic disease self-management (CDSM) that is founded on a health coaching (HC) approach, includes supervised exercise and mindfulness-based stress reduction components and is delivered within a private practice physiotherapy setting. An explanatory mixed method design, framed by theory-based program evaluation, was employed to evaluate an eight-week group-based program. Standardized self-rated and performance measures were evaluated pre- and post intervention. Additionally, participant focus groups were conducted following the intervention period. An inductive thematic approach was undertaken to analyze the qualitative data. Seventeen participants (N = 17) completed the study. Improvements were seen in both self-report and performance outcomes. Participants explained how and why they felt the program was beneficial. Six themes were generated: (1) group dynamic; (2) learning versus doing; (3) holism and comprehensive care; (4) self-efficacy and empowerment; (5) previous solutions versus new management strategies; and (6) healthcare provider support. This study established that a group program in support of CDSM founded on a HC approach demonstrated potential value from participants as well as favorable outcomes. A pragmatic randomized control trial is required to determine efficacy of this intervention.

  15. Overview of the SAMSI year-long program on Statistical, Mathematical and Computational Methods for Astronomy

    Science.gov (United States)

    Jogesh Babu, G.

    2017-01-01

    A year-long research (Aug 2016- May 2017) program on `Statistical, Mathematical and Computational Methods for Astronomy (ASTRO)’ is well under way at Statistical and Applied Mathematical Sciences Institute (SAMSI), a National Science Foundation research institute in Research Triangle Park, NC. This program has brought together astronomers, computer scientists, applied mathematicians and statisticians. The main aims of this program are: to foster cross-disciplinary activities; to accelerate the adoption of modern statistical and mathematical tools into modern astronomy; and to develop new tools needed for important astronomical research problems. The program provides multiple avenues for cross-disciplinary interactions, including several workshops, long-term visitors, and regular teleconferences, so participants can continue collaborations, even if they can only spend limited time in residence at SAMSI. The main program is organized around five working groups:i) Uncertainty Quantification and Astrophysical Emulationii) Synoptic Time Domain Surveysiii) Multivariate and Irregularly Sampled Time Seriesiv) Astrophysical Populationsv) Statistics, computation, and modeling in cosmology.A brief description of each of the work under way by these groups will be given. Overlaps among various working groups will also be highlighted. How the wider astronomy community can both participate and benefit from the activities, will be briefly mentioned.

  16. A new strategy for the passive skin delivery of nanoparticulate, high molecular weight hyaluronic acid prepared by a polyion complex method.

    Science.gov (United States)

    Tokudome, Yoshihiro; Komi, Tatsuya; Omata, Ami; Sekita, Marie

    2018-02-05

    Restoring hyaluronic acid (HA) content is important for maintaining the function of photo-aged skin. This study aimed to evaluate the passive delivery into skin of HA nanoparticles formed by the polyion complex method. Nanoparticles were prepared by mixing and stirring anionic HA with a cationic polymer, protamine, at the charge ratio 55:45. The permeation of fluorescently-labelled HA nanoparticles (HANP) or free HA through hairless mouse skin was characterized in vitro. HANP or free HA was applied to ultraviolet (UV)-irradiated mice in vivo, and their transepidermal water loss (TEWL) was measured after 4 days. HA that had been delivered into skin was separated and characterized by molecular sieve chromatography. HANP were able to deliver HA into the dermis both in vitro and in vivo, whereas free HA penetrated no further than the stratum corneum. Following HANP application, HA within the skin was present in the form of free HA rather than nanoparticles. When applied in vivo, HANP significantly reduced the TEWL caused by UV irradiation. Thus, although free HA does not penetrate into the skin by passive diffusion, HA can be effectively delivered by nanoparticles. HA is then released from the nanoparticles and can contribute to barrier recovery following UV irradiation.

  17. Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach.

    Science.gov (United States)

    Williams, Katherine M; Kirsh, Susan; Aron, David; Au, David; Helfrich, Christian; Lambert-Kerzner, Anne; Lowery, Julie; Battaglia, Catherine; Graham, Glenn D; Doukas, Michael; Jain, Rajiv; Ho, P Michael

    2017-07-01

    Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.

  18. Comparison of Text-Based and Visual-Based Programming Input Methods for First-Time Learners

    Directory of Open Access Journals (Sweden)

    Daisuke Saito

    2017-06-01

    Full Text Available Aim/Purpose: When learning to program, both text-based and visual-based input methods are common. However, it is unclear which method is more appropriate for first-time learners (first learners. Background: The differences in the learning effect between text-based and visual-based input methods for first learners are compared the using a questionnaire and problems to assess first learners’ understanding of programming. In addition, we study the benefits and feasibility of both methods. Methodology: In this research, we used the sandbox game Minecraft and the extended function ComputerCraftEdu (CCEdu. CCEdu provides a Lua programming environments for the two (text and visual methods inside Minecraft. We conducted a lecture course on both methods for first learners in Japan ranging in age from 6 to about 15 years old. The lecture taught the basics and concepts of programming. Furthermore, we implemented a questionnaire about the attitude of programming before and after the lecture. Contribution: This research is more than a comparison between the visual method and the text method. It compares visual input and text input methods in the same environment. It clearly shows the difference between the programming learning effects of visual input and text input for first learners. In addition, it shows the more suitable input method for introductory education of first learners in programming learning. Findings: The following results are revealed: (1 The visual input method induces a larger change in attitude toward programming; (2 The number of operations and input quantity influence both groups; (3 The overall results suggest that a visual input is advantageous in a programming implementation environment for first learners. Impact on Society: A visual input method is better suited for first learners as it improves the attitude toward programming. Future Research: In the future, we plan to collect and analyze additional data as well as elucidate the

  19. Next Generation Nuclear Plant Methods Research and Development Technical Program Plan -- PLN-2498

    Energy Technology Data Exchange (ETDEWEB)

    Richard R. Schultz; Abderrafi M. Ougouag; David W. Nigg; Hans D. Gougar; Richard W. Johnson; William K. Terry; Chang H. Oh; Donald W. McEligot; Gary W. Johnsen; Glenn E. McCreery; Woo Y. Yoon; James W. Sterbentz; J. Steve Herring; Temitope A. Taiwo; Thomas Y. C. Wei; William D. Pointer; Won S. Yang; Michael T. Farmer; Hussein S. Khalil; Madeline A. Feltus

    2008-09-01

    One of the great challenges of designing and licensing the Very High Temperature Reactor (VHTR) is to confirm that the intended VHTR analysis tools can be used confidently to make decisions and to assure all that the reactor systems are safe and meet the performance objectives of the Generation IV Program. The research and development (R&D) projects defined in the Next Generation Nuclear Plant (NGNP) Design Methods Development and Validation Program will ensure that the tools used to perform the required calculations and analyses can be trusted. The Methods R&D tasks are designed to ensure that the calculational envelope of the tools used to analyze the VHTR reactor systems encompasses, or is larger than, the operational and transient envelope of the VHTR itself. The Methods R&D focuses on the development of tools to assess the neutronic and thermal fluid behavior of the plant. The fuel behavior and fission product transport models are discussed in the Advanced Gas Reactor (AGR) program plan. Various stress analysis and mechanical design tools will also need to be developed and validated and will ultimately also be included in the Methods R&D Program Plan. The calculational envelope of the neutronics and thermal-fluids software tools intended to be used on the NGNP is defined by the scenarios and phenomena that these tools can calculate with confidence. The software tools can only be used confidently when the results they produce have been shown to be in reasonable agreement with first-principle results, thought-problems, and data that describe the “highly ranked” phenomena inherent in all operational conditions and important accident scenarios for the VHTR.

  20. [Closed automatic programmed aspiration-irrigation method in the treatment of abdominal abscesses].

    Science.gov (United States)

    Kanshin, N N; Bystritskiĭ, A L

    1989-12-01

    Treatment of 124 patients with abdominal abscesses is analysed. Sixty-four patients (a test group) were treated by air-tight drainage of the abscess cavity with double-tube silicone drains and automatic fraction irrigation of the purulent cavity in the postoperative period. Other methods of intraabdominal abscess drainage were used in 60 patients (a control group). The advantages of closed programmed aspiration-irrigation treatment are shown.

  1. Effect of a package of integrated demand- and supply-side interventions on facility delivery rates in rural Bangladesh: Implications for large-scale programs.

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    Sayedur Rahman

    Full Text Available According to the Bangladesh Demographic and Health Survey 2014, only approximately 37 percent of women deliver in a health facility. Among the eight administrative divisions of Bangladesh, the facility delivery rate is lowest in the Sylhet division (22.6 percent where we assessed the effect of integrated supply- and demand-side interventions on the facility-based delivery rate.Population-based cohort data of pregnant women from an ongoing maternal and newborn health improvement study being conducted in a population of ~120,000 in Sylhet district were used. The study required collection and processing of biological samples immediately after delivery. Therefore, the project assembled various strategies to increase institutional delivery rates. The supply-side intervention included capacity expansion of the health facilities through service provider refresher training, 24/7 service coverage, additions of drugs and supplies, and incentives to the providers. The demand-side component involved financial incentives to cover expenses, a provision of emergency transport, and referral support to a tertiary-level hospital. We conducted a before-and-after observational study to assess the impact of the intervention in a total of 1,861 deliveries between December 2014 and November 2016.Overall, implementation of the intervention package was associated with 52.6 percentage point increase in the proportions of facility-based deliveries from a baseline rate of 25.0 percent to 77.6 percent in 24 months. We observed lower rates of institutional deliveries when only supply-side interventions were implemented. The proportion rose to 47.1 percent and continued increasing when the project emphasized addressing the financial barriers to accessing obstetric care in a health facility.An integrated supply- and demand-side intervention was associated with a substantial increase in institutional delivery. The package can be tailored to identify which combination of

  2. Effect of a package of integrated demand- and supply-side interventions on facility delivery rates in rural Bangladesh: Implications for large-scale programs.

    Science.gov (United States)

    Rahman, Sayedur; Choudhury, Aziz Ahmed; Khanam, Rasheda; Moin, Syed Mamun Ibne; Ahmed, Salahuddin; Begum, Nazma; Shoma, Nurun Naher; Quaiyum, Md Abdul; Baqui, Abdullah H

    2017-01-01

    According to the Bangladesh Demographic and Health Survey 2014, only approximately 37 percent of women deliver in a health facility. Among the eight administrative divisions of Bangladesh, the facility delivery rate is lowest in the Sylhet division (22.6 percent) where we assessed the effect of integrated supply- and demand-side interventions on the facility-based delivery rate. Population-based cohort data of pregnant women from an ongoing maternal and newborn health improvement study being conducted in a population of ~120,000 in Sylhet district were used. The study required collection and processing of biological samples immediately after delivery. Therefore, the project assembled various strategies to increase institutional delivery rates. The supply-side intervention included capacity expansion of the health facilities through service provider refresher training, 24/7 service coverage, additions of drugs and supplies, and incentives to the providers. The demand-side component involved financial incentives to cover expenses, a provision of emergency transport, and referral support to a tertiary-level hospital. We conducted a before-and-after observational study to assess the impact of the intervention in a total of 1,861 deliveries between December 2014 and November 2016. Overall, implementation of the intervention package was associated with 52.6 percentage point increase in the proportions of facility-based deliveries from a baseline rate of 25.0 percent to 77.6 percent in 24 months. We observed lower rates of institutional deliveries when only supply-side interventions were implemented. The proportion rose to 47.1 percent and continued increasing when the project emphasized addressing the financial barriers to accessing obstetric care in a health facility. An integrated supply- and demand-side intervention was associated with a substantial increase in institutional delivery. The package can be tailored to identify which combination of interventions may

  3. A Recourse-Based Type-2 Fuzzy Programming Method for Water Pollution Control under Uncertainty

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    Jing Liu

    2017-11-01

    Full Text Available In this study, a recourse-based type-2 fuzzy programming (RTFP method is developed for supporting water pollution control of basin systems under uncertainty. The RTFP method incorporates type-2 fuzzy programming (TFP within a two-stage stochastic programming with recourse (TSP framework to handle uncertainties expressed as type-2 fuzzy sets (i.e., a fuzzy set in which the membership function is also fuzzy and probability distributions, as well as to reflect the trade-offs between conflicting economic benefits and penalties due to violated policies. The RTFP method is then applied to a real case of water pollution control in the Heshui River Basin (a rural area of China, where chemical oxygen demand (COD, total nitrogen (TN, total phosphorus (TP, and soil loss are selected as major indicators to identify the water pollution control strategies. Solutions of optimal production plans of economic activities under each probabilistic pollutant discharge allowance level and membership grades are obtained. The results are helpful for the authorities in exploring the trade-off between economic objective and pollutant discharge decision-making based on river water pollution control.

  4. Development of territories of municipal formations with use of a program method

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    Vladimir Stepanovich Bochko

    2014-03-01

    Full Text Available The perfection of a system of local self-management and the transition to effective development of territories of municipal formations assumes specification of principles and methods of measures’ realization. In the work, the analysis of the reasons restraining the development of local self-management through the development of the relations of a civil society is carried out, the approaches to the development of the successful model of development of municipalities are offered, the role of a program method of the budgets is shown, the initial principles of a substantiation of prospects of economic development of territories of municipal formations are revealed. The system of target indicators of strategic municipal development is offered. The problem of processing of household dust is considered as one of the essential projects in activity of municipalities. The following conclusion is made: use of strategic planning (the creation of the document of the public consent and program (program-design method will ensure complex development of territories of the municipalities and development of the relations of a civil society.

  5. A new method of measuring gravitational acceleration in an undergraduate laboratory program

    Science.gov (United States)

    Wang, Qiaochu; Wang, Chang; Xiao, Yunhuan; Schulte, Jurgen; Shi, Qingfan

    2018-01-01

    This paper presents a high accuracy method to measure gravitational acceleration in an undergraduate laboratory program. The experiment is based on water in a cylindrical vessel rotating about its vertical axis at a constant speed. The water surface forms a paraboloid whose focal length is related to rotational period and gravitational acceleration. This experimental setup avoids classical source errors in determining the local value of gravitational acceleration, so prevalent in the common simple pendulum and inclined plane experiments. The presented method combines multiple physics concepts such as kinematics, classical mechanics and geometric optics, offering the opportunity for lateral as well as project-based learning.

  6. Fatores determinantes para as expectativas de primigestas acerca da via de parto Primigravid expectations about the delivery method and the causal factors for their choice

    Directory of Open Access Journals (Sweden)

    Ricardo Porto Tedesco

    2004-12-01

    profissionais da saúde e a paciente sobre as possíveis dificuldades, dúvidas e anseios que permeiam a escolha por determinada via de parto. Do ponto de vista ético concluímos que os obstetras devem questionar cada indicação para a realização de uma cesárea e respeitar a autonomia da escolha materna sem ignorar os verdadeiros critérios clínicos que levam à decisão médica pela via de parto.PURPOSE: to find out the preference in regard to the way of delivery among primigravidae, as well as the reasons for their choice, in order to improve the quality of the doctor-patient relationship. METHODS: a qualitative-type study was conducted through analysis of the collective subject, including primigravidae attended from September to November 2003 at the emergency rooms of the hospital of the "Faculdade de Medicina de Jundiaí". A questionnaire, specially developed to accomplish the proposed objectives was applied. An informed and free consent, signed by the pregnant woman and one of the researchers in charge was obtained. This questionnaire was based on doubts of patients attended at this hospital some months before the trial. For the purpose of sample standardization, the patients' selection followed some inclusion criteria: age above 16, primigravidae that were receiving prenatal assistance and a post-informed and free consent. Mental disorders and clinical and/or obstetric pathologies that could interfere in the patient's choice were considered exclusion criteria. RESULTS: the studied population had as prevailing profile women in the third quarter of gestation, above 21 years of age, white, married and with completed school. Most of the women (90% preferred vaginal delivery for the following main reasons: ease to be done (94% and the fear of suffering and pain during the postpartum period caused by cesarean section. There was a relationship between older and married women and the preference for vaginal delivery, with no significant difference between races. CONCLUSION

  7. Job shop scheduling model for non-identic machine with fixed delivery time to minimize tardiness

    Science.gov (United States)

    Kusuma, K. K.; Maruf, A.

    2016-02-01

    Scheduling non-identic machines problem with low utilization characteristic and fixed delivery time are frequent in manufacture industry. This paper propose a mathematical model to minimize total tardiness for non-identic machines in job shop environment. This model will be categorized as an integer linier programming model and using branch and bound algorithm as the solver method. We will use fixed delivery time as main constraint and different processing time to process a job. The result of this proposed model shows that the utilization of production machines can be increase with minimal tardiness using fixed delivery time as constraint.

  8. PLGA nanoparticles prepared by nano-emulsion templating using low-energy methods as efficient nanocarriers for drug delivery across the blood-brain barrier.

    Science.gov (United States)

    Fornaguera, C; Dols-Perez, A; Calderó, G; García-Celma, M J; Camarasa, J; Solans, C

    2015-08-10

    Neurodegenerative diseases have an increased prevalence and incidence nowadays, mainly due to aging of the population. In addition, current treatments lack efficacy, mostly due to the presence of the blood-brain barrier (BBB) that limits the penetration of the drugs to the central nervous system. Therefore, novel drug delivery systems are required. Polymeric nanoparticles have been reported to be appropriate for this purpose. Specifically, the use of poly-(lactic-co-glycolic acid) (PLGA) seems to be advantageous due to its biocompatibility and biodegradability that ensure safe therapies. In this work, a novel approximation to develop loperamide-loaded nanoparticles is presented: their preparation by nano-emulsion templating using a low-energy method (the phase inversion composition, PIC, method). This nano-emulsification approach is a simple and very versatile technology, which allows a precise size control and it can be performed at mild process conditions. Drug-loaded PLGA nanoparticles were obtained using safe components by solvent evaporation of template nano-emulsions. Characterization of PLGA nanoparticles was performed, together with the study of the BBB crossing. The in vivo results of measuring the analgesic effect using the hot-plate test evidenced that the designed PLGA loperamide-loaded nanoparticles are able to efficiently cross the BBB, with high crossing efficiencies when their surface is functionalized with an active targeting moiety (a monoclonal antibody against the transferrin receptor). These results, together with the nanoparticle characterization performed here are expected to provide sufficient evidences to end up to clinical trials in the near future. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. [The effectiveness of physical therapy methods (Bobath and motor relearning program) in rehabilitation of stroke patients].

    Science.gov (United States)

    Krutulyte, Grazina; Kimtys, Algimantas; Krisciūnas, Aleksandras

    2003-01-01

    The purpose of this study was to examine whether two different physiotherapy regimes caused any differences in outcome in the rehabilitation after stroke. We examined 240 patients with stroke. Examination was carried out at the Rehabilitation Center of Kaunas Second Clinical Hospital. Patients were divided into 2 groups: Bobath method was applied to the first (I) group (n=147), motor relearning program (MRP) method was applied to the second (II) group (n=93). In every group of patients we established samples according to sex, age, hospitalization to rehab unit as occurrence of CVA degree of disorder (hemiplegia, hemiparesis). The mobility of patients was evaluated according to European Federation for Research in Rehabilitation (EFRR) scale. Activities of daily living were evaluated by Barthel index. Analyzed groups were evaluated before physical therapy. When preliminary analysis was carried out it proved no statically reliable differences between analyzed groups (reliability 95%). The same statistical analysis was carried out after physical therapy. The results of differences between patient groups were compared using chi(2) method. Bobath method was applied working with the first group of patients. The aim of the method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While applying this method at work, physical therapist guides patient's body on key-points, stimulating normal postural reactions, and training normal movement pattern. MRP method was used while working with the second group patients. This method is based on movement science, biomechanics and training of functional movement. Program is based on idea that movement pattern shouldn't be trained; it must be relearned. CONCLUSION. This study indicates that physiotherapy with task-oriented strategies represented by MRP, is preferable to physiotherapy with facilitation/inhibition strategies, such the Bobath programme, in the

  10. The Ontario Mother and Infant Study (TOMIS III: A multi-site cohort study of the impact of delivery method on health, service use, and costs of care in the first postpartum year

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    Landy Christine

    2009-04-01

    Full Text Available Abstract Background The caesarean section rate continues to rise globally. A caesarean section is inarguably the preferred method of delivery when there is good evidence that a vaginal delivery may unduly risk the health of a woman or her infant. Any decisions about delivery method in the absence of clear medical indication should be based on knowledge of outcomes associated with different childbirth methods. However, there is lack of sold evidence of the short-term and long-term risks and benefits of a planned caesarean delivery compared to a planned vaginal delivery. It also is important to consider the economic aspects of caesarean sections, but very little attention has been given to health care system costs that take into account services used by women for themselves and their infants following hospital discharge. Methods and design The Ontario Mother and Infant Study III is a prospective cohort study to examine relationships between method of delivery and maternal and infant health, service utilization, and cost of care at three time points during the year following postpartum hospital discharge. Over 2500 women were recruited from 11 hospitals across the province of Ontario, Canada, with data collection occurring between April 2006 and October 2008. Participants completed a self-report questionnaire in hospital and structured telephone interviews at 6 weeks, 6 months, and 12 months after discharge. Data will be analyzed using generalized estimating equation, a special generalized linear models technique. A qualitative descriptive component supplements the survey approach, with the goal of assisting in interpretation of data and providing explanations for trends in the findings. Discussion The findings can be incorporated into patient counselling and discussions about the advantages and disadvantages of different delivery methods, potentially leading to changes in preferences and practices. In addition, the findings will be useful to

  11. Student perception of initial transition into a nursing program: A mixed methods research study.

    Science.gov (United States)

    McDonald, Meghan; Brown, Janine; Knihnitski, Crystal

    2018-02-03

    Transition into undergraduate education programs is stressful and impacts students' well-being and academic achievement. Previous research indicates nursing students experience stress, depression, anxiety, and poor lifestyle habits which interfere with learning. However, nursing students' experience of transition into nursing programs has not been well studied. Incongruence exists between this lack of research and the desire to foster student success. This study analyzed students' experiences of initial transition into a nursing program. An embedded mixed method design. A single site of a direct-entry, four year baccalaureate Canadian nursing program. All first year nursing students enrolled in the fall term of 2016. This study combined the Student Adaptation to College Questionnaire (SACQ) with a subset of participants participating in qualitative focus groups. Quantitative data was analyzed using descriptive statistics to identify statistically significant differences in full-scale and subscale scores. Qualitative data was analyzed utilizing thematic analysis. Significant differences were seen between those who moved to attend university and those who did not, with those who moved scoring lower on the Academic Adjustment subscale. Focus group thematic analysis highlighted how students experienced initial transition into a baccalaureate nursing program. Identified themes included reframing supports, splitting focus/finding focus, negotiating own expectations, negotiating others' expectations, and forming identity. These findings form the Undergraduate Nursing Initial Transition (UNIT) Framework. Significance of this research includes applications in faculty development and program supports to increase student success in the first year of nursing and to provide foundational success for ongoing nursing practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru.

    Science.gov (United States)

    LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Rodriguez Castro, Manuel J A; Valderrama, Roberto; Isquith-Dicker, Leah N; Herrera-Matta, Jaime; Mock, Charles N

    2017-04-01

    Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru.

  13. Brucellosis Prevention Program: Applying “Child to Family Health Education” Method

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    H. Allahverdipour

    2010-04-01

    Full Text Available Introduction & Objective: Pupils have efficient potential to increase community awareness and promoting community health through participating in the health education programs. Child to family health education program is one of the communicative strategies that was applied in this field trial study. Because of high prevalence of Brucellosis in Hamadan province, Iran, the aim of this study was promoting families’ knowledge and preventive behaviors about Brucellosis in the rural areas by using child to family health education method.Materials & Methods: In this nonequivalent control group design study three rural schools were chosen (one as intervention and two others as control. At first knowledge and behavior of families about Brucellosis were determined using a designed questionnaire. Then the families were educated through “child to family” procedure. At this stage the students gained information. Then they were instructed to teach their parents what they had learned. After 3 months following the last session of education, the level of knowledge and behavior changes of the families about Brucellosis were determined and analyzed by paired t-test.Results: The results showed significant improvement in the knowledge of the mothers. The knowledge of the mothers about the signs of Brucellosis disease in human increased from 1.81 to 3.79 ( t:-21.64 , sig:0.000 , and also the knowledge on the signs of Brucellosis in animals increased from 1.48 to 2.82 ( t:-10.60 , sig:0.000. Conclusion: Child to family health education program is one of the effective and available methods, which would be useful and effective in most communities, and also Students potential would be effective for applying in the health promotion programs.

  14. Spur gears: Optimal geometry, methods for generation and Tooth Contact Analysis (TCA) program

    Science.gov (United States)

    Litvin, Faydor L.; Zhang, Jiao

    1988-01-01

    The contents of this report include the following: (1) development of optimal geometry for crowned spur gears; (2) methods for their generation; and (3) tooth contact analysis (TCA) computer programs for the analysis of meshing and bearing contact on the crowned spur gears. The method developed for synthesis is used for the determination of the optimal geometry for crowned pinion surface and is directed to reduce the sensitivity of the gears to misalignment, localize the bearing contact, and guarantee the favorable shape and low level of the transmission errors. A new method for the generation of the crowned pinion surface has been proposed. This method is based on application of the tool with a surface of revolution that slightly deviates from a regular cone surface. The tool can be used as a grinding wheel or as a shaver. The crowned pinion surface can also be generated by a generating plane whose motion is provided by an automatic grinding machine controlled by a computer. The TCA program simulates the meshing and bearing contact of the misaligned gears. The transmission errors are also determined.

  15. The Effect of a Program Using Some Therapeutic Methods to Rehabilitate Patients Suffering from Neck Pain

    Directory of Open Access Journals (Sweden)

    Ayad O MAR

    2015-09-01

    Full Text Available Neck pain is one of the common physical problems of the adults which needs to be taken seriously in order to prevent further health problems. As the daily life of the modern people leads physical in activity, and the use of electronic devices causes imprope r effect on certain parts of the body, specials programs have to be developed as preventive treatment. Therapeutic methods can also be listed through such preventive methods. The purpose of this study was to i dentify the impact of the proposed program usin g some natural methods of treatment for the rehabilitation of people with neck pain , to i dentify the improved range of motion in all directions to the neck area , and also t o identify the extent of improvement in muscle strength for the neck and back. Twelv e patients in Ain Zara Physiotherapy Center and Tripoli Clinic (in Tripoli city were chosen as voluntarily whose age ranged from 30 to 50 years, and the subjects were divided into two groups , as experimental and control groups. This study proved that pro posed therapeutic methods help the treatment of neck pain.

  16. Promoting Healthy Development among Adolescent Girls: A Mixed-Methods Evaluation of the HERstory Program

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    Emily MacFarlane

    2013-03-01

    Full Text Available The Leadership Program’s HERstory is a school-based, universal, preventative intervention designed to promote healthy youth development among adolescent girls by increasing their connections to pro-social peers and to school and community while developing social-emotional skills that serve as protective factors. In this school-year-long program, a facilitator implements three program phases: group development activities in Community Building, self-reflective Writing Workshop exercises, and a final Creative Output project, an ethnographic theater production or literary journal developed from participants’ Writing Workshop responses. The current mixed-methods study presents early evidence of program effectiveness based on focus groups and school record data review at two NYC public schools during the 2010-2011 school year. Participants reported improvements in key areas targeted by HERstory, including peer connectedness, academic achievement, and a range of protective factors including future orientation and goal setting. Results suggest this program approach may be suitable promoting healthy adolescent development for girls.

  17. Evaluating Behaviorally Oriented Aviation Maintenance Resource Management (MRM) Training and Programs: Methods, Results, and Conclusions

    Science.gov (United States)

    Taylor, James C.; Thomas, Robert L., III

    2003-01-01

    Assessment of the impact of Aviation Resource Management Programs on aviation culture and performance has compelled a considerable body of research (Taylor & Robertson, 1995; Taylor, 1998; Taylor & Patankar, 2001). In recent years new methods have been applied to the problem of maintenance error precipitated by factors such as the need for self-assessment of communication and trust. The present study - 2002 -- is an extension of that past work. This research project was designed as the conclusion of a larger effort to help understand, evaluate and validate the impact of Maintenance Resource Management (MRM) training programs, and other MRM interventions on participant attitudes, opinions, behaviors, and ultimately on enhanced safety performance. It includes research and development of evaluation methodology as well as examination of psychological constructs and correlates of maintainer performance. In particular, during 2002, three issues were addressed. First, the evaluation of two (independent & different) MRM programs for changing behaviors was undertaken. In one case we were able to further apply the approach to measuring written communication developed during 2001 (Taylor, 2002; Taylor & Thomas, 2003). Second, the MRM/TOQ surveys were made available for completion on the internet. The responses from these on-line surveys were automatically linked to a results calculator (like the one developed and described in Taylor, 2002) to aid industry users in analyzing and evaluating their local survey data on the internet. Third, the main trends and themes from our research about MRM programs over the past dozen years were reviewed.

  18. [Development and effects of emotional intelligence program for undergraduate nursing students: mixed methods research].

    Science.gov (United States)

    Lee, Oi Sun; Gu, Mee Ock

    2014-12-01

    This study was conducted to develop and test the effects of an emotional intelligence program for undergraduate nursing students. The study design was a mixed method research. Participants were 36 nursing students (intervention group: 17, control group: 19). The emotional intelligence program was provided for 4 weeks (8 sessions, 20 hours). Data were collected between August 6 and October 4, 2013. Quantitative data were analyzed using Chi-square, Fisher's exact test, t-test, repeated measure ANOVA, and paired t-test with SPSS/WIN 18.0. Qualitative data were analyzed using content analysis. Quantitative results showed that emotional intelligence, communication skills, resilience, stress coping strategy, and clinical competence were significantly better in the experimental group compared to the control group. According to the qualitative results, the nursing students experienced improvement in emotional intelligence, interpersonal relationships, and empowerment, as well as a reduction in clinical practice stress after participation in the emotional intelligence program. Study findings indicate that the emotional intelligence program for undergraduate nursing students is effective and can be recommended as an intervention for improving the clinical competence of undergraduate students in a nursing curriculum.

  19. Gompertz: A Scilab Program for Estimating Gompertz Curve Using Gauss-Newton Method of Least Squares

    Directory of Open Access Journals (Sweden)

    Surajit Ghosh Dastidar

    2006-04-01

    Full Text Available A computer program for estimating Gompertz curve using Gauss-Newton method of least squares is described in detail. It is based on the estimation technique proposed in Reddy (1985. The program is developed using Scilab (version 3.1.1, a freely available scientific software package that can be downloaded from http://www.scilab.org/. Data is to be fed into the program from an external disk file which should be in Microsoft Excel format. The output will contain sample size, tolerance limit, a list of initial as well as the final estimate of the parameters, standard errors, value of Gauss-Normal equations namely GN1 GN2 and GN3, No. of iterations, variance(σ2, Durbin-Watson statistic, goodness of fit measures such as R2, D value, covariance matrix and residuals. It also displays a graphical output of the estimated curve vis a vis the observed curve. It is an improved version of the program proposed in Dastidar (2005.

  20. Gompertz: A Scilab Program for Estimating Gompertz Curve Using Gauss-Newton Method of Least Squares

    Directory of Open Access Journals (Sweden)

    Surajit Ghosh Dastidar

    2006-04-01

    Full Text Available A computer program for estimating Gompertz curve using Gauss-Newton method of least squares is described in detail. It is based on the estimation technique proposed in Reddy (1985. The program is developed using Scilab (version 3.1.1, a freely available scientific software package that can be downloaded from http://www.scilab.org/. Data is to be fed into the program from an external disk file which should be in Microsoft Excel format. The output will contain sample size, tolerance limit, a list of initial as well as the final estimate of the parameters, standard errors, value of Gauss-Normal equations namely GN1 GN2 and GN3 , No. of iterations, variance(σ2 , Durbin-Watson statistic, goodness of fit measures such as R2 , D value, covariance matrix and residuals. It also displays a graphical output of the estimated curve vis a vis the observed curve. It is an improved version of the program proposed in Dastidar (2005.